Community Based Health Workers: Review and Risk Reduction

Community Based Health Workers:

Review and

Risk Reduction Process

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WHO

Module 5

Introduction

Module's Objectives

This module contains three sessions, each reviewing the concept of disaster

risk reduction cycle/process and its management , the community health

worker and the community response before, during and after the disaster and

identify areas for improvement and Roles, Responsibilities and functions for

community health workers in relation to disaster risk management.

Understand the continuous nature of the disaster risk reduction

cycle/process and its management

Understand the need to review the community health worker and the

community response before, during and after the disaster and identify

areas for improvement

Know the Roles, Responsibilities and functions, including the Do's and

Don'ts, for community health workers in relation to disaster risk

management

1.

2.

3.

Session 5.1:

The Disaster Risk Reduction Cycle and Its Management

Session 5.2:

Reviewing the Community Health Response and

Identifying areas for Improvement

Sessions to be covered in this module:

Community Based Health workers:

Review and Risk Reduction Process

Community Based Health workers:

Review and Risk Reduction Process

Session 5.3:

Roles, Responsibilities and Functions of Community Health

Workers in Disaster Risk Management

121

Session 5.1:

Session Objectives

5.1.1. Disaster Risk Reduction - A Continuous Process:

The Disaster Risk Reduction Cycle and Its Management

At the end of the session, participants are expected to:

Understand the continuous nature of the disaster risk reduction cycle/process and its management

Disaster risk reduction cycle is a continuous process of planning and implementation of measures aimed

at preventing or reducing the risk of disasters; mitigating the severity or consequences of disasters;

emergency preparedness; and rapid and effective response to disasters and post-disaster recovery and

rehabilitation.

In the post- disaster phase, after providing required response, there is a need to start the disaster risk

management planning again to further minimize the harm in future by assessing;

COMMUNITY RISKS Are proportional to

x

_________________________



HAZARDS

VULNERABILITIES

READINESS FOR RESPONSE

Figure 5.1:

Disaster Management Cycle

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· Community risks are a function of the relationship between hazards, vulnerabilities and capacities.

The health consequences are the result of this interaction

· Capacity refers to the capacity to reduce hazards, reduce vulnerability and the capacity to respond

and recover from emergencies and disasters

· If hazards increase, the risk increases

· If vulnerability increases, the risk increases

· If capacity decreases, the risk increases

· To reduce risk, we need to reduce hazards, reduce vulnerability, and increase capacities - therefore

risk is lower

CHW as a member of emergency response team is primarily concerned with protecting community

health. As your clients are threatened and injured/damaged communities so your key role is to involve in

re-assessing and responding to community needs and planning for future.

Risks must be assessed.

Risks must be communicated

to communities and to health

Professionals.

Measures to reduce risk should

be identified and implemented.

Risk must be monitored to assess

changes in hazard, vulnerability

and capacities over time.

Figure 5.2: Re-assessing and Responding to Community Needs

Risk (need) Re-Assessment

Risk Communication

Risk Reduction

Risk Monitoring

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a. Risk Assessment Process

1. Prepares hazard profiles

2. Maps the distribution of those hazards

3. Identifies the elements of the community exposed to those hazards (vulnerabilities)

4. Predicts the consequences of a hazard (risk)

5. Analyses each of the risks

6. Assesses risk reduction capacities within communities

The information from a Risk Assessment is used to undertake immediate measures to tackle the problems

during recovery phase as well as plan future interventions to reduce risks by reducing exposure to

hazards, reducing vulnerabilities and building capacities.

The actual and potential health problems resulting from the disaster are multifaceted and do not all occur

at the same time. The re-assessment find out health risks/ problems might be related to food and

nutrition, water and sanitation, reproductive or mental health, climatic exposure and communicable

diseases.

The ultimate goal of CHW is to prevent the transmission of disease to generally healthy populations by

using the following actions:

· Community mobilization

· Health education

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· Promoting healthy practices

· Implementing public health measures that reduce a population's exposure to risk factors such as

ensuring a safe drinking water supply to prevent diarrhoea, an Adequate food supply to minimize

malnutrition and distributing mosquito nets to prevent malaria

· Conducting medical interventions such

as chemo-prophylactics against malaria

and Measles immunization.

In addition to preventive measures, identifies

and refer as early as possible diseased people

for treatment to prevent the infection from

progressing to serious complication or death.

This is done using the following:

· Alleviating symptoms of diseases such

as giving Oral Rehydration Solution

early to achild with diarrhoea to

prevent dehydration and possible

death

Medical Interventions

Healthy Practices

Alleviating Symptoms of Diseases

Participants’ Work Book CBDRM: Review and Risk Reduction Process (MODULE 5)

· Referring patients with diseases through early detection for treatment of TB, dysentery etc

The purpose of risk re-assessment is also to guide communities and concerned stakholders in planning for

community risk reduction activities (protecting health and safety) for future by developing and maintaining 3 sets

of plans:

Hazard Reduction Plans

Vulnerability Reduction Plans

Emergency Preparedness Plans (increase capacity for response and recovery)

Q: What is the role of risk re-assessment in future disaster risk reduction plan?



Q: What activities do you want to plan as a result of re-assessment to protect your community's health?

...................................................................................................................................................................................

Exercise:

125

Referring Patients for Treatment

Participants’ Work Book CBDRM: Review and Risk Reduction Process (MODULE 5)

Session 5.2:

Session Objectives

5.2.1. Why do You Need to Review the Emergency Response?

Reviewing the Ccommunity Health Response and Identifying Areas for

Improvement

At the end of the session, participants are expected to:

Understand the need to review the community health worker and the community response;

before, during and after the disaster and identify areas for improvement.

An emergency plan is not complete without post-

incidence review procedures.

After emergency, there are several things you should ask

yourself:

· What can be learned from what happened?

· How do you avoid repeating mistakes?

· How do you assess what is and is not working?

· What are the implications of what just happened not only on you, but also on your community?

· Are program and plan revisions needed?

How do these questions get answered? The best way to answer these and more is to conduct a post-

incident review.



126

CHW Reviewing the Emergency Response

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5.2.2. Reviewing of Emergency Response - A Process of Improvement:

Review will help the CHW and the community members to assess the achievements, results and

effects of a disaster risk reduction project or activity.

The purpose is to find out whether the activity or project is successful or not in achieving its objectives

of disaster risk reduction.

Review results will inform the CHW, local authorities and the community members about the effects of

the risk reduction activities on vulnerability reduction of the target groups. If vulnerability is not

significantly reduced, the reasons for this should be analyzed.

Review will also help them in learning about successful strategies that were applied. They would like to

continue the good practices in future activities and promote them to other areas.

Review can also analyze if some groups in community are affected negatively by the project activities.

Identify the appropriate actions to rectify the situation to avoid negative impact upon people.

On the basis of review and analysis the CHW, local authorities and the communities can identify lessons to

improve their future disaster risk reduction activities.

Box: 5.1: In order to conduct a good review it is important to focus on the following:

· Clearly defined purpose of the review.

· Participation of multiple stakeholders in review process; e.g. local authorities,

community groups, project beneficiaries, other local organizations e.g. NGOs,

mass organizations.

· Commonly agreed methodology for review.

· Actions taken before, during and after emergency.

· Positive aspects of how the response occurred.

· Aspects identified for improvement.

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5.2.3 How to Conduct Review?

1. SWOT Analysis

a. Strengths

b. Weaknesses

Different tools can be used to review and improve the emergency response plan such as;

· analysis

· Collecting data through surveys, statistics, etc.

· Exercise/drill followed by discussion

· After Action Review

A SWOT analysis lets you gain a better understanding

of your emergency plan's strengths, weaknesses,

opportunities and threats. This section describes how

a SWOT analysis can help your emergency planning

team understand potential vulnerabilities.

· What assets do you currently have in terms of emergency readiness? Are you near a hospital

facility? Do your members have first aid training? Do you already have good relationships with

your local emergency authorities?

· What resources are available for your emergency plan? Do any of your community members

have family members who could provide emergency training? Do you have a back-up power

source?

· What steps have you already taken to increase your readiness for emergencies? Think about the

condition of your facility, training programs available in your community, etc.

· What could you improve, in terms of emergency preparedness? Do all of your community

members know where they have to gather in case of emergency? Do they know first aid Do they

know how to response early warning system?

· In what areas is your emergency preparedness plan particularly deficient? For example, do you

need to develop a relationship with your local disaster authorities? Does your emergency plan

cover all the types of care required by vulnerable population if emergencies you might face? Is

the coverage adequate for these emergencies?

Strengths, Weaknesses, Opportunities and Threats (SWOT)

Process of Conducting a Review

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c. Opportunities

d. Threats

· What opportunities exist that you can take advantage of? Is there a local Community Emergency

Response Team program that you can team up with? Are any other organization such as Red

Crescent Society currently developing emergency plans that you can use as examples and

inspiration?

· What local events could provide opportunities for raising community awareness of emergency

preparedness? Does your community have street fairs or seasonal festivals?

· What obstacles do you face in terms of planning? Some obstacles could be lack of money or

time, low enthusiasm from other community members etc.

What are the specific hazards and threats that your community faces? Keep in mind that such threats

could be natural, such as earthquake or flood, as well as man-made, such as terrorism and crime. Is your

community particularly susceptible to any of these due to the nature of your locality? Make this list as

detailed as possible. Your plan needs to address all potential hazards and threats.

The strengths, weaknesses, opportunities and threats listed in your SWOT analysis will be the framework

for determining the future priorities.

Helpful (to achieve the goals) Harmful (to achieve the goals)

Internal Origin (attributes of

the community)

 Strengths  Weaknesses

External Origin (attributes of

the environment)

 Opportunities  Threats

Table 5.1: Strengths, Weaknesses, Opportunities and Threats (SWOT):

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On the basis of priorities, task will be identified and improvement plan will be prepared by using the table

5.2 format;

Table 5.2: Improvement Plan

The results of the SWOT should be combined with information from re-mapping/re-assessing community

needs and with this information you can re-plan your work in the community, focusing on the most

vulnerable and the priority risk areas through providing health education, awareness and mobilization.

Continuous reviewing and improvement is essential to ensure that our emergency response and recovery

arrangements are reflective of contemporary practices and emerging trends in emergency management.

The level of preparedness will vary from one country to another, from one community

to another, from one individual to another. This level of preparedness is often

reflective of the number of times and frequency that they have been through a cycle

or process of continuous improvement.

Identified

Task

Action to be taken

Responsible

Party/Agency

Completion

Date

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Exercise:

Q: How do you conduct SWOT analysis to improve your community emergency response plan?

....................................................................................................................................................................

Q: What activities do you want to plan as a result of SWOT analysis to protect your community's health in

case of emergency?

....................................................................................................................................................................

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Session 5.3:

Session Objectives

5.3.1. Roles, Responsibilities and Functions of CHW in Disaster Risk

Management

5.3.2. CHW Role Before Disaster

a. In Community Assessment

Roles, Responsibilities and Functions of Community Health Workers in

Disaster Risk Management

At the end of the session, participants are expected to:

 Know the Roles, Responsibilities and functions, including the Do's and Don'ts, for community

health workers in relation to disaster risk management

Community health workers are an integral part of disaster planning and implementation efforts. They are

involved as planners, educators, direct care givers and assessment supervisors.

They serve as a community survey assessment officer after the disaster has occurred. Hence participate

actively in disaster management as a community health worker and protect the health of the community

before, during and after disaster.

· Assess the community past history of disaster

· Determine the actual and potential disaster threats

· Identify community disaster risks

· Personal available in the community

· Local agencies

· Health care facilities available

· Mobilize the community

Assessment of the Community

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b. Community Disaster Planning

c. In Community Risk Reduction

· Identify community volunteers for emergency response team

· Mobilize the community

· Identify & coordinate with local back up agencies and personnel

· Identify specific responsibilities for various personnel involved in the disaster plan

· Identify local community communication system

· Identify location and accessibility of equipments and supplies

· Storage of equipment and supplies

Identify the protocol of notification

· Get first aid and rescue training

· Create awareness about disaster

· Training to people

· Mass health education

· Education about warning signs of disaster

· Help in forming emergency kit at household and community level

Risk Reduction Awareness at Community Level

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5.3.3. CHW Role During Disaster

a. In Disaster Phase

b. In Response Phase

· Coordinate with the nearby hospitals

· Getting ready with emergency equipment

· Passing warning messages in the community

· Helping in evacuation

· Coordinate activities with emergency

response team

· Care for injured persons

· Transporting patients

· Arranging for physical facilities for the victim

· Help vulnerable population in getting the

basic facilities

· Supply of food ,water

· Help in rescue operation

· Monitor the outbreak of any infectious

disease

· Co-ordinate activities

Role of CHW in Disaster Phase

Role of CHW in Response Phase

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5.3.4. CHW Role After Disaster

a. In Recovery Phase

b. In Evaluation Phase

· Counseling

· Continuing care

· Behavior modification

· Rehabilitation

· Creating awareness

Participate in practice drills to test the DRR

plan

? Co-ordinate activities

· Re-assess the community's health needs

· Participate in determine disaster impact on

community and surroundings regions

· Help in evaluation of all aspects of disaster

plans

·

Role of CHW in Recovery Phase

Role of CHW in Evaluation Phase

Exercise:

Q: What are the main role, responsibilities and function of CHW before disaster?

....................................................................................................................................................................

Q: What are the main role, responsibilities and function of CHW during disaster?

....................................................................................................................................................................

Q: What are the main role, responsibilities and function of CHW after disaster?

....................................................................................................................................................................

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References:

· Joint statement / Scaling-up the community-based health workforce for emergencies October 2011

· Encyclopedia of Disaster Management Volume 1 on Disaster Management Policy and Administration by SW.L. Goel

· Participant's workbook on “Community Based Disaster Risk Reduction” Asian Disaster Preparedness Center found at www.adpc.net

(2011), Bangkok Thailand.

· UNISDR terminology on Disaster Risk Reduction found at website

http://www.unisdr.org/files/7817_UNISDRTerminologyEnglish.pdf, (2009), Thailand.

· Selected pictures have been downloaded from NDMA website available at http://www.pakistanfloods.pk, ADPC website

www.adpc.net and consultant own library.

· CBDRM trainer's manual Care International, Pakistan/NDMP April 2012

· http://www.scribd.com/doc/72761623/CBDRM-Framework (Community based disaster risk management in Vietnam, center for

international studies and cooperation.

· National Disaster Risk Management Framework, National Disaster Management Authority, 2008, Islamabad, Pakistan

· Valuable maps and reports are available at the following websites;

· http://www.gsp.gov.pk/Geological Survey of Pakistan, Islamabad, Pakistan

· http://www.pmd.gov.pk/Pakistan Meteorological Department, Islamabad, Pakistan

· http://www.ffc.gov.pkFederal Flood Commission, Islamabad, Pakistan

National disaster National disaster risk situations in Pakistan, available at

http://ndma.gov.pk/Documents/NIDM/NIDM%20COurses/Flood%20Mitigation%2015-

19%20Feb%202010/National%20disaster%20risk%20situations%20in%20Pakistan.pdf

· images.search.yahoo.com/search/images?_adv_prop=image&fr=yfp-t-563&sz=all&va=internal+displacement+Pakistan

· Disaster risk Management Programs For Priority Countries South Asia: http://gfdrr.org/ctrydrmnotes/Pakistan.pdf

Environmental health in emergencies and disasters: a practical guide, WHO, 2003 available at

http://www.who.int/water_sanitation_health/hygiene/emergencies/em2002chap11.pdf

· The Johns Hopkins and IFRC Public Health Guide for Emergencies

· National Disaster Risk Management Framework, National Disaster Management Authority, 2008, Islamabad, Pakistan

· National Disaster Management Authority www.ndma.gov.pk

· National Disaster Management Authority, Publication, available at http://www.pakistanfloods.pk:83/about-us/ndma-at-a-

glance.html?start=5

· http://www.ncbi.nlm.nih.gov/pubmed/9223980 Majumdar B, Amarsi Y, Carpio B.

Source: McMaster University Faculty of Health Sciences, Hamilton, Ontario

· Joint statement / Scaling-up the community-based health workforce for emergencies

October 2011

· Community Planning Toolkit for State Emergency Preparedness Managers, U.S.

Department of Health & Human Services, available at website, http://www.hhs.gov/od/disabilitytoolkit/index.html

· Designing a community disaster preparedness plan, National Service Knowledge Network, available at website,

http://www.nationalserviceresources.org/practices/17608

· An In-depth Guide to Citizen Preparedness, FEMA, USA available at website,

Participants’ Work Book CBDRM: Review and Risk Reduction Process (MODULE 5)

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Http://www.ready.gov/are-you-ready-guide

· City of San Rafael: community emergency preparedness plan available at website, Office of Emergency Services Attn: Emergency

Services Manager

· http://docs.cityofsanrafael.org/oes/Community_Emergency_Preparedness_Plan.pdf

· Family Supply list by “Ready Kids & The Federal Emergency Management Agency” available at

http://www.ready.gov/document/family-supply-list

· http://dictionary.reference.com/browse/contingency+planhousehold water trsafe storage in Emergencies; IFRC

· Sphere Minimum Standards on Water Supply Access and Quantity

· Household water treatment and safe storage in emergencies, IFRC

· Hazard Risk Assessment Instrument pdf Available at http://www.cphd.ucla.edu/npdfs/HRAI_Workbook.pdf

· Introduction to Health Vulnerability and Risk Analysis and Mapping (VRAM) available at

http://www.euro.who.int/__data/assets/pdf_file/0011/78995/VRAM_EHA_EURO_09.pdf

· How to do a VCA, A practical step-by-step guide for Red Cross Red Crescent staff and volunteers available at

http://www.ifrc.org/Global/Publications/disasters/vca/how-to-do-vca-en.pdf

· WHO Cholera in Pakistan available at http://www.who.int/csr/don/2010_10_25/en/index.html

· CONCEPTS OF HAZARDS, DISASTERS AND HAZARD ASSESSMENT available at http://www.adpc.net/casita/course-materials/Mod-2-

Hazards.pdf

· Capacity Building in Asia using Information Technology Applications (CASITA), Module 2, available at

http://www.cphd.ucla.edu/npdfs/HRAI_Workbook.pdf

· Village level disaster risk reduction plan of Naudega village, Biraul block available at http://drralliance.net/plans/Naudega.pdf

· Community-Based Disaster Risk Management for local authorities available at http://www.adpc.net/pdrsea/pubs/curriculum-

cbdrm.pdf

· Allen et al., Post-Disaster Infectious Disease Management available

http://mediccom.org/public/tadmat/training/NDMS/inf_disease.pdf

· Urban Governance and Community Resilience Guide: Planning for Disaster Risk Reduction: ADPC/USAID

· Integrated Disaster Rusk Management in Local Governance, Facilitator Guide and Source Book

· CBDRM Training Manual, Care International

· Demystifying Community Mobilization: An Effective strategy to Improve Maternal and Newborn Health, Lisa Howard-Grabman;

USAID

· Demystifying Community Mobilization, An Effective Strategy to improve Maternal and New born Health, USAID , 2007 available at

http://pdf.usaid.gov/pdf_docs/PNADI338.pdf

· The First Mile: The Potential for Community-Based Health Cooperatives in Sub-Saharan Africa, 2010, available at

http://www.uwcc.wisc.edu/pdf/Staff%20Papers/Community-

Based%20Health%20Cooperatives.pdfhttp://www.icrw.org/files/images/Community-Mobilization-and-Youth-Reproductive-and-

Sexual-Health-Findings-from-Intervention-Studies-in-India.pdf

· Early Warning", New Scientist, 2531(2), 24-31 December 2005, P. 5.

· Principles of Awareness Raising, Available at : http://www.ifla.org/@yourlibrary/index.htm (accessed 14 March 2006)

· Steps to a HealthierUS - Centers for Disease Control and Prevention , available at http://www.cdc.gov/steps

· Community Health Promotion, Mobilizing Your Community to Promote Health Available at:

http://www.health.state.mn.us/divs/hpcd/chp/hpkit/index.htm

· Definition of Health Education | eHow.com http://www.ehow.com/facts_4882795_definition-health-education.html#ixzz2EduP3f2x

· Staying alive and well, Child health and DRR, Save the Children, 2012 available at website,

http://www.savethechildren.org.uk/sites/default/files/docs/Staying-Aliveand- Well-low-res-2.pdf

· “Medical Emergency Services”, the Johns Hopkins and the International Federation of Red Cross and Red Crescent Societies.

· Maternal Health Considerations During Disaster Relief, 2011, available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100103/

Participants’ Work Book CBDRM: Review and Risk Reduction Process (MODULE 5)

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· Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the

2008 Sichuan earthquake, 2010, available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2867995/

· “Staying alive and well” Child health and disaster risk reduction, 2012 available at

:http://www.savethechildren.org.uk/sites/default/files/docs/Staying-Alive-and-Well-low-res-2.pdf

· Assar, 1971; United Nations High Commissioner for Refugees, 1999; Sphere Project, 2000

· Malaria, onchocerciasis (river blindness), schistosomiasis (bilharzia) and trypanosomiasis (sleeping sickness)

· The Jhons Hopkins and IFRC Public health Guide for Emergencies

· Community-based psychosocial support, Participant's book, 2003 available at

http://psp.drk.dk/graphics/2003referencecenter/Doc-man/Documents/docs/Participants%20book%20LowRes.pdf

· Resource Guide for Disaster Medicine and Public Health available at

http://psp.drk.dk/graphics/2003referencecenter/Announcements/News/VOLUNTEER%20PROJECT_ENG_FINAL.pdf

· The Communication Process available at

http://www.gsahec.org/html/health_promo/CHW%20Conference%20communication%20skills%20roundtable.pdf

· Hybrid manual adapted from the original VHT Manual and the new 2010 Ministry of Health Manual (1st Edition (February 2011)by

Dr. Jennifer Thompson & Zachary Tabb

· Free Dictionary http://medical-dictionary.thefreedictionary.com/referral

· Rehabilitation, Reconstruction, and Recovery Phase, ADB Institute,

http://www.adbi.org/discussionpaper/

2007/08/31/2354.sri.lanka.post.tsunami.reconstruction/rehabilitation reconstruction and.recovery.phase/

· Rehabilitation and Reconstruction , Training module, 1993, available at

http://iaemeuropa.terapad.com/resources/8959/assets/documents/UN%20DMTP%20-%20Rehabilitation%20&%20Recovery.pdf

· Knowledge Centre for Public Health and Disasters available at :

http://www.saludydesastres.info/index.php?option=com_content&view=article&id=133&Itemid=1010&lang=en

· Disaster management cycle , available at http://pre-drp.org/about-2/disaster-management-cycle

· “Emergency Medical services”, The Johns Hopkins and the International Federation of Red Cross and Red Crescent Societies.

· The%20Emergency%20Response%20Plan%20%20Demobilization%20and%20Post-Incident%20Review.htm

· PN-ADF-360, After-Action Review Technical Guide. United Stated Agency International Development, February 2006.

· Emergency Management Planning Guide 20102011, available at: http://www.publicsafety.gc.ca/prg/em/emp/emp-2010-11-

eng.aspx

· Emergency Preparedness Toolkit for Community Health Centers & Community Practice Sites, July 2007 available at:

http://www.nycepce.org/Resources/EPtoolkitForCHC.pdf

· SWOT analysis, Virginia Department of Emergency department available at : http://www.vaemergency.gov/node/1444

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Annex 4.1: Minimum Standards for Communicable Disease Prevention and Control

Intervention Minimum standards Target diseases

Shelter and

site planning

Existing shelter and settlement solutions

are prioritized via the return of hosting

of disaster –

affected households and the security,

health, safety and well -being of the

affected population are ensured.

Diarrhoeal diseases,

ARI, meningitis, TB,

HIV

Water supply All people have safe and equitable

access to sufficient quantity of water for

drinking, cooking and personal and

domestic hygiene.

Diarrhoeal diseases, typhoid,

scabies

Sanitation and

hygiene

People have adequate numbers of

toilets, sufficiently close to their

dwellings to allow them rapid, safe and

acceptable access at all times of the day

and night;

Diarrhoeal diseases, polio

Each disaster-affected household has

access to sufficient soap and other

items to ensure personal hygiene,

health, dignity and well -being.

Food safety People have access to adequate and

appropriate food and non -food items

that ensures their survival, prevents

erosion of assets and upholds

their dignity;

Food is stored, prepared and consumed

in an appropriate manner at both the

household and

community levels;

Moderate and severe malnutrition is

addressed.

Top killer diseases

since malnutrition

increases risk of disease

Health education People have access to information and

services that are designed to prevent

the communicable

diseases that contribute most

significantly to excess morbidity and

mortality.

Diarrhoeal diseases, malaria,

Sexually Transmitted

Infections (STIs), TB, HIV

Annexures:

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Health services All people have access to health

services that are prioritized to

address the main causes of excess

mortality and morbidity;

People have access to clinical

services that are standardized and

follow accepted protocols and

guidelines;

All children aged 6 months to 15

years have immunity against

measles.

All diseases

Vector control

All disaster affected people have the

knowledge and means to protect

themselves from disease and

nuisance vectors that are likely to

represent a significant risk to health

and well-being;

Malaria, trypanosomiasis,

leishmaniasis, dengue,

yellow fever,

typhus, chikungunya,

Japanese encephalitis

Number of disease vectors that pose

a risk to people’s health and

nuisance vectors that pose a

risk to people’s wellbeing are kept to

an acceptable level;

Environmental

control

People have an environment that is

acceptable, uncontaminated by solid

waste, including medical waste, and

have the means to dispose their

domestic waste conveniently and

effectively;

People have an environment in

which health and other risks posed

by water erosion and standing

water including storm water,

floodwater, domestic wastewater

and wastewater from medical

facilities are minimized.

Malaria, dengue,

yellow fever

Epidemic

preparedness

and response

Measures are taken to prepare for

and respond to outbreaks of

infectious diseases;

Outbreaks of communicable

diseases are detected, investigated

and controlled in a timely and

effective manner.

All diseases

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Table 5.1: Annexure

Do’s Don’ts

Always be alert to respond immediately Don’t wait for external help

Be aware to whom contact in case of

emergency

Do not become panic

Call for help.

Know how to communicate with

emergency response team

Don’t create and believe in rumors

Have disaster supplies in hand Don’t put your life in danger

Know when & how to evacuate Don’t take responsibilities of others

Give first aid where appropriate

Do not move seriously injured persons

unless they are provided with first aid to

avoid further injury.

Help vulnerable people who may require

special assistance - children, women, the

elderly, and people with disabilities.

Don’t leave serious patient unattended

Keep surrounding clean and hygienic in

camps

Don’t focus on health needs only

Make referral to the nearest health

facility

Don’t refer without referral slip

Keep record of all the activities Don’t breach the confidentiality

Watch on any disease outbreak Don’t go beyond your scope of work

Provide psychosocial support to victim

Focus on preventive measures and

available resources

Participants’ Work Book CBDRM: Review and Risk Reduction Process (MODULE 5)

WHO

PAKISTAN

Country Office for