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Policy Brief

Challenges for Curriculum Development in Disaster Health Management:What we can do?

This policy brief is addressed to policy maker and stakeholder in Higher Education Agency, Universities, Faculty of Medicine and Health, and Section of Human Resources in Ministry of Health

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Introduction

Disaster events increase continuously and require adequate medical treatment. Education on disaster medicine and disaster management is important because the post-disaster requires a lot of health workers assistance. Health institutions and medical schools involved in disaster management. There are involvements on disaster management of both formally through education for students and informally through training for health workers.

Increasing threat of natural disasters and social is impacted to increasing the world’s preparedness with to enter disaster education into college, including disaster education in medical school. United States began to take notice of disaster education in medical school since the Sept. 11 attacks and outbreaks anthrax in 2001. Disaster preparedness followed by many countries as the incidence of natural disasters in the Southeast Asian tsunami and Hurricane Katrina in 2004 South America in 2005. In Indonesia, the tsunami Aceh in 2004 is start steps to develop disaster management.

Context and Challenges in Development of Disaster Health Curriculum

The first challenge in the development of health disaster management curriculum is up to the current disaster management and emergency by health personnel is still not good. Health workers have not been able to understand its role in emergency response and disaster management. Doctors are still not ready and feel less capable in dealing with disaster situations, such as an outbreak of disease after a disaster. The health workers have poor performance where they do not know the work area at the time of the disaster as well as the low approaches to leadership and coordination in disaster management in the health sector. In fact, lack of health care will bad impact for health workers and patients.

The second challenge is the medical school felt it was important to prepare students in the face of disaster, but still found the low quality of learning are developed. Many medical schools only develop disaster education as elective courses and informal courses. Curriculum developed health disaster is still unclear with the competencies required of students and not properly describe the role and collaboration with health professionals that took place in the system of the disaster. In addition, medical student insight is still low against disasters. However, students feel important for learning about disaster medicine.

The third challenge is the lack of coordination. Chaos in the management of health disasters often occur not because of a lack of resources but because of lack of coordination in health professionals. Students or health workers who have not received education or training of disaster management will feel confused face a chaotic situation at the time of the disaster. In hope, material of disaster health management for medical students can provide an overview of their role in disaster management along with other health professionals in a system.

Policy Recommendations

Based on the above challenges then we can provide a solution through learning methods approach of disaster health management. We can describing the real problem and situation of disaster through online learning, interactive video, simulations, and live exercise, field trips, discussions based on real cases and other. In some studies, disaster cases developed based on the local situation. Learning models to integrate the role of physicians in disaster management continue to be developed in disaster health management. Studies in disaster management learning geared to provide the best understanding for medical students about health disaster management, able to describe their role in the future of health disaster management, and be able to retain the knowledge of disaster management in spite of the long term between the occurrence of disaster to next disaster.

Disaster Curriculum for Medical Student, Faculty of Medicine UGM

Since 2010, Faculty of Medicine UGM has developed a block 4.2 about Health System and Disaster. Block 4.2. is the second block in year 4. This block is part of Phase 2 of the medical curriculum, entitled transition from Theory to Practice.

In this block, students learn about the health system and disaster management, which are closely related. A health system is a set of collections of components organized to accomplish a set of functions in health. The health system can be analyzed from a normal situation perspective. However due to the natural and man-made disasters, the system can be disturbed or even destroyed. Block 4.2 is divided into two modules and five weekly themes. The modules are: (1) Health System, and (2) Disaster Management. In Module 1, there are three weekly themes discussing: (1) The Concept of Health System, (2) Physician Payment Mechanism and Quality of Care, and (3) Leadership and Communication. In Module 2 there two themes: (1) Disaster Management and (2) Disaster Medicine.

To achieve goals of this block, particularly in module 2, we develop problem based learning beside lecture and tutorial based learning, such as disaster practitioners for guest lecture, practice session, and disaster exhibition in one week. Disaster exhibition always invited Disaster and Humanitarian NGO, Local Disaster Management Agency, District Health Office, Red Cross, and etc. All disaster exhibition participants and student were direct communication. This exhibition always becomes favorite session chosen by students.

Arranged by:

Madelina Ariani, SKM

Phone : +62 87815691175

Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
________________________________

dr. Bella Donna, M.kes

Phone : 0811286284

Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
________________________________

POLICY BRIEF

The Importance of Standardization, Accreditation, and Classification of Disaster Medical Assistance Team

This policy brief is addressed to policy maker in National Agency for Disaster Management and Ministry of Health especially to Health Crisis Center

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Introduction

Indonesia is one of the most disaster prone countries in the world. It is scientifically explainable as Indonesia’s geography, geology, and hydrology are vulnerable to earthquake, tsunami, flood, and landslide. It is also Indonesia located at the convergence of Eurasia, Indo-Australia, and Pacific Plates. Indonesia has experienced many major natural disasters such as earthquake and tsunami in Aceh (2004), earthquake in Bantul Yogyakarta (2006), earthquake and tsunami in Pangandaran (2006), earthquake in Padang (2009), and Mount Merapi eruption (2010). When disaster happens, many health problems arise. In emergency situation, medical team is needed to provide health services and support to disaster victims. Disaster medical assistance team plays an essential role to save human lives during the emergency response periods.

Based on the past experiences, started from tsunami in Aceh 2004 untill the Mount Merapi eruption 2010, there were two things to be highlighted. First, is the quality of disaster medical team who assisted on disaster and second, is the system to cordinate and control the disaster medical assistance team. Until now, there is no system to control disaster medical assistance team. It can be seen that there is no guidelines to manage standard for competences of disaster medical assistance team.

Indonesia has experienced many major natural disasters. In emergency response phase, there were many medical teams from Indonesia and overseas that went to disaster-affected area. But until this time, there is no guideline to manage the medical team. In developed countries, they already have a guideline to manage the disaster medical team so that they can do it in effective and efficient way. The problem of management and professionalism of disaster medical team is vital because it affects to the results. Therefore this problem is highlighted at Pre-Conference 11^th Asia-Pacific Conference Emergency and Disaster Medicine, which held at Denpasar Bali, September 2012.

Context and The Importance of Problem

Indonesia is one of the most disaster prone countries in the world. In an emergency situation, there were many disaster medical teams from Indonesia and overseas that went to area affected by disasters. There is no guideline to manage disaster medical assistance teams. Therefore, it needs a system to manage these problems:

There were many disaster assistance teams came to Indonesia, but it was not clear whether they have a permission or not. Thus, it is very important to register all the medical assistance teams and provide information on how many disaster medical teams are needed. Then, it is essential to provide quality control to disaster medical teams for both local and oversea teams.
Disaster medical teams who came to area affected by disaster was not clear whether they have competences or not. Sometimes this problem cause secondary effect after disaster such as infection. Therefore, it is essential to determine the qualification of disaster medical assistance
There isno minimum standard in giving medical assistance. Thus, it needs management system to coordinate disaster medical teams so that they can work in effective and efficient way. It is very important to build a system to manage this problem. Then it also needs an institution to carry out this work. It can be done independently or corporately with other institutions.

Policy Recommendation

To control and coordinate disaster medical assistance teams in Indonesia, the policy recommendations are given as follows:

Register all medical assistance teams for both local and international teams with one door policy so that the authority can monitor the activities of the medical teams. Besides, it can be determined on how many disaster teamsare needed in the field.
The government should provide guideline for disaster medical assistance teams, include minimum standard for health services, list of hospital specification, and medical logistic and non medical logistic that available in hospital during a disaster. This guideline is aimed to provide standard and practical guide for disaster medical assistance teams for both local and international teams in order to work effectively with minimum impact.
Legalization of institution and official of health institution, therefore they have a power to coordinate disaster medical assistance team. This health institution can be a part of national agency for disaster management that has authority to conduct feasibility test for medical teams.
It is essential to collect, compile and record medical doctor and medical specialist data that has an expertise in disaster field so that it will simplify coordination. It is also important to make a list of hospital specification in Indonesia.

Arranged by :

dr. Bella Donna, Mkes

Phone : 0811286284

Email : This email address is being protected from spambots. You need JavaScript enabled to view it.

________________________________

dr. Hendro Wartatmo, SpB KBD

Phone : 0811283118

Email : This email address is being protected from spambots. You need JavaScript enabled to view it.

________________________________

POLICY BRIEF

Perlunya Standarisasi, Akreditasi dan Klasifikasi Tim Bantuan Medis dalam Bencana

Policy Brief ini ditujukan untuk pemerhati kebencanaan dan pengambil kebijakan di Badan Nasional Penanggulangan Bencana dan Kementrian Kesehatan khususnya Pusat Penanggulangan Krisis Kemenkes.

Pengantar

Indonesia merupakan negara dengan tingkat frekuensi bencana yang tinggi. Hal ini dibuktikan dengan banyaknya bencana besar yang terjadi di Indonesia, seperti bencana Gempa dan Tsunami Aceh, Gempa Padang, Gempa dan Tsunami Pangandaran, Gempa Bantul Yogyakarta dan Letusan Gunung Merapi Yogyakarta pada tahun 2010. Bencana yang sering terjadi di berbagai wilayah Indonesia menyebabkan banyak masalah, salah satunya adalah masalah kesehatan. Hal ini mendorong tim kesehatan, termasuk tim bantuan medis untuk memberikan pelayanan dan bantuan terhadap korban akibat dampak bencana yang terjadi terutama pada fase akut. Pada proses penanggulangan bencana, peran Tim Medis sangat penting.

Berdasarkan pengamatan selama kejadian bencana mulai dari Tsunami Aceh tahun 2004 sampai Letusan Gunung Merapi tahun 2012, ada dua hal yang cukup menonjol. Pertama adalah perkembangan kuantitatif maupun kualitatif dari Tim Bantuan Medis Indonesia serta banyaknya Tim Medis Asing yang terlibat. Kedua adalah kurangnya Sistim yang mengatur dan mengkoordinir (Controll and Coordination) aktifitas Tim Medis tersebut. Ketiadaan sistim tersebut dapat dilihat dari tidak adanya pedoman yang mengatur standar kompetensi dari Tim Bantuan Medis, maupun evaluasi kinerjanya.

Selama ini, belum ada regulasi untuk pengaturan tim medis yang datang ke daerah bencana baik untuk tim medis lokal maupun tim medis asing. Hal ini sangat berbeda di negara yang sudah maju dalam Manajemen Penanganan Bencana, karena ada sistim yang jelas, yang berfungsi sebagai pedoman dalam mengatur bekerjanya Tim Bantuan Medis agar efektif dan efisien. Masalah manajemen dan profesionalisme dari Tim Medis ini memang sangat vital karena akan menentukan hasil akhir, sehingga hal ini diangkat menjadi salah satu topik Pre-Conference pada 11^th Asia-Pasific Conference Emergency and Disaster Medicine yang diadakan di Denpasar Bali, akhir bulan September 2012.

Konteks dan Pentingnya Permasalahan

Indonesia sebagai salah satu negara yang rawan terhadap kejadian bencana (disaster prone country), sehingga pada saat terjadi bencana banyak Tim Medis yang datang membantu. Sementara itu, sistim yang mengatur terhadap tim bantuan medis belum ada. Adapun yang perlu diatur adalah:

Banyak bantuan Asing yang datang ke Indonesia tidak jelas perizinan dan keberadaannya, sehingga perlu adanya registrasi tim bantuan medis yang didukung dengan Penetapan kebutuhan akan Tim Bantuan Medis yang jelas akuntabilitasnya. dan adanya quality control terhadap tim bantuan medis baik lokal maupun asing serta sistem pelaporan.
Tim bantuan medis yang datang tidak jelas kompetensinya sehingga sering menimbulkan masalah, seperti infeksi setelah bencana selesai sebagai efek sekunder yang ditimbulkan. Oleh karena itu, perlu penetapan kualifikasi Tim Bantuan Medis seperti kompetensi klinik yang jelas dan tercatat serta data-data yang selalu terarsip dan tersimpan rapi.
Tidak ada standar minimal yang sama untuk setiap profesional dalam pemberian bantuan medis, sehingga perlu adanya sistim manajemen untuk mengkoordinasikan Tim Medis tersebut agar bisa bekerja secara efektif dan efisian serta termonitor. Sistim manajemennya harus diatur dengan jelas dan perlu ada Institusi yang melaksanakannya, baik secara mandiri maupun bekerja sama dengan Institusi lain yang legal.

Rekomendasi Kebijakan

Dalam upaya mengkoordinir dan mengontrol tim bantuan medis yang ada di Indonesia, maka diberikan beberapa rekomendasi kebijakan:

Registrasi tim bantuan medis baik asing maupun lokal yang mengatur mobilitas keluar masuk pada satu pintu, sehingga bisa memonitor aktifitas yang dilakukan serta kebutuhan tim medis dilapangan.
Penetapan Pedoman (Guideline) untuk Bantuan Tim Medis Asing termasuk didalamnya Standar Minimal pelayanan kesehatan yang diperlukan, list spesifikasi rumahsakit dan logistik medis serta non-medis yang ada di setiap rumah sakit saat bencana. Pedoman (Guideline) ini dimaksudkan untuk memberi arah kebijakan dan petunjuk praktis dalam operasionalisasi dari Tim Medis, baik lokal maupun asing, agar dapat bekerja secara efektif dan efisien dengan dampak seminimal mungkin.
Legalisasi Institusi dan pejabat dari jajaran kesehatan, agar memiliki power yang cukup untuk dapat mengkoordinir para profesional dalam tim bantuan medis. Institusi kesehatan ini menjadi bagian dari Badan Nasional Penanggulangan Bencana yang berwenang melakukan uji kelayakan tim medis.
Pengumpulan, kompilasi dan recording data dokter dan dokter spesialis yang expert dalam bidang bencana sehingga akan memudahkan koordinasi terhadap kebutuhan sumber daya tim bantuan medis, serta list spesifikasi rumah sakit yang ada di Indonesia

Penyusun :

dr. Bella Donna, Mkes
Phone : 0811286284
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.

________________________________

dr. Hendro Wartatmo, SpB KBD
Phone : 0811283118
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.

________________________________

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