Overall Management

In a major emergency, a full-time Emergency Health Services Coordinator should be designated by the government and provided with appropriate authority and necessary administrative support. When the government is non-existent, the U.N. should take the initiative.

Particular attention should be paid to:

· mobilizing and re-assigning available medical and paramedical personnel, including any outside medical teams, according to priority needs;

· redistributing and ensuring the controlled use of the available stocks of drugs and other medical supplies and ordering and receiving additional supplies, including control and co-ordination of donations;

· establishing budgets for all aspects of health care operations and ensuring the availability of operating funds to all field units;

· systematically collecting and analysing data on the incidence of diseases (epidemiological surveillance) and ensuring prompt and appropriate responses to reports of outbreaks;

· co-ordinating activities with other related operations (i.e. food, water supply, sanitation, education);

· providing precise guidelines to all personnel and teams engaged in health-related activities;

· involving local communities in the management of their health units.

Guidelines should specify: standard treatment schedules to be applied using a limited number of essential drugs; what vaccination activities to undertake and how; how to requisition and take delivery of supplies; and what reports to submit and how. Clear guidelines on the role of local communities in relation to the management of the unit should also be established.