“With resilience, our goal is for communities to no longer rely exclusively on organizations to help them.”

With these words,  Carlyne McKenzie, Resilience Project Coordinator for the Bahamas Red Cross, explained the purpose of the 9^th Caribbean Conference on Comprehensive Disaster Management, hosted by the Caribbean Disaster Emergency Management Agency (CDEMA) jointly with Bahamas’ National Emergency Management Agency (NEMA) between the 30^th of November and the 4^th of December of 2015, in Bahamas.

This conference gathered participants from several organizations and agencies, both national and regional, for five days of presentations, discussions and exchanges regarding the state of disaster management and community resilience in the Caribbean .

Delegates from organizations such as EU Humanitarian Aid and Civil Protection (ECHO), United Nations Development Programme (UNDP), United Nations International Strategy for Disaster Reduction (UNISDR), The Nature Conservancy (TNC), the University of West Indies (UWI), the Caribbean Development Bank (CDB), the Caribbean Institute for Meteorology and Hydrology (CiMH), the St. Vincent and the Grenadines Red Cross, the Grenada Red Cross, the Suriname Red Cross, the Bahamas Red Cross, the American Red Cross, the Canadian Red Cross and The International Federation of Red Cross and Red Crescent Societies (IFRC), among others, convened in plenary sessions and work groups to address issues such as climate change, sustainable development, monitoring and evaluation practices, the Sendai Framework for Disaster Risk Reduction (DRR), strengthening preparedness and response, communications technologies,  knowledge management and community resilience.

“We gained knowledge with our participation in this conference, it feels really good.  We want to broaden our horizons when it comes to disaster preparedness in ways that we can modify with what we’re doing here in the Bahamas.  To expand our experience with the experience of other countries, of other organizations, it gives us added insight into how to be better prepared” stated Daryll Armbrister. Social Media Officer for the Bahamas Red Cross.

One event that generated a considerable amount of activity among the conference delegates was the Knowledge Marketplace, a new feature to the CDM Conference where current disaster risk management initiatives and tools were “sold” to delegates through quick five minute presentations.  The delegates were given paper money, and would then express their interest in the tool by “buying” it, with the three most bought tools receiving awards later in the day.

IFRC/CDEMA, with the support of the Suriname Red Cross, presented a Strategic Targeting Methodology (STM), a tool designed for organizations to improve their process in selecting communities for their programs and projects through carefully designed criteria that reduce external influences and focus on the communities by their needs and vulnerabilities.  The STM was the most “bought” tool of the conference, winning the CDM Conference prize.

The second most bought tool belonged to the American Red Cross, in support of the Bahamas Red Cross through their Resilience in The Americas (RITA) program, with their multi-hazard smartphone app, which features information on natural hazards, basic first aid procedures, emergency messaging including location, as well as emergency lights and sound.  You can find more information on this app by visiting: http://www.redcross.org/mobile-apps/emergency-app

Another session where the Red Cross movement was well represented was the Youth Conference, where a panel comprised of a 16-18 year old representative from each CDEMA participating state discussed CDM in relation to Caribbean youth.  The representative from Dominica, Phael Lander, is a youth volunteer for the Red Cross of Dominica, who witnessed the value of Psychosocial Support (PSP) in disaster recovery when his home country was gravely affected by Tropical Storm Erika in August 2015.

“The youth of the Caribbean need education, training and resources.  If these three things are provided to us, I foresee the world to be a much safer place.”

Lander, along with his fellow youth panellists, engaged in lively exchanges on community action, youth involvement in risk management, the possibility of including comprehensive disaster management in high school curriculum throughout the Caribbean, careers in Disaster Risk Management and the use of multimedia to engage younger generations in preparedness and risk management.

- See more at: http://www.ifrc.org/en/news-and-media/news-stories/americas/bahamas/the-future-of-disaster-management-in-the-caribbean/#sthash.BnJV6mQm.dpuf

Completely unprepared for disasters: the hospitals in Chennai — private as well as government — were particularly vulnerable, improvising solutions as the situation developed. At least 13 primary health centres in Kancheepuram and Tiruvallur districts were affected. The Tambaram Taluk Hospital in Chromepet ran outpatient (OPD) services from a wedding hall for two days after evacuating many of its inpatients to other hospitals.

Water had entered the ground floor of the ESIC Hospital in K.K. Nagar too.

Patients were shifted to a higher floor. But the worst affected was MIOT International, where 18 patients on ventilator support died on December 2 and 3, as per the Health Secretary’s press release. Within days, police registered a case under section 174 of the Criminal Procedure Code (Cr.PC) against the hospital. The post-mortem reports are likely to be submitted this week.

The floods in Chennai bring to the fore the need for stricter implementation of hospital safety standards. The last time this topic was debated was after what has come to be known as the ‘AMRI fire tragedy.’ In December 2011, around 3 a.m. a fire broke out in the basement of the seven-storey hospital in Kolkata — Advanced Medical Research Institute (AMRI) Hospitals. By morning, 90 patients had choked to death.

A few months before the AMRI tragedy, Kavita Narayan, a disaster management expert trained by the Federal Emergency Management Agency (FEMA), along with some of the best minds in the country — structural engineers, doctors and specialists in hospital design — had written a policy document that laid out in great detail what was expected of medical and non-medical staff in case of any disaster.

Every single one of the 111 pages of Hospital Standards Safety Committee had answers that could have saved lives. The document had exhaustive instructions to doctors, nurses, and management about how to plan and evacuate in case of emergency. It even laid out how and where to store which equipment; how to avoid flooding in critical units; the norms of fire safety, etc. The document has been gathering dust since December 2013, when it was submitted to the National Disaster Management Authority (NDMA).

In an ideal situation, the response begins soon as water levels start rising or, as in the case of AMRI, the fire was spreading.

In Tamil Nadu, the private sector currently caters to roughly 60 per cent outpatient services, and 40 per cent of in-patient services, as per the State Health Department. The Clinical Establishments (Registration and Regulation) Act, 2010 — enacted by the Central Government — which prescribes minimum standards to be followed has not been notified by Tamil Nadu because they already have a State Act. As of now, the Central Act is notified only in four States — Arunachal Pradesh, Himachal Pradesh, Mizoram, Sikkim and all union territories except Delhi.

While the State has an Act in place to regulate private players, expecting any norms and standardised care from private hospitals is like building castles in the air.

Here is why: for nearly 18 years, the Tamil Nadu government has been sitting on The Tamil Nadu Private Clinical Establishments (Regulation) Act, 1997. The Act came into force in April 1997, the rules for it are yet to be notified.

The State government has three options: either adopt the Central Act, or enact its own or, lastly, make changes on the existing Act governing clinical establishments. Tamil Nadu has done none of this.

“We actually got the idea for the Central Act from Tamil Nadu. We were hoping it will pressure the State government to implement the existing law, if the Centre also passes it. Tamil Nadu passed the Act in the Assembly. Since then, it has been in animated suspension. We kept pushing for it but the lobby of private hospital owners is so strong that no progress has been made for nearly two decades.” said Sunil Nandraj, who was an adviser to the government as the Clinical Establishments Act was drafted.

Health Secretary J. Radhakrishnan said: “We are in the final stages of framing the rules for the Act. Several meetings have already been held with all stakeholders, and the rules will be notified shortly.”

With even minimal standards lacking, enforcing disaster preparedness is a far cry in India, Ms. Narayan said. “The draft hospital safety document has very specific rules — to the extent of specifying exact locations of storing emergency equipments. We do not follow any of this because India currently does not have a policy for this,” she said.

As the weather returns to normalcy in Chennai, the citizens should ask the question whether medical culture as well as governance in this country is willing to accept the virtues of regulation in the interest of patient safety.

Otherwise, this is the grim reality of Indian hospitals: they harm as much as they heal.

source: thehindu.com