Simulation Exercise

Discussion of Management Issues

Members of the EOC

Functions selected for representation on the Health Sector EOC?

Why?

First flight to Neper

Subject: relief flight Time after impact: 4 H

LEVEL: CENTRAL

Source: M o D (Defense) Addressee: M o H

10 The relief flight is leaving in app. one hour. The director of the military hospital in Sto Foligro is sending a medical team, equipment and supplies. Is the MoH sending some one? There are up to three seats available. Other flight will leave in the afternoon, whether permitting.

A convoy of military and civilian trucks will also leave later in the day.

Mass media

LEVEL: CENTRAL 5

Subject: hospital damages Time after impact: 3H 40 M.

Source: CNN Addressee: None The secretary of the Minister informs that CNN is broadcasting that: The main hospital would be severely damaged in Neper. CNN also reports that, according to one international NGO, the number of casualties would be very large and remain without attention.

In a satellite telephone interview, a doctor in the hospital of NEPER is requesting immediate assistance with blood, drugs, equipment and any other assistance. The hospital has been almost destroyed and patients are treated in make-shift facilities outside.

The Ambassador of Dearland in Washington is making an emotional appeal for immediate medical assistance for the victims and is expressing his fears of cholera and other epidemics

Validating information

LEVEL: LOCAL Subject: Warehouse of medical supplies Time after impact: 4H Source: Hospital Pharmacist Addressee: Chief Pharmacist

15 The director of the General hospital has been heard that the main warehouse of the MOH, where all medical and surgical supplies for the State are stored, has been destroyed. He reiterates the urgent need for medical supplies and also for additional staff.

Hint: The warehouse is located 8 Km outside Nepercity.

Preliminary Statistics

Damage caused by the Earthquake

(10 h after impact)

District Population

Nepercity 370,000 2

3

4 5 6 7 Total 70,000

71,000

69,000 40,000 130,000 110,000 860,000

Affected

125,000 40,000

71,000

45,000 5,000 7,540 6,230 299,770

Dead

347 279

45

545 17 2 0 1235

Missing

127 37

0

473 0 0 0 637

Injured

3,763 1,245

267

1,231 0 0 7 6,513

Homeless

27,000 12,000

0

18,000 540 135 25 57,700 Information compiled from approximately 65% of the municipalities

Statistics District 3

LEVEL: LOCAL

Subject: Medical casualties Time after impact: 30 Source: Red Cross Addressee: All

105

The local Red Cross is estimating the number of deaths and missing in District 3 to 6,500. This number has been reported in the situation report of the IFRC.

Hint: Figures do not match according to sources… what do you do?

Information from remote areas

LEVEL: LOCAL

Subject: Number of Victims Time after impact: 7H 30 Source: District 3 Addressee:

30

The first news is coming from one rural municipality in District 3. A Ham Operator is reporting at least 1000 bodies at the local cemetery and thousands of injured victims in one small town. The information can not be confirmed. Ambulances, medicines, Blood, food and tents are urgently required for the entire population of the district.

LEVEL: LOCAL

Subject: Number of victims Time after impact: 9 H

30

Source: District 4 military commander Addressee: HQ in Nepercity The military forwards information from the Mayor of the district 4: 545 dead, 473 missing and 1,231 injured (Red Cross and public health centers data). The MoH local clinic (35 beds) is destroyed and two patients and one nurse died in the partial collapse of the structure. An estimated 60% of the houses are damaged in the main city (population 34,000), 10-15% have totally collapsed...

Preliminary Statistics – Red Cross

LEVEL: LOCAL

Subject: Time after impact: 12 H Source: Addressee:

45

The Red Cross issued and disseminated statistics of at least 2,000 deaths, 9,550 injured and 85,000 homeless. They claim that the government is minimizing the impact of the disaster and not including some of the information they provided Hint: Which figure will prevail?

International appeal

LEVEL: CENTRAL

Subject: Field Hospital Time after impact: 5H Addressee: Minister of H

15

Source: Director of civil protection The President has called a press conference. He has pledged immediate assistance to the victims of the EQ. He requested international assistance and in particular the dispatch of foreign medical teams and field hospitals to provide medical assistance. The MoH is requested to provide information to the countries interested in assisting.

Assessment of Needs

Subject: UNDAC Time after impact: 10 H

LEVEL: CENTRAL

Source: UN Coordinator Addressee: Civil protection

30

The UN coordinator is informing that a UNDAC team will arrive within 24 H. Six experts in disaster needs assessment (incl. one health specialist and one water expert) will assist the UN Disaster management Team to coordinate the assistance.

LEVEL: CENTRAL

Subject: Arrival of Fact finding missions Time after impact: 25 H Source: civil defense Addressee: all

95

Two assessment teams from donor countries arrived. They plan to travel to the affected areas to determine the needs for humanitarian short and medium-term assistance.

They request a briefing from the health sector and information on pending needs.

They diplomatically expressed concern that the government of Dearland has not clearly indicated what support is needed yet. They offer their assistance to formulate priorities and identify gaps.

Hint: Donors are submitted to strong pressure for quick action and allocation of resources. How to retake the leadership?

Coordination : WHO

LEVEL: CENTRAL 35

Subject: WHO guidelines Time after impact: 7 H Source: WHO/PAHO HQ Addressee: WHO Representative HQ is confirming that its expert on Disaster Management with one epidemiologist and one hospital expert will arrive tomorrow morning to increase her office capability.

She is also reminded that WHO post guidelines for disaster response in its Webpage. HQ suggests that she shares this information and copy of other material with the MoH experts.

HQ also stresses the urgency of getting information on the health needs to launch an appeal, if justified, as soon as possible.

Hint: Guidelines might be available from the group coordinator. Is WHO actively involved in the EC?

WHO

Any attempt to negotiate or renegotiate the budget of WHO?

WHO/PAHO appeal

LEVEL: CENTRAL 100

Subject: WHO appeal Time after impact: 31 H Source: WHO rep Addressee: MoH

PAHO/WHO regional office is eager to make an appeal for international assistance but it needs some information on the health situation. The WHO rep is instructed to report ASAP as the appeal should be issued today (Thursday). If issued on Friday, with the time lag, it may not be acted upon by donors before Monday. She also stresses that IFRC and large NGOs have launched an appeal for health relief for an amount totaling $ 3.5M.

What should she reply to her HQ?

Hint: Wait for full assessment? Go ahead and suggest technical areas to be covered? Mass casualties? Others?

Coordination – Private Sector

Subject: offer Time after impact: 8H

LEVEL: CENTRAL

Addressee: MoH

55

Source: Private Company in USA

My company Tecnodesastre is offering modular hospitals that can be airlifted by helicopter and be operational in a matter of hours. They come fully equipped and ready to use with one operating room.

Tecnodesastre has a considerable expertise and has deployed this equipment in several recent humanitarian operations such as in Kosovo, Bosnia and Turkey.

Modules are available at very short notice.

Hint:

Which questions to ask?

Military-Civilian Coordination

LEVEL: CENTRAL

Subject: relief flight Time after impact: 4 H Addressee: M o H

10

Source: M o D (Defense)

The relief flight is leaving in app. one hour. The director of the military hospital in Sto Foligro is sending a medical team, equipment and supplies. Is the MoH sending some one? There are up to three seats available. Other flight will leave in the afternoon, whether permitting.

A convoy of military and civilian trucks will also leave later in the day.

Hint: Who should travel? Why and to do what?

LEVEL: LOCAL

Subject: Arrival aircraft Time after impact: 6:30 Source: Military commander Addressee: MoH

20 The commander informs that a C130 from the Air Force is expected within three hours. It carries medical personnel from the armed forces, equipment and supplies (unknown quantity and nature).

Hint: Who is coordinating whom? How to improve this?

NGO’s

LEVEL: LOCAL 20

Subject: Offer of assistance Time after impact: 5 H Source: NGOs Addressee: M o H

A group of NGOs active in the health sector offer their assistance. Medical personnel in field projects in Neper have reported high casualties in district 3 and 4. One small (1,200 Inhabitants) isolated municipality (District 3) where MSF is working has app 75 injured and 9 deaths. The local health center is intact and the staff of MSF is working closely with the local nurse. Supplies are short for the following items: Gauze, syringes, anti-tetanus vaccine and serum and analgesics. The sock of antibiotics and local anesthetics is low but will last 24 h more.

The HQs of NGOs are certainly aware of the tragedy and additional assistance is expected within a matter of days. How can they assist and what is mostly required from them?

Hint: are they integrated in the committee?

NGOs

Subject: NGO Time after impact: 4H 10

LEVEL: LOCAL

Source: An assistant to the minister Addressee: MoH

15 An assistant to the minister reminds him that MSF and the Adventists have a large medical program in Neper. Surely, they should have large stocks of supplies that the Ministry could requisition.

Hint: A good idea?

Bridge for Peace

LEVEL: LOCAL

Subject: Less-Than-Friendly country Time after impact: 4:30 Source: The MoH from the neighbor country Addressee: MOH

20

The minister of this “less-then-friendly” neighbor offers his condolences and places at the disposal of the Minister the services of the trauma hospital located at 25 km from the border. Three medical units and one team of public health experts sent to provide services to the affected district are held at the border post. If the immigration matter can be arranged, they can be on site within one hour.

His assistance is kindly requested to facilitate their arrival.

Hint: In spite of the constant frictions at the border, the ministers of health often meet and cooperate at international meetings. Who can help?