phases of emergency

Changing priorities in the management of early and late phase emergency response. Case studies from recent complex emercency managed by Red Cross".

Dott. L.E.Pacifici

Phases of EmergencyPhases of Emergency

F. M Burkle Jr (2001) :F. M Burkle Jr (2001) :“Disaster - a “Disaster - a series of catastrophic events that series of catastrophic events that overwhelm the capacity of response of a overwhelm the capacity of response of a community, which result in a threat to community, which result in a threat to both public health and the environment”both public health and the environment”


Sharing of information however is complicated Sharing of information however is complicated not only in the first phase of a disaster but also not only in the first phase of a disaster but also in the post and late emergency phasesin the post and late emergency phases

Post and late emergency phases in particular Post and late emergency phases in particular require that specific attention is dedicated to require that specific attention is dedicated to the surveillance and early detection of the surveillance and early detection of communicable diseasescommunicable diseases

Early identification and specific prevention are Early identification and specific prevention are often the only tools available in order to avoid often the only tools available in order to avoid the development and spread of epidemicsthe development and spread of epidemics


Partnerships between the local Partnerships between the local authorities and international agencies authorities and international agencies are most needed in order to favour are most needed in order to favour coordination, avoiding the overlaps and coordination, avoiding the overlaps and waste of resources that have been waste of resources that have been witnessed in the pastwitnessed in the past

Multi-sector approach to humanitarian Multi-sector approach to humanitarian requires the interaction of different requires the interaction of different professionals and among several professionals and among several organizationsorganizations

The collection of dataThe collection of data The systematic collection of The systematic collection of

information concerning the relative information concerning the relative frequency and impact of disasters frequency and impact of disasters might provide Governments and might provide Governments and various institutions funding various institutions funding assistance with an indispensible assistance with an indispensible instrument for managing it in an instrument for managing it in an optimal manner. There is still, optimal manner. There is still, however, a lack of international however, a lack of international consensus regarding the question consensus regarding the question which is the best method for which is the best method for collecting data during a disaster. collecting data during a disaster.

Health Info System in Situations Health Info System in Situations of Complex Emergencyof Complex Emergency

Epidemiology is the field of medical Epidemiology is the field of medical science that science that deals with the study of deals with the study of the causes,the causes, distribution, and control distribution, and control of disease in populationsof disease in populations

Application of the Health Info System Application of the Health Info System in Situations of Complex Emergencyin Situations of Complex Emergency

The important role of Epidemiology in a The important role of Epidemiology in a multi-sector approach to humanitarian aidmulti-sector approach to humanitarian aid

promoting accountability promoting accountability basis for re-assessment and constant basis for re-assessment and constant

improvement of the activities carried out on improvement of the activities carried out on the fieldthe field

Phases of Emergency and Application Phases of Emergency and Application of the Health Info System in Situations of the Health Info System in Situations

of Complex Emergencyof Complex Emergency

technical advantages can provide in:technical advantages can provide in:

improving and adjusting the improving and adjusting the humanitarian activities to the needs humanitarian activities to the needs of the affected population of the affected population

increasing the overall accountability of increasing the overall accountability of the programs.the programs.

Case Study: Sri LankaCase Study: Sri Lanka

Partnership model developed among Partnership model developed among the Sri-Lankan health authorities, the Sri-Lankan health authorities, the Italian Red Cross and the the Italian Red Cross and the University of Rome on the wake of University of Rome on the wake of the 2004 tsunami the 2004 tsunami


Setting: Setting: • Post-emergency phase of the tsunami Post-emergency phase of the tsunami

that hit south east Asia and the eastern that hit south east Asia and the eastern coasts of Africa on the 26th of coasts of Africa on the 26th of December 2004December 2004

• Sri Lanka was the second most severely Sri Lanka was the second most severely hit country suffering form a partial or hit country suffering form a partial or total destruction of all the buildings total destruction of all the buildings that lay within 2 km from the coast line that lay within 2 km from the coast line in 13 of the 25 districts of the country in 13 of the 25 districts of the country

Sri Lanka and the Establishment of a Sri Lanka and the Establishment of a System of Surveillance of System of Surveillance of Communicable DiseasesCommunicable Diseases

The Partnership ModelThe Partnership Model involves: involves:• Middle income countriesMiddle income countries (Sri Lanka (Sri Lanka

District health authorities) District health authorities) • High income countriesHigh income countries ( The Italian Red ( The Italian Red

Cross - ItRC- in collaboration with the Cross - ItRC- in collaboration with the infectious disease physicians of the infectious disease physicians of the University of Rome “Sapienza”)University of Rome “Sapienza”)

• Unilateral donorUnilateral donor (the ItRC). (the ItRC).

Sri Lanka and the Establishment of a Sri Lanka and the Establishment of a System of Surveillance of System of Surveillance of Communicable DiseasesCommunicable Diseases

Setting: Setting: • Number of casualties amounted 31 141 with Number of casualties amounted 31 141 with

more that 23,000 wounded more that 23,000 wounded • Population of Population of 547 727547 727 IDPs IDPs• WHO: WHO: present risk for the spread of present risk for the spread of

communicable disease for all examined communicable disease for all examined categoriescategories (cholera, thyphoid, shigellosis, (cholera, thyphoid, shigellosis, hepatitis A and E, dengue fever, malaria, hepatitis A and E, dengue fever, malaria, scrub typhus, leptospirosis, acute lower tract scrub typhus, leptospirosis, acute lower tract respiratory infections, measles, meningitis respiratory infections, measles, meningitis and tuberculosis) and tuberculosis)


The policy innovation consisted in the The policy innovation consisted in the introduction of a programme of introduction of a programme of systematic communicable diseases systematic communicable diseases epidemiological surveillance within a epidemiological surveillance within a health assistance project in the health assistance project in the Eastern Province of Sri LankaEastern Province of Sri Lanka

BackgroundBackground politically unstable since 1983 politically unstable since 1983

2004 tsunami 2004 tsunami

ItCR and OXFAM GB: Public Health Course

Course participants during a role playing session.

Sri Lanka Sri Lanka ResultsResults

Two clusters of scabies and acute hepatitis Two clusters of scabies and acute hepatitis were identified and interventions were were identified and interventions were made on both local and district levels made on both local and district levels • ItRC medical teams were deployed in the ItRC medical teams were deployed in the

affected IDP camps acting on affected IDP camps acting on treatment/isolation of cases and prevention treatment/isolation of cases and prevention campaignscampaigns

• Cases were notified according to local lawsCases were notified according to local laws• Coordination meetings were held at district Coordination meetings were held at district

level with health authorities and NGOslevel with health authorities and NGOs• ““Community health” trainings were organized Community health” trainings were organized

for local volunteers in IDP camps.for local volunteers in IDP camps.

Sri Lanka Sri Lanka ResultsResults

No epidemics followed the containment No epidemics followed the containment interventions on the two clusters identified and interventions on the two clusters identified and data collected between August 2005 and March data collected between August 2005 and March 2006 did not show further epidemic clusters2006 did not show further epidemic clusters

Achievement of cooperation and coordination Achievement of cooperation and coordination with all organizations present in the assigned with all organizations present in the assigned area area

Value attribution to existing public health Value attribution to existing public health Capacity building in epidemiological Capacity building in epidemiological

surveillance applied to public health surveillance applied to public health • Included potable water control at distribution points Included potable water control at distribution points

Sri Lanka :Sri Lanka :ResultsResults

Sri Lanka:Sri Lanka:ConclusionsConclusions

Connection between clinical assistance Connection between clinical assistance and public health programmes allowed and public health programmes allowed the implementation of rapid containment the implementation of rapid containment strategies avoiding the spread of strategies avoiding the spread of communicable diseases in poor hygiene communicable diseases in poor hygiene settings settings

Coordination achieved with the divisional Coordination achieved with the divisional health authorities and NGOs increased health authorities and NGOs increased accountability and strengthened the accountability and strengthened the relationship with the host country. relationship with the host country.

Haiti and Early WarningHaiti and Early Warning

Assessment in Port de Paix. The Assessment in Port de Paix. The purpose of this assessment is to purpose of this assessment is to evaluate the possibility to deploy the evaluate the possibility to deploy the ERU – BHC coordinated by Spanish ERU – BHC coordinated by Spanish and French Red Cross. and French Red Cross.

16 th Sept. 2008. 16 th Sept. 2008.


NGOs in Port de PaixNGOs in Port de Paix From an informal source of information, From an informal source of information,

the NGOs in Port de Paix are:the NGOs in Port de Paix are: CaritasCaritas CARECARE Action contre la Faim.Action contre la Faim.

Action contre la Faim works in Action contre la Faim works in Community disaster preparedness: Community disaster preparedness: ““GESTION DES RISQUES »GESTION DES RISQUES »..


After the hurricane 2000 people were After the hurricane 2000 people were evacuated from market area to evacuated from market area to suburbs.suburbs.

The region is very poor and there is not The region is very poor and there is not every livelihood activities. Since ten every livelihood activities. Since ten month ago in Port de Paix there is very month ago in Port de Paix there is very often a lack of electricity. After the often a lack of electricity. After the hurricane there is a shortage of fuel.hurricane there is a shortage of fuel.


The all District population is 525.367 The all District population is 525.367 inhabitants and 250.000 in Port de Paixinhabitants and 250.000 in Port de Paix

The health district is organised with one The health district is organised with one Public Hospital and dispensaries. The Public Hospital and dispensaries. The Public Hospital provides services in Public Hospital provides services in MedicineMedicine SurgerySurgery GynaecologyGynaecology PaediatricsPaediatrics EmergencyEmergency


“ “ There could be an increase of There could be an increase of diarrhoeal cases due to the bad diarrhoeal cases due to the bad hygiene and water conditions. For hygiene and water conditions. For this reason could be recommended a this reason could be recommended a midmid-long term project based on -long term project based on Prevention and Health Prevention and Health PromotionPromotion.”.”

The The Good GovernanceGood Governance for the for the reduction of disasters can exist only reduction of disasters can exist only there where there is an adequate there where there is an adequate space for the participation of the space for the participation of the various various stakeholdersstakeholders, including the , including the vulnerable community, the State, the vulnerable community, the State, the civil society, volunteers, the civil society, volunteers, the volunteering organizations, and volunteering organizations, and other partners in the sector of other partners in the sector of developmentdevelopment

Health as a Bridge for Health as a Bridge for Peace (WHO)Peace (WHO)

““The project of HBP is based on the idea The project of HBP is based on the idea that the common concern regarding the that the common concern regarding the fundamental sanitary questions shall fundamental sanitary questions shall stand in the focus of the process of stand in the focus of the process of negotiation “negotiation “

““Sanitary questions transcend political, Sanitary questions transcend political, economical, social and ethical divisions economical, social and ethical divisions between people and provide a link for a between people and provide a link for a dialog on multiple levels”dialog on multiple levels”

(Guerra de (Guerra de Macedo,1994).Macedo,1994).

HEALTH AND PEACEHEALTH AND PEACE

• During the 80’s, the tie between During the 80’s, the tie between health and peace has found health and peace has found expression through a series of expression through a series of different players.different players.

• During the years of the war in El During the years of the war in El Salvador, the UNICEF has organized Salvador, the UNICEF has organized repeatedly temporary ceasefires to repeatedly temporary ceasefires to allow the vaccination of the children.allow the vaccination of the children.

phases of emergency

Documents

health info system

country sri lanka

srilankan health authorities

sri lankasetting

late emergency phases

public health

sri lankapartnership

late phase emergency