|Disaster Reports Number 5: Hurricane Gilbert in Jamaica, September, 1988 (PAHO-OPS, 1988, 42 p.)|
The PAHO/WHO  survey of seven parishes revealed an information gap with regard to disaster management in the health sector. At the primary care level, 17 percent of the staff knew of the disaster management structure at the Ministry Headquarters. Fifty-seven percent knew of the structure at the local level. The situation was better in the secondary care system in that 50 percent of staff knew of the structure at Ministry Headquarters and 75 percent in their own institution.
Other serious limitations were identified.
· emergency medical and non-medical supplies were inadequate
· there were serious deficiencies with regard to medical equipment
· serious deficiencies with regard to transportation and communication existed
· there was a shortage of manpower and an inadequate mix
The relative lack of preparedness of the health sector was underscored by the fact that the Disaster Plan at the Ministry of Health had not been completed. Where one existed at the parish level, it could not be brought into operation because of a resource gap. Disaster plans for some hospitals existed but they had not been activated. In addition, simulation exercises had not been carried out.
Devolution of authority was seen as being necessary in a disaster. There was the feeling among field staff that they had to await directives from the central level before taking administrative actions. Devolution, however, would call for access to emergency funds, clear guidelines as to the type of responses that were appropriate at the local level and close co-ordination with the Parish Disaster Preparedness and Response Programme.
The survey also emphasized the need for greater speed with initial damage and needs assessments and for greater accuracy in identifying real emergency needs.
Backup systems for water supply, power and radio communication should be provided at all hospitals and health centers.
The report recognized the dedication of health service personnel who, though lacking the necessary support, proved an important resource in the wake of Hurricane Gilbert. The will to continue in the face of adversity should be encouraged by the development of local self sufficiency.