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Commentary: Complexity of healthcare requires a new approach to disaster preparedness

Every year, the start of summer begins with a familiar refrain predicting the severity of the upcoming hurricane season. This year, forecasters say it could be the most active season since 2012—the year Superstorm Sandy pounded parts of the East Coast.

Over the past few weeks, tropical storms Bonnie and Colin have already forced states to mobilize emergency plans. In response, emergency officials are pushing out messages, checklists and warnings to try and get individuals to make a plan, create an emergency kit, or download apps that will help them if the worst happens.

Yet, the data show individuals just don't care that much about being prepared for a disaster. Healthcare Ready's 2016 survey on disaster preparedness found only 25% of adults have discussed a plan and even fewer, 18%, have an emergency survival kit. Even relatively easy tasks like keeping track of one's medicines are not a priority, with less than half of Americans able to list all of their prescriptions.

Who does plan? The majority of large healthcare systems have robust business continuity programs, and every facility accredited by the Joint Commission is required to certify they meet minimum levels of preparedness. But the lack of individual planning makes the job of hospitals, health systems and emergency responders more difficult. Not only must providers plan for continuity among loss of power and critical supplies, they must plan for mass casualty events and, increasingly, help people manage chronic health conditions that could worsen and drive acute incidences.

Even more requirements may be on the horizon as the CMS considers a rule to require providers and health systems to establish emergency plans across 17 types of healthcare settings. Providers plan not just because it makes good business sense, but because they recognize their responsibility to their communities.

So why don't people plan? For one, disasters are scary. No one wants to think about the terrible things that could befall them, destroy their homes, or hurt their families. Also, the likelihood of a massive, catastrophic, disaster hitting one person's community feels so small that the time and effort to prepare doesn't feel worth it.

The reality is we are at risk. Whether it's wildfires, tornadoes, hurricanes or H1N1, there have been more than 1,400 federally declared disasters in the past 10 years. These disasters are not confined to one geographic region; they hit every state.

How can we fill the gap between the need for every person to be ready and the apathy of many Americans? One way is to copy the successful early childhood and elementary programs like those on seat belt use or anti-smoking campaigns. Many organizations, including the Federal Emergency Management Agency, HHS and the American Red Cross have developed programs that can begin to change our culture to embrace preparedness.

But change of this scale can take decades, and until that occurs, preparedness should be focused on community-level resiliency. Doing so lifts some of the burden from individuals and moves it to a higher level without replacing it all together. New approaches to community resiliency involve government entities partnering with private enterprises to develop plans prioritizing how critical services such as power, healthcare and communications will be restored.

In a sector like healthcare, this coordination is critical because of the sheer number of groups involved. Providers of care include nurses, doctors, hospitals, nursing facilities, assisted living centers, home care staffers and pharmacists. They all need access to medications, durable supplies, oxygen, and other materials provided in a timely manner. They need healthcare distributors to get them products. They need power and communications to perform critical services. They need passable and safe roads. Restoring critical services like theses can only be done in partnership between government and private industry.

Superstorm Sandy was a wake-up call, and communities are responding. Efforts like the Community Disaster Resilience Initiative by the Robert Wood Johnson Foundation show a new commitment to planning and response. Sometimes preparedness doesn't look like preparedness. The growth of wellness centers and pharmacist collaborative practice agreements—which can allow pharmacists to conduct tests and dispense medicines without the need for a doctor—can increase Americans' access to convenient healthcare and help increase community resiliency.

Over the past decade, the 1,400 disaster declarations have shown us the strength and indomitable resiliency of the American people. In time, better individual planning combined with a deliberate approach to disaster preparedness—through government and private industry collaboration—will certainly increase our readiness.

As we begin the summer season that seems to bring so many natural disasters, it is imperative communities work to adopt structured, public-private disaster planning—starting today. Because of their critical role in the communities they serve, America's hospitals and health systems must be proactive participants in these conversations.

Emily Lord is executive director of Healthcare Ready (founded in 2006 as Rx Response), a not-for-profit dedicated to building healthcare resilience by strengthening healthcare supply chains through collaboration with the public health and private sectors to address pressing issues before, during, and after disasters.

Plan better for disasters

ONE year has passed but the tragedy of the Mount Kinabalu earthquake is still etched in the memories of the affected residents, survivors, families of the victims, the malim gunung (mountain guides), Sabahans and all Malaysians.

The survivors remember that day like it was yesterday. On 5 June last year, Mount Kinabalu and the surrounding districts were jolted by a series of earthquakes, with the first measuring 5.8 on the Richter scale.

A total of 18 climbers were killed, including four mountain guides. Although life is slowly returning to normal, the scars of the tragedy will never fade, just like the tsunami which occurred 12 years ago.

The families and the loved ones of the victims are still coming to terms with the tragedy.

 
 

The mountain guides were the real heroes who put their own lives at risk and four of them died while protecting climbers during the earthquake. In fact, they were among the first who were killed .

The guides, who know the area well, had carried out the main rescue work by cutting out temporary trails through the devastated mountain landscape to bring climbers down the mountain.

When the earthquake struck, other guides and park rangers raced up the mountain from below to provide assistance. .

The supreme sacrifices and selfless acts of these unsung heroes should be forever remembered and their roles and contributions should be recognised and appreciated. For the guides who died in the earthquake -- Valerian Joannes, Ricky Masirin, Robbie Sapinggi and Joseph Solungin – they will always be in our hearts.

The tragedy brought out the best in people and positive human values were shown .

The incident has shown that Malaysia can no longer be regarded as free from natural disasters. The earthquake was proof that that the country needs to establish a centre that pools domestic and foreign expertise to provide emergency response plans for any disaster.

This should be a priority for Sabah, which is prone to such natural disaster.

We need to have an effective disaster management procedure that can prepare an early warning system as well as mobilise speedy and efficient disaster relief efforts.

While we may not be able to prevent such disasters, we can however minimise the suffering and damage. We cannot afford to take the matter lightly and the Government should be willing to invest in minimising damage and loss of lives due to natural disasters.

Malaysia also needs a medium to long-term plan for natural disaster management that incorporates environmental planning, building design standards, evacuation Standard Operating Procedures and efficient relief procedures. We can learn from experiences of other countries and cities such as Japan and San Francisco.

The educational programmes on disaster preparedness conducted by experts from the Fire and Rescue Department and Universiti Malaysia Sabah need to be enhanced so that a culture of preparedness can be built.

Besides safety education, we must also implement all forms of safety drills, whether for earthquakes or other emergencies.

Climbers, divers and tourists coming to Malaysia need to be assured that should any untoward incident happen, the country has a well-trained search-and-rescue team and efficient disaster management centre.

Despite their familiarity of the mountain terrain and survival skills, the local guides need to have formal safety training.

The National Institute of Occupational Safety and Health (NIOSH) is developing a special occupational safety and health (OSH) training module, targeted at mountain guides and other high-risk workers in the tourism sector. This would enable those involved in marine, forest and river activities, to identify hazards, be more prepared and react better in the event of emergency.

Good communication is essential for mountain guides and in this case, walkie-talkies should be provided for them when they bring climbers up on Mount Kinabalu.

These mountain guides should also be given better benefits such as improved allowances and they should have insurance.

I strongly believe that the damage and loss can be curbed by the safety steps we take before, during, and after a natural disaster.

source: thestar

India’s plan to tackle disasters neglects women, disabled and lower castes: aid workers

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India’s new plan to tackle disasters fails to address the needs of vulnerable groups, which could lead to millions of women, children, disabled and elderly people as well as lower caste and tribal communities being put at further risk, aid workers said.

Prime Minister Narendra Modi unveiled India’s first National Disaster Management Plan (NDMP) last week. The plan aims to boost resilience to earthquakes, cyclones and floods and reduce deaths by focusing on early warning, response and recovery.

While the United Nations and relief agencies have generally welcomed the plan, some aid groups say there are serious gaps.

Fiji, Indonesia To Endorse Disaster Risk Management Pact

Government will today sign a memorandum of understanding with Indonesia on disaster risk management.

It underscores Government’s bid for improved bilateral relationships with its international counterparts in this sector.

The Minister for National Disaster Management Inia Seruiratu will sign the agreement with the head of the National Disaster Management Authority of the Republic of Indonesia Willem Rampangilei at the National Disaster Management office at around 11:30am in Suva.

Mr Rampangilei is also the chair of Association of Southeast Asian Nations (ASEAN) Ministerial Meeting on Disaster Management as well as a member of the Conference of the Parties to ASEAN Agreement on Disaster Management and Emergency Response (AADMER).

He was previously a deputy to Indonesia’s co-ordinating minister for culture and human development, and in charge of disaster impacts and social affairs.

At 1:30pm, he will depart Suva for a site visit at Queen Victoria School where the Indonesian military are carrying out Tropical Cyclone Winston rehabilitation work on the school.

The Indonesians offered to rebuild the badly-damaged boarding school under the Government’s Adopt a School programme.

Why ASEAN’s disaster management strategy must include gender

The ASEAN Agreement on Disaster Management and Emergency Response (AADMER) came into being in December 2009. It has played a tremendous role in enhancing regional and national capacities for disaster response in the region. The recent ‘ASEAN Vision 2025 on Disaster Management’ document provides thoughtful insights on how AADMER can move towards a more people-centred, sustainable and better-networked approach. But these suggestions do not directly address the disproportionate impact disasters have on women.

Survivors stand near the ruin of a house as a helicopter flies above the tsunami devastated village of Pororogat, South Pagai island, West Sumatra, Indonesia, 28 October 2010. (Photo: AAP).

The UN Security Council’s first resolution on the Women, Peace and Security (WPS) agenda was launched in October 2000. Although it was developed with the plight of women in conflict settings in mind, the WPS agenda itself is not just about conflict or even just about women. It is a transformative agenda that seeks to create sustainable peace, ensure greater participation and facilitate the move from gender inequality to gender justice. In its broader vision the agenda resonates with the objectives of the ASEAN Community post-2015 and is contiguous with ASEAN’s human rights agenda.

It is critical that the WPS agenda becomes an important component of disaster response planning and management. There is ample evidence that women are disproportionately affected both during disasters and in response settings. For example, an Oxfam report in 2005 highlighted how women and girls were extremely affected by the 2004 tsunami, stressing their disproportionately high mortality rates. A 2007 study on disasters in 141 countries revealed that gender differences in mortality rates were directly related to women’s economic and social rights, and that men and boys were given preferential treatment during rescue operations. Beyond the immediate effects, both women and girls suffered more acutely from shortages of food and economic resources.

The four pillars that bolster the WPS agenda — prevention, participation, protection, and relief and recovery — correspond to the objectives outlined in AADMER and could be adapted into its framework. To become a more effective tool, AADMER should incorporate an explicitly gendered perspective on disaster response.

AADMER does currently take into account vulnerable groups in disaster settings and has specific provisions for this purpose, like the inclusion of and consultation with these groups in planning and management. But the agreement does not explicitly mention any specific focus on the forms of vulnerabilities unique to women, including the increase in sexual and gender-based violence in post disaster settings. Instead ‘vulnerable groups’ mentioned in the agreement should be understood to implicitly include women.

Article 6 of the agreement aims to include local practices and knowledge into disaster management processes. But it does not acknowledge the active role many women can, and often do, play throughout the various stages of disaster response and rehabilitation like procuring food, clothing and shelter through their own informal networks before aid arrives. This locks women in a victim narrative and does not recognise their role as valuable actors in disaster management. The absence of an explicit gendered approach in AADMER hence reduces the sustainability of rebuilding and rehabilitation efforts.

Post disaster this can further increase women’s vulnerability and economic insecurity. Persistent gender inequalities are only exacerbated in a crisis setting. A gendered perspective on disaster planning and management may significantly reduce these risks.

There are various possible entry points to incorporate the WPS agenda in AADMER. Article 3 of AADMER, for example, outlines the need to extend disaster risk reduction efforts in order to incorporate sustainable development policies at all levels and involve all relevant stakeholders, including local communities. As mentioned earlier, Article 6 specifies the importance of strengthening community participation as well as promoting and utilising local knowledge and practices. This could potentially include formalising women’s ‘informal networks’, for example, through the creation of local women’s response teams. These articles provide avenues through which ASEAN could help develop more resilient communities.

Indonesia and the Philippines have already embarked on the WPS agenda through their specific WPS National Action Plans that address women’s protection during conflict settings and their participation in peace building efforts. This is reflected in a 2014 Indonesian Presidential decree and in the Philippines through the National Action Plan on Women, Peace and Security (NAPWPS). These could be ‘launching pads’ for incorporating the agenda in disaster settings as well. But for this to be successful it will be crucial that more developed ASEAN states assist their ASEAN neighbours in areas where they may lack the financial and technical capabilities or necessary skills and training programs.

Singapore, for example, can certainly step in to fill this void. Singapore could play a leading role in promoting and coordinating the WPS agenda in AADMER as well as creating strong monitoring and evaluating systems. Supporting research investigating gender sensitive early warning systems, and providing gender-sensitivity training for disaster response teams are two possible areas for greater collaboration and involvement.

What is also needed is the collection of greater disaggregated data at a regional level to facilitate a more nuanced picture of the gendered impacts of disasters across the region. It will also be necessary to further investigate how discourses on risk and safety following a disaster are shaped.

The integration of ASEAN into a single regional market through the ASEAN Economic Community compels Singapore to work towards greater stability in the region. In such an interconnected community disasters that happen elsewhere can have repercussions across the entire region. The increased movement of people following a disaster — as many succumb to desperate measures to survive due to heightened economic insecurity — can evolve into issues of national security, for example human trafficking, where Singapore becomes a crucial node in the system or a destination point. A disaster in one area has transnational implications.

Natural disasters are not discerning. They affect all: men and women, rich and poor. It will be imperative to support the WPS agenda using the AADMER platform to create a more disaster resilient region. This should be a key goal for Singapore as chair of ASEAN in 2018.

Tamara Nair is a Research Fellow at the Centre for Non-Traditional Security (NTS) Studies at the S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University, Singapore.