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MODULE TITLE. RECOVERY AND RECONSTRUCTION. ROLE OF THE HEALTH SECTOR. INTER-REGIONAL TRAINING COURSE ON PUBLIC HEALTH AND EMERGENCY MANAGEMENT IN ASIA AND THE PACIFIC. Learning Objectives. By the end of this course, the participant should be able to:

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  1. MODULE TITLE RECOVERY AND RECONSTRUCTION ROLE OF THE HEALTH SECTOR INTER-REGIONAL TRAINING COURSE ONPUBLIC HEALTH AND EMERGENCY MANAGEMENT IN ASIA AND THE PACIFIC

  2. Learning Objectives By the end of this course, the participant should be able to: • Describe health needs, risks and services in disaster recovery and reconstruction • Discuss processes for recovery and reconstruction of health services and infrastructure within the larger context of community recovery and reconstruction plans • Discuss the opportunities presented for health risk reduction and health systems capacity development during disaster recovery and reconstruction • Describe the roles of an HEM in managing health in disaster recovery and reconstruction

  3. Disaster Recovery Recovery “... focuses on how best to restore the capacity of the government and communities to rebuild and recover from crisis and to prevent relapses. In so doing, recovery seeks not only to catalyze sustainable development activities, but also to build upon earlier humanitarian programs to ensure that their inputs become assets for development.” (source: United Nations Development Program 2001)

  4. Q&A What are the factors in recovery and reconstruction that might provide opportunities for long-term capacity development?

  5. Emergency Response and Recovery Sudden Impact Mitigation Preparedness 2 Ongoing Development 1 3 5 4 Warning Indicators (Flash Points) ACTIVITY Reconstruction Rehabilitation Rapid / Detailed Assessment Emergency Relief Search & Rescue EMERGENCY PHASE Days / Weeks WARNING PHASE Months / Weeks / Hours Rehabilitation / Recovery Many Months TIME

  6. Health Roles in Managing Risks Over Time

  7. Health Roles in Managing Risks

  8. From Response to Recovery and Reconstruction If there is no clear cut boundary between responses and recovery processes… this means: Don’t wait, think ahead! Build on the momentum of response to anticipate longer-term recovery and reconstruction.

  9. Long-term Health Considerations for the Recovery Process Psychosocial Concurrent problem due to disaster: decrease in mental health services, increase in incidence of common mental health problems • Psycho physiological • Behavioral • Emotional • Cognitive Emergency health care system addresses acute cases and initiate long-term plan for community- based psychological interventions.

  10. Long-term Health Considerations for the Recovery Process Emergent and Re-emergent illness • Monitoring for delayed / ongoing health impacts • Surveillance for potentially emergent and re-emergent endemic diseases or areas Environment • Clean-up, hazard reduction and environmental management of the incident site Housing • Permanent Accommodation • Access to regular Services • Resettlement and / or Repatriation • Worst possible plan is to resettle

  11. Health Recovery and Reconstruction Within Community Recovery and Reconstruction Plans Community recovery and reconstruction addresses essential infrastructure and services: • Building and permanent installations living • Energy • Water • Food • Waste disposal • Education • Health

  12. HEALTH - A Systemic approach It is crucial to consider ‘health’ in recovery and reconstruction as a system, operating in collaboration with other systems. A systemic approach to health draws attention to: • Facilities and infrastructure • Health care resources (medicines, PPE, supplies, etc) • Financial resources • Human resources

  13. HEALTH - A Systemic Approach A systemic approach to health enables: • Adequate strategies • Understanding and enhancement of capacity of health system to meet the health needs of population • Understanding of and mitigation of system’s main vulnerabilities • Understanding and filling of gaps in system - for instance, inclusion of surge capacity considerations • Appropriate allocation of resources throughout the health care system • Lessons learned from disaster in own or other countries to be incorporated into health system recovery and reconstruction

  14. Principles of Health Recovery Plans • Look at the big picture • Be country-owned and backed by political commitment • Ensure community participation • People begin almost immediately to re-house themselves and re-establish their social and economic networks after a disaster - build upon, don’t supplant community initiatives! • People have good ideas of what they want to do to rebuild their lives - take their views into account when planning for recovery! • Take into account the overall context and the changes in this context (political, economic, social and military) • Establish partnership with ALL key stakeholders

  15. Principles of Health Recovery Plans • Use a ‘zoom approach’ (medium / long-term time frames, with short-term cycles) • Assess the functional health system elements of the affected community in relation to the community’s health needs • Develop and formalise arrangements for the effective management of the recovery process • Facilitate the rehabilitation and improvement of affected infrastructures as quickly as possible • Facilitate the recovery of affected individuals (physical, social) • Ensure general understanding of planning process and programme (agencies, authorities and communities)

  16. Principles of Health Recovery Plans • Describe organisational networks and structures appropriate to recovery process (different types and scale events) • Be reviewed on a regular basis • Incorporate performance indicators and measurable results into the plan, in order to readjust the strategy to the outcomes. • Set out appropriate resourcing arrangements • Define responsibility for the range of specific services to be provided And… ALWAYS CONSIDER LONG-TERM CAPACITY DEVELOPMENT AND RISK REDUCTION!

  17. Recovery, Capacity Development and Risk Reduction - Some Examples • Reducing population vulnerabilities • improving access to basic resources • reducing exposure to disease vectors and pests. • improving knowledge of health risks and mitigation strategies • Improving factors affecting public health • housing, water supply, sanitation, food safety, nutrition, dietary security, personal hygiene. • Developing health system capacities • stronger, better located & equipped facilities • better training for staff • addressing systemic weaknesses

  18. Recovery Planning - Baseline Questions what? vulnerabilities, available capacities & resources, support who? target group & beneficiaries how much / many? needs and limitations who? responsible, involved, support, where? co-ordination lines - (coverage, prevent duplication of services) overlapping of subdistricts

  19. Recovery Planning - Baseline Questions how & when? appropriate response, reactive and / or proactive how long? continuity & sustainability - (training, supervision, ownership, integration, financing), reconciliation, resettlement. what type? policy, guideline or good will. why? understand Root Issues and what is being done to address them?

  20. Recovery Planning - Health Assessment • Identify new vulnerability to future disasters or make existing vulnerability worse. • Failure to recover, or partial recovery, can make people more vulnerable.

  21. Guidelines for Delivery of Recovery Services 1 • maximise the flow of information • make programs that enable the affected persons to actively participate in programs which affect their future • maximise the use of local resources, groups and individuals (local suppliers and services) • ensure effective liaison (recovery teams, volunteer resources and CBO’s). • encourage practice that allow for self-determination and community involvement in restoration planning

  22. Guidelines for Delivery of Recovery Services 2 • make use of the existing structures, resources and local formal and informal networks • ensure recovery workers are given ongoing support, debriefing, relief and rest • aim at keeping families together (evacuation, temporary accommodation or resettlement) • plan withdrawal of external recovery resource whilst ensuring continuity of the recovery process

  23. Roles of the Recovery Manager • Ensure • appropriate strategies are in place • maximum community involvement • immediate & long-term individual and community needs • Facilitate • acquisition, allocation of material • Identify • staff and financial resources • Promote • planning at all stages of the emergency cycle.

  24. Tasks of the Recovery Manager • organise and manage • resources, staff and systems. • advocate (behalf of the affected community) • with government departments • voluntary agencies, • the wider community, • Business. • other organisations • liaise and consult (if necessary, coordinate) participating agencies, groups, authorities in order to achieve the most effective and appropriate recovery

  25. Tasks of the Recovery Manager • provide information • mediate where conflicts occur. • develop relationships • be partially distanced from the immediacy of the event to provide guidance • overall recovery process • establishing priorities • anticipate future requirements

  26. THANK YOU

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