Disaster Management Awareness Program in Medical Schools in Nepal An Inclusive and Comprehensive Approach..., Sunita PANTA

6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Disaster management Awareness
Program
Dr Sunita Panta
Anaesthesiologist and Assistant Professor
Nepal

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Namaskar
Good Afternoon

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Scope
• Introduction and Disaster Overview
• Risk assessment and Gap Analysis
• Way Forward
• Disaster management awareness Program
• Conclusion

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Introduction and Disaster
Overview

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An inclusive and comprehensive approach
To build a resilient community
In a vulnerable and underdeveloped nation

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NEPAL
This is where we stand in the world

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NEPAL
• Small land locked country in South Asia
• Situated between China in the North and rest by India
• Himalayan Range -Mt. Everest the highest peak in the world
• Birthplace of Siddhartha Gautam Buddha
• Member of South Asian Association for Regional Cooperation
(SAARC)

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• Population approximately 28 million (2014)
– 83 percent live in the rural areas
– 17 percent in the urban areas
• The literacy rate of the country is 57.4 percent (Index Mundi)
– male literacy rate is 71.1 percent
– female literacy rate is 46.7 percent
• Nepal is a low income country
– Human Development Index (HDI) (2013)
– 0.463
– 157 out of 187 countries

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Nepal is a beautiful country but is prone
to natural Disasters...
1. Flood
2. Landslide
3. Earthquake
4. Epidemics
5. Fire
6. Thunderbolt
7. Drought
8. Glacial Lake Outburst
Flood (GLOF)
9. Avalanches
10. Windstorm
Frequent Disaster : Landslide and Flood..
Earthquake likely to happen !!!!

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• Nepal falls top 20th list of the multi-hazard prone countries
• Ranked 4th, 11th and 30th in term of climate change,
earthquake and flood risk respectively
• Persistent threat to huge loss of human lives due to natural
disasters
• The economic cost associated with natural disasters has
increased tremendously in each episode of the calamity

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Nepalese Community
• Close knit and social
• Wards , Village Development Committee (VDC)
• Majority – Hindu
• Limited education
• Limited health infrastructure
• Vulnerable to natural and human made hazards
• Limited knowledge on disaster preparedness
• Reconstruction phase –Nepal Earthquake 2015

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Community and Disasters
• Social unit is situated in a given geographical area vulnerable
to the same disaster risks
• Community developed against disasters by empowering
individuals and groups of people by providing them with the
coping skills
• Community resilience is achieved by training teachers,
students, leaders, health workers and social workers who can
make an impact in the community.
• Medical personnel should be involved in the community
during the student phase itself

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Medical professionals in community
• Medical practitioners in integral part in the Nepalese society
• Primary Health Centers, Health Posts, Hospitals
• Involved directly in community medicine
• Epidemiological studies
• Involved in all the phases of the disaster cycle
– Rescue
– Relief
– Rehabilitation
– Reconstruction

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Advantages of Community Involvement
• Voluntary
• Need based and specific
• Economic
• Cost effective
• Resourceful in a country with limited disaster management
capacity
• Self-sufficient till external assistance avails
• Community – first responders

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Risk Assessment and Gap Analysis

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Mega Earthquake in Nepal
2015

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Earthquake 2015: Worst Affected Area

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Vulnerabilities
• Rugged and fragile geophysical structure
• Variable climatic conditions
• Active tectonic processes
• Unstable government
• Weak economy
• Unplanned settlement
• Poor construction practices
• Dense and increasing population
• Poor socioeconomic conditions
• Low literacy

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Gaps
• The existing disaster response framework of Nepal is not
adequate to effectively manage the large scale disasters
• The recent mega earthquake of Nepal in 2015 revealed
various drawbacks in disaster preparedness
• Public awareness and disaster management education is
lacking, but essential
• Enhancing public awareness is found to be the cost effective
tool in a low economy country like Nepal

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Disaster Management Section
Ministry of Home Affairs (MOHA)
• Nepal: Guidance note - Disaster preparedness and response planning 2011
• Nepal: National progress report on the implementation of the Hyogo Framework for
Action (2009-2011)
• Nepal: National progress report on the implementation of the Hyogo Framework for
Action (2007-2009
• Department of Archaeology, Ministry of Culture, Tourism and Civil Aviation, Nepal - gov
• Department of Forest Research and Survey, Nepal - gov
• Department of Hydrology and Meteorology, Nepal - gov
• Ministry of Environment (MOENV), Nepal - gov
• Ministry of Health and Population (MOH), Nepal - gov
• Ministry of Home Affairs (MoHA), Nepal - gov
• National Disaster Risk Reduction Centre (NDRC), Nepal - gov

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Education
Awareness
Empowerment
Way Forward

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Initiatives…
• Flagship approach on Disaster Risk Reduction
• Establishment of Emergency Operation Centers
• Program for Enhancement of Emergency Response (PEER )
Program
• Disaster management awareness program (DMAP)

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Flagship Approach on Disaster Risk Reduction
• National Strategy for Disaster Risk Management
(NSDRM)based on Hyogo Framework for Action (HFA) 2005
• Includes
– Emergency preparedness and response capacity
– Integrated community based disaster risk reduction/management
• Aims to ensure that communities receive consistent
community based disaster risk reduction support
• Increasing disaster resiliency at Wards/VDC level across the
country

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Flagship Approach- 9 minimum characteristics
of a disaster resilient community
1. Organizational base at VDC / ward and community
2. Access to Disaster Risk Reduction (DRR) information
3. Multi-hazard risk and capacity assessments
4. Community preparedness / response teams
5. Disaster Risk Reduction / Management plan at VDC/municipality
6. Disaster Risk Reduction (DRR) Funds
7. Access to community-managed resources
8. Local level risk / vulnerability reduction measures
9. Community based early warning systems

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NEOC HEOC
• National Emergency
Operation Center
• Functional at the central,
regional and District level
• Ministry of Home Affairs
• Humanitarian Staging Area
(HSA)
• Health Emergency
Operation Centre
• Functional at the central
level
• Ministry of Health
• Hub and Satellite Hospitals
Emergency Operation Centers

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DOLPA
MUGU
JUMLA
KAILALI
BARDIYA
HUMLA
DOTI
SURKHET
KAPIL-
BASTU RUPAN-
DEHI
DANG 2
BANKE
ACHHAM KALIKOT
JHAPA
MORANG
SIRAHA
SAPTARI
BAJHANG
BAITADI
DADEL-
DHURA
KANCHANPUR
BAJURA
PARSA
BARA RAUT-
AHAT
DHA
NUSA
MAHO-
TARI
SUNSARI
SARLAHI
DHADING
MAKAWAN-
PUR
CHITWAN
KASKI
TANAHU
PALPA
SYANGJA
PARBAT
ARGHAK
HACHI
GULMI
UDAYAPUR
ILAM
BHOJ-
PUR
DHAN-
KUTA
TAPLEJUNG
OKHAL-
DHUNGA
TERHA-
THUM
KHOTANG
LALIT
BHAK
KATHM
SULUK-
HUMBU
DOLAKHA
SANKHUWA-
SABA
NUWAKOT
SINDHU-
PALCHOWK
KAVRE
RASUWA
LAMJUNG
GORKHA
PYUT-
HAN
ROLPA
SALYAN
MYAGDI
DAILEKH
JAJARKOT
RUKUM
MUSTANG
Hub/Satellite Hospitals (HEOC)
KATHMANDU 4
LALIT 1
BHAK 1
Hub Hospitals
Satellite Hospitals
India
China
Regional HEOC
National HEOC
Regional MS
Central MS
National
HEOC
WHO Stock

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Program for Enhancement of Emergency Response
(PEER)
– Regional training program by U.S. Agency for International
Development, Office of U.S. Foreign Disaster Assistance
(USAID/OFDA)
– The National Society for Earthquake Technology (NSET) is
implementing the program in close collaboration with the
national government agencies
– Trainings offered :
• Medical First Responder (MFR)
• Collapsed Structure Search and Rescue (CSSR)
• Hospital Preparedness for Emergencies (HOPE)
• Community action for disaster response
• Incident command system operation

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Shree Birendra Army Hospital
SBH
Nepal Army Institute of Health Sciences
NAIHS
Disaster Management Awareness Program

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Disaster management awareness program
(DMAP)
• Another initiative to provide comprehensive course on
disaster management in medical schools in Nepal
• In coordination with
• Office of Defense cooperation (ODC), Embassy of the USA
• National Society for Earthquake Technology (NSET)
• Pilot project completed in the present academic session in the
Nepal Army Institute of Health Sciences (NAIHS)
• In the next academic session the project will be implemented
in other medical institutions (22) of Nepal

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Requirement
• Medical personnel have a pivotal role during the
whole spectrum of the disaster
• Medical studies focus only on clinical aspects of
disaster management
• A comprehensive educational disaster program
providing holistic knowledge from strategic to
operational level beneficial
• Module extended to the VDC/Wards during the
community medicine training
• Able to function on the basis of NDRF when required

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GOAL

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• Direct audience
• Fourth year medical students (MBBS)
• Second year nursing students(BSc Nursing)
• Indirect audience
• Medical officers
• Nurses
• Paramedics

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Objectives
Enhance the community resiliency against future disasters in
Nepal by obtaining following :
– Education on comprehensive disaster management in
medical schools by informal lectures and workshops
– Capacity building in the community by spreading
awareness about disaster risks, mitigation measures and
preparedness
– Empowerment and inclusion of the marginalized group
during disaster management trainings

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Location….

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Renovation….

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Curriculum
• Introduction to disasters- Multi-hazards in Nepal
• Disaster epidemiology
• Nepal earthquake 2015- Experiences and lessons learnt
• Mass casualty incidents and Triage
• Structural and Functional components
• National disaster response frameworks and HEOC
• International cooperation and humanitarian assistance
• Disaster Preparedness

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Timeline
November
2015
January
2016
March
2016
September
2016
November
2016
Project
Finalization
Curriculum
approval
Implementation
Workshop
Assessment

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Lectures….

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Souvenirs…..

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Conclusion
• Disaster are sudden and disaster management is a difficult
task
• Disaster preparedness economical to disaster management -
significance to low economy country like Nepal.
• Community inclusion is vital in disaster preparedness and
mitigation
• Medical personnel can be involved in community capacity
building starting from their formative years
• Disaster management awareness program – comprehensive
disaster management training to medical personnel
• Effort to build a disaster resilient Nepalese community

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Resilience starts early……
The Miracle Baby (rescued alive after 22 hours under rubble)

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Thank You

Disaster Management Awareness Program in Medical Schools in Nepal An Inclusive and Comprehensive Approach..., Sunita PANTA

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