Appendix III: Course proposals

Details on course requirements

The following nine courses and modules listed cover many of the most urgent needs in postgraduate education of health related personnel. In some cases the courses already take place in one or even two countries of Europe (see pages 10-15). Others could be readily started given adequate funding, and yet others are far from implementation. Table 4 lists the present status of the nine courses.

Table 4

Course No.	Level needed
1	National	Planned attempts
2	National	Planned, Netherlands
3	European, international	Held in Belgium
4	National
5	European	Expertise exists
6	National
7	Some countries	Exists in France and UK
8	Some countries	Planned, Netherlands
9	National	Held regularly in UK

There is therefore a need to replicate the courses in 3, 7 and 9. Those numbered 5 and 6 need stimulation and assistance and the new modules will benefit from encouragement.

COURSE SHEETS

1. Title of course: Module on the public health aspects of disasters

Duration and timing: 15 hours

Type of teaching institution: schools of public health

Type of student: Master in Public Health and similar

Purpose:

1. To provide postgraduate students in public health with the basic aspects of health management of disasters

2. To prepare them for participation in disaster rescue and relief

Detailed aims: -

Curriculum related to competency aimed at:

- the general health aspects of natural and man-made disasters: assessment of needs	3 hours
- Epidemiological approach to disasters
- Health information systems in disasters
- Control of communicable diseases in disasters	2 hours
- Basic emergency cases; essentials of triage; tagging; life-maintaining procedures	2 hours
- Environmental health protection in disasters; identification and control of environmental hazards; shelter, water supply, sanitation and disposal of the dead	2 hours
- Nutritional problems in disasters including refugee camps; basic nutritional requirements; techniques of feeding and rehydration; organisation of food aid; nutritional education	2 hours
- Disaster preparedness; stress reactions of the community; cultural patterns and management of disasters; team work; interdisciplinary aspects of disaster management; the role of national and international agencies including nongovernmental organisations	2 hours
- special protection for disaster work; the pros and cons of voluntary work	2 hours

2. Title of course: Module on public health engineering; rapid environmental assessment

Duration and timing: 20 hours including some field and laboratory exercises

Type of teaching institution: -

Type of student: Graduate public health engineer (or civil or agricultural engineer)

Purpose: To assess environmental factors after a disaster

Detailed aims: To provide a base for preventive health measures, if needed, and to obtain data for repair works

Curriculum related to competency aimed at:

- Quick map changes in morphology (land-slides, silt accumulation, breaches in dams) as far as they present potential dangers

- Assessment of water supply and sewage systems (pipe breaks, pollution of supplies, changes in ground-water levels) and of the resulting biological and chemical water quality

- Assessment of air quality (dusts, smoke, fumes)

- Inspection of potential dangers due to stores of chemicals and other goods in industrial and commercial establishments

3. Title of course: Short course on health management for disasters

Duration and timing: 2-3 weeks (10-15 working days)

Type of teaching institution: School of public health

Type of student: Senior health administrators

Purpose: To promote a professional approach to the management of disaster-related health problems

Curriculum related to competency aimed at:

- Health aspects of disasters - general introduction, the health aspects of disasters, from prevention and pre-disaster preparedness to post-impact rescue, short-term relief and long-term rehabilitation

- The epidemiological approach to disaster management - methods and techniques for the systematic assessment of needs and optimal use of local resources

- Emergency care in disasters - inventory of the major medical and nursing care. Care problems associated with immediate rescue and short-term relief, with special emphasis on the logistics of organisation of triage, evacuation and second-level care. Emergency medical care as part of primary health care

- Hospital preparedness for disaster - special questions of hospital planning for disasters. Hospital administration in the case of disasters, specific procedures and management of personnel

- Surveillance of communicable diseases in comprehensive review of communicable diseases, including animal diseases, as possibly associated to natural and man-made disasters. Organisation of epidemiological surveillance, including the setting up of an appropriate health information system in situations of natural disasters - relations with veterinary public health

- Nutritional problems in disasters - basic nutritional requirement, methods and surveys for nutritional surveys, organisation of a food distribution system, general policy of food replenishment of seeds and livestock and economic marketing

- Refugee camp - general review of the refugees’ problems - specific questions raised by temporary relocation of populations, including control of communicable diseases, environment, out food supply - organisation of refugee camps accelerated - training of local and expatriate personnel for the management of refugee camps

- Disaster and the community - short-term and long-term effects of disasters on the socio-economics structure community. The impact of natural and man-made disasters on the socio-economic development, specific mental and psychological problems in situation of disasters

- Environmental health protection - inventory of environmental health in natural and man-made disasters. Surveying methods. Environmental priorities according to the different sequences of the relief activities. Maintenance and/or re-establishment of appropriate water supply

- Medical supplies - essential drugs, packing, shipping and sorting

Control of unsollicited drugs

- Manpower in disasters - management of personnel in the resume - short-term and long-term relief phases. Handling of volunteers - Inventory and review of teaching material available for training of disaster personnel

- Health planning for disaster - health problems in disasters in relation to other community problems resulting from disasters. The health components of planning for disaster

- International assistance - the role of national and international official and non-governmental organisations inter-agency co-ordinators

4. Title of course: Short courses for accident - Emergency - Specialists

Problem oriented courses and related issues suggested for training of senior health officials. This course is intended for senior health officials who are likely to be involved in the planning and emergency provision of health services following disasters.

Its objectives are:

1.- To transfer knowledge and promote exchange of information between health officials regarding emergency preparedness for natural disasters and disaster relief co-ordination.

2.- To identify the health problems and managerial deficiencies most common following natural disasters and discuss technical solutions.

3.- To provide the elements for the establishment of national focal points for disaster relief co-ordination in the health sector.

4.- To promote a professional approach to the management of disaster related health problems based on the systematic assessment of needs and optimal use of local resources.

The course addresses the main aspects of disasters from pre-disaster preparedness to rescue, short and medium terms relief and long term rehabilitation.

An essential feature of this course should be its multiplying effect. By supplying the participants with appropriate teaching material, it should be repeatable on a national basis, being adopted to the various levels of the health services.

5. Title of course: Short course on veterinary public health in disaster situations

Duration and timing: 3 days

Type of teaching institution: A school of veterinary public health (one or two courses in Europe probably sufficient)

Type of student: Teachers and co-ordinators of veterinary public health

Purpose: To provide training for teachers of veterinary public health workers to prepare for work in emergency disaster situations

Detailed aims:

Curriculum related to competency aimed at:

- Generic training	3 hours	(2) *
- Control of epidemic in disaster situations	3 hours	(5)
- Disease problems associated with stray and wild dogs	2 hours	(4)
- Rodent control	2 hours	(2)
- Destruction of carcasses and other infected material	2 hours	(4)
- Disinfection processes	2 hours	(4)
- Problems of animal shelters and feeding	2 hours	(4)
- Veterinary medicine in emergency situations	3 hours	(4)
- Food hygiene and animal slaughter in emergencies	4 hours	(4)
- Co-operation with other professional bodies	1 hour	(2)

* Veterinary officials working in endemic areas should have analogous classes for 5 days made up as in brackets

Those requiring specialisation in particular aspects may need twice the time specified on certain topics

6. Title of course: Short course on disaster planning and action

Duration and timing: 1 week

Type of teaching institution: Universities/medical schools/public health schools

Type of student: Medical doctors, veterinarians, pharmacists, nurses, public health officers, policy makers, senior planners and health professionals

Purpose:

1. To create awareness of disaster situations
2. To introduce students to roles and functions of health personnel in a disaster environment

Detailed aims:

- Through case-studies develop emergency relief measures appropriate to national plans

- Be able to implement relevant technical aspects

Curriculum related to competency aimed at:

- Definitions and characteristics of natural and man-made disasters

Training and phases in disasters

- National disaster planning and preparedness measures

- International disaster relief

- Acute medical care in disasters/emergencies; triage

Search, rescue and evacuation
Emergency transportation and communication
Emergency hospital system
Provision of medical supplies

- Epidemic surveillance and control

Vital statistics

- Food and nutrition in disasters

Emergency feeding
Medical problems in a famine

- Water supply, sanitation, waste disposal, vermin control

- Care of the homeless, shelter, emergency housing of refugees

- Mental health in disasters

- Medical views on radiological and chemical hazards

- Public health related services and training of the community.

7. Title of Course: Module on the epidemiology of chronic disasters in a tropical public health course

Duration and timing: 2 weeks

Type of teaching institution: University

Type of student: Doctors training in tropical public health with additional training to cope with famine, refugee camps or epidemic situations

Detailed aims:

Curriculum related to competency aimed at:

- Epidemiology of planning:

- Methodology of evaluation including health indicators and specific criteria
- Training in epidemiological investigation
- Methodology of nutritional surveillance

- Training in specific medical problems

- Methods for the standardisation of diagnostic and therapeutic techniques
- Training in resuscitation and basic surgery under “primitive” conditions
- Methods of mass vaccination
- Methods of mass nutrition

- Training in hygiene

- Studies of hygiene among refugee groups with particular reference to the management of water supplies and sanitation

- Organisation and logistics of refugee camps

- Organisation and logistics of supplies and field hospitals

8. Title of course: Module in public health engineering for refugee communities

Duration and timing: 12 hours

Type of teaching institution: Public health (and related) engineers

Type of student: Post-graduate and relief administrators

Purpose: To assure people who have had to leave their homes a healthy habitat in a different environment

Detailed aims:

Curriculum related to competency aimed at:

- Available solutions: rehousing in the provisionally repaired home, in temporary buildings spread over a wider area, concentrated in camps

- Siting: protection against floods and landslides, accessibility and availability of services; relation with the master plan for definitive reconstruction; survey techniques

- Layout: taking care of the need for central services. For large camps division into identifiable blocks is necessary for psychological and administrative reasons

- Equipment: facilities for solid waste and fire-fighting management. Clinics and wards, administration, police and correction facilities. Desirability or non-desirability of fencing all or parts of the camp

- Housing: orientation with regard to sun and prevailing winds; ventilation; pest and vermin control; communal or individual cooking and washing facilities

- Water and waste-water: the need to disrupt the infection chain by water-related vectors; installation of short-term water systems; later full-scale installations using appropriate technology

- Impact of the camp on its environment and the population living there. Prevention of health changes caused by their mutual relations

- Food technology

9. Title of course: Short course on health care in refugee and camp situations

Duration and timing: 1 week

Type of teaching institution: Institutes teaching public health for developing countries or public health courses in Europe which have students from developing countries

Type of student: Doctors, nurses, nutritionists, water engineers, health educators and administrators

Purpose: To demonstrate usefulness of community health so that potential workers will have an appreciation of the activities in which they will need to be involved

Detailed aims:

1. Awareness of the concept of community health

2. Introduction to the technical skills required to help solve the priority health and disease problems

Curriculum related to competency aimed at:

- Overview of world refugee problem
- Role of international organisations
- Cultural, political, social and economic factors
- Health planning
- Mapping
- Practical epidemiology including estimating numbers, census and surveys
- Control of communicable diseases including immunisation
- Environmental health including location of sites
- Feeding programmes
- Health centre activities including curative care
- Health management
- Training refugees
- Personal health care