Protocols Flashcards
Why is mass migration post disaster such a big issue?
Less healthcare infrastructure and increased risk of disease
What are the benefits of the cluster system?
Increased capacity
Leadership
Agreed objectives
Accountability
Field-level coordination
How many global clusters are there?
11
Who are clusters accountable to?
UN emergency relief coordinator
Why might some organisations not take part in the cluster system?
They want to be independent and neutral (👀MSF, ICRC)
How much money does the department for international development donate?
£528 million in 09/10
£100m to ECHO and £66m to the ICRC
What proportion of DFID money went to humanitarian emergencies?
11%
What is the disasters and emergency committee?
Up to 15 charities working in the disaster field
Joint fundraising
Response focal point
Cooperation and coordination
Accountability and effectiveness
What was the Crisp report and what did it say?
Report published in feb 2007 making 14 recommendations about the UK’s response to emergencies
Basically said we need Human Resources (and organisation) not money
But ignored till after Haiti 2010
What is the international emergency trauma register?
Database of accredited volunteers that have a prospective release agreement with their employers
When was the international emergency trauma register first used?
Libya
What was the international emergency trauma register rebranded as for Ebola?
Emergency medical register
Who created the international emergency trauma register?
DFID/DOH and interested NGOs
What caused the set up of the international emergency trauma register?
Haiti 2010
What does training for disaster relief include?
Introduction
Speciality courses
Under canvas simulation training
Security training
Health screening
Leadership courses
What is the issue with austere training courses?
They’re so expensive
What is the Hyogo framework for action?
Disaster risk reduction as priority
Assess risks and enhance early warning
Measures taken to protect vunerable populations
Reduce risk factors
Strengthen disaster preparedness
When did the Hyogo framework for action come about and how many countries signed?
2005
168 signatories
What is the Sendai framework for disaster risk reduction?
The successor to the Hyogo framework that focuses on:
Improving capacity and resilience
Reducing mortality
What years is the Sendai framework for disaster risk reduction active?
2015-30
What are the limiting factors in trauma care?
Staff, stuff, space, systems
Staff availability and training
Enough equipment and implants
Available theatres and wards
Transport and funding
What are the Geneva conventions?
Laws protecting those no longer involved in war (civilians and ex military)
What are the laws of Hague?
Rights and obligations of belligerents and restricts means of harming the enemy
(basically protecting how war is carried out)
Who can use the red cross (/moon/crystal) symbol?
Armed forces medical services
ICRC/IFRC
Civilian hospitals
Other agencies with authorisation
What does the Red Cross mean?
That place is protected
What are some examples of war crimes?
Willful killing of a protected person
Torture or inhumane treatments
Willful injury or suffering
Deliberate civilian attacks
Use of prohibited weapons
Misuse of emblem
Pillage of private property
What is the difference between military physicians and humanitarian workers?
Can only carry weapons as self defence
If captured, they’re considered detained persons not POW
What are the minimum maternal health services that should be available?
For every 500,000:
1 comprehensive EmOC
4 BEmOC
And
20km away from CEmOC
5km from BEmOC
What proportion of births should take place in EmOC?
> 15%
What could cause <15% births to take place in EmOC?
Bad quality
Community rumours
Male doctor
Language barriers
Money
Logistics
What % of births should be C sections?
5-15%
What is the maximum acceptable case fatality rate in EmOCs?
1%
What are the Oslo guidelines?
Basically military shouldn’t be involved in humanitarian work because it puts them at risk (unless humanitarian agencies are unable or unwilling to provide the necessary support)
What does the criminal court act of 2001 say?
British nationals can be prosecuted for certain crimes committed overseas
What are the international PMCs?
Framework for establishing, implementing, operating, monitoring, reviewing, maintaining and improving the management of security operations
What are the emergency phase priorities of a refugee camp?
Initial assessment
measles immunisation
Water and sanitation
Shelter
Food and nutrition
HR and training
Coordination
Sources
What are the medical priorities in the emergency refugee phase?
Communicable disease control public health surveillance
What does the initial assessment of the emergency refugee phase include?
Political context
Population size and movement assessment
Map of site
Environmental conditions
Epidemic/endemic disease
Estimation of recent mortality rates
Food/water availability
International or local organisations
What is the sphere project (and what year was it implemented in)?
Minimum standards to improve the quality of humanitarian assistance and ensure accountability
1997
What are the chapters in the sphere protocols?
What is sphere
Humanitarian charter
Protection principles
Core humanitarian standard
Water supply, sanitation and hygiene promotion
Food security and nutrition
Shelter and settlement
Health
What triggered the creation of the sphere project?
Rwandan genocide
What is the humanitarian charter?
Summary of the core legal principles that are the most relevant for the welfare of people affected by disaster or conflict
What is the standard information collected in a health assessment?
Mortality
Morbidity
Vaccination
Nutrition
Water
Sanitation
Shelter
When are health assessments relevant?
Refugee/IDP
Disaster relief
Complex emergencies
Infectious disease
What do you need to consider when carrying out a health assessment?
Timescale
Purpose
Ability to respond
Stove-pipes and sectors
Politics
Cost
Quality/quantity
What are the key mortality indicators?
Crude mortality rate
Age specific
Case specific death rates
Maternal mortality
What are the key morbidity indicators?
Incidence
Prevalence
Nutritional situation
Immunisation
Vital needs
Health service activities
What is the early warning alert and response network used for?
Supply essential data esp in the acute phase of an emergency
Why is surveillance data useful?
Set priorities
Detect disease outbreaks in a timely manner (prevent epidemics)
Determine distribution and spread of disease
Set up appropriate and effective public health responses
Provide data to evaluate control measures
Plan and set up programmes and monitor progress
What does DAPS framework stand for and where does it come from?
Dignity
Access
Participation
Safety
From ICRC
What does the DAPS framework say ?
Dignity - respect, safeguard and promote the dignity and privacy of individuals
Access - non-discriminatory and physical/economic access
Participation - everyone involved in decision making
Safety - sector specific but inc child protection, sexual and gender based violence, internal protection system
How do you deal with communicable disease in emergencies?
Rapid assessment
Prevention
Surveillance
Outbreak control
Disease management
How much water do you need per person per day?
15 Litres
What are the guidelines for water availability?
Max:
250/tap
500/hand pump
400/open hand well
100/laundry facility
50/bathing facility
What are the key considerations for emergency water supply?
Phased approach is best
Quantity over quality
Choose sites near water
Assessment of water sources
Operation and maintenance
Community participation and training
Importance of hygiene activities
What are the guidelines for toilets?
1 per 20 people
Min 50m from dwelling
What are the minimum hygiene requirements in a refugee situation?
2 water containers (storage and collection)
250g pp bath soap
200g pp laundry soap
Soap and water at hand washing station after toilet
What are the triggers for urgent nutritional action?
Crude mortality 1/10000/day
Child (<5yrs) mortality 4/10000/day
<1500 kcal/day in adults
What is a triage sieve vs triage sort?
Sieve = quickly sort lots of casualties on the front line
Sort = in depth in hospital (evidence based)
