HEALTH SECTOR SELF ASSESSMENT TOOL FOR DISASTER RISK REDUCTION IN GRENADA TERENCE WALTERS

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

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)

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

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

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.

7. 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 HEALTH SECTOR SELF ASSESSMENT TOOL FOR DISASTER RISK REDUCTION

8. HEALTH SECTOR ASSESSMENT TOOL FOR DRRPHASES & 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

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.

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

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

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

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

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

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

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

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

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

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

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

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)

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

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

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

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

28. THANK YOU