1 REGI ONAL ISSUES AND CHALLENGES IN KEEPING HEALTH FACILITIES SAFE FROM DISASTER HEALTH FACILITIES SAFE FROM DISASTERS INDONESIA COUNTRY REPORT By Dr. Lucky Tjahjono : Crisis Center, MOH Dr. Wuwuh Utaminingsih : Dit. Basic Medical Care, MOH Dr. R. Suhartono, Emergency Unit, Ciptomangonkusumo Hospital Drg. Maria Sidangdoki, National Coordination Board for Disaster Management 2 The Geographic Nature of Indonesia Indonesia located on 4 moving tectonic plates, has daily, average of 5 Earth quakes (> 5 RS) and Ring of Fire where 126 active volcanoes Around the country 3 Earthquake & Tsunami Volcanoes Eruption Floods Flash floods & Landslides Conflict – Social unrest Bomb Blast Industrial Accident Transportation Accident Cyclone Hazards Earthquake Infectious Diseases Black Outs 4 Hazard Mapping, Indonesia NAD 2,3,4,5,6,7,13 ,14 N. Sumatra 3,4,7,14 W Sumatra 1,2, 3,4,8,11,14 Bangka Belitung 3,14 S. Sumatra 3,4,14 Riau 3,5,7,8,14 Kep Riau 14 3 Lampung 2,3,14 Bengkulu 2,4,14 Jambi 3,14 Jakarta 3,4,6,7,9,14 W, Java 2,3,4,5,6,7,11 ,14 Banten 2,3,5,12,14 C. Java 1,2,3,4,5,9,11 ,12,14 Jogyakarta 1,11,14 E. java 1,2,3,5,6,7,9 ,11,12,13,14, Bali 2,3,4,6,7,9,14 NTB 3,6,2,9,4,5,11,7,1 4 NTT 1,3,6,9,11,2,13,4,5, 14 W. Kalimantan 1,3,8,4,6,10,9,5,11, 13,14 S. Kalimantan 3,10,5,13,14 C. Kalimantan 6.10,8,9,3,11,7, 14 E. Kalimantan 3,10,8,9,5,14 N. Sulawesi 1,3,8,2,4,11,13,14 S. Sulawesi 3,4,6,7,13,14 C. Sulawesi 2,3,6,9,7,13,14 S.E Sulawesi 3,6,14 Gorontalo 3,14 Maluku 2,3,6,7,9,11,13,14 N.Maluku 2,4,6,7,9,13,14 Papua 2,3,4,6,7,9,11,13, 14 Type of Emergency and Disaster 1. Volcano 5. Hurricane 9. Disease outbreak 13. Tsunami 2. Earthquake 6. Conflict 10. storm 14. Transportation 3. Flood 7. Terrorism 11. Drought Accident 4. Landslide 8. Environment Pollution 12. Industrial Accident 5 Indonesia National Hazards Risk Geographic size : 1.890.754 Km² 33 provinces, 349 districts, 91 city, 5.263 sub districts, 62.806 villages, and 7.123 sub villages. Popul ation size : 217.072 .346 peo ples 6
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8/3/2019 Hospitals Safe From Disasters Document 11
Challenges faced to improve the stateof preparedness in health facilities
Decentralized administrativepolicy and structure – down todistrict level 446 Districts.
Weak in role and responsibility of Provinces (33 Provinces)
Hospitals under control of Province and District Authorities –Governors
Hospital (T-S-P) have nosystematic link
Transfer of health staff dependsmore on local authorities.
Hospitals, most of the time overloaded with day to day patientsespecially with road trafficaccidents and seasonal diseases.
Emergencies and disastersaffecting different districts on
weekly basis.
Health Sector and Cluster Structural andMethodology used in Indonesia
Heath Sector / ClusterGeneral Coordination
Sub – Groups Coordination andpresentation•Immunization•Child, reproductive and maternal•Water and Sanitation•Surveillance and outbreak control•Mental Health•Mobile Clinics
•Field Hospitals•Hospital care•Supplies
HealthEmergencyInformationOperation
Center
Government CoordinationMeeting
UN ClusterCoordination Meeting
OperationalMapping
Building codes
Indonesian standardbuilding codes.
Hospital buildingcodes – Higherstandards.
Guidelines available. Applications of BC
varies as weakness inmonitoring andenforcement system.
Location of hospitalschallenged byurbanization.
Disaster Risk Reduction
Risk = Hazard x Vulnerability
---------------------
Capacity
Hazard
Vulnerability
Capacity
Risk
GlobalWarming
ClimateChanges
DevelopmentVs
Developing
8/3/2019 Hospitals Safe From Disasters Document 11
SOP, Check List andmonitoring toolsdevelopment in process.
Integrating data toEmergency InformationSystem in process.
Capacity building of human resources inprocess through ITC-DRR.
Recommendations Health facility preparedness
strengthen through EPR programmeroad map – Regional Crisis Centers,SOP and ITC-DRR.
Follow up on assessment findings,socialized central - local authoritiesand private sector to supportnecessary preparedness andmitigation interventions.
Strengthen Health Engineeringcapacity.
Support for Health centersassessment and mapping.
Strengthen emergency informationsystem.
Strengthen emergency operationunits.
Strengthen health centers capacity,responsibility and services to reducethe over load of hospitals.
Learn form experiences, use goodmodels and strengthen overall EPRprogramme.
Strengthen capacity of hospitalassessment soon after emergency ordisaster stricks.