 |
1. Emergency
Preparedness
As an international
public health agency, the Pan American Health Organization/World
Health Organization (PAHO/WHO) commonly defines disaster preparedness
as the set of measures taken to plan a public health response
to disasters. Unlike activities or interventions aimed at protecting
physical infrastructure, preparedness measures focus on dealing
with the health consequences quickly and efficiently.
PAHO’s disaster preparedness activities take many forms,
including lobbying for and investing in a strong disaster office
in the Ministry of Health (MOH) that is capable of taking leadership
and coordinating all health aspects of disasters; building the
capacity of the Region’s human resources through training;
providing up-to-date guidelines and technical and training materials;
encouraging information and knowledge management partnerships;
and ensuring access to global sources of information. This chapter
presents regional advances in these efforts.
Strengthening Disaster Institutions in
the Health Sector
The establishment of a disaster management office in the MoH
has been, and continues to be, a primary objective of PAHO/WHO.
In assessing the success of this indicator, we looked at the position
of the program within the MoH (direct access and reporting to
the decision making or policy level), the level of staff ing,
the budget for preparedness and response activities and the unit’s
outreach across sectors.
The numbers point to encouraging trends. Presently, 26 (79%)
of the 33 countries in the Americas who responded to a 2006 survey,
prepared by PAHO's Emergency Preparedness Program, have formally
established a disaster reduction program. In six countries, the
functions are carried out, but they are assigned to another program
or individual. Only one country lacks either a focal point or
some other ad hoc arrangement. Most offices or units are modestly
staffed. Only 15 of the 33 countries have a specific budget line
for disaster health preparedness. Others (18 countries) fund their
activities through ad hoc arrangements for health disaster response,
which places them in a vulnerable position. PAHO and WHO will
closely monitor this situation in periodic surveys of Member States.
Access to the decision-making level has improved and it is now
rare to see the health disaster offices buried within the structure
of one or another technical department in the Ministry. In 19
countries, this office is attached to the Minister’s Cabinet
or to the Office of the Director General of Health—an excellent
indication of the importance given to this field. In all 33 countries,
the health disaster unit actively works with the institutions
in charge of overall disaster management and reduction (civil
protection or a similar organization). Cooperation with other
non-health actors (whose support, collaboration and/or information
are essential for reducing the health impact of disasters) varies:
25 (78%) health disaster programs link with Civil Defense; 28
(85%) with Red Cross; 20 (61%) with the ministry of environment;
21 disaster programs (64%) with the Armed Forces; 22 programs
(67%) with international NGOs and United Nations Agencies; 18
(54%) with universities; 17 (51%) with the ministry of foreign
affairs and fewer (14 – 42%) with other institutions.
In May 2006, health disaster coordinators from across the Region
came together at a regional forum in Lima, Peru to look at the
collective challenges they face in health sector disaster risk
reduction and to discuss strategies to best meet their goals.
This was the first time in many years that the predominantly English-speaking
Caribbean coordinators and the Spanish-speaking coordinators from
Central and South America conducted a joint exercise. The rapidly
changing humanitarian environment, both regionally and globally,
prompted this expanded meeting, which provided an important opportunity
to craft a common plan to tackle issues that are becoming increasingly
complex and urgent (safe hospitals; the management of humanitarian
aid regionally and globally, etc.). Among the conclusions of this
meeting are the following:
- The technical quality of the health disaster
offices and the scope of activities they conduct have improved
dramatically in the last decade (as evidenced by the data obtained
through the regional survey). However, when disasters do occur,
often they are transformed into political events. The significant
experience of the health disaster coordinator can take a backseat
to the more visible, ad hoc management of the response.
- Dramatic changes at the global level in the
humanitarian response to disasters makes it imperative that
Latin America and the Caribbean draw upon the lessons of major
emergencies in other parts of the world, such as the tsunami
in South East Asia and the Pakistan earthquake, where information
management was a priority for sound decision making. Priority
also must be given to establishing indicators and continuously
collecting data.
- Health disaster offices in the MoH must clearly
define their role in preparedness and response to pandemic influenza,
ensuring they are active partners at the national level in planning
and control by developing working relationships with focal points
in other organizations. National health disaster plans must
also include specific recommendations for pandemic influenza.
- Many existing hospitals in the Americas were
constructed without due regard to prevalent natural hazards
and are therefore unsafe; new health facilities continue to
be built in such a way that they are vulnerable to disasters.
The national health coordinators concurred that a safe hospitals
platform demonstrates a nation’s commitment to effective
risk reduction and helps safeguard a country’s economy.
However, making hospitals safe requires the support of all sectors—particularly
those outside the health sector that control capital expenditures.
The countries considered that the goals of the Safe Hospitals
initiative1 can be realistically met, given existing
economic resources—if the political will exists and national
policies are developed.
| 1 The
Hyogo Framework for Action 2005-2015, adopted at the Kobe
World Conference on Disaster Reduction, includes an indicator
on vulnerability reduction in the health sector: “ .
. . promote the goal of “hospitals safe from
disaster” by ensuring that all new hospitals
are built with a level of resilience that strengthens their
capacity to remain functional in disaster situations and implement
mitigation measures to reinforce existing health facilities,
particularly those providing primary health care.” |
For more than 30 years, since PAHO’s Emergency Preparedness
Program was created, a strong disaster program in the Ministries
of Health has been an important indicator of the Region’s
progress in preparedness for the health impact of emergency situations.
Sustaining progress made in this indicator, throughout the last
three decades, has required ongoing efforts to convince the decision
making level of the importance of creating a specialized unit
and investing in the training of the Region’s human resources
and expanding their knowledge and skills. These areas are expanded
on later in this report.
Training – Capacity Building
PAHO/WHO continues to support more than 200 training events annually
in the Americas, although increasingly, government agencies, universities
and other institutions are assuming more of the cost and
responsibility for routine training topics. This has allowed PAHO/WHO
to focus more closely on specialized activities, such as those
described below.
- PAHO/WHO helped to organize three LEADERS (LIDERES)
courses in 2006. These courses have become the regional standard
for capacity building in the field of risk reduction, with an
emphasis on health sector issues of development, mitigation,
preparedness and response. After a three-year hiatus, an English-language
LEADERS course was offered in 2006. Its focus
on small island states attracted participants primarily from
the English-speaking Caribbean. The three-year gap in courses
accounted for the high number of applicants (79), of which 18
were selected. The mixture of professional backgrounds—officials
from Ministries of Finance and Defense, the Red Cross, university
professors, national disaster offices and health professionals—led
to rich discussions, one of the hallmarks of the course. Another
indication of the relevance of the course content2
was that 50% of the participants were either funded by their
own government or institution or received sponsorship from organizations
other than PAHO. While the overall evaluation of the course
was positive, and for future growth, PAHO/WHO will look into
formally placing the course within a Caribbean academic institution
that can provide participants with official or recognized certification.
The new Regional Center for Disaster Risk Reduction at the University
of the West Indies (UWI), a co-sponsor of this year’s
course, is one alternative and a memo of understanding is under
consideration to organize, manage and deliver future courses.
The frequency with which these courses are carried out, as well
as the length of the course are also being evaluated, as the
current two-week duration makes it difficult to attract the
highest-level of participants.
| 2
The syllabus for all LEADERS/LIDERES courses is on line
at www.disaster-info.net/LIDERES;
click on either English or Spanish and follow the links. |
A Spanish-language LIDERES Course,
the eighth since 2000, took place in Lima, Peru at the Cayetano
Heredia University. UNICEF and the IFRC joined PAHO/WHO and
Peru’s Ministry of Health in the organization and funding
of this course, which provided a platform for interagency cooperation
and focused on disasters and health. As a contribution to achieving
the Millennium Development Goals, the organizing agencies reaffirmed
their commitment to strengthen coordination in disaster preparedness
and response, support the exchange of ideas and information
on risk management and improve skills in vulnerability reduction
and disaster mitigation. More than 30 participants from the
Americas attended this course, representing government agencies,
NGOs, international organizations, bilateral donor agencies
and academic centers. All participants paid at least a portion
of the cost of their participation, demonstrating an increased
interest in the LIDERES course as well as a regional commitment
to disaster risk reduction.
The Ministry of Health of Brazil organized the third Portuguese-language
LIDERES Course, this time in Brasilia, in collaboration
with the Federal University of Santa Catarina. This course helped
to initiate formal cooperation with WHO’s Regional Office
for Africa, whose Director requested PAHO’s cooperation
in strengthening emergency preparedness and response, in particular
for African Portuguese-speaking countries and small island countries.
A medical doctor from Mozambique and a biologist from the Democratic
Republic of Sao Tome and Principe were welcomed by the Brazilian
participants. Negotiations are underway to organize a LIDERES
course in Africa for Portuguese-speaking countries. Brazil would
provide some participants and instructors for this course.
- Training for pandemic
influenza preparedness and response was a rallying
point for intra- and inter-institutional collaboration. The
PAHO Task Force for Epidemic Alert and Response organized a
series of subregional workshops for Central America, the Caribbean,
the Southern Cone and the Andean Community. The Organization
advocated for the participation of various sectors, among them
national disaster offices, agriculture, interior, education,
security forces and communications, and developed simulation
exercises for pandemic influenza phases 4-5 and phases 5-6 that
involved key departments inside the MoH as well as actors from
other sectors. Consequently, many disciplines and sectors have
shifted from working in an isolated fashion to coming together
to participate in planning and to take part in these tabletop
exercises, which has prompted the development of national influenza
pandemic plans, reinforced aspects of existing plans and helped
to identify gaps. Panama, Peru, Chile, Argentina, Paraguay,
El Salvador, Costa Rica, Mexico and Honduras have adapted these
exercises, using them to assess their own national plans and
to promote multisectorial engagement in pandemic influenza.
The English version of these pandemic influenza simulation exercises
was used by other WHO regions in support of their own preparedness
programs. In 2007, this will be a major strategic push in the
Caribbean, and all countries are expected to have pandemic plans
by September.
- The Cricket World Cup will be held in eight
Caribbean countries in March and April 2007, and preparations
for this sporting event, which is expected to draw 500,000 people,
dominated the disaster agenda of many English-speaking Caribbean
islands in 2006. PAHO/WHO led sustained training programs in
11 countries on emergency care
and treatment (ECAT), mass casualty management and incident
command systems.3 Seven of the 11
countries requested a second round of training. By the end of
the year almost 1,000 persons had participated in these courses.
In order for a host country to be ICC compliant, the International
Cricket Council (the governing body for these games) requires
that they hold simulation exercises prior to the event. In 2006,
PAHO/WHO assisted four countries to organize, conduct and evaluate
exercises—a tabletop exercise followed by a drill. Training
in all 11 countries was conducted on a cost-sharing basis—PAHO/WHO
provided the instructors and the countries covered the cost
of the participants and other local costs. Although the countries
used this training to improve preparedness for the upcoming
Cricket World Cup, PAHO/WHO saw it as an opportunity to improve
skills needed for multi-hazard emergency response.
| 3 The
ECAT
courses target first responders with limited medical
background; the mass casualty management courses are directed
at first responders such as police, fire and rescue, hospital
medical personnel, etc.; the incident command training targets
those who manage emergency situations—national disaster
coordinators, police and brigade captains, etc. The impact
of these training activities extended beyond the Caribbean.
A medical doctor in Banda Aceh organized similar mass casualty
management training for her region, based on experience
she observed in the Caribbean while on an exchange program
with PAHO in late 2005-early 2006. |
- The management
of cadavers has stimulated widespread interest
throughout the Region and indeed worldwide. For the first time,
a workshop was organized and held in the British Virgin Islands
for contingency planning for mass fatalities. All English-speaking
Caribbean countries participated. Country representatives developed
an outline of a plan to be adapted to each island. The workshop
was co-sponsored by the Overseas Territory Department of the
Department for International Development of the U.K. (DFID).
The topic of management of cadavers or mass fatalities has gained
significant attention lately – not only because of a possible
tsunami but also as requirements to prepare for the Cricket
World Cup. Recently, a group of refugees perished while trying
to reach the Caribbean by boat. Small islands, which do not
have the capacity to identify mass fatalities, will benefit
from this type of training.
 The
assessment of damage and needs
in the health sector (EDAN-health) has been
a strategic area of training for several years in South America
and was a major focus in 2006 in Central America. The EDAN strategy
has helped to unify assessment criteria (see Annex
4 for an editorial on this topic from PAHO’s quarterly
newsletter). The support materials developed in South America
(CD
and publication) were field tested in Central America following
Hurricanes Beta and Stan (2005) and the floods in Costa Rica
(2006). Field testing confirmed that the assessment forms are
better utilized if accompanied by training, and in some cases,
modification. As a result, training courses were held throughout
Central America.
- In Costa Rica, Guatemala, El Salvador and Nicaragua, national
response teams were created and included specialists from
a variety of health disciplines (health services, epidemiological
surveillance, and environmental and mental health).
- The forms and other tools developed to evaluate damage
and needs were reviewed and standardized in each country,
using the regional models developed by PAHO as a baseline.
- In both preparedness and response, countries worked in
close coordination with non-health actors, national emergency
commissions, the Red Cross and others.
- Hospital disaster
planning has become an important strategic training
initiative regionwide. Now that course material has been prepared
to train trainers, the countries themselves are taking responsibility
for strengthening national capacity. During 2006, Central America
focused on standardizing the application of the methodology
and training a team of facilitators for future training initiatives.
In Costa Rica, more than 90% of the nation’s hospital
network (hospitals of high and medium complexity and health
centers) received training in hospital disaster planning and
subsequently prepared their hospital’s emergency plan.
Drills are scheduled to be held in 2007 in Costa Rica’s
major hospitals.
 The
LSS/SUMA system (more
in Chapter 3) requires better trained human resources to
operate the new and more sophisticated system. Activities in
2006 focused on training both operators and trainers. One training-of-trainers
course was held for English-speaking countries (in Jamaica)
and two for Spanish-speaking countries (in Panama and Argentina)
to develop national capacity and increase the pool of LSS instructors.
More than 20 additional workshops were carried out in the Americas
and, with the support of WHO headquarters, three training workshops
took place outside the region: in the Philippines, Turkey and
Iran. Thanks to this new pool of instructors, national workshops
are, on many occasions, carried out by national authorities
or institutions (national Red Cross societies, NGOs, etc.) and
require very minimal external support. The interest and ownership
demonstrated by many different actors is the best indicator
of the impact of LSS. A complete list of training activities
related to LSS/SUMA—in the Americas and beyond—
is provided in Annex
5.
As PAHO/WHO continues to support these types of technical training
initiatives in areas that are critical to strengthening disaster
preparedness in Latin America and the Caribbean, the Organization
is also looking to create new training opportunities and alliances
with other partners, making maximum use of new information and
communication technologies to allow us to pursue new strategies
and reach an ever broader audience. The development of distance
learning courses and the use of computerbased simulation exercises
are two examples of new training techniques, which PAHO will develop
further in 2007.
- The Latin American Faculty of Social Sciences,
FLACSO, the Federation of the Red Cross and PAHO/WHO developed
a stand-alone distance learning
module on Policies
on Health and Disasters. This module forms part of the FLACSO
diploma course of studies on health policies. Developed in conjunction
with regional development experts, the course module covers
a wide variety of issues: the epidemiology of disasters; the
importance of measures that guarantee that health services remain
functional in the aftermath of disasters; the management of
health situation rooms as an effective response management tool;
practical, proven tools and techniques for evaluating damage
and needs in the environmental health sector and the application
of corrective measures. In 2006, the eight-week module was offered
between October-December; 26 students completed the course.
PAHO/WHO is developing additional complementary modules that
in the future will comprise an integrated diploma course.
 A
computer-based multimedia simulation exercise
was developed to aid countries to set up and run an Emergency
Operations Center (EOC). The program simulates massive flooding
in a country—the most recurring type of disaster in the
Americas and the one claiming the highest death toll. This new
simulation exercise is based on software created in 2005 to
simulate a volcanic eruption (see box), which many countries
have used and widely accepted as a tool to improve decision-making.
The current scenario uses multimedia resources (TV, radio, press
releases, etc.) and guides members of an EOC to make decisions
during three phases of a flood emergency: pre-crisis, crisis
and post-crisis. Participants develop contingency plans, conduct
a damage assessment and epidemiological analysis, provide medical
assistance to the injured, conduct sanitary control in shelters,
and deal with the media. Meanwhile, a situation room collects
and processes the data generated. The simulation tests intra-
and intersectoral coordination mechanisms and decision-making
and promotes the creation of a situation room and the work of
the EOC as a key element for disaster management.
Capacity building workshops are not directed exclusively to
health professionals in PAHO/WHO countries. At the request of
several European Union countries, PAHO/WHO organized and carried
out a pilot workshop on emergency preparedness for embassies and
diplomatic missions based in Ecuador. The workshop dealt with
recognizing the characteristics of natural hazards in the country
and the roles and responsibilities of national and international
agencies in disaster response. One of the principal objectives
was to exchange information and improve coordination mechanisms
between UN agencies and donor countries in terms of international
assistance.
All capacity building initiatives in Latin America and the Caribbean
are conducted with the intention of producing a multiplier effect
at the national and eventually at the local level (there is evidence
that this is becoming the case with training for the LSS/SUMA
system and EDAN). Annex 6
contains a list of the major training initiatives conducted in
Latin America and the Caribbean in which PAHO’s Area on
Emergency Preparedness and Disaster Relief had a hand.
Partnerships – Framework Agreements
Partnerships and framework agreements are essential to generating
processes and commitments that extend beyond the political realm
into concrete action. The following examples highlight this approach
to improve health sector disaster risk reduction.
- PAHO/WHO’s health response to disasters
has been strengthened through collaboration with regional entities
such as REDLAC.4 The REDLAC is based in Panama and
comprised of disaster focal points from a number of UN agencies
and NGOs who are headquartered in that country. This proximity
has made for a more coordinated UN response to disasters.
| 4
REDLAC (Risk Emergency and Disaster Task Force for Latin
America and the Caribbean) was established in 2003 on
the recommendation of the UN Inter-Agency Standing Committee.
REDLAC is a regional coordinating mechanism, chaired by
OCHA and made up of focal points from all UN agencies
with regional headquarters based in Panama [the UN Development
Program (UNDP); UNICEF; the Pan American Health Organization,
Regional Office for the Americas of the World Health Organization
(PAHO/WHO); World Food Program (WFP); the International
Strategy for Disaster Reduction (ISDR); and the International
Organization for Migration (IOM), as well as representatives
from the International Federation of the Red Cross and
other major international NGOs]. |
- Joint evaluation meetings were conducted in
Guyana, Suriname and Bolivia following emergencies in 2006 (see
Chapter 3). Despite the need to make
the REDLAC team operational, Latin America and the Caribbean
is the only region that has established such a mechanism, under
the umbrella of OCHA. Attempts are being made to replicate this
arrangement in other parts of the world.
- The Economic
Commission for Latin America and the Caribbean
(ECLAC) and PAHO/WHO have a great deal of collective experience
in assessing the economic and health impact (respectively) of
natural disasters. Now, in collaboration with the Inter-American
Development Bank, a new methodology is being developed to measure
the socioeconomic impact of a potential influenza pandemic.
This new methodology and a set of tools will be field tested
in two countries in the coming months. After making necessary
adjustments, this methodology will be made available, free of
charge, to governments and institutions in the Americas. With
this tool, countries, national disaster systems as well as the
health and other sectors can measure the socioeconomic impact
of losses to the workforce, decreased production, changes in
supply and demand, and other factors associated not only with
an influenza pandemic, but also with other epidemics and health
emergencies.
- In Central America, a number of subregional
activities carried out under framework agreements related to
the Central American Plan for Disaster Reduction were temporarily
put on hold because of changes in governments in 2006. In 2007,
it will be necessary to reposition the health sector in this
subregional context. The Safe Hospitals initiative will serve
as one catalyst for developing and implementing agreements and
norms, in collaboration with the Central American System for
Integration (SICA) and Meeting of the Health Sector of Central
America and Panama (RESSCAP).
In the field of management of hazardous materials and chemical
accidents, Costa Rica’s Ministry of Health and the University
of Costa Rica demonstrated leadership and sponsored a course for
participants from Nicaragua, Guatemala, Honduras and Costa Rica,
with technical input from the WHO Collaborating Center CETESB.
In addition to updating operating procedures and reviewing inter-institutional
coordination response mechanisms, the participants committed to
updating emergency plans, developing a roster of experts on the
topic and organizing follow up training. Health crises caused
by the ingestion of methanol and diethylenglycol (DEG) in Nicaragua
and Panama (respectively), and a fire at a chemical laboratory
in Costa Rica, prompted action in this area.
- Caribbean countries began a review of the regional
Comprehensive Disaster Management
Strategy (CDM), prepared in 2001 under the coordination
of the Caribbean Disaster Emergency Response Agency (CDERA).
The CDM aims to set regional priorities through 2012. Currently
CDERA member countries are looking at achievements and gaps
within the existing strategy. Health was identified as a priority
sector (along with agriculture, tourism and education) and PAHO/WHO
has been called on to lead the health sector review. The expectation
is that the new CDM strategy will provide a platform for collaboration,
coordination and advancement among donors, bilateral and multilateral
organizations, regional and national institutions and the civil
society.
- In 2005, Ministers of Health of the Andean
Region approved a regional disaster plan (2005-10)
that incorporated four strategic approaches: strengthening the
position of the health sector vis-à-vis “safe hospitals,”
knowledge management, inter-country support and international
assistance. Under this umbrella, PAHO/WHO, CRID and the Secretariat
of Andean Community5 are collaborating to develop a network
of disaster information centers in Bolivia, Colombia, Ecuador,
Peru and Venezuela. This network will enable access, exchange
and dissemination of information to aid decision making.
| 5The Andean
Community of Nations (CAN) is comprised of Ecuador, Peru,
Colombia, Bolivia and Venezuela. CAPRADE is the acronym for
the Andean Committee for Disaster Prevention and Response,
the disaster agency for the Andean region and part of the
CAN. PREDECAN
is a disaster prevention project under the auspices of CAPRADE. |
Publications and Multimedia
In 2006, the production of publications and training materials
continued to be a cornerstone of PAHO/WHO’s work. This body
of material responds to the need to strengthen disaster preparedness,
mitigation and response in the health sector. It has been developed
with contributions from experts in PAHO/WHO Member States and
the Organization’s own staff. The production of this material
is always coupled with an active dissemination and distribution
plan so that users have the information they need to take opportune
decisions that reduce the impact of disasters on health.
 A
new edition—the fourth—of the electronic Health
Library for Disasters (HELID) has been developed
in close collaboration with WHO’s Health Action in Crises
Department. More than 20 international agencies have contributed
hundreds of publications and basic reference documents which
are accessible, free of charge, in the most important and up-to-date
electronic library on health, emergencies and disasters currently
available (on both CD-ROM and the Internet). Since the first
edition was launched in 1998, the HELID has become a platform
for collaboration between the disaster programs of WHO and PAHO
and other technical divisions in these agencies, and among UN
agencies such as UNHCR, UNICEF, and ISDR; the Red Cross movement
(IFRC and ICRC); the Sphere Project, and other non-governmental
and national agencies. The new HELID allows easy access to more
than 650 full-text documents, or more than 40,000 scanned pages
of text and 12,000 images, which were selected using practical
and scientific criteria. The CD-ROM makes distribution quick
and economical, particularly when there is limited Internet
access. The HELID’s user-friendly search function makes
it easy to locate technical guidelines, manuals, field guides,
disaster chronicles, case studies, emergency kits, newsletters,
and other training material in English, Spanish or French (a
limited amount of material is even included in Russian). Also
included is the complete collection of the PAHO/WHO newsletter
Disasters: Preparedness and Mitigation in the Americas, now
in its 28th year of publication.
 Technical
publications on topics of special interest,
such as management of dead bodies and damage and needs assessment,
have been reprinted or revised. The field
manual on management of dead bodies, published in 2006 together
with the ICRC and WHO, was revised and several thousand copies
were reprinted. In less than a year, more than 15,000 copies
of this publication have been distributed worldwide. New training
material is currently being developed to train trainers on the
technical content. The manual on damage assessment is also being
revised to adapt the format for data collection to that which
is used by PAHO’s Regional Disaster Response Team. Finally,
new training material on mental health, to complement the book
published at the beginning of 2006, is in the production schedule.
- During 2006, the material and documents used
to support the virtual course
on Public Health and Disasters (see previous
section on Training) was revised and updated. This course was
developed as a pilot project in 2005, in collaboration with
the International Federation of the Red Cross (IFRC) and FLACSO;
it was then given twice during 2006. The course is a clear example
of how virtual training can efficiently complement traditional
classroom-based activities by reaching a broader audience at
a lower cost.
In the Andean Region, several regional documents are being prepared
in the context of a special project to strengthen technical capacity
and coordination in the health sector in Bolivia and Ecuador.
This consolidated package is designed for use at the local level
and includes the following material:
- A comprehensive publication for local health authorities
to prepare contingency plans and develop training activities
on health and water and sanitation.
- A CD compendium of disaster health management experiences/tools/models
that can be replicated at the local level (will also be made
available on Internet).
- Practical guidelines for maintenance directors in health
facilities to assess vulnerability and implement simple mitigation
measures.
- Guidelines for monitoring water quality control.
- Guidelines for reducing the vulnerability of rural drinking
water systems.
In the area of publications and production of multimedia training
material, challenges for 2007 include:
- Preserving and compiling lessons learned from
smaller emergencies, which often go unnoticed by the media and
the international community, but which can be an important challenge
for the affected country, and especially to the health sector
that may face an increased demand or the need for specialized
care. Two examples include the emergencies caused by mass poisoning
in Nicaragua and Panama in 2006.
- The preparation of guidelines and materials
with a more practical focus on decision-making during the response
phase of an emergency to support training activities to consolidate
PAHO’s Regional Response Team.
- A new work plan that will allow for the revision
and realignment of materials published over the last 20 years,
with special emphasis on organizing this body of material into
three major headings: preparedness, safe hospitals and disaster
response.
Information and Knowledge Management
In theory, knowledge management is the process through which
organizations generate value from their knowledge-based assets.
In practice, it involves capturing what we know, indexing it in
some organized and accessible fashion, and distributing or sharing
this knowledge to improve learning and awareness. When it comes
to disaster preparedness and mitigation, there is collective agreement
on the part of PAHO and our stakeholders about the importance
of information and knowledge management (IKM) to improve performance.
The following initiatives have contributed to this:
- The Regional Disaster
Information Center (CRID)
is an inter-agency project that compiles and disseminates disaster-related
information. CRID is located in Costa Rica and its members are:
PAHO/WHO; the International Strategy for Disaster Reduction;
the Costa Rica National Risk Prevention and Emergency Commission;
the International Federation of Red Cross and Red Crescent Societies;
the Coordination Center for Natural Disaster Prevention in Central
America; and Doctors Without Borders. For the past 15 years,
CRID has worked to improve information services regionwide and
generate specialized information resources on emergencies and
disasters. In addition to the its traditional partners, CRID
has developed new partnerships with the European Union’s
Humanitarian Office (ECHO), the U.S. National Library of Medicine,
OCHA and the Andean Community of Nations to broaden the reach
of its work. In 2006, CRID handled requests for information
both on-site at the Center and over the web. CRID’s web
site received 173,000 hits (approximately 14,400 monthly) and
700 monthly information requests. CRID published and distributed
specialized bibliographies on disasters and health related topics
such as disaster myths and realities, avian flu, health and
hurricanes. CRID also produced, edited and distributed training
and technical material and public information; and increased
its database of full-text publications by making accessible
new publications on a wide variety of topics such as safe schools
(the focus of the ISDR World Disaster Reduction Campaign for
2006- 07), global warming and climate change, legislation in
health and disasters, and risk management in municipalities.
CRID has also conducted training on disaster and healthrelated
information management and coordinated with other institutions.
 Networking
disaster information centers. CANDHI
is the Central American Network for Disaster and Health Information,
a project sponsored by PAHO and the US National Library of Medicine.
Its objective is to set up and strengthen a regional network
of disaster information centers in El Salvador, Guatemala, Honduras,
Nicaragua, Panama and Costa Rica to improve access to disaster
and health related information. Central American countries continue
to participate in the CANDHI network, which helps strengthen
national capacity to collect, organize and disseminate technical,
educational and scientific information on health and disasters.
The support given through the CANDHI network has transformed
these knowledge and information centers into well-respected
providers of reliable information; developed and promoted the
use of technology to produce information products and services
and helped to create institutional capacity that has made it
possible to meet the regional demand for information on disasters
and health. Specific achievements include the creation of electronic
libraries in each of the five countries; the training of specialists
in information management and network technology; and, the transformation
of these public institution libraries, which used the support
as a catalyst to grow and gain credibility and support from
their institutions. The members of this network of information
centers, with web sites and contact information is listed in
Annex 7.
In South America, PAHO and CRID are working (with the support
of the PREDECAN project) with the national Civil Defense institutions
in Bolivia, Colombia, Ecuador, Peru y Venezuela to create information
centers with the technical capacity to manage disaster information
and thereby reduce vulnerability. Each Center is promoting a
national network; providing training to standardize the collection,
indexing, management, storage and dissemination of information;
and producing specialized electronic information kits. Activities
began in October 2006 and will continue throughout 2007, using
the CRID’s existing experience, tools and work methodology
to improve the ability of these five countries (which are all
highly vulnerable to disasters) to develop information services
and products. These national information centers will be interconnected
through the Internet, which will significantly increase the
amount and diversity of the information available.
- Every four years PAHO produces Health
in the Americas, its flagship publication, which
analyzes the health situation and the trends in the Region of
the Americas. PED was involved in the design of the contents,
the revision of national chapters and the elaboration of specific
information and knowledge analysis related with emergencies
and disasters. At the outset, when the content was defined,
it was agreed that disasters should be included in the Chapter
II (risks and damage), in Chapter IV (management) and Chapter
V (resource mobilization). The guidelines were sent to the authors
at regional and country level to prepare their respective reports.
All these reports were reviewed by PED/ HQ, in subregional offices
and in selected country offices, to ensure that disaster topics
were appropriately included and that the figures presented were
accurate and from reliable sources.
For the 2007 edition, Health in the Americas will include not
only data and information on disasters but most importantly,
analyze data and trends in the Americas. It will also show the
trends in mitigation and preparedness at country and subregional
levels as well as the resources mobilized through PAHO for humanitarian
assistance in health. This status will provide health decision
makers with key information to review disaster impact on health,
response capacity and the cost benefit of investing in disaster
mitigation and preparedness.
-
 Activities
to promote the dissemination and widespread use of PAHO/WHO
technical publications were stepped up in 2006, thanks to the
publication of a new catalog
(print version) and a completely redesigned
virtual catalog on the web. The latter underwent
a radical change, making it more intuitive, dynamic and easy
to use. Currently PAHO/WHO is working with web managers (more
than 25) in its country offices to ensure that the virtual publications
catalog can be easily accessed, thereby getting the information
to as many people as possible. Work is also underway to increase
the prominence of this information of all Internet search engines.
No amount of preparedness
is too much.
By preparing for worst-case scenarios,
many smaller health crises are averted.
|
 |
|