ناریا رد رطخ تیریدم یاه شلاچ file•yokohama strategy and plan of action for...
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دکتر حمید رضا خانکه
معاون بحران و پدافند غیر عامل مرکز مدیریت حوادث
فوق دکتری مدیریت خطر سالمت در حوادث و بالیا از سوئد
چالش های مدیریت خطر در ایران
(1)World Conference on Natural Disaster Reduction
Yokohama, Japan, 23-27 May 1994
• Yokohama Strategy and Plan of Action for a Safer World
• Guidelines for Natural Disaster, Prevention, Preparedness and Mitigation
• Each country has the responsibility to protect its citizens from natural disasters
Hyogo Framework for action health system
• Based on the Hyogo Framework for action disaster management system in every country should follow 5 Priorities for Action towards strengthening community and country resilience to disasters.
• Priority 1: Disaster risk management as a national and local priority
• Priority 2: Risk assessment and early warning
• Priority 3: Education and information to build a culture of safety and resilience at all levels
• Priority 4: Reduction of underlying risk factors
• Priority 5: Disaster preparedness for effective response and recovery at all levels.
(2)Six problems related disaster to be solved based on Hyogo Framework for Action
1. Disasters are an increasing threat to sustainable development.
2. Developing countries rarely have the tools or expertise to consider disaster risks through their development planning and investment.
3. DRM policies do not always translate into local action.
4. Many developing countries lack the financial capacity to respond immediately after a disaster.
5. The potential of partnership with the private sector in building resilient societies is not yet fully harnessed.
6. Support from the international community for DRM is critical, but donor financing is still response focus instead of preparedness focus.
(3)The Sendai Framework for Disaster Risk Reduction 2015-2030
• Framework aims to achieve the following outcome over the next 15 years:
• The substantial reduction of disaster risk and losses in lives, livelihoods and health and in the economic, physical, social, cultural and environmental assets of persons, businesses, communities and countries.
• The realization of this outcome requires the strong commitment and involvement of political leadership in every country at all levels in the implementation and follow-up of this Framework and in the creation of the necessary conducive and enabling environment.
Why we should be prepared against Emergency and Disaster?
Because…
Disasters are of significant threat for human life worldwide and can have destructive consequences for human
being
Father carries his two sons to be buried after earthquake, Bam, Iran, 27 December
A Disaster is:
حوادث و بالیا اتفاقاتی با تاثیرات منفی بر سالمت، محیط 1.زندگی، دارایی ها و خدمات مورد نیاز جامعه هستند که
منابع محلی کفایت مدیریت آنها را نکرده و نیاز به منابع .حمایتی از خارج منطقه آسیب دیده است
Civil defense
•Civil defense is an effort to protect the citizens of a country (generally civilian) from military
attack.
Threats to the health system
oThreats to health infrastructure
oThreats of health human resources
oThreats of strategic reserves for health (blood, drug ,...)
oThreats to essential health functions
o Threats to operational capability of health system
oThreat of sanctions on health system
oThreat posed by new science in health systems
Civil defense goals in health system
Increase deterrence افزایش پایداری
Reducing vulnerability کاهش آسیب پذیری
Continuity of essential functions تداوم فعالیت های اساسی
Promote national consistency تقویت انسجام ملی
Facilitate emergency management تسهیل مدیریت حوادث
Worldwide Disaster Trend
2016-03-01 Davoud Khorasani 19
Iran • Location: Middle East region
• Area: 1 648 000 km2
• Worldwide: 18th largest country
• Asia: 4th country
• Population: about 77 million
• Life expectancy: 74
• Population density:
• 39 inhabitants per km2
• Neighbour to seven countries
• 32 provinces
• 336 districts
• 1012 cities
• 64 000 villages
Problem Statement
• Iran is exposed to a wide range of natural and man-made disasters.
• “According to EM-DAT,:
1. 181 disasters were recorded in Iran from 1900–2007,
2. which caused 155,811 deaths
3. and 680,217 injuries,
4. and affected 44,037,516 people.”
Most common disaster in Iran
1. Natural
• Earthquake
• Flood
• Drought
2. Manmade
• Road Traffic Injuries
Seismic Hazard Map, Iran
Map of Iran's earthquake
Tabriz, Iran 2012 Agust
1391تبریز تابستان
Legal Framework
عامل اصلی آمادگی ملی 10
سطح ملیسیاست ها
راهنماها
روش ها
سطح محلیبرنامه ها منابع ساختار قدرت
سطح فردیدانش مهارت نگرش
Cap
abili
tie
s an
d R
eso
urc
es
پاسخ ملی
پاسخ قطبی
پاسخ استانی
افزایش شدت و بزرگی حادثه
پاسخ محلی
استراتژی پاسخ الیه ای
Minimal Low Medium High Catastrophic
National Disaster Management Organization
دستگاهها ونهاد های وابسته به قواهای سه گانه و تصویب ضوابط هماهنگی به منظور ایجاد• .و مقررات حاکم بر مدیریت بحران در مراحل چهارگانه شورای عالی تشکیل گردید
و با عضویت وزارء اطالعات ،کشور شورای عالی مدیریت بحران به ریاست رئیس جمهور • .و رئیس سازمان تشکیل می گردد....،اقتصاد ودارایی ،
به عنوان قائم مقام حضور وزیر کشور جلسات شورای عالی در غیاب رئیس جمهور با • .تشکیل می گردد ومصوبات این شورا پس از تائید رئیس جمهور الزم االجراست
.مستقر استدبیرخانه شورا ،در سازمان مدیریت بحران •
سازمان مدیریت بحران وابسته به وزارت کشور بوده و رئیس آن به پیشنهاد وزیر کشور و • .منصوب می گرددشورای عالی و با حکم وزیر تائید
رده های سازمانی متناسب در استان ها و شهرستانها به ترتیب زیر نظر استاندار و فرماندار • .تشکیل می شود
شورای عالی مدیریت بحران کشور
(معاون امنیتی –وزارت کشور ) کارگروه نیروهای مسلح ، امنیت و انتظامات 1.
(سازمان امداد و نجات –هالل احمر ) کارگروه امداد و نجات و آموزش همگانی 2.
(بنیاد مسکن ) کارگروه تامین مسکن 3.
(وزارت نیرو ) کارگروه امور سیل و مخاطرات دریایی ، برق ، آب و فاضالب 4.
وزارت ) کارگروه مخاطرات زلزله ، لغزش الیه های زمین ، ابنیه ساختمان و شهرسازی 5. (مسکن و شهرسازی
(سازمان صدا و سیما ) کارگروه آموزش و اطالع رسانی 6.
(سازمان حفاظت محیط زیست ) کارگروه مخاطرات زیست محیطی 7.
(وزارت ارتباطات و فناوری اطالعات ) کارگروه مخابرات و ارتباطات 8.
(وزارت جهاد کشاورزی ) کارگروه خشکسالی ، سرمازدگی و مخاطرات کشاورزی 9.
(وزارت راه و ترابری ) کارگروه حمل و نقل ، بالیای جوی و طوفان 10.
(معاون اجتماعی –وزارت کشور ) کارگروه تشکل های مردم نهاد 11.
وزارت کشور ) کارگروه بازسازی و بازتوانی ، تامین و توزیع ماشین آالت ، آوار برداری 12. (معاون امور عمرانی –
( وزارت بهداشت ) کارگروه بهداشت و درمان 13.
(وزارت نفت ) کارگروه تامین سوخت 14.
اسامی کارگروه ها
Result: Challenges 1 • DRM policies did not translate into local action and did
not integrated to health policies
• the lack of planning,
• Inadequate management of resources,
• insufficient coordination,
• a lack of single emergency number in emergencies,
• which can be resulted :
• duplication efforts,
• wasting resources and time,
• organizational conflict, different emergency phone numbers,
• lack of a comprehensive NEMP,
• Lack of a system approach for providing trauma care
Result: Challenges 2
• Unclear national policies and poor organization of emergency management,
• lack of providing comprehensive recovery services
• Absence of standardized Medical Assistant Teams (DMAT) and related law and regulations,
• Shortage of resources
• and finally insufficient policies to improve the quality of pre-hospital medical care and improve interaction between pre-hospital and hospital.
What has been done?
• National campaign for RTI,s since 2005 and decreasing the number of death by 5% each year respectively
• National single emergency number
• Improving the organizational level of EMS
• Public education
• Activated Health in Emergency and Disaster Working Group(HEDWG)
High Council of NDMO
Disaster Management Coordination Council
NDMO
HEDWG
Secretariat
Departments
National chain of Command and Coordination
Achievement • 14 Working Groups that are responsible for inter and intra-sectoral
coordination of disaster risk management in Iran(NDMO).
• Health in Emergency and Disaster Working Group(HEDWG)
• This working group consists of seven committees: medical services(Curative affairs), public health, logistics(administration & Finance), education, research, rehabilitation and food and drug.
• The corresponding departments of MOHME are in charge of these various committees.
• EMC
• EOC
NEMC
Regional EOC/EMC
Provincial
EOC/EMC
EOC/ECC Secretariat for
HEDWG
HEDWG chain of Command and Coordination
Road Map for HEDWG
1. Establishing Provincial HEDWG leading by UMS,s based on national guideline
2. Developing provincial risk map based on risk assessment using national tools
3. Writing scenarios based on the results of risk assessment
4. Developing Early Warning system based on national template
5. Establishing and activating EOC and drawing chain of command and coordination
6. Developing Preparedness plan, EOP, and response plan based on national template
7. Writing Job action sheet for all involved people in Emergency Response Plan
8. Training and education based on the plans
9. Designing IMS,ICS
10. Planning for exercises from theoretical to practical
11. Post Action Revision
12. Developing Guidelines and Protocols
Achievements
• Hospital Safety Index
• National tools for:
1. Hazard, Capacity, Vulnerability,
2. Hospital preparedness,
3. Rapid assessment,
4. Disaster Leveling,
5. Hospital mental preparedness,
• Developing 50 national scenarios
Achievements
• National strategic plan for HEDWG
• National Guideline for Emergency Operations Center (EOC).
• National guideline for Hospital Disaster Planning (HDP) and installed in all hospitals.
• A National Emergency Operation Plan developed based on National disaster Scenarios in public health, pre-hospital and hospital care.
• Integrating some disaster risk reduction indexes in National hospital accreditation system
• Developing national indexes to rank Medical universities related Disaster Risk Management
46
Final EWS Flowchart in Disaster
Result: Achievement
• PhD Program of Health in Emergency and Disaster by MOHME has been established in some Universities.
• The main intention of this initiation is to train some experts in order to develop new knowledge, solve existing problems by scientific inquiries and improve health disaster risk reduction in Iran.
Conclusion • Findings of the current study show that it is of the utmost importance
that efforts and actions focused on the disaster risk reduction been coordinated more in order to restrict the impacts of disasters and to achieve recovery as soon as possible.
• Health system should be strengthened in intra and inter-sector collaboration and coordination, information management system and community-based initiatives for disaster preparedness.
• It is also essential to focus on disaster risk reduction while enhancing the response capacity.
• Investing on research would lead to quality decision-making in disaster health management.
Conclusion
• Authorities and health system administrators should consider the physical and psychological health of their staff
• and make policies to improve the quality of pre-hospital Emergency Medical care.
Future Plan • NHERP: National health Emergency Response Plan • National Health Risk Map • National Emergency and Disaster Registry
• Integrated emergency dispatch system with common emergency number(SOS)
• National DMATeams
• Social vulnerability for older adults tool
• Community Mental Health Preparedness tool
Ongoing Projects
• Chain of Command and Coordination in Health system
• Technology development in Health in Emergencies and Disasters
• Community Based Early Warning System
• Community Based Preparedness Plan
• Traffic Psychology
• Hospital Resilience
Integrated Dispatch System(SOS)
Caller
110
115
Police
EMS
Police Dispatch
EMS Dispatch
Dispatch Amb
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Hope to have a safe and developed
world Free of disaster risk