workshop report

17th 19th September 2015 Hosted by: NAN, DNGL

Sponsored by: JST

Report prepared by : Sushila Paudel, Epinurse Center, Nursing Association of Nepal (NAN) [email protected]

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Workshop Training for using Assessment Toolkit on"Monitoring for Ensured Communicable Disease Control on Evacuation Sites by Domestic Nurses"

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Organizing Committee Japan Principal investigators

Associate Professor Sakiko Kanbara, University of Kochi

Associate Professor Sachiko Hirono, University of Kochi

Researcher Dr. Archana Shrestha Joshi, Okayama Prefectual University

Associate Professor Shoko Miyagawa, Keio University

Nepal Principal Investigators

Associate Professor Tara Pokharel, Presisent of Nursing Association of Nepal (NAN)

Associate Professor Chandrakala Sharma, President of Nepal Nursing Council (NNC)

Lecturer Apsara Pandey, Vice-president of Nursing Association of Nepal (NAN)

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Contents Page number

Background

4

Objectives

5

DAY I

5

DAY II

6

Session I : Introduction

6

Session II : Inauguration

6

Session III : Presentation

7

Session IV : Speech

9

Session V : Monitoring toolkit skill training

10

Session VI : Distribution of monitoring toolbag

13

DAY III

14

Discussion

14

Closing Ceremony

19

ANNEXES

Annex I

20

Annex II

21

Annex III

21

Annex IV

24

Photo Feature

32

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Background

Disaster nursing is a crucial element of disaster response, and training nurses to obtain human security information through use of an ordinary technology to provide actionable information that impact the future practice of disaster response from experiences of daily monitoring. The population density in the evacuation sites is also extraordinary for the survivors. They have to pay more attention towards the hygiene control to maintain a minimum health safety. Domestic nurses can share the responsibility for carrying out the monitoring community. This project is one of J-RAPID Programmes. The Japan Science and Technology Agency (JST), in collaboration with three Nepalese governmental institutions, initiated support to 5 projects related to the magnitude 7.8 earthquake that struck Nepal in April 2015, within the framework of the J-RAPID Program that supports urgent international collaborative research. This program was supervised by committee (chair is MOSTE) to research/investigation that contributes to the collection of scientifically important but short-lived data, speedy restoration after disasters and improvement of disaster preparedness in the future. Project Partners from Japan include Disaster Nursing Global Leadership Program, University of Kochi (DNGL), The Japan Society of Disaster Nursing (JSDN), and World Society of Disaster Nursing (WSDN), Partner from Nepal include Nursing Association Nepal (NAN), Tribhuvan University, School of Nursing and Global Partner include Ebayanihan, Ateneo De Manila University, WHO WPRO.

This project aims to visualize and summarize prevention of communicable diseases through communication in real time with Nepali nurses who will be conducting the monitoring, so that the information can be delivered to health cluster who can make informed decisions in order to protect and promote health & safety of people and the community during disasters. The most critical challenge is data collection to generate reasonable information that can be used in predicting whether something is likely to occur. Our interest lies in collecting information on the items to A) ensure adequate water and sanitation facilities, B) availability of food, C) control vectors, and D) syndromic surveillance focused on the most common health conditions, encountered after disaster, for preventing communicable disease rather than detecting outbreak by dispatched nurses. So, the action plan was to establish health coordination mechanism and development of the toolkit after visiting the model site, and pre-meeting with NAN, as consulted

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by leading organizations (WHO, MoHP, JICA, MOH) and to conduct Disaster Nursing Workshop to train Nepali Nurses for using toolkit, in Kathmandu.

- Sakiko Kanbara, University of Kochi, Japan - Tara pokharel, President, Nursing Association of Nepal (NAN)

Objectives of the Workshop To gather details of the shelter/s from the disaster affected areas representative Nurses. To introduce the survey Monitoring for Ensured Communicable Disease Control on

Evacuation Sites by Domestic Nurses. To discuss about survey tool and provide tool kit skill training for monitoring and rapid

assessment.

To distribute survey toolkit and J-rapid Monitoring tool bag.

DAY I

The training workshop was attended by 25 representative Nurses from disaster affected districts of Nepal. Districts represented were Kathmandu, Lalitpur, Bhaktapur, Nuwakot, Dhading, Gorkha, Rasuwa, Kavrepalanchok, Sindhupalchok and Dolakha. Day 1st was a warm up session where participants informally interacted with each other. Registration was done by Epinurse Sushila Paudel where the participants, one by one, were requested to provide their name, living address, email, contact number, their working office, working status, past experiences, including the Shelter/s name, Shelter address and the number of Shelter they covered. The participants list is attached as Annex II.

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DAY II

SESSION I : INTRODUCTION

The training workshop session was opened at 10:30 am with a warm welcome by Mrs. Rajkumari Gyawali, Secretary of Nursing Association of Nepal. She asked participants and all other members present, to introduce themselves. Participants were asked to give a brief description about the epidemiological conditions of their respective districts/shelters as resulted by the devastating earthquake and aftershocks.

The inaugural session was postponed for a while due to Chief guest's absence. Till then Sakiko Kanbara provided the participants with materials like paper handouts, toolkit, diaries, pen and Disaster Nursing Global leader Degree Program overview Prospectus.

Archana Joshi distributed the form containing shelter characteristics. Participants were divided into groups representing their district and were required to fill the details of the Shelter they covered, including Shelter mapping. There were altogether 40 shelters covered. Shelter Characteristics form is attached as Annexe IV.

SESSION II : INAUGURATION

The Inaugural session was chaired by Associate Professor Tara Pokharel, President of Nursing Association of Nepal. The chief guest of the session was Dr. Baburam Marasini, Chief of Epidemiology and Disease Control Division, Nepal. The other diginitaries on the dais were Associate Professor Sakiko Kanbara, University of Kochiko, Japan and Associate Professor Chandrakala Sharma, President of Nepal Nursing Council. The session was hosted by Rajkumari Gyawali, secretary of NAN.

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SESSION III: PRESENTATION

Associate Professor Sakiko Kanbara presented a paper on Introduction of J-rapid Epinurse. She outlined the objectives of rapid assessment as:

to assess the extent of the emergency and the communicable disease threat to the population;

to define the type and size of interventions and priority activities; to pass the implementation of these activities; to pass information to the government, donors and the media in order to mobilize

human and financial resources.

She showed framework of the new initiatives.

Fig: Framework of the New Initiatives.

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Kanbara explained about the initial preparations done like getting information from Epinurse Center and collecting background geopolitical and health data along with review of existing information, visual inspection of the affected areas, interviews with key informants and ethical approval. After the workshop training, nurses will be dispatched to their site and with investigation toolkit, they will be monitoring the living environment, SPEED and EWARS by WHO, MOH.

Kanbara highlighted that the assigned tasks should be reported by the surveyors i.e. participated nurses, per week or even soon for any changes within the time frame of three months. After

assessment, all the datas, informations and opinions collected will be aggregated from individual case report sheet and analysed collaboratively by Epinurse Center, NAN and Japanese team members. Datas will be analysed into demographic pyramids, priority health interventions and identification of high risk groups. As an expected outcome, these informations will be shared with other health sectors, MoHP and WHO, to integrate with their own data, and supply relevant information into central and actionable form for community leaders so as to prevent unnecessary deaths, through early detection of cases of diseases, having outbreak potentials. Likewise, informations will be passed to the PH Centers, Hospitals, Government, donors, NGOs, INGOs, media and the concerned authorities, so that the encountered problems of the disaster affected areas can be sort out through new interventions, programmes and launching further projects. She also mentioned that the budget for this survey is limited upto monitoring living environment and communicable disease by domestic nurse. Kanbara concluded her presentation showing the next challenge, i.e.

How To Care Couity People ad ake Health Village? How To Care Couity People ad ake Health Village?

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SESSION IV: SPEECH

Associate Professor Chandrakala Sharma, President of Nepal Nursing Council, who is also a member of Nepal Health Research Center (NHRC) and one of the Principal Investigators from Nepal gave a brief overview of Nepal Nursing Council as the legal body of Nursing profession which registers nurses and ANM, accrediates all nursing education programmes and strengthens nursing services within health institutions. She briefed the background and said that this is preliminary survey and highlighted with the participants to call it as a survey rather than a research.

A representative speaker from the overall participants, on her remarks said that it gave all of them a great pleasure and honor to be in this very important workshop and they will have their best to mark it a success.

Dr. Baburam Marasini, Chief Guest of the workshop on his speech said that the Surviellance is the heart of public health. Earthquake April 2015 resulted many epidemic outbreaks like Hepatitis.A in Gorkha, Brucellosis in Kavrepalanchok , Dysentery in Kakani, and few cases of cholera in Kathmandu. Further he stated that surveillance alone is not a big deal but to response is a big deal. So he requested participants to apply whatever theyve learnt, and for the problems encountered, using vertical channel collaboration, solutions can be sought soon. He extended his vote of thanks to Japanese team and the organizing committee and ended his speech with the expectation that this gathering will be fruitful and will be able to come up with important solutions to overcome the problems.

Associate Professor Tara Pokharel, President of Nursing Association of Nepal, and one of the Principal Investigators from Nepal gave overview about NAN as the professional Organization of the nurses in Nepal which became the member of International Council of Nurses (ICN) in 1969 A.D and it works to protect, promote and develop the professional right and interests of all nurses in country and to raise health standard of people. She explained that the nurses are playing vital role in monitoring and promoting health of people at disaster affected sites. Most of the remote nurses were called for participation because they have better ideas of their sites. A teacher from Dhading was also included as she was monitoring and providing health care and education to the affected children in school. She added that this is a great opportunity for Nurses

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to be the part of this national level disaster survey. She ended her speech encouraging the participant nurses to do their best, so as to get the next best project in days to come, that works for health preservation and promotion of people.

After speech session,Dr. Baburam Marasini displayed the J-rapid t-shirt designed for this survey, along with diginitaries Sakiko Kanbara, Tara Pokharel and Chandrakala Sharma.

During lunch break, participants and other members enjoyed dance and songs on the auspicious occasion of women Teej and Panchami.

SESSION V: MONITORING TOOLKIT SKILL TRAINING

Guidance for nurses to use the survey toolkit was the core objective of the workshop. Researcher Dr. Archana Shrestha Joshi, requested participants to have a glance at the survey toolkit. She told them to go through all the contents and to clarify their confusions, if any. She described the ways of using tool, for whom, when and how to monitor. She explained that participant nurses at their respective shelters needed to have a clear assessment of the following:

A) Living Environment Assessment I. WASH services II. Shelter status

III. Sleeping room IV. Companion animals

V. Health & Nutrition B) SPEED

C) EWARS by WHO, MOH

D) Nursing Assessment Sheet

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For three months, Datas have to be reported per week or even soon for any changes to Sushila Paudel at Epinurse Center, NAN either through email,facebook, phone or sms.

Associate Professor Shoko Miyagawa, Keio University gave the URL address surveymonkey.com for the smartphone users. Some participants performed trial to get the tool containing their shelter address, make entries and report to Epinurse center.

Sushila Paudel read the tool again and described each of the headings, subheadings and every contents in simple clear nepali language and in comprehensible ways to ensure that all the participant nurses have understood well. Further, for their convenience, she made the new tool having questions written in both English and Nepali Language, in simple format, without making any sense of changes to its meanings.

Participants questions and confusions regarding the tool were highly welcomed and clarified. Toolkit is attached as Annex III.

SESSION VI: DISTRIBUTION OF MONITORING TOOLBAG

After the toolkit guidance session, Associate Professor Sachiko Hirono, University of Kochi

and Shoko Miyagawa, Keio University distributed J-rapid monitoring tool bag which contained:

Bag

T Shirts

Stethoscope

Sphygmomanometer-B.P

Towel

Basal thermometer

Alcohol/Spirit

Torch

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Globes

Mask

Weighing machine

Soap

Thermostate

Measuring tape

At the end, Sushila Paudel summed up the session and thanked all the participants for their day.

DAY III

At 8 am, Participants were welcomed by Archana Joshi. She asked them regarding any confusions and clarified all their queries. Then the participants were requested to be divided into their district groups and some of the questions regarding living environment assessment added by Sakiko Kabara were asked to be filled up again. questions added were main source of drinking water, fuel usually used for cooking and lighting, households with and without toilet facility and household having facilities like radio, television, computer, motorcycle, refrigerator, etc. After filling form district wise, they were told to mark on their shelters on district map.

DISCUSSION

The session then continued with the questions:

What are the main health issues of your district? How to improve? Where to report? What kind of information feedback needed? How to report?

Participants had group discussion and then district wise presentation.

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Sindhupalchok (Maya Shrestha, Roshani Shrestha, Srijana khadka, Chandramaya Dangal, Indramaya Gurung ) Main health issue Safety and security, Communicable disease, Sanitation problem

Toilet/drainage problem, Scarcity of drinking water Psychosocial problem, Starvation Economic disease ( diarrhea, measles, dysentery) Family crisis, Over crowding

How to improve? Mobilise community leaders, FCHV Health survey, Data analysis

Health action as per priority

Implementation , Health education Coordinate with DPHO, INGO, NGO, local leaders, social workers and so on

Where to report ? Health center, Local leaders, DPHO, NAN Epidemiology department/MOH

What kind of information

feedback needed?

Human resources, Money

Communication materials, Monthly supervision

Medicines, Referral format

How to report ? Sms email phone

Dolakha (Pramila Jirel , Sanumaya Khadka )

Main health issue Unsafe Drinking water, Sanitation, Handwashing Fever, injury, diarrhea

How to improve? SODIS, chlorine tablets Dressing

Medicine

Where to report ? --------

What kind of information needed?

Health education Counselling

How to report ? Phone, Sms, viver

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Kathmandu ( Ram kumara Luitel, Jasmaya Jirel, Samjhana Kunwar, Babita Jirel, Sunita Panthi, Thakchi Sherpa)

Main health issue earthquake fear , sanitation, Handwashing Fever, diarrhea with fever,dysentery, insomnia, eye/ear infection, skin disease, headache, epigastric pain, ANC/PNC/family planning, gynaecological problems, worm infestation, Malnutrition, jaundice, asthma/cCOPD, injury

How to improve? Health education Counselling Money

Medicines/ Aqua water distribution/ bottle water supply

Where to report ? Food/masks Vaccination Programme

Health campaign, committee formation


feedback needed?

Protocol

Medicine, Vaccine, Money man material, Food/ cloth Bp instrument, umbrella, raincoat, sleeping bag

How to report ? Office Incharge, Phone

Sms, facebook, skype, viver

Rasuwa (Sarita Dhakal)

Main health issue Psychological problems, Safety/security, Diarrhoea , Skin problems Severe Gastritis , Reproductive Health, Insufficient Latrines

Environmental sanitation, Lack of proper nutrition, problem on Infection Prevention

How to improve? Community diagnosis, Planning, health education, health strategies from local level, MOHP, EDCD, supportive group

Where to report ? MOHP, WHO, Unicef

How to report ? Phone, Sms , Email

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Dhading (Sarita Dhungana, Sarada Barakoti, Sundari tamang, Urmila chitrakar, Madhu Gomja )

Main health issue Communicable disease threats, Unsafe Drinking water, Poor Sanitation, Poor Hygiene,Overcrowding, malnutrition , viral fever, typhoid fever, jaundice, diarrhoea, skin problems

How to improve? Awareness programme

Mobilize community leader Treat the water source/ use purification methods Sanitation improvement Programme

Solid waste disposal, Latrine Hand washing technique/ personal hygiene Safe storing and serving food Assess the nutrition status

Counselling for nutrition

Refer to nutrition rehabilitation Campaign programme

Where to report ? Community leader Local health institution

District health office, NAN

MOH/Epidemiological section

What kind of information feedback needed?

IEC material,

Medicine (first aid) Handwashing material Water treatment materials, Water bins Electronic communication material

Assesssment and referral formats

How to report ? As necessary (weekly/monthly Immediately if any outbreak As government HMIS system

By phone, sms, email

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Nuwakot (Devaki Khatiwada, Sreemaya Jirel)

Main health issue Fever, ARI, AGE, open wound cuts, skin diseases like allergies, scabies, eye infections, Acute peptic diseases, smoking, alcoholism

How to improve? Awareness programme

School health programme Coordination with VDC chairperson, local leaders

Where to report ? District health office, NAN

How to report ? Phone, Sms , Email, Written report

Kavrepalanchok ( Sumala Basnet )

Main health issue Fever, Headache, Muscle pain, Eye irritation, Jaundice, Skin rash Diarrhea, Scabies, Fracture, Conjunctivitis, Wounds, High blood pressure

How to improve? Awareness in hygiene and sanitation School health program

Where to report ? District health office

How to report ? Phone, Monthly written report, sms ,Email

Gorkha ( Saran Khanal )

Main health issue Drinking water,

Sanitation, Latrines

How to improve? Health education Co-ordination

Where to report ? VDC chair person District public health office Female community health volunteer

How to report ? Phone, Sms ,Email, Pamphlet

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Lalitpur /Bhaktapur(Lumbini Shakya, Indramaya Shrestha)

Main health issue Allergies, Allergic Rhinitis, peptic diseases, COPD, Anxiety, depression, abortion, premature delivery, water born disease, ARI, STI, eye infections, hazardious health habits

How to improve? Health education School health programme

Water purification

Temporary latrine construction

Immunization Campaign for under 5 children/regular immunization Immediate report to higher health center

Where to report ? Local health insttute

Local leader VDC/ municipality/ward District health office


feedback needed?

Health History

Health checkup

Environmental sanitation

Water resources

Available health facilities Logistic support

Financial support

How to report ? Phone, email, sms, record keeping/reporting

CLOSING CEREMONY

Participants were given the instrument tool and a permission letter to the district. Queries regarding reporting datas were clarified again by Sushila Paudel. Sakiko Kanbara, Archana Shrestha Joshi and Sushila Paudel provided their contact and email address. President of NAN Tara Pokharel wrapped up the session by summing up the two days workshop. She wished all a good luck and gave thanks to all for their support in delivering 2 days workshop training.

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Annex I

Agendas (September 18th

)

10:00- Opening Remark

10:30 Introduction 11:00- Inauguration

12:00- Presentation

13:00- Monitoring tool kit skill training

15:00- Distribution of Monitoring toolbag

Agendas (September 19th

)

10:00- Discussion

12:00- Wrap up and Closing

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Annex II

S.N

Name of

Participants

Age

(yrs) Living Address Office Status experience year

1 Sarada Barakoti 30 Salyantar-7, Dhading Salyantar PHC, Dhading Staff Nurse 10

2 Sundari Tamang 21 Nilkantha-3, Dhading

District Hospital

Dhading Staff Nurse 2

3 Urmila Chitrakar 20 Nilkantha-3, Dhading

District Hospital

Dhading Staff Nurse 18 months

4 Sarita Dhungana 45

Chhatradeurali-2,

Dhading

Chhatra Deurali HP

Dhading ANM 14

5 Pramila Jirel 24 Jiri, Dolakha

Jiri Dolakha District

Hospital,Jiri ANM 3

6 Shreemaya Jirel 50 Kharanitar, Nuwakot

Kharanitar PHC

Nuwakot

Senior

ANM,6th Level 20

7 Devaki Khatiwada 42 Bidur-3, Nuwakot Deurali PHC, Nuwakot Staff Nurse 20

8 Babita Jirel 28

Bajrayogini-1,

sankhu, Kathmandu

Sankhu Ilaka HP

Kathmandu ANM 5

9 Lumbini Shakya 49 Luboo, Lalitpur Lubhoo PHC Lalitpur Staff Nurse 25

10 Sunita Panthi 52

Chalnakhel-2,

Kathmandu

Chalnakhel PHC

Kathmandu

Senior

ANM,6th Level 20

11 Roshani Shrestha 37

Melamchi,

Sindhupalchok

Melamchi PHC

Sindhupalchok Staff Nurse 17

12

Chandramaya

Dangal 43

Mahankal-1,

Sindhupalchok

Mahankal HP,

Sindhupalchok ANM 19

13 Indramaya Gurung 42

Melamchi-5,

Sindhupalchok

Melamchi PHC

Sindhupalchok ANM 10

14 Maya Shrestha 54

Chautara,

Sindhupalchok

Chautara DH,

Sindhupalchok

Staff Nurse,

6th level 33

15 Sharan Khanal 45 Haramtari, Gorkha Gorkha DPHO, Gorkha

Public Health

Nurse 22

16

Indramaya

Shrestha 48

Kamalbinayak,

Bhaktapur

Nagarkot HP,

Bhaktapur ANM 27

17 Ram kumari Luitel 45

Saraswotinagar ,

Kathmandu

Dharmasthali HP

Kathmandu

Senior ANM,

6th level 27

18 Samjhana Kunwar 43

Budhanilkantha,

Kathmandu

Budanilkantha HP

Kathmandu ANM 20

19 Thakchi Sherpa 37

Bouddha-6,

Kathmandu

Friends of

Shantabhawan, Jorpati Senior ANM 17

20 Sumala Basnet 39

Panauti-5, kapalkot,

Kavrepalanchok

Sunthan PHC

Kavrepalanchok ANM 13

21 Sanumaya khadka 52 lamabogar, Dolakha Lamabogar HP, Dolakha Senior ANM 27

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22 Jasmaya Jirel 48

Balaju-16,

Kathmandu

Gordhunga HP,

Kathmandu

Senior ANM,

6th level 28

23 Srijana Khadka 33 Ramche-7, Bahrabise

Barhabise PHC,

Ramche-

7Sindhupalchok ANM 18 months

24 Sarita Dhakal 43 Dhunche-5, Rasuwa

Rasuwa District

Hospital Staff Nurse 21

25 Madhu Gomja 21

Damgade-12,

Dhading

Dhading Damgade

School Teacher 2

S.N

Name of

Participants

Name of Shelter covered shelter address shelter

experience

1 Sarada Barakoti Lapa Basti 2 3 4 5 lapabasti Dhading August

2 Sundari Tamang Sankosh-12 Sankos-12 Dhading Apr-25

3 Urmila Chitrakar Sankosh-12 Sankosh-12 Dhading Apr-25

4 Sarita Dhungana Ramche Ramche Dhading Apr-25

5 Pramila Jirel Shikri Gaun Jiri Shriki Gaun, Jiri May-13

6 Shreemaya Jirel Bangetar-1 Kharane-6

Bangetar, Kharane,

Nuwakot Apr-25

7

Devaki

Khatiwada Deurali-8 Deurali-8, Nuwakot Apr-25

8 Babita Jirel SankhuBajra-1

Sankhu

Bajra-2

Sankhu

Bajra-3 sankhu, Kathmandu Apr-25

9 Lumbini Shakya Mahalaxmi-8

Mahalaxmi,Luboo,

Lalitpur Apr-25

10 Sunita Panthi Boshan Khahare Gwalda Dakshinkali, Kathmandu Apr-25

11 Roshani Shrestha Melamchi-2

Melamchi-2,

Sindhupalchok Apr-25

12

Chandramaya

Dangal Mahankal-1 Mahankal-9

Mahankal,


13

Indramaya

Gurung Melamchi 5

Melamchi-5


14 Maya Shrestha Chautara 3

Chautara,

sindhupalchok Apr-25

15 Sharan Khanal

Simalgaire

Alegaun

Simalgaire Alegaun,

Gorkha Apr-25

16

Indramaya

Shrestha Lamatol -4

Lamatol-4 Nagarkot,

Bhaktapur Apr-25

17

Ram kumari

Luitel Dharmasthali-3

Dharmasthal

i-4

Dharmasthali,

Kathmandu Apr-25

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18

Samjhana

Kunwar Thulogaun-4

Thulogaun,

Budanilkantha Apr-25

19 Thakchi Sherpa Phulpinkatti Tembathang

Gorkana

Camp

Thali

Camp

Padma

Tower

Jorpati, Gokarna,

Kathmandu Apr-25

20 Sumala Basnet

Sunthan-10,

Panauti

sunthan-10, Panauti,

Kavrepalanchok Apr-25

21

Sanumaya

khadka Gongar Tol-5 Jagat-9 Gongar, Jagat, Dolakha Apr-25

22 Jasmaya Jirel Phuyalthok-9 Dhitalthok

Bihanibast

i-4 Gordhunga, Kathmandu Apr-25

23 Srijana Khadka Plykarkhana

Ramche-7,Bahrabise,

Sindhupalchok September

24 Sarita Dhakal Dhunche-5 Dhunche-5, Rasuwa May-14

25 Madhu Gomja Damgade Chabedanda

Damgade, Chabedada,

Dhading May-01

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Annex III

Name : Form Number :

District : Date of data collection :

A) Living Environment and Population Characteristics

I.WASH Services (Water, Sanitation, Hygiene)

Drinking Water ( )

1.Type of drinking water source

Bottle

Tap

Other: ........................... : .......................

2.Adequate water supply Yes No

Not Available/ Unknown

/ 3.Quality / safety checked assured Yes No Not Available/ Unknown 4.Average amount / person/ day

Specify......................... .............. Not Available/ Unknown

5.Distance water dwelling place

Specify........................ ............. Not Available/ Unknown

Washing Water ( Bathing/ Laundry) ( / )

6. source

None

Tap

Other: ........................... : .......................

7.Adequate water supply Yes No


/ 8.Distance water dwelling place

Specify........................ .............


/

Management of solid waste ( )

9. Waste Collectors Yes No


/ 10Adequate number of collectors

? Yes No Not Available/ Unknown

/ 11.Separation of waste type


/ 12. Appropriate waste storage Yes No Not Available/ Unknown

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? / 13.Appropriate waste disposal


/

Latrines / Toilets and hand washing supplies ( ) 14. Toilets Available


/ 15.Adequate number of Toilet


/ 16.Average number of person/ toilet

Specify........................ .............


/ 17. Distance toilet dwelling place ?

Specify........................ .............


/ 18. Detergent / soap available

/ ? Yes No Not Available/ Unknown

/

II.Shelter Status ( )

19. Type of shelter

Specify........................ .............


/ 20. Damaged

/ Yes No Not Available/ Unknown

/ 21. Security / Safety Assured


/ 22. Adequate Ventilation Yes No


/ 23. Adequate space per person per family


/ 24. Free of hazard(s) Yes No


/ 25. Free of Vector(s) Yes No


/ 26. Acceptable indoor temperature


/ 27. Acceptable Cleanliness


/ 28. Source of light ( Electricity) Yes No


/ 29. Generator in use Yes No


/ 30. Designate smoking area Yes No


/

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III.Sleeping Room ( ) 31. Acceptable Number of Mats /Beds


/ 32. Acceptable spacing Yes No


/ 33. Acceptable Cleaniness Yes No


/ 34. Blanket or other items


/

IV. Companion Animals ( ) 35. Presence Yes No


/ 36. Animal Care Available Yes No


/

V. Health and Nutrition ( ) 37. Unusal disease / event , outbreak

/ If Yes , Specify: ..............................................................

Yes No Not Available/ Unknown

/

38. Health Care services on site Yes No


/ 39. Psychological support / counselling Yes No


/ 40. Nursing care ( Community Health,

Preventive care ) provided If Yes give details:

. ...............................................................................................................................

Yes No Not Available/ Unknown

/

41. Safe and clean food items provision Yes No


/ 42. Cook food served on site Yes No


/ 43. Common kitchen available Yes No


/ 44. Personal/ family kitchen


/ 45. Appropriate food storage Yes No


/ 46. Handwashing facilities Yes No


/

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B) SPEED

S.N Disease Syndrome/ Health Event

12 month and over: sudden onset of fever (>38C) with severe headache and stiff neck : 38C, 38)with bulging fontanel , or refusal to suckle (MEN) 38C,

6

Fever with headache , muscle pain and any of the following: Eye irritation , jaundice , skin rash, scanty urination (LAP) , , , , ,

7 Yellow eyes or skin with or without fever (AJS)

8 Fever with other symptoms not listed above (FOS)

9

Loose stools 3 or more in the past 24 hours with or without dehydration(AWD) ,

10 Loose stools with visible blood (ABD)

11 Open wounds and bruises / burns (WBS) ,

12 Fractures (FRS)

13 Skin Diseases (STS)

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14 Animals bites (ANB)

15 Eye itchiness, redness with or without discharge(CON) , , 16 Spasms of neck and jaw (Lock jaw )(TET)

17 High blood pressure (140/90 (HBP) /,

18 Known diabetes (KDM) / 19 Difficulty in breathing and wheezing (AAA)

20 Floppy paralysis of the limbs which occurred recently in a child

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C) EWARS by WHO MOH

S.N. Disease Syndrome Of NEW cases in medical and general OPD and

Emergency

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Appendix) Nursing Assessment Form

Daily Habit ( ) Smoke ( ) Drink ( )

Anamnesis () DM ( ) Hypertension ( ) Liver Disease ( ) Stroke ( ) History of present illness

Appetite ( ) Sleep ( ) Urination ( ) Defecation( ) Numbness of limbs Gait disturbance ( ) Conversation Discomfort () Cough ( ) Breath ( ) Inspection ( ) Face ( ) Trauma ( ) Skin ( ) Measurement () Measure ( ) Weight () Body temperature ( ) BP ( ) Palpation () Pain ( )

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Annex IV

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Photo

Feature

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THANKYOU

workshop report

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