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Government of Sri Lanka
National Institute of Health Italy
Italian Cooperation
Disaster preparedness the Training of Trainers
for Sri Lanka. An international cooperation
project of the National Institute of Health
PL INGRASSIA, MD, EMDM Dpt of Anaesthesiology,
Intensive Critical Emergency Care Maggiore
della Carità HospitalUniversity of Eastern
Piedmont "A. Avogadro - Novara, Italy
speaker
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Government of Sri Lanka
National Institute of Health Italy
Italian Cooperation
Capacity Building Project for the Management of
Disasters and Complex Emergencies
RANIERI GUERRA Istituto Superiore di
Sanità Capo-Ufficio Relazioni Esterne ROMA
Project Director
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Introduction
At 0057 GMT an hearthquake of 9 Richter scale
magnitudo causes a displacement along a 1000
mts fault
The displacement causes a tsunami of enormous
proportion
The tidal wave is initially positive toward Sri
Lanka and negative toward Thailand
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Introduction
0106 later the tidal wave goes toward Sri Lanka
with a velocity of 720 km/h
0132 later the tidal wave reachs the East Cost
of Sri Lanka. 5000 victims
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Introduction
0150 later the tidal wave reachs the cost of
Thailand. 5300 victims.
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Introduction
9 hours later from the first quake the tidal wave
reachs the cost of Kenya. Anywhere, from Mexico
to Cile, abnormal waves well be seen
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Introduction
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Purpose

• strengthening national skills on planning,
  managing and coordinating emergencies in Sri
  Lanka
• support the Ministry of Health of Sri Lanka and
  the National Institute of Health Sciences (NIHS),
  on planning and carrying out of a training
  programme on management of emergencies

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Strategic Approach
International Experts
NATIONALLEVEL
DISTRICT LEVEL
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Didactic Approach
ANDRAGOGY

• Adults need to be involved in the planning and
  evaluation of their instruction (Self-concept and
  Motivation to learn).
• Experience (including mistakes) provides the
  basis for learning activities (Experience).

• Adults are most interested in learning subjects
  that have immediate relevance to their job or
  personal life (Readiness to learn).
• Adult learning is problem-centered rather than
  content-oriented (Orientation to learning)

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Didactic Approach
PROBLEM-BASED LEARNING
An instructional strategy (a curriculum
framework) that, through student and community
interests and motivation, provides an appropriate
way to teach sophicated content and high-level
processall while building self-efficacy,
confidence, and autonomous learner behaviors
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Didactic Approach
PROBLEM-BASED LEARNING
A learning method based on the principle of
using problems as a starting point for the
acquisition and integration of new
knowledge. H.S. Barrows 1982
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Didactic Approach
PROBLEM-BASED LEARNING Features

• Usually based on real life cases, relevant
• Cases are characterized by progressive
  disclosure
• Participants determine the learning issues
• Sessions are open-ended to allow learning in the
  interval
• The tutor is a facilitator and not necessarily an
  expert, except in the process

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Didactic Approach
Teacher
Traditional Tutorial
Students
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Didactic Approach
PBL Tutorial
Facilitator
Participants / learners
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Didactic Approach
THE ITERATIVE PROCESS
Mrs. P. E. is a 78 year old woman who has come to
the emergency room complaining of shortness of
breath and pain in her chest. She had been in
relatively good health until three weeks
previously, when she
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Didactic Approach
PROBLEM-BASED LEARNING
Students show significant learning gains in
experimental design through a PBL approach
(VanTassel-Baska, et.al. 2000) Students show
enhanced real world skills with no loss in
content knolwdge as result of using PBL
(Gallagher Stepein, 1996) Students and teachers
are motivated to learn using the PBL approach
(Van Tassel-Baska, 2000) Students show enhanced
higher order skill development using PBL over
other approaches to teaching science (Dods, 1997)
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Course
PERIOD

• WORKSHOP 1 Nov 2005
• WORKSHOP 2 Dec 2005
• WORKSHOP 3 Jan 2006
• WORKSHOP 4 Feb 2006
• WORKSHOP 5 Mar 2006

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Course
PERIOD

• WORKSHOP 1 Nov 2005

curriculum were developed in collaboration with
the national and local managers
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Course
PERIOD

• WORKSHOP 1 Nov 2005

To highlight managerial problems encountered by
the health sector officials after the Tsunami
disaster and to obtain their views and
contribution in regard to the specific managerial
contents to be included into the training
programme.
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Course
PERIOD

• WORKSHOP 1 Nov 2005

Objectives To describe managerial problems faced
by Health Officials following 2004 Tsunami
disaster To identify managerial inputs to be
included in the training programme on management
of emergencies
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Course
PERIOD

• WORKSHOP 1 Nov 2005

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Course
PERIOD

• WORKSHOP 1 Nov 2005

• strengths and weaknesses in the months following
  the tsunami
• further profiles to be involved in the course
• topics to be included in the course

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Course
PERIOD

• WORKSHOP 1 Nov 2005

STRENGTHS WEAKNESSES (difficulties encountered after the tsunami)
Human Resources Support from UN Agencies, NGOs Donations Local and informal communication Formal and informal leaders of communities on site Lack of human resources Lack of knowledge of public health staff to respond well to this disaster. Lack of coordination with district provincial office. Poor sectoral coordination, lack of proper coordination between sectors Lack of transport - poorly organized. Lack of stock to maintain good sanitation, safe water, safe food. Lack of monitoring procedures. Mobilisation of financial provisions and regulations Lack of communication between health staff focal points. Community did not know disaster management technologies.
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Course
PERIOD

• WORKSHOP 1 Nov 2005

Topics to be included in the course

• Epidemiology
• MCH
• Nutrition
• Environmental problems
• Communication
• Co-ordination
• Rapid disaster assessment
• Emergency management
• Technical, managerial, administrative and
  supportive issues in emergencies

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Course
PERIOD

• WORKSHOP 1 Nov 2005

Health professional profiles Non-health profiles
DMO District Medical Officers MOH Medical Officers of Health SPHM Supervising Public Health Midwives PHNS - Public Health Nursing Sister Community leaders Grama Sevaka Samurdhi officers Local authorities School teachers Personnel from public utility services NGO personnel Police
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Course
PERIOD

• WORKSHOP 2 Dec 2005

• Objectives
• To finalize the editing of the curriculum
• To review the main features and steps of
  curriculum development with the NIHS core team

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Course
PERIOD

• WORKSHOP 2 Dec 2005

STRUCTURE OF THE COURSE

• FOUR MODULES
• Disaster preparedness and early warning
• Rapid disaster assessment
• Disaster response
• Managerial aspects in emergencies

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Course
PERIOD

• WORKSHOP 2 Dec 2005

MODULE STRUCTURE

• Introduction
• General and specific objectives
• Problem
• Selected readings
• List of resources key informants, web
  references, contacts, organisations
• Facilitator guide
• Student guide
• Monitoring guide
• Assessment tools (essay, questionnaire )
• Module evaluation questionnaire

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Course
PERIOD

• WORKSHOP 3 Jan 2006

To introduce the participants to the
Problem-Based Learning principles and to the
techniques to be utilised in the Curriculum for
the management of disasters and complex
emergencies.
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Course
PERIOD

• WORKSHOP 3 Jan 2006

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Course
PERIOD

• WORKSHOP 4 Feb 2006

reading materials were selected, reviewed and
identified in a single document
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Course
PERIOD

• WORKSHOP 4 Feb 2006

MODULE 1 Disaster preparedness and early
warningMODULE 2 Rapid disaster assessment and
surveillance MODULE 3 Disaster response MODULE
4 Managerial aspects in emergencies
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Course
PERIOD

• WORKSHOP 4 Feb 2006

MODULE 1
At the end of the module the participant will be
able to 1. Describe nature, types and
characteristics of disasters and emergencies 2.
Analyse risks and vulnerability. 3. Identify
stakeholders (health, non-health, community ) and
their roles and responsibilities 4. Plan for
community risk management and disaster
mitigation 5. Identify aims, objectives,
mechanisms and strategies for planning community
disaster preparedness and awareness 6. Identify
the appropriate strategies, tools and materials
for planning community-based disaster
preparedness
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Course
PERIOD

• WORKSHOP 4 Feb 2006

At the end of the module the participant will be
able to 1.Describe concepts, terminology and
indicators used in disaster epidemiology and in
rapid health assessment 2.Choose and use the
appropriate epidemiological method 3.Set up
reporting and surveillance system under emergency
condition 4.Monitor nutritional status and apply
nutritional programmes and guidelines
MODULE 2
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Course
PERIOD

• WORKSHOP 4 Feb 2006

At the end of the module the participant will be
able to 1.Describe management concepts in health
emergencies 2.Develop a disaster response plan
including coordination and networking (acute,
medium and long term) 3. Describe health aspects
that can be affected by disasters and
emergencies psychological, nutritional,
environmental, preventive (personal hygiene,
food, water, shelter, clothing) 5.Describe and
apply basic principles of environmental health
(garbage disposal, sanitation, vector control
) 6. Apply basic concepts of management of
common communicable diseases associated with
emergencies 7. Identify and apply appropriate
initiatives/measures for protecting vulnerable
groups or people with special needs 8. Manage the
acute stage of a disaster (rescue, first aid,
evacuation ) 9. To ensure psyco-social support
during acute, medium and long term phases of
emergencies and disasters
MODULE 3
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Course
PERIOD

• WORKSHOP 4 Feb 2006

At the end of the module the participant will be
able to 1.Describe and apply basic concepts of
health emergency management 2.Develop and
implement a plan for emergency response and
disaster preparedness at community level with
community involvement 3.Describe and apply basic
principles and tools for public information and
media management 4. Manage logistics issues such
as material (emergency health kit) and financial
resources (including auditing) 5. Ensure
continuation of routine health services 6. Manage
and co-ordinate external support 7. Monitor and
review disaster management plans 8. Perform
properly record keeping and report writing
MODULE 4
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Course
PERIOD

• WORKSHOP 4 Feb 2006

GROUP Sub-group 1 Sub-group 2 Sub-group 3 Sub-group 4 Facilitator
A A1 A2 A3 A4 Dr. G Diegoli
B B1 B2 B3 B4 Dr. PL Ingrassia
C C1 C2 C3 C4 Dr. L. Copertino
D D1 D2 D3 D4 Dr. R. Colonna
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Course
PERIOD

• WORKSHOP 4 Feb 2006

GROUP Sub-group 1 Sub-group 2 Sub-group 3 Sub-group 4 Facilitator OBJECTIVE
A A1 A2 A3 A4 Dr. G Diegoli Temporary document
B B1 B2 B3 B4 Dr. PL Ingrassia Temporary document
C C1 C2 C3 C4 Dr. L. Copertino Temporary document
D D1 D2 D3 D4 Dr. R. Colonna Temporary document
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Course
PERIOD

• WORKSHOP 4 Feb 2006

GROUP Sub-group 1 Sub-group 2 Sub-group 3 Sub-group 4
A A1 A2 A3 A4
B B1 B2 B3 B4
C C1 C2 C3 C4
D D1 D2 D3 D4
Facilitator Dr. G Diegoli Dr. PL Ingrassia Dr. L. Copertino Dr. R. Colonna
OBJECTIVE Final document Final document Final document Final document
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Course
PERIOD

• WORKSHOP 4 Feb 2006

REVIEW
FINAL REPORT
DAY 1st
DAY 3rd
DAY 4th
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Course
PERIOD

• WORKSHOP 4 Feb 2006

SELECTED READING MATERIALS
OBJECTIVES 1. Describe nature, types and
characteristics of disasters and emergencies 2.
Analyse risks and vulnerability. 3. Identify
stakeholders (health, non-health, community ) and
their roles and responsibilities 4. Plan for
community risk management and disaster
mitigation 5. Identify aims, objectives,
mechanisms and strategies for planning community
disaster preparedness and awareness 6. Identify
the appropriate strategies, tools and materials
for planning community-based disaster
preparedness
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Course
PERIOD

• WORKSHOP 4 Feb 2006

MODULES LECTURES
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Course
PERIOD

• WORKSHOP 4 Feb 2006

AT THE END
THE TEACHING TOOLS

• SHARED CORE CONTENT
• SELECTION OF READINGS
• .ppt PRESENTATIONS

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Course
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Course
PERIOD

• WORKSHOP 5 Mar 2006

To complete the process of curriculum definition
of the course for the management of disasters and
complex emergencies, according to the
Problem-based learning method, by developing the
modules outlines, problems, guides and assessment
tools.
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Government of Sri Lanka
National Institute of Health Italy
Italian Cooperation
Project Coordinator Dr Rainiei Guerra ISS
Ufficio Relazioni Esterne Technical Responsable
Dr Rita Ferrelli ISS Ufficio Relazioni
Esterne Local Project Coordinator Dr Franco
Macera Training Officer S.ra Laura Masiello
ISS Project assistantes Dr. Alice
Fauci Dr. Manila Bonciani Dr. Luca
Rosi Dr. Alfonso Mazzaccara Administrative
Coordinator Mrs Antonella Marzolini External
Expert Advisors Dr Giuseppe Diegoli Miss
Roberta Colonna Dr Liliana Copertino Dr
Pier Luigi Ingrassia
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thank you