1. Health Emergency Risk Management Pir Mohammad Paya MD, MPH,DCBHD Senior Technical Specialist Public Health in Emergencies Asian Disaster Preparedness Center

2. Outline Definition of Public Health Essential Public Health Functions General effects of Disaster on Health Health Emergency Risk Management Community Disaster Hazard Vulnerability Capacity Preparedness Programs Steps in Responses Services in emergencies

3. WHAT IS PUBLIC HEALTH? Public health (PH) is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" (1920, C.E.A. Winslow)

4. Essential Public Health Functions

6. Health Emergency RISKs MANAGEMENT... is a comprehensive strategy for reducing threats and their consequences to public health and safety of communities by: Preventing exposure to hazards (target = hazards) Reducing vulnerabilities (target group = community) Developing response and recovery capacities (target group = response agencies)

7. A Community Consists of 5 Elements

8. What do you think?

9. 1918-19

11. Disaster A serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources.

12. What is this?

13. A Hazard is A dangerous phenomenon, substance, human activity or condition that may cause loss of life, injury or other health impacts, property damage, loss of livelihoods and services, social and economic disruption, or environmental damage

14. Types of Hazards There are 4 classes of hazards:

15. An Emergency is any actual threat to public health and safety any actual threat to public health and safety

16. The difference Hazard Event Damage Emergency Needs Changes in Function Local response Outside response Disaster An EMERGENCY is the occurrence of an event that can be handled by local response A DISASTER is the occurrence of an event that cannot be handled by local response and requires outside actors

17. What do you think?

18. Vulnerability is the characteristics and circumstances of a community, system or asset that make it susceptible to the damaging effects of a hazard.

19. Factors influencing human vulnerability/Determinants of Health Risks

20. Capacity The combination of all the strengths, attributes and resources available within a community, society or organization that can be used to achieve agreed goals.

21. Risks are: The probability AND the consequences of exposure to a hazard Risk Hazard x Vulnerability Capacity (for response and recovery) 

22. Risk Analysis Process Community HazardsxVulnerabilities/Capacities  Risks Risk initiatorRisk Modifier Indicators Hazards - Natural - Biological - Technological - Societal People - Density and growth - Vulnerable groups / gender Multi-sectoral collaboration Contingency planning All-hazard approach Emergency Preparedness - Deaths - Injured - Displaced - Affected - Damage to infrastructure - Loss of property - Secondary hazards - Security Property - Emergency and health infrastructure Legislation Management structures Administrative procedures Technical guidelines Institutional arrangements Information systems Warning systems Resources Education and research Training and simulation Participation Private sector collaboration Probability & Scale - magnitude - intensity - area - spread - duration Services - Fire stations, vehicles, equipment - Hospitals and ambulances - Schools and community centers Livelihoods -Employment -Income sources Environment and resources -Water, soil, air quality - Forestry, agriculture PREVENTION MITIGATION + VULNERABILITY REDUCTION + EMERGENCY PREPAREDNESS = RISK MANA- GEMENT

23. Hazardous events have potential negative consequences

24. Preparedness Programs Preparedness is: A long term institutionalised program of measures to build capacities to prevent, mitigate, respond to and recover from emergencies A program has: A visible place in the organisational chart Full time staff A regular budget An annual work PLAN Preparedness is not a PLAN, it is: A program WITH A PLAN!

25. 10 indicators of preparedness National, provincial, local, agency and institutional level Personal and community level

26. Health Emergency Managers primarily concerned with protecting public safety and public health Our clients are threatened and injured / damaged communities are

27. THANK YOU

28. Additional Slides

29. Aims of Risk Communication meaningful, relevant, accurate and timely information  Provides meaningful, relevant, accurate and timely information on how to  prepare for,  protect against,  respond to,  or recover from the risk advocacy  For advocacy and policy development wasting of resources  Help prevent misallocation and wasting of resources decrease illness, injuries and deaths  Can decrease illness, injuries and deaths

30. Different communication objectives For each stage of the disaster, there is a different informational need of the different audiences Different messages

31. Communication Objectives Preparedness Prevention Mitigation Behavior change Advocacy for policy and structural reforms Community organization and mobilization Public Information and education Pre-Crisis Stage

32. Crisis Stage Reduce injury, illness and death Information and education Behavior change Social mobilization Process/effect/impact documentation Process/effect/impact documentation

33. Post Crisis Stage Counseling Behavior change Public information and education Process documentation Process documentation Social mobilization Recovery/Rehabilitation

34. General context of emergency management Source of risks Hazards Prevention Mitigation Preparedness Response Recovery Risks identification Risks Evaluation Prioritization Risk Reduction Monitor and review communicate and consult Elements exposed - community Probability - likelihood Harmful consequences Risks analysis Levels of risks Options identification, selection, implementation Capacity development Overall policy and political commitment 1 2 3 4 5 6 7 8 Steps for Readiness

35. Service Needs in an Emergency