Emergency Response in Health Sector

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Learning Objectives:

At the end of the session, the participants will be able to: 1. Define common terminologies in emergency management 2. Relate Emergency Response in the Emergency Management Framework 3. Describe Emergency Response Operation 4. Explain the roles of the health sector in managing the risks during response operations 5. Discuss the role of the Emergency Operation Center in managing the emergency

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Q & A

1. Define Emergency 2. Differentiate Emergency from Disaster 3. What is Emergency Response 4. What is Emergency Management 5. Define Health Sector

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Emergency

  Actual threat to public health and safety is a threatening condition that requires urgent action

Disaster

 a serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts which exceeds the ability of the affected community or society to cope using its own resources

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Emergency Response

 the process of responding to any type of emergency situations that can threaten the human and safety of the public  These are dealt with differently based on the type of emergency  The main aim of emergency response is to mitigate the effect of an emergency on human life and property

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Emergency Management Framework

Disaster Impact

Response Preparedness Recovery Mitigation Prevention

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Emergency Management

 Comprehensive strategy of building, utilizing and restoring capacities employed in addressing the actual threat to public health and safety  Organization and management of resources and responsibilities for addressing all aspects of emergencies, in particular preparedness, response and early recovery steps  Involves plans, structures and arrangements established to engage the normal endeavors of government, voluntary and private agencies in a comprehensive and coordinated way to respond to the whole spectrum of emergency needs.

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

In Emergency Response there are two basic concerns to be addressed:

1. Managing the risks 2. Managing the incident

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

1. Managing the Risks

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

What are the Risks?

People Typhoon (Hazard) Properties Services Community Livelihood Environment

What will be the impacts or risks to the community?

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

1. What are the risks?

Exercise 1

Group the participants Group 1: List the risks to people Group 2: List the risks to properties Group 3: List the risks to environment Group 4: List the risks to services Group 5: List the risks to livelihood

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Risks to people :

        injuries like wounds, fractures, etc. drowning burns disabilities diseases psychological disorder displacement deaths

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Risks to properties :

        damaged buildings and structures damaged hospitals damaged schools damaged electric and telephone lines destroyed houses damaged transport vehicles damaged bridges damaged water sources and toilets

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Risks to services :

       disrupted health services disrupted education paralyzed transportation bogged down communication electrical brown outs or power shortage lack of water supply lack of food supply

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Risks to environment :

     poor sanitation air pollution water contamination poor sewage disposal etc.

Risks to livelihood :

   closure of business no work loss of job

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

2. Who will manage the risks?

Exercise 2

 

What are your response actions to manage the 5 categories of risks?

Who will be involved in the response?

The reporter must explain the roles of each listed involved persons, agencies, or organization

Risks Response Actions Responders First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Q & A

What is Health Sector?

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Definition: Health Sector

 A part of the economy dealing with health-related issues in society  a division, or a collective aspect of a geographical area, an economy or a society dealing with health-related issues

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Q & A

Who are the members of the Health Sector in Oman?

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Emergency Response Operation

 Measures undertaken in responding to emergencies    Includes operationalization of appropriate emergency management systems and procedures Emergency Response Operation involves  responsibilities  management structures  resource and information management  SOPs ERO focus on protecting life, property, essential services delivery and the environment

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

      

What are the services of the Health Sector in emergencies?

Casualty management (first aid, triage, transport, pre hospital care, in-patient care, out-patient care) Communicable disease control (surveillance, tracking, treatment, prophylaxis, isolation and quarantine) Management of the dead Environmental health measures (water, sanitation, environmental pollution) Psychosocial services Health information Management of health risks (risk assessment, mitigation, communication, preparedness and response leadership)

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

3. How will you manage the risks? Exercise 3:

Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager on the first 24 to 72 hours?

Priority Activities Services Needed Concerned Agencies First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Exercise :

Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager after the first week?

Priority Activities Services needed Concerned agencies First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Exercise :

Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager on the after one month?

Priority Activities Services needed Concerned Agencies First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

EMERGENCY AND HEALTH

EMERGENCY COMMUNITY

DIRECT IMPACT VULNERABILITIES CAPACITIES INDIRECT IMPACT

DAMAGE AND NEEDS ASSOCIATED FACTORS

Climate/ weather/ time of the day Location Security situation Political environment Economic environment Socio-cultural environment Morality, solidarity, spirit Competence, corruption

12 – 23 March 2011. Muscat, Oman 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

EPIDEMIC EMERGENCIES

Specific morbidity and mortality

OUTBREAK

- in health facilities - in the community - in health facilities Risk for health and lab workers Difficult access Agent unknown

NEEDS 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

12 – 23 March 2011. Muscat, Oman

Health Roles in Managing Risks Over Time

stage time frame general needs health needs

immediate first 24 hours search and rescue evacuation / shelter food water public information system first aid triage primary medical care transport / ambulances acute medical and surgical care emergency communication, logistics and reporting systems (including injury and disability registers) short term end of first week security energy (fuel, heating, light, etc.) environmental health services for: •vector control •personal hygiene •sanitation, waste disposal etc.

emergency epidemiological surveillance for Vector Born Disease, Vaccine Preventable Disease, Diseases of Epidemic Potential control of disease of public health significance control of acute intestinal and respiratory disease care of the dead general curative services nutritional surveillance and support (including micronutrient supplementation) measles vaccination and Vitamin A

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Health Roles in Managing Risks

stage

medium term long term conclusion

time frame

end of first month end of 3 months

general needs

protection (legal and physical) employment public transport public communications psychosocial services education agriculture environmental protection

health needs

(re) establishment of the health information system restoration of preventive health care services such as EPI, MCH, etc.

restoration of priority disease control programmes such as TB, malaria, etc.

restoration of services of non-communicable diseases / obstetrics care of the disabled reconstruction and rehabilitation specific training programmes health information campaigns / health education programmes disability and psychosocial care evaluation of lessons learned compensation / reconstruction restitution / rehabilitation revision of policies, guidelines, procedures and plans prevention and preparedness upgrade knowledge and skills, change attitudes

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

2. Managing the Emergency Operation Center

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Q & A

What is an Emergency Operation Center?

What are the roles of EOC in Incident Management?

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Emergency Operation Center

 a place, activated for the duration of an emergency, within which personnel responsible for planning, organizing, acquiring and allocating resources and providing direction and control can focus these activities on responses to the emergency

Purpose of EOC:

 to provide a place to manage the health sector’s contribution to an emergency

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Roles of EOC

1. Support site (ICP): logistical support and policy direction to site-level 1. Use standard functions - Protect response personnel and resources 1. Mobilize extra resources and coordinate 1. Minimize loss of life, disability and suffering 1. Protect public health 2. Protect civil infrastructure, environmental and economic assets, including property 3. Reduce economic losses

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

32

Management Support staff Operations

Organizational Structure

Policy Management Develops goals and objectives Communications Safety/ risk mgmt Liaison officer Planning Logistics Administration Accomplishes Goals and objectives Supports Management and Operations

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Elements are both functional and structural

      Policy Management Operations Planning Logistics Administration

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Draw personnel from appropriate agency operations

 Policy group: Elected officials; chief medical officers; chairs of boards or board committees; legal advisors; chief executive, operating, administrative or financial officers; senior department heads  Management: Chief executive, operating or administrative officers; emergency program coordinators or planners; communications officers; safety officers; risk managers  Operations: Division and department heads with programmatic responsibility relevant to the emergency, who can work directly with the incident manager

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Draw personnel from

  Planning: program and emergency planners; analysts; subject matter experts Logistics: staff from purchasing departments; information technology and systems support; human resources officers  Administration: financial officers, accounts and contracts processing personnel; financial analysts; administrative assistants; clerks

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Competent staff

    An EOC needs skilled people who will work together Functional familiarity through regular job Oriented and trained to the EOC role Good team players

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

EOC preparedness plan

 purpose of the plan  concept of operations, management structure, roles of personnel and how the components work together  Activation procedures and levels, and who has authority  Escalation and de-escalation plan  Call-out list and notification procedures  Procedures /SOPs (resources mobilization and allocation, etc.)  Communications  Information management

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

38

EOC preparedness plan

 Checklists of the roles and responsibilities of EOC functions  Checklists of standard operating procedures  floor plan, with inventory and locations of equipment and supplies  Electronic information management processes (including a layout plan of phone, fax, data lines, cables, switches and outlets)  Communication resources and procedures, especially mobile phones and radios  Public information and warning processes

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

39

EOC preparedness plan

 Procedures for engaging levels of government and/or a superior jurisdiction  Standard forms and instructions for documenting EOC activities  Maps of the area of the event  Guidelines for worker care and safety  agency and position responsible for maintaining and updating the plan  Training and exercise schedule to ensure staff and procedures are up-to-date.

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

40

Physical attributes of an EOC

Two primary considerations:   Location, including access, security, proximity to partners Facility, including size, amenities and configuration

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Location

 Is there an emergency management agency that could sponsor it?

 Proximity to partners, stakeholders, donors and humanitarian agencies  Is some integration with the broader emergency management infrastructure of the jurisdiction possible.

 Can the facility survive the hazards in the area?

 Is it accessible in an emergency?

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Facility

   a dedicated, purpose-built Health EOC is relatively rare except at the level of national governments a dual or multi-purpose EOC, where the space is routinely used for some other purpose is more common If contemplating dual use space, consider: o o o convert and activate the space as an EOC in less than one hour, appropriate security measures can be put in place in the same time facility should meet the basic requirements of disaster survivability and access o o a mix of open and closed work space .

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

 o

Size and configuration

There are no standards except for staff safety o evaluate the scale of likely events o size depends on people depends on event size o make form follow function o Must provide space for: • core functions (management, operations, planning, logistics and administration) • • Policy group intermittently when required A communications and message centre • Break-out/meeting rooms • • Rest and eating areas Storage • Media relations/public information. (may be off-site)

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman



Useful considerations:

o o o o o o o the EOC Director should be positioned so that they can easily oversee operations.

Functions that are interdependent should be co located Locate functions adjacent to any displays that pertain to their activity A separate, quiet meeting room for priority setting discussions, management briefings, etc. If a high volume of incoming communication is anticipated, a separate message centre in the communications room is desirable All entrances and exits must be secure at all times. Food and rest areas should be away from the main area, and food handling practices and storage facilities should meet the highest public health standards

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Building and resources:

 If staff sleep on site, segregated sleeping facilities will be required, along with enhanced facilities including water and

sewage systems

 Heating, ventilation and air conditioning and emergency power systems scaled for the extra burden of some crowding heat-producing office equipment.  Furnishings may be fixed or movable, with movable, ergonomically suitable furniture offering greater flexibility  The facility should support generous use of communications technologies,  There should be a facility floor plan that identifies the workstations and maps the wiring and equipment at each station.

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Office equipment and supplies

 office equipment and supplies should, to the extent possible, be identical to that which the assigned personnel normally use in their daily work.  Where computers are used, there should be a back-up pen and paper system systems for documentation and reference, in the event of a system failure.

 Information displays, if electronic or projected, should be backed up by manual systems (flipcharts, whiteboards)  Information is the lifeblood of an EOC. Use all the possible display space.  At least one television and radio tuned to the local media

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Redundancy

 have back-up plans for technological failures within the EOC  have an alternate site for the EOC itself, in the event that circumstances make the designated facility uninhabitable.  the alternate site may not fully satisfy all the requirements  rely on moving some of the equipment, along with personnel from the primary site.

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Learning Objectives:

At the end of the session, the participants will be able to: 1. Define common terminologies in emergency management 2. Relate emergency Response in the Emergency Management Framework 3. Describe Emergency Response Operation 4. Enhance their awareness on the roles of the health sector during response operations

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

“An effective emergency management will prevent the escalation of the incident into a disaster”

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

Thank You

First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman