Health Emergency Management in an Urban Setting

Transcription

1 Health Emergency Management in an Urban Setting Dr Arturo M Pesigan Urban Health Emergency Management World Health Organization Kobe, Japan pesigana@who.int

2 Urban Health is recognized as a global public health issue

3 Proportion of global population living in cities has increased dramatically in past century 1900: 15% Now : 50% and increasing Urbanization One third of the total urban population live in slums (1 billion) 70% of urban population of developing countries live in slums

4 52% of the world is urban. 60% by % by % of world s s GDP from urban areas United Nations World Urbanization Prospects (2011 Revision)

5 By 2025 Tokyo Delhi Shanghai Mumbai 39 M 33 M 28.4 M 27 M

6 Basic concepts (1) Urbanization and health issues Weak development policies and programmes to settle urban populations in safer areas Over-population In-migration to urban areas, growth of slums Environmental concerns Poor water, sanitation and waste disposal systems Consider risk reduction in urban planning

7 Basic concepts (2) Urbanization and health issues Limited application of technical information related to hazard environment, vulnerabilities and assessment tools to identify risk Poor enforcement of building codes, inadequate infrastructure Duality: capacity, risks (expertise, infrastructure, technology) Hidden cities: eclipsed in the buildings are slums, marginalized Floating urban population

8 Disasters cities versus rural areas Cities Poverty Overcrowding Inadequate infrastructure Insufficient land for resettlement Complex political scenario Better health services but poor access economic, social-cultural Greater response efforts but less coordinated Rural areas Poverty also present No overcrowding Infrastructure also inadequate Sufficient land for resettlement; affected individuals can live with relatives Less complex politics Limited availability of health services geographic access Response easier to organize

9 Need for a deeper knowledge of spatial and social structure of cities Increasing migration of IDPS, refugees and undocumented migrants Natural linkages between cities and peri-urban and rural communities Majority of tools, approaches policies and practices are designed for rural settings

10 Urban skills required for effective response and recovery vary from rural setting Faster growing smaller and medium cities are less equipped to deal with problems of urbanization Marginalized groups more marginalized The poor are poorer

11 WHO Consultation on Strategic Directions for Urban Health Emergency Management (4-5 June 2012) Key Objective: To identify priority issues, needs and strategic directions of urban areas to strengthen health emergency management in the context of broader emergency/disaster management

12 WHO Kobe Centre Review Health and health system impacts of major urban disasters from 2008 to 2011 Response and recovery efforts, gaps and challenges in the health sector Preparedness efforts and gaps and disaster risk reduction (DRR) programming in the health sector and Recommendations for urban health emergency management

13 Case disasters Great East Japan Earthquake (2011) Christchurch earthquakes (2010 and 2011) Bangkok Floods (2011) Ketsana (2009) Wenchuan earthquake (2008) Cyclone Nargis (2008)

14 Findings/Conclusions Health work in urban emergencies is management work Health officer must understand how the system works through time Health manager must identify priority needs and alternative solutions based on existing resources and capacity Context-based and multisectoral DRR and preparedness planning is very important

15 Way forward (1) Governance: Strong planning, policy, leadership and health organizational preparedness are vital to effective and efficient health emergency management Financing: Find mechanisms to ensure financial risk due to health care; assessment tool to determine economic impact Health workforce: Capacity building for general staff, specialized staff (information, risk communication, etc.), reserve workforce and decision makers

16 Way forward (2) Service delivery: Assessment of risks and capacities; Primary Health Care; Safe Hospitals/Health Facilities; strengthening of water, sanitation and waste systems; risk communication Logistics: Management system, essential medicines and supplies, rational drug use, stockpiling Health information system: Capacity building, back up systems, IT system to map needs and resources

17 Strategic directions Topic of concern Enhancing resilience, risk reduction, preparedness, response and recovery among national and local health authorities in urban areas RESILIENCE Building technical surge capacity and urban health emergency management expertise HEALTH AND GOVERNANCE Strengthening health systems to support urban health emergency management HEALTH SYSTEMS Ensuring the protection of the health of vulnerable urban populations HEALTH EQUITY and SECURITY Improving sector coordination for health by strengthening multisectoral partnership and community ownership INTERSECTORAL COLLABORATION Developing and adapting tools to urban contexts, including city health risk assessment and city plans RISK IDENTIFICATION AND MANAGEMENT

18 WHO Kobe Centre Actions Convening of the Consultation on Strategic Directions for Urban Health Emergency Management Collaboration with global/regional networks of cities, urban health Case studies on Great East Japan Earthquake Development of Project City LHITE (Leadership in Health Innovations and Technologies in Emergencies) Development of City CHEK (City Health Emergency Kits) composed of checklists, guides and references on urban health emergencies Research on preparedness of cities to climate change effects on health

19 In summary Urbanization is inevitable. HEALTHY urbanization is needed. Resilience risk reduction are key Academics to support: research and development of tools and guidelines training/capacity building Innovations/technologies

20 Our greatest concern must always rest with disadvantaged and vulnerable groups. Dr Margaret Chan WHO Director-General

21 Thank you!