1. HEALTH SECTOR SELF ASSESSMENT TOOL FOR DISASTER RISK REDUCTION IN GRENADA TERENCE WALTERS DEPUTY DISASTER COORDINATOR NATIONAL DISASTER MANAGEMENT AGENCY (NaDMA) GRENADA 1

2. 2

3. Grenada is located in the southern Caribbean and is one of the CDEMA Participating States (PS) CDEMA – Caribbean Disaster Emergency Management Agency. Regional body responsible for driving the DRR programme in the Caribbean Grenada complies with the Comprehensive Disaster Management (CDM) approach as put forward by CDEMA (The management of all hazards, through all phases by all people) 3

4. Grenada’s Disaster Management Structure is integrative and Inclusive It includes all sectors and all people Ministry of Finance Ministry of Works Ministry of Education Ministry of Health Royal Grenada Police Force Social Services Communities/Villages 4

5. Grenada views the Health Sector involvement in DRR as very critical and important The Health Services Sub Committee of the NDO is very active This area must be given significant attention because of the health challenges that present after any disaster 5

6. RESPONSIBILITIES OF HEALTH SERVICES COMMITTEE Co-ordination of medical and first-aid assistance Requisitioning of medical supplies Proper identification of health service workers and first aid personnel and First-Aid stations Co-ordinating arrangements with Transport sub-committee for the use of additional vehicles Training of health service workers and emergency First-Aid personnel Provision of environmental health services at emergency shelters Preparing a list of all health facilities including pharmacies, in the State, which can be used in the event of a disaster. Ensure counselling is provided to population affected in the case of a disaster. 6

7. HEALTH SECTOR SELF ASSESSMENT TOOL FOR DISASTER RISK REDUCTION A tool for HS Disaster Coordinators to assess and apply themselves for their own programming & learning purposes Assist countries in developing a snapshot of ‘where they are’ in terms of Disaster Risk Reduction (DRR) in the HS DEVEOPLED BY PAHO

8. HEALTH SECTOR ASSESSMENT TOOL FOR DRR PHASES & COMPONENTS MITIGATION – Risk Identification Hazard, vulnerability, and risk assessments – Soft (Non-structural) Mitigation Land-use planning and building code – Hard (Structural) Mitigation Assessment of new and old facilities

9. HEALTH SECTOR ASSESSMENT TOOL FOR DRR PHASES & COMPONENTS PREPAREDNESS – DRM Governance Legal, policy and systemic frameworks – HS DRM Planning Planning frameworks, national-level and facility-level plans – HS DRM Resources Material and human resources – HS DRM Public Awareness Pre-event awareness and post-event public health information

10. HEALTH SECTOR ASSESSMENT TOOL FOR DRR ADVANCES ISDR TERMINOLOGY: The Tool utilizes the accepted terminology in the field of disaster risk and disaster management as advanced by ISDR 10

11. The health sector encompasses all entities that produce actions, services, goods, opportunities, and knowledge that contribute to the maintenance and improvement of the individual and collective health. This includes the economic and productive activities of other sectors which impact on health; the political decisions, and their legal- administrative forms of expression, as well as environmental and educational interventions that influence the health determinants. 11

12. THE PROCESS The assessment was conducted in Grenada over a two day period, June 18 and 19, 2010 It consisted of a Working Group meeting with HS Stakeholders, and Meeting with national disaster coordinator to corroborate HS response 12

13. STAKEHOLDERS Hospital Administrator Hospital Director Health Disaster Co-ordinator Chief Nursing Officer Representative of Private Pharmacies Representative of Private hospital Medical Officer of Health Senior Community Health Nurse Representative from Central Medical Stores National Disaster Coordinator PAHO Country Programme Officer 13

14. FINDINGS - MITIGATION RISK IDENTIFICATION: – Vulnerability assessments completed for some public sector health facilities (HSI) – Flood studies conducted & flood maps exists but not used for planning 14

15. FINDINGS - MITIGATION SOFT MITIGATION – HS was never involved in land-use planning – Except for the General Hospital, respondents could not confirm whether facilities were built to code 15

16. FINDINGS - MITIGATION HARD MITIGATION – No mitigation program – Hospital safety improvement plan not totally implemented 16

17. FINDINGS - PREPAREDNESS DRM GOVERNANCE: – Health Service Committee very active, performs both emergency response and advisory functions – Health Disaster Coordinator (HDC) exist but does not have sufficient resources to lead a HS DRM programme – Lack of key policies and legislation 17

18. FINDINGS - PREPAREDNESS HS DRM PLANNING: – National Pandemic Preparedness Plan completed – National HS Disaster Plan almost completed 18

19. FINDINGS - PREPAREDNESS HS DRM RESOURCES: – All health facilities equipped with an emergency power supply – Adequate island wide emergency communication – DRM included in training curricula for HS practitioners 19

20. FINDINGS - PREPAREDNESS HS DRM PUBLIC AWARENESS: – Health Promotion Department broadcasts health disaster messages annually – No dedicated public awareness program and no planned public awareness strategy in place 20

21. RECOMMENDATIONS GENERAL RECOMMENDATION – Establish full-time Health Disaster Coordinator with: Dedicated office Minimum of one administrative officer Financial resources 21

22. RECOMMENDATIONS MITIGATION – Develop Awareness and Training Programs to enhance the HS’s familiarity with risk reduction and mitigation issues – Get health officials and practitioners more involved with: Site selection of facility Design of facility Construction of facility – Expansion of Safe Hospital Initiative to all national facilities – Review building codes to ensure that it contains provisions which are specific to health facilities – Enhance DDR information knowledge sharing 22

23. RECOMMENDATIONS PREPAREDNESS (I) – Develop an HS DRM Policy – Develop HS DRM program plan – Design, plan and execute an annual simulation exercise based on national HS DRM plans – Test all health facilities disaster plans – Develop implementation plan for to address recommendations of the vulnerability assessment of community health facilities – Establish dedicated office for HS DRM with DRM information (e.g. maps, plans, training material) 23

24. RECOMMENDATIONS PREPAREDNESS (II) – Expand Health Services Committee to include greater representation from private sector facilities – Review MOU with La Qua Brothers Funeral Home – Establish MOUs with with private health services providers, e.g. St. Georges University and St. Augustine Medical Service to utilize facilities – Integrate HS DRM into educational training courses – Develop public awareness strategy 24

25. WAY FORWARD The government of Grenada recognizes the importance of the contribution of all sub-sectors in the DRM process The Health Sector Self Assessment Tool for Disaster Risk Reduction has presented an opportunity for the government to review its policies as it relates to Health Services in DRR 25

26. WAY FORWARD Given the current economic constraints, government understands the importance of investing in DRR today in order to reduce cost of disasters in the future Government is working with CDEMA towards the development of legislation for DRR in Grenada Government is working towards mainstreaming DRR at all levels 26

27. WAY FORWARD CHALLENGES – Training – Limited financial resources – No Legislation The government of Grenada embraces Comprehensive Disaster Management (CDM) as put forward by CDEMA in an effort to ensure that all phases of the Disaster Management cycle are integrally and adequately addressed by all people 27

28. THANK YOU 28