HEALTH FACILITIES SAFE FROM DISASTERS

Transcription

1 The Geographic Nature of Indonesia REGIONAL ISSUES AND CHALLENGES IN KEEPING HEALTH FACILITIES SAFE FROM DISASTER HEALTH FACILITIES SAFE FROM DISASTERS INDONESIA COUNTRY REPORT By Dr. Lucky Tjahjono : Crisis Center, MOH Dr. Wuwuh Utaminingsih : Dit. Basic Medical Care, MOH Dr. R. Suhartono, Unit, Ciptomangonkusumo Hospital Drg. Maria Sidangdoki, National Coordination Board for Disaster Management Indonesia located on 4 moving tectonic plates, has daily, average of 5 Earth quakes (> 5 RS) and Ring of Fire where 126 active volcanoes Around the country 1 2 Hazards Hazard Mapping, Indonesia Earthquake & Tsunami Earthquake Volcanoes Eruption Floods NAD W. Kalimantan 2,3,4,5,6,7,13 1,3,8,4,6,10,9,5,11,, 13, N. Sumatra 3,4,7, W Sumatra 1,2, 3,4,8,11, Bangka Belitung 3, C. Kalimantan 6.10,8,9,3,11,7, S. Kalimantan 3,10,5,13, E. Kalimantan 3,10, 8,9,5, Gorontalo 3, N. Sulawesi 1,3,8,2,4,11,13, C. Sulawesi 2,3,6,9,7,13, S. Sulawesi 3,4,6,7,13, S.E Sulawesi 3,6, Flash floods & Landslides Conflict Social unrest Bomb Blast S. Sumatra 3,4, Riau 3,5,7,8, Kep Riau Lampung 3 2,3, N.Maluku 2,4,6,7,9,13, Papua 2,3,4,6,7,9,11,13, Maluku 2,3,6,7,9,11,13, Transportation Accident Infectious Diseases Cyclone Bengkulu 2,4, Jambi 3, Banten 2,3,5,12, Jakarta 3,4,6,7,9, W, Java C. Java Jogyakarta E. java 2,3,4,5,6,7,11 1,2,3,4,5,9,11 1,11, 1,2, 3,5,6,7,9,,12,,11,12,13,, Type of and Disaster NTT 1,3,6,9,11,2,13,4,5, Bali NTB 2,3,4,6,7,9, 3,6,2,9,4,5,11,7,1 4 Industrial Accident 1. Volcano 5. Hurricane 9. Disease outbreak 13. Tsunami 2. Earthquake 6. Conflict 10. storm. Transportation Black Outs Flood 7. Terrorism 11. Drought Accident 4. Landslide 8. Environment Pollution 12. Industrial Accident Indonesia National Hazards Risk Geographic size : Km² 33 provinces, 349 districts, 91 city, sub districts, villages, and sub villages. Population size : peoples 5 6

2 MOH Preparedness and Response Programme Supported by WHO and Partner Agencies Regional Crisis Center of Sumatera Utara (NAD, SUMUT, RIAU, KEPRI, SUMBAR) Regional Crisis Center of Sumatera Selatan (SUMSEL, JAMBI, BENGKULU, BABEL) Regional Crisis Center of DKI Jakarta (JAKARTA, LAMPUNG, BANTEN, JABAR, KALBAR) Regional Crisis Center of Jawa Tengah (JATENG,YOGYAKATA) PPK Regional Jawa Timur (JAWA TIMUR) Regional Crisis Center of Bali (BALI, NTB, NTT) Regional Crisis Center of Kalimantan Selatan (KALSEL, KALTENG, KALTIM) Regional Crisis Center of Sulawesi Utara (SULUT, GORONTALO, MALUT) Regional Crisis Center of Sulawesi Selatan (SULSEL, SULTENG, SULTRA, SULBAR, 8 MALUKU, PAPUA BARAT, PAPUA) REGIONAL CRISIS CENTER ROLES: a. The center of health operational support b. The center of health support control c. The center of health referral d. The center of health information / Media Center CAPACITY BUILDING HR (BLS) Layman (MFR, CSSR) Police Fire Brigade Security Guard Civil Defense Scouts Red Cross (Paramedic, CSSR) 118 Ambulance Service HOPE Nurse (BTLS, BCLS, BNLS, BPLS) physician (ATLS, ACLS, ANLS, APLS) Surgeon (ATLS, BSS, DSTC, Peri OPE CC) and Disaster management (Basic, Master Degree Courses) DISASTER MANAGEMENT E.D. I.C.U Ward NUMBER OF GENERAL HOSPITALS Hospital Quantity Percentage(%) Public MOH, Prov./ Distric Police/ ARMY Others Department DISASTER Access Telephone Number 110,113,118 Public Health Center Rehabilitation Total Privates TOTAL Public & Private 1268 Pre-Hospital Phase Hospital Phase

3 Hospital Distribution PUBLIC HOSPITAL DISTRIBUTION Hospital Quantity Percentage (%) General Hospital ,5 Mental Health Hospital 51 4 Leprosy Hospital 22 1,7 Tuberculosis Hospital 9 0,7 Delivery Hospital 56 4,4 Eye Hospital 10 0,8 Other specialized hospital 125 9,9 NO MANAGEMENT HOSPITAL A CLASSES B C D TOTAL 1 M.OH PROVINCE DISTRICT/CITY INDONESIA Health Human Resources Total number of Health Staff: Total number of Specialist: Total number of General practitioners: Total number of Nurses: Total number of Midwives: Total number of Paramedics: Total number of support staff: Total number of engineers: Type of Hospitals Units Based on: Infrastructure Human resources Medical equipment Quality control Classification : 4 stars RS TIPE A 3 stars RS TIPE B 2 stars RS TIPE C 1 star RS TIPE D Health Centers / Puskesmas Tert Secd Prim HOSPITAL DISASTER PLAN Has internal & external disaster plan Only has internal disaster pan Case Example Mortality Hospital loaded with dead body Disaster Management Mechanism National Coordination Board for Disaster Management Crisis Center, MOH Operation Unit Disaster Management Committee Multispectral Disaster Plan (Contingency Operation Plan) TSUNAMI NAD Total collapsed BENGKULU EARTHQUAKE Minimal damage Psychologi cal effect Field hospital established JOGJAKARTA EARTHQUAKE Medium damage Injured patient Capacity over loaded Limited human resources 10 - Regional Crisis Centers (Hospital Public Health University) operation Unit Provincial Crisis Center Operation Unit District Crisis Center Operation Unit Standard Operation Procedures (SOP) Training of Hospital Staff Training of Medical Professions Drills and Simulations

4 Early warning Information 1983 Crisis Center Central Operation Unit MoH, Antenna HF-SSB National-Wide Operator Radio Medik Jatim pada akhir 1984 Review, monitoring Coordination Resource Mobilization 19 Tahun 1995 s/d 2008 Challenges Challenges faced to improve the state of preparedness in health facilities Decentralized administrative policy and structure down to district level 446 Districts. Weak in role and responsibility of Provinces (33 Provinces) Hospitals under control of Province and District Authorities Governors Hospital (T-S-P) have no systematic link Transfer of health staff depends more on local authorities. Hospitals, most of the time over loaded with day to day patients especially with road traffic accidents and seasonal diseases. Emergencies and disasters affecting different districts on weekly basis. Health Sector and Cluster Structural and Methodology used in Indonesia Government Coordination Meeting Operational Mapping Health Information Operation Center Heath Sector / Cluster General Coordination UN Cluster Coordination Meeting Sub Groups Coordination and presentation Immunization Child, reproductive and maternal Water and Sanitation Surveillance and outbreak control Mental Health Mobile Clinics Field Hospitals Hospital care Supplies Building codes Indonesian standard building codes. Hospital building codes Higher standards. Guidelines available. Applications of BC varies as weakness in monitoring and enforcement system. Location of hospitals challenged by urbanization. Disaster Risk Reduction Capacity Global Warming Climate Changes Risk Vulnerability Hazard Development Vs Developing Risk = Hazard x Vulnerability Capacity

5 Disaster Risk Reduction Assessment for both internal and external done to all hospitals in Hazard / Vulnerability / Capacity assessment and mapping SOP, Check List and monitoring tools development in process. Integrating data to Information System in process. Capacity building of human resources in process through ITC- DRR. Recommendations Health facility preparedness strengthen through EPR programme road map Regional Crisis Centers, SOP and ITC-DRR. Follow up on assessment findings, socialized central - local authorities and private sector to support necessary preparedness and mitigation interventions. Strengthen Health Engineering capacity. Support for Health centers assessment and mapping. Strengthen emergency information system. Strengthen emergency operation units. Strengthen health centers capacity, responsibility and services to reduce the over load of hospitals. Learn form experiences, use good models and strengthen overall EPR programme. Strengthen capacity of hospital assessment soon after emergency or disaster stricks. Strengthen law enforcement. Super Thanks for Your Support!