HEALTH RELATED ISSUES IN DISASTERS

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HEALTH RELATED ISSUES IN DISASTERS

• Knowledge comes, but wisdom lingers ( Tennyson)

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Pan American Health Organization(PAHO)

• Established in 1902
• 35 Member Governments
• 3 Participating European Governments
• PAHO serves as regional office for WHO

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Program on Emergency Preparedness and Disaster
Relief

• Pan American Health Organization /
• World Health Organization
• PAHO / WHO

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EARTHQUAKES
LANDSLIDES
NATURAL DISASTERS
FLOODS
HURRICANES
VOLCANIC ERUPTIONS
OTHERS
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AIRCRAFT ACCIDENTS
RADIATION ACCIDENTS
EXPLOSIONS
TECHNOLOGICAL DISASTERS
FIRES
CHEMICAL ACCIDENTS
OTHERS
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COMPLEX DISASTERS
CIVIL STRIFE
ARMED CONFLICTS
Refugees, IDP
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Latin America and the Caribbean move from Ad Hoc
Disaster Response to Prevention
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Program Objectives

• Before a Disaster

• After a Disaster

Prevention, Mitigation, Preparedness
Coordinationof International Assistance
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Before a disaster

• Building national capacity through training(
  standardized but adapted to local context)
• Strengthening Ministry of Health disaster
  programs
• Special projects
• Promote Hospital mitigation
• SUMA
• CRID

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Human Resources Development , not stockpiling
equipment, is the key to Preparedness . . .
Workshops/ short courses
University training
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The National Health DisasterProgram must
Strengthening Institutions

• encompass entire health sector
• lead the health sector in disaster prevention,
  mitigation, preparedness, response, early
  rehabilitation
• have a multi-hazard scope (natural,
  technological, complex disasters)
• coordinate with other sectors

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Belize Karl Heusner Hospital Hurricane Keith
Photo Tony Gibbs
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Photo Tony Gibbs
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The WHO/PAHO standardized methodology and tool to
manage large amounts of humanitarian supplies.
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Regional Disaster Information Center

• 12,000 documents on disaster-related topics
• THE source of material in Spanish
• Internet Access

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PAHO/WHO Cooperation in Disasters

• Coordinates International Health Assistance
• Provides Technical Cooperation in health
• Assist with rapid needs assessment
• Coordination with Foreign Affairs, Ministry of
  Health, National Disaster Agency, UN Org.s

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External assistance post disaster
PAHO/WHO
MSF
DHA/UNDP
France
USA
Red Cross National Societies
Canada
UNHCR
OXFAM
IFRCS
ConvenioHipólito Unánue (CHU)
WFP
Japan
European Union/ECHO
UNFPA
OAS
Nordic countries
WHO/PAHO
CARE
United Kingdom
Netherlands
CRS
ICRC
SICA/CEPREDENAC
PADF
UNICEF
CDERA
Local NGO
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Assistance to disaster affected country

• Japan, UK, USA/OFDA, Red Cross, ICRC, UNDP, CARE,
  MSF, UNDAC. CIDA
• The Netherlands,ECHO, ICRC, local NGO, IFRC,
  OXFAM, OCHA, CDERA, RSS, CARICOM, OAS,

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SUB-REGIONAL AGENCIES

• CDERA/CEPREDENAC
• RSS
• PAHO
• Federation of the Red Cross
• OFDA
• Agreements

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National Support Network

• Health Disaster Focal Points
• Ministries of Health
• PAHO/WHO
• Disaster Focal Points
• Foreign Affairs ,UN agencies

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The principles of Coordinationand national
responsibility

• Generating reliable Information
• Developing technical experience
• Cultivating the credibility
• Learning to say no
• serving the health sector rather than the donors

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International Assistancein Perspective . . .
ASSISTANCE FROM WITHIN THE COUNTRY
EXTERNAL ASSISTANCE (1-2)
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Health Disasters

• Immediate Needs
• Managed by local emergency response
• Short Term Needs
• Water, Shelter, food , medicines Epidemiological
  Surveillance, Etc.
• Long Term Needs
• Rehabilitation of Health Infrastructure,

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Health Related Issues

• Myths
• External Emergency Assistance (SAR, field
  hospitals and surgeons) needed
• Any donation is Acceptable
• Disease Outbreaks Occur w/in the Population or
  from dead bodies
• Immunization is Necessary

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Reality

• Local response within the first days
• Public health problems and population
  displacement are more frequent and of slow onset.
• In kind unsolicited donations
• Dead bodies are DEAD, no epidemics
• Rehabilitation of hospitals and water system
  needed when donors and media interest decrease

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Conclusion

• Disaster management is a multi sectorial and
  multi hazard business, so should training be
• Many actors , therefore coordination remains a
  problem
• Local presence and involvement in preparedness
  and training ensures a good response when
  necessary

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FROM ONE EXTREME TO THE OTHER
1980s National sovereignityof the affected
country is absolute
1990s Donor countryknows best!