saint lucia national pandemic preparedness plan n.
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  2. COMMENTS on the process involved in the development of the NIPPP CHALLENGES • Political Will • Leadership • Inter Agency Collaboration • Legislation & Legal Framework • Secretariat

  3. PROJECT TO CONDUCT SIMULATION EXERCISESNIPPP FINAL REPORT – SAINT LUCIA The Pan American Health Organization (PAHO) with support of the United States Agency for International Development (USAID) worked with Caribbean countries and territories to upgrade their level of preparedness for Pandemic Influenza. The simulation exercise in Saint Lucia was carried out to in furthering development of its NIPPP. The exercises were jointly executed by the Ministry of Health (MOH) and the Ministry of Agriculture (MAFF) MAFF conducted its full scale exercise in the field while MOH’s exercise was conducted at Victoria Hospital. A joint table top exercise was conducted with all stake- holders.

  4. Purpose The overall purpose of the exercise was as follows: • To test the roles and responsibilities of the key players • To test the specific skills for the efficient execution of the plan a. Organization of outbreak investigation team b. Use of PPEs c. Extraction and management of samples • To determine hospital surge capacity and response 4 To identify gaps and areas for improvement

  5. OBJECTIVES Table Top Table top exercise was conducted on the first day Designed to simulate outbreak into Pandemic Phases 4 & 5 Test was focus on multi – sectoral approach to emergency management Involved Ministries & other agencies identified in the NIPPP Simulation intended to: • Provide opportunity to rehearse specific activities • Determine state of readiness • Reveal gaps • ID areas for improvement Table top focused on 4 specific areas:

  6. Table Top continued…. • Decision making (command & control) • Inter & intra agency communication • Information management • Record keeping

  7. FULL SCALE The full scale exercise was conducted on the second day comprising a series of drills to Test specific aspects of the sectors response using 20 volunteers presented to a health facility with AI symptoms contracted from a neighbouring farm. The health facility’s emergency functions tested were: • Use & application of PPEs • Sampling techniques Participation Agencies involved in the table top included MAFF, Police, NEMO,Min. of Trade, Red Cross, Fire & Ambulance Service, Min. of Finance, Min. of Tourism. The full scale exercise was predominantly MOH & MAFF with limited involvement of NEMO, volunteers, Police, Fire & Ambulance service. Observers and Evaluators Primarily regional participants from St. Vincent, Antigua, Aruba, Dominica, St. Kitts & Nevis, IICA, FAO & PAHO.

  8. CHALLENGES A number of issues were raised during the table top exercise, the key issues being: Design Flaws • Insufficient inserts created for sectors other than MOH • Exercise started at Phase 3 leading to Phases 4 & 5 (not realistic) Execution Flaws • Table triangles as markers were not used • Difficulty with viewing of inserts Other contributing factors • Number & roles of persons not specific • Limited awareness of the plan • Understanding of a table top exercise The overall success of the exercise was that it illustrated the strengths & weaknesses of the NIPPP design & implementation process in St. Lucia.

  9. FULL SCALE EXERCISEThe exercise was conducted according to schedule CHALLENGES Separation of Ministries Two separate exercises were conducted on the same day, one by MOH & the other by MAFF with very little inter agency collaboration & coordination. Duplication There was overlapping of roles & some persons played the roles of player, controller, Planner, and evaluator. However the original objectives to test the application & use of the PPEs and the Sampling methodology was realized.

  10. AFTER ACTION REVIEW (AAR) Two separate AAR sessions were held to address the strengths & weaknesses of the system and to make general recommendations for improvement. 1 Observation: many participants had no opportunity to review plans Recommendation: NIPPP committee to develop & schedule orientation sessions 2 Observation: Ministries/ Departments/Agencies operating in isolation Recommendation: NIPPP committee to identify key players & have regular sessions to harmonize relationships (private & public sectors) 3 Observation: lack of effective leadership & management Recommendation: NIPPP committee to identify training needs & ensure cadre of trained persons in awareness & management of the contents of the NIPPP

  11. CONCLUSIONGeneral overview & comments The design and execution flaws identified were not limiting factors in achieving the Goals and Objectives of the exercises. The four (4) focal Decision making, Inter & Intra Agency Communication, Information Management & Record Keeping have been simulated, since the general intention was to create a scenario that would cause the various stake holders to interact and react accordingly. The inserts were designed to afford participants the opportunity to generate discussion, anticipate problems & find solutions as a team or teams. Sections of the NIPPP were identified as missing and needed development, including but not limited to: • A communication plan • Sections indentifying specific roles & responsibilities for other Ministries & agencies, Private sector & Media Houses. • As a national plan the non-health issues such as the socio-economic implications

  12. GENERAL COMMENTS FROM THE PARTICIPANTS & EVALUATORS • The NIPPP was not seen by many in the exercise • Organizations need improvement • All inserts should be read aloud or projected from one source • Many did not take the inserts seriously • Ministry of agriculture was lost in the simulation • Could not determine the lead agency or incident command • Were the appropriate persons present for the exercises • Persons not aware of their roles or functions • Too much time was taken for dressing in PPEs • Hospital communications required improvement • Labs weakness in use of PPEs & equipment failure • Repairs/maintenance of hospital facilities • ID of backup space for surge