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Recovery and Transition: Building Resilient Community First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Learning Objectives By the end of this course, the participant should be able to: Describe health needs, risks and services in disaster recovery and reconstruction Discuss processes for recovery and reconstruction of health services and infrastructure Discuss the opportunities for risk reduction and health systems capacity development during disaster recovery Explain Community Disaster Resilience Elaborate the elements of Resilient Community First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Emergency Management Framework Emergency/Disaster Response Preparedness Recovery Mitigation Prevention First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Disaster Recovery Recovery “... focuses on how best to restore the capacity of the government and communities to rebuild and recover from crisis and to prevent relapses. In so doing, recovery seeks not only to catalyze sustainable development activities, but also to build upon earlier humanitarian programs to ensure that their inputs become assets for development.” (source: United Nations Development Program 2001) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Recovery Phase Emergency Hazard Community Risks People Property Environment Services Livelihood (Vulnerable) People Property Environment Services Livelihood Recovery/ Rehabilitation Disaster INFORMATION Capacities used To manage Risks, (Damages, Losses Needs) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Emergency Response and Recovery Sudden Impact Mitigation Preparedness 1 2 Ongoing Development 3 ACTIVITY Warning Indicators (Flash Points) 5 4 Reconstruction Rehabilitation Rapid / Detailed Assessment Emergency Relief Search & Rescue WARNING PHASE EMERGENCY PHASE Months / Weeks / Hours Days / Weeks Rehabilitation / Recovery Many Months TIME First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Recovery - from Response to Development RESPONSE 1. Saving Lives 2. Emergency Aid 3. Short term Intervention 4.Emergency Funding 5. Providing for the Community. 6. Emergency (Relief) Aid. 7. Spontaneous Interventions 8. Consumption Subsidy 9. Politicization of Emergencies. 10. Short Time Frame used advantageously. 1. Saving Livelihoods 2. Support to rehabilitation 3. Longer term planning 4. Combined Funding Proposals TRANSITION 5. Working with the community 6. Integration of Relief Aid & Developmental Support 7. Appropriate Interventions 8. Building of Assets 9. Political Competence 10. Strengthening of Coping Strategies 1. Building Livelihoods 2. Building Communities 3.Long Term Development 5. Understanding the community 7. Planned strategies. 9. Political Proficiency 10. Sustainability 4. Developmental Funding 6. Developmental Support 8. Investment Subsidy SUSTAINABLE DEVELOPMENT First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Damage Assessment and Needs Analysis (DANA) a description of what has happened and what needs to be done Direct damage Damage Assessment and Loss Analysis (DALA) includes quantification of direct, indirect, economic, social, and psychological damage incurred by a disaster indirect losses First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Comprehensive DALA: indirect losses estimation of macro-economic impacts national income government debt trade deficit development prospects estimation of intangible impacts social psychological environmental loss of life First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Exercise 1 What are the damages and losses incurred in a typhoon disaster, the needs, and the capacities utilized during the response operations that we need to rebuild, recover for the better? Risks of Disaster Areas for recovery Needs for recovery Partners Damages Losses Other capacities utilized First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Q&A “Opportunities in disasters” What are the opportunities in recovery and reconstruction that might be considered for long-term capacity development? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Some opportunities for development (of health systems): additional financial resources (national / international) additional human resources (national / international) lessons learned from experience, including gaps in health system demonstration and opportunities for training needs reconstruction but “build back better” social pressure and political will to reduce risk and enhance capacity First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman From Response to Recovery and Reconstruction If there is no clear cut boundary between responses and recovery processes… this means: Don’t wait, think ahead! Build on the momentum of response to anticipate longer-term recovery and reconstruction. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Health Roles in Managing Risks Over Time stage immediate timeframe first 24 hours general needs search and rescue evacuation / shelter food water public information system health needs first aid triage primary medical care transport / ambulances acute medical and surgical care emergency communication, logistics and reporting systems (including injury and disability registers) security emergency epidemiological surveillance for energy (fuel, heating, Vector Born Disease, Vaccine Preventable light, etc.) Disease, Diseases of Epidemic Potential environmental health control of disease of public health significance services for: control of acute intestinal and respiratory •vector control disease shortend of first •personal hygiene care of the dead term week •sanitation, waste disposal etc. 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 timeframe end of first month general needs protection (legal and physical) employment public transport public communications psychosocial services end of 3 education months agriculture environmental protection compensation / reconstruction 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 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 Medium-term Health Considerations for the Recovery Process Some key health effects from disasters: contamination of food and water supplies, emotional stress, epidemic diseases - diarrhoea, measles, etc. endemic diseases reduced health levels decline in nutritional status First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Long-term Health Considerations for the Recovery Process 1. Psychosocial Concurrent problem due to disaster: decrease in mental health services, increase in incidence of common mental health problems 2. Gender and Health Family planning and reproductive health services Safety of women and children Inclusion of women in reconstruction planning 3. Environment Clean-up, hazard reduction and environmental management of the incident site First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Long-term Health Considerations for the Recovery Process 4. Chronic Illnesses Continued health care services for long-term disabilities from the events 5. Emergent and Re-emergent illness Monitoring for delayed / ongoing health impacts Surveillance for potentially emergent and re-emergent endemic diseases or areas 5. Housing Permanent Accommodation Access to regular Services First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Post- Incident Evaluation Clear picture of what really happened Actual test to the capacity to manage risk Damages, losses, capacities utilized Way to monitor plan iplementation Good practices and lessons learned What went right, what went wrong and what is the next action to be done to build better Basis for documentation First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Q&A What is your concept about Resilience in the context of disaster management? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Resilience The ability of a system, community or society exposed to hazards to resist, absorb, accommodate to and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential structures and functions ability to spring back from the impacts of disaster It is determined by the degree the community has the necessary resources and capability of organizing itself during times of need First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Resilience Resilience of a community in respect to potential hazard events is determined by the degree to which the community has the necessary resources and is capable of organizing itself both to and during times of need First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Q&A Can you share us your concept of a Disaster Resilient Community based on the definition given? Differentiate Resilience from Capacity. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Resilient Community A resilient community has the capacity to: absorb stress or destructive forces trough resistance or adaptation manage or maintain certain basic functions and structures during disasters recover or bounce back after and event First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Resilience vs. Capacity Resilience is generally seen as a broader concept than capacity because it goes beyond the specific behavior, strategies and measures for risk reduction and management that are normally understood as capacities though in everyday usage, capacity and coping capacity often mean the same as resilience focus of resilience – what communities can do for themselves and how to strengthen their capacities rather than concentrating on their vulnerability to disaster or their needs in an emergency First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Exercise 2: Resilient Community Revisit the Exercise 1 Output. From this the community can now recover for better. Based from your outputs, conceptualize by listing down the Elements of a Resilient Community. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Resilient Community “Disaster Resilient Community” is ideal that no community can ever be completely safe from natural and man-made hazards……!!! First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman WHO 6 Building Blocks of a Health System for a Resilient Community Service Delivery Health Workforce Access Coverage Improved Health (Level and Equity) Information Responsiveness Medical Products, Vaccines & Technologies Social and Financial Risk Protection Health Financing System Quality Safety Improved Efficiency Leadership/Good Governance First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 1. Good health services involves effective, safe, quality personal and non-personal health interventions to those who need them, when and where needed, with minimum waste of resources 2. Well Performing Health Workforce one which works in ways that are responsive, fair, and efficient to achieve the best health outcomes possible, given available resources and circumstances , First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 3. Well functioning health information system ensures production, analysis, dissemination and use of reliable ad timely information on health determinants, health systems performance and health status 4. Equitable access to essential medical products, vaccines and technologies with assured quality, safety, efficacy and cost-effectiveness, and their scientifically sound and cost-effective use First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 5. Good Health Financing System raises adequate funds for health, in ways that ensure people can use needed services, and are protected from financial catastrophe or impoverishment associated with having to pay for them 6. Leadership and Governance ensure existence of strategic policy frameworks combined with effective oversight, coalition building, the provision of appropriate regulations and incentives, attention to system-design, and accountability First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman ADPC Indicators of a Minimum level of resilience A community organization A DRR and disaster preparedness plan A community early warning system Trained manpower: risk assessment, search and rescue, medical first aid, relief distribution, masons for safer house construction, fire fighting Physical connectivity: roads, electricity, telephone, clinics Relational connectivity with local authorities, NGOs, etc. Knowledge of risks and risk reduction actions A community disaster reduction fund to implement risk reduction activities Safer sources of livelihood First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman ADPC Indicators of a Minimum level of resilience A community organization A DRR and disaster preparedness plan A community early warning system Trained manpower: risk assessment, search and rescue, medical first aid, relief distribution, masons for safer house construction, fire fighting Physical connectivity: roads, electricity, telephone, clinics Relational connectivity with local authorities, NGOs, etc. Knowledge of risks and risk reduction actions A community disaster reduction fund to implement risk reduction activities Safer sources of livelihood First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Learning Objectives By the end of this course, the participant should be able to: Describe health needs, risks and services in disaster recovery and reconstruction Discuss processes for recovery and reconstruction of health services and infrastructure Discuss the opportunities for risk reduction and health systems capacity development during disaster recovery Explain Community Disaster Resilience Elaborate the elements of Resilient Community 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