Health Security and Nursing model on disaster risk reduction with a community monitoring of their daily life Ma. Regina E. Estuar, Associate Professor, Ateneo de Manila University Sakiko Kanbara, Associate Professor, University of Kochi Marlene M. De Leon, Assistant Professor, Ateneo de Manila University John Noel Victorino, Graduate Student, Ateneo de Manila University Jhoanna Isla, Graduate Student, Ateneo de Manila University John Clifford Rosales, Graduate Student, Ateneo de Manila University Mami Nojima, Graduate Student, University of Kochi Duinantoaji Hastoro, Graduate Student, University of Kochi
Transcript
Health Security and Nursing model on disaster
risk reduction with a community monitoring of
their daily life
Ma. Regina E. Estuar, Associate Professor, Ateneo de Manila UniversitySakiko Kanbara, Associate Professor, University of KochiMarlene M. De Leon, Assistant Professor, Ateneo de Manila UniversityJohn Noel Victorino, Graduate Student, Ateneo de Manila UniversityJhoanna Isla, Graduate Student, Ateneo de Manila UniversityJohn Clifford Rosales, Graduate Student, Ateneo de Manila UniversityMami Nojima, Graduate Student, University of KochiDuinantoaji Hastoro, Graduate Student, University of Kochi
Aim
Extract the “disaster mitigation nursing indicator” contributed by Nursing activities from global trends as well as lessons learned in past disasters
Develop the Rapid needs assessment tool of disaster with daily community diagnosis
GoalTo build a DRR nursing model
that contribute to human security
Health
Environment
Food
Water
HUMAN SECURITY MEASURES
now or never
Care Cure
Review from Great East Earthquake and Tsunami
Information confusion
Operational coordination
Chronic disease
Medication
Under-nutrition
Pressure ulcer
ADL decline
Hypothermia
Pneumonia
Emergency delivery
Active listening Medical assistance Psychological care
Hygiene management Evacuation of outpatient
Dispatch relief squad Multiple cooperation
Evaluation of living environmentArticle management Needs assessment
Support of supportersOutreach
VulnerablePregnant woman
Elderly
Dementia
Alien
Stranded commuters
Survivor in small evacuation center
Digital divide
TIME
Population
Global
Acute
Individual
Reconstruction
HOSPITAL
<Past Achievements>Immediate Needs Based
Focused on Relief in Acute Phase
Vertical Support in Disaster Cycles
Individual-based Support
Organization-centered Decision-
making DMAT・Training Dispatched Nurses
Lessons from Past Disaster Relief
Work
Challenges &Tasks Long-term, Social Problem-Solving
The importance of nursing activities with bird's-eye view focused on living environment primary health care of shelter
Background : Disaster Nursing
Background
Disaster risk reduction (DRR) is…..• the concept and practice of reducing disaster risks through
systematic efforts to analyze and reduce the causal factors of disasters. Reducing exposure to hazards, lessening vulnerability of people and property, wise management of land and the environment, and improving preparedness and early warning for adverse events are all examples of disaster risk reduction.
Lesson learned from 3.11 Data collection of the damage = slow to assessUtilization rapid monitoring data for the health crisis → urgent needHuman security was threatened
Lesson learned from Typhoon in Philipine
SHEREPO Team at Fort
Santiago
•2014 Summer, We visited a barangay in Novaliches, Quezon City in the aftermath of Typhoon Mario. In the afternoon, the group went to Fort Santiago in Intramuros, Manila for a taste of Filipino history.
Survey results from data collected during Typhoon Mario
Kanbara et al, 33th Japan Association for International Health, March 2015
Local Barangay staff were contacted by phone and explanatory meetings held at Barangay offices. Five shelter managers were interviewed; they received 325 individuals and 30 families;
Result>>>Larger evacuation center have equipment But enough in number ?
# 1-2 FOCUS INTERVIEW WITH FIRST RESPONDER AT THE TIME OF TYPHOON YOLANDA
公衆衛生の視点で見る
創傷リスク高い
足の外傷多い
診療の構造化
絶え間ない患者
地元の外傷処置の未熟
さ
衛生状態保持困難
病院の未稼働モノ、ヒト不足
医療活動
ニーズ調整
急性期外科的処置のみで撤収
新規外傷患者の減少創部洗浄
の指導
ニーズアセスメント
通常診療のフォロー
TB再燃リスク
下痢患者の発生
乳幼児の脱水
感染症予防
地域ナースやボランティアへの研修
心のケア
村落への巡回診療
飲料水の運搬
井戸水を煮沸して飲用
井戸水の使用雨水でしのぐ
飲料水の不足
雨水の使用
タブレット配布にて雨水の利用
飲料水としてコーラ配給
盗難、暴力など犯罪発生
Communication state instability
避難所の情報はなかった
トイレは数回に一度流す
屋根のあるところに住む
自分で家の修復避難所ではなく、
壊れた自宅に住み続ける
自宅に住み続ける
使える物を使う
倫理ではなく生存が優先
タクロバンでの医療活動が多
い
クラスターミーティングへの参
加
治安が悪いという情報
水や食料の安定≒安全 か
日本人が入っているかが安全の指標;/.
場所による治安の違い
クラスター会議への出席
クラスターミーティングで情報共有
地域行事の開催
刑務所の崩壊→治安の悪化
銃撃戦
食料がない
栄養状態の把握が難しい
食料四日間なし
自宅近辺で炊き出し
食料が配給されない（備蓄はありそうだった）衣類の問題
は大きくない
ロジとしての役割
食糧援助あり
看護と公衆衛生のマッチング
All
Environment
FoodNon-Food
Health
Water
problem
Public Health Needs Assessment
Cluster MeetingInformation of Shelter
Amount of Food
Skill Level of local Staff
Equipment
Human resource
Dehydration Diarrhea
Exacerbation of Infection Diseases
Existence of New patients
Continuity of usual care
Place of Activity
Satisfaction(Water +Food)→Peace？
Nutrition Balance
Stockpile& Distribution
Water purification
Drinking Water
Drink( Beverage bottle water)
cooking methods
toiletShelter or Home
Mental Health Care
Training of Local Professionals
Lan
ge o
f p
eop
leIn
div
idu
al
Disaster Occurrence Time Reconstruction
Disparity of Security
Trauma
1 report / Week by nurses
11
Health Security IndicatorLiving Environment, Preventable Symptom
EOC：Emergency Operation Center)MOH WHO
District Hospital, Citizens
Robust network not by office but Nurse
EpiNurse Center
Temporary shelter
EpiNurses of will register information after the disaster.
SimulationPreparation• Based on the map, to create an virtual disaster scenario, DRR plan and
shelter, relief's• From disaster countermeasures headquarters, and originated the situation• In accordance with timer scenario, analyze the information in the disaster
countermeasures office• Survey and analysis of pre, post intervention
Construction of nursing model on disaster risk reduction with a community monitoring of their daily life
Demonstration in Yokohama and Kochi
Case study 1 Community in Japan Tsunami Prone Area
SHEREPO Training and Workshop in Japan (November 2014)
The Tacloban City Deployment of eBayanihan-SHEREPO started with a presentation by Ma. Regina Estuar, PhD of Project eBayanihan and Sakiko Kanbara of SHEREPO to Hon. Alfred Romualdez, City Mayor of Tacloban, Leyte.
The presentation was followed by Hon. Romualdez’s sharing of the city’s experiences at the wake of Typhoon Haiyan (Yolanda) and how the city has since worked towards recovering from the said disaster. Dr. Estuar and Dr. Kanbara also responded to the mayor’s questions regarding the systems (eBayanihan and SHEREPO).
After the presentation to the Mayor, the team commenced the training and simulation workshop with the participants, which include members of TACRU (Tacloban City Rescue Unit), a Tacloban CDRRMO representative, a TOMECO-PNP representative, City Health Office representatives, and barangay officers (captains and treasurer) from Brgy. 5-A and Brgy. 95.
New Challenge for Nepal Earthquake 2015
• We seek to provide an open framework that can easily provide APIs (application programming interface) for integration with others as well as provide APIs for data integration and data sharing with other health sectors, MoH and WHO. The framework start creating Rapid Analytic Tools in excel spreadsheets delivered in layman’s terms for Nepali nurse by using paper and ICT.
Approach
• Nurses observe the living environment of shelter, assess symptom of communicable diseases by consultation and measuring.
• Data aggregation was reported by Epinurse who trained on workshop in advance.
• The most critical challenge is data collection to generate reasonable information that can be used in predicting whether something is likely to occur.
• The most critical challenge is data collection to generate reasonable information that can be used in predicting whether something is likely to occur.
• Focused on the most common health conditions encountered after a disaster, to prevent communicable disease earlier than detecting outbreak.
Steps in ensuring communicable disease control in emergencies
Step 1 Conduct rapid health assessment When By whom
• Identify main disease threats, including potential epidemic diseases
After April 25 Health professionals
• Obtain data on the host country, on the country of origin of displaced persons and on the areas through which they may have passed
government inte-rdisciplinally Logisticsupport
• Identify priority public health interventions Health professionals• Identify the lead health agency• Establish health coordination mechanisms By consensus
Step 2. Prevent communicable diseases Longitudinal By Relief NursesA. Select and plan sites ASAP AugustB. Ensure adequate water and sanitation facilitiesC. Ensure availability of foodD. Control vectors
E. Implement vaccination campaigns (e.g. measles)Health center Nurses
• Provide essential clinical services Report• Provide basic laboratory facilities
3.Set up surveillance/early warning system
• Detect outbreaks earlyBy Community people including volunteer
• Report diseases of epidemic potential immediately• Monitor disease trends
WHO: A field manual - Communicable disease control in emergencieshttp://www.who.int/diseasecontrol_emergencies/publications/9241546166/en /
Our Mission is to conduct Monitoring these issue
Mining from Open Data
Set up By MOH, WHO
University of Kochi(UK) Nursing Association of Nepal(NAN)(Katmandu)
Relief Site
①August
orSeptember
②September
③October
and November
④March
Educator
Japan Team(J)
Relief Nurse(Rel.Ns)
Work Shophost by NAN,DNGLsponsored by JST
・Monitoring took kit
Nepal Team (N) visit Relief Site・observation・interview
Monitoring &Promoting Health
on Site
Japanese Team・analyze・suggestion
Relief Nurse Center(Analyst)
MOH,WHO
SeminarContinuous Disaster
Nursing Training
Nepali Nurse
Nepali Nurse
Nepali Nurse
Wrap upSymposium
in Japan Nepali Team
Relief Nurse
visit
Report
Report
JAPAN NEPAL
・Nursing・Public Health・Anthropology
・Disaster Nursing
VisitNAN,WHO,JICA,MOH,etc…
From Now
DNGL, WSDN, JSDN
Step 2. Prevent communicable diseases
Expected Outcome
• Through mutually complementary engagement by the global research teams in the calm period of time before a disaster occurs, it will be possible to conduct quick comparative evaluation of health conditions and needs from the perspective of normal, everyday life even within the time constraints imposed by a large-scale disaster.
• This study will be able to show that this very activity will contribute to a reduction of the effects of disasters as a disaster simulation, and that it will drive the wide use of the system in the countries of Asia where natural disasters occur frequently.
