1 THE TYPHOON HAIYAN EXPERIENCE In Eastern Visayas, Philippines ASEAN Disaster Medicine Workshop Royal Phuket City Hotel Phuket, Thailand April 23-25, 2014 FIDELITA D. DICO, MD, MSc HEMS Coordinator Department of Health Regional Office VIII Philippines
2 THE Tropical Storm HAIYAN Phil is highly susceptible to typhoons located within pacific typhoon belt area
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5 Topic Outline Background Destruction in Eastern Visayas DOH Response Foreign Medical Team Mobilization Challenges Lessons Learned
6 Typhoon HAIYAN Local name: Typhoon Yolanda strongest typhoon, unprecedented a perfect typhoon to bring a perfect disaster - 2 super typhoons in the history of Eastern Visayas: - Year 1897 7,000 deaths - Year 1912 15,000 deaths -
Typhoon Haiyan 7 Nov 1, 2013 (LPA); Nov 08, 2013 (landfalls) 235 kph recorded max sustained winds up to 275 kph gustiness - 10-20 feet storm surge Typhoon Signal No. 4 Made 7 landfalls: E. Visayas: E. Samar, 4:40am, Leyte, 7:00am Central Visayas : Cebu, 9:40am, Bantayan Island Cebu, 10:40am Western Visayas : Iloilo, 12:00nn, Antique, 3:00pm S. Luzon: Palawan 8:40PM
TYPHOON YOLANDA LANDFALLS 8 Haiyan Landfalls
AFFECTED Haiyan Pathway AREAS in Eastern IN EASTERN Visayas VISAYAS 10
11 Destruction in Eastern Visayas Destroyed power and communication lines, rendering Eastern Visayas isolated Major airports seaports closed down Major roads impassable due to piles of debris, minor roads collapsed
Destruction to life and properties 12
13 CASUALTIES Region Province Deaths Injured IV-A Quezon, Batangas 3 6 IV-B Palawan 19 63 V Albay, Masbate, Camarines Norte 6 32 VI Iloilo, Aklan, Capiz, Antique, Negros Occidental 285 2,733 VII Cebu, Bohol 74 22 *VIII Leyte, Samar, E. Samar, Biliran Tacloban & Ormoc City 5,921 26,123 IX Zamboanga 0 1 CARAGA Surigao del Sur 0 1 Total 6,308 28,981 Note: *RDRRMC Sitrep No. 92 as of Feb 28 2014. Discrepancies in figures are still subject for validation by respective regions DRRMC.
14 OTHER IMPACTS Manpower DOH office personnel residing in affected area who reported for work in the first 3 days Local Govt Unit Health personnel who reported for work in the first week Ground estimate of around 5% Ground estimate of 10 to 20%
OTHER IMPACTS 3 damaged offices (PHO, 2CHO) Warehouse and prepositioned logistics destroyed. 15 Health Infras- tructure 29 out of 84 assessed hospitals are damaged. All functional. 222 out of 1,022 assessed Rural Health Units & Barangay Health Stations are damaged. All Rural Health Units are functional EVRMC as the only remaining functional hospital in Tacloban with personnel on duty for 3-5 straight days daily averages: 300 inpatients, and 70 E.R. Consultations
Destruction to life and properties 16
TIMELINE OF RESPONSES 17 DRRMC meetings conducted at all levels Alert memo issued by DOH CO to all CHDs Logistics prepositione d in CHDs of typhoon pathway OpCen on 24 hrs operations at all levels, network established Hospitals on code blue alert Schools & offices suspended. RDRRMC meetings & media briefings w/ top authorities & experts Typhoon Haiyan made landfalls No lifelines in affected areas No communicatio n from OpCens Only qualitative info and pictures from mainstream media Calbayog City Medical Team arrived Tac & served at EVRMC. Nat l Medical Response Teams ready to depart for Tac. DOH on Code Red Alert Foreign medical Team started to arrive Tacloban, US Army Med Team performed surgery in Tanauan, Leyte 2 DOH HEMS Response Teams arrived Tacloban Health Cluster Meetings with Int l Teams started in temp bldgs Teams from MM hospitals arrived in Tacloban National & International Medical Teams started pouring in Nov 6 Nov 7 Nov 8 Nov 9 Nov 10 Nov 11 ntext: Unprecedented magnitude of Typhoon Yolanda effects
CATEGORY SUMMARY OF TEAMS DEPLOYED NUMBER OF TEAMS PERSONNEL DOCTORS NURSE OTHERS TOTAL 18 DOH TEAMS 126 363 568 411 1342 OTHER LOCAL HEALTH RESPONDERS 34 343 167 78 588 FOREIGN TEAMS 185 3040 TOTAL 345 706+ 735+ 489+ 4970+
CLASSIFICATION OF TEAMS DEPLOYED CLASSIFICATION DOH LOCAL FOREIGN TOTAL MEDICAL TEAM 70 32 170 272 TECHNICAL TEAM 4 0 3 7 PUBLIC HEALTH TEAM 10 0 0 10 PSYCHOSOCIAL TEAM 3 0 0 3 COMPOSITE TEAM 26 2 7 35 RHA TEAM 3 0 1 4 HEALTH PROMOTION TEAM 1 0 0 1 ADMIN TEAM 2 0 0 2 WASH TEAM 5 0 0 5 VACCINATION TEAM 2 0 0 2 TO BE DETERMINED 0 0 4 4 19
20 FOREIGN MEDICAL TEAMS
21 Foreign Medical Team Entry DOH Central Office - Bureau of International Health Cooperation (BHIC) Coordination with WHO (Country Office) Register all FMT & assess capability: 1. Type of service Type 1 Mobile clinic Type 2 Major surgery /hospital 2. Sustainability of service (short or long term) 3. Self sufficiency
22 Foreign Medical Team Entry BHIC coordinates with other national agencies: 1. Professional Regulations Commission (waiver of Special Temp Permit (STP) for professional practice in the Phils). 2. Bureau of Immigration (facilitates entry of foreign nationals ) 3. Bureau of Customs (facilitates entry of donations, goods)
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24 Foreign Medical Team Entry BHIC coordinates with other national agencies: 4. Embassy (coordination as to time of arrival, ports of entry) 5. Dept of Foreign Affairs (verification of in-coming teams) Finally, BHIC issues clearance for deployment Team assignment using maps
This map 25
26 On the ground: 1. Receiving & registering FMT at the Central Operations Center (Tacloban/Palo) and hubs (Borongan, E. Samar, Ormoc City, Tacloban City, Catbalogan, W. Samar) 2. Open communication lines: Conduct orientation (health situation, maps) Invite them to daily/ weekly Quad Cluster coordination meetings at the Dept of Health OpCen - Cluster meetings maintained/sustained
27 On the ground: 3. Maintain a logbook of FMT registry and create directory (networking, coordination, collaboration) 4. Complemented each other in the assessment: Locals have pre Yolanda data/information FMT have data on-site
28 On the ground: 5. Complemented each other in addressing a problem: FMT can provide the logistics/item Locals can facilitate in bringing or establishing the logistics in the area 6. Involvement in health reporting system Role in SPEED reporting Sharing of daily/weekly accomplishment during meetings Submit written report using a template
29 On the ground: 7. Work with them in coming up with ideas to manage disaster and in managing difficulties that comes with disaster. Establishment of hubs (Leyte, Ormoc, E. Samar) Build capabilities of human resources 8. Acknowledge & thank them Certificate of Recognition signed by top authorities Streamers of thank you are hang in streets & in the communities.
Establish hubs as satellite OpCen 30
Acknowledgment 31
32 Challenges 1. Poor communication lines due to damaged facilities National actions not fully communicated to the local (impact sites) and vice-versa 2. Overwhelming responsibility due mass arrivals (team/manpower & logistics)
33 Challenges 3. No existing protocols on dealing with Foreign Medical Response Teams & donated logistics in large magnitude National offices established the protocols as necessary Ground ICS rely on common practices in receiving /accepting FMT and their logistics 4. Reliance of data-on-hand as basis for deployment in order to avoid overserved & underserved areas.
34 Challenges 5. Non-flexibility Area of deployment based on central office pronouncements Adaptability to limitations in the disaster sites (e.g. no electricity to run equipment, a large storage space enough to house their logistics )
35 Challenges 6. Coordination with many agencies that works for the entry and purpose of FMT. 7. Unregistered FMT: a. Back-registration b. Unaccounted for
36 Maraming Salamat THANK YOU SO MUCH
37 Lessons Learned 1. The need to review national and local Health Emergency Preparedness, Response & Recovery Plan with particular attention on networking and coordination mechanisms with responding teams especially in a mega disaster scenario.
38 Lessons Learned 2. The need for national protocols, guidelines, procedures on the acceptance, deployment, and exit of foreign medical teams. 3. Registration of international/ national teams and identification of their teams capabilities/ expertise during pre-disaster phase.
39 Lessons Learned 4. There is a need to develop a feedback mechanism from the central office to impact site and vice-versa on the deployment processes, in order to help assess the relevance/ appropriateness of an FMT in the disaster site. 5. Contingency Plan of Action when standard protocols and procedures fail.
40 Typhoon Haiyan is a storm of historic severity, it was unprecedented in magnitude. It will forever be talked about by Filipinos and people all over the world in the many years to come.
Kob khun ka 41