1. 2010 FIFA World Cup State of Readiness National Department of Health Health Portfolio Committee 10 March 2010

2. 2Contents Government Guarantees Role of the Department of Health Scope of Responsibilities DOH / LOC Relationship Service Areas Responsibility Linkages Planning Cycle 2009 FIFA Confederation Cup Planning and Preparation Structures Preparations Activities Stadia / FIFA Fan Parks / Public Viewing Areas Legacy Challenges

3. 3 Ministerial Guarantees to FIFA Health and Medical Services Health and Medical Services “The infrastructure of the South African National Health System, with specific regard to the availability of a comprehensive medical service (including 24-hour emergency medical treatment) and disaster management, will be put at the disposal of the 2010 FIFA World Cup in the cities where the games will be played. This applies to both foreign and local delegations including the FIFA delegation and representatives, SAFA, players, management and coaching staff, foreign and local spectators, media, sponsors, officials, administrators and the small business sector servicing the spectators at the respective venues.” “The infrastructure of the South African National Health System, with specific regard to the availability of a comprehensive medical service (including 24-hour emergency medical treatment) and disaster management, will be put at the disposal of the 2010 FIFA World Cup in the cities where the games will be played. This applies to both foreign and local delegations including the FIFA delegation and representatives, SAFA, players, management and coaching staff, foreign and local spectators, media, sponsors, officials, administrators and the small business sector servicing the spectators at the respective venues.”

4. 4 Ministerial Guarantees to FIFA cont. The existing health infrastructure will be significantly upgraded in keeping with the governments mission to promote the health of all people of South Africa, and to provide caring and effective services ” The existing health infrastructure will be significantly upgraded in keeping with the governments mission to promote the health of all people of South Africa, and to provide caring and effective services ”

5. 5 Ministerial Guarantees to FIFA cont. Accreditation of Foreign Medical Personnel Accreditation of Foreign Medical Personnel Approval of medicines, scheduled substances and medical substances Approval of medicines, scheduled substances and medical substances Marketing, distribution, serving and consumption of Alcohol Marketing, distribution, serving and consumption of Alcohol

6. 6 Role of Department of Health Mandated to ensure overall coordination and provision of health and medical services utilising the entire health system Mandated to ensure overall coordination and provision of health and medical services utilising the entire health system

7. 7 Scope of Responsibilities Command and Control Command and Control Management and Coordination Management and Coordination Planning Planning National Health Operations Centre National Health Operations Centre Provincial Health Operations Centres Provincial Health Operations Centres Communications (Media) Communications (Media) Communications (Radio) Communications (Radio) Information Systems Information Systems Legislation, Policy and Guidelines Legislation, Policy and Guidelines Finance Finance

8. 8 Scope of Responsibilities cont. Health Services Health Services Environmental Health Environmental Health Port Health Port Health Travel Medicine Travel Medicine Communicable Disease Communicable Disease Hospitals Hospitals Health Promotion Health Promotion Pharmaceuticals / Medical Equipment Pharmaceuticals / Medical Equipment Forensic Pathology Forensic Pathology

9. 9 Scope of Responsibilities cont. Medical Services Medical Services EMS EMS Medical Centres / Medical Posts Medical Centres / Medical Posts Mass Casualty / Deaths Contingency Planning Mass Casualty / Deaths Contingency Planning Aero-medical Aero-medical Chemical, Biological, Radiological and Nuclear Hazards Chemical, Biological, Radiological and Nuclear Hazards

10. 10 DOH / LOC Relationship Overlap in service responsibilities Overlap in service responsibilities Government Guarantees versus Organising Association Agreement Government Guarantees versus Organising Association Agreement Limited resource pool in the health sector Limited resource pool in the health sector Establishment of a Memorandum of Agreement in June 2008 Establishment of a Memorandum of Agreement in June 2008 Background and mandates Background and mandates Duration of MOA Duration of MOA Duties Duties Financial considerations Financial considerations Conflict resolution Conflict resolution Responsibility Matrix Responsibility Matrix

11. 11 DOH / LOC Relationship cont. DOH appointed as service provider for LOC DOH appointed as service provider for LOC

12. 12 DOH / LOC Relationship cont. Sole Service Provider Sole Service Provider Players Medical Centre Players Medical Centre VIP Medical Centre VIP Medical Centre On-field Personnel On-field Personnel FIFA Motorcades FIFA Motorcades FIFA Headquarters FIFA Headquarters FIFA Headquarter Hotels FIFA Headquarter Hotels Team Base Camps Team Base Camps Team Training Grounds Team Training Grounds Team Training in Stadia Team Training in Stadia Referee Headquarters Referee Headquarters Referee Training Site Referee Training Site Stadia Set Up and Breakdown Stadia Set Up and Breakdown FIFA Medical Emergency Number FIFA Medical Emergency Number Football for Hope Football for Hope Final Draw Final Draw

13. 13 DOH / LOC Relationship cont. GovernmentOC Spectator Medical Centre Stadia Spectator Medical Post Tier Personnel Precinct Patrols Environmental Health Casualty Clearing Station Players Medical Centre VIP Medical Centre On – Field Personnel Doping Control Team Base Camps

14. 14 DOH / LOC Relationship cont. GovernmentSA Football Assoc Health Technical Task Team Medical Advisory Board DOH World Cup Unit Chief Medical Officer Strategic Structure

15. 15 DOH / LOC Relationship cont. GovernmentSA Football Assoc Health Technical Task Team Provincial Health 2010 Program Managers Medical Advisory Board LOC Medical Officers Host Cities DOH World Cup Unit Chief Medical Officer Tactical Structure

16. 16 DOH / LOC Relationship cont. GovernmentSA Football Assoc Provincial Health 2010 Program Managers LOC Medical Officers Host Cities Operational Structure

17. 17 Service Areas : DOH Ports of Entry Ports of Entry International Health Regulations International Health Regulations Monitoring of communicable disease Monitoring of communicable disease Teams Medical Equipment / Drugs Teams Medical Equipment / Drugs Emergency Medical Services Emergency Medical Services Headquarter Hotels (Govt. VIPs) Headquarter Hotels (Govt. VIPs) Medical Post Medical Post Standby Medical Practitioners / Specialists Standby Medical Practitioners / Specialists Motorcade Routes (Govt VIPs) Motorcade Routes (Govt VIPs) Strategic Deployment of Emergency Medical Services Strategic Deployment of Emergency Medical Services

18. 18 Service Areas : DOH cont. General accommodation areas General accommodation areas Mass casualties Mass casualties Mass deaths Mass deaths Repatriation of patients / bodies Repatriation of patients / bodies Recreational areas Recreational areas Tourist destinations Tourist destinations Tourist routes Tourist routes Team Base Camps Team Base Camps FIFA Headquarters FIFA Headquarters FIFA HQ Hotels FIFA HQ Hotels

19. 19 Service Areas : DOH cont. Practice Sessions Practice Sessions Spectator Medical Centre / Medical Post Spectator Medical Centre / Medical Post

20. 20 Service Areas cont. Stadium Stadium Govt VIPs Govt VIPs Spectators Spectators Support Personnel Support Personnel Vendors Vendors Service Providers Service Providers Competitions Area Competitions Area Players Medical Centre Players Medical Centre On-field On-field VIPs VIPs Medical Centres Medical Centres Medical Posts Medical Posts Casualty Clearing Station Casualty Clearing Station Ambulances Ambulances Response Units Response Units Disaster Vehicles Disaster Vehicles Rescue Units Rescue Units All Terrain Vehicles All Terrain Vehicles Golf Carts Golf Carts

21. 21 Service Areas : Host City Environmental Health Environmental Health Clinics Clinics Communicable Disease (concurrent) Communicable Disease (concurrent) FIFA Fan Parks FIFA Fan Parks Public Viewing Areas Public Viewing Areas

22. 22 Responsibility Linkages Department of Health SA Police Services Host City OC Venue Manager OC Venue Medical Officer SA Military Health Services CGTA Disaster Management SA Airport Company FIFA Stadium Manager Private Sector

23. 23 Health and Medical Services Planning Cycle Phases Phases Phase 1Master Planning01/01/2008 – 31/03/2008 Phase 1Master Planning01/01/2008 – 31/03/2008 Phase 2Preparation01/04/2008 – 31/01/2009 Phase 2Preparation01/04/2008 – 31/01/2009 Phase 3Testing01/02/2009 – 31/03/2009 Phase 3Testing01/02/2009 – 31/03/2009 Phase 4Confederation Cup01/04/2009 – 31/07/2009 Phase 4Confederation Cup01/04/2009 – 31/07/2009 Phase 5Review of Plan01/08/2009 – 31/01/2010 Phase 5Review of Plan01/08/2009 – 31/01/2010 Phase 6Testing01/02/2010 – 31/03/2010 Phase 6Testing01/02/2010 – 31/03/2010 Phase 7Final Preparation01/04/2010 – 31/05/2010 Phase 7Final Preparation01/04/2010 – 31/05/2010 Phase 8Execution of Plan01/06/2010 – 31/07/2010 Phase 8Execution of Plan01/06/2010 – 31/07/2010 Phase 9Post Event01/08/2010 – 31/03/2011 Phase 9Post Event01/08/2010 – 31/03/2011

24. 24 2009 FIFA Confederations Cup Deployed from 30 May to 2 July 2009 Deployed from 30 May to 2 July 2009 >98 000 deployment hours were utilised with between 225 medical personnel on non-match days and 690 on match days >98 000 deployment hours were utilised with between 225 medical personnel on non-match days and 690 on match days 28 and 116 emergency medical vehicles utilised. 28 and 116 emergency medical vehicles utilised. 32 Hospitals designated 32 Hospitals designated Only 344 patients seen but resources on standby for major events. Only 344 patients seen but resources on standby for major events.

25. 25 Planning and Preparation Structures Role Players Dept of Health (convener) Provincial Health Dept. SAMHS SA Police Services Host Cities SALOC SALGA Private Sector NGOs Professional Assoc. Statutory Bodies Health Technical Task Team

26. 26 Planning and Preparation Structures cont Role Players Dept of Health Provincial Health Departments SAMHS SA Police Services Host Cities SALOC SALGA Private Sector NGOs Professional Associations Statutory Bodies 14 Expert workgroups Health Technical Task Team

27. 27 Planning and Preparation Structures cont 14 Expert Work Groups = Command & Control Communications Media Stadia Emergency Medical Services Hospitals Environmental Health Port Health Health Promotion Communicable Disease Pharmaceuticals Human Resources Forensic Pathology Chem, Bio, Radiological & Nuclear Health Technical Task Team

28. 28 Planning and Preparation Structures cont Participants NDOH 2010 World Cup Unit (convenor) NDOH Program Managers Provincial Health 2010 Coordinators SA Military Health Services SA Police Services LOC Medical Office Host Cities Preparations Workgroup

29. 29 Preparations Activities Health Technical Task Team (quarterly) Health Technical Task Team (quarterly) Preparations Work Group (monthly) Preparations Work Group (monthly) Private Sector Forum (monthly) Private Sector Forum (monthly) Debrief related Task Teams Debrief related Task Teams Command & Control Command & Control Private Sector Private Sector SOPs SOPs Volunteers Volunteers Accreditation Accreditation Inter-provincial agreements Inter-provincial agreements Establish provincial response teams Establish provincial response teams

30. 30 Preparations Activities cont. Requirement for all areas; Requirement for all areas; Medical Facility norms Medical Facility norms Medical personnel norms Medical personnel norms Medical equipment norms Medical equipment norms Drugs and surgical sundries norms Drugs and surgical sundries norms Vehicle norms Vehicle norms Training Training Standard Operations Procedures Standard Operations Procedures Access & egress routes Access & egress routes

31. 31 Preparations Activities cont. 2010 FWC Plan 2010 FWC Plan Environmental Health strategies Environmental Health strategies National Tenders and guidelines National Tenders and guidelines Medical Equipment Medical Equipment Rescue Equipment Rescue Equipment Aero-medical services (helicopters) Aero-medical services (helicopters) Uniforms Uniforms Emergency Vehicles Emergency Vehicles Mass casualty equipment Mass casualty equipment

32. 32 Preparations Activities cont. Provincial & Host City visits Provincial & Host City visits FIFA Inspection – October 2009 FIFA Inspection – October 2009 Designated hospitals Designated hospitals Hospital preparations Hospital preparations Disaster preparedness Disaster preparedness Technical Coordinating Committee Technical Coordinating Committee Host City Forum Host City Forum Nat Joints Planning Support Team Nat Joints Planning Support Team

33. 33 Preparations Activities cont. Web-based Project Management System Web-based Project Management System Web-site(http://www.doh.gov.za/sa2010) Web-site(http://www.doh.gov.za/sa2010) Health Promotion Health Promotion Volunteer Registration Volunteer Registration Training Training Forensic Pathology Services Forensic Pathology Services Incident Management Incident Management

34. 34 Preparations Activities cont. Training Training Clinical Forensic Medicine 524 Clinical Forensic Medicine 524 Major Incident Medical Management System 281 Major Incident Medical Management System 281 Hospital MIMMS 265 Hospital MIMMS 265 SA Triage Scale 214 SA Triage Scale 214 CBRN CBRN Department of Health

35. 35 Department of Health World Cup Unit Stadia / FIFA Fan Parks / Public Viewing Areas MEDICAL FACILITIES PLANNING 2010 MOSES MAHBIDA STADIUM Department of Health World Cup Unit

36. 36 Stadia / FIFA Fan Parks / Public Viewing Areas cont. Criteria for; Criteria for; Medical facility design Medical facility design Specifications for; Specifications for; Lighting, ablutions, electrical points, back up power, telecommunications, IT, sluice, fixed equipment Lighting, ablutions, electrical points, back up power, telecommunications, IT, sluice, fixed equipment Casualty Clearing Station Casualty Clearing Station

37. 37 Stadia / FIFA Fan Parks / Public Viewing Areas cont. FIFA has issued specific requirements for the players and VIP medical centres, and doping control FIFA has issued specific requirements for the players and VIP medical centres, and doping control DOH have recommended plans for spectator facilities based on statistics from previous events, and with a view to forthcoming legislation DOH have recommended plans for spectator facilities based on statistics from previous events, and with a view to forthcoming legislation

38. 38 Stadia / FIFA Fan Parks / Public Viewing Areas cont. Mass Gathering Regulations Mass Gathering Regulations Will be utilised to determine medical resource requirements at Mass Gatherings Will be utilised to determine medical resource requirements at Mass Gatherings Refers to the MINIMUM medical staff requirements for Mass Gatherings Refers to the MINIMUM medical staff requirements for Mass Gatherings Each venue should still have an individual risk assessment taking into account the layout, number of tiers, access to levels (e.g. stairs/ramps/lifts etc) Each venue should still have an individual risk assessment taking into account the layout, number of tiers, access to levels (e.g. stairs/ramps/lifts etc) Each event will also have an individual risk assessment Each event will also have an individual risk assessment

39. Comprehensive Costings 39

40. 40 Stadia / FIFA Fan Parks / Public Viewing Areas cont. Analysis of the plans for each stadium Analysis of the plans for each stadium Compliance workshops with the Organising Committee Technical Team and host city project managers and architects Compliance workshops with the Organising Committee Technical Team and host city project managers and architects Ad hoc site meetings and inspections with all stadia Ad hoc site meetings and inspections with all stadia FIFA inspections in February and October 2007, February, September 2008, February 2009 and October 2009 FIFA inspections in February and October 2007, February, September 2008, February 2009 and October 2009

41. 41 Legacy Emergency Medical Services Ambulances Aero-medical Services Communications National Tenders Volunteer Database Web-based Project Management System Web-site ( http://www.doh.gov.za/sa2010) Health & Medical Services at Mass Gathering Regulations Emergency Care Training Emergency Care Technician Provincial Emergency Care Colleges

42. 42 Legacy cont. Emergency Centres MIMMS SA Triage Score Forensic Medicine Reception Centres Training Volunteer Database Enhancing major incident / disaster management strategies Improved co-operative governance Improved association between public and private sectors

43. 43 Challenges Timeous Information Timeous Information Budget Budget EMS and Port Health Resources EMS and Port Health Resources Port Health Port Health FIFA Fan Parks / Public Viewing Areas FIFA Fan Parks / Public Viewing Areas Residential Spread / Team Base Camps Residential Spread / Team Base Camps