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The Yolanda Experience:The Yolanda Experience:
Lessons LearnedLessons Learned
44th Annual Convention of Philippine College...
Outline
• Introduction
• What were prepared?
• What happened?
• What have been done?
• Specific challenges and way forward
Introduction
• On November 08, 2013, Typhoon “YOLANDA” made seven landfalls:
– Guiauan, Eastern Samar, 4:40am
– Dulang-Tol...
Typhoon “Yolanda” Landfalls
Typhoon “Yolanda” Storm Surges
Affected Areas in Eastern Visayas
What were prepared?
November 6:
• Alert Memorandum was issued to all CHDs
• Prepositioned logistics worth PhP 350M
Novembe...
Timeline of DOH Response
Nov 6 Nov 7 Nov 8 Nov 9 Nov 10 Nov 11
Alert memo
issued to all
CHDs
Logistics
prepositioned
in CH...
What happened?
What happened?
Region Province Deaths Injured
IV-A Quezon, Batangas 3 6
IV-B Palawan 19 63
V Albay, Masbate, Camarines
Nor...
What happened?
Other impactsOther impacts
People CHD personnel who reported for work in the first
week
15 out of 267 (5.6%...
What happened?
Health facility status
Region /
Province
No. of
existing
HF
No. of
assessed
HF
No. of
damaged
HF
Extent of ...
What have been done?
Logistics provided
SourceSource RecipientRecipient AmountAmount
DOH-Central Office
CHD IV A 80,640.00...
What have been done?
• As the Health Cluster lead, DOH provided
support to 144 registered foreign medical
teams as well as...
What have been done?
• Facilitated the acceptance and quality control
of donated medicines and medical supplies
• Health p...
What have been done?
• Deployment of composite team with
toxicology experts to manage the secondary
event of oil spill in ...
What have been done?
Summary of Services
Areas of ServiceAreas of Service Specific AccomplishmentsSpecific Accomplishments...
What have been done?
Hospital services
REGION
No. of Patients
served
Consultations
Admission
No. of
Operations
Conducted
S...
What have been done?
Team mobilization
PROVINCE CITY/MUNICIPALITY
DOH TEAMS
DEPLOYED (120)
OTHER LOCAL
HEALTH
RESPONDERS (...
What have been done?
Public Health services
What have been done?
Nutrition services
What have been done?
WASH services
REGION
No. of Population Served
Provision of
Potable Water
Water Testing
Distribution
o...
What have been done?
MHPSS services
REGION
No. of Population Served
PFA
Community &
Family Support
Counselling
Psycho-
edu...
Gaps identified
In consideration of the magnitude of Typhoon Yolanda
and the new normal, there is a need to:
• Update logi...
Some specific challenges identified
• Current procurement plan accounted mainly for non-
capital outlay needs during emerg...
Way forward
On February 19 to 21, top management level of the
Department of Health held a strategic planning workshop
to i...
The Yolanda Experience: Lessons Learned
The Yolanda Experience: Lessons Learned
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The Yolanda Experience: Lessons Learned

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44th annual convention of philippine college of physicians, may 5, 2014

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The Yolanda Experience: Lessons Learned

  1. 1. The Yolanda Experience:The Yolanda Experience: Lessons LearnedLessons Learned 44th Annual Convention of Philippine College of Physicians 5 May 2014 TEODORO J. HERBOSA, MD Undersecretary of Health Coordinator, Disaster and Rehabilitation Management Task Force
  2. 2. Outline • Introduction • What were prepared? • What happened? • What have been done? • Specific challenges and way forward
  3. 3. Introduction • On November 08, 2013, Typhoon “YOLANDA” made seven landfalls: – Guiauan, Eastern Samar, 4:40am – Dulang-Tolosa, Leyte, 7:00am – Daanbantayan, Cebu, 9:40am – Bantayan Island Cebu, 10:40am – Concepcion, Iloilo, 12:00nn – Tibiao, Antique, 3:00pm – Busuanga, Palawan • PAGASA’s morning bulletin recorded maximum sustained winds of 235 kph and gustiness of up to 275 kph • Many areas have become out of reach as the typhoon destroyed power and communication lines • Major airports and ports closed down • Major roads in greatly affected areas have become impassable due to devastating effects of the typhoon
  4. 4. Typhoon “Yolanda” Landfalls
  5. 5. Typhoon “Yolanda” Storm Surges
  6. 6. Affected Areas in Eastern Visayas
  7. 7. What were prepared? November 6: • Alert Memorandum was issued to all CHDs • Prepositioned logistics worth PhP 350M November 7 • Code Blue alert was raised in the CHDs most at risk • CHD OpCen opened for 24 hours • Continuous monitoring
  8. 8. Timeline of DOH Response Nov 6 Nov 7 Nov 8 Nov 9 Nov 10 Nov 11 Alert memo issued to all CHDs Logistics prepositioned in CHDs VI, VII, and VIII Typhoon Yolanda Landfall DOH-CO on Code Red No lifelines in affected areas Medical response teams ready to board C130 Code Blue raised in all CHDs at risk OpCen operational 24 hours Continuous monitoring of the situation DOH personnel on duty at NDRRMC No communication from CHD VIII; Only qualitative info and pictures from mainstream media CARAGA and Albay medical response teams arrived in Tacloban Continuous monitoring of the situation Secretary Ona and other officials visited Tacloban Teams from MM hospitals arrived in Tacloban Context: Unprecedented magnitude of Typhoon Yolanda effects
  9. 9. What happened?
  10. 10. What happened? Region Province Deaths Injured IV-A Quezon, Batangas 3 6 IV-B Palawan 19 63 V Albay, Masbate, Camarines Norte 6 32 VI Iloilo, Aklan, Capiz, Antique, Negros Occidental **285 2,733 VII Cebu, Bohol 74 22 *VIII Tacloban City, Leyte, Samar, Eastern Samar, Biliran 5,803 26,123 IX Zamboanga 0 1 CARAGA Surigao del Sur 0 1 Total 6,190 28,981 Note: *NDRRMC Sitrep No. 92 as of January 14, 2014 for Region VIII. **CHD VI reported 285 deaths while NDRRMC reported 294 deaths. Discrepancies in figures are still subject for validation by the CHD VI.
  11. 11. What happened? Other impactsOther impacts People CHD personnel who reported for work in the first week 15 out of 267 (5.6%) Local health personnel who reported for work in the first week Ground estimate of 10 to 20% Health Infrastructure 3 Damaged offices (Warehouse and prepositioned logistics destroyed) PHP 50,350,000.00 50 out of 91 assessed hospitals are damaged (45 partial, 5 complete; 45 functional, 5 non functional) PHP 696,810,800.00 550 out of 1,593 assessed RHU/BHS are damaged (354 partial, 183 complete; 350 functional, 180 non functional) PHP 541,239,000.00 EVRMC as the only remaining functional hospital in Tacloban with personnel on duty for 3 straight days 250 bed hospital accommodating 60 admissions reaching 300 inpatients, and 70 E.R. Consultations (daily averages)
  12. 12. What happened? Health facility status Region / Province No. of existing HF No. of assessed HF No. of damaged HF Extent of Damage Operation Status Estimated Cost of Damage Partially damaged Completely damaged Functional Non- functional Region VIII 620 289 289 177 92 177 92 1,013,119,800.00 Leyte 334 195 195 153 42 153 42 665,354,300.00 Eastern Samar 141 78 78 15 43 15 43 279,186,200.00 Western Samar 145 16 16 9 7 9 7 68,629,300.00 Region VII 1,007 74 71 19 52 19 52 29,930,000.00 Region VI 1,907 1,282 418 366 52 372 44 149,675,000.00 Region IV-B 146 42 41 41 0 41 0 100,625,000.00 Total 3,680 1,687 819 603 196 609 188 1,293,399,800.00
  13. 13. What have been done? Logistics provided SourceSource RecipientRecipient AmountAmount DOH-Central Office CHD IV A 80,640.00 CHD IV B 702,640.00 CHD V 932,658.00 CHD VI 9,736,688.26 CHD VII 8,009,607.30 Washed Out (Tacloban Airport) 1,130,897.50 CHD VIII 78,990,219.70 Sub-allotment (EAMC, V, VII, and VIII) 42,300,000.00 Total DOH Central Office logisticsTotal DOH Central Office logistics 141,883,351.00 DOH HOSPITALS CHD VIII 4,025,232.54 CHD's (I,IV-A, IV-B, V, VI, VII, VIII, X, XI, XII, MM, CAR, CARAGA) CHD IV-A, IV-B V, VI, VII,VIII 46,882,754.10 Total DOH Central Office logistics 50,907,986.64 Local Donation CHD VI, VII, VIII 14,023,226.65 International Donation CHD VII, VIII 21,006,027.40 Total donationsTotal donations 35,347,174.05 GRAND TOTALGRAND TOTAL 228,138,511.69 Note: Logistics include essential medicines, aquatabs and ORS, hospital and laboratory equipments, family tent and cot beds, cadaver bags, fogging machines, generator sets, computer equipment
  14. 14. What have been done? • As the Health Cluster lead, DOH provided support to 144 registered foreign medical teams as well as other local and international NGOs through: – Deployment coordination – Technical advice through provision of local protocols and guidelines – Health services report consolidation – Early disease warning detection and response
  15. 15. What have been done? • Facilitated the acceptance and quality control of donated medicines and medical supplies • Health promotion activities and other public health advisories • Provision of cadaver bags • Assistance to NBI and LGUs in the management of the dead
  16. 16. What have been done? • Deployment of composite team with toxicology experts to manage the secondary event of oil spill in Barangay Botongan, Estancia, Iloilo
  17. 17. What have been done? Summary of Services Areas of ServiceAreas of Service Specific AccomplishmentsSpecific Accomplishments Hospital services 34,522 patients served 2,127 operations conducted Health teams deployed (composite teams) 298 teams (154 national, 144 international). National teams are composed of 1,827 personnel). Approximately 20% were deployed to Tacloban while the rest are distributed across all affected areas Public Health services 126,299 out-patient consultations 46,865 measles immunization 12,165 tetanus vaccination No disease outbreak as of today Nutrition services 73,730 children screened for acute malnutrition (141 cases managed) 69,764 children received supplementary feeding program 33,619 children received vitamin A supplementation 27,020 children received multiple micronutrient powder 8,876 pregnant/lactating women assessed and counseled for infant and young child feeding No worsening of nutrition condition and no deaths related to malnutrition in the areas Water, Sanitation, and Hygiene services 1,747 latrines constructed/ rehabilitated 206,051 hygiene kits distributed 199,278 water kits distributed MHPSS services 1,196 recipients of Counseling 6,924 recipients of Psychological First Aid 12,875 recipients of Psychosocial Processing 32 advance case referrals
  18. 18. What have been done? Hospital services REGION No. of Patients served Consultations Admission No. of Operations Conducted Status ER OPD No. of Referral No. of Discharged No. of Deaths REGION VIII 30,375. 2,194. 30,896. 3,318. 2,046. 190. 619. 83. Leyte 30,375. 2,123. 30,810. 3,247. 1,944. 190. 600. 83. Eastern Samar 0. 71. 86. 71. 102. 0. 19. 0. Western Samar 0. 0. 0. 0. 0. 0. 0. 0. REGION VII 2,598. 0. 2,598. 149. 60. 0. 0. 3. REGION IV-B 155. 55. 61. 18. 21. 0. 0. 0. NCR (Patients from Reg.8; Villamor Airbase) 1,394. 690. 408. 226. 219. 10. GRAND TOTAL: 34,522. 2,249. 34,245. 3,893. 2,127. 416. 838. 96.
  19. 19. What have been done? Team mobilization PROVINCE CITY/MUNICIPALITY DOH TEAMS DEPLOYED (120) OTHER LOCAL HEALTH RESPONDERS (34) FOREIGN TEAMS (124) TOTAL (278) NO. OF TEAMS NO. OF PERSONNEL NO. OF TEAMS NO. OF PERSONNEL NO. OF TEAMS NO. OF PERSONNEL NO. OF TEAMS NO. OF PERSONNEL LEYTE TACLOBAN 53 626 15 367 14 279 82 1272 ORMOC 4 59 8 34 8 127 20 220 OTHERS 21 263 5 39 18 248 44 550 SAMAR EASTERN SAMAR 16 147 6 142 22 289 WESTERN SAMAR 1 11 1 11 CEBU DAANBANTAYAN, MACTAN, CAMOSTES IS., SAN REMEGIO, TABUELAN, BORBON, TOBOGON, BOGO, STA. FE, MEDELLIN 8 49 4 90 10 167 22 306 METRO MANILA VILLAMOR AIRBASE, PASAY 11 72 1 4 12 76 DSWD NROC 5 11 5 11 PALAWAN CULION 1 5 1 5 ILOILO, CAPIZ, AKLAN, ANTIQUE 4 91 1 50 2 74 7 215 OTHERS 5 12 5 12
  20. 20. What have been done? Public Health services
  21. 21. What have been done? Nutrition services
  22. 22. What have been done? WASH services REGION No. of Population Served Provision of Potable Water Water Testing Distribution of Water Container Water Treatment/ Disinfectant Provision of Water for General/ Domestic Use Construction/ Installation of Toilets & Latrines Hygiene Kits Provided* Jerry Cans Provided Others (water purifier, mobile water tanks) VIII 20,681,572 41,008 230,385 84,380 224,137 1,610 166,815 251,802 193 Leyte 20,681,572 14,631 230,137 84,200 224,137 1,590 142,271 249,217 171 Eastern Samar 0 20,905 248 180 0 20 20,020 2,585 22 Western Samar - 5,472 - - - - 2,709 - - Biliran - - - - - - - - - VII - 1,500 - - - - 3,886 - 2 VI 0 21,088 1,653 0 0 157 15,917 1,653 618 IV-B - 4,000 - - - - - - - Total 20,681,572 67,596 232,038 84,380 224,137 1,767 184,803 253,455 813
  23. 23. What have been done? MHPSS services REGION No. of Population Served PFA Community & Family Support Counselling Psycho- education session Psychosocial processing Stress Management Program Referral of cases Defusing Mental Health Services not specified VIII 1,261 245 696 113 2,205 290 17 415 1,962 Leyte 1,261 245 696 113 2,193 278 17 415 1,336 Eastern Samar 0 0 0 0 12 12 0 0 626 Western Samar - - - - - - - - - Biliran - - - - - - - - - Northern Leyte - - - - - - - - - VII 672 0 408 0 302 0 0 0 0 VI 0 0 0 0 9,917 0 0 0 0 IV-B - - - - - - - - - NCR 4,991 311 92 155 451 310 15 5 15 Total 6,924 556 1,196 268 12,875 600 32 420 1,977
  24. 24. Gaps identified In consideration of the magnitude of Typhoon Yolanda and the new normal, there is a need to: • Update logistics and lifeline needs for emergency health sector response • Ensure health facilities to remain functional during disasters • Enhance equipment and preparation of health response teams (local and international) • Update health emergency preparedness, response, and recovery plans • Update systems for health service delivery especially for mega disasters
  25. 25. Some specific challenges identified • Current procurement plan accounted mainly for non- capital outlay needs during emergency/disaster • Some operational issues on cash advance releases/ liquidation experienced • Team mobilization, composition, qualifications, and deployment not clearly defined in responding to Yolanda • Current policies and guidelines covering most aspects of health emergency and disaster response lack provisions in addressing “mega” or “new normal” emergencies and disasters • Current CHD and hospital response plans did not match the surge capacities requirements contingency and business-continuity components
  26. 26. Way forward On February 19 to 21, top management level of the Department of Health held a strategic planning workshop to increase its capacity to respond to emergencies and disasters. There were five identified strategic objectives: 1. Improve the responsiveness of policies and plans at all levels to mega disasters 2. Institutionalize effective ICS at all levels supported by functional OpCen and IMS 3. Enhance the logistics and financing capacities to support response operations 4. Build-up the resiliency of hospitals and other health facilities against mega disasters 5. Enhance the adequacy, timeliness and appropriates of health services delivered

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