Emergency Response and Preparedness

Country  Emergency Situational Profiles

India

Disaster management structure in health sector (source – GOI):

      National Level

The Emergency Medical Relief Division of Directorate General of Health Services in the Ministry^- of Health & Family Welfare is the technical unit exclusively meant for management of crisis situations. The Division is headed by the Director, Emergency Medical Services and Relief. For the purpose of the crisis situations, he reports/receives instructions directly from the technical chief (Director General ofHealth Services) and Administrative Head of the Ministry (Secretary Health & FV). The Secretary, Health & F.W has empowered Director, EMR to represent the ministry of health and family welfare in different Crisis Management Groups at the national level.

The Director, Emergency Medical Services & Relief (EMR) coordinates with the other health sector partners like director of Health Services of the state governments, stores division under the central government, vaccine producing institutes, central government hospitals and national institute of communicable diseases and director, malaria unit. The objective of the coordination is to review crisis situations from time to time and meet those needs, which State Governments cannot meet. For this purpose, continuous dialogue and communication are maintained with them.

A Health Sector Emergency Preparedness and Response Programme is in place since 1980 which was revised from time to time. Last revision was done in the year 1996. The emergency health sector focal points of national, state and district levels are the integral part of the crisis management groups at the respective levels. In the central Ministry of Health and Family Welfare, the Emergency Medical Relief Division is the responsible technical unit.

A detailed guideline separately for flood, drought, cyclone and earthquake has been prepared and circulated in the month of March and April to all the drought-prone States and during May and June to the flood and cyclone-prone States. The Telephone numbers and other relevant information of the concerned officers at the State level are updated.

      State level:

Usually a joint director or a deputy director of the state health services under director of health services is responsible for crisis management, coordination, monitoring and implementation of the emergency activities in the state as laid down in the state health sector contingency plan. The detail information about key personnel involved in disastermanagement at State, District and Central level is available with him.

      District/PHC level:

At district level, the chief medical officer/Civil Surgeon is responsible to implement and coordinate health sector activities. He has details of information about officer involved in^-disaster management at PHCS, District and State level.

In case of manpower deployment during emergencies, the initial re-deployment of medical team is done by the chief medical officer of the affected districts from non-affected districts under his jurisdiction. Subsequently, the state governments mobilises the additional manpower from other non-affected districts state directors of health services. In case further supplementation is required, the director (EMR) on behalf of the central government is responsible to do the same from central government institutions.

      Non-governmental organizations:

There are a number of NGOs involved by the state governments with objective to enhance disaster management capabilities in the field. Most of them are small and work locally. However, Indian Red Cross Society and Ramakrishna Mission are the two organizations, which take very active part in disaster management.

      Government of India initiatives:

With an intention to gradually change the existing practice of disaster management from response to preparedness, the Government of India initially allocated US 50,000 for EHA activities at the beginning of 2002-03 biennium under the regular country budget - no such budgetary provision existed during the last biennium. With the successful implementation of EHA program activities by mid 2002, the Government of India subsequently enhanced the said allocation from US 50,000 to US $ 250,000. 

Areas of WHO technical support in the Indian efforts of improved emergency/disaster management in the country:

Keeping in view of the WHO mandate on Emergency & Humanitarian Action in the health sector, the WHO representative office can assist the Indian efforts in the following areas;

     Strengthening of Health Sector capacity and capabilities in the 4 states (4 additional states are Himachal Pradesh, Uttaranchal, Andhra Pradesh and Madhya Pradesh). It is a continuation activities since 2002-03 during which four states namely Gujarat, Orissa, Mizoram and Sikkim were supported.

     Assisting states of Mizoram, Sikkim, Gujarat and Orissa in completing Health sector orientation/

     Training activities towards newly developed health sector contingency plans prepared during 2002-03.

     NGO,s networking.

     Introduction of Public Health and Emergency Management in Asia and the Pacific (PHEMAP) course in the states – two courses per year (total – 4 courses).

     Continuation of institutionalisation process in Rajiv Gandhi Medical University, Karnataka, Ban galore and All India Institute of Hygiene and Public Health, Kolkata.

     Establishment of EHA focal point in the WHO representative Office to provide technical support at the state and national levels.

      Institutionalization of Health Sector Disaster Management in India:

Experience shows that despite a good administrative set up a well formulated disaster management plan, disaster mitigation masers may not find the required direction and yield desired results in the field. Memories of disasters usually fade away after the acute phase of events.

In India, the health sector disaster preparedness has been institutionalized with the objective to incorporate disaster plan in the health delivery system. With this intention, two institutions throughout the country have been identified. The broad functional responsibility of these institutions are:

     A.I.I. H & P. H, KOlkata

The All India Institute of Hygiene and Public Health (AIIPH) Kolkata has been assigned to undertake mutually agreed research, training activities as well as collection and evaluation of technical / scientific information about emergency preparedness and response in  collaboration with the National and State Governments, WHO and its international reference centres for Emergency Preparedness and Response. In this direction, the institute under guidance of WHO-India is discharging the following responsibilities;

     To collect and disseminate information about national disaster situation and to serve as a reference centre for information networking for strengthening disaster management endeavour;

     To design a uniform protocol for hazard mapping, vulnerability analysis, evaluation of health sector disaster preparedness and management programs with particular emphasis to states vulnerable to natural disasters and to provide technical support for improvement of preparedness plan;

     To formulate guidelines, manuals, training modules including standardised training methodology, technical support for organizing training programs on emergency preparedness and management for government officials, NGOs, research and other fellows and WHO fellows, particularly from developing countries;

     To develop mechanism for networking of functionaries of government agencies, NGOS and different institutions for integrated operationalization of training, research and community educational activities of disaster preparedness and management at different levels;

      RGUHS, Bangalore

Under the WHO and GOI collaboration, Initiative for Emergency Medical Preparedness and Response (IEMPRESS) is under implementation the by Rajiv Gandhi University of Health Sciences, Karnataka (RGUHS). This project is aimed at promoting and supporting prompt and essential response to emergencies arising out of natural or man made calamities. Immediate relevant response, rescue and relief could reduce morbidity, mortality and human suffering and economic loss.  The project would be implemented in three phases starting with development of model hospital contingency plan for tertiary hospitals, training of medical and other health professionals, capacity building of hospitals/institutions to meet with management of mass casualties. The expertise so built in the first phase would be extended to district and secondary level hospitals during the second phase and to the primary health care centres in the third phase. The initiative would encourage teaching hospitals in the government as well as private sectors to develop their own individual hospital contingency plans. A networking of hospitals will be established on zonal basis. Professional associations, NGOs and State government health services has been planned to be involved.

      INTERNATIONAL Coordination (source – UNDP):

UNDMT is an inter-agency working group of UN organizations concerned with response to humanitarian emergencies and is headed by the UN Resident Coordinator.

FAO, ILO, UNDP, UNFPA, UNICEF, WFP and WHO are members of the UNDMT-India.

Purpose of UNDMT is to ensure prompt, effective and concerted country-level response by the UN system in the event of a Disaster.

It tries to ensure co-ordination of UN assistance to the Government in respect of rehabilitation, reconstruction and disaster mitigation. The general and sectoral coordination structures are as follows;

      Information Sharing on recent Disasters:

–A Bi-Multi meet was organized by UN organizations to update the bilateral partner

agencies on the recent disasters          (Assam, Bihar Flood 2002, drought in various states)

     Capacity Building of the UNDMT members:

     A hands-on training on joint assessment was organized in Bhubaneshwar to enhance the damage assessment and need-gap analysis skills of the DMT members.

     Ongoing efforts to prepare Disaster Response and Preparedness

     SitReps:

Issue of regular Situation Reports to various partners on the damage statistics and need-gap analysis –http://www.un.org.in/undmt/

UNDMT has also been working in tandem with Government of India’s (GoI) resolve to evolve a National Disaster Management Plan to combat natural disasters. The major goal of the UN mission in India has been to advocate for reduction in vulnerability and engage with the GoI in building capacity for disaster preparedness and management, thus, reducing the incidence of and sustainable recovery and transition from complex emergencies and natural disasters.