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Does Health Promotion has a role in disaster management? Does Health Promotion has a role in disaster management? LABENESE EPIDEMIOLOGICAL ASSOCIATION 12 th ANNUAL CONFERENCE, BIERUT 18 November 2006 Dr Syed Jaffar Hussain Dr Syed Jaffar Hussain Regional Regional Advisor Advisor Healthy Lifestyle Promotion/Injuries & Violence Healthy Lifestyle Promotion/Injuries & Violence Prevention Prevention

Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

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Page 1: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Does Health Promotion has a role in disaster management?Does Health Promotion has a role in disaster management?

LABENESE EPIDEMIOLOGICAL ASSOCIATION 12th ANNUAL CONFERENCE, BIERUT

18 November 2006

Dr Syed Jaffar HussainDr Syed Jaffar HussainRegionalRegional AdvisorAdvisor

Healthy Lifestyle Promotion/Injuries & Violence Healthy Lifestyle Promotion/Injuries & Violence PreventionPrevention

Page 2: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Outline of the presentationOutline of the presentation

The concept of health promotion

The public health consequences of emergencies/disasters

The public health challenges witnessed in Lebanon

Public Health Response to emergencies/disasters

The role of health promotion and health promotion professionals

Page 3: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Health PromotionHealth Promotion

“Health promotion is the process of enabling people to increase control over, and to improve, their health” (Ottawa Charter 1986).

Five Key Action Areas:

Build Healthy Public Policy

Create Supportive Environments

Strengthen Community Actions

Develop Personal Skills

Reorient Health Services

The fundamental conditions and resources for health are:

Peace,

Shelter,

Education,

Food,

Income,

A stable eco-system,

Sustainable resources,

Social justice, and equity

Page 4: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

The Bangkok CharterThe Bangkok Charter

The Bangkok Charter identifies actions, commitments and pledges required to address the determinants of health in a globalized world through health promotion.

Four Key Commitments•Central to the global development agenda

•A core responsibility for all of government

•A key focus of communities and civil society

•A requirement for good corporate practice.

Make health promotion centralto Global Development Agenda

Health promotion must become an integral part of , foreign policy and international relationsdomestic and

war and conflictincluding in situations of

Make health promotion a key focus of communities and civil society

Communities and civil society often lead in initiating, shaping and undertaking health promotion.

They need to have the rights, resources and opportunities to enable their contributions to be amplified and sustained

Page 5: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

What happens in a Emergency-Man made or NaturalWhat happens in a Emergency-Man made or Natural

Five Major Outcomes:

Human Loss, Injuries

Massive damage to infrastructure

Population Displacement and dismemberment of the family fabric

Economic hardships

Intense Bereavement and Anger

Page 6: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Loss of human lives/injuriesLoss of human lives/injuries

Immediate social and health needs.

Psychological trauma

Injuries (or injured) are not receiving quality treatment

Loss of Human lives due to secondary causes of injuries

Long-term disabilities

Page 7: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Damage to infrastructureDamage to infrastructure

Not only health facilities but infrastructure having tremendous impact on human health (water, housing, sanitation, etc)

Existing mechanism of care is disrupted (family care, etc)

Greater risk of epidemics

Limited access of the relief agencies to affected population (damaged roads, insecurity, etc)

Page 8: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Population DisplacementPopulation Displacement

New habitats

Strain on existing civic amenities

Patients with chronic diseases become more vulnerable

Sense of insecurity

Loss of self esteem

Refugees

Page 9: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Economic HardshipsEconomic Hardships

Loss of entrepreneurships

Reliance on aid

Increased dependency

Vulnerability to ill-health and new diseases

May lead to nonsocial behaviors and events

Page 10: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Bereavement and/or angerBereavement and/or anger

Psychologically and emotionally vulnerable

May resort to bizarre behaviors

May become unhappy with the response of the government and agencies

Partly may be misinformation received through local media or other sources

Page 11: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Public Health impact of War in Lebanon Public Health impact of War in Lebanon

More than 1200 dead due to war

More than 4000 injured due to war

974 184 displaced before ceasefire and still 255 986 after ceasefire (as of 3 September)

Page 12: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Public Health impact Lebanon Health infrastructure

Public Health impact Lebanon Health infrastructure

Graph 1: Status of health facilities assessed in total numbers (total = 410)(total number of health facilities per district is mentioned between brackets)

Source: MOH/WHO assessment

Graph 2: Status of all health facilitiesin percentage (n=410)

01020304050607080

Beirut S

uburbs (50)

Bent Jbeil (33)

Hasbaya (20)

Marjayoun (28)

Qada of N

abatieh (53)

Beirut (78)

Jezzine (31)

Sour (59)

Herm

el (8)

Baalbeck (50)

No Information Functioning

Partially functioning Not Functioning

Functioning51%

Not Functioning26%

Partiallfunctioni

6%

No Information17%

Page 13: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

What happened during the war n Lebanon?

What happened during the war n Lebanon?

33 days of conflict

Massive population displacement

Significant damage to infrastructure

Oil spill contaminating 150 kilometers of coastline

Sea, air and road blockade

Occupation in several areas of south Lebanon

US$ ??3.6 billion estimated damage

Page 14: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Estimated more than1 million people displaced in and outside Lebanon

230 000 fled to neighboring

countries

735 000displaced in

Lebanon

Population displacementPopulation displacement

Page 15: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Roads and at least 77 bridgesMore than 15 000 homes Power plants and fuel stations

Infrastructure damage Limited access due to:

Infrastructure damage Limited access due to:

2. Sea and air embargo

1. Destruction of civil infrastructure

Page 16: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Growing public health concernAssessed UXOs and mines in South Lebanon (estimated numbers)

Growing public health concernAssessed UXOs and mines in South Lebanon (estimated numbers)

Source: OCHA

cluster bombs101 760

air delivered

bombs825

artillery (naval)4950

artillery13 200

air delivered missiles

825

Page 17: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

The Role of Health Promotion & Public Health Professionals

The Role of Health Promotion & Public Health Professionals

Organizing and Informing the community

Page 18: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

The phases of an emergency/disasterThe phases of an emergency/disaster

Preparedness Response

Recovery Rehabilitation

Com

mun

ity p

artic

ipat

ion

and

empo

wer

men

t

Page 19: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Unfortunately Emergencies/Disaster do not follow a linear course

Emergency/DisasterAcute Phase

Adaptation

Recovery

Rehabilitation

Page 20: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Importance of Health Promotion in Emergencies/Disasters

Importance of Health Promotion in Emergencies/Disasters

Emphasizing the public health impact of the issue.

In the context of emergency/disasters management, HP involves working with people to prevent, prepare for, and respond to disasters to reduce risks, increase resilience and mitigate the impact of disaster on health.

Community participation, therefore, is the basis of successful HP in such disaster situation

Page 21: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

The Importance of Community Participation in HP in aemergency/disaster situation

The Importance of Community Participation in HP in aemergency/disaster situation

Emergency Prevention and Preparedness: Community participation in assessing risks and vulnerability; promoting awareness of environmental hazards and safety consciousness; strengthening community resilience and organization. Awareness raising and training are the cornerstones.

Emergency response and recovery: community participation in the response phase in the immediate aftermath of disaster; ensuring sustainable and incremental improvements in environmental health

Page 22: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Summary of the Role of Health Promotion Professionals in various phasesSummary of the Role of Health Promotion Professionals in various phases

Focus on disaster preparedness and prevention

Provide training and guidance in performing action

Promoting good health practices in community development

Psychological rehabilitation and long term support

Identification of specific messages and communication methods appropriate to the situation

Adaptation of methodologies to actual and potential needs

Use of messages based on problems/practices associatedwith recovery phase

Need to deal with psychosocial problems of the situation

Help the individual develop her/his own perception of risk

Ensuring that the rebuildingprocess is ‘health focused’

Adjustments of health promotion activities to prevailing health conditions and scarcities

Tailor risk information based on an individual’s characteristics

Assessment of individuals/ groups who may require long term care

Specify the consequences of the condition and recommended action

Define pop at risk and their evel of risk

Gradual blending into more stable condition

Provide “how to” information, promote awareness

Organize community for making them health and safety conscious

RecoveryResponsePreparedness

Page 23: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Its all about assessing and mitigating risksWhich specific practices are placing health at risks?

Which is the most vulnerable group of population?

What could motivate the adoption of safe practices?

Who should be targeted by the program?

How can one communicate with these groups?

Page 24: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Coordination-the real challenge? Coordination-the real challenge?

Duplication and wastage of scarce resources.

Often community needs are not assessed-they receive the support we perceive they need not what their real needs are.

Non-synthesis of information

Donors’ driven agenda?

Government’s “over-reliance” on relief agencies.

Page 25: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Some Critical Public Health Areas where healthpromotion professionals can play a critical roleSome Critical Public Health Areas where healthpromotion professionals can play a critical role

Generating data and information on the effectiveness of interventions

Environmental Hygiene (water, sanitation, housing, etc)

Mental health promotion

Immunization-Maternal and Child Care

Prevention of epidemics

Care of patients with chronic illnesses

Calculating trends

Engaging media as an active partner

Page 26: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Source: Smedley BD, Syme SL (eds.), Institute of Medicine. Promoting Health: Strategies from Social and Behavioral Research. Washington, D.C.:, National Academies Press, 2000.

A Multilevel Approach to Epidemiology of CommunityParticipation in Health Promotion

A Multilevel Approach to Epidemiology of CommunityParticipation in Health Promotion

Page 27: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

Future challenges Lebanon

Future challenges Lebanon

Transition relief to recovery

Medium- to long-term rehabilitation

Ensuring that reconstruction and rehabilitation policies are health

driven rather than only health system driven

Page 28: Does Health Promotion has a role in disaster management?...Health Promotion “Health promotion is the process of enabling people to increase control over, and to improve, their health”

THANK YOUTHANK YOU