Eric K. Noji, M.D., M.P.H. Consultant in Global Health Security

1. Perspectives on Civil-Military Cooperation in International Disaster Management and Humanitarian Assistance Eric K. Noji, M.D., M.P.H. Consultant in Global Health Security Former Director, Division of International Emergencies & Refugee Health Centers for Disease Control & Prevention (CDC) Washington, D.C.

2. Issues • Increased involvement of US military in peace keeping, disaster management and humanitarian assistance • Escalating bi-lateralism in international response • Cultural differences among organizational actors • Humanitarian principles and neutrality • Limits to military participation? • Multiple agendas

3. MHS Action Items vis a vis New Humanitarian Challenges in 21st Century • Education and training leading to recognized certification • Scholarly research to support operational readiness • Coordinated information sharing

4. Traditional Vertical Organizations US Military ASD/HA can facilitate collaboration can via: • Integrated education and training • Integrated operational-level research • Optimized information-sharing and technologies • Protection of autonomy of operational-level agencies

5. US Military Learning Institutions Northern Command (Northcom) Host Country Armed Forces Geographical Combatant Commands Centers for Disease Control and Prevention (CDC) Governmental Agencies Defense Medical Readiness Training Institute United Nations Agencies Uniformed Services University of Health Sciences Naval Post Graduate School ICRC International Organizations Red Cross Movement Army War College Non- Governmental Organizations International Rescue Committee Indonesia Armed Forces Office of ASD/HA State Department Harvard Research Institutions State Department MacFarlane Burnet Centre Johns Hopkins Energy Department Ministries of Health Lester Pearson Peacekeeping Institute

6. ASD HA’s Mission To facilitate civil-military operations and cooperation through: Integrated education & training Collaborative research Information management Operational readiness

7. Core Competencies Fostering civil-military collaboration: • Building trusting partnerships • Education and training • Information technology • Operations research

8. Technology Tools

9. Technology Assisted Learning Modules (TALM) • TALM toolkit for developing online courses, includes freeware software: • E-Class and tutorials • Image editors • Video editors • Sound Editors • Has been used successfully by professors and leaders with no previous technical background • Examples in many different domainsand settings View E-ClassExamples

10. Value-added to traditional tools • Interactive CD/ROM based on PAHO training manuals in health aspects of disaster management • Integration of information management user interfaces and training: SUMA

11. Other Libraries • Food and Nutrition Library • Medical and Health Library • World Environmental Library

12. DoD Humanitarian Assistance Databases

13. Education and Training

14. Knowledge Base Skills Base • Intervention Phases • Prevention • Preparedness • Mitigation • Response • Recovery Disasters Disaster Cycle Underdevelopment Framework X

15. Curriculum Framework • Knowledge Base • hazards, population characteristics, population effects, intervention components, policy and organizational environment • Skills Base • Program management, information management, personal health and safety management • Intervention phases and the disaster life cycle • prevention, mitigation, preparedness, response and recovery

16. Training And Curriculum Development & Distance Learning Review of Current Major Course Content Software development for rapid courseware creation: E-Class trainer Joint Masters and PhD potential for active duty personnel Disaster University Project

17. Applied Research

18. Research Management Process for Intramural and Extramural Research Activities Start small. Perhaps a small grants competitive research program modeled after the National Science Foundation’s small grant process

19. Illustrative Research • Epidemic forecasting for the development of early warning systems in every geographic CoCom AOR • The role of the for-profit private sector in prevention, mitigation, response and recovery • Composite materials development for wind resistant structures • Evaluation of determinants and consequences of stress among military personnel involved in disaster management work • Risk of helminth infections in military and civilian relief workers • Role of women in determining household health in post-disaster environments • Risk of STD’s in shelters and camps

20. Private Sector Initiative • Suggest playing major role in the World Economic Forum’s disaster response program: “Global Relief Initiative” • Support private company post-disaster surveys • Endorsement of private sector companies • Products expected include: • Database • Inventory and disaster readiness format • Working group formulation (Private sector advisory committee) • Joint training materials development • US Chambers of Commerce training seminars

21. Issues, Challenges and Observations

22. Structural issues and challenges • Commonalities and differences in needs of the CoComs • Sustainability of military disaster education programs (e.g., “Centers of Excellence”) and financing • Perceived incompatibility of missions and corporate cultures between the civilian and military organizations

23. Observations • Bi-lateralism and the increased competition among organizational actors has had some positive effects on DR/HA • Nature of military involvement in DR/HA is highly dependent on the personality and agenda of a given CoCom • ASD/HA can enhance civil-military cooperation and collaboration, especially in light of high personnel turnover and the need for numerous bridges to the civilian world

24. In summary, the Office of the Assistant Secretary Health Affairs... • “Link to and from the CoComs” • Fulfills both civilian and military disaster management needs • Breaks down barriers to communication • Clearing house for information sharing • Window into difficult relationships • Responder, educator, assessor, researcher