Medical needs documented by Emergency Medical Services (EMS) responders to areas affected by Typhoon Haiyan in the Philippines: Implications on disaster response policy

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Despite existing disaster preparedness policies in the Philippines, there has not been any validated assessment of the quality of disaster medical response, which would require reliable aggregate data on patient diagnoses and management.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This mixed-methods study documented the diagnoses, triage classification and case management of patients seen by Philippine EMS groups who responded to the Typhoon Haiyan disaster in the Philippines in November and December 2013, as well as difficulties associated in gathering these data, using the Utstein-style Template for Uniform Data Reporting of Acute Medical Response in Disasters as framework.</p><p style="text-align: justify;"><strong>METHODS:</strong> Three hundred (300) individuals vetted by EMS organizations were invited to answer a survey modeled after the Utstein-style template, and submit tallies of patients seen. Out of 52 responses received, policy recommendations were subsequently generated on concerns assessed by the template using the nominal group technique.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The submitted data yielded a total of 41,202 patients with information on age, sex, and diagnosis; 19,193 with triage classification; and 27,523 with information on case management. The focus group discussion underlined the absence of a standard communication and information management system. Participants recommended establishing such a system and highlighted the role of the Department of Health - Health Emergency Management Bureau in coordinating disaster medical response efforts and information management.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This study underlines the importance of effective communication, and multisectoral coordination, to generate reliable data and thus, facilitate resource allocation for disaster medical response.</p>

Enabling factors, hindrances, and self-perceived level of preparedness of Typhoon Haiyan Emergency Medical Services (EMS) responders

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Despite the implementation of policies related to disaster risk reduction and management in the Philippines, the response after Typhoon Haiyan in November 2013 was hampered by operational challenges.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> The purpose of this study was to document disaster response experiences of Typhoon Haiyan from field level emergency medical service (EMS) responders, a key component of the disaster response, specifically the enabling factors and hindrances to disaster medical response activities, including their self-perceived level of preparedness in these activities.</p><p style="text-align: justify;"><strong>METHODS:</strong> In this mixed-methods study, 52 respondents identified enabling factors and hindrances to their disaster response and their corresponding self-perceived level of preparedness. In a subsequent focus group discussion, the researchers used the nominal group technique to process the respondents' experiences.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The respondents identified factors that enabled or hindered their response activities such as coordination, stress debriefing, infrastructure, and preparedness. Furthermore, an average of 33% of the respondents said they were adequately prepared to deliver the necessary medical services during the disaster response, thus validating previous studies on preparedness and disaster response operations.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The government should critically examine its cluster approach to disaster response and consider an integrated, inclusive, and proactive approach in disaster planning.</p>

A community-based gastroenteritis outbreak after Typhoon Haiyan, Leyte, Philippines, 2013

BACKGROUND: Three weeks after Typhoon Haiyan, an increasing number of acute gastroenteritis cases were reported in Kananga, Leyte, an area where evacuated residents had returned home two days after the disaster. An outbreak investigation was conducted to identify the source and risk factors associated with the increase of gastroenteritis. METHODS: A case was defined as any person in Kananga who developed acute diarrhoea (≥ 3 times/24 hours) and any of the following symptoms: fever, nausea, vomiting or abdominal pain from 11 November 2013 to 10 December 2013. Active case finding was conducted by reviewing medical records, and a case-control study was conducted. Rectal swabs and water samples were tested for bacteriological examination. RESULTS: One hundred and five cases were identified. Multivariate analysis revealed that consumption of untreated drinking-water was associated with illness (adjusted odds ratio: 18.2). Both rectal swabs and municipal water samples tested positive for Aeromonas hydrophila. On inspection of the municipal water system, breaks in the distribution pipes were found with some submerged in river water. CONCLUSION: This acute gastroenteritis outbreak was most likely caused by Aeromonas hydrophila and transmitted through a contaminated water source. This study highlights that areas less damaged by a disaster that do not require ongoing evacuation centres can still have acute gastroenteritis outbreaks. All affected areas should be monitored during a disaster response, not just those with evacuation centres. Boiling or chlorinating of water should also be recommended for all areas affected by disaster.

Is registration of foreign medical teams needed for disaster response? Findings from the response to Typhoon Haiyan

We conducted a descriptive study on the deployment of all FMTs to Haiyan-affected areas in the Philippines from 8 November 2013 to 30 June 2014. An FMT coordinating body was established at the national level which comprised representatives from the DOH and the World Health Organization (WHO) Representative Office in the Philippines. This team disseminated the new registration form to all FMTs that had contacted the WHO Western Pacific Regional Office, WHO Representative Office in the Philippines and the DOH from 10 November (two days after the typhoon made landfall). All FMTs were required to register regardless of their location inside or outside the Philippines at the time.

Managing surge staff and resources at the WHO Representative Office in the Philippines after Typhoon Haiyan

The objective of this paper is to compare the role of the administrative team from the WHO Representative Office in the Philippines in the response following Typhoon Haiyan to the response with the three previous large-scale events, assess the lessons learnt and provide recommendations for managing future responses.

Is the response over? The transition from response to recovery in the health sector post-Typhoon Haiyan

During the overlap period between response and recovery activities, the authors were all working in the health sector at the national level supporting coordination and strategic planning with government and partners and at the field level implementing response activities and revisiting the medium- and long-term programming approach to recovery. It is from this perspective, combined with data from existing documents such as plans, reports and policies, that we highlight the need to define a period of transition from response to recovery of the health sector as it may have important implications on the health system functioning as a whole.

Responding to Typhoon Haiyan in the Philippines

During the overlap period between response and recovery activities, the authors were all working in the health sector at the national level supporting coordination and strategic planning with government and partners and at the field level implementing response activities and revisiting the medium- and long-term programming approach to recovery. It is from this perspective, combined with data from existing documents such as plans, reports and policies, that we highlight the need to define a period of transition from response to recovery of the health sector as it may have important implications on the health system functioning as a whole.