i

CONTENTS

Acknowledgements ....................................................................iii Introduction .................................................................................1 Abbreviations .............................................................................2 Roles and Responsibilities .........................................................3 PREPARING FOR EMERGENCIES ..........................................5 Coordinating with Other Agencies ............................................11 Drafting the Health Disaster Management Plan .......................15 RESPONDING TO EMERGENCIES .......................................16 Rapid Health Assessment ........................................................19 Critical Incident Management ...................................................22 Pre-Hospital Activities ...............................................................23 Hospital Activities .....................................................................25 Prevention and Control of Communicable Diseases ................29 Nutrition Concerns ...................................................................31 Environmental Health ...............................................................37 Water Supply ...........................................................................38 Sanitation and Waste Management .........................................43 Vector and Vermin Control .......................................................49 Epidemiology and Surveillance ................................................52 Psychosocial Care and Mental Health .....................................56 Management of Dead Bodies ..................................................63 Forensic Science Concerns in Mass Fatalities .........................65 Resource Management ............................................................71 Risk Communication ................................................................73 APPENDICES ..........................................................................77 Emergency Manager Deployment Checklist ............................78 Rapid Health Assessment Forms ............................................79 Reference Values for Rapid Health Assessment and

POCKET EMERGENCY TOOL

........................98 ConversionTable ..................................................................................................ii CONTENTS Contingency Planning .........99 Websites .....105 POCKET EMERGENCY TOOL ..............................................................................................103 Emergency Call Number Directory ....85 Radio Procedures .............................................................................................................................................101 References ....................

Dr. Robin Willison. Quirino. Susan P. Dr. Carmencita A. Dr. Carmencita A. Mrs. Mercado. Edgardo Sarmiento. Banatin. and Dr. Habacon . Emmanuel S. Dr. Arnel Z. with support from the World Health Organization-Regional Office for the Western Pacific Region (WHO-WPRO). Pesigan of Emergency and Humanitarian Action (EHA) of the WHO-WPRO. Guia P. Herbosa. Morales. Dr. Florinda V. Dr. Russell Abrams. Arturo M.iii ACKNOWLEDGEMENTS This pocket tool is a project of the Department of HealthHealth Emergency Management Staff (DOH-HEMS). Hipolito. Reyes. Dr. Go. Dr. Dr. Enriquez . Flores . Zando Escultura. Raquel dR. Yoshihiro Takashima. Arnel Z. Miguel C. Dr. The first edition was through the efforts of the following individuals: Engr. Fortun . Manuel F. Joven. Dr. Mrs. Dr. Dr. Dr. who reviewed the text and provided valuable comments. Dr. Dr. Dr. Mr. Mrs. Acknowledgement is also given to Dr. Agnes B. Dr. Jr. Dr. Xiangdong Wang. Yuchongco. Josephine H. Teodoro J. Ms. Lay-out and cover design was done by Mr. Ignacio . Xiangdong Wang. Rivera. Dr. Tayag. Pesigan. Hitoshi Oshitani. Enrique A. Lourdes L. JeanMarc Olivé. Panlilio. Edgardo Sarmiento and Dr. under the technical supervision of Dr. Banatin . Prudente. Dr. Zen Delica Willison. Shigeki Asahi . Elizabeth M. Camilla A. Daniel T. Ladislao N. Lilia M. Dr. Marilyn V. Dr. Rivera. Mr. Beñegas . Arturo M. POCKET EMERGENCY TOOL . The review and revision for this second edition was done through the efforts of Dr.

This pocket tool. WHO and other international agencies' guidelines. the success of this guide depends largely on the dynamics of its use and the tireless efforts of its users to improve it. networking and coordination. checklists and standards. Also. POCKET EMERGENCY TOOL . where more detail can be found. business and civil society groups. this 2nd edition was conceived from the lessons learned from the recent disasters that affected the country and the Western Pacific Region. Thus. references to complementary documents and websites. The goal of the Department of Health (DOH) through the Health Emergency Management Staff (HEMS) is to prevent or minimize the loss of lives during emergencies and disasters in collaboration with government. neither provides nor claims to be the definite and only guideline to follow in emergencies. A compendium of recent DOH. some of the suggested procedures may need to be tailored to local conditions. because every disaster is unique. however. this booklet provides essential pointers on how to carry out rapid health assessment. are provided at the end of the booklet.1 INTRODUCTION Human survival and health are the common objectives and measures of success of all humanitarian endeavors. Furthermore. Indeed. planning. and other necessary tools especially in times of tragedies and adversities. this pocket tool is an evolving text. The main purpose of this pocket tool is to help guide and prepare health sector professionals in the field in the event that an emergency occurs.

2 ABBREVIATIONS CDC CHD CMR CSR DND DOH-HEMS DOTC DPWH DSWD EHA EMS EOC EPI ER IEC HEICS LGU MUAC NBI NDCC NEC NEHK NGO NNC NPDEP OpCen PHC PNRC RDCC SARS WHO-WPRO WMD Centers for Disease Control and Prevention (USA) Center for Health Development Crude Mortality Rate Communicable disease Surveillance and Response Department of National Defense Department of Health-Health Emergency Management Staff Department of Transportation and Communication Department of Public Works and Highways Department of Social Welfare and Development Emergency and Humanitarian Unit Emergency Medical Services Emergency Operations Center Expanded Program of Immunization Emergency Room Information. Education and Communication Hospital Emergency Incident Command System Local Government Unit Mid-Upper Arm Circumference National Bureau of Investigation National Disaster Coordinating Council National Epidemiology Center New Emergency Health Kit Nongovernmental organization National Nutrition Council Nutrition Preparedness in Disasters and Emergencies Plan Operation Center Primary Health Care Philippine National Red Cross Regional Disaster Coordinating Council Severe Acute Respiratory Syndrome World Health Organization-Office for the Western Pacific Region Weapons of Mass Destruction POCKET EMERGENCY TOOL .

of a Health Emergency Manager/Coordinator T ake the lead within the community in: ! health coordination and networking ! rapid health assessment ! disease control and prevention ! epidemiologic and nutrition surveillance ! epidemic preparedness ! essential medicines management ! physical and psychosocial rehabilitation ! health risk communication ! forensic concerns and management of mass casualties ecord and re-evaluate lessons learned to improve preparedness in the future ssess and monitor health and nutrition needs so that they are immediately dealt with mprove health sector reform and capacity building by networking end and protect the practice of humanitarian access.R.I.A. neutrality and protection of health systems in emergency situations R A I T POCKET EMERGENCY TOOL .T.3 ROLES AND RESPONSIBILITIES T.

HEICS. Observe all requirements and standards (hospital emergency plan. 2. Report all health emergencies to the Operation Center.) needed to respond to emergencies and disasters. Network with other hospitals in the area to optimize resources and coordinate transferring of victims to the appropriate facility. 3. etc. Code Alert System. and document all incidents responded.4 ROLES AND RESPONSIBILITIES Roles of Hospitals in Health Emergency Management 1. POCKET EMERGENCY TOOL . Ensure enhancement of their facilities to respond to the needs of the communities especially during emergencies. 4.

5 PREPARING FOR EMERGENCIES POCKET EMERGENCY TOOL .

Policy Formulation and Development ! policy statement/implementing rules ! guidelines. protocols. Networking ! organization of the health sector ! coordination and planning ! memorandum of agreement with stakeholders ! networking activities 5. ambulance. POCKET EMERGENCY TOOL .g. hospitals ! procurement of supplies. communications and equipment 4. Operation Center. SARS.6 PREPARING FOR EMERGENCIES Steps in Preparing for Emergencies 1. Facilities Development ! standardization/mprovement/upgrading of ER. procedures ! organizational structure ! roles and functions ! resource mobilization 2. Capability Building ! training needs assessment ! human resource development ! training of trainers ! database of experts ! tabletop drills and exercises 3. Disaster Planning ! vulnerability and hazard assessment ! all-hazards emergency operations plan ! specialized planning for uncommon incidents (e.

7 PREPARING FOR EMERGENCIES WMD) ! communication plans ! hospital preparedness and response plans 6. Establishment of Emergency Operation Centers ! Infrastructure. technology 10. Systems Development ! Logistics Management System ! Management Information System ! Communication System 9. manpower. Documentation and Research ! publications ! databanking ! accomplishment reports ! research studies ! lessons learned POCKET EMERGENCY TOOL . Public Information and Mass Media ! advocacy activities ! development of IEC's 7. Post-disaster Response Evaluation ! monitoring and evaluation activities ! postmortem evaluation 8.

Maintain operation center as regional repository of vents for the health sector. Identify an official spokesperson to answer concerns by the public and the media 6. Manintain updated hazard and vulnerability assessment of their catchment areas 3. Organize health sector in the region and provide mechanism for coordination and collaboration. (Based on DOH Administrative Order 168.2004) POCKET EMERGENCY TOOL . Report to the Central DOH (HEMS) for all emergencies and disasters and any incident with the potential of becoming an emergency 8.8 PREPARING FOR EMERGENCIES Roles of Centers for Health Development in Emergency Management 1. Serve as the DOH Coordinating Body in their region 2. Provide technical assistance and empower all LGUs in the area on health emergency management 7. Observe all requirements and standards needed to respond to emergencies (Regional Emergency Plan) 4. Document all health emergency events and conduct researches to support policies and program development. Provide advice to the RDCC for health emergency concerns 5. s.

barangay captain.. medicine. health and water treatment and other sanitation supplies in government stores. indigenous health workers. These information must be updated regularly: ! Disaster profile of the region ! Population size and distribution ! Topography and maps showing communication lines ! Epidemiologic profile of the region ! Location of health facilities and the services they provide ! Location of potential evacuation areas ! Location of stocks of food.e. traditional healers. etc. commercial warehouses and international agencies and major NGOs ! Key people and organizations who would be responsible for/active in relief (contact phone numbers AND addresses) ! Individuals with special competencies and experience who may be mobilized on secondment from their institutions or as consultants in case of need (contact phone numbers AND addresses) ! A roster of regular resource persons ready to translate technical information materials into local dialect (i.9 PREPARING FOR EMERGENCIES At the Center for Health Development (CHD) level… The following information should be readily available for reference and may be compiled in collaboration with other partners (government and non-government units).) POCKET EMERGENCY TOOL .

10 PREPARING FOR EMERGENCIES The following resources should be readily available for use AT ALL TIMES: 1. Communications equipment 3. Funding requirements 9. Vehicles 2. Water testing sets 6. Food supplements 7. Temporary shelter capacities 8. Back-up power supplies 4. printers. Personal protective equipment POCKET EMERGENCY TOOL . Computers. facsimiles and photocopying machines 5.

and other institutions in the country whose expertise and/or services may be called upon during emergencies (DND. unforeseen events and new opportunities. 13. 2. Educate all members about the range of services each agency can provide. 9. PNRC. NGOs. 11.) Steps in Establishing Good Working Relationships with Other Groups or Entities 1. POCKET EMERGENCY TOOL . Maintain regular communication and correspondence among members. Adopt responsibilities in the context of what was agreed upon 15. Discuss needs and lines of action. Reach a consensus on objectives. 3. 7. Each agency is vital. DPWH. Adjust to changes. Encourage member participation. Make partners aware of policies and protocols. Define the parameters of the project. Have a common goal. NDCC. 12. Designate a good and strong facilitator. 4. Be flexible and be open to possibilities. Give priority to the whole group. Fix issues early on. strategies and plans. DSWD. 5. Enlist and maintain the support of top-level-management. 6.11 COORDINATING WITH OTHER AGENCIES Prepare internal arrangements within the DOH and with other public health related government entities. UN agencies. Build trust among members. 8. 14. 10. Have operating guidelines. DOTC. Develop clear and attainable mission statements from the beginning of the project. etc.

! Reach a consensus on objectives. strategies. Have a product or concrete result showing the team's effort and share among members so that there is a sense of accomplishment. A designated and experienced chairperson should practice facilitative behavior: listening. changes are fast and many. 2. PRODUCT describes the session's deliverables in specific outputs. To coordinate is to facilitate. Health coordination must start as soon as possible. At the start of a crisis. and plans. it should be regular and frequent. 17. not being defensive. Know their perspectives and concerns. 3. Celebrate.12 COORDINATING WITH OTHER AGENCIES 16. 5 Ps of Facilitation: 1. allow adequate incentive. asking open-ended questions. a clear agenda. ! Have ground rules. ! Discuss needs and lines of action. encouraging participation. and optimistic but realistic 4. PROBABLE ISSUES give an idea of the potential POCKET EMERGENCY TOOL . PARTICIPANTS push the issues. For members to attend. PURPOSE explains the overall aim of the session. and desired outcomes.

! Preliminary word clarification and definition.based on regular communication of relevant data. PROCESS is the detailed set of steps that will be taken to create the product. ! Approve the agenda before starting the meeting. ! Sort issues by categories and types. The resulting consensus should be that everyone feels that he has been heard and that everyone agrees and is willing to support the decision. brainstorming. ! Have group memory by using flip charts or handouts. ! Circulate information among partners.13 COORDINATING WITH OTHER AGENCIES roadblocks. Coordination is sharing information with other persons or organizations so they can work together in harmony without friction or overlapping . 5. rank order of issues according to importance to the group. POCKET EMERGENCY TOOL .

leading to misinformation. and their consequences… POCKET EMERGENCY TOOL .14 COORDINATING WITH OTHER AGENCIES Disaster Reaction Sequence: ! ! ! ! ! ! ! ! Surprise: Is it true? Has it really happened? Lack of information: What is happening? Events escalate: It's getting worse but I don't know the details? Lack of control: I don't know therefore I cannot do.” “I might upset other people with what I'll say. misunderstanding. Siege mentality: Why is this happening to us? Panic: Will we ever recover from this? Short term reaction: Get everyone away from me Common Communication Concerns: ! ! ! ! ! ! ! “I don't have the correct facts.” If you do not tell.” “I might sound stupid.” “I might be asked something I cannot answer.” “I might risk my reputation. information will be gathered elsewhere.” “There may be legal implications to what I say.” “There might be a better spokesperson.

abbreviations. Specify command. however. Roles and Responsibilities VII.. Management Structure a. Goals and Objectives III. Potential Problems Analysis IV. Strategies VIII. Resource Analysis V. I. it is not meant to replace alternative outlines that you may deem more appropriate and useful. Annexes (i. lead organization and coordination VI. Explain the organization (an accompanying diagram is essential) b.15 DRAFTING THE DISASTER HEALTH MANAGEMENT PLAN You may follow the outline provided below. glossary.e. control. Background Present the following: ! geographic description ! disasters that have occurred ! gaps in response ! hazard maps ! vulnerabilities and risks II. directory of contact persons) POCKET EMERGENCY TOOL .

16 RESPONDING TO EMERGENCIES POCKET EMERGENCY TOOL .

Initiate risk communications activities 10. children. organizations and the public 9. Ensure that the site safety and health plan is established. elderly. 7. etc. Verify that health surveillance systems are operational 2. Develop initial health response objectives and establish an action plan 4. reviewed. Assign and deploy resources and assets to achieve established initial health response objectives 8. Ensure that the needs of special populations (e.Document all response activities Intermediate Response: 1. Contact key health personnel 3. Establish communication with other key health and medical organizations.) are being addressed 4. Ensure that laboratories likely to be used during the response are operational and verify their analytical capacity 3. Establish communication and maintain close coordination with the EOC 5. Manage health-related volunteers and donations POCKET EMERGENCY TOOL Hours 2-12 ..17 RESPONDING TO EMERGENCIES Steps in Responding to Emergencies Hours 0-2 Immediate Response: 1.g. Assess the situation 2. disabled persons. and followed 6. Address health-related requests for assistance and information from other agencies.

Collect and analyze data that are becoming available through health surveillance and laboratory systems 7.) POCKET EMERGENCY TOOL .18 RESPONDING TO EMERGENCIES 5. Update emergency risk communication messages 6. Prepare for transition to extended operations or response disengagement 3. Continue health surveillance/epidemiologic services 5. Address risks related to the environment 4. Periodically assess health resource needs and acquire as necessary Hours 12-24 Extended Response: 1. is guaranteed (Adapted from CDC's Public Health Emergency Response Guide. including essential drugs and vaccines. Ensure that local health systems are preserved and access to health care. Address psychosocial and mental health concerns 2.

reports/rumors of outbreak) POCKET EMERGENCY TOOL . Direct impact: reasons for alert (3 main causes of morbidity/mortality. acute malnutrition rate) b. Affected population (sex/age breakdown) 3. Executive Summary 2. date. trauma. projected evolution) b. the following key questions need to be answered: ! Is there an emergency or not? (If so. Affected area (administrative division. CMR. access) c. Basically. by DOH-HEMS) ! What decisions need to be made? ! What information is needed to make these decisions? Situation Report Outline: 1. under-5 mortality rate.19 RAPID HEALTH ASSESSMENT The following critical information required should be made available for reference within 24 hours from the event. Nature of the emergency (causative and additional hazards.. Main Issue a. Other reasons for concern (e. Health Impact a. indicate type. magnitude and size of affected area and population) ! What is the main health problem? ! What health facilities or services have been or may be affected? ! What is the existing response capacity? (actions taken by the local authorities.g. Affected health facilities d. time and place of emergency.

Activities already underway b. Other vital needs (e. Pre-emergency baseline morbidity and mortality (when available) e. Other constraints Response Capacity: functioning resources a. Are the current levels of mortality and morbidity aboveaverage for this area and this time of the year? POCKET EMERGENCY TOOL . Social/political and geographical limits d. Fuel. Waste disposal c. damage to critical infrastructures/lifelines) d. Food d. mechanisms. 5. external assistance. Strategic coordination (local/international relationships) Conclusions a. National protocols.20 RAPID HEALTH ASSESSMENT 4. contingency plans c. flow of information) e. 6. Indirect health impact (e. electricity.. Shelter and environment on site e. c. Security: coordinate with the safety officer to identify hazards or unsafe conditions associated with the incident b. state of communications) d. and communication f. 7.. Operational support (command post. regional unit and referral system. Transport and logistics c. Projected evolution of health situation: main causes of concern if the emergency will be protracted Vital Needs: current situation a.g. Operational coordination (lead agencies. Water b. clothing and blankets) Critical Constraints a.g.

DOH counterparts and neighboring regional directors. Is a further increase in mortality expected in the next 2 weeks? 8. sanitation.Annexes: include all detailed information that are relevant *See appendix for sample of rapid health assessment form. 10. What are the risks to be monitored? d. Who will be doing what? Be honest in the conclusions and practical in the recommendations. Prioritize the health problems (in terms of magnitude and severity and of feasibility of response interventions). mortality. Which inputs are needed to implement all these? f. water. What must be put in place as soon as possible to reduce avoidable mortality and morbidity? b. Are the current levels of morbidity. POCKET EMERGENCY TOOL . 9. Recommendations for Immediate Action a. Recommendations that cannot be put into practice quickly are useless. Emergency Contacts: local donor representatives. shelter and health care acceptable by international standards? c. Which activities must be implemented for this to happen? c. How can they be monitored? e. nutrition.21 RAPID HEALTH ASSESSMENT b.

22 CRITICAL INCIDENT MANAGEMENT Steps as First Responders a. Monitor events and respond to changing circumstances m. cold zone) ! Implement safety and security measures ! Identify access and egress routes d. Develop an incident plan in conjunction with members of the Incident Management Team j. Establish the initial medical command post e. Report actions and activities to the appropriate agencies and authorities POCKET EMERGENCY TOOL . Establish Staging Officer g. Coordinate resources and support l. warm zone. Assume command (until a more senior personnel arrives) b. Assess the situation and advise the appropriate authorities and agencies c. Establish liaison with other services on site h. Set perimeters ! Identify and set perimeter (hot zone. Establish Safety Officer f. Task response agencies and supporting services k. Determine priorities and time constraints i.

breathing disturbance (RR =30/min or RR <10/min) c. altered level of consciousness e. the following information should be contained in the patient's color tag: a.needs to be treated within 1-3 hours a. external bleeding with CVS collapse POCKET EMERGENCY TOOL . obstruction/damage to airway b. Reverse triaging is done during the Search and Rescue stage where the priority is to get as much people out of danger with the least effort. circulation disturbance (HR =100/min or weak pulses) d.23 PRE-HOSPITAL ACTIVITIES Triaging Objective: To quickly identify victims needing immediate stabilization or transport and the level of care needed by these victims by assessing airway. injuries identified d. Triaging is done if there are more victims than health responders. Color Tagging Ideally. patient's sequence number b. name of patient c. previous interventions given at the scene RED TAG 1st priority: Life-threatening . and circulation (ABC's). breathing.

obviously mortal wounds where death is certain (such as head injuries or massive burns) BLACK TAG Last priority: a.24 PRE-HOSPITAL ACTIVITIES YELLOW TAG 2nd priority: Urgent . complicated by major soft tissue trauma b. major burns: involving hands. spinal injuries. minor injuries not threatened by ABC instability b. environmental injuries (heat/cold exposure) GREEN TAG 3rd priority: Requires no treatment or can be delayed a. feet or face (excluding respiratory tract).needs to be treated within 4-6 hours a. minor fractures/soft tissue injuries/burns c. long bone or pelvic fractures c. death or moribund state In emergency situations the most practical means of tagging may only be by color ribbons or even pentel pens POCKET EMERGENCY TOOL . injuries so severe that survival cannot be expected even under the most ideal conditions.

the following should be on-call anytime during his/her duty days: 1. orthopedic surgeons 3. Aside from those who are on regular duty for the day. the path of which may affect the area ! national or local elections or plebiscites ! national holidays or celebrations (e. ophthalmologists POCKET EMERGENCY TOOL .. New Year's Eve. The alert status shall continue to be in effect until cancelled by the Chief of Hospital or the HEMS Coordinator. O. etc. internists 5.g.g. the HEMS Director. CODE WHITE Alert Mode is called with any of the following conditions: ! a strong possibility of a military operation (e.R.) ! other conditions which may be declared as disasters by the Chief of Hospital or other appropriate authority There should be necessary preparations of the necessary equipment and even personnel. Holy Week. nurses 6.25 HOSPITAL ACTIVITIES Color-Coded Alert Systems The hospital alert status shall be declared either by the Secretary of Health. anesthesiologists 4. surgeons 2. coup attempt) ! any planned mass action or demonstration within the area ! forecasted typhoons. the Chief of Hospital or the HEMS Coordinator..

medical officer in charge of the emergency room 3. This may require the activation of the hospital network or at the judgment of the director or the HEMS coordinator. CODE BLUE Partial/Selective Activation is proclaimed when 20-50 casualties (red tags) are expected. The following should respond once CODE BLUE is on: 1. The suggestions here are based on a general tertiary hospital.26 HOSPITAL ACTIVITIES 7. surgical team on duty for the day POCKET EMERGENCY TOOL . nursing personnel and administrative personnel residing at the hospital dormitory shall be placed on on-call status for immediate mobilization The composition of the back-up and on-call teams would depend on the type and level of the hospital. may only involve the hospital nearest the emergency site. on-scene response team 2. These specialty hospitals act as support to a receiving hospital (e. medical officer in charge of the operating room 5. there can also be designated support hospitals (usually specialty hospitals).g. otorhinolaryngologists 8. In some places like Metro Manila.. Each hospital can come up with its own team members. 2nd response team should be on call 9. EMS. San Lazaro and Fabella Hospital supporting Jose Reyes Memorial Medical Center). ALL orthopedic residents 4.

R.institutional workers on duty CODE RED Full Activation is put into effect when more than 50 (red tag) casualties are momentarily anticipated. nurses 14. expected or suddenly brought to the hospital. ALL persons enumerated under Code Blue 2.operating nurses living within or in the vicinity of the hospital 11. nursing supervisor on duty 10. ALL medical interns and clinical clerks POCKET EMERGENCY TOOL .ALL O.27 HOSPITAL ACTIVITIES 6.ENTIRE security workforce 12.ALL third and fourth year residents 13. ALL anesthesiology residents 9. surgical team on duty the previous day 8. ALL nursing attendants 4. The situation may require more than one hospital to respond by sending an on-scene team. The following should respond once Code Red is on: 1. ALL institutional workers 3. officer in charge of supplies at the CSR 7. ALL nurses 5.

3. cancel elective surgeries. etc. Take other steps necessary to respond to the emergency situation (e.28 HOSPITAL ACTIVITIES If there is a strong possibility that there would be a need to change the alert status from code white to blue to red. the Chief of Hospital is authorized to: 1. Cancel all leaves of personnel and for them to report to the hospital.g.). Put back-up teams on standby within the hospital for rapid deployment. POCKET EMERGENCY TOOL . 2.

Preparation b. such as mass measles vaccination campaign. Provide general prevention measures in coordination with other sectors. Detection c.29 PREVENTION AND CONTROL OF COMMUNICABLE DISEASES Steps in Ensuring Communicable Disease Control in Emergencies 1. 5. Conduct rapid health assessment (see previous section) 2. Implement as indicated. Provide essential clinical services 6. Control outbreaks a. Monitor disease trends 8. including: ! Food security. cough. (especially children. Provide basic laboratory facilities 7. Report diseases of epidemic potential immediately c. Set-up surveillance/early warning systems a. pregnant women and older people) ! Promote good hygienic practice ! Ensure safe food preparation techniques ! Ensure boiling or chlorination of water 4. specific prevention measures. Confirmation POCKET EMERGENCY TOOL . Detect outbreaks early b. and vector control. etc. Provide community health education messages including information on how to prevent common communicable diseases and how to access relevant services ! Encourage people to seek early care for fever.. Expanded Program on Immunization. diarrhea. nutrition and food aid ! Water and sanitation ! Shelter 3.

Vaccination program activities should be included as part of basic emergency health care services. ! Mass vaccination against cholera and typhoid fever is not recommended. Investigation e. ! Each visit to health care facilities should be seen as an opportunity to vaccinate for routine EPI regardless of the reason for the visit. in areas where there is substantial crowding. tetanus boosters may be indicated for previously vaccinated people who sustain open wounds or for other injured people depending on their tetanus immunization history. However. The suggested target age group may be expanded up to 15 years. ! Mass tetanus vaccination programs are not indicated. if feasible. The most practical and effective strategy to prevent cholera and typhoid is to provide clean water in adequate quantities and adequate sanitation. Evaluation Notes on Immunization ! A single suspected measles case is sufficient to prompt an immediate immunization response. Control measures f.30 PREVENTION AND CONTROL OF COMMUNICABLE DISEASES d. ! Mass vaccination for Hepatitis A is not recommended. POCKET EMERGENCY TOOL . Life-saving measles vaccine should be made available immediately targeting all infants and children 6-59 months of age. Sufficient soap and hygiene education will further prevent the transmission of both diseases.

local government and even non-government units. Support the innovation of nutritionally dense ready-to-eat foods.e. noodles.. Adequate Nutrition: During emergencies. Public Education: Promote the acceptability and utilization of donated foods ideal for disasters (i. 2. Interrupted breastfeeding and inappropriate complementary feeding will heighten the risk for malnutrition. 5.31 NUTRITION CONCERNS Nutrition Preparedness 1.e. Resource Generation and Mobilization: Maintain a stockpile of culturally acceptable food items that can be stored for a long period of time such as rice. illness and mortality. Intensify campaign on creating vegetable gardens in schools and backyards. It is equally the responsibility of the national government. 4. canned goods. POCKET EMERGENCY TOOL . Disaster Coordinating Teams implement the NPDEP while involving the Municipal Nutrition Action Officer in the creation of Disaster Response Teams. NNC's Nutrition Preparedness in Disasters and Emergencies Plan or NPDEP). Identify and coordinate with donor agencies and companies that can donate food during disasters. Nutritional Management: Is an institutional and multisectoral concern. dried fish and canned/powdered milk. Planning: Every effort should be done to formulate an intersectoral and comprehensive plan (i. 3. infants (<1y/o) and children (<5y/o) are the most vulnerable group. compact food).

and resettlement feeding. through supplementary feeding) if nutritional status is at risk. it will be important to monitor nutritional status and households' access to food. ! Following a major sudden disaster. particularly in areas where nutritional status was already poor. Gate Keepers: Identification of local/tribal leaders are critical for nutrition education. ! Because the number of caregivers is reduced during emergencies and their ability to cope is diminished by physical and mental stress. supplementation. ! In slow-onset crisis or in situations where the livelihood of the community is greatly undermined. and to initiate remedial action (e. supervised therapeutic feeding (TF) may be required.g. Aside from looking after the basic health and nutritional needs of the displaced population. nutritional rehabilitation through intensive. health workers have to be debriefed to look after their personal health as well. strengthening caregiving capacity is an essential part of promoting good feeding practices for infants and young children. POCKET EMERGENCY TOOL . 7. some people may have no access to food and/or be unable to prepare food for a few days at least. ! In extreme cases.32 NUTRITION CONCERNS 6. ! Healthy workers are essential. Cultural and Indigenous Habits: Customs should be taken into consideration in food management.

. during construction or land preparation works) ! Age/sex distribution when adult males make up more than 50% of the population. ! Special needs of pregnant and lactating women a. 350 kcal for heavy activity (e. requirements are reduced. when the population is exclusively women and children. requirements are increased. need another 500 kcal/day ? Should receive sufficient fluids.g.e. 52 to 64 g) ! Fat/oil: = 17% of diet (i.33 NUTRITION CONCERNS Energy Requirements For initial planning purposes: ! Average daily energy requirement : 2.e.100 kcal/person/ day ! When the data are available. need another 500 kcal/day ? Should receive iron and folate supplements b. the planning figure should be adjusted according to: ! Physical activity level add 140 kcal for moderate activity. Lactating women ? Need an additional 500 kcal/day ? If malnourished. Pregnant women ? Need an additional 300 kcal/day ? If malnourished. 50 g) ! Micronutrients: a range of micronutrients (vitamins and minerals) are required for survival and good health POCKET EMERGENCY TOOL . taking into account activity Other nutritional requirements: ! Protein: 10 to 12% of diet (i.

5 cm 12. Nutritional Assessment The most widely accepted practice is to assess malnutrition levels in children aged 6-59 months as a proxy for the population as a whole. bread. canned meat and fish. Reports should always describe the probable causes of malnutrition. Two-stage cluster sampling is normally used: 30 clusters are selected. Classification of Acute Malnutrition Moderate Severe Mild Malnutrition Malnutrition Malnutrition Edema of both feet No Yes No Weight-for-Height* 70-79% < 70% 80-90% (<-2 to -3 SD) (<-3 SD) (-1 to -2 SD) MUAC <12 cm 12. margarine ! Vitamin and mineral sources fruits and vegetables ! Others coffee and other beverages * see appendix for examples of rations.0 to 12. then 30 children within each cluster. fresh meat and fish.5 cm Body Mass Index 16 to <17 <16 17 to <18. noodles ! Protein sources eggs. milk ! Fat sources cooking oil.5 POCKET EMERGENCY TOOL . dried meat and fish.5 to 13. and nutritional edema should be reported separately. root crops.34 NUTRITION CONCERNS Ideal Foods for Disaster ! Carbohydrate sources rice.

day and night. ! 12 months to 2 years: Breastfeed as often as the child wants.000 IU *see appendix for length-for-weight/height-for-weight reference values **see appendix for decision framework for implementing feeding programs. ! 6 months to 12 months: Breastfeed as often as the child wants. Feeding Recommendations ! Up to 6 months of age: Encourage mothers to exclusively breastfeed as often as the child wants. In addition. at least 8 times in 24 hours. There should be a continual search for malnourished children so that their condition can be identified and treated before it becomes severe. Give adequate serving of locally available complementary food at least 5 times a day.35 NUTRITION CONCERNS Give vitamin A if a child has severe malnutrition.000 IU 1-5 years 200. Give one dose in your presence and give one dose to the mother to give it to the child at home the next day. give adequate servings of locally available complementary foods at least 3 times a day. Age Dose 6-11 months 100. POCKET EMERGENCY TOOL . Do not give any other fluid or food.

36 NUTRITION CONCERNS ! 2 years and older: Give three meals of family food per day. ! A nutritionally adequate breast-milk substitute. POCKET EMERGENCY TOOL . privileged nurturing moment important for both mother and child).. ! The nutritional status of breastfeeding women should be protected as an end in itself. Notes on Breastfeeding ! Breastfeeding's multiple advantages are especially important during emergencies (i. Also. and as a means of maintaining the adequate growth and development of their children. should be available for infants who do not have access to breast milk. contraceptive effect. give nutritious snacks.e. twice daily. ! Emergencies do not justify routine distribution of breast-milk substitutes. protection from infection and its consequences. Every effort should be made to create and sustain an environment that encourages frequent breastfeeding for children under two years of age. Every effort should be made to identify ways to breastfeed infants whose mothers are absent or incapacitated. The use of infant-feeding bottles and artificial teats in emergency settings should be actively discouraged. fed by cup. Formula feeding may increase the considerable risk of child morbidity and mortality.

POCKET EMERGENCY TOOL . ! Floor area per person: 3.37 ENVIRONMENTAL HEALTH Minimum level of necessary services to be provided: 1. Adequate shelter for displaced persons ! Evacuees should be protected from the elements ! Secure against violence ! Provide allocations for privacy ! Avoid overcrowding. Sufficient quantities of accessible drinking water 3.5 square meters ! Fresh air ventilation per person per hour: 20-30 cubic meters ! Lighting: adequate (minimum is a 5-foot candle) ! Ventilation: adequate (combined openings at least 10% of floor area) 2. Protection of individuals in affected population against vectorborne diseases through vector control activities and through chemoprophylactic methods. Facilities for excreta and liquid waste disposal 4. Protection of food supplies against contamination 5.

Evaluate the technology used in the water supply system to ensure that continuous and long-term operational needs are within reach of the community and the evacuees. Always consider seasonal factors in the assessment. 2. making water available for domestic uses (such as cleaning and washing) should be considered. Organize water allocations between the host community and the evacuees to prevent overstraining water resources. It should first be made accessible to victims and relief workers and in essential locations. 3. From the start. 3.38 WATER SUPPLY Provision of adequate amounts of drinking water is of utmost importance after disaster. After drinking water is secured within stricken areas. Organization 1. such as hospitals and treatment centers. Assessment 1. 5. Consult local people in the identification of water sources to be developed. Tap the expertise of the local Sanitary Engineer in the assessment of the water resources and the conduct of sanitary survey. involve the evacuees in the maintenance and operation. Estimate the demand. 2. POCKET EMERGENCY TOOL . Assess water resources for human consumption to ascertain the availability of water (quantity and quality) in relation to the demand. 4. identify possible sources and assess the possibility of developing these resources.

39 WATER SUPPLY 4. Provide water in good quantities and reasonable quality. 2. and maintenance is not a complicated aspect. 8. 6. use water sources that do not need treatment. Train evacuees without prior experience. 4. Consider using pumps and other mechanical equipment attainable in the area where fuel and spare parts are available. Improve access to supplies by developing water sources and a storage and distribution system to deliver sufficient amounts of safe water. Set up schedules for operation and maintenance. 7. including reserve. Technical breakdown should be quickly repaired. Protect water sources from pollution. Monitor both the organizational and technical aspects of the complete water supply system. decontamination of water is necessary. If there is a large number of evacuees. POCKET EMERGENCY TOOL . 5. Combine water control and treatment with improved personal hygiene and environmental health practices. 7. Treat water according to the characteristics of the raw water. 5. Make an inventory of water sources and assess all sources in terms of their quality and yield. Immediate Action after a Disaster 1. 3. 6. If possible. The design and construction of the water supply system must be closely coordinated with evacuation camp planning and layout as supported by health promotion and sanitation. Conduct regular sample collection and testing of water quality. Estimate water requirements and assess water supply possibilities.

15 liters for laundry e. Control: Bacteriological. Maintain and update information on water resources obtained during needs assessment. recommend transfer to another evacuation camp. 15 liters for bathing d. Organize a distribution system that prevents pollution of the source and ensures equity if water is insufficient. planning. biological. 2. physical and POCKET EMERGENCY TOOL . Intermediate Response 1. calculate the following: a. 2 liters for drinking b. If storing the water in tanks is employed. a large amount of reasonably safe water is preferred over a small amount of purified water. Water Need 1. 3. 10 liters for food preparation and cooking c. operation and maintenance. chemical. construction. Quality: To preserve public health. Domestic hygiene and environmental health measures should be observed in order to protect the water between collection and use. 3. Minimum Demand (per person per day). the storage should be tested periodically. 10 liters for sanitation and hygiene 2. If the minimum amount of water cannot be made available from local sources.40 WATER SUPPLY 8.

Mass Feeding Centers: 20-30 liters per person per day Animals ! Cow/Carabao: 30 liters per day ! Pig: 1. and assessment shows no significant probability of such an effect. 5. 7.5 liters per day ! Poultry: 2 liters per day Water Decontamination/Disinfectants: ! Water Purifier: 2 tablets per person per day ! HTH (high-test hypochlorite) Stock Solution: 1 liter/20 families/5 days ! Shock Disinfection: 50-100 parts per million (ppm) of 6070% of available chlorine ! Environmental Cleaner-Sanitizer Drinking Water Container: one container of 10 liters per family Communal Water Storage Tank: 10 liters per person per day.41 WATER SUPPLY 4. ! There are no fecal coliforms per 100 ml at the point of delivery. Volume of tank good for 2 days demand. ! People drink water from a protected or treated source in preference to other readily available water sources. radiological quality of water must be deemed safe.5 liters per day ! Goat: 1. half full in the POCKET EMERGENCY TOOL . 6. ! No negative health effect is detected due to short-term use of water contaminated by chemical (including carry-over of treatment chemicals) or radiological sources. ! Steps are taken to minimize post-delivery contamination. Other Needs: a. Hospital and Clinics: ! Out-Patient: 5 liters per patient per day ! In-Patient: 40-60 liters per patient per day b.

POCKET EMERGENCY TOOL .42 WATER SUPPLY evening. 8. ! It takes no more than three minutes to fill a 20-liter container.7 ppm. with free residual chlorine of 0. Shallow Well: for toilet flushing and cleaning 9.) ! Minimum Number of Water Points: 1 tap per 250 users ! Queuing time at a water source is no more than 15 minutes. Water Points: ! Distance between Water Point and Users: 150 m (max.

Are soil conditions suitable for on-site excreta disposal? 9. Is the soil prone to water logging? 3.How do women manage issues related to menstruation? Are there appropriate materials available for this? Drainage 1. are they sufficient and are they operating successfully? Can they be extended or adapted? 4.? 7. etc. trenches. flooding of dwellings or toilets. What is the current defecation practice (including anal cleansing)? If it is open defecation. Is the current defecation practice a threat to water supplies (surface or ground water) or living areas? 3. Are there any existing facilities? If so. is there a designated area? 2.g. are they used. Are there materials or water available for anal cleansing? How do people normally dispose of these materials? 11. Is there a drainage problem (e. What is the level of the groundwater table? 8. defecation fields. Do people have the means to protect their dwellings and toilets from local flooding? POCKET EMERGENCY TOOL . polluted water contaminating living areas or water supplies)? 2. vector breeding sites. What is the maximum one-way walking distance for users? 6. Are people prepared to use pit latrines.43 SANITATION AND WASTE MANAGEMENT Assessment Excreta Disposal 1. What is the ratio of domestic facilities to population? 5. Do current excreta disposal arrangements encourage vectors? 10.

Localize defecation and prevent contamination of water supply. Develop appropriate systems for the disposal of excreta.6 m. Excreta Facilities 1. Collect baseline data of the site and locate zones for sanitary facilities. Establish sanitation teams for the construction and maintenance of facilities. 6. 1. refuse and wastewater.3 m x 0. Use only soil for cover. 2. Can solid wastes be disposed of on-site. 5. Establish a monitoring and reporting system. Include environmental health as an integral part of health promotion. or does it need to be collected and disposed of off-site? 4. Set up services for management of dead bodies 8. Is solid waste a problem? 2. Are there health facilities and activities producing waste? How are wastes being disposed of? Who is responsible? Immediate Action 1. 4. How do people dispose of their waste? What type of how much solid waste is produced? 3.6 m x 0. 3. Set up services for vector and vermin control.2 m x 0. Communal Trench Latrine: for 50 persons. 1. 2. 7. Pit Latrine: 1 seat for 20 persons. 9.6 m POCKET EMERGENCY TOOL .44 SANITATION AND WASTE MANAGEMENT Solid Waste Management 1.2 m x 0. Plan the number and location of sanitary facilities and services to be established and provided.

Shelters. 6. Protect from vermin harborage and breeding.5 meters above the water table. Others: “Antipolo.0 m 4.8 m x 0.) ! From any water source: 25 m radial distance Bottom of any latrine should be at least 1. Drainage: Run-in and run-off water management. POCKET EMERGENCY TOOL . Grease Trap and Soakage Pit. Four-Funnel Urinal 7.7 m x 3.) ! From shelters: 30 m (min. Locate not less than 25 meters radial distance from any source of water supply. Baffle Grease Trap. 5. Urinals: Urine Soakage. 2. Deep Pit Latrine. There should be no standing wastewater around water points or elsewhere in the settlement. 4. 3. Drainage or spillage from defecation systems must not run towards any surface water source or shallow groundwater source Liquid Waste Facilities 1. Chemical Toilet: 1 seat for 20 persons. Infiltration Trench. 5.45 SANITATION AND WASTE MANAGEMENT 3. 0. 6. Pour-Flush Water-Sealed Toilet: 1 seat for 20 persons. paths. Children's Feces: should be disposed of immediately and hygienically 8. Distance of Latrines: ! From users: 250 m (max. Ventilated Improved Pit: 1 seat for 20 persons.” Aqua Privy. and Cold Water Grease Trap. Reed Odorless Earth Closet (ROEC). water and sanitation facilities should not be flooded or eroded by water.

46 SANITATION AND WASTE MANAGEMENT Solid Waste Facilities 1. notably for Hepatitis B should therefore be provided to waste handlers. Segregate: POCKET EMERGENCY TOOL . 1.3 m) ! Barrel and Trench Incinerator. Be aware of the public health and occupational risks from health-care waste a. Bailleul Incinerator.2 m x 1. Hand-washing and disinfection are a must. Collection: organize a camp refuse collection team 3. All waste handlers should wear protective clothing.2 m x 1. Vaccination. c. Disposal: ! Burial: Communal Open Pit. 2.) ! Bulk storage bin: centralized bin for temporary storage before collection ! No contaminated or dangerous health waste in living or public spaces 2. Rock Pit Incinerator.8 m ! Cross Fire Trench Incinerator: for 20 families (2. Minimize health-care waste 3. b. Storage: ! 100-liters capacity per 10 families ! Distance from users: 15 m (max. Inclined Plane Incinerator.3 m x 0. Open Corrugated Iron Incinerator. Drying Pan Incinerator and Open Turf Incinerator: for 10 families ! Final disposal does not create health or environmental problems Health-care Wastes 1.4 m x 0.

Approximate percentage of waste types per total waste in PHC centers Non-infectious waste 80% Pathological waste and infectious waste 15% Sharps waste 1% Chemical or pharmaceutical waste 3% Pressurized cylinders. used infectious plastic syringes and needles b.47 SANITATION AND WASTE MANAGEMENT ! To be done at point of generation using dedicated. colored and/or marked containers ! Separate wastes into three main categories: i. Dig a pit 1 to 2 meters wide and 2 to 5 meters deep. other infectious PVC plastics such as tubing. non-infectious wastes ! If no separation of wastes takes place. infectious sharps (collect sharps in puncture proof containers with a lid that can be closed. Construct an earth mound around the mouth to prevent to prevent water POCKET EMERGENCY TOOL . broken Less than 1% thermometers… 1. mark with biohazard symbol) ii. anatomical wastes All these should be buried in a sharps waste burial pit. IV sets c. catheters. Wastes to be buried and should not be incinerated: a. Dispose properly. non-sharp infectious wastes iii. Line the bottom of the pit with clay or low permeable material. the whole mixed volume of health care waste needs to be considered as being infectious.

Management of solid health-care waste at primary health-care centres: A decision-making guide. cover the waste with soil and permanently seal it with cement or embedded wire mesh. please see WHO (2004). Geneva: World Health Organization. The container or drum can be sealed and buried in a trench or transported to a local landfill.48 SANITATION AND WASTE MANAGEMENT from entering. Security fence 50cm of soil cover Cement or embedded wire mesh Earth mound to prevent surface water from flowing into the pit 2 to 5m Soil or soil-lime layer Bio-medical waste Bottom clay layer 1 to 2m Another method involves placing the sharps waste in hard containers such as metal drums and adding an immobilizing material such as bituminous sand.) POCKET EMERGENCY TOOL . clay or cement mortar. Construct a fence around to prevent unauthorized entry. (For other strategies. Alternately place layers of waste and 10 cm of lime and soil inside. When the pit is within about 50 cm of the ground surface.

Vulnerable populations are settled outside of the malarial/dengue zone. refuse disposal. do people at risk have access to individual protection? 3. Vector breeding or resting sites modified.) to discourage vector breeding? 4. Conduct vermin population density survey. Is it possible to make changes to the local environment (by drainage. If vector-borne disease risks are high. In areas of known malaria risk: ! spraying of shelters with residual insecticide and/or retreatment/distribution of insecticide-treated mosquito nets in areas where their use is well-known. Is it necessary to control vectors by chemical means? 5. What are the vector-borne disease risks and how serious are these risks? 2. In areas endemic of dengue: ! water storage containers should be covered to prevent them from becoming mosquito-breeding sites. What information and safety precautions need to be provided to households? Preventive Measures a. flies and other mechanical nuisance pests kept within POCKET EMERGENCY TOOL .49 VECTOR AND VERMIN CONTROL Assessment 1. Attempts should be made to eliminate pooled water which may be gathering amongst the debris. d. Screening of living quarters. e. excreta disposal. c. etc. b. Rats.

The following can be determined: POCKET EMERGENCY TOOL . Spray the insecticide and wait 20 minutes until the insecticide has killed the mosquitoes. 4. Garbage must be collected and appropriately disposed to discourage rodent vector breeding. In the shelter. Rodenticide: for rats and mice (under some conditions) g. 2. 1 sprayer for every 50 families 1 misting machine for every 50 families 1 fogging machine for every 500 families Fumigation for the camp. if needed (with proper precautions).50 VECTOR AND VERMIN CONTROL acceptable levels. 5. holes. Removal of breeding and harborage places of vectors and maintenance of sanitation. etc. 6. Count the number of killed adult mosquitoes and record. Intensive fly control is carried out in high-density settlements when there is risk or presence of diarrhea outbreak. h. c. windows. close all openings. Adulticides: for crawling and flying insects f. Spread a white sheet on the floor of the rooms. Larviciding: introduction of local bioremediation microbes Estimation of Vector Population Mosquitoes: 1. f. 3. g. b. d. Select several shelters in the camp. Larvi-trapping Chemical Control a. done under the supervision of an emergency Sanitary Engineer e.

Send the collected mosquitoes to a laboratory for identification. 7. Count the average number of flies that land on a grill placed where flies congregate during three 30-second periods. CJ and Reed RA (1999) Emergency Vector Control Using Chemicals. ! The number of killed adult mosquitoes divided by the number of persons occupying each shelter will give the average number of mosquitoes per person. ! The number of mosquitoes found with blood in the abdomen (red or black) divided by the number of person living in the shelter will give the average number of bites per person. Flies: 1. Loughborough.) POCKET EMERGENCY TOOL .51 VECTOR AND VERMIN CONTROL ! The number of killed adult mosquitoes divided by the number of inspected shelters will give the average mosquito density per shelter. Water. (from: Lacarin. Engineering and Development Center (WEDC).

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EPIDEMIOLOGY AND SURVEILLANCE

Epidemiologic Methods of Emergency Management
Objectives: ! Assess the urgent needs of human populations ! Match available resources to needs ! Prevent further adverse health effects ! Monitor and evaluate program effectiveness ! Improve contingency planning ! Optimize each component of emergency management Application: ! Hazard mapping ! Analysis of vulnerability ! Assessment of the flexibility of the existing local system for emergency ! Assessment of needs and damages ! Monitoring health problems ! Implementation of disease-control strategies ! Assessment of the use and distribution of health services ! Etiological research on the cause of mortality and morbidity ! Follow-up long-term impacts of health, etc.

Steps in Developing a Surveillance System After a Disaster
1. Establish objectives ! Detect epidemics ! Monitor changes in the population ? Numbers
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? Health status including nutritional conditions ? Security ? Access to food ? Access to water ? Shelter and sanitation ? Access to health services ! Facilitate the management of relief 2. Develop Case Definitions (Request NEC) ! Standard case definitions of health conditions simplify reporting and analysis 3. Choose the Indicators ! Indicators must: ? Illustrate the status of the population ? (e.g., death rates) ? Measure the effectiveness of relief ? (e.g., immunization coverage)
“Case definitions” and “Indicators” need to be agreed upon by all those involved in the relief operations.

4. Determine Data Sources ! Data can come from health-care facilities (“passive surveillance”) and from surveys in the community (“active surveillance”) ! Involve those who provide health care ! Health surveillance in an emergency requires input from all sectors
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5. Develop Data Collection Tools and Flows ! Use pre-existing local formats and/or international standards ! Use formats that facilitate data entry (EpiInfo): ! Utilize existing process flows 6. Field-Test and Conduct Training ! Can these data produce the information required? ! Training field workers will improve data facility and local analysis 7. Develop and Test the Strategy of Data Analysis ! Data analysis should cover: ? Hazards and impact on the population's health ? Quality and quantity of services provided ? Impact of services on population's health ? Relation between services provided to different groups (evacuees and hosts) ? Deployment and utilization of resources ! Major operations may require a central epidemiological unit 8: Develop Mechanisms for Disseminating Information (Risk Communication) ! Who will receive the information? ! For the information to be useful, it must be disseminated widely and in a timely fashion: ? Feedback will sustain data collection and the performance of field workers ? Health information is important for the activities of other sectors

POCKET EMERGENCY TOOL

55 EPIDEMIOLOGY AND SURVEILLANCE ! Sharing information is good coordination 9: Monitor and Assess Usefulness of the System ! Is everybody reporting on time? Which data are missing? ! Lack of information in areas or programs that have problems ! Is the system useful? ! Is the information generated by the system being used for decision making? ! If not. readjust the system POCKET EMERGENCY TOOL .

Schedule consultative meetings with the provincial and municipal health workers in the affected area to: ! Estimate the psychosocial problems experienced by the people. Steps in Promoting Psychosocial and Mental Health 1. disorientation and need for active participation. clothing.. and those who lack family and peer support. guided by the classification of people at high risk ! Estimate available resources for mental health/social services * see appendix for Summary Table on Projecting Mental Health Assistance 2. religious and political leaders). grief. shelter. greater exposure to the disaster and its aftermath. the control of communicable diseases. Red Cross volunteers.56 PSYCHOSOCIAL CARE AND MENTAL HEALTH The impact of a traumatic event is likely to be greatest in persons who had a pre-existing mental health problem.g. Assess psychosocial and mental health concerns. and. POCKET EMERGENCY TOOL . Brief field officers in the areas of health and social welfare regarding issues of fear. if applicable. a history of prior trauma. 3. PHC services. Conduct mostly social interventions that do not interfere with acute needs such as the organization of food. Mobilize informal human resources in the community (e.

'psychological first aid'. manage acute distress without medication. dangerousness to self or others. ! Ensure availability of essential psychotropic medications at the PHC level. 5.Establish contact with PHC. It is also not advisable to organize single session psychological debriefing to the general population as an early intervention after exposure to trauma. provision of appropriate psychotropic medication.e. start training and supervising PHC workers and community workers (e. suicide prevention.g.. mania. This is vital since it is during this phase that survivors will be rebuilding their lives amidst the grief from the loss of loved ones. 6. substance use issues and referral). property.57 PSYCHOSOCIAL CARE AND MENTAL HEALTH As far as possible. management of medically unexplained somatic complaints. epilepsy) within PHC. 4. ! Manage urgent psychiatric complaints (i. severe depression. Start planning medium. psychoses. POCKET EMERGENCY TOOL .. If the acute phase is protracted. Many persons with urgent psychiatric complaints will have pre-existing psychiatric disorders and sudden discontinuation of medication needs to be avoided. working with families. supportive counselling. and livelihood. ! Develop the availability of mental health care for a broad range of problems through general health care and community-based mental health services.and long-term development of community-based mental health services and social interventions needed during recovery and rehabilitation.

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PSYCHOSOCIAL CARE AND MENTAL HEALTH

7. Educate other humanitarian aid workers as well as community leaders (e.g., village heads, teachers, etc.) in core psychological care skills (e.g., 'psychological first aid', emotional support, providing information, sympathetic reassurance, recognition of core mental health problems) to raise awareness and community support and to refer persons to PHC when necessary. 8. Carefully educate the public on the difference between psychopathology and normal psychological distress, avoiding suggestions of wide-scale presence of psychopathology and avoiding jargon and idioms that carry stigma. 9. Facilitate creation of community-based self-help support groups. The focus of such self-help groups is typically problem sharing, brainstorming for solutions or more effective ways of coping (including traditional ways), generation of mutual emotional support and sometimes generation of community level initiatives. 10.Provide support to caregivers who, because of the exhaustion and enormity of the job, may experience "burn-out."

Interventions for Children Affected by Emergencies
1. Encourage parents, teachers, and other caregivers to understand and monitor child emotional reactions. Remember that children's reactions vary with age. 2. Help reduce effects by offering emotional support and security to the child.
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3. Facilitate recovery by modelling healthy coping strategies.
* See “Mental health and psychosocial care of children in disasters” (WHO, 2005) for further guidance.

Valuable social interventions include: ! Ensuring ongoing access to credible information on the emergency, on the availability of assistance, and on the location of relatives to enhance family reunion ! Establishing access to communication with absent relatives, if feasible ! Organizing family tracing for unaccompanied minors, the elderly and other vulnerable groups. ! Giving 'psychological first aid': ? basic, non-intrusive pragmatic care with a focus on listening but not forcing talk ? assessing needs and ensuring basic physical needs are met ? providing or mobilizing company (preferably family or significant others) ? encouraging but not forcing social support ? protecting from further harm ! Widely disseminating uncomplicated, empathic information on normal stress reactions and culturally appropriate relaxation techniques to the community at large ! Public education should focus primarily on normal reactions, because widespread suggestion of physical and mental disease may potentially lead to unintentional harm. ! The information should emphasize an expectation of hope, resilience and natural recovery. ! Promote community self-help activities- conceived and

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managed by communities themselves. ! Discouraging unceremonious disposal of corpses. Facilitate conditions for maintaining or re-establishing appropriate cultural practices, including grieving and burial rituals by relevant practitioners. ! Assuming the activity is safe: 1. Encouraging activities that facilitate the inclusion of the bereaved, orphans, widows, widowers, or those without their families into social networks 2. Encouraging the organization of normal recreational activities for children and encouraging starting schooling for children, even partially 3. Involving adults and adolescents in concrete, purposeful, common interest activities (e.g., assist in caring for the ill especially if people are cared for at home, constructing/organizing shelter) ! Strengthening the community's and the family's ability to take care of children and other vulnerable persons.

Specific Concerns for Victims of Attacks Involving Biochemical Weapons
Attacks involving biochemical weapons may induce significant mental and social effects. 1. Exposure to any stressor is a risk factor for a range of longterm social and mental problems (including anxiety and mood disorders as well as non-pathological trauma and grief reactions) 2. Physical exposure to agents may induce organic mental disorders
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Attacks are associated with experience of intense social and psychological distress. ! If appropriate and feasible. and social stigma associated with contagion or contamination) ! In case of quarantine or evacuation. set-up telephone support systems to reduce isolation of people who are isolating themselves to reduce the chance of infection. breakdown of community support systems. ! Manage medically unexplained symptoms immediately to prevent potential chronicity of such symptoms. physically. ! Public education campaigns may need to be organized to reduce social stigma and related social isolation of expatients and health workers who may be shunned because of undue public fear of contagion or contamination.g.61 PSYCHOSOCIAL CARE AND MENTAL HEALTH 3. population displacement. Social problems may emerge after exposure to agents (e. Fear of biochemical attacks may be associated with epidemics of medically unexplained illness 5. emotionally. especially fear 4. enhance access to communication with absent relatives and friends. Psychosocial Concerns for Disaster Workers Burnout or Disaster Fatigue: ! state of extreme exhaustion or depletion.. mentally and socially ! person feels worn-out and depleted of energy but feels that he/she has not done enough Signs of Burnout: ! Low energy and exhaustion POCKET EMERGENCY TOOL .

62 PSYCHOSOCIAL CARE AND MENTAL HEALTH ! Detachment and separation from one's self. “I don't care” Management of Burnout ! Rotation of work assignments to allow time away from the daily routine of disaster work for those in the field ! Rest and recreation program for those in active duty ! CISD sessions should be done regularly for those in the field ! Superiors and the agency itself should provide for situations to give credit. Disasters may leave some communities with increased social coherence. heightened irritability ! Increasing anger. express appreciation and recognition of their disaster workers at regular intervals ! Provision of appropriate assistance for those who might require counseling and/or specialist psychiatric attention Historical research on group behavior has shown that contrary to common expectations. limiting ability to focus mind and behavior ! Depression. POCKET EMERGENCY TOOL . suspiciousness ! Confusion. feeling unappreciated and mistreated ! Impatience.” indifference and even skepticism ! Aloneness.” “deadness. psychosomatic complaints ! Denial that anything is wrong. Community members often show great altruism and cooperation. public panic is uncommon. agitation. increasing feeling of “non-feeling. and people may experience great satisfaction from helping each other.

or other water sources. ! The health sector should take the leading role in: 1. The corpse has a lower risk for contagion than an infected living person. POCKET EMERGENCY TOOL . bodies are quite unlikely to cause outbreaks of diseases. the health officer may need to carry out these tasks to the best of his or her abilities. ! They may. However.63 MANAGEMENT OF DEAD BODIES ! The National Disaster Plan/Emergency Operations Committee should specify the institution that will coordinate all processes related to the management of dead bodies. in the absence of medico-legal experts. and disposing of dead bodies is based on forensic sciences and requires a multidisciplinary team. the presence of exposed corpses poses no threat of epidemics. The key to preventing disease is to improve sanitary conditions and to educate the public. Addressing concerns about the supposed epidemiological risks posed by dead bodies 2. ! If death resulted from trauma. Health Considerations in Cases of Mass Fatalities ! Emphasize that. transmit gastroenteritis or food poisoning syndrome to survivors if they contaminate streams. ! The work of handling. however. any bodies (or dead animals) lying in water sources should be removed as soon as possible. in general. wells. Thus. Providing medical assistance to family members of the victims. identifying.

cholera. Principal diseases that should be avoided by those responsible for managing corpses in order to prevent possible contagion: 1. salmonellosis) 3.64 MANAGEMENT OF DEAD BODIES ! The risk posed by bodies buried by a landslide or mudslide is nonexistent. HIV POCKET EMERGENCY TOOL . However. even in such cases the presence of dead bodies should not be considered an important public health risk.. ! It should be noted that in areas where certain diseases are endemic. the disposal of bodies may become a priority. Hepatitis B and C 4.g. streptococcal infection 2. gastrointestinal infection (e.

burnt. Ideally a list of the people involved and their contact numbers should have been prepared beforehand. ! Sketch and photograph for documentation. ! Mobilize volunteers like medical and dental students or specialists from the area.g. ! Mark bodies/body parts to preserve their relationship to one another. e.. Handling of the Bodies at the Scene ! As much as possible document the location and position of each body at the scene prior to removal. e. Initial Concerns ! Type of incident (natural hazards.g.65 FORENSIC SCIENCE CONCERNS IN MASS FATALITIES Practical Approach to a Multiple Fatality Incident 1.. contaminated) ! Estimated number of fatalities ! Location of incident ! Local authority in-charge ! Budget 2. Personnel ! Tap medico-legal officers from the NBI or PNP and local government doctors. fire. earthquake. decomposed. human-generated. POCKET EMERGENCY TOOL .g. accidental or deliberate use of biochemical/radionuclear agents) ! Probable condition of remains (e. land/sea/air transport crash. with severe trauma. epidemics. 3. landslide. flood.

with floors that are either waterproof or covered with plastic ! Using health service vehicles—specifically. ! When adapting vehicles to transport dead bodies. Before anything else... badly burned or crushed remains). ! Properly labeled separate bags must be used.66 FORENSIC SCIENCE CONCERNS IN MASS FATALITIES ! Every effort must be taken to identify the bodies at the site where they are found. proximity to which body) should be documented prior to collection. body part or property. ! The location of loose items (e. ambulances—to transfer human remains from the site of the disaster is ill-advised. there should be adequate documentation. and location of the body. 4. preferably closed.g. put a bag around the head. 5. contaminate or switch such body. POCKET EMERGENCY TOOL . sex. ! Be particularly careful of potential loss of teeth if they are loose (e. Removal and Transport of Remains ! Before removing any body. ! Care must be taken not to lose. Tags should be attached to the bodies that provide the name (if known). ! Other items associated with a body should be collected as property and tagged with the body. body parts or property to be removed and transported. it is advisable to use trucks or vans. observe and record first. approximate age.g. Evidence and Property ! All items of property that are on the body should remain on it.

7. ! A more reliable system of identification entails an objective comparison of antemortem and postmortem information..e.. should consist of a reception. covered basketball court). ventilation. burnt or mangled) and should be subject to verification by other means. ! Because of limited resources. ! Identification through visual identification by the next-of-kin should be limited to bodies that are suitable for viewing (i. not all bodies can undergo a full autopsy. empty warehouse.g.67 FORENSIC SCIENCE CONCERNS IN MASS FATALITIES 6. water supply ? Examining tables ? Instruments for examining the remains and documentation ! Ideally. priority may be given to certain remains (such POCKET EMERGENCY TOOL . not decomposed. Temporary Mortuary Facility ! Identify a place that can be converted into a makeshift morgue (e. ! Basic requirements: ? Security ? Adequate lighting. a storage chamber for bodies not suitable for viewing and a room to store personal possessions and records. usually the critical need is to identify the victims. Examination of Remains ! Objectives of the postmortem examination: ? Identification of the remains ? Cause of death determination ? Manner of death determination ? Collection of forensic evidence ! In emergency situations. a viewing room.

pilot/ship captain and crew).g.68 FORENSIC SCIENCE CONCERNS IN MASS FATALITIES ! ! ! ! as those of transport operators driver. 8. marks such as tattoos. and individualized manner.) Significant medical history ! Ask the next-of-kin to submit the following: Medical records including x-ray films POCKET EMERGENCY TOOL . Blood and other tissue/fluid samples are collected for possible tests (e. toxicology). moles. ! Organize a separate area where the next-of-kin can be systematically interviewed for data. orderly. build Appearance when last seen Distinguishing features (tattoos. A detailed examination of the external body is done. Fingerprints are obtained and dental charting is done. scars. histopathology.. clothes. moles and deformities are searched. ! Useful antemortem information to get: Name. Preservation of the Body ! Remains are best stored refrigerated (e. ! After the postmortem examination. IDs) must be described and inventoried. 9. deformities. Property collected from each body (e. sex. age..g. wallets. jewelry. scars. etc. Dealing with Claimants ! Notify family members of the death or disappearance of victims in a clear.. height.g. DNA analysis. in rented refrigerated storage trucks) while awaiting examination. embalming can be done.

could potentially contain reference fingerprints or DNA samples. ! Burial is the preferred method of body disposal in emergency situations unless there are cultural and religious observances that prohibit it. ? The location of graveyards should be agreed upon by the community and attention should be given to ground conditions.g. proximity to groundwater drinking sources POCKET EMERGENCY TOOL . 10.. hairbrush.Disposal of Dead ! Respond to the wishes of the family and provide all possible assistance in final disposition of the body. addresses and contact numbers. these remains should be buried separately (not cremated!) and their postmortem records stored for future evaluation. ! Bodies could remain unidentified in case of insufficient antemortem and postmortem data. ! Maintain a record of how the bodies are disposed of including information regarding the claimants' names. 11. toothbrush. ! Court proceedings could be initiated according to Philippine laws that would legally declare dead the unidentified and missing victims. other items).Death Certification and Release of Bodies ! Properly identified victims shall be issued death certificates and the bodies released to the next-of-kin.69 FORENSIC SCIENCE CONCERNS IN MASS FATALITIES Dental records Clear photograph with teeth bared Fingerprints on file ! Note that personal items that a person believed to be among the victims could have used (e.

Handling a large number of corpses can have an enormous impact on the health of the working team. unidentified bodies should be placed in individual niches or trenches. ? If coffins are not available. 12.Other concerns Ensure that there is a plan for the psychological and physical care for the relief workers.5 m above the groundwater table. corpses should be wrapped in plastic sheets to keep the remains separate from the soil. ? Burial depth should be at least 1. ! Reject unceremonious and mass disposal of unidentified corpses. Give priority to the living over the dead: The priority is to treat survivors and re-establish the health care system as soon as possible! POCKET EMERGENCY TOOL . which is a basic human right of the surviving family members. ? Burials in common graves and mass cremations are rarely warranted and should be avoided.70 FORENSIC SCIENCE CONCERNS IN MASS FATALITIES (which should be at least 50 m) and to the nearest habitat (500 m). As a last resort. with at least 1 m of soil cover.

the medicines must have a remaining shelf life of at least 1 year. Based on the list of essential drugs. strength. and expiry date. amounts. ! ! ! ! ! POCKET EMERGENCY TOOL . dosage forms. Guidelines for Drug Donations Based on expressed needs of the affected population. quantity in container. ! After the arrival of foreign drug donations. Formulation and efficacy of foreign donations should be similar to those commonly used in the country. Obtained from a quality source with quality standards. and formulations (compatible with the size of the affected population). Supply Management General Guidelines: ! Only a single government official should be made responsible for channeling requests to avoid duplication and confusion.71 RESOURCE MANAGEMENT The arrival of inappropriate relief donations can cause major logistic chaos. ! Requests should indicate clearly the order of priority. ! Label should at least contain generic name. ! Do not request perishable products and vaccines unless refrigeration and special handling facilities are available. Sent only with prior consent of recipient. ! Donors should be asked to provide large amounts of a few items to simplify and expedite transfers.

POCKET EMERGENCY TOOL . Size and weight ! Goods should be in a 25-50 kg container. acknowledge their receipt. Upon arrival of the donations/ consignments. method of transport. ! Value of relief goods is lost if there is no color-coding.g.. date. and other special requirements for handling). manageable by a single person. 3. ! Give advance notice to the health relief coordinator and supply information about the package (e. Contents ! Relief supplies must be packed by type in separate containers. details of contents. Call or write the senders and thank them. Labeling: ! Consignments of medicines branded green should indicate expiry date and temperature controls. ! English should be used on all labels. 2.72 RESOURCE MANAGEMENT Donation Labeling and Donation Marking RED BLUE — — foodstuff clothing and household items medical supplies/equipment GREEN — 1. name and contact number of donor.

! Listen to feedback and correct misinformation. ! Empower risk/benefit decision-making. 2. Determine credibility. Activate Crisis Plan ! Ensure direct and frequent contact with the EOC POCKET EMERGENCY TOOL . ! Determine who should be notified of this potential emergency. Conduct notifications 3. ! Establish spokesperson credibility ! Explain and inform the public. ! Obtain information from additional sources to put the event in perspective. ! Review and critically judge all information.73 RISK COMMUNICATION Communication Objectives: ! Acknowledge the event with empathy. about the risk ! Provide emergency courses of action (including how/where to get more information) ! Commit to partners and public to continued communication. Verify situation ! Get the facts. in simplest terms. Steps in Communicating Risks 1. ! Begin to identify staffing and resource needs to meet the expected media and public interest. ! Clarify information through subject matter experts.

Don't speculate ! Repeat the facts about the event ! Describe the data collection and investigation process ! Describe what your organization is doing about the emergency. Prepare information and obtain approvals 6. ! Explain what the public should be doing POCKET EMERGENCY TOOL . ! Describe what other organizations are doing. or would some issues be more appropriately addressed by other government entities? 5. Organize assignments ! Identify the spokesperson for this event. Release information to media. ! Determine what other agencies/organizations are doing. What are their perceptions? What do they want and need to know? ! Determine what the public should be doing. ! Determine what's being said about the event. public and partners through arranged channels ! Provide only information that has been approved by the appropriate managers. ! Determine if the organization should continue to be a source of information to the media about this emergency.74 RISK COMMUNICATION ! Determine what your organization is doing in response to the event. Is the information accurate? 4. ! Determine who is being affected by this crisis. ! Determine if subject matter experts are needed as additional spokespersons.

Everything you say and do can be reported. Be careful with what you say in the presence of journalists. 7 days/week) POCKET EMERGENCY TOOL . Obtain feedback and conduct communication evaluation 8. Crisis and Emergency Risk Communication. even after a formal interview is finished and at social gatherings ! Never make disparaging or critical remarks about local authorities or international partners ! Do not mention weaknesses they might be all that is reported What makes a “good” spokesperson? ! Media savvy/rapport ! Versatility to be a statesman or a brawler ! Consistent and continuous authority ! Sufficient knowledge and information ! Available anytime (24 hours/day. Monitor events (Adapted from CDC (2002). Conduct public education 9. and put them in context ! There is no such thing as 'off-the-record'.75 RISK COMMUNICATION ! Describe how to obtain more information about the situation 7.) Media Management Stick to facts.

A4) ! Use language appropriate for the audience ! Advocate for health in general ! Share credit and visibility with partners POCKET EMERGENCY TOOL .76 RISK COMMUNICATION Spokespersons must be supported by authority with the following: ! Information and facts ! Resources and contacts ! Equally competent alternate What do the people want to know? ! What has happened? (Incident and Scope) ! Why did it happen? (Cause) ! Who or what should be held responsible? (Blame) ! What is being done about it? (Action) ! What will prevent it from recurring? (Result) Press Releases: ! Titles and opening lines are the most important parts grab attention and encourage awareness ! Put key points in first paragraph ! Text needs to be brief (max.

77 APPENDICES POCKET EMERGENCY TOOL .

Mission order? b. Laptop computer? k. 2. materials. Cash & reimbursement vouchers? n. equipment needed in the field. Communication equipment? g.78 EMERGENCY MANAGER DEPLOYMENT CHECKLIST This list contains basic supplies. Pocket Emergency Tool? NO POCKET EMERGENCY TOOL . Emergency call number directory? d. Mission area map? e. Water canteen? o. Digital camera? w. First aid kit? q. Handheld radio & accessories? i. Pocket notebook & ball pen? j. gloves)? m. Portable tent (if available)? t. 4. Flashlight/candles & matches? s. Basic PPE (cap. mask. Did you receive your orders? Is/are the mission objective/s clear? Did you inform your family? Do you have with you a. Transistor radio (with extra batteries)? l. Cell phone? Mobile phone? h. List of contact persons/numbers? f. Mosquito repellent? u. Pocket knife? v. Backpack with clothing & blanket? r. 3. Food provisions? p. Identification card? c. YES 1.

79 RAPID HEALTH ASSESSMENT FORMS HEMS FORM 1 RAPID HEALTH ASSESSMENT (To be submitted within 24 hrs) as of ____________________. of No. of Families & No. Consequences Municipality /City No. of No. of Missing TOTAL POCKET EMERGENCY TOOL . of Injured No. of Death/s No. Magnitude of Event No. Nature of Event: ___________________________________________ Date and Time of Occurrence: ________________________________ Region: __________________________________________________ A. of Individuals Municipality Families Individuals Evacuation in Evac'n Province /City Affected Affected Centers Centers TOTAL B.

Problems Encountered POCKET EMERGENCY TOOL . of Functional No. Status of Essential Drugs/Suppliers Stock level good for ________________________________ (no.80 RAPID HEALTH ASSESSMENT FORMS C. Lifelines Available in Affected Area Type Communications Electric Power Water Roads/Bridges Others Yes No Remarks E. of days/weeks/month) F. Actions Taken \ G. Health Facilities Available in Affected Area Total No. No. of Non Functional Remarks Hospitals Gov't Private RHU Others D. of cases/no.

Recommendations Prepared by: ___________________ Position: ______________________ Office: ________________________ Date: _________________________ HEMS FORM II RAPID HEALTH ASSESSMENT FOR MASS CASUALTY INCIDENT (To be submitted within 24 hrs) A. Number of persons affected Death: __________________________________________ Injured: __________________________________________ Treated on site: _________________________________ Referred to hospital: _____________________________ OPD: _________________________________________ Admitted: ______________________________________ Missing: __________________________________________ Total: ___________________________________________ POCKET EMERGENCY TOOL .81 RAPID HEALTH ASSESSMENT FORMS H. Description of the Event Nature of the Event: ________________________________ Time of the Event: _________________________________ Date of the Event: _________________________________ Place of the Event: _________________________________ B.

Recommendations Prepared by: ___________________ Position: ______________________ Office: ________________________ Date: _________________________ * Please fill up Form A for the listing of cases.82 RAPID HEALTH ASSESSMENT FORMS C.HEMS FORM III RAPID HEALTH ASSESSMENT FOR OUTBREAKS A. Description of the Event Nature of the Event: _______________________________ Time of the Event: _________________________________ POCKET EMERGENCY TOOL . Problems Encountered E. Actions Taken D.

83 RAPID HEALTH ASSESSMENT FORMS Date of the Event: _________________________________ Place of the Event: ________________________________ B. Consequences Population Exposed: _______________________________ Number of Death/s: ________________________________ Number of Cases: _________________________________ Admitted: _____________________________________ OPD: _________________________________________ C. POCKET EMERGENCY TOOL . Recommendations Prepared by: ___________________ Position: ______________________ Office: ________________________ Date: _________________________ * Please fill up Form A for the listing of cases. Actions Taken D. Problems Encountered E.

Referred. Missing) (Sent Home. etc. Died.) HEMS FORM A POCKET EMERGENCY TOOL RAPID HEALTH ASSESSMENT FORMS 84 .List of Patients / Victims Name Age Sex Diagnosis Status Remarks /Actions Taken (Injured. Admitted. Surgery Done. Outpatient.

sanitation. community activities.7 10.4 11.6 2.5 48.5 9. warehousing access Household fuel Weight of firewood 15 kg/household/day with one economic stove per family.4 Basic Needs Average Requirements Water Quantity Quality Sanitation Latrine Waste disposal Soap Shelter Individual requirements Collective requirements 20 L/person/day 200 persons/water point In hospital settings more water per person is needed Ideally one per family.85 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Estimating Population Size Age Groups 0 — 4 years 5 — 9 years 10 — 14 years 15 — 19 years 20 — 59 years *Pregnant women Average % in Population 12. services. size: 2 m x 5 m x 2 m 250 g/per person/per month 4m2/person 30m2/person including shelter. the needs may be reduced to 5 kg/stove/day POCKET EMERGENCY TOOL . minimum of one seat per 20 persons 6 to 50 meters from housing 1 communal pit per 500 persons.

and is useful as weaning food Needed for proteins and minerals (including iron) Needed for cultural habits. A) are important.As available Ration 3 Function (g) 400 Main source of energy and protein 60 Provide protein and various micronutrients 25 50 15 5 Concentrated source of energy for palatability and the absorption of Vit. peas.4 kg Micronutrients (e.86 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Emergency Food Requirements Food Cereals Pulses Oil (vegetable) Sugar kcal content 350/100 g 335/100 g 885/100 g 400/100 g g/person/month 13. A Provides essential vitamins and minerals.e. mongo) Oil/fat Fortified cereal Canned fish/meat Sugar Salt Vegetables/fruits Ration 1 Ration 2 (g) (g) 450 420 50 60 25 20 5 30 30 20 5 . palatability..6 Recommended ration person/day: 2.5 0.g.5 1.8 0. and home oral rehydration Provides sodium.116 kcal Total kg/person/month for alimentation: 16. beans. Examples of Rations for General Food Distribution (Providing 2100 kcal/person/day) Commodities Meal with rice Pulses (i. Vit. and is needed for home oral rehydration Valuable source of vitamins and minerals Continued on next page POCKET EMERGENCY TOOL . iodine.

87 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Examples of rations continued Condiments/ spices Approximate food value: Energy (kcal Protein (g Fat (g) .5 per person/yr 0.5 per 30% per month Tetanus toxoid pregnancy all new births 1/12 of total group per month BCG 0-1 yr 1/12 of total group per month DTP1-TT1 0-1 yr 1/12 of total group per month DTP2-TT2 1/12 of total group per month 9-12 months Measles POCKET EMERGENCY TOOL .100% of <5y/o per month 59 months all pregnancies 50% of pregnancies/month all deliveries 1/12 of total group per month 1.As available - Needed because of cultural habits and for palatability 2113 58 43 2116 51 41 2092 45 38 Essential Primary Health Care (PHC) Activities Essential PHC Activities <5y/o clinic & growth monitoring Antenatal clinic Assisted deliveries OPD Consultation Target Optimal Coverage of Target all children of 0.13 per person/month 4 per outpatient consultation Treatment & followup sessions Vaccination 1.

POCKET EMERGENCY TOOL . WHO Supplementary NEHK Unit Safe water calcium hypochlorite 70%: 15 g/L of water Preparing 1 L of stock bleaching powder 30%: 33 g/L of water solution 1% sodium hypochlorite 5%: 250 ml/L of water sodium hypochlorite 10: 110 ml/L of water Using the stock solution 0.000 population Health Supplies Requirements Essential drugs and medical equipment WHO Basic NEHK Unit 1 kit for 10.6 ml or 3 drops/liter of water 60 ml/100 liters of water Allow the chlorinated water to stand at least 30 minutes before using.000 pop for 3 mos.000 pop for 3 mos.000 1:500 or 1:1000 1 person/day = 7 hours of field work REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Health Workers Emergency requirements (e.g.88 Health Personnel Requirements Hospital:Population ratio Normal staffing: 2 medical officers 60-100 other staff CHWs (or home visitors) or Health Information Teams 1:150. refugee camp) for treatments. management and clerical duties: 60 staff x 10.000 to 300. 1 kit for 10.

000 children <5 y/o 10% of children <5 y/o 30% of monitored children 7% of live births POCKET EMERGENCY TOOL .5 kg) More than 1 per 10.000 population 2 per 10.89 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Cut-off Values for Emergency Warning Health Status Daily Crude Mortality Rate Daily Under-5 Mortality Rate Acute Malnutrition (W/H or MUAC) in Under-5 Growth Faltering Rate in Under-5 Low Weight at Birth (<2.

9 Continued on next page POCKET EMERGENCY TOOL REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING .3 7.5 2.5 6.5 7.6 10.7 8.5 3.3 7.6 7.8 7.6 3.3 7.3 4.9 11.5 5.1 3.4 3.4 6.8 7.5 6.8 8 8.6 8.5 6.9 3.3 6.1 6.3 2.4 2.9 10.3 3.3 8.7 8 8.8 4 4.5 4.2 2.5 3.1 7.5 7.6 8.8 2.2 6.5 5.5 7.5 3.3 3.90 NCHS/WHO normalized reference values for weight-for-length (49-84) and weight-for-height (85-110 cm) by sex.4 5.9 -3 SD 70% 2.5 2.6 9.5 4.5 11.8 7.2 4.7 4 4.5 4.3 2.1 9.2 9.9 5.5 3.6 5.1 3.8 2.2 8.7 5 5.2 10.9 6.7 7 7.7 7 7.6 2.3 3.3 8.2 7.2 2.3 8.8 8 8.8 1.4 8.2 5.1 3.8 9 9.5 8.7 -1 SD 90% 2.1 7.8 5.3 5.6 6.3 10.7 6 6.2 9.1 3.8 4 4.9 3.3 4.8 1.8 8.4 7.8 6.1 4.6 2.1 5.4 10.3 3.8 9 9.8 8.7 9.3 11.9 2 2.7 3.6 7.7 3.8 9.2 6.9 1.8 6 6.7 2.8 7 7.9 -4 SD 60% 1.9 3.9 4.8 1.4 6.8 7 7.5 8.7 9.8 10 10.2 2.6 4.1 10. Boys Length (cm) 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 Median 3.3 4.1 3.3 5.2 8.2 3.8 Boys' weight (Kg) -2 SD 80% 2.2 6.3 5.4 4.4 7.1 2.7 5.6 9.9 3.9 4.6 4.8 5 5.1 4.7 2.1 8.4 5.8 6 6.8 5.4 9.4 9.7 10.1 11.5 2.3 9.1 5.5 10.

6 Girls' weight (Kg) -2 SD 80% 2.1 8.9 11 11.6 16.3 2.4 14.5 2.2 12.6 10.5 12.6 11.2 11.7 -1 SD 90% 11 11.6 15.2 15.9 15.9 4.9 11.7 18 18.6 11.7 13.4 14.1 2.7 16 16.6 14.5 11.3 12.7 14.7 3.9 17.6 2.7 13.1 10.6 12.1 12.4 10.1 13.8 -4 SD 60% 7.5 13.7 -4 SD 60% 1.9 15.4 13.2 11.4 3.4 -3 SD 70% 9 9 9.3 10.8 17.5 16.6 8.3 12.7 15 15.3 2.2 16.3 10/5 10.8 9.9 14.6 9.4 11.3 8.9 3 3.1 17.2 9.3 13.3 11.8 8.7 11.8 12 12.4 17.9 9.1 12.2 14.9 16.4 9.1 12.1 -3 SD 70% 2.1 11.1 -1 SD 90% 2.8 1.8 12 12.2 11.3 10.9 12.9 12.9 10.1 8.9 8.2 Continued on next page POCKET EMERGENCY TOOL .9 2 2.1 9.8 13 13.9 10.7 10.4 12.2 2.8 13 13.2 13.1 14.4 13.3 16.6 9.4 13.1 10.9 14.9 1.8 3 3.1 3.6 13.4 11.2 9.91 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Boys continued Length (cm) 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 Median 12.7 11.5 10.4 8.4 12.3 3.2 15.7 2.7 14 14.3 3.7 9.5 3.9 10.1 10.5 11.9 13.7 12.8 11 11.4 2.8 13 13.2 Girls Length (cm) 49 50 51 52 53 54 Median 3.3 18.1 15.6 2.2 14.7 10.4 15.2 13.5 15.6 12.4 9.4 3.5 15.1 Boys' weight (Kg) -2 SD 80% 9.

7 2.1 8.8 7.9 8.6 10.4 4.7 3.1 8.8 11 -3 SD 70% 2.5 8.4 9.6 4.1 8.6 8.9 9.7 10.3 3.2 13.9 3.9 5.1 10.8 8.7 12.3 8.5 5.8 7 7.92 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Girls continued Length (cm) 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 Median 4.5 10.4 5.2 6.1 9.2 7.1 8.3 5.7 9.4 -1 SD 90% 3.7 6 6.5 12.4 7.1 3.4 5.3 5.7 4.7 9.8 6 6.2 9.5 10.7 7 7.5 9.3 10.4 8.6 2.2 Girls' weight (Kg) -2 SD 80% 3.5 3.5 4.8 6 6.3 10.8 12 12.8 12 12.8 3 3.9 -4 SD 60% 2.2 8.1 3.1 7.3 8.5 3.3 4.7 7.7 7.2 10.8 9 9.6 8.2 7.9 8.6 9.5 7.8 9 9.5 4.3 3.8 5 5.3 9.5 5.9 10.2 5.4 9.7 9.2 5.5 6.9 10.9 4.2 6.7 3.6 7.4 8.8 8 8.3 7.2 9.5 9.3 12.3 6.1 10.5 7.9 4.7 8.8 6.1 4.6 9.6 7.1 6.2 7.1 4.5 5.4 4.5 8.3 3.6 6.1 8.4 6.7 7.6 7.8 8.4 11.7 8.3 9.2 11.3 8.9 7.4 6.5 8.3 7.1 4.7 Continued on next page POCKET EMERGENCY TOOL .7 8.5 3.6 5.3 2.2 4.3 6.9 4.8 4 4.4 7.7 7 7.8 6 6.8 5 5.6 6.5 6.1 5.1 7.7 6.3 5.8 11 11.7 3.3 4.4 11.8 11 11.6 4.1 9.6 7.4 6.8 5 5.3 4.8 10 10.9 9.4 2.5 8.8 5.2 11.9 13.4 10.6 11.

6 13.9 14.4 15.6 12.6 10.9 1.8 14 14.3 14. Length is generally measured in children below 85 cm.9 11.9 13.9 11.5 10.8 11 11. Recumbent length is on average 0. and height in children 85 cm and above.6 9.3 9.8 12 12.6 17.1 13.9 10.4 11.3 11.4 12.9 8. POCKET EMERGENCY TOOL .5 15.1 12.2 11.5 11.1 13.5 9.6 Girls' weight (Kg) -2 SD 80% 9.5 13.5 13.7 17 17.9 13.6 14. a correction may be made by deducting 0.4 11.1 11.1 14.9 15.3 14.1 9.2 10.3 15.8 9.9 12.2 13.6 10.7 12.9 18.5 14.3 14.4 -4 SD 60% 7.5 cm from all lengths above 84.6 15.2 16.3 17.2 11.9 cm if standing height cannot be measured.2 -1 SD 90% 11 12.8 16.3 13.1 15. although the difference is of no importance to the individual child.93 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Girls continued Length (cm) 85 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 Median 12.7 15 15.2 12.4 12.5 12.4 16.3 13.7 10.6 11.7 13 13.5 cm greater than standing height.1 16.1 10.8 15 -3 SD 70% 9 10 10.8 9 9.4 10.3 12.1 13.6 11.7 11.5 14.5 16.9 16.8 14 14.3 10.

respectively. Between 1 and 5 years median -1 SD and median -2 SD correspond to approximately 90% and 80% of median (weight-for-length. particularly in children of school age. the adolescent growth spurt begins and the time of its onset is variable. Somewhere beyond 10 years or 137 cm. Hence the use of “percentage-of-median” is not recommended. SD = standard deviation score (or Z-score). median 02 SD is much below 80% of media.94 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING 2. Beyond 5 years of age or 110 cm (or 100 cm in stunted children) this equivalence is not maintained. and beyond 5 years. The correct interpretation of weight-forheight data beyond this point is therefore difficult POCKET EMERGENCY TOOL . particularly in the first year of life. and weight-for-age). The relationship between the percentage of median value and the SD-core or Z-score varies with age and height.

95 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Decision Framework for Implementing Selective Feeding Programs Findings Actions Required ! 'Blanket' supplementary feeding for Serious situation: all members of vulnerable groups Malnutrition rate: (especially children. selected 5-9%. pregnant and = 15% lactating women. plus aggravating ! Therapeutic feeding programs for factors severely malnourished individuals ! Targeted supplementary feeding for Alert/Risky situation: individuals identified as Malnutrition rate: malnourished in vulnerable groups 10-14% (mildly to moderately malnourished Or children under 5 years. plus aggravating other children and adults) factors ! Therapeutic feeding programs for severely malnourished individuals Unsatisfactory situation: ! Improve general rations until local food availability and access can be Food availability at made adequate household level below 2100 kcal per person per day ! No need for population interventions Acceptable situation: ! Attention for malnourished Malnutrition rate: individuals through regular < 10% with no aggravating community services factors POCKET EMERGENCY TOOL . adults showing or signs of malnutrition) 10-14%.

96 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING 1. Aggravating factors: ! Food availability at household level less than the mean energy requirement of 2100 kcal/person/day ! Crude mortality rate more than 1 per 10. Malnutrition rate: defined as the percentage of the child population (6 months to 5 years) who are below either the reference median weight-for-height minus 2 SD or 80% of reference weight-for height and/or with edema. 2.000 per/day ! Epidemic of measles or whooping cough ! High incidence of respiratory or diarrheal diseases POCKET EMERGENCY TOOL .

.. that extent) resolves over time or mild distress that does not resolve over time No specific aid needed No estimate 20-40% Mild psychological (which over the distress.g.97 REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT AND CONTINGENCY PLANNING Summary Table on Projecting Psychosocial/Mental Health Assistance Before Disaster: After Disaster: 12 month 12 month prevalence prevalence Type of aid rates rates recommendations Description 2-3 % 3-4% Make mental health care Severe disorder (e.) 1. severe health services and in depression. sociocultural factors. severely community mental health disabling form of anxiety services disorders. available through general psychosis. that resolves years increase over time as people with severe problems recover) These rates vary with setting (e.g. mild and moderate community mental health 15% through forms of depression and natural recovery services anxiety disorders 2. Make mental health care 20% Mild or moderate mental 10% (which over the available through general disorder years reduces to health services and in (e. Make social interventions without including PTSD) and basic psychological intervention) support interventions available in the community Make social interventions and No estimate 30-50% Moderate or severe (which over the basic psychological support psychological distress years will reduce interventions available in the that does not meet to an unknown community criteria for disorder. previous and current disaster exposure) and assessment method but give a very rough indication what WHO expects the extent of morbidity and distress to be. etc.g. POCKET EMERGENCY TOOL .

POCKET EMERGENCY TOOL . Repeat only important numbers. Use the correct prowords and phonetic alphabet. A B C D E F G H I J K L M — — — — — — — — — — — — — Alpha Bravo Charlie Delta Echo Foxtrot Golf Hotel India Juliet Kilo Lima Mike N O P Q R S T U V W X Y Z — — — — — — — — — — — — — November Oscar Papa Quebec Romeo Sierra Tango Uniform Victor Whiskey X-ray Yankee Zulu Numerals should be transmitted digit by digit except round figures as hundreds and thousands. Check your equipment regularly.98 RADIO PROCEDURES Good communications are essential for management and security. Spell only important words.

053 quartz liters Weights grams grains 15.03937 inches mm cm inches 0.281 feet meters meters yards 1.155 sq.6 yards km km miles 0.03527 ounces grams kg ounces 35. feet m2 m2 sq.06102 cubic inches cm3 m3 cubic feet 35.54 0.0 0.8361 2.0 0.308 cubic yards m3 m3 gallons (US) 264.59 0.0936 yards meters km yards 1093.785 5.2642 gallons (US) liters ml teaspoon 0.9144 0.27 ounces kg kg pounds 2.0160 POCKET EMERGENCY TOOL .387 0.128 pints liters liters quartz 1.6 pounds metric ton metric ton ton (US) 1.0929 0.033 fluid ounces ml liters cups 4. inches 0.471 acres hectares Volumes 3 cm cubic inches .9072 1.1023 ton (US) metric ton metric ton ton (long) 0.3861 sq.196 sq.0004536 0.016387 28.0009144 1.028317 0.314 cubic feet m3 m3 cubic yards 1.4 2. yards m2 km2 sq. miles 0.0254 0.023 cubic inches liters liters cubic feet 0.6214 miles km Surfaces cm2 sq.37 inches meters meters feet 3.317 3.609 6.2 teaspoon ml ml tablespoon 0.432 grains grams grams ounces 0.0648 28.3937 inches cm meters inches 39.0 15.4536 907. inches cm2 m2 sq. miles km2 hectares acres 2.003785 0.9842 ton (long) metric ton Multiply by 25. feet 10.2046 pounds kg kg ton (US) 0.02835 0. yards 1.24 0.47 0.03531 cubic feet liters liters gallons (US) 0.7646 0.001102 ton (US) kg kg ton (long) 0.4047 16.764 sq.000984 ton (long) kg metric ton pounds 2204.3048 0.99 CONVERSION TABLE METRIC TO ENGLISH ENGLISH TO METRIC To convert into Multiply by To convert into Length mm inches 0.452 0.067 tablespoon ml ml fluid ounces 0.95 0.44 1016.166 cups liters liters pints 2.2 gallons (US) m3 liters cubic inches 61.35 0.0 30.

79 liters 1 liter = 0.100 CONVERSION TABLE Temperature Centigrade to Fahrenheit: Multiply by 1.3 pounds POCKET EMERGENCY TOOL .7°C or 62°F): 1 liter = 1 kg 1 UK gallon = 10 pounds 1 UK gallon = 1.555 Weight of water by volume (at 16.8333 UK gallons 1 US gallon = 8.33 pounds 1 US gallon = 3.54 liters 1 US gallon = 0.2 US gallons 1 UK gallon = 4.8 and add 32 Fahrenheit to Centigrade: Subtract 32 and multiply by 0.26 gallons 1 cubic foot = 62.

Geophysical and Astronomical Services Administration (PAGASA) Phil.ph http://www. Nuclear Research Institute (PNRI) Phil.undmtp.unicef.int/mental_health Nutrition http://www.int/nut Reproductive Health http://www.ph/pnri http://www.jp http://www. Atmospheric.gov.adrrn.net/SUMA Centro Regional de Informacion Sobre Desastres http://www.101 WEBSITES NAME National ADDRESS http://www.unep.unaids.Disasters & Humanitarian Assistance Regional Office for the South-East Asia (SEARO) Essential Drugs and Medicines policy Injuries and Violence Prevention POCKET EMERGENCY TOOL .adpc.de sastres.paho.org.who.gov.doh. National Red Cross Asian Asian Disaster Preparedness Center (ADPC) Asian Disaster Reduction Center (ADRC) Asian Disaster Reduction & Response Network WHO Emergency and Humanitarian Action (EHA) Regional Office for the Western Pacific (WPRO)-EHA European Region.or.desastres.net http://www.Emergency Preparedness and Response Programme Pan-American Health Organization (PAHO).whosea.euro.htm http://www.int/emergencies http://www.th http://www.who.ch UN International Children's Educational Fund http://www.gov.adrc.int/violence_injury_ prevention Mental Health http://www.who.int/sites/eha http://www.pagasa.gov.int/reproductive_health Water and Sanitation http://www.or.ph http://www.who.org (UNDMTP) UN Environmental Programme http://www.phivolcs.ac.int/medicines http://www.org/index.ph http://www.ait.org/english/ped http://w3.who.gov.dost.disaster.unhcr.ph http://www.ph http:/www.who.who.who. Institute of Volcanology & Seismology (PHIVOLCS) Phil.org (UNICEF) Continued on next page Department of Health-Philippines (DOH) National Disaster Coordinating Council (NDCC) Phil.wpro.int/water_sanitation _health PAHO SUMA http://www.info.cr/crid Health Library for Disasters http://www.net Other UN Agencies UNAIDS http://www.ndcc.helid.crid.dost.int/disasters http://www.dost.org UN High Commissioner for Refugees (UNHCR) http://www.redcross.who.org UN Disaster Management Training Program http://www.

unpfa.acep.cdc.org/dataoecd/ for Chemical Accidents (2000) 0/39/1933385.ema.int Refugee Nutrition Information System http://acc. USA Centers for Disease Control & Prevention http://www.org Natural Hazards Center at the University http://www.be/entites/ Bibliographic References (CRED) esp/epid/mission International Directory of Emergency Centers http://www.au Federal Emergency Management Agency http://www.org UN Office for the Coordination of Humanitarian http://ochaonline.org Affairs (UN-OCHA) World Bank http://www.org Other International Organizations Emergency Management Australia (EMA) http://www.org World Food Programme http ://www.ucl.cred.atsdr.rhrc.gov.html EM-DAT: Center for Epidemiology and Disaster http://www.sphereproject.org UN Population Fund http://www.ch/web/www/reparts/ expert-ERA-0498.msf.102 WEBSITES Websites continued NAME ADDRESS UN International Strategy for Disaster Reduction http://www.ifrc.ac.org One World http://www.org International Committee of the Red Cross http://www.unsystem.org Disaster Relief http://www.html Reproductive Health for Refugee Consortium http://www.pdf World Meteorological Organization http://wmo.org/scn/ publications/html/rnis.icrc.org American College of Emergency Physicians (ACEP) http://www.alertnet.disasterrelief.be/emdat/ (CRED) International Disaster Database Databases on Emergency Statistics and http://www.net Organization for Economic Co-operation http://www.reliefweb.wfp.oneworld.edu/hazards of Colorado Central Investigation Agency (CIA) Factbook http://www.gov/cia/publications/ factbook POCKET EMERGENCY TOOL .fema. USA Agency for Toxic Substances and Disease Registry http://atsdr1.gov (FEMA).cia.unisdr.cdc.un.org (RHRC) Sphere Project http://www.worldbank.org and Development Relief Web http://www.html Alertnet http://www.gov (CDC).oecd.md.org Crescent Societies Medecins Sans Frontiers http://www.org International Federation of Red Cross and Red http://www.gov:8080/ hazdat.oecd.colorado.

Environmental Health 1. 2005. Georgia: Centers for Disease Control and Prevention. Management of solid health-care waste at primary health-care centres: A decision-making guide. WHO (2003). Module 3: Public Health Issues in Emergencies. Communicable disease control in emergencies: A field manual. Jakarta. Geneva: The Sphere Project. Guiding principles for feeding infants and young children during emergencies. Module 5: Emergency Medical Services System.0. Nutrition 1. Postgraduate Course in Health Emergency Management. WHO. WHO.103 REFERENCES General 1. and Tribal Public Health Directors Version 1. UP Open University/DOH/WPRO. 1999. Public health emergency response guide for State. Geneva: World Health Organization. 5. UP Open University/DOH/WPRO. WHO (2004). Local. Sphere Project (2004). Indonesia January 7. August 14-20. Technical note: Post-tsunami flooding and communicable disease risk in affected Asian countries. POCKET EMERGENCY TOOL . WHO (2004). 2. Emergency Medical Services System Manual. 4. 3. Emergency response manual (provisional version). 2. 1999. Atlanta. Postgraduate Course in Health Emergency Management. CDC. Geneva: World Health Organization. Geneva: World Health Organization. (2003). Geneva: World Health Organization. Communicable Diseases 1. Humanitarian charter and minimum standards in disaster response. Recommendations on infant feeding in emergencies. August 14-20. 2. 6. Emergency Medical Services System Manual. Joint UNICEF WHO ISP (2005). WHO (2005). Essentials for emergencies.

Management of dead bodies in disaster situations. Geneva: World Health Organization. WHO. Georgia: Centers for Disease Control and Prevention. Water. WHO. 3. Crisis and emergency risk communication. Mental health of populations exposed to biological and chemical weapons. WHO/SEARO. Risk Communication 1. Engineering and Development Center (WEDC). Management of Dead Bodies 1. (2005). WHO. Disposal of dead bodies in emergency conditions. (2005). CDC (2002). Technical Note No. Resource Management 1. WHO. WHO/SEARO. POCKET EMERGENCY TOOL . 12. Technical Note No. Washington DC: Pan American Health Organization. Lacarin. Guidelines for drug donation 2nd ed. (1999). CJ and Reed RA (1999) Emergency Vector Control Using Chemicals. Mental health and psychosocial care of children in disasters. Geneva: World Health Organization. Mental health in emergencies: psychological and social aspects of health of populations exposed to extreme stressors. (2005) Planning Emergency Sanitation. (2003). Loughborough. PAHO (2004). Geneva: World Health Organization. Psychosocial Care and Mental Health 1. Atlanta. 2. India: WHO/Regional Office for South Asia. India: WHO/Regional Office for South Asia. (2005). 3. Technical Notes in Emergencies.8. 2. Geneva: World Health Organization.104 REFERENCES 2.

Inc. Bureau of Fire Protection (BFP) EARNET Network DOH-Dengue DOH OPCEN Metro Manila Development Authority (MMDA) Road Emergency Group EARNET Network National Disaster Coordinating Council (NDCC) National Poison Control Control & Information Service National Voluntary Blood Center Office of Civil Defense (OCD) Operation Center Philippine Atmospheric. Inc. Geophysical and Astronomical Services Administration (PAGASA) Philippine Coast Guard (PCG) Action Center Coast Guard Medical Philippine General Hospital (PGH) EARNET Network Philippine Institute of Volcanology and Seismology (PHIVOLCS) Philippine Long Distance Telephone Company (PLDT) Philippine National Police (PNP) Patrol 117 Philippine National Red Cross (PNRC) EARNET Network Disaster Management PNP Firearms and Explosives Quezon City Rescue-Sagip Buhay EARNET Network Hotline Number/s 921-3746 911-6509 911-6001 loc. of Volunteer Fire Chiefs & Firefighters of the Phil. of Phil.105 EMERGENCY CALL NUMBER DIRECTORY Organization AFR Reserve Command-Rescue and Emergency Medical Team AFP-Office of the Surgeon General (AFP-OTSG) Assoc.. 6416 522-2222 160-16 928-8363 911-9009 723-2493 929-6919/929-6853 743-1937/741-7048 882-0851 136 912-5668 524-1078/404-0257 5218450 local 2311 929-6274 911-1406/912-2556 929-4570/927-1541 928-2031/927-2877 527-3880/338-5634 527-8481 loc 6134 301-9369 523-5350 521-8450 loc. Volunteer Fire Brigades. 3166 426-1468/927-1104 171 117 527-0864 527-8384 loc 133/134 724-8085 928-4396 POCKET EMERGENCY TOOL . Assoc.

RN (033) 321-0607 loc 15 0919-5555194 Mr. Michelle Dumbrique POCKET EMERGENCY TOOL EMERGENCY CALL NUMBER DIRECTORY . RN (032) 418-7629 0917-3248741 Atty. Aurora Enojado (02) 995-0827 020-9242841 Dr. Leo Chiong. Jerry Porras. Teodofreda Sarabosing (085) 342-5208 loc 102 0921-7650285 Ms. Julie Villadolid (064) 421-6842 0919-8981919 Coordinator Ms. Rennan Cimafranca.106 Centers for Health Development. CHD CHD I CHD II CHD III CHD IV-A CALABARZON CHD IV-B MIMAROPA CHD V CHD VI CHD VII CHD VIII CHD IX CHD X CHD XI CHD XII CHD-Metro Manila CHD-CAR CHD-CARAGA CHD-ARMM Tel No. (075) 515-6842 0928-2979687 Dr. Elnoria Bugnosen. Marianne Trabajo (088) 350-4322 0918-4477173 Dr. Nemesio Santos (045) 961-3802 0917-4586351 Dr. (062) 9911313 0919-3424124 Dr. Marcos Redoble Jr. Marilyn Go (02)535-1488 0920-2993329 Ms. Noel Pasion (02) 913-0864 0920-2290001 Dr. RN (074) 444-5255 0918-3641876 Dr. Anabelle De Veyra. Juancho Gideon Torres (052) 483-0840 loc 513 0919-4704465 Mr./Cell No. Baldomero Lasam (078) 844-6585 0927-3046479 Dr. Paolo Pantojan (082) 224-3011 0927-7798177 Mr. RN (053) 323-5025 0920-2587119 Dr. RN (064) 421-4583 0920-2031559 Dr.

Noel Valderrama (02) 294-4853 0916-4838300 Dr. Celia Pangan. Rommel Menguito Tel No. Romeo Sabado (02) 531-9001 loc 356 091 5-7444709 Ms. Romeo Bituin (02) 734-5561-65 0919-2045910 Dr.107 EMERGENCY CALL NUMBER DIRECTORY Hospitals HOSPITALS Amang Rodriguez Medical Center Dr. Rodrigo Hao (02)873-0556 loc 105 0917-8255210 Dr. (02) 942-5988 0920-9624967 Dr. Jose Fabella Memorial Hospital Dr. Willy Veloria (02) 711-2316 0928-2142979 Dr. Ma. Elmer Benedict Collong (02) 925-2401 loc 3830 0919-4175540 Mr. Emmanuel Bueno (02) 921-6480 0917-8391240 Dr. Roel Tito Marcial (02) 671-9740 0918-9100589 Dr. Joseph Espinosa (02) 962-8209 0918-6973937 Dr. Rodriguez Memorial Hospital Dr. David Geollegue (02) 924-6101 loc 333/403 0927-4407329 Dr. Maria Eva Jopson (02) 924-9158 0917-6454339 Mr. Reyes Memorial Medical Center East Avenue Medical Center Las Pinas General Hospital & Satellite Trauma Center Lung Center of the Philippines National Center for Mental Health National Children's Hospital National Kidney & Transplant Institute Philippine Children's Medical Center Philippine Heart Center Philippine Orthopedic Center Quirino Memorial Medical Center Research Institute for Tropical Medicine Rizal Medical Center San Lazaro Hospital San Lorenzo Ruiz Women's Hospital Taguig-Pateros District Hospital Tondo Medical Center Coordinator Metro Manila Hospital Dr. RN (02) 724-0656-59 0915-4406067 Ms. Arnel Rivera (02) 251-8420-23 loc 234 0919-5905244 Continued on next page POCKET EMERGENCY TOOL . Arthur Platon (02) 740-3785 0919-5538588 Dr. Jose R. Roberto Dalmacion (02) 421-9289 0918-9121169 Dr. Alexis Uy (02) 838-3485 loc 116 0919-6525470 Dr. Jose N. Miguel Montes La'o (02)732-3776 loc 428 0918-4230855 Dr./Cell No. Renato Alegabres (02)V807-2628-32 0920-2452485 Dr. Belinda Evangelista (02) 924-3601 loc 3094 0917-9514096 Dr.

Barotac Nuevo. City of San Fernando Paulino J. Santiago City. Cesar Bernabe Dr. Antonio Vasquez (078) 844-0033-34 0321-5803907 (078) 805-3561 loc 132 0919-6314981 (047) 237-3635 0920-5743077 (045) 963-6845 0917-5106373 (044) 463-9937 0918-9173970 (043) 723-0165 0918-9250911 (054) 472-5106 0920-9055649 (052) 483-0635 0919-3340542 (054) 451-2244 0919-3210904 (034) 435-1591 loc 229 0920-9277506 Ms. Jesus Tomas (02) 294-6711 loc 106 0920-8225384 (072) 242-5543 0919-2500155 (077) 792-3144 0919-8183679 Dr. La Union Mariano Marcos Memorial Hospital & Medical Center. Manuel Ponce Dr. Edgardo Sarmiento Dr. Jr. Jaime Balubal Dr. Alfonso Danac Dr. Camarines Sur Corazon Locsin Montelibano Memorial Hospital. Albay Bicol Sanitarium. Balanga City. Ernesto Reyes Dr. RN (033) 361-2011 0915-9671354 Continued on next page POCKET EMERGENCY TOOL . Cagayan Veterans Regional Hospital. San Fernando City. Batangas City Bicol Medical Center. Dominador Manzano. Basco. Tuguegarao. Dagupan City Batanes General Hospital. Batanes Cagayan Valley Medical Center. Legaspi City. Bataan Jose B. Garcia Memorial Regional Medical Center. Jacobina Padojinog. Cabusao. DMD Dr. (075) 523-4103 0919-8888067 Dr. Cabanatuan City Batangas Regional Hospital. Rico Nebres Dr. Epifanio Pagalilauan 0321-6349448 Dr. Rosario. Jose Gabriel Penas Dr. Iloilo Ms.108 EMERGENCY CALL NUMBER DIRECTORY Hospitals continued Valenzuela General Hospital Ilocos Training & Rehional Medical Center. Tenejero. Aida Caudra Regional Hospital Dr. Naga City Bicol Regional Training & Teaching Hospital. Huberto Lapuz Dr. Batac. Isabela Bataan General Hospital. Bacolod City Don Jose Monfort Medical Center. Lingad Memorial General Hospital. Joselito Gonzales. Dolores. Ilocos Norte Region I Medical Center.

Tandag. Edgar Pizarras Dr. Butuan City Ms. Emmanuel Cadut Dr. Tagbilaran City Vicente Sotto Memorial Medical Center. Freida Sorongon. Davao City Davao Regional Hospital. Zamboanga City Amai Pakpak Medical Center. Adelaida Asperin Ms. Iloilo City Gov. Tacloban City Margosatubig Regional Hospital. George Rojo Engr. Ozamis City Northern Mindanao Medical Center. Lanao del Sur Mayor Hilarion Ramiro Regional Training & Teaching Hospital. Bauko. Joseph Al Alesna Dr. Cotabato City Baguio General Hospital & Medical Center. Cagayan de Oro City Davao Medical Center. Nona Galvez. Mindog. Maningcol. Celestino Gallares Memorial Hospital. Enrique Saab Dr. Ricardo Audan Dr. RN Dr. Proceso Mintalar (033) 321-1797 0919-4316384 (038) 411-3185 0918-5047051 (032) 253-9891 loc 134 0917-5469234 (053) 321-3129 0919-5540022 (062) 991-8523 0919-4970004 (063) 352-0070 (088) 521-0022 0917-5803174 (08822) 726-362 0917-4042987 (082) 227-2731 loc 4116 0927-3455823 (084) 400-4416 0920-9219690 (064) 421-2340 loc 303 0917-7266737 (074) 443-5678 0920-9117224 0919-4418559 (086) 211-3700 0918-5848214 (085) 341-2579 0916-8283513 Dr. Edgardo Bolombo Dr. Tagum City Cotabato Regional Medical Center. Manuel Quirino Dr. Panfilo Jorge Tremedal POCKET EMERGENCY TOOL . Apokon. Zamboanga del Sur Zamboanga City Medical Center. Sergio Dalisay Dr. Dimarin Dimatingkal Dr. Baguio City Luis Hora Memorial Regional Hospital Abatan. Province Adela Serra Ty Memorial Medical Center. Margosatubig. Surigao del Sur Caraga Regional Hospital. Mandurriao.109 EMERGENCY CALL NUMBER DIRECTORY Hospitals continued Western Visayas Medical Center. RN Dr. Mt. Amando Gen Barbadillo Dr. Cebu City Eastern Visayas Regional Medical Center. Marawi City.

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