WHO in South-East Asia

Background

Sudden onset disasters occur without any advanced notice or warning and often cause extensive injuries to affected people and damage to the healthcare systems – making health facilities partially or completely damaged in crisis situations that may go beyond national capacities to respond.

The South-East Asia region is vulnerable to different types of disasters and emergencies. Countries in this region face a broad range of disasters from natural hazards including earthquakes, floods, tsunamis, landslides and volcanic eruptions that may require immediate assistance from national Emergency Medical Teams (EMTs) within the affected country or by international EMTs. Examples in the South-East Asia Region are Gujarat, India earthquake (2001), Indian Ocean Tsunami (2004), Kashmir earthquake, India (2005), Yogyakarta earthquake, Indonesia (2006), Cyclone Nargis, Myanmar (2008), Nepal earthquake (2015), Chennai flood (2015) and Aceh earthquake, Indonesia (2016).

In an emergency, the outcome of response depends on how quickly the right expertise reaches at right place at the right time to meet the needs of affected people. During the emergency phase, the presence of multiple humanitarian stakeholders working with or without any partnership arrangements can make the emergency response less effective and inefficient with duplication of response activities and wasting of resources that are already scarce. On top of that, weak coordination and communication mechanisms affect the quality and timely delivery of much needed emergency relief and services. In order to have a timely, well-coordinated, effective and efficient emergency response, the Emergency Operations (EMO) unit of WHO SEARO collaborated with various partners through different partnership mechanisms; of which the Emergency Medical Team is an important mechanism activated in emergencies.

Emergency Medical Teams (EMTs)

An Emergency Medical Team is a group of health professionals (e.g., doctors, nurses, paramedics) providing direct clinical care to populations affected by disasters and health emergencies. This includes governmental (both civilian and military) and non-governmental teams and can include both national and international teams. The scope of EMTs range from management of trauma due to sudden onset disasters (mass casualty management) to acute medical emergency care especially in highly infectious outbreaks (e.g. Ebola). The WHO EMT initiative aims to support Member States, NGOs and international organizations by identifying minimum standards, best practice, logistics and operational field coordination SOPs. The EMTs are an important part of the global health workforce and the EMT initiative places a strong focus on helping every country in developing its own EMT that can arrive where they are needed in the shortest possible time. EMTs are expected to comply with globally agreed standards and coordination mechanism in humanitarian response.

It is important to adopt standards, implement quality assurance and governance mechanisms for strengthening of national and international EMTs that may work in the South East Asia region. It was noted that there is already some existing EMT capacity in the region in forms of national EMTs but it became important to have a mapping of EMTs and their coordination mechanisms for further strengthening.

The WHE/SEARO organized a ‘Regional Consultation on Strengthening of EMTs in the South-East Asia Region, in New Delhi on 5-6 June 2018.

Objectives of Regional Consultation on Strengthening of EMTs

  • To discuss and review global and regional developments in the area of EMT,
  • To map EMTs in the South-East Asia region,
  • To develop EMT strengthening plan,
  • To adopt regional EMT governance mechanism and EMT coordination arrangements and
  • To draft a discussion paper on EMTs for the Regional Committee

This consultation is also in preparation for the meeting of the Regional Committee of WHO/SEARO in September 2018 wherein strengthening of EMTs will be discussed as an agenda item.

Participants

  • Representatives from Ministry of Health (involved in policy and operational aspects of EMTs) from 11 Member States of the SEA Region
  • Non-governmental organizations and other agencies running EMTs in the SEA Region
  • Operational partners and UN agencies involved in emergencies and EMTs
  • EMT focal persons WHO Country Offices, Regional Offices and HQ

Conclusion and recommendations

The consultation concluded by recognizing the existing capacities and potential for establishing and strengthening EMTs in the region vis-à-vis hazards and vulnerabilities in the South-East Asia region. It was acknowledged that there is a need to build capacity of national EMTs as per country context in the areas of (a) coordination of various partners (government-civil and military; civil society partners), (b) policies and standard operating procedures and (c) quality assurance mechanisms. The discussion paper resulted from this consultation has also been tabled in the WHO Regional Committee Meeting in 1st week of September 2018 as an important agenda item.

The following were the recommendations of the regional consultation:

For Member States:

  • Establish mechanism/systems for strengthening and coordination of national EMTs

  • Establish a system for quality assurance for EMTs at national level
    • Designate national EMT focal point/s (Policy and Operations)
    • Establish a system for quality assurance for EMTs at national level
    • Encourage in-particular teams deploying internationally to sign-up to the WHO mentorship and classification process
    • Establish, train and build capacity of national EMTs
    • Establish EMT Coordination Cell and mechanism for EMT coordination and deployments
    • Ensure sending and receiving EMTs that confirm to quality assurance
  • Optimize the contributions (expertise, equipment, human and material resources) of partners agencies in strengthening EMTs

For WHO:

  • WHE/Regional Office to initiate steps to establish Regional EMT Working Group as described in the discussion paper
  • Provide technical assistance to Member States for strengthening their national EMTs
  • Promote, advocate and mobilize regional operational partners to support and build capacity of EMTs in the region
  • Facilitate dialogue with ASEAN/SAARC, other inter-governmental bodies in complementing efforts on strengthening EMTs in the region

The civil-military and NGOs coordination mechanisms for utilizing EMTs in the right time, at right place with right quality of services for people-in-need should be improved for saving lives. Emergency medical teams are encouraged to sign-up for mentorship and classification coordinated by WHO.

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