21 st May pm WHO conference room Surveillance

Before TC PamImmediately after (first 72hrs) Emergency phase (72hrs to 6 weeks) - 8 sites for the Pacific syndromic surveillance with 4 core syndromes covering all the 6 provinces. - Event Based Surveillance set- up in 2012 N/A On Epi week 12 (the week right after the cyclone), already 11 extra sites included for EWARN system 16 additional sentinel sites were identified for EWARN system to cover the affected areas and 8 syndromes to be reported on - Contact with existing sites for assessment of the general situation EWARN materials sent from WHO Suva office

Before TC PamImmediatel y after (first 72hrs) Emergency phase (72hrs to 6 weeks) No identified position of surveillance in the MoH (National and provincial health) - No case investigation and - no response because 1) no mechanism in place 2) low human resources and 3) low logistic resources - No timely reporting for some sites and - no systematic reporting of syndrome that need urgent report(like AFR) because 1) not enough training and 2) poor communication means In the laboratory, no systematic test and no systematic testing and reporting linked to the surveillance Lack of communication and coordination between existing national system (national and provincial surveillance officer and 1) emergency team and 2) FMT Lack of coordination with Logistics cluster, especially to facilitate or join transportation

Before disaster-PreparednessImmediately after (first 72hrs) Emergency phase (72hrs to 6 weeks) Training on surveillance for health centers (not included in regular syndromic surveillance) about : EWARN system EBS system training In case of disaster or emergency, health centers in affected areas could be quickly activated as EWARN sentinel sites. Set-up of multi-unit Outbreak Response Team at national and provincial level to be adapted to type of outbreak (surveillance, health promotion, lab, VBCD, EPI, environmental health, WASH) Inclusion of the lab as part of the surveillance system Sensitization of the lab officers on importance of testing for surveillance purpose Surveillance topic should be a requirement for the FMT and part of their briefing (similar as registration and evacuation)and