HEALTH RELATED ISSUES IN HEALTH RELATED ISSUES IN DISASTERSDISASTERS
Knowledge comes, but wisdom Knowledge comes, but wisdom lingers ( Tennyson)lingers ( Tennyson)
Pan American Health OrganizationPan American Health Organization(PAHO)(PAHO)
• Established in 1902Established in 1902• 35 Member Governments35 Member Governments• 3 Participating European Governments3 Participating European Governments• PAHO serves as regional office for WHOPAHO serves as regional office for WHO
Program on Emergency Program on Emergency Preparedness and Disaster ReliefPreparedness and Disaster Relief
Pan American Health Organization /Pan American Health Organization /
World Health OrganizationWorld Health Organization
PAHO / WHO PAHO / WHO
NATURALNATURALDISASTERSDISASTERS
OTHERSOTHERSVOLCANICVOLCANICERUPTIONSERUPTIONS
HURRICANESHURRICANESFLOODSFLOODS
EARTHQUAKESEARTHQUAKESLANDSLIDESLANDSLIDES
TECHNOLOGICALTECHNOLOGICALDISASTERSDISASTERS
OTHERSOTHERSCHEMICALCHEMICALACCIDENTSACCIDENTS
EXPLOSIONSEXPLOSIONS
FIRESFIRES
AIRCRAFTAIRCRAFTACCIDENTSACCIDENTS
RADIATIONRADIATIONACCIDENTSACCIDENTS
““COMPLEX”COMPLEX”DISASTERSDISASTERS
Refugees, IDPRefugees, IDP
ARMEDARMEDCONFLICTSCONFLICTS
CIVILCIVILSTRIFESTRIFE
Latin America and the Caribbean move from Latin America and the Caribbean move from Ad Hoc Disaster Response to PreventionAd Hoc Disaster Response to Prevention
Disasters andDisasters andDevelopmentDevelopment
Mitigation andMitigation andPreparednessPreparedness
PreparednessPreparednessand Responseand Response
ResponseResponse19761976
EarthquakeEarthquakein Guatemalain Guatemala
19851985EarthquakeEarthquakein Mexicoin Mexico
19901990IDNDRIDNDR
Program ObjectivesProgram Objectives
Before a DisasterBefore a Disaster After a DisasterAfter a Disaster
Prevention,Prevention,Mitigation,Mitigation,PreparednessPreparedness
CoordinationCoordinationof Internationalof International
AssistanceAssistance
Before a disasterBefore a disaster
• Building national capacity through Building national capacity through training( standardized but adapted to local training( standardized but adapted to local context)context)
• Strengthening Ministry of Health disaster Strengthening Ministry of Health disaster programsprograms
• Special projects:Special projects:• Promote Hospital mitigationPromote Hospital mitigation• SUMASUMA• CRIDCRID
Human Resources Development , Human Resources Development , not stockpiling equipment, is the not stockpiling equipment, is the
key to Preparedness . . .key to Preparedness . . .
University trainingUniversity training
Workshops/Workshops/short coursesshort courses
The National Health DisasterThe National Health DisasterProgram must:Program must:
• encompass encompass entireentire health sector health sector• lead the health sector in disaster lead the health sector in disaster
prevention, mitigation, preparedness, prevention, mitigation, preparedness, response, early rehabilitationresponse, early rehabilitation
• have a multi-hazard scope (natural, have a multi-hazard scope (natural, technological, “complex” disasters)technological, “complex” disasters)
• coordinate with other sectorscoordinate with other sectors
Strengthening Institutions
Belize Karl Heusner Hospital
Hurricane Keith Photo Tony Gibbs
Photo Tony Gibbs
The WHO/PAHO standardized The WHO/PAHO standardized methodology and tool to manage methodology and tool to manage large amounts of humanitarian large amounts of humanitarian
supplies.supplies.
Regional Disaster Information Regional Disaster Information CenterCenter
• 12,000 documents on disaster-related topics12,000 documents on disaster-related topics
• ““THE” source of material in SpanishTHE” source of material in Spanish
• Internet AccessInternet Access
PAHO/WHO Cooperation in PAHO/WHO Cooperation in DisastersDisasters
• Coordinates International Health AssistanceCoordinates International Health Assistance
• Provides Technical Cooperation in healthProvides Technical Cooperation in health
• Assist with rapid needs assessmentAssist with rapid needs assessment
• Coordination with Foreign Affairs, Ministry of Coordination with Foreign Affairs, Ministry of Health, National Disaster Agency, UN Org.’sHealth, National Disaster Agency, UN Org.’s
External assistance post disasterExternal assistance post disaster
PAHO/WHOPAHO/WHO
European Union/European Union/ECHOECHO
OASOAS
SICA/SICA/CEPREDENACCEPREDENAC
ConvenioConvenioHipólito UnánueHipólito Unánue
(CHU)(CHU)
CDERACDERA
CanadaCanada USAUSA
United KingdomUnited KingdomNordicNordic
countriescountriesNetherlandsNetherlands
FranceFrance
JapanJapan
DHA/UNDPDHA/UNDP
WFPWFP
WHO/WHO/PAHOPAHO
UNICEFUNICEF
UNFPAUNFPA
UNHCRUNHCROXFAMOXFAM
MSFMSF
CARECARECRSCRS
Local NGOLocal NGOPADFPADF
Red CrossRed CrossNational SocietiesNational Societies
IFRCSIFRCS
ICRCICRC
Assistance to disaster affected Assistance to disaster affected countrycountry
• Japan, UK, USA/OFDA, Red Cross, ICRC, Japan, UK, USA/OFDA, Red Cross, ICRC, UNDP, CARE, MSF, UNDAC. CIDAUNDP, CARE, MSF, UNDAC. CIDA
• The Netherlands,ECHO, ICRC, local NGO, The Netherlands,ECHO, ICRC, local NGO, IFRC, OXFAM, OCHA, CDERA, RSS, IFRC, OXFAM, OCHA, CDERA, RSS, CARICOM, OAS, CARICOM, OAS,
SUB-REGIONAL AGENCIESSUB-REGIONAL AGENCIES
• CDERA/CEPREDENACCDERA/CEPREDENAC• RSSRSS• PAHOPAHO• Federation of the Red CrossFederation of the Red Cross• OFDAOFDA• AgreementsAgreements
National Support NetworkNational Support Network
• HealthHealth Disaster Focal Points Disaster Focal Points– Ministries of HealthMinistries of Health– PAHO/WHOPAHO/WHO
• Disaster Focal Points Disaster Focal Points – Foreign Affairs ,UN agenciesForeign Affairs ,UN agencies
The principles of CoordinationThe principles of Coordinationand national responsibilityand national responsibility
• Generating reliable InformationGenerating reliable Information• Developing technical experienceDeveloping technical experience• Cultivating the credibilityCultivating the credibility
– Learning to say “no”Learning to say “no”– serving the health sector rather than the serving the health sector rather than the
donors donors
International AssistanceInternational Assistancein Perspective . . .in Perspective . . .
ASSISTANCE FROMWITHIN THE COUNTRY
EXTERNALASSISTANCE
(1-2%)
BILATERAL
MULTILATERAL
NGOs
Health & DisastersHealth & Disasters
• Immediate Needs Immediate Needs
– Managed by local emergency response Managed by local emergency response
– Short Term NeedsShort Term Needs
– Water, Shelter, food , medicines Water, Shelter, food , medicines
Epidemiological Surveillance, Etc.Epidemiological Surveillance, Etc.
• Long Term NeedsLong Term Needs
– Rehabilitation of Health Infrastructure, Rehabilitation of Health Infrastructure,
Health Related IssuesHealth Related Issues
• MythsMyths
– External Emergency Assistance (SAR, External Emergency Assistance (SAR,
field hospitals and surgeons) neededfield hospitals and surgeons) needed
– Any donation is AcceptableAny donation is Acceptable
– Disease Outbreaks Occur w/in the Disease Outbreaks Occur w/in the
Population or from dead bodiesPopulation or from dead bodies
– Immunization is NecessaryImmunization is Necessary
RealityReality
• Local response within the first daysLocal response within the first days• Public health problems and population Public health problems and population
displacement are more frequent and of displacement are more frequent and of slow onset.slow onset.
• In kind unsolicited donationsIn kind unsolicited donations• Dead bodies are DEAD, no epidemicsDead bodies are DEAD, no epidemics• Rehabilitation of hospitals and water Rehabilitation of hospitals and water
system needed when donors and media system needed when donors and media interest decreaseinterest decrease
ConclusionConclusion
• Disaster management is a multi sectorial Disaster management is a multi sectorial and multi hazard business, so should and multi hazard business, so should training betraining be
• Many actors , therefore coordination Many actors , therefore coordination remains a problemremains a problem
• Local presence and involvement in Local presence and involvement in preparedness and training ensures a good preparedness and training ensures a good response when necessaryresponse when necessary
FROM ONE EXTREME TO THE OTHERFROM ONE EXTREME TO THE OTHER
1980’sNational sovereignity
of the affected countryis absolute
1990’sDonor country
knows best!