Regional Consultation on Emergency Preparedness and Response From Lessons to Action

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Regional Consultation on Emergency Preparedness
and ResponseFrom Lessons to Action

• WHO/SEARO
• Bali, Indonesia
• 27-29 June 2006
• Day 1

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Quotes of the Day

• Forget old wisdoms
• Work coordinately
• Coordination requires partnerships
• Cross-sector partnerships
• Interdisciplinary partnerships
• Synergies and partnerships
• Integrating frameworks
• Networks for Collaboration
• We think its good, but have not gone anywhere.
• Must plan together, work together, exercise
  together

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Quotes of the Day

• Trust is based on information
• Accountability
• Coping
• Able to cope with any emergency in an effective
  and efficient manner.
• Prevent a bigger loss.
• Do we need a regional strategy?
• People

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Definitions WHO Expert Consultation 02/06

• Cooperation ? shared goals
• Coordination ? shared tasks
• Collaboration ? shared resources
• Competent ? adequately qualified/capable
• Prepared vs. Protected
• Preparedness vs. Protection
• Protection vs. Safety

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Coordination et al

• Command and control is vertical
• Coordination is horizontal
• What is Coordination and Control?
• Coordination
• Inside and outside
• Involve ALL stakeholders?Partners
• Private sector
• Military sector involvement
• Coordination team
• ???role of military (armed forces)

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• Disasters
• Create
• Windows of Opportunity

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Windows of Opportunity

• Gone from nothing to something
• Take advantage of other peoples misery!!
• Gujarat Earthquake?Alert?Call for HELP!
• Process accelerated by Tsunami
• Shifted from Relief Paradigm to Preparedness
  Paradigm
• Importance of EPR endorsed by WHA (2005 and 2006)
• Medical care small part of health

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Capacity Building

• At all levels
• Prepare the people (for what hazard(s)?)
• Education and Training
• Need for standards

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• Stakeholders
• Partners
• Team

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Political Issues

• Health sector not major player
• Expect we always will be there
• Preparedness?effects not known until next
  disaster
• Preparedness
• Goal
• Increase the level of
• protection (safety)
• of the population-at-risk

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Strategies from Bangkok (2005)

• Themes
• Monitoring, evaluation, surveillance, and
  assessments
• Education and training
• Information and communication
• Legislation, policies, and authority
• Funding
• Planning and preparedness
• Coordination and Control

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Qualities of Benchmarks

• Define current status of society-at-risk
• Realistic
• Achievable
• Progressive
• Result in BENEFIT to the society-at-risk
• Valid-Effective in multiple settings

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Summary

• Yesterdays presenters provoked great discussions
• Yall participated
• We need to Act!!!!!
• The Benchmarks and strategies from Bangkok have
  helped to make a difference
• The Benchmarks are achievable
• Are the Benchmarks valid?
• May the 2nd Day be as productive as the 1st

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• Have a Great Day
• and
• Take Care!!!!

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• Preparedness
• vs.
• Response

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• Responses
• Depend on
• Preparedness

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12 Bangkok BenchmarksCompressed by PDM Editorial
Staff

• Achieved legal framework for EPR
• Coordination mechanisms including defined roles
  in place
• National Disaster Plan for EMR in place and
  exercised at all levels. Includes
• SOPs
• MOUs
• Mechanisms for coordination and control
• Responsibilities
• All hazards and specific hazards approaches

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12 Bangkok BenchmarksCompressed by PDM Editorial
Staff

• 4. Community EPR plans in place
• 5. Communities have capacity to manage crisis
• 6. Countries have line item in budgets for EPR
  with access to funds for emergencies
• 7. Rules of engagement exist for all external
  actors
• 8. Awareness advocacy programs for population
  implemented
• 9. Hazards vulnerabilities identified and
  measures implemented to reduce vulnerabilities

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12 Bangkok BenchmarksCompressed by PDM Editorial
Staff

• 10. Appropriate programs to educate AND train
  people to cope with events implemented AND
  adequate numbers trained and experts available
• 11. Heath facilities able to continue to function
• 12. Surveillance EWS in place for population at
  risk

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• Benchmarks
• Strategies
• Plans
• Interventions
• Outcomes
• Best Practices

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Strategies from Bangkok (2005)

• Monitoring, evaluation, surveillance, assessments
• Classify risks (country and hazard)
• Enhance surveillance, collection, compilation,
  interpretation of data at central level
• Strengthen monitoring and evaluation methods
  annual analysis
• Develop/test standardized tools

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Strategies from Bangkok (2005)

• 2. Education and training
• Identify competencies required
• Education/training based on competencies
• Evaluate efficacy/effectiveness/efficiency/costs/b
  enefits
• Update knowledge
• Exercises and drills
• Forum for educational standards
• Programs at community and legislative levels
• Sensitization and guidance of donors

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Strategies from Bangkok (2005)

• 3. Information and Communications
• Analysis of strengths, weaknesses, opportunities,
  and threats
• Static info (current)
• Accessibility of hazard/disaster info
• Enhanced info systems
• Computed directory
• Emergency info units
• Upgrade existing Health info systems
• Improve warning signals
• Risk communications to vulnerable populations
• Terminology
• Annual review of preparedness for region
• Media management strategies
• Reporting mechanisms for finances

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Strategies from Bangkok (2005)

• 4. Legislation, Policy, Authority
• Determine if national enabling legislation exists
• Legislation review
• Engagement of national/international actors
• Authority to use funds in emergency
• Organogram

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Strategies from Bangkok (2005)

• 5. Funding
• Standardize mechanisms
• Assure availability of earmarked funds
• Allocate budgets at all levels
• Simplified reporting system

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Strategies from Bangkok (2005)

• 6. Planning and Preparedness
• Health Task Force for emergencies
• Needs assessments-gtidentify gaps
• Assess National capacities
• Ability to define scale of emergencies
• Define vulnerabilities
• EWS
• Exercises and drills
• Supervision and monitoring system part of plan
• Best-practice guidelines
• Assign roles and responsibilities
• Involve stakeholders
• Cache supplies and dynamic inventories
• Long term recovery plans
• Safe health facilities

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Strategies from Bangkok (2005)

• 7. Coordination and Control
• Define scale of emergency
• Inter-country linkages for info exchange
• Coordination rings
• Involve stakeholders
• Regular audits
• Logistical mechanisms
• Regulate all incoming
• Establish local working group involving all
  sectors

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Significance of Bangkok Meeting

• Moved forward from Phuket Conference
• Process produced needed standards for world
  community
• 67 strategies/mechanisms suggested
• Applicable beyond natural hazards
• Wider distribution
• Expanded by Expert Consultation (Geneva, 2/06)
• 62 Recommendations/13 in addition to Bangkok
  Papers!!!

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WHO-Geneva Expert ConsultationFebruary 2006

• Recommendations not reflected in Bangkok
  Benchmarks and Strategies
• Agency in MoH
• Legislative Review
• Partnerships
• Intersectoral
• Private sector
• Academic
• Role of Military
• Threats to Public Healthinfectious diseases
• Cross-border Issues
• Cooperation (goals)
• Coordination (tasks)
• Collaboration (resources)
• Supplies, Equipment, Personnel
• MORE

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WHO-Geneva Expert ConsultationFebruary 2006

• Recommendations not reflected in Bangkok
  Benchmarks and Strategies (continued)
• Field Hospitals
• Credentialing/Accreditation/Competence
• Inter-human Conflict-Complex Emergencies
• Communications
• Pilot Projects
• Guidance for Donors
• Similarities rather than differences

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The Language of Disaster
Hazard
Risk 1
Modification
Event
Risk 2
Absorbing Capacity
Damage
Preparedness
Vulnerability
Risk 3
Buffering Capacity
Change in Function
Responses
Risk 4
Disaster
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Current Status

• Where Are You
• Relative to
• Benchmark
• ????

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Needs

• Needs BenchmarkCurrent Status

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Plans

• Plans
• consist of
• selected intervention(s)
• Interventions?Outcomes
• Outcomes?New Current Status

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• Benchmarks
• Strategies
• Plans
• Interventions
• Outcomes
• Best Practices

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Evaluation

• Must evaluate every intervention for
• Efficacy in reaching benchmark
• Effectiveness in reaching objectives
• Costs (economic, human, opportunity)
• Efficiency-resources consumed for outcome
• Benefits to society-at-risk

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Conclusions

• Preparedness?Safety?Protection?Public Health
• Until Bangkok meeting (2005) Preparedness and
  Capacity Building has been all but ignored
• Tsunami ? Window of Opportunity
• Countries in Region led the way
• Record positives ? best-practices
• Evaluation-Research ? Outcome vs Benchmark
• Policies, Education, and Training must be based
  on what works
• Nations?Policies?Communities apply in accord with
  local needs