MODULE 3 HEALTH EMERGENCY MANAGEMENT CAPACITY

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MODULE 3HEALTH EMERGENCY MANAGEMENT CAPACITY
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Learning Objectives

• By the end of this module, the participant should
  be able to
• Describe the elements of capacity to manage
  health risks of emergencies
• Identify key elements of capacity for specific
  health service delivery functions
• Describe the role of a health emergency manager
  in health emergency management systems and in
  developing health emergency management capacity

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Outline of the presentation

• Relevance of Risk Management to Health
• Emergency Management Capacity
  Development
• Elements of capacity to manage health risks
• of emergencies
• Elements of capacity for specific health service
  
• delivery functions
• Roles of a health emergency manager in
• developing health emergency management
• capacity

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Challenges Roles of HEM in Disaster Risk
Mgt. Risk Mgt. concepts Risk mgt. services
Health Emergency Management Capacity
Delivery of functions/Services Preparedness Res
ponse Recovery
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Relevance of Risk Management to HEM Capacity
Development

• Risk Hazard x Vulnerability
• Capacity
• In managing Risk
• Reduce Hazard
• Reduce vulnerability
• Increase Capacity

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ANATOMY OF COMMUNITY RISK MANAGEMENT
Community risk
readiness
community

hazard
?
vulnerability
multisectoral, all hazards
indicators
indicators
indicators
indicators
probability scale/magnitude/ strength/intensity
spread duration biological hazards season,
infectivity, latency, transmission
resistance, etc.
policy, plans, procedures knowledge, skills,
attitudes resources legislation national
sectoral policy administrative procedures response
recovery plans preparedness plans technical
guidelines management structure institutional
managements information systems warning
systems human resources material
resources financial resources simulations
training education public information community
participation research publications
People access to health care measles
vaccination under 5 nutrition under 5
mortality access to clean water access to
sanitation adequate housing employment/
income female literacy Property health
infrastructure vehicles medical
supplies Services curative care
services ambulance services public health
services health info system Environment water/so
il/air quality
risk of death injury (mental/ physical) disease
(mental/physical) loss of life displacement loss
of property loss of income secondary
hazards breakdown in security damage to
infrastructure breakdown in services Contamination

natural phenomena famine diseases of epidemic
potential events/crowds intoxification infestation
s transport accidents structural
failures industrial accidents chemical
accidents pollution refugees war terrorism
Prevention Mitigation Programme
Vulnerability Reduction Programme
Emergency Preparedness Programme

Community Risk Management
?
?
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Group Activity I

• What do you understand by the term capacity in
  the context of health emergency management?

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Defining Capacity

• System definition of capacity
• Capacity includes capability (or capacity) of
  the
• component parts, the resources (financial,
• equipment) which support the system, and
  the
• relationships which together form the
  system.
• Capacity is a quantitative measure
• Measurement of human and material resources
• i.e. number or volume or size. For example,
  the
• capacity of the hospital is 500 beds

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Defining Capacity

• Sum of
• capability
• resources
• relationships
• Within
• community
• organization
• country
• region
• world

• Aims
• Reducing illness, disability and death from risks
• Promoting health, safety and security

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Health Emergency Management Capacity

• Capacity to perform the following functions
• Reduce hazard
• Reduce vulnerability
• Respond to reduce and manage consequences
• Recover and reconstruct to reduce and manage
  consequences

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Disaster Risk Management Framework

• Response
• Preparedness Recovery
• Prevention Mitigation

(Capacity utilization)
(Capacity building)
(Capacity rebuilding for better)
(Capacity to Reduce/prevent Hazard)
(Capacity to Lessen Impact of hazard)
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Elements Of capacity To manage Health risks of
emergencies
Organizations Systems People
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• In Risk Management Module Capacity is directly
  associated to health emergency preparedness
• 10 elements of Health Emergency Preparedness
• Legal framework
• Policies
• Guidelines
• Procedures
• Resources
• Plans
• Knowledge
• Attitude
• Skills

Organizations
Systems
People
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Group Activity II

• What do you understand by organizations, in the
  context of health emergency management? Give
  examples.
• What are systems in health emergency management?
  Give examples.
• How does people contribute to organizations and
  systems?

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Organizations

• In the context of health emergency
• Designated/organized body
• Defined organizational structure
• Clear roles and directions
• United action or functions
• Legal framework

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Systems

• Definition
• a regularly interacting or interdependent group
  of items forming a unified whole (Merriam
  Webster Dictionary)
• an orderly grouping of facts, principles, or
  methods in a certain field any formulated method
  or plan a manner of arrangement or procedure
• (The Random House Dictionary)

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Systems to Manage Health Risks of Emergencies

• Systems
• systems operating at each administrative level
• systems in specific sectors
• systems to manage specific types of risks
  (hazards and vulnerabilities)
• systems for specific functions or services

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Systems to Manage Health Risks of Emergencies

• Systems
• Logistics Management
• Information Management
• Coordination and Networking
• Surveillance System
• Human Resource Development
• Communication and Public Information
• Mass Casualty Management

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People

• People contribute to organizations and systems by
  providing
• skills, knowledge and attitudes
• Competency
• People may be
• Career (or paid), volunteer and community
• Managers, coordinators, operators or responders

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Elements Of capacity Perform Functions
Organizations Systems People
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Group Activity III

• What are the health risks expected from the
  hazard assigned to your group?
• What are the roles and function of the ministry
  of health in response to the hazard?(You may
  identify your organization or identify the level
  of administration)
• What capacities must they have in place in order
  for them to perform their roles and functions

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ANATOMY OF COMMUNITY RISK MANAGEMENT
Community risk
readiness
community

hazard
?
vulnerability
multisectoral, all hazards
indicators
indicators
indicators
indicators
probability scale/magnitude/ strength/intensity
spread duration biological hazards season,
infectivity, latency, transmission
resistance, etc.
policy, plans, procedures knowledge, skills,
attitudes resources legislation national
sectoral policy administrative procedures response
recovery plans preparedness plans technical
guidelines management structure institutional
managements information systems warning
systems human resources material
resources financial resources simulations
training education public information community
participation research publications
People access to health care measles
vaccination under 5 nutrition under 5
mortality access to clean water access to
sanitation adequate housing employment/
income female literacy Property health
infrastructure vehicles medical
supplies Services curative care
services ambulance services public health
services health info system Environment water/so
il/air quality
risk of death injury (mental/ physical) disease
(mental/physical) loss of life displacement loss
of property loss of income secondary
hazards breakdown in security damage to
infrastructure breakdown in services Contamination

natural phenomena famine diseases of epidemic
potential events/crowds intoxification infestation
s transport accidents structural
failures industrial accidents chemical
accidents pollution refugees war terrorism
Prevention Mitigation Programme
Vulnerability Reduction Programme
Emergency Preparedness Programme

Community Risk Management
?
?
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EMERGENCY AND HEALTH
HEALTH RESPONSE Search and rescue First
Aid Triage Medical evacuation Primary
care Disease surveillance and control Curative
care Blood banks Laboratories Referral
system Special units (burn, spinal) Evacuation
centers Shelter and Water Food and
nutrition Energy and Security Environmental
health Primary Health Care Care of the
dead Psychosocial care Disability care Recovery
and Reconstruction
COMMUNITY VULNERABILITIES CAPACITIES
DIRECT IMPACT
DAMAGE AND NEEDS
EMERGENCY
INDIRECT IMPACT
ASSOCIATED FACTORS Climate/ weather/ time of the
day Location Security situation Political
environment Economic environment Socio-cultural
environment Morality, solidarity,
spirit Competence, corruption
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EPIDEMIC EMERGENCIES
HEALTH RESPONSE Case definition Admission
criteria Case confirmation Case
management Discharge criteria Contact
tracing Vector control Environmental
controls Surveillance system Referral
system Professional education Public Information
and awareness Laboratory plans Hospital
plans Supplies and equipment Borders
control Quarantine Animal culling Commerce/
trade
Specific morbidity and mortality
OUTBREAK
NEEDS
- in the community
- in health facilities
- in health facilities
Risk for health and lab workers
Difficult access
Agent unknown
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Health Emergency Capacity Development Plan Matrix
Risk Capacity needed Preparedness Strategies/ Activities Time Frame Resource Requirement Resource Requirement Resource Requirement Person Responsible Indicators
Risk Capacity needed Preparedness Strategies/ Activities Time Frame Required Available Resource Person Responsible Indicators


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General or Cross-cutting Functions

• Risk communication
• Occupational health and safety
• Facility design
• Organization-based disaster planning
• Managing critical supplies and protecting
  infrastructure

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General or Cross-cutting Functions

• Communication and transport
• Information management
• Health surveillance
• Mental health
• Reproductive health
• Environmental health
• Food safety, emergency feeding and nutrition
• Water supply management
• Waste management

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Specific Emergency Response and Emergency
Recovery Functions

• First aid, self-aid and first-responder health
  assistance
• Incident site management
• Assessing needs
• Mass-casualty management
• Decontamination
• Epidemiological investigation

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Specific Emergency Response and Emergency
Recovery Functions

• Forensic investigation
• Management of the dead and the missing/ fatality
  management
• Shelter and temporary accommodation (including
  evacuation shelters)
• Community support
• Longer-term issues (health effects, recovery,
  rehabilitation, reconstruction)

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Specific Emergency Response and Emergency
Recovery Functions
Hazard and Risk Reduction functions Preparednes
s Functions Recovery Response
Functions General and Cross Cutting
Functions Functions for specific services
CAPACITY 10 Elements of Preparedness
Service Delivery
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• Evacuation Site Scenario
• Damaged lifelines
• Overcrowding
• Poor environmental sanitation
• No access to safe water
• Inadequate sanitary toilets
• Health workers are direct victims
• Disrupted basic health services

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Group Activity IV

• As Health Emergency Manager, what could be the
  priority service that you could deliver to reduce
  the possible secondary health risks in the
  evacuation site? Name just one.
• What capacities must you have to be able to
  deliver such health services to manage the risk?
• People
• Organization
• System

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• Evacuation Site Scenario Typhoon
• Poor environmental sanitation
• No access to safe water
• Inadequate sanitary toilets
• No community surveillance system
• Disrupted basic health services
• Foul smell of decomposing bodies
• Severe depression of the bereaved
• and other health workers

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Group Activity V

• In your group, address one of the following
• Environmental health
• Communicable disease
• Management of the dead and the missing
• Mental health and psychosocial support
• Assess the risk and identify capacity needed in
  terms of organization, systems and people. Write
  your answers on a flip chart for presentation.
• (20 minutes)

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Health Emergency Capacity Development Plan Matrix
Risk Capacity needed Preparedness Strategies/ Activities Time Frame Resource Requirement Resource Requirement Resource Requirement Person Responsible Indicators
Risk Capacity needed Preparedness Strategies/ Activities Time Frame Required Available Resource Person Responsible Indicators


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Environmental Health in Evacuation Center

• Environmental health risks are assessed,
  including
• Water supply services
• Waste handling and disposal
• Food safety
• Garbage disposal
• Local Capacity ( laboratory services, sampling,
  diagnosis and analysis equipment etc.)
• Inventory of organizations with environmental
  health roles and responsibilities (laboratories,
  surveillance, chemical industries, water supply
  services, waste disposal services, fire service,
  etc.)
• Availability of supplies, reagents, medicines

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Environmental Health in Evacuation Center

• Environmental health risks
• Food and water borne diseases
• Environmental Capacity
• Environmental assessment, surveillance
• Environmental teams
• Environmental logistics including systems of
  distribution
• Laboratories and other confirmation devices
• Reporting, monitoring, evaluation

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Communicable Disease

• Communicable health risks are assessed
  including
• Diseases of Epidemic Potential
• Vaccine Preventable Diseases
• Vector Born Diseases
• Diseases of Public Health Significance
• Considerations
• Health status
• Local capacity, program implementation
• Inventory of Organizations
• Availability of health services, facilities
• Availability of drugs, medicines, supplies,
  vaccines

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Communicable Disease

• Communicable health risks
• Epidemic and Outbreak
• Communicable Disease Capacity
• Surveillance System in place in evacuation
  centers
• Surveillance teams available
• Case definition etc..
• Epidemiological investigation
• logistics including systems of distribution
• Laboratories and other confirmation devices
• Reporting, monitoring, evaluation
• Networking and referral system

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Management of the Dead and Missing

• MDM Issues
• Identification of the Dead
• Cultural Considerations
• Final Disposal of the Dead
• Management of the Relatives
• Considerations
• Legal framework, functioning coordination
  mechanisms and organizational structure in place
  for health emergency preparedness and response
• Local capacity
• Inventory of Organizations
• Mortuary System

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Management of the Dead and Missing

• MDM health risks?
• Myths and realities about dead bodies
• Mass burial
• MDM Capacity
• Organizational/Institutional Arrangements roles
  and responsibilities management structures
• Procedures (identification, keeping of
  records,fingerprinting, dental records, DNA and
  photographing)
• Provisions for notification of relatives (next of
  kin)
• Logistics
• Reporting, monitoring, evaluation
• Networking and referral system

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Mental Health and Psychosocial Support

• Psychosocial health risk assessment
• Coverage
• Silent victims, Family displacement
• Medical Responders/Leaders
• Early identification and referral
• Considerations
• Local capacity for emergency provision of
  essential services and supplies
• Inventory of organizations, health facilities,
• Availability of drugs, medicines, supplies,
• Availability of training modules and trainers

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Mental Health and Psychosocial Support

• Psychosocial health risks
• Long lasting affects rehabilitation and recovery
  (children, responders, etc.)
• Psychosocial Capacity
• Policies and Plan
• Training modules, pool of trainers range of
  services
• Advocacy and awareness through education,
  information management and communication
• Health facilities, drugs and medicines
• Reporting, monitoring, evaluation
• Networking and referral systemInter and Intra
  sectoral coordination
• Local capacity for emergency provision of
  essential services and supplies

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Group Activity VI

• In your group, discuss the role of the Health
  Emergency Manager in developing health emergency
  management capacity

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Role of the Health Emergency Manager

• Determine the risk and plan to manage it
• Identify the capacity needed in terms of
  Organization, Systems and People
• Determine strategies to reach the goals set
• Determine resource requirements (Compare from
  what is available to what is required and what
  is the gap)
• Look for resources, identify partners, co
  share
• Determine a point person, time frame and
  indicators
• Monitor and evaluate

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Health Emergency Capacity Development Plan Matrix
Risk Capacity needed Preparedness Strategies/ Activities Time Frame Resource Requirement Resource Requirement Resource Requirement Person Responsible Indicators
Risk Capacity needed Preparedness Strategies/ Activities Time Frame Required Available Resource Person Responsible Indicators


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Learning Objectives

• By the end of this module, the participant should
  be able to
• Describe the elements of capacity to manage
  health risks of emergencies
• Identify key elements of capacity for specific
  health service delivery functions
• Describe the role of a health emergency manager
  in health emergency management systems and in
  developing health emergency management capacity.

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• THANK YOU