1. Hospital Safety in Tajikistan Experience to date Ms. Rahima Mukairshoeva WHO, Tajikistan Government of Japan

2. Hospital Safety in Tajikistan Experience to date Date of presentation Examples of Important Events Cold crisis 2007 – 08 related to extreme weather conditions and infrastructure weaknesses Floods / earthquake – (Khuroson 09, Vanj 10 and Tavildara 12) Polio (2010) outbreak and H1N1 Conflict (military operations in Rasht and GBAO) Impact Contraction of service delivery Overwhelm facility and system capacities Infrastructure (system) failures

3. Hospital Safety in Tajikistan Experience to date Date of presentation Hospital safety levels in Tajikistan 33 of the 83 central level hospitals assessed to date 57% (19) category C 42% (14) category B Over half of the hospitals likely need urgent measures to protect occupants and maintain operations in crisis All hospitals need measures taken to improve safety conditions to a reasonable level Weaknesses and gaps exist in all areas of concern (structural, non-structural and operational)

4. Hospital Safety in Tajikistan Experience to date Date of presentation Impact and focus of joint actions taken Combined approach: HSI and PHEM course –Assessment Risk Awareness Planning District level planning informs National level planning Local priorities direct Hospital improvements Operational and management capacity gaps addressed Practical training focused on Incident Command System (ICS) use and Mass Casualty Management MoH Emergency Situations department fully engaged with local level planning and coordinates implementation Hospital safety made a priority in the National Health Strategy

5. Hospital Safety in Tajikistan Experience to date Date of presentation Future plans and needs Holistic approach Collaboration with District government planning Joint agency programming Practical training and field exercises EMS development