( By Pan American Health Organization (PAHO) )

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3.2 Planning and technical programs

The overall assessment of this component will measure the degree of technical development in the following areas:

3.2.1 Disaster plans - operational plans for natural, technological, and manmade disasters
3.2.2 Mass casualty management - prehospital and hospital disaster plans
3.2.3 Epidemiology - surveillance mechanisms for disease control
3.2.4 Sanitation and sanitary engineering
3.2.5 Temporary settlements - organization and function

3.2.1 Disaster plans (operational)

The assessment of disaster plans should verify the existence of contingency plans according to the country's vulnerability and the extent of their application during emergency situations.

Key issues:

Availability of disaster plans, and degree of familiarity with these plans on the part of the health sector's human resources

Availability of a directory of key disaster personnel at national, regional, and local levels

Availability of critical supplies; inventory at national, regional or local levels

Degree of complexity of existing plans

Degree of community familiarization with existing plans

Mechanism for activation of disaster plans

Levels of authority and chain of command in the activation process

Public information strategy

Mass media information procedures

Existing mechanisms to respond to health needs

A devastating result of the 1985 Mexico City earthquake was the collapse of two major hospitals and serious damage sustained by others. More than 500 ambulances were mobilized to evacuate and relocate patients to unaffected institutions. (Photo: Vizcarra, PAHO/WHO)

Sources of information:

Interviews should be carried out with disaster preparedness offices of the Ministry of Health, Civil Defense and selected health institutions. Existing plans should undergo extensive review. Some of the issues mentioned above must be separated in accordance with the complexity of the national disaster preparedness program.

Summary of findings:

The analysis of operational disaster plans should indicate their practical applicability.

3.2.2 Mass casualty management

Assessment should focus on the mechanisms, strategies, or procedures for providing emergency medical care during disaster situations. Mass casualty management can be divided into two components: Prehospital activities Hospital activities

Key issues/Check list Prehospital activities

Availability of an established Medical System (EMS), and regulations for its operation

Is the EMS controlled by state or private institutions?

Existence of search and rescue teams. Do they also provide medical care? At what level of complexity?

Does the Ministry of Health control EMS activities during emergency situations?

Is there any understanding or identified role in coordinating activities between the EMS and the Ministry of Health during disaster situations?

Basic profile of EMS personnel, academic qualifications, training

Degree of training for the general population Hospital activities

Hospital network: are hospitals organized in a network for disaster situations?

Hospital disaster plans: Do hospitals have disaster preparedness plans? How current are they? What are their contingency provisions?

Hospital organization: How do these plans address the organization of main services? Are they operational?

Hospital staff: Has the staff received adequate training to face disaster situations? What is the level of motivation and staff participation? Are staff familiar with the hospital disaster plan?

Do the hospitals perform drills? How often?

Hospital facilities: Have methods of construction and maintenance been applied to reduce structural and nonstructural vulnerability in hospitals and other health facilities?

Do the hospitals have basic backup equipment for key services? Are they operational?

Emergency team: How are personnel organized for emergency response?

Emergency directory: Is it accessible and updated?

Emergency communication: Inspect/inventory means of emergency communications.

Emergency transport: Inspect/inventory means of emergency transport.

Emergency medical supplies: Inspect/inventory existing supplies.

Safety measures: Inspect main items (i.e., fire alarms, elevators, emergency exits, evacuation routes).

Sources of information:

Select two or three hospitals, meet with hospital authorities, emergency services, and personnel. Visual inspection is highly advisable. Quick review of the hospital plan is also recommended.

Summary of findings:

Analysis of mass casualty management should be oriented to qualify the prehospital and hospital response capacity in case of a disaster.

3.2.3 Epidemiology

This component should outline the existing surveillance system for disease control in emergency situations and the existing resources to face potential health risks.

Key issues/Checklist

Indicators of morbidity and mortality on important communicable diseases

Surveillance system: Existing information and reporting system adapted to emergency situations. Who is in charge?

Existence of special programs for vector control. What are the main resources?

Existence of laboratory support: Is there a network? How does it work at the national, regional, and local levels?

Technological disasters: Is there a surveillance system for health effects caused by chemical or radiological accidents? Who is in charge?

Sources of information:

Ministry of Health, laboratories, departments of epidemiology.

Summary of findings:

The analysis of surveillance mechanisms for disesase control should indicate the response capacity for early detection and prompt intervention of the existing system in emergency situations.

3.2.4 Sanitation and sanitary engineering

This component should identify the state of preparedness of the basic sanitation services and their ability to operate under emergency situations.


Inventory of water supply and environmental sanitation institutions participating in the national program on disaster preparedness.

Existence of contingency plans for disasters, staff training and their active participation. Who is in charge? What is the level of their authority?

Vulnerability analysis: List of institutions carrying out vulnerability analyses of the main water supply services.

Resources and equipment: Existence of emergency teams and backup equipment to be used in emergency situations. How are they activated?

The isolation caused by flooding interrupts basic public health services and can lead to the long-term decline in a population's well-being. (Photo: Vizcarra, PAHO/WHO)

Sources of information:

Water supply companies, Ministry of Health, on-site inspection of water supply plants.

Summary of findings

These should identify the existing potential risks and response capacity in case of disasters.

3.2.5 Temporary settlements

The assessment of this component determines the organization and operation of facilities serving as temporary shelters and settlements, their location, housing capacity, and the availability of basic health services.


How are facilities designated to serve as temporary shelters. How are they organized? Under whose authority? When are they activated? Are they known to be structurally safe?

Are existing basic services, water supply adequate?

Are excrete control, waste disposal services operational?

What is estimated number of persons to be housed?

What areas are identified for temporary settlements? What is the policy for establishing them? What type of shelters? What kind of materials are being used? Are they temporary shelters or settlements?

What are existing health problems in temporary settlements?

What is management system of the temporary settlements?

Are health care programs available?

Sources of information:

Civil Defense, Red Cross, Ministry of Internal Affairs, on-site inspection.

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