SAINT LUCIA NATIONAL PANDEMIC PREPAREDNESS PLAN

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SAINT LUCIA NATIONAL PANDEMIC PREPAREDNESS PLAN

• PRESENTATION
• 13TH HEALTH DISASTER COORDINATORS MEETING

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COMMENTS on the process involved in the
development of the NIPPP

• 
  CHALLENGES
• Political Will
• Leadership
• Inter Agency Collaboration
• Legislation Legal Framework
• Secretariat

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PROJECT TO CONDUCT SIMULATION EXERCISESNIPPP
FINAL REPORT SAINT LUCIA

• The Pan American Health Organization (PAHO) with
  support of the United States
• Agency for International Development (USAID)
  worked with Caribbean countries and
• territories to upgrade their level of
  preparedness for Pandemic Influenza.
• The simulation exercise in Saint Lucia was
  carried out to in furthering development of
• its NIPPP.
• The exercises were jointly executed by the
  Ministry of Health (MOH) and the Ministry
• of Agriculture (MAFF)
• MAFF conducted its full scale exercise in the
  field while MOHs exercise was
• conducted at Victoria Hospital. A joint table top
  exercise was conducted with all stake-
• holders.

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Purpose

• The overall purpose of the exercise was as
  follows
• To test the roles and responsibilities of the key
  players
• To test the specific skills for the efficient
  execution of the plan
• a. Organization of outbreak investigation team
• b. Use of PPEs
• c. Extraction and management of samples
• To determine hospital surge capacity and response
• 4 To identify gaps and areas for improvement

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OBJECTIVES

• Table Top
• Table top exercise was conducted on the first day
  
• Designed to simulate outbreak into Pandemic
  Phases 4 5
• Test was focus on multi sectoral approach to
  emergency management
• Involved Ministries other agencies identified
  in the NIPPP
• Simulation intended to
• Provide opportunity to rehearse specific
  activities
• Determine state of readiness
• Reveal gaps
• ID areas for improvement
• Table top focused on 4 specific areas

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Table Top continued.

• Decision making (command control)
• Inter intra agency communication
• Information management
• Record keeping

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FULL SCALE

• The full scale exercise was conducted on the
  second day comprising a series of drills to
• Test specific aspects of the sectors response
  using 20 volunteers presented to a health
  facility with AI symptoms contracted from a
  neighbouring farm.
• The health facilitys emergency functions tested
  were
• Use application of PPEs
• Sampling techniques
• Participation
• Agencies involved in the table top included MAFF,
  Police, NEMO,Min. of Trade, Red
• Cross, Fire Ambulance Service, Min. of Finance,
  Min. of Tourism.
• The full scale exercise was predominantly MOH
  MAFF with limited involvement of
• NEMO, volunteers, Police, Fire Ambulance
  service.
• Observers and Evaluators
• Primarily regional participants from St. Vincent,
  Antigua, Aruba, Dominica, St. Kitts Nevis,
  IICA, FAO PAHO.

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CHALLENGES

• A number of issues were raised during the table
  top exercise, the key issues being
• Design Flaws
• Insufficient inserts created for sectors other
  than MOH
• Exercise started at Phase 3 leading to Phases 4
  5 (not realistic)
• Execution Flaws
• Table triangles as markers were not used
• Difficulty with viewing of inserts
• Other contributing factors
• Number roles of persons not specific
• Limited awareness of the plan
• Understanding of a table top exercise
• The overall success of the exercise was that it
  illustrated the strengths weaknesses
• of the NIPPP design implementation process in
  St. Lucia.

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FULL SCALE EXERCISEThe exercise was conducted
according to schedule

• CHALLENGES
• Separation of Ministries
• Two separate exercises were conducted on the same
  day, one by MOH the other by
• MAFF with very little inter agency collaboration
  coordination.
• Duplication
• There was overlapping of roles some persons
  played the roles of player, controller,
• Planner, and evaluator.
• However the original objectives to test the
  application use of the PPEs and the
• Sampling methodology was realized.

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AFTER ACTION REVIEW (AAR)

• Two separate AAR sessions were held to address
  the strengths weaknesses of the
• system and to make general recommendations for
  improvement.
• 1 Observation many participants had no
  opportunity to review plans
• Recommendation NIPPP committee to develop
  schedule orientation sessions
• 2 Observation Ministries/ Departments/Agencies
  operating in isolation
• Recommendation NIPPP committee to identify key
  players have regular sessions to
• harmonize relationships (private public
  sectors)
• 3 Observation lack of effective leadership
  management
• Recommendation NIPPP committee to identify
  training needs ensure cadre of trained persons
  in awareness management of the contents of the
  NIPPP

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CONCLUSIONGeneral overview comments

• The design and execution flaws identified were
  not limiting factors in achieving the
• Goals and Objectives of the exercises. The four
  (4) focal Decision making, Inter
• Intra Agency Communication, Information
  Management Record Keeping have
• been simulated, since the general intention was
  to create a scenario that would cause
• the various stake holders to interact and react
  accordingly. The inserts were designed to
• afford participants the opportunity to generate
  discussion, anticipate problems find
• solutions as a team or teams.
• Sections of the NIPPP were identified as missing
  and needed development, including but not limited
  to
• A communication plan
• Sections indentifying specific roles
  responsibilities for other Ministries agencies,
  Private sector Media Houses.
• As a national plan the non-health issues such as
  the socio-economic implications

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GENERAL COMMENTS FROM THE PARTICIPANTS
EVALUATORS

• The NIPPP was not seen by many in the exercise
• Organizations need improvement
• All inserts should be read aloud or projected
  from one source
• Many did not take the inserts seriously
• Ministry of agriculture was lost in the
  simulation
• Could not determine the lead agency or incident
  command
• Were the appropriate persons present for the
  exercises
• Persons not aware of their roles or functions
• Too much time was taken for dressing in PPEs
• Hospital communications required improvement
• Labs weakness in use of PPEs equipment failure
• Repairs/maintenance of hospital facilities
• ID of backup space for surge