B health operations protocol 20140331

National Disaster Response Plan for Hydro-Meteorological Disaster (DRAFT) MAR2014

CLUSTER B: Health (WASH, Medical and Public Health, Nutrition, Mental Health and Psychosocial Support) Cluster Operations Protocol

Copy Number:Issuing Agency: National Disaster Risk Reduction and Management CouncilPlace of Issue: Camp General Emilio Aguinaldo, Quezon CityDate of Issue: Integrated Plan: National Disaster Response Plan

1. RATIONALE

In emergencies and disasters, delivery of appropriate and timely public health and medical interventions is critical in order to save lives and decrease preventable mortalities, morbidities, injuries and disabilities. The Health Cluster is comprised of the health emergency management systems of the Department of Health which was tasked to lead four (4) key sub-clusters: 1) Water, Sanitation and Hygiene (WASH), 2) Medical and Public Health, 3) Nutrition and 4) Mental Health and Psychosocial Support (MHPSS) clusters each of which answers defined outcomes and objectives in the response plan working harmoniously with one another and with other clusters in large scale disaster response in the country.

The DOH will lead the cluster in coordination and collaboration with local, regional, national and international partners shall ensure to provide related services in accordance with legal frameworks and acceptable standards. 2. OBJECTIVE

The Health Cluster comprised of the WASH, Medical and Public Health, Nutrition and Psycho-social sub-clusters of the DOH aims to provide support for the delivery of appropriate and timely public health and medical services to the affected population.

In the National Disaster Risk Reduction and Management Plan, the DOH is answerable to the following objectives and indicators in the response phase:

DISASTER RESPONSE INDICATORS1. To establish an effective

and efficient health sector response operations

Activated functional ICS on site

Well –established system of information gathering, reporting and dissemination

Established and functioning system for coordinated and efficient medical and public health operations

2. To ensure adequate and prompt assessment of health needs and damages at all levels

Timely and appropriate and consolidated health assessment and needs assessment reports

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MAR2014 National Disaster Response Plan for Hydro-Meteorological Disaster (DRAFT)

3. To ensure that basic health services are provided to affected population inside or outside evacuation centers

All patients seen/treated and epidemics and diseases prevented

Data-base of hospitals and other health care providers maintained

Timely access to appropriate and adequate public health services established

Lifelines restored4. To ensure coordinated and

integrated system for early recovery

Mechanisms for coordinated and integrated early recovery established and essential health services restored

To address these, the response plan of the DOH follows the framework of management to cover the following aspects: Event, Cases, Environment, Services, and Public Health Implications as follow:

1. Managing the event (command, control, coordination)

2. Managing the cases (clinical management)

3. Managing the environment (environmental sanitation)

4. Managing the services (response services)

5. Managing the properties (diagnostic tools, the hospital, laboratories, and logistics)

6. Managing public health implications (community)

All of these are contributory to the attainment of the ultimate goal of health response in emergencies and disasters: To save lives and decrease preventable mortalities, morbidities, injuries and disabilities in emergencies and disasters.

3. CONCEPT OF OPERATIONS

All requests for additional emergency health services will be coordinated to the Health Cluster Lead or focal person assigned at the NDRRMC OpCen during the disaster. Validation of the requests will be done by the DOH National Cluster through their counterpart focal person on ground. The DOH will be the Lead and will assign its Focal Coordinator/s for all government and non-government (local and International) emergency health teams and volunteers.

Deployment of DOH Team will be done through the directive of the DOH, NDRRMC Chairperson or the President. The DOH Team will coordinate with the LCE of the affected areas or the Incident Commander as directed by the LCE. Demobilization of the DOH Team will come from the LCE or Incident Commander.

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Cluster B

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National Disaster Response Plan for Hydro-Meteorological Disaster (DRAFT) MAR 2014

Warning Agencies

PAGASA

Directive from the President

ACTION : Receives and disseminates warning message. All instructions and updates on request made on ground will be coursed through the Health Cluster.

DOH Teams deployed to

affected areas.

ACTION:DOH Teams coordinates with EOC and reports to the Incident Commander for deployment.

ANNEX 1: Operations Flow for Health Cluster.

ACTION:Coordinates with all Health Cluster member agencies with DOH Teams on nearby areas (Region, Province, City/Municipal) for possible mobilization to the affected area.

Emergency Operations

Center (EOC)

ACTION:EOC will determine the Incident Command Posts needing emergency health support and coordinate with the DOH Team.

Selected Incident

Command Posts

HealthFocal Person

NDRRMC

OPCEN


The following are the key players and actors in the implementation of this concept.

A. Lead Cluster Agency

a) Department of Health (DOH)

i. Pre-Disaster Phase

Medical and Public Healtha. Early Warning and Alerting System (EWARS)1. Organize ERT and put them on standby status2. Hospital to enhance Surge capacity3. Team Mobilization

b. Pre-Emptive Evacuation Phase1. Provision of health service (Deployment Hospital Emergency

Response Team and evacuation center clinic) 2. Provide patient transport services

WASH1. Alert WASH Team both at national and regional level.2. Establish contact with WASH cluster at national level3. Prepare list of available WASH logistics.

MHPSS1. Re-orient LGU officials and responders on MHPSS2. LGU to prepare to mobilize MHPSS teams,3. LGU to activate MHPSS teams; CHD and National to support and

augment LGUs when necessary4. LGU, CHD and National to coordinate with partners on the

following:a. Conduct of MHPSS assessmentb. Preparation of teamsc. Delivery of appropriate MHPSS services.d. Activation of MHPSS resources (experts, partners, facilities)

5. Assist LGU in reviewing resource map and inventory of resources (health facilities, psychiatric facilities, rehab centers, trained MHPSS providers, experts, drugs and medicines)

6. Assist LGU in mapping partners7. Assist LGU in coordinating with partners8. Assist LGU in activating screening and referral system9. Assist LGU in monitoring event and providing alert notifications10.Assist LGU in deployment of MHPSS teams11.Prepare to augment MHPSS teams12.Assist LGU in the conduct of coordination meetings

Nutrition1. Update resource inventory/mapping of micronutrients by Nutrition

Clusters at all levels

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a. Vitamin A capsulesb. Multiple micronutrient powdersc. Ferrous sulfate and iron with folic acidd. IECs for Nutritione. MUAC Tapesf. Weighing scaleg. Weight for height reference tableh. Height Boardi. Ready-to-Use Therapeutic Food (RUTF)j. Ready-to-Use Supplementary Food (RUSF)k. Antibiotics, deworming tablets (for routine acute malnutrition

management, to be coordinated with the health office/centers)l. Human milk banks (inform them ahead for proper coordination)m. Breastfeeding Kit (container/katsa, feeding cup with cover, food

container with spoon and fork, 1 liter glass tumbler with cover, IEC materials, birth registration form)

2. Mapping of partners (4Ws- Who, what, when, where) by Nutrition Clusters at all levels

3. National/Regional Nutrition Clusters providing augmentation to LGU Nutrition Clusters on the following:a. Conduct of general and blanket supplementary feeding for 6

to 59 months old children, and pregnant and lactating women b. Setting-up of breastfeeding corner/space in evacuation

center4. Support LGU in giving alert notification to health facilities with

capacities for SAM (severe acute malnutrition “severe wasting” management)

5. Augment activation of the following:a. Joint Rapid Nutrition Assessment Teams, if necessaryb. Infant feeding/ Breastfeeding Support Groups, if necessary

6. Support LGU in the conduct of Intra/InterCluster Coordination Meetings

ii. During Disaster Phase

a) 0-24 Hours

Medical and Public Health1. Rapid Health Assessment (RHA) Team and Team deployment2. Patient Referral /conduction to Hospitals3. Hospital Care and support to pre-hospital care4. Deploy Emergency Response Teams (Command team/ Incident

Management Team, Medical Team, Technical Team, support service team)

5. Transport services 6. Augment cadaver bags and other logistics (medical station tent,

medical supplies, Drugs and medicines etc.)7. Establish Health Command Post ( ACP for Health Services)

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8. Establish disease surveillance system – Surveillance in Post Extreme Emergencies and Disasters (SPEED)WASH1. Monitor on the overall situation and possible impact on

WASH facilities in the area. 2. Establish initial information from the regional counterpart on

the extent of WASH condition in the affected areas3. Dispatch team to conduct rapid WASH Assessment as per

request of the LGU concerned.

MHPSS1. Coordinate with LGU on team deployment 2. Assist LGU in data gathering, prioritization of targets and

planning for MHPSS services3. Assist and support LGU on MHPSS needs assessment and

information management using 4Ws4. Assist LGU in provision of MHPSS services:

Psychological First Aid (PFA) and facilitation for provision of basic services and security

Community and family support5. Assist LGU in activating referral system6. Augment LGU resources in terms of manpower,

infrastructure, logistics.7. Assist LGU in organizing cluster meetings

Nutrition1. Augment team deployment by LGU 2. Assist LGU in establishing contacts, gathering critical

information (baseline) and identifying immediate priorities to include areas that situation may worsen.

3. Support LGU in the conduct of gap analysis and in the prioritization and planning/ scheduling of nutrition interventions

4. Support LGU in the preparation and submission of daily situation report

b) 25-48 Hours

Medical and Public Health1. Deploy Medical Teams 2. Augment additional logistics3. Cleaning & clearing of health facilities4. Repair of facility damage5. Coordinate Health Sector Response (Emergency meeting)6. Definitive treatment of injured victims continued7. Support continuation or restoration of health services in

affected areas8. Proper recording and timely reporting

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WASH1. Facilitate the provision of potable water (bottled water, water

rationing/trucking, water treatment) by LGU and partners.2. Monitor the LGU activities to respond to WASH needs such as

to the following: a. water quality monitoringb. provision of toilet facilitiesc. solid waste managementd. hygiene promotion

3. Coordinate WASH team deployment (CHD and national) to LGU.

4. Provide water kits, hygiene kits and other WASH commodities to LGUs.

5. Continue monitoring and coordination regarding status/needs through CHDs by national

MHPSS1. CHD and National to support and augment team deployment as

necessary.2. LGU, CHD and or National to coordinate with partners3. Organize and call MHPSS cluster meeting4. LGU to conduct and review MHPSS Assessment to gather

baseline and identify needs5. Prepare MHPSS action plan with all stakeholders6. Support LGU in providing appropriate MHPSS services as

follow:a. Psychological First Aid (PFA)b. Community and Family Supportc. Focused, non-specialized servicesd. Specialized services including referral to specialists and

treatment7. Set up MHPSS referral system8. Attend meetings of other clusters (Health, Education and

Protection) together with LGUs9. Prepare 4Ws (Who, What, When, Where)10. LGU to collate and submit MHPSS report to cluster lead.

Nutrition1. Augment team deployment by LGU 2. Assist LGU in establishing contacts, gathering critical

information (baseline) and identifying immediate priorities to include areas that situation may worsen.

3. Support LGU in the conduct of gap analysis and in the prioritization and planning/ scheduling of nutrition interventions

4. Support LGU in the preparation and submission of daily situation report

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c) More than 72 Hours

Medical and Public Health1. Augment medicines & supplies2. Health Education, Promotion and 3. Distribution of IEC materials4. Continue Health sector Coordination to include resource sharing

and mapping5. Continue provision of Consultations , case treatment, referral to

hospitals and Hospital care services6. Organize and deploy public health and medical mission teams7. Conduct DANA/DALA (at 1 week)8. Prepare Early Recovery to Rehab Plan ( 2nd-3rd week)9. Activate SPEED. 10.Support to continue or restore health services of health facilities

(hospital, Health Center, Rural Health Units, Barangay Health Stations, etc)

11.Submission of reports and updates.

WASH1. Continue the WASH assessment in cooperation with LGU and

WASH partners.2. Coordinate WASH team deployment (CHD and national).3. Ensure that provision of potable water (bottled water, water

rationing/trucking, water treatment) by LGU and partners are continuously managed.

4. Continue water quality monitoring by WASH Team and LGU.5. Continue provision of water kits and hygiene kits and other

WASH commodities (water testing reagents, waste receptacles, etc.) by national and regional if available.

6. Extend assistance on the installation/construction of toilet facilities (in case of gaps) by LGUs and partners.

7. Conduct hygiene promotions.8. Monitor the repair/ restore water facilities by LGU or water

providers. 9. Continue monitoring and coordination regarding status/needs

through CHDs by National. 10.Timely reporting. . Nutrition1. Augment LGU’s logistics on the following:

a. Implementation of nutrition interventionsb. Information management (e.g. 4Ws, use of data tracking

matrix of DSWD)c. Monitoring and evaluationd. Documentation

2. Support LGU in policy monitoring of EO513. Support LGU in the conduct of Intra/Inter-Cluster Coordination

Meetings

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4. Assist LGU in the advocacy for services related to mental health and psychosocial care, water, sanitation and hygiene, health, and others

5. Technical assistance for “exit” strategy6. Continuous collation of updates and reporting

MHPSS1. Provide technical assistance to LGU on team deployment and

provision of MHPSS services: Psychological First Aid (PFA) and facilitation for provision of

basic services and security Community and family support Focused, non-specialized services Specialized psychological and mental health services

2. Assist LGU in activating the referral system3. Augment LGU resources in terms of manpower, infrastructure,

logistics.4. Coordinate with LGU on cluster activities5. Assist LGU in the accomplishment of the 4Ws6. Assist LGU in organizing cluster meetings7. Assist LGU in the conduct of continuous MHPSS needs

assessment and planning for services 8. LGU to collate and submit MHPSS report to cluster lead.

iii. Post Disaster Phase

Medical and Public Health1. LGU to Continue provision of Medical and Public Health Services2. Participate in Conduct of PDNA3. Prepare and submit recovery plan4. LGU to Continue Disease Surveillance and monitoring in

Evacuation Centers5. Emergency Health Teams to demobilize and report to mother unit

under the instructions of the Incident Commander or LCE. 6. Post operation assessment and report to be prepared and

submitted to the National Cluster Lead.

MHPSS1. LGU to provide MHPSS services as needed; CHD and National to

support and augment2. Continuously coordinate with partners to resolve MHPSS issues3. Implement recovery and rehabilitation plan.4. LGU to collate and submit MHPSS report to cluster lead.

B. Cluster Member Agency

a) Office of the Civil Defense (OCD)

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i. Pre-Disaster Phase1. Forward all alerts and warnings to all government and local

government units. 2. Alert all Regional Offices to put on stand-by mode all available

resources for possible deployment.

ii. During Disaster Phase1. Assist in establishing priorities and coordinating the transition of

mass care operations with recovery activities based on disaster situation information and the availability of resources that can be appropriately applied.

iii. Post Disaster Phase1. Provide assistance in the demobilization of emergency health

teams to mother unit.

b) Armed Forces of the Philippines (AFP)i. Pre-Disaster Phase

1. All available medical teams/supplies placed on stand-by for possible deployment under the directive of the Health Cluster Lead.

2. Monitoring of available medical teams and submitting the list to the National Health Cluster Lead for possible deployment.

3. Prepositioning of medical teams and supplies at the UC and or Infantry Division Station Hospitals.

ii. During Disaster Phase1. Deployment of available medical teams and supplies in

coordination with the National Health Cluster Lead and the LCE/Incident Commander of the affected areas.

2. Deployed medical teams to report to the LCE or Incident Commander for proper deployment.

3. Status reporting to the Health Cluster Lead and IC/LCE.

iii. Post Disaster Phase1. Recall of deployed medical teams on the instructions/approval

of the LCE/IC and return to mother unit. 2. Submit post disaster operations report to the Cluster Lead.

c) Philippine Coast Guard (PCG)i. Pre-Disaster Phase1. All available medical teams placed on stand-by for possible

deployment under the directive of the Health Cluster Lead. 2. Monitoring of available medical teams and submitting the list to

the National Health Cluster Lead for possible deployment.

ii. During Disaster Phase

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1. Deployment of available medical teams in coordination with the National Health Cluster Lead and the LCE/Incident Commander of the affected areas.

2. Deployed medical teams to report to the LCE or Incident Commander for proper deployment.

3. Status reporting to the Health Cluster Lead and IC/LCE.

iii. Post Disaster Phase1. Demobilization of deployed medical teams on the instructions of

the LCE/IC and return to mother unit. 2. Submit post disaster operations report to the Cluster Lead.

d) Bureau of Fire Protection (BFP)Shall support the provision of assistance to the affected LGU within their area of jurisdiction to facilitate the operations of the medical teams deployment on ground.

e) Department of the Interior and Local Government (DILG)Shall assist the Emergency Health Teams in coordinating with the LCEs of the affected LDRRMCs.

f) Philippine Red Cross (PRC)i. Pre Disaster Phase1. Continuous monitoring and reporting2. Readiness of status check of all resources including manpower,

supplies, equipment and tools.3. Coordinate with chapters to verify and identify needs of

operation4. Coordinate with partner agencies at the national level such as

NDRRMC, PAGASA, DOH, DSWD, etc.

ii. During Disaster Phase1. Rapid assessment and coordination2. Develop PRC operational action plan3. Provide pre-hospital care for injured and ill –persons

(ambulance-patient transport if needed)4. Continuous monitoring of the situation5. Conduct after operation de-briefing

iii. Post Disaster Phase1. Conduct post-disaster and need assessment2. Conduct of inventory of resources3. Prepare and submit operation report4. Conduct debriefing

j) Volunteers/Civil Society OrganizationsAll Volunteer Medical Teams will coordinate with the National Health Cluster Lead for proper deployment to the affected areas.

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m) National Bureau of Investigation (NBI)Shall provide assistance in the identification of casualties. (See MDM Cluster)

n) Department of Foreign Affairs (DFA)Shall provide assistance in the processing of incoming Health Emergency Teams from regional and international community

o) Philippine National Police (PNP) through the Health Service and Women and Children Protection Center.

i. Pre-Disaster Phase1. Alert all teams to be ready for deployment in affected

regions.2. Ensure Disaster Teams Safety by providing safety

equipment & nutritional needs.

ii. During Disaster Phase1. Deployment of medical teams to affected areas 2. Provide transportation to medical teams and patients.3. When available, keep medical doctors, nurses,

psychologists, dentists, etc to help assess & treat disaster victims in the evacuation areas.

4. Record all actions per case including follow-up 5. Report to Women Children Protection Center Desks on a

daily basis on GBV incidents6. Ensure availability of women health staff.

iii. Post Disaster Phase1. Provide security to medical teams and patients to affected

areas. 2. Assign personnel to assist in the Evacuation Centers. 3. Ensure updated reports to provide assistance, manpower for

rescue and relief operations and medical services.

p) Department of Social Welfare and Development (DSWD)Shall assist in the provision of medical and health emergency services to the affected population in coordination with the Health Cluster Lead or the head of the deployed emergency health teams.

4. CONCEPT OF SUSTAINMENT

a) The DOH as Cluster Lead will coordinate all support and requirements of response cluster in their activities to augment the requirements at the affected areas during disasters.

b) Concerned government agencies and their subordinate offices shall utilize their respective internal personnel. Additional personnel

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requirements shall be coordinated through the NDRRMC in collaboration with all Council members.

5. COMMAND AND CONTROL

A. Command Relationship – all DRRM actors and key players will refer and based their actions as prescribed in IRR of R.A. 1021, Rule 3, Section 2. Composition

B. Command Center – National Disaster Risk Reduction and Management Operations Center (NDRRMOC), Camp General Emilio Aguinaldo, Quezon City.

a) Succession of Command:

(1) Chairperson, NDRRMC (S, DND)(2) Vice-Chairperson for Disaster Response (S, DSWD)(3) Health Cluster Lead (DOH)(4) Health Cluster Members

a) Interagency Communication System Support

For the entire duration of the operations, the existing means of communications shall be utilized whatever is applicable. However, the Emergency Telecommunication Cluster will be activated once communication is cut-off from the affected areas.

FOR GUIDANCE AND STRICT COMPLIANCE

SEC VOLTAIRE GAZMINChairperson, NDRRMC Department of National Defense

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Data & Analytics

B health operations protocol 20140331