Strengthening emergency preparedness through the WHO emergency medical team mentorship and verification process: experience from Thailand.

The World Health Organization (WHO) emergency medical team (EMT) mentorship and verification process is an important mechanism for providing quality assurance for EMTs that are deployed internationally during medical emergencies. To be recommended for classification, an organization must demonstrate compliance with guiding principles and core standards for international EMTs and all technical standards for their declared type, in accordance with a set of globally agreed minimum standards. A rigorous peer review of a comprehensive documentary evidence package, combined with a 2-day verification site visit by WHO and independent experts, is conducted to assess an EMT's capacity. Key requirements include having sufficient systems, equipment and procedures in place to ensure an EMT can deploy rapidly, providing clinical care according to internationally accepted standards, being able to be fully self-sufficient for a period of 14 days and being able to fully integrate into the emergency response coordination structure and the health system of the country affected during deployment. Through the WHO mentorship programme, each EMT is provided with a mentor team, which guides and supports it during the preparatory process. The process typically takes around 1 to 2 years to complete. The Thailand EMT is the first team from the WHO South-East Asia Region to successfully complete the WHO mentorship and verification process. The experience of this process in Thailand can serve as an example for other countries in the South-East Asia Region and encourage them to strengthen their emergency preparedness and operational readiness by getting their national EMTs verified.

Assessment of drought resilience of hospitals in Sri Lanka: a cross-sectional survey.

Background: Drought is an extreme weather event. Drought-related health effects can increase demands on hospitals while restricting their functional capacity. In July 2017, Sri Lanka had been experiencing prolonged drought for around a year and data on the resilience of hospitals were required. Methods: A cross-sectional survey was done in five of the most drought-affected and vulnerable districts using two specially developed questionnaires. Ninety hospitals were assessed using the Baseline Hospital Drought Resilience Assessment (BHDRA) tool, of which 24 purposefully selected hospitals were also assessed using the more detailed Comprehensive Hospital Drought Resilience Assessment (CHDRA) tool and observation visits. Results: Of the hospitals assessed, 73 and 77 reported having adequate supplies of drinking and non-drinking water, respectively. Of the 24 hospitals studied using the CHDRA tool, bacteriological water quality testing was done in 8, with samples from only 4 hospitals being satisfactory. Adequate electricity supply was reported by 77 hospitals, of which 72 had at least one generator. None of the hospitals used rainwater or storm water harvesting, water recycling, or solar or wind power. Of the 24 hospitals selected for detailed analysis, awareness materials on safeguarding water or electricity and avoiding wasting water or electricity were displayed in only 6 hospitals; disaster preparedness plans were available in 9; and drought was considered as a hazard only in 6. Conclusion: The findings indicate that drought needs to be considered as an important hazard in hospital risk assessments. Drought preparedness, response and recovery should be embedded in hospital disaster preparedness plans to ensure the continuity of essential health services during emergencies.

Building operational readiness for responding to emergencies in the WHO South-East Asia Region.

The World Health Organization (WHO) has an essential role to play in supporting Member States to prepare for, respond to and recover from emergencies with public health consequences. Operational readiness for known and unknown hazards and emergencies requires a risk-informed and structured approach to building capacities within organizations such as WHO offices and national ministries of health. Under the flagship priority programme on emergency risk management of the WHO Regional Office for South-East Asia, a readiness training programme consisting of four modules was implemented during 2017-2018, involving staff from WHO country offices as well as from the regional office. The experience of and lessons learnt from designing, developing and delivering this phased training programme have fed into improvements in the curriculum and training methodology. The training programme has also facilitated the development of business continuity plans and contingency plans in some of the 11 Member States of the region and has increased the readiness of WHO staff for swift deployment in recent emergencies. It is recommended that the strengthening of operational readiness for responding to emergencies in the region be sustained and accelerated through the development of a regional training consortium that can scale the training programme up at national level, taking into account country contexts, national health systems and the needs of populations. The resilience of the populations and health systems in the region will be increased if disaster risk reduction and emergency preparedness and response activities are supported by operational readiness.

Health Consequences of Typhoon Haiyan in the Eastern Visayas Region Using a Syndromic Surveillance Database.

INTRODUCTION: Typhoon Haiyan was the strongest storm recorded in Philippine history. Surveillance in Post Extreme Emergencies and Disasters (SPEED) was activated during the typhoon response. This study analyzes the health impact of different diseases during different timeframes post-disaster during Typhoon Haiyan in 2013 using a syndromic surveillance database. METHODS: SPEED reports medical consultations based on 21 syndromes covering a range of conditions from three syndrome groups: communicable diseases, injuries, and non-communicable diseases (NCDs). We analyzed consultation rates for 150 days post-disaster by syndrome, syndrome group, time period, and health facility type for adults as well as for children under the age of five. RESULTS: Communicable diseases had the highest consultation rates followed by similar rates for both injuries and NCDs. While communicable diseases were the predominant syndrome group for children, wounds and hypertension were common syndromes observed in adults. Village health centers had the most consultations amongst health facilities, but also showed the highest variability. DISCUSSION: Children were more vulnerable to communicable diseases compared to adults. Community health centers showing consistently high consultation rates point out a need for their prioritization. The predominance of primary care conditions requires disaster managers to focus on basic health care and public health measures in community health centers that target the young, elderly and impoverished appropriate to the time period.

Post-disaster health impact of natural hazards in the Philippines in 2013.

BACKGROUND: In 2011, the Health Emergency Management Bureau (HEMB) created the Surveillance for Post Extreme Emergencies and Disasters (SPEED), a real-time syndromic surveillance system that allows the early detection and monitoring of post-disaster disease trends. SPEED can assist health leaders in making informed decisions on health systems affected by disasters. There is a need for further validation of current concepts in post-disaster disease patterns in respect to actual field data. This study aims to evaluate the temporal post-disaster patterns of selected diseases after a flood, an earthquake, and a typhoon in the Philippines in 2013. METHODOLOGY: We analyzed the 21 syndromes provided by SPEED both separately and grouped into injuries, communicable diseases, and non-communicable diseases (NCDs) by calculating daily post-disaster consultation rates for up to 150 days post-disaster. These were compared over time and juxtaposed according to the type of disaster. RESULTS: Communicable diseases were found to be the predominant syndrome group in all three disaster types. The top six syndromes found were: acute respiratory infections, open wounds, bruises and burns, high blood pressure, skin disease, fever, and acute watery diarrhea. DISCUSSION: Overall, the results aligned with the country's morbidity profile. Within 2 months, the clear gradation of increasing syndrome rates reflected the severity (flood

Panel 2.7: first 30 days: organizing rapid responses.

This is a summary of the presentations and discussion of Panel 2.7, First 30 Days: Organizing Rapid Response of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to organizing rapid responses as pertain to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) issues; (2) key questions; and (3) recommendations.

Strengthening community-based initiatives for health emergency management.

An analysis of the situation of health emergencies in the Western Pacific Region and how the World Health Organization (WHO) has provided support to member states is presented in the paper. Emergency and Humanitarian Action is one of the youngest programmes of the WHO Regional Office for the Western Pacific. Despite its organizational size and budgetary limitations, it has endeavored to adequately respond to regional needs for preparedness and response. The paper further looks into approaches for strengthening preparedness, collaboration, and action for disasters and how a community-based approach should offer the best preparedness and response alternative for the region. Examples of country efforts are included. Community-based initiatives are taken as integral components of public health efforts for health emergency management. Thus, public health plays a very crucial role in emergencies.