Pandemic Influenza International Response and Civil-Military Coordination; Exercise

1. Pandemic Influenza International Response and Civil-Military Coordination; Exercise Andrew Bates June, 2011 FEMA Higher Education Conference Adapted from Kira Kay - HandswithHands Pan American Health Organization and the World Health Organization Volume #5

2. International Pandemic Response • National/Province/local Response mechanisms • Surveillance • Containment • Response • Essential services • Regional Response mechanisms • Neighbors & Borders; People and Commerce • Regional assistance organizations; ASEAN, EU, African Union, etc

3. International Pandemic Response • United Nation mechanisms • Int’ Health Regulations 2005 • UN Cluster model • The Big three; WHO, WFP, OCHA • FAO, UNHCR, UNICEF, IOM, IFRC • One Health and Emerging Infectious Diseases • Climate Changes and Population trends

4. Civil-Military Coordination • When does civil-military coordination become a requirement? • Whole-of-Government response • Complex Emergencies; The long disaster! • NGOs and Do No Harm • Phased transitions and friction points

5. Transitions during Civil-Military Responses Recovery Relief Need for Assistance Foreign Military and Civil Defence Assets International Civilian Relief Local/National Response incl. military Time Information Sharing Task Division Planning Command & Control Planning Task Division Information Sharing CMCOORD slide

6. Essential Services Exercise • Eight Critical Infrastructure Sectors • Food/Agriculture • Water/Sanitation • Transportation • Telecommunications • Rule of Law & Defense • Healthcare/Public Health • Banking/Credit • Power/Electricity

7. Learning objectives Mortuary Affairs You will be able to: • Define what is meant by mass graves • Explain the role of the community and military in mass graves situations • Define the legal, social, and psychological impacts • Determine planning initiatives

8. Mortuary Affairs Disaster Response Priorities • Authorities must look for and care for the living first • Secondly; the authorities must restore essential services to support the living; Power, Water, Food, transportation, telecommunications, and shelter • Authorities must work to identify and process the dead

9. Characteristics in Mass Casualty Situations Mortuary Affairs What happens? • Relatives and friends are looking for the dead • Authorities are searching for victims who are alive • Mortuaries are overwhelmed • Police and medical personnel must provide information to maintain order

10. Preparing for Mass Death Mortuary Affairs • Identify coordinating institutions in advance – mortuaries, religious groups, hospitals, police & military and others as appropriate • Provide technical training for body identification • Develop relations with the Media per roles and responsibilities

11. Mortuary Affairs Public Perceptions and Community Relations What are some ways to assist? • Any identifying items must be saved; photos, cards, and documents: They must be logged with the location of where the body was found • Get the local religious leader to declare a special situation in order to expedite graves: Hindu, Buddhist, Moslem, Christian Why? • Emotional response of friends and family • Impact of media difficult to quantify • Increase in political complexity = increase in controversy • Civilians can hinder rescue operations and logistics

12. Mortuary Affairs Planning Operational Public Health Items • Organized shifts and reserves • Prepare the workers to deal with mass casualties • Get supplies stored and pre-positioned; Body bags • Can alternative sites be acquired to avoid mass grave situations. Consider refrigeration if possible • Only preserve bodies that are not identified • Request ICRC assistance to provide guidance on mass graves.

13. Mortuary Affairs Cultural Considerations • Get local religious leaders engaged in the communications process • If the cultural norm is cremations do it quickly and away from the population centers • Allow for limited mourning and rituals • Determine the level of family authorization

14. Psychological Aspects Mortuary Affairs • Shock and Trauma for victims • Post Traumatic Stress Syndrome • Notification process • Counseling services • Importance of truth and a structured process for accounting of the dead

15. Religious and cultural considerations Mortuary Affairs • Involve community leaders and educate them with ICRC standards which provide proper mass grave markings • Group religious types in the same grave or storage areas if possible • Do not physically disrespect a dead body if possible

16. Legal Considerations Mortuary Affairs • Legal implications of unidentified bodies • Missing persons • National and International legal issues • Mass Graves markings; ICRC International standards • Return of foreign nationals to their homeland during a pandemic

17. Summary Mortuary Affairs • Treat bodies with respect • Provide training and exercises for burial tasks that are part of the disaster plan • Work through the local authorities • Involve religious people when you can • Identify and record body remains and personal effects • Involve the media if possible in exercises • Mass grave sites must be planned for in advance • Take care of your people

18. QUESTIONS?