1. Emergency Response in Health Sector First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

2. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman At the end of the session, the participants will be able to: 1.Define common terminologies in emergency management 2. Relate Emergency Response in the Emergency Management Framework 3.Describe Emergency Response Operation 4.Explain the roles of the health sector in managing the risks during response operations 5.Discuss the role of the Emergency Operation Center in managing the emergency Learning Objectives:

3. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Q & A 1.Define Emergency 2. Differentiate Emergency from Disaster 3.What is Emergency Response 4.What is Emergency Management 5.Define Health Sector

4. Emergency Response First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  the process of responding to any type of emergency situations that can threaten the human and safety of the public  These are dealt with differently based on the type of emergency  The main aim of emergency response is to mitigate the effect of an emergency on human life and property

5. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Emergency Management Framework Emergency/Disaster Preparedness Response Recovery Prevention Mitigation

6. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Emergency Management  building, utilizing and restoring capacities employed in addressing the actual threat to public health and safety  address all aspects of emergencies, in particular preparedness, response and early recovery steps  Involves plans, structures and arrangements established to engage the normal endeavors of government, voluntary and private agencies in a comprehensive and coordinated way to respond to the whole spectrum of emergency needs.

7. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman In Emergency Response there are two basic concerns to be addressed: 1.Managing the risks 2.Managing the incident

8. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman I. Managing the Risks

9. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman What are the Risks? Typhoon (Hazard) Vulnerable Community PeopleProperties Environment Livelihood Services Risks

10. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Exercise 1: What will be the impacts or risks of typhoon to the community?

11. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 1. What are the risks? Group the participants Group 1: List the risks to people Group 2: List the risks to properties Group 3: List the risks to environment Group 4: List the risks to services Group 5: List the risks to livelihood Exercise 1

12. Risks to people : First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  injuries like wounds, fractures, etc.  drowning  burns  disabilities  diseases  psychological disorder  displacement  deaths

13. Risks to properties : First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  damaged buildings and structures  damaged hospitals  damaged schools  damaged electric and telephone lines  destroyed houses  damaged transport vehicles  damaged bridges  damaged water sources and toilets

14. Risks to services : First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  disrupted health services  disrupted education  paralyzed transportation  bogged down communication  electrical brown outs or power shortage  lack of water supply  lack of food supply

15. Risks to environment : First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  poor sanitation  air pollution  water contamination  poor sewage disposal  etc. Risks to livelihood :  closure of business  no work  loss of job

16. 2. Who will manage the risks? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Exercise 2  What are your response actions to manage the 5 categories of risks?  Who will be the people responsible for the response actions?  What are the response services needed?  Who are the responsible response agencies? RisksResponse Actions Responders (People) Response Services Response Agencies

17. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman What are the services of the Health Sector in emergencies?  Casualty management (first aid, triage, transport, pre hospital care, in-patient care, out-patient care)  Communicable disease control (surveillance, tracking, treatment, prophylaxis, isolation and quarantine)  Management of the dead (Disaster victim identification)  Environmental health measures (water, sanitation, environmental pollution)  Psychosocial services (Psychological First Aid, etc)  Health information (Provision of reports, updates, etc)  Management of health risks (risk assessment, mitigation, communication, preparedness and response leadership)

18. Q & A First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman What is Health Sector?

19. Definition: Health Sector First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  A part of the economy dealing with health-related issues in society  a division, or a collective aspect of a geographical area, an economy or a society dealing with health-related issues

20. Exercise 3 First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  Revisit the Response agencies you have listed in Exercise 2  Who are the members of the Health Sector in Oman?

21. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Emergency Response Operation  Measures undertaken in responding to emergencies  Includes operationalization of appropriate emergency management systems and procedures  Emergency Response Operation involves  responsibilities  management structures  resource and information management  SOPs  ERO focus on protecting life, property, essential services delivery and the environment

22. 3. How will you manage the risks? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager on the first 24 to 72 hours? Priority ActivitiesServices NeededConcerned Agencies Exercise 4-A:

23. Exercise 4-B : First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager after the first week? Priority ActivitiesServices neededConcerned agencies

24. Exercise 4-C : First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager on the after one month? Priority ActivitiesServices neededConcerned Agencies

25. Exercise 4-D : First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager on the after three months? Priority ActivitiesServices neededConcerned Agencies

26. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Health Roles in Managing Risks Over Time stage time- frame general needshealth needs immediate first 24 hours search and rescue evacuation / shelter food water public information system first aid triage primary medical care transport / ambulances acute medical and surgical care emergency communication, logistics and reporting systems (including injury and disability registers) short- term end of first week security energy (fuel, heating, light, etc.) environmental health services for: vector control personal hygiene sanitation, waste disposal etc. emergency epidemiological surveillance for Vector Born Disease, Vaccine Preventable Disease, Diseases of Epidemic Potential control of disease of public health significance control of acute intestinal and respiratory disease care of the dead general curative services nutritional surveillance and support (including micronutrient supplementation) measles vaccination and Vitamin A

27. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Health Roles in Managing Risks stage time- frame general needshealth needs medium term end of first month protection (legal and physical) employment public transport public communications psychosocial services (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 long termend of 3 months education agriculture environmental protection reconstruction and rehabilitation specific training programmes health information campaigns / health education programmes disability and psychosocial care conclusioncompensation / reconstruction evaluation of lessons learned restitution / rehabilitation revision of policies, guidelines, procedures and plans prevention and preparedness upgrade knowledge and skills, change attitudes

28. II. Managing the Incident (Emergency Operation Center) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

29. Q & A First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  What is an Emergency Operation Center?  What is the purpose of EOC?  What are the roles of EOC in Incident Management?

30. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Emergency Operation Center  a place, activated for the duration of an emergency, within which personnel responsible for planning, organizing, acquiring and allocating resources and providing direction and control can focus these activities on responses to the emergency Purpose of EOC:  to provide a place to manage the health sector’s contribution to an emergency

31. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 31 Roles of EOC 1.Support site (ICP): logistical support and policy direction to site-level 1.Use standard functions - Protect response personnel and resources 1.Mobilize extra resources and coordinate 1.Minimize loss of life, disability and suffering 1.Protect public health 2.Protect civil infrastructure, environmental and economic assets, including property 3.Reduce economic losses

32. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Organizational Structure Policy Management Communications Safety/ risk mgmt Liaison officer Operations Planning Logistics Administration Supports Management and Operations Management Support staff Develops goals and objectives Accomplishes Goals and objectives

33. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Elements are both functional and structural  Policy  Management  Operations  Planning  Logistics  Administration

34. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Draw personnel from appropriate agency operations  Policy group: Elected officials; chief medical officers; chairs of boards or board committees; legal advisors; chief executive, operating, administrative or financial officers; senior department heads  Management: Chief executive, operating or administrative officers; emergency program coordinators or planners; communications officers; safety officers; risk managers  Operations: Division and department heads with programmatic responsibility relevant to the emergency, who can work directly with the incident manager

35. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  Planning: program and emergency planners; analysts; subject matter experts  Logistics: staff from purchasing departments; information technology and systems support; human resources officers  Administration: financial officers, accounts and contracts processing personnel; financial analysts; administrative assistants; clerks Draw personnel from

36. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Competent staff  An EOC needs skilled people who will work together  Functional familiarity through regular job  Oriented and trained to the EOC role  Good team players

37. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 37 EOC preparedness plan  purpose of the plan  concept of operations, management structure, roles of personnel and how the components work together  Activation procedures and levels, and who has authority  Escalation and de-escalation plan  Call-out list and notification procedures  Procedures /SOPs (resources mobilization and allocation, etc.)  Communications  Information management

38. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 38 EOC preparedness plan  Checklists of the roles and responsibilities of EOC functions  Checklists of standard operating procedures  floor plan, with inventory and locations of equipment and supplies  Electronic information management processes (including a layout plan of phone, fax, data lines, cables, switches and outlets)  Communication resources and procedures, especially mobile phones and radios  Public information and warning processes

39. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 39 EOC preparedness plan  Procedures for engaging levels of government and/or a superior jurisdiction  Standard forms and instructions for documenting EOC activities  Maps of the area of the event  Guidelines for worker care and safety  agency and position responsible for maintaining and updating the plan  Training and exercise schedule to ensure staff and procedures are up-to-date.

40. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Physical attributes of an EOC Two primary considerations:  Location, including access, security, proximity to partners  Facility, including size, amenities and configuration

41. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Location  Is there an emergency management agency that could sponsor it?  Proximity to partners, stakeholders, donors and humanitarian agencies  Is some integration with the broader emergency management infrastructure of the jurisdiction possible.  Can the facility survive the hazards in the area?  Is it accessible in an emergency?

42. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Exercise 5: The destructive typhoon has hit the City X. Reports say That there are 2, 000 affected families, 500 injuries, 100 Deaths. The Head of MOH has ordered to establish an Emergency Operation Center near the disaster site. 1.You have to convert the available space into EOC 2. Draw a schematic diagram or floor plan of your EOC

43. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Facility  a dedicated, purpose-built Health EOC is relatively rare except at the level of national governments  a dual or multi-purpose EOC, where the space is routinely used for some other purpose is more common  If contemplating dual use space, consider: o convert and activate the space as an EOC in less than one hour, o appropriate security measures can be put in place in the same time o facility should meet the basic requirements of disaster survivability and access o sufficient space for personnel and equipment required to run it. o a mix of open and closed work space.

44. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  Size and configuration o There are no standards except for staff safety o evaluate the scale of likely events o size depends on people depends on event size o make form follow function o Must provide space for: core functions (management, operations, planning, logistics and administration) Policy group intermittently when required A communications and message centre Break-out/meeting rooms Rest and eating areas Storage Media relations/public information. (may be off-site)

45. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman  Useful considerations: o the EOC Director should be positioned so that they can easily oversee operations. o Functions that are interdependent should be co- located o Locate functions adjacent to any displays that pertain to their activity o A separate, quiet meeting room for priority setting discussions, management briefings, etc. o If a high volume of incoming communication is anticipated, a separate message centre in the communications room is desirable o All entrances and exits must be secure at all times. o Food and rest areas should be away from the main area, and food handling practices and storage facilities should meet the highest public health standards

46. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Building and resources:  If staff sleep on site, segregated sleeping facilities will be required, along with enhanced facilities including water and sewage systems  Heating, ventilation and air conditioning and emergency power systems scaled for the extra burden of some crowding heat-producing office equipment.  Furnishings may be fixed or movable, with movable, ergonomically suitable furniture offering greater flexibility  The facility should support generous use of communications technologies,  There should be a facility floor plan that identifies the workstations and maps the wiring and equipment at each station.

47. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Office equipment and supplies  office equipment and supplies should, to the extent possible, be identical to that which the assigned personnel normally use in their daily work.  Where computers are used, there should be a back-up pen and paper system systems for documentation and reference, in the event of a system failure.  Information displays, if electronic or projected, should be backed up by manual systems (flipcharts, whiteboards)  Information is the lifeblood of an EOC. Use all the possible display space.  At least one television and radio tuned to the local media

48. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Redundancy  have back-up plans for technological failures within the EOC  have an alternate site for the EOC itself, in the event that circumstances make the designated facility uninhabitable.  the alternate site may not fully satisfy all the requirements  rely on moving some of the equipment, along with personnel from the primary site.

49. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Learning Objectives: At the end of the session, the participants will be able to: 1.Define common terminologies in emergency management 2. Relate emergency Response in the Emergency Management Framework 3.Describe Emergency Response Operation 4.Enhance their awareness on the roles of the health sector during response operations

50. “An effective emergency management will prevent the escalation of the incident into a disaster” First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

51. Thank You First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman