A Critical Look at National States of Emergency Preparedness

It is particularly encouraging to note that the health sector of Central America and Panama is taking a serious and critical look at their own national state of emergency preparedness.

Recent natural disasters such as the earthquake in Mexico and the volcanic eruption in Colombia have made these countries more mindful of their vulnerability. But natural disasters are not the only risk to which they are exposed. The countries of Central America and Panama are also vulnerable to manmade disasters brought about by mass migrations of refugees and displaced persons.

With this in mind, representatives of the health sector from Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama met in Tegucigalpa, Honduras from 18-20 August at the "2nd Subregional Meeting on Evaluation of Health Activities in Emergency Situations."

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The group recognized the significant efforts initiated by the health sector of the countries in the subregion to satisfy emergency needs caused by disasters. But the countries identified as critical the need to increase financial allocations for emergency preparedness activities, develop operating plans for specific aspects of disaster management, improve continuity of disaster programs in spite of administrative changes, and ensure that disaster preparedness units fall within the ranks of high-level decision makers in national organizational structures.

Emergency planning must be an ongoing process. This is true during non-emergency times when seemingly unrelated activities such as changes in national infrastructure or multisectoral reductions in personnel can alter the logistics of a national plan. And, it is perhaps more critical in the aftermath of a disaster when the opportunity to evaluate strategies, learn lessons from the implications of emergency decisions, and revise disaster plans is at hand.

Manmade disasters brought about by the mass migration of refugees and displaced persons can pose as great a threat as natural disasters. Photo: J. Vizcarra/PAHO

Disaster preparedness was also a topic of discussion among the representatives to the II Health Sector Meeting of Central America and Panama (RESSCAP) which met from 25-29 August in Tegucigalpa. The meeting was attended by Ministers of Health and directors of national Social Security Institutes, with the technical support of PAHO and the participation of international agencies lending technical and financial cooperation. The purpose of the meeting was to collectively analyze the most serious common problems affecting the health sector of the countries in the subregion.

At this meeting, resolutions were passed calling for improvements to the health sector. Among the resolutions was one dealing with emergency preparedness. Below are highlights of Resolution XIII passed at the meeting of RESSCAP:

· to call upon each country to strengthen their existing technical units that deal with emergency health preparedness or create units in those countries which still do not have them.

· to promote the necessary political support for these activities, including the commitment of sufficient resources for their execution.

· to encourage the development and distribution of health sector plans for disasters.

· to motivate the countries to include training in emergency health preparedness in their programs of continuing education.

· to encourage vulnerability assessments of national health institutions, drinking water and sanitation systems and other systems vulnerable to disasters.

· to request that the Director of PAHO consider the need not only to maintain but also increase the Organization's support to national emergency preparedness programs.

· to manifest their concern for the state of health care in temporary settlements for refugees and displaced persons; for the health problems derived from mass migrations presently occurring in the subregion; and express their hope that these areas will be granted the high priority they deserve.

The fact that the countries of the subregion realize that deficiencies exist and much remains to be accomplished is encouraging. The Caribbean subregion also held a meeting last June in Barbados of health disaster relief coordinators to evaluate health activities in emergency situations. The Andean subregion is scheduling a similar meeting In early 1987. Countries of the Region are encouraged to continue this positive trend. Close self-examination of national programs and the sharing of experiences in emergency preparedness and planning is our mutual responsibility. It is never too soon to begin.

Although earthquakes cannot be prevented, mitigation measures can reduce their impact. Photo: J.L. Zeballos, PAHO

Emergencies and disasters often have different meanings for different persons or institutions. The manual of the World Health Organization defines an emergency as "any situation implying unforeseen, severe and immediate threats to public health." PAHO has commonly used the term disaster to signify "an overwhelming ecological disruption which exceeds the capacity of a community to adjust, and consequently, requires assistance from the outside." In planning national programs to fortify a country's ability to withstand or cope with a disaster, it is well to keep in mind several concepts inherent in disaster management. Prevention. Prevention measures are defined as measures aimed at impeding the occurence of a natural event. Constructing a dam or levy to control floods is one example of a preventive measure. Hurricanes and earthquakes cannot be prevented with the technology presently available. Mitigation. Mitigation measures are aimed at reducing the impact of a natural disaster on a population or country. Developing and enforcing building codes, for instance, will reduce losses in the event of earthquakes or hurricanes. Preparedness. Preparedness measures enable individuals and institutions to respond rapidly and effectively to emergency situations created by any type of disaster. Such measures include formulating and updating contingency plans, training personnel, and maintaining inventories of resources.