FIMDP 2013 DEPT OF COMMUNITY MEDICINE SRM MEDICAL COLLEGE ,SRM UNIVERSITY & UNSW AUSTRALIA 9TH & 10TH JAN 2013
Successful Models in Disaster Risk Management
Dr Kyaw Win Vijay Nath
Change – Cultural Shock In Disasters ????????????????????????
Gods, Universe and the Story of A Wise Old Man
Risk in Life “Take your own Risk”, “Hay it’s Risky”, “Risky business”, “What are the Risk Factors”, “Take the Risk”, etc;
Basic Principle in developing programmes and operational plans in the field of Emergency and Disasters is Risk
What’s my Risk. Seems Ok to me ?
Risk (Level of Impact) Definition of Risk (Logical) Risk is a potential level or degree of impact impose from a potential or direct affect of hazards, depending on vulnerability and capacity to cope it in a giving condition and situation.
Risk Risk
Capacity
Global Warming Climate / Planets Changes
Hazard
Developed Vs Developing Vulnerability
Risk = Hazard x Vulnerability ----------------------------Capacity
Hazards (Types of Harmful Effects)
Earthquake & Tsunami
Earthquake
Volcanoes Eruption
Floods
Flash floods & Landslides
Bomb Blast Conflict – Social unrest
Infectious Diseases
Transportation Accident
Cyclone
Industrial Accident
Dam collapsed
Black Outs
Type of Hazards 1. Geological – Earthquake, tsunami, lands lides, volcano
2. Hydro-meteorological – Flood, storm, drought, flash flood
3. Biological – Epidemics, plant diseases,
4. Technological – Transportation and industrial accidents -BCRN
5. Environmental – Bush fires, fire, deforestation, urbanization, pollution, etc.
6. Political and Social - War, terrorism, bomb, social unrest, conflicts – social – ethic religious, complex emergencies, etc
The Geographic Nature of Earth
There are total of 14 tectonic plates, 7 major and 7 minor There are total average of 1,500 land volcanoes in the world and 600 are active. Most of them are situated in the Ring of Fire regions.
Vulnerability Exposure to harmful effects Vulnerable Group Identification
Vulnerable groups are identified in two types. • Population living and facilities situated close or potentially exposed to different hazards. • Group of people who needs special attention during emergencies and disasters such as children, pregnant women, old aged, disables and ill patients.
Capacity Knowledge, skill and practice to manage risk
Capacity Identification
• Human, supplies, str ucture, operating system and funds are identified as 5 main resources to be build up as capacity.
Emergencies and Disasters • Emergency = An Incident / Impact where Risk can be managed using existing resources and support in a given condition and situation.
• Disaster = An major incident / impact where Risk can be managed only with the support of external resources and support in a given condition and situation.
Management (Logical) Mobilize and utilize available resources most effectively and strategically in a given condition and situation to obtain maximum output and outcome.
Risk Mapping Risk Mapping (Dr.KWVN) Risk mapping is where potential hazards, vulnerability population essential facilities and structures and existing capacity to cope are map out in the geographic map.
Risk Index Risk Index (Dr, KWVN) Risk can be calculated in a numerical value using the risk index methodology and compare against one entity to another. The calculation can be made possible using the Risk formula. Risk = Hazard x Vulnerability divided by Capacity. The numerical number as a result of the calculation is know as Risk Index. A score of 1 to 10 can be used. To compare different programmes’ indicators. To prioritize programme interventions. No
Area
Hazard
Vulnerability
Capacity
Risk Index
1
District 1
10
5
5
10
2
District 2
10
10
5
20
3
District 3
10
5
10
5
Risk Reduction Plan Risk Mapping and Index To obtain a map which has identify potential hazards, violability and capacity and Analyze for Indexing Contingency Plan If emergency or disasters hit, what to do? Operation Plan When emergency or disaster hits, how to manage? Standard Operating Procedure (SOP) Guidelines to guide how to management specific
Risk Reduction Plan Components Risk Mapping, Analysis and Indexing
Contingency Plan
Operational Plan Check List
Standard Operating Procedure
Risk Reduction Plan Geographic Risk Reduction Plan (RRP) - Vertical • For province, district, sub-district and village levels, contingency and operation plans will be developed, practiced and integrated with risk mapping to formulate RRP. Facility Risk Reduction Plan (RRP) - Horizontal • For each public health facility, health offices and hospital, contingency and operation plans will be developed, practiced and integrated with risk mapping to formulate RRP.
V
H
The First Wake Up Call
Wake Up Calls and Hiccups
Aceh Tsunami
Hurricane Katrina, USA
Wars
India - AMRI Hospital Fire
Haiti Earthquake
Japan Tsunami
Hyogo frame Work For Action 2005 to 2015
Why Do We Need Coordination In Health Emergencies / Crisis ? INGOs UN NGOs
Private Sectror
Local Groups
Media Individual
We already have too many challenges to manage. So many of them coming now. Who are they? What can they help? When can they do it? Where can they go? Why they came? How can I manage?
reform
HUMANITARIAN
THREE PILLARS OF REFORM AND THE FOUNDATION CLUSTER APPROACH Adequate capacity and predictable leadership in all sectors
HUMANITARIAN COORDINATORS
HUMANITARIAN FINANCING
Effective leadership and coordination in humanitarian emergencies
Adequate, timely and flexible financing
PARTNERSHIP Strong partnerships between UN and non-UN actors
HUMANITARIAN
UN – Global Cluster Leads Cluster/Sector Working Group Global Cluster Leads 1. Agriculture FAO 2. Camp Coordination & Camp UNHCR & IOM Mgmt 3. Early Recovery UNDP 4. Education UNICEF & Save the Children 5. Emergency Shelter UNHCR & IFRC (Convenor) 6. Emergency Telecoms OCHA (UNICEF & WFP) 7. Health WHO 8. Logistics WFP 9. Nutrition UNICEF 10. Protection UNHCR 11. Water, Sanitation & Hygiene UNICEF
Health Sector and Cluster Structure and Mechanism used in Indonesia Government Coordination Meeting
UN Cluster Coordination Meeting
Heath Sector / Cluster General Coordination Operational Plan
Health Emergency Information Operation Unit
Sub – Groups •Child, Reproductive and Maternal Health •Water, Sanitation, Waste Management •Early warning and rapid response (EWARS) •Immunization •Psychosocial - Mental Health •Mobile Clinics •Field Hospitals / Hospital care •Non communicable / care of injured •IDP Management •Food and Nutrition •Logistic (Medical Supplies) •Information and Communication
The 12 Golden Rules during the first phase of Emergencies and Disasters 1. Live saving treatment and care of traumatized victims and care of the dead. 2. Evacuation and containment of high risk population to safer locations. 3. Rapid assessment for immediate needs and resource mobilization. 4. Provision of safe water. 5. Provision of food for vulnerable groups (Special Vulnerable Groups : Children, pregnant women, old people, special attention needed persons, etc) 6. Provision of shelter. 7. Provision of sanitation. 8. Provision of waste care and environmental health. 9. Provision of essential health services. 10. Setting up emergency operation and information unit, public and media education and supply chain. 11. Early warning system for disease surveillance and outbreak control. 12. Security
SEAR Twelve Benchmarks For DRR The Twelve Benchmarks For Emergency Preparedness and Response
Legal framework and functioning coordination mechanisms and an organizational structure in place for health EPR at all levels involving all stakeholders; 2. Regularly updated disaster preparedness and emergency management plan for health sector and SOPs (emergency directory, national coordination focal point) in place; 3. Emergency financial (including national budget), physical and regular human resource allocation and accountability procedures established; 4. Rules of engagement (including conduct) for external humanitarian agencies based on needs established; 5. Community plan for mitigation, preparedness and response developed, based on risk identification and participatory vulnerability assessment and backed by a higher level of capacity; 6. Community-based response and preparedness capacity developed, supported with training and regular simulation/ mock drills; 7. Local capacity for emergency provision of essential services and supplies (shelters, safe drinking water, food, communication) developed; 8. Advocacy and awareness developed through education, information management and communication, including media relations (pre-, during and post-event); 9. Capacity to identify risks and assess vulnerability at all levels established; 10. Human resource capabilities continuously updated and maintained; 11. Health facilities built/modified to withstand expected risks, and 12. Early warning and surveillance systems for identifying health concerns established. 1.
SEARHEF – Made ready for immediate allocation
CARE
CURE
Resilience Preparedness Preventive
• Layman • Community
Ambulance crew
If you can not manage day to day emergencies, forget about disasters
• G.P. • Nurse
• Spec.Physician • Spec Nurse
COMMUNICATION
Quick Response
TRANSPORTATION
+ Victims
Ambulance
Development
H.C
Safe Health Facilities
Class C Hosp Class B / A Hospital Intra Hosp.
Pre Hospital
Public Safety Center
Intra Hosp.
• Inter Hospital Post Hospital
Safe Community Injury Early Warning and Surveillance System
Factories
Schools
Offices
Local Transportation Hotels Restaurants Health Facilities
Highways
Ambulance
Traffic Recreation Centers Religious Places
Shopping Places
Public Houses
Emergency and Disaster Phases 1 = Before Disaster Preparedness Phase
Prevent Develop
Prepare
1 Mitigate
Emergency / Disaster Reconstruct
Rehabilitate
3 = After Disaster Recovery Phase
Rescue
2
3
Golden Hr
Relief
Golden Week
Recover
Respond 2 = During Disaster Response Phase
Risk Management Wheel Before Disaster
During Disaster
M&E Time
Logistic
Human
C
C
Finance
I&C SOP M&E
C Action Plan & Operations
After Disaster
Values M&E
Evolution of DRR – PHS Indonesia
Dr. Kyaw Win Vijay Nath
Emergency and Disaster Incidence 2004-2009 Number of Disaster Incidence from 2004 to 2009
No
Year
Emergency & Disaster Incidence
Number of Provinces Affected
Number of Districts Affected
Death
Injured
IDP
Missing
1
2004
37
18
81
129,103
173,452
570,185
2
2005
45
21
40
96,985
12,591
80,611
407
3
2006
162
27
101
7,679
291,110
2,485,953
712
4
2007
205
28
156
642
355,336
870,708
507
5
2008
359
30
162
299
75,457
288,323
82
6
2009
415
30
493
Total
771
124
540
310 105,605
16,955 734,494
250,010 3,725,595
151 1,708
Emergency & Disaster Incidence During 2009 No
Type of Disasters
Total District
Frequency
SubDistrict
Major Injury
Dead
Minor Injury
IDP
Missing
Damaged House
Damaged Health Facilities
1
Bomb Blast
3
3
3
10
64
0
0
0
0
1
2
Explosion
4
4
4
33
17
0
0
0
0
0
3
Collapsed Bridge
2
2
2
0
19
0
0
0
0
0
4
Collapsed Building
5
5
5
7
42
0
0
0
6
0
5
Disease Outbreak
2
2
2
3
241
0
0
0
0
0
6
Drought
15
47
165
9
3
0
194
0
31
0
7
Earthquake
24
46
44
1,201
1,539
12,306
41,578
48
385,720
450
8
Fire
84
84
87
41
44
0
1734
37
2305
1
9
Flood
96
120
282
45
993
1105
198477
7
30570
111
10
Food Poisoning
3
3
3
3
44
0
0
0
0
0
11
Industrial Accident
3
3
3
0
11
0
0
0
4
0
12
Landslide
46
46
56
44
52
8
607
5
214
10
13
Mudflow
1
1
1
0
0
0
0
0
1
0
14
Sinking Ship
2
2
3
9
0
0
0
1
0
0
15
Social Conflict
10
10
10
1
58
0
0
0
3
0
16
Strong Wind
3
3
4
0
4
0
0
0
26
0
17
Thunderbolt
4
4
4
7
3
0
0
1
0
0
18
Thunder Storm
2
2
2
3
11
0
0
1
0
0
19
Tide wave
3
3
3
1
0
0
33
3
0
0
20
Tornado
57
57
58
7
112
0
7375
0
2726
85
21
Transportation Accident
46
46
46
310
279
0
12
48
44
1
415
493
787
1734
3536
13419
250010
151
421650
659
TOTAL
Damaged Health Facilities in 2008 147
160 140 120
100 80
51
50
60 40 20
7
2
0
Rumah Sakit Puskesmas
Pustu
Polindes
GFK
Vision, Goal and Objective Communities are well prepared with the support of different sectors, able to respond, management emergencies and disasters, sustain and maintain their livelihood and development at different levels
Health sector prepared to reduce and minimize health consequences, social and economic impacts aftermath of emergencies and disasters under DRR Programme
DRR Programme strengthened, enabling self sustainability in reducing risk by having good preparations and effective response to emergencies and disasters according to updated Standard Operating Procedures in 446 districts, Indonesia by 2012
Strategic Approach - Conceptual Framework Disaster management Bill. Indonesia
Hyogoframe Work For Action (HFA)
MDG Goals
Human Rights Principles
Regional Crisis Center of Sumatera Utara (NAD, SUMUT, RIAU, KEPRI, SUMBAR)
Regional Crisis Center of Sumatera Selatan (SUMSEL, JAMBI, BENGKULU, BABEL)
Regional Crisis Center of DKI Jakarta (JAKARTA, LAMPUNG, BANTEN, JABAR, KALBAR)
Regional Crisis Center of Jawa Tengah (JATENG,YOGYAKATA) Regional Crisis Center of Jawa Timur (JAWA TIMUR)
Regional Crisis Center of Bali (BALI, NTB, NTT) Regional Crisis Center of Kalimantan Selatan (KALSEL, KALTENG, KALTIM)
Regional Crisis Center of Sulawesi Utara
(SULUT, GORONTALO, MALUT)
Regional Crisis Center of Sulawesi Selatan
(SULSEL, SULTENG, SULTRA, SULBAR, MALU U, PAPUA BARAT, PAPUA)
Role of Regional Crisis Centers Emergency Operational Units
Emergency Supplies Depot
Hospitals
Public Health Facilities
Universities Training Centers
Emergency Shelter
Each Crisis Centers is formed by 3 Basic Structural Components of the Health System. Hospitals, Public Health Facilities and Universities.
Early warning
Information
Crisis Center Central Operation Unit MoH,
Review, monitoring
Coordination Resource Mobilization
HEALTH PERSONNELS TRAINED IN 9 REGIONAL CRISIS CENTERS No ITEM 1
EMERGENCY & DISASTER MANAGEMENT
2
CONTINGENCY PLANNING
3
EMERGENCY NURSING
4
2006
2007
2008
TOTAL
133
120
341
594
59
230
135
424
266
30
270
866
ADVANCE TRAUMA LIFE SUPPORT (ATLS)
96
388
224
708
5
ADVANCE CARDIAC LIFE SUPPORT (ACLS)
32
360
300
692
6
HEALTH SUPPLY & DRUG MANAGEMENT
227
30
270
827
7
RADIO COMMUNICATION
59
184
142
385
8
EMERGENCY INFO & COMMUNICATION
51
101
121
273
9
FIELD HOSPITAL MANAGEMENT
103
69
120
292
10
ITC-DRR, INT. TRAINING ON EDM
-
23
58
81
1,026
1,535
1,981
4,542
TOTAL
Safe Health Facilities, Add 4 % cost to total cost of a building
•
Structural and Non Structural Assessment
•
Risk Reduction Plan and Check List (Risk Mapping, Contingency and Operational Plan)
•
Mitigate – Retrofit / Re-Allocate / Rebuild / New Building
•
Skill base trainings – (Risk Management)
CARE
CURE
Resilience Preparedness Preventive
• Layman • Community
Ambulance crew
If you can not manage day to day emergencies, forget about disasters
• G.P. • Nurse
• Spec.Physician • Spec Nurse
COMMUNICATION
Quick Response
TRANSPORTATION
+ Victims
Ambulance
Development
H.C
Class C Hosp Class B / A Hospital Intra Hosp.
Pre Hospital
Public Safety Center
Intra Hosp.
• Inter Hospital Post Hospital
Standard Operation Procedures (SOP)
Updated annually: 1st version launched in 2006 2nd version launched in 2007
ITCDRR - The Orbital Design Brother CC Int: Centers
CC UV-9
CC UV-8
Brother CC
CC UV-7
CC UV-1
CC UV-2
Mother ship Coordinating Center MOH PPK – CC INT / NAT
CC UV-6
Sister CC
CC UV-3 CC UV-4
Org:
Sister CC
CC UV-5
Universities in each Regional Crisis Center will participate and facilitate others The whole unit is known as ITCDRR
Design Framework Practice Tailored Made Courses Advance
Degree
Intermediate
Theory
Skill Basic Non Degree
Pre-service
Service
Free-lance
Module Design Usual – Vertical or / and Horizontal
Must Know
Should Know
New - Circular
Nice to Know
ITC-DRR – INTERNATIONAL TRAININGS
CPR
Communication
Boat Rescue
Media
DVI - Bomb
ITC-DRR 1. Ministerial degree issued 2. Officially launched in September 2007 3. 1st International Training on Emergency and Disaster organized in 4. November 2007 5. 2 Training of trainers courses organized in October 2007 and May 2008 6. 3 International Training Courses and 1 Study tour scheduled to organized 7. in June, July, August and November 2008. 8. ITC-DRR training courses used interactive integrated participatory and skill base stimulatory circular modules. 9. It net-works with all institutes, universities, agencies around the world.
Vertical rescue
Coordination
Tele-Conference
Field visit
Fun-Joy
International Emergency Health Services
Mission to Myanmar
Mission to China
Mission to Palestine
ITC-DRR WEBSITE & EMAIL PPK-DEPKES
DRR Interactive (Face Book)
Web Sample
Link to International Web Sites
9 Regional ITC-DRR Crisis Centers Universities
Web Link: www.who.or.id/download/docs/eha/DRR-Programme-Concept-
Public Alert System • • • • • • • • • •
Contingency Plan Survival skills BLS Serine / Bell Community watch Traffic light indicators Maps for evacuation Shelters Call signs Media alert
Our Future - Global Warming My dear, you look very sad. What happen to you ?
Darling, It’s getting hotter every day. Difficult to find food to feed our family. What have we done to human beings. Why are they doing this to us ?
In February 2007, the United Nations released a scientific report that concludes that global warming is happening and will continue to happen for centuries. The report also stated with 90% certainty that the activity of humans has been the primary cause of increasing temperatures over the past few decades.
Smile and be happy while you can, life will go on… Ha Ha Ha !!!
Thank You The World can satisfy our needs but not our greed. We all live in an island called Earth. Let us all join hands to make our mother planet to give healthy environment for our future generations, Gems of our Countries This presentation is prepared by Dr Kyaw Win Vijay Nath for the purpose of training only. For referencing, please contact at
[email protected]