MILITARY ENVIRONMENTAL HEALTH RAPID RESPONSE TO HA&DR OPS DEALING WITH DISASTERS 17 SEP 2015 MILITARY MEDICAL/ENVIRONMENTAL HEALTH RAPID RESPONSE TO HA&DR OPERATIONS Lt Col Gareth Moore RAMC MCIEH CMIOSH Head of Army EH Cadre LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)

Planning to Support HADR Once UK Assistance has been requested Initial Planning Group convened at Joint Force HQ Bespoke Recce team established (minimum of operational planner, medical planner/env hlth, logistician, engineer) LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)

Med Recce in Support HADR Identify and prioritise health threats based on medical risks – i.e. Medical Needs Assessment – this will determine the most appropriate troops to task (e.g. Royal Engineers to Nepal under direction of Env Hlth Specialist) Determine efficacy of Host Nation Med Services – will determine level of deployed medical care - e.g. UK Mil Med Support to Sierra Leone. Health Protection of the Deployed Force LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)

UK FORCE HEALTH PROTECTION STRATEGY Health Intelligence Health Protection Morbidity Surveillance Medical Planning Recording Environmental Exposure CBW Monitoring Employability Deployability Mitigation of health hazards of the workplace Med FP audits Operational Deployments Recruit Collect health data: PUD Smoking - Fitness - Obesity - Alcohol - Sexual Health - Suicide rate - Dental health - Immunisation schedules - Post-code - Employability Train Health Promotion Quality Health Services Epidemiology Health Information Post-deployment Health Surveillance Health Research Identifying cohorts Discharge Analysis of Medical Discharges Force Generation Pathway Force Health Protection Pre-deployment Med/EH Recce/ Needs Assessment Medical Intelligence Country Health Information Medical Preparation of the Force Med FP Audits Pre deployment briefings Pre-Recruitment Understand health of population: - Smoking Post-Discharge Health surveillance of veterans Post discharge health surveillance LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)

Med Assessment Criteria – Disease And Injury Prevention Identify Population at Risk Shelter – Infrastructure capacity and stability Endemic Disease threats Food and Water – Quantity Integrity Sanitation & Waste Medical Support LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)

Health Risk Matrix Example Ser Threat Likelihood Impact Overall Risk Proactive measures Reactive measures Residual Risk Remarks Non-battle traumatic hazards   1 Road Traffic Accidents Probable 9 10 Defensive driving. No moves at night except in emergency situations. 2 General training injuries Possible 7 Wearing of eye protection and knee pads. 6 Infective and vector hazards 3 Gastro-intestinal infection Extremely likely 5 Bottled drinking water, food from reputable sources, hand washing measures to be in place. Report to Medic at an early stage. Isolation of infected personnel. Highly probable 4 Hepatitis A Typhoid/paratyphoid Hepatitis E Unlikely Cholera Bottled drinking water. 8 Meningitis Vaccination Tuberculosis STI Reduced opportunity of being infected with STI. Report to Medic at an early stage. 11 HIV 12 Hepatitis B 13 Hepatitis C 14 Malaria Personal and communal bite protection measures are to be taken. 15 Leishmaniasis –cutaneous 16 Rabies Avoidance of domestic and wild animals. 17 Anthrax Environmental and Industrial Hazards 18 Climate Likely Direction in JSP 539 to be adhered to. Highly Possible LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)

LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)

Recent UK Mil Interventions Recent military support to HADR Operations Nepal Sierra Leone Philippines Bosnia UK Resilience(e.g. Floods) Strategic Med/PH/EH Support to National Health Services: Afghanistan Iraq LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)

QUESTIONS? LT COL GW MOORE RAMC – SO1 EH, Hd Of Army Env Hlth (01276 412931, gareth.moore819@mod.uk)