Applying Interagency Concepts from Domestic Disaster Response to Foreign HA/DR

A Warm Sunny Day

It is a warm and sunny October evening in Cilegon, Indonesia. As the small city of 416,000 moves through its afternoon rush a strong shake is felt.  It stops, after two minutes, and then a loud explosion is heard coming from the west, with a large mushroom cloud enveloping the sky. Traffic on National Highway 3 is at a standstill.  People are getting out of their cars trying to determine what has just happened.  Some of them realizing that the explosion has come from the Sunda Strait abandon their vehicles, and start running south up a hill, as a thirty meter tsunami appears on the horizon heading towards the coast. Those who survive the tsunami are then enveloped in a cloud of burning ash.

Several hours later, local authorities are overwhelmed, and the Indonesian military is completely overwhelmed.  Reinforcements are being flown in from other parts of the country. The low-lying areas of Cilegon are completely destroyed, and more than 1,500 towns and villages in both Banten and Lampung Provinces are going. At least five million people are estimated to be dead. The Prime Minister accepts an offer of aid from the Ambassador of the United States. At this point, the close to ten million more people who survived the disaster lack access to food, clean water, or housing.  Furthermore, weather reports are showing that the first storm of the monsoon season will reach the affected area within the next 72 hours. Meanwhile, an Amphibious Ready Group transiting the Malacca Straits receives orders to sail to Cilegon. Its orders also indicate that the ARG Commander is to assume command of the Joint Task Force being formed from U.S. military personnel.

litho1888 Lithograph of 1883 Eruption of Krakatoa: Parker & Coward. Source: Wikipedia.

This disaster has happened before. The last major explosion of Krakatoa occurred in 1883, causing a pyroclastic flow with a 50 km radius, and sent a thirty meter high tsunami across the Sunda Strait in all directions. The noise of the explosion was heard as far away as Alice Springs, Australia, and Mauritius.  Skeletons found laying on pumice were found washing ashore in East Africa for several years afterwards. The official death toll was around thirty-six thousand. The area around Krakatoa has a significantly higher population today, and major eruptions of the mountain have been recorded as occurring between every 100-250 years.[1] It is not uncommon for disasters of a large magnitude to be followed by a subsequent event that exacerbate the conditions for survival, such as monsoon events, like Winter Storm Athena that followed a month after Hurricane Sandy.[2]

Introduction

In the scenario described above it is very likely that the assistance of the United States will be requested by the host nation, and it is very likely that in an archipelagic nation, such as Indonesia naval forces will be the first to arrive. It is also distinctly possible that a Naval or Marine officer will be appointed as Joint Task Force Commander. The doctrine on how to respond to disasters or provide humanitarian assistance depends on where a Joint Task Force is responding and whether or not it is inside or outside the United States. 

For Domestic Disaster Response/Humanitarian Assistance missions there is a set framework in the form of the Incident Command System (ICS), the National Incident Management System (NIMS), Multiagency Coordination System (MACS), and National Response Framework (NRF). These include a common operating language and procedures that allow for integration of responding agencies and unity of effort.[3] The major proponent of doctrine for domestic response within the Department of Defense is U.S. Northern Command.[4] The military forces that most commonly exercise these missions are within State Military Forces such as theArmy & Air National Guard, as well as State Defense Forces[5] and Naval Militias in those states that have such organizations.[6]

When it comes to Foreign Disaster Response and Humanitarian Assistance, there is no common operating language, procedures, and organizational structures.  Instead, the doctrine that is put forward for foreign response displays the common organizational structures needed for integration- namely where a commander should deploy Liaison Officers. However, this doctrine does not integrate common operating language and procedures to better facilitate the mission. Meanwhile, other agencies of the Federal Government, especially U.S. Agency for International Development’s Office of Foreign Disaster Assistance, not only utilize ICS and MACS in their response doctrine, but teach that doctrine to host nation response forces.[7]

Current Doctrine on Defense Support to Civil Authorities

During a domestic disaster response/humanitarian assistance operation, utilized doctrine focuses on Defense Support to Civil Authorities (DSCA) that is largely controlled by U.S. Northern Command (NORTHCOM).  The design of the DSCA mission is largely built around supporting the United States’ federalist system.  The most important laws relating to this doctrine are the Stafford Act of 1988, the Insurrection Act of 1807, and the Posse Comitatus Act of 1869. 

The concept here is that all disasters are local disasters first.  Under the Stafford Act and other supporting state legislation, when local governments are responding to a disaster and their resources become overwhelmed, they must first request assistance from surrounding counties under Emergency Mutual Assistance Compacts (EMAC).  If those resources become overwhelmed, a County Executive may request the Governor to declare a State of Emergency, which then allows the Governor to allocate funding and deploy resources to support the affected area.  In turn, if a state’s resources become overwhelmed, then the Governor will request EMAC resources from other states.  If those resources become overwhelmed, a Governor may request the President to declare a Federal State of Emergency, which allows federal resources to be allocated to the response.  During a State of Emergency declared by a Governor, State Military Forces may be utilized in the response- during a Federal State of Emergency, National Guard forces operating under Title 32 USC (Militia of the United States) orders may be utilized.[8]

3TF Blackheart Team 5 (Joint NY ARNG/NY State Guard Platoon) at the end of Operation Hurricane Sandy Phase IV, 16 December 2012). Photo taken at FOB Floyd (Floyd Bennett Field, Brooklyn, NY), Source: Author.

Under the Posse Comitatus Act of 1869, there are limits to how the Armed Forces of the United States operating under Title 10 USC may be utilized for domestic response missions. [9]  Title 10 forces cannot be used for direct response or humanitarian assistance, but can be used for various support activities.   For example, during the response to Hurricane Sandy, Marines from the Wasp Amphibious Ready Group conducted an amphibious landing at Breezy Point, Far Rockaway, Queens, and began distributing meals and heater packs.[10] However, they were later withdrawn due to issues with the Posse Comitatus Act.  Around the same time Joint Task Force Sandy (New York Army National Guard 53rd Troop Command) troops began arriving.[11] Meanwhile, the U.S. Army 19th Engineer Battalion’s Headquarters Company and two Engineer Companies deployed from Fort Knox, Kentucky, where they conducted pumping operations to mitigate flooding of twenty-seven stories of subterranean infrastructure across New York City, and the 249th Engineer Battalion provided prime power services, along with general support from the U.S. Army Corps of Engineers’ New York District.[12] 

9999A Regular Army soldier from the 249th Engineer Battalion (Prime Power), U.S. Army Corps of Engineers, turns on a generator in Lakehurst, NJ, after Hurricane Sandy. Source: U.S. Army. 1212Marines from the 26th MEU conduct an amphibious landing in the Breezy Point neighborhood of Far Rockaway, Queens, NY. Source: Department of Defense.

The provisions of the Insurrection Act of 1807 allow for the exceptions where Title 10 troops may be used for response to a disaster.  In these provisions a disaster would have to lead to law and order to break down.  Since all disasters are local, first Title 32 troops- both in the state of disaster, as well as those called in under EMAC must be unable to enforce order, and then federal troops can be utilized after the President has declared a Federal State of Emergency.[13] A great example of Title 10 troops being deployed to enforce law and order after a natural disaster was when the 82nd Airborne Division was deployed in the aftermath of Hurricane Katrina.  This occurred primarily due to the failures of the initial response, and the fact that half of the Louisiana Army National Guard (256th Infantry Brigade Combat Team), was deployed to Iraq at the time.[14]

1422Soldiers from the 82nd Airborne Division conducting Search & Rescue Operations in flooded sections of New Orleans. Source: Department of Defense.

In order to facilitate the integration of military forces at all levels, the common operating language of ICS, MACS, and NRF, are taught to National Guard troops, and troops assigned to U.S. Northern Command.  Incident Command System is organization at the tactical and operational level that allows for personnel from multiple agencies to integrate into mission-specific organizations to facilitate unity of effort- led by an Incident Commander.  For example, during the response to the Deepwater Horizon oil spill, an ICS organization was created utilizing all agencies of the U.S. Government and the Incident Commander was Admiral Thad Allen, USCG (Ret).[15] 

7ICS Organization Chart. Source: Federal Emergency Management Agency.

The Multiagency Coordination System (MACS) is the policy working group of the response. Such a group is facilitated by an Emergency Operations Center, and consists of policymakers with the ability to make strategic decisions.  Their mission is to implement policies that assist the ICS organization responding to the disaster to better accomplish their mission. Conversely the National Response Framework (NRF) is a document that establishes agency responsibilities and roles in a variety of disaster responses.[16]  

Current Doctrine for Foreign Humanitarian Assistance/Disaster Response            

The doctrine for Foreign Humanitarian Assistance/Disaster Response is similar to the doctrine for Defense Support to Civil Authorities, but there is no common operating language or framework. The doctrine first looks at how a host nation requests assistance and how a mission is assigned to military forces in an area.  When a disaster occurs, the host nation government requests assistance from the United States through the Ambassador. The Ambassador, through the Department of State, provides that request to the President, who approves or denies it. From that point the lead agency for coordination is the U.S. Agency for International Development through its Office of Foreign Disaster Assistance, which is similar to the role FEMA plays in domestic response. 

888Members of USAID’s Disaster Assistance Response Team loading aid boxes onto a U.S. Navy Seahawk Helicopter at Tacloban Airport on 17 November 2013. Source: U.S. Agency for International Development.

From this point it is determined if defense support will be needed for the mission- if so it is requested through the Department of Defense, who in turn tasks the mission to the appropriate Geographic Combatant Command.  In turn, the Geographic Combatant Commander will appoint a JTF Commander, who will provide resources.  Once the Joint Task Force arrives on site, it must integrate with other agencies of the U.S. Government, host nation forces, and any International/NGO forces.  How that integration occurs is completely up to ad-hocracy, coming up with an organizational structure on the fly.[17] 

The doctrine primarily focuses on where to deploy Liaison Officers.  It recommends deployment to a series of coordination centers for: the host nation Government, the U.S. Embassy, UN Country Team/Mission Headquarters, Information Centers, Intelligence Centers, and the list goes on.  Most importantly, the focus is that the U.S. Government Joint/Interagency Task Force responding to this disaster has to respond immediately, but go through the entire process of integration and develop a common operating language simultaneously. 

854Marines in Manila, Philippines, loading pallets of USAID relief boxes onto a KC-130 to be delivered to victims of Super Typhoon Haiyan in Tacloban on 15 November 2013. Source: U.S. Agency for International Development.

Recommendations for ICS Doctrine in Foreign Humanitarian Assistance/Disaster Response

ICS doctrine should be adapted to Foreign Humanitarian Assistance/Disaster Response, in order to help increase the efficiency of U.S. Armed Services response to foreign disasters.  ICS is already being utilized by civilian U.S. Government agencies for their response doctrine, especially the USAID, which is the federal coordinating agency for foreign disaster response. The federalist system of disaster response currently utilized in statutes and doctrine is similar to foreign response. The United States is after all a supranational organization of fifty sovereign states (who have given up little chunks of their sovereignty).  Each state has its own government structure and security forces (including military forces) that operate under the orders of a Governor, and the United States Government cannot intervene without the request of that Governor (except for limited circumstances). Such a system can be in place for international response.

A basic ICS education should be taught to all service members who may be deployed on a foreign HA/DR mission. This is a very simple syllabus, and could be taught over short periods of time, and would include curriculum already available through the FEMA Independent Study Program. The various centers where LNOs can be deployed can simply be defined as Emergency Operations Centers, and JTF Commanders can integrate at a minimum with other U.S. Government Agencies in an ICS Organizational HQ. The Ambassador, USAID Response Team, and Global Combatant Command Response Team can serve as a MAC Group for U.S. Government Response, and integrate with the Host Nation’s policymaking group. A Joint Interagency Task Force at the Global Combatant Command can serve as a reach back center for the MAC Group, and in turn reach back to National Command Authority in Washington. 

In order to facilitate an integrated doctrine for both Defense Support to Civil Authorities and foreign HA/DR, it would be important to centralize proponency for that doctrine. The best place to do so would be within the Political-Military Affairs Branch of the J-5 Directorate (Strategic Plans & Policy) of the Joint Staff. At a minimum, integrating this common operating language and structure into the doctrine for Foreign HA/DR will allow U.S. Military Forces to integrate with other U.S. Government agencies.  Domestic and foreign disaster assistance should utilize doctrine that is built around integrating military forces into a whole of government response, whether or not they are forces from the National Guard under state control integrating with state and federal agencies or federal troops integrating with host nation response agencies during a disaster.

Conclusion

Both domestic and foreign Disaster Response/Humanitarian Assistance missions are essentially the same mission, but simply occur in different spaces. Both missions should have the same doctrine, in order to help U.S. military forces integrate with other response forces quickly in order to more efficiently respond to disasters. Integrating the ICS, MACS, and NRF doctrine from FEMA into the training for active duty forces that may perform HA/DR abroad will help achieve the goals of that mission. 

Robert C. Rasmussen is a Second Lieutenant in the New York State Guard, and currently serves as the Aide-de-Camp to the Commanding General of the New York State Guard.  He holds a MA in International Relations and a CAS in Security Studies from Syracuse University, and BA in International Relations & Geography from SUNY Geneseo.  He served on State Active Duty in support of Operation Hurricane Sandy from November 2012-January 2013.  His views are his own and do not reflect those of the New York State Division of Military & Naval Affairs.

[1] Dunk, Marcus,  “Will Krakatoa Rock the World Again?  Last Time It Killed Thousands and Changed the Weather for Five Years, Now It Could Be Even More Deadlier…”  Daily Mail Online,  31 July 2009, http://www.dailymail.co.uk/news/article-1203028/Will-Krakatoa-rock-world-Last-time-killed-thousands-changed-weather-years-deadlier.html.

[2] Author participated in disaster relief operations attached to Task Force Blackheart (642nd Aviation Support Battalion, NY ARNG) and Team Sandy (Joint Task Force Empire Shield) from 19 November 2012-22 January 2013.

[3] Federal Emergency Management Agency, “National Incident Management System,” https://www.fema.gov/national-incident-management-system

[4] Department of Defense, “Joint Publication 3-28: Defense Support to Civil Authorities,” http://www.dtic.mil/doctrine/new_pubs/jp3_28.pdf, 31 July 2013.

[5] Department of Defense Inspector General, “Evaluation of Department of Defense Interaction with State Defense Forces,” 30 April 2014, http://www.dodig.mil/pubs/documents/DODIG-2014-065.pdf

[6] McNeil, Deano, “Naval Militia: an Overlooked Domestic Emergency Response Option,” In Homeland Security, 30 April 2015, http://inhomelandsecurity.com/naval-militia-an-overlooked-domestic-emergency-response-option/

[7] U.S. Agency for International Development, “Disaster Risk Reduction- East Asia & the Pacific,” 30 September 2012, https://www.usaid.gov/sites/default/files/documents/1866/eastasia_drr_fs01_09-30-2012.pdf

[8] Federal Emergency Management Agency, “IS-700: Introduction to the National Incident Management System,”  31 October 2013, https://training.fema.gov/is/courseoverview.aspx?code=IS-702.a

[9] National Guard Association of the United States, “NGAUS Fact Sheet: Understanding the Guard’s Duty Status,” http://www.ngaus.org/sites/default/files/Guard%20Statues.pdf.

[10] II Marine Expeditionary Force, “Marines Land at Breezy Point,” 9 November 2012, https://www.youtube.com/watch?v=XZhZFRRgtWg.

[11] Author served with the New York State Guard Element of Headquarters, Joint Task Force Sandy from 3-19 November 2012.

[12] U.S. Army Corps of Engineers New York District, “Army Corps Responds to Hurricane Sandy,” New York District Times, January 2013, http://www.nan.usace.army.mil/Portals/37/docs/nydistricttimes/2013/New%20York%20District%20Times%20Hurricane%20Sandy%20Edition.pdf

[13] Brinkerhoff, John, “Understanding the Posse Comitatus Act and the Insurrection Act,” Defense Technical Information Center, 2008, http://www.dtic.mil/dtic/tr/fulltext/u2/a494995.pdf

[14] Department of the Army, “The Army Responds to Hurricane Katrina,” 10 September 2010,  http://www.army.mil/article/45029/The_Army_response_to_Hurricane_Katrina/

[15] Marine Log, “Thad Allen Named National Incident Commander for Deepwater Horizon Spill,” 1 May 2010,  http://www.marinelog.com/DOCS/NEWSMMIX/2010may00010.html.

[16] Federal Emergency Management Agency, “IS-701: NIMS Multiagency Coordination System,”  12 October 2010, https://training.fema.gov/is/courseoverview.aspx?code=IS-701.a

[17] Department of Defense, “Joint Publication 3-29: Foreign Humanitarian Assistance,” 3 January 2014, http://www.dtic.mil/doctrine/new_pubs/jp3_29.pdf

Featured Image: Soldiers assist residents displaced by Hurricane Sandy in Hoboken, N.J., Oct. 31, 2012. The soldiers are assigned to the New Jersey National Guard. U.S. Army photo by Spc. Joseph Davis.

Komisi VIII : anggaran penanganan bencana perlu ditambah

Komisi VIII : anggaran penanganan bencana perlu ditambah
Kemensos ini radiusnya kelihatan besar dan cakupannya luas sekali seluruh Indonesia karena itu perlu dipikirkan oleh pemerintah untuk menambah anggaran,”

Jakarta (ANTARA News) – Ketua Komisi VIII DPR RI Saleh Partaonan Daulay mengatakan anggaran penanganan bencana di Kementerian Sosial perlu di tambah karena melihat luasnya cakupan penanganan di seluruh Indonesia.

“Kemensos ini radiusnya kelihatan besar dan cakupannya luas sekali seluruh Indonesia karena itu perlu dipikirkan oleh pemerintah untuk menambah anggaran,” kata Saleh Daulay pada HUT ke-12 Tagana di Tagana Training Center di Sentul Bogor, Selasa.

Dia mengatakan saat ini anggaran di Kemensos mencapai Rp300 miliar untuk penanganan bencana alam. Namun perlu diketahui bahwa penanganan bencana juga dilakukan bersama-sama dengan Kementerian Dalam Negeri, Basarnas dan Badan Nasional Penanggulangan Bencana (BNPB).

“Kalau digabung secara keseluruhan sebetulnya besar juga termasuk diantaranya pemda karena pemda juga memiliki anggaran untuk itu,” tambah dia.

Tapi setidaknya kebutuhan-kebutuhan pokok yang diinginkan oleh Kemensos bisa dicapai misalnya buffer stok atau stok penyangga.

“Itu anggaran untuk mengantisipasi sewaktu-waktu ada bencana jadi mereka ada makanan, selimut, tenda kebutuhan air bersih dan sebagainya di daerah-daerah yang memang rawan bencana. Itu hal pokok karena jangan sampai terjadi bencana bantuan kemanusiaannya datang terlambat,” ujar Saleh.

Dia mengatakan yang bisa memberikan bantuan kemanusiaan pada saat situasi darurat seperti itu yang pertama sekali adalah pemerintah maka pemerintah harus menyediakannya.

Di samping itu juga masalah logistik seperti perahu karet, tenda yang besar, dapur umum memang harus disiapkan. Terlebih lagi tugas Kemensos dalam koordinasi penanggulangan bencana adalah memberikan bantuan pada mereka yang ada di pengungsian.

Sementara Basarnas melakukan evakuasi, PMI memberi pertolongan kesehatan pertama sedangkan Kemensos tugas utama adalah memberikan perlindungan di tempat pengungsian.

“Di tempat pengungsian itu harus disiapkan semua kebutuhannya

Kalau anggaran kecil tentu seperti yang ada di rapat komisi VIII mereka menganggap anggaran seperti ini masih jauh dari kebutuhannya. Saya kira pemerintah juga sudah memikirkan itu tapi dengan segala keterbatasannya kita akan mendorong terus,” kata Saleh.

Editor: Ruslan Burhani

Students need disaster preparedness skills

Mr Khamis Arazak, the Coordinator for ‘Disaster Preparedness and Management Commission (DPMC)’ in Pemba, said that children in schools at all levels should understand the need for disaster preparedness so that they can rescue themselves or help others in case of disasters while at home or in school.

“Natural disasters and those caused by man are becoming common. We have decided to educate children in schools so that they remain well prepared,” said Mr Arazak. Students at the Benjamin William Mkapa College of Education at the State University of Zanzibar (SUZA) were among the students in Pemba to benefit from the disaster preparedness awareness campaign.

He said lack of knowledge about disaster preparedness remains a big challenge among communities in Zanzibar and that his office has decided to run an awareness campaign so that people including children can be in a better position to respond to disasters.

Mr Makame Khatib Makame from DPMC told the students at SUZA that a house or a village can be hit by disasters if it is located in a risky area.

“Causes of disasters are many including climate change, improper disposal of wastes, political unrests, environmental ruin by sand digging and felling of trees. Ms Jokha Hakim Seif, a students’ president, commended the (DPMC) for the awareness programmes, saying it should be extended to villages.

Prambanan Miliki Lima Potensi Bencana Sekaligus

Sejumlah warga menangani korban longsor dalam simulasi bencana yang digelar di Taman Tebing Breksi, Sambirejo, Prambanan, Kamis (3/3/2016). (Abdul Hamied Razak/JIBI/Harian Jogja)

SLEMAN– Dibandingkan 16 kecamatan lainnya di Sleman, Kecamatan Prambanan yang berada di Timur DIY merupakan wilayah yang paling rawan mengalami bencana. Uniknya, wilayah ini memiliki lima potensi bencana sekaligus.

Kepala Badan Penanggulangan Bencana Daerah (BPBD) Sleman Julisetiono Dwi Wasito mengatakan, Kecamatan Prambanan termasuk daerah yang unik. Pasalnya, dari tujuh macam bencana yang berpotensi dan mengancam wilayah Sleman, lima di antaranya berada di wilayah Prambanan.

“Mulai bencana tanah longsor, angin kencang, banjir, kekeringan dan gempa bumi,” ucapnya, Minggu (27/3/2016).

Meski memiliki potensi bencana yang besar namun Setiono menilai masyarakat di kecamatan Prambanan sudah tangguh dan siap menghadapi kemungkinan terjadi bencana. Saat bencana terjadi, katanya, relawan dan warga cepat menanganinya. Dia berharap, masyarakat memiliki kesadaran tinggi terkait mitigasi bencana.

“Kesiapsiagaan bencana warga termasuk tinggi. Sampai saat ini kami memiliki 39 kelompok relawan dengan 1.500 lebih relawan. Mereka selalu siap siaga membantu pemerintah saat terjadi bencana,” katanya.

“Kami memberikan pelatihan secara rutin. Tentu disesuaikan dengan resiko bencana yang dihadapi. Penanganan korban bencana erupsi dengan tanah longsor tentu tidak sama. Termasuk simulasi. Kalau terjadi bencana, baik masyarakat maupun relawan sudah benar-benar tanggap,” imbuhnya.

Mitigasi bencana yang ditanamkan kepada warga juga termasuk tata letak rumah. Seperti tidak menempatkan ruang tidur yang berdekatan dengan tebing. Ruangan yang dekat tebing bisa digunakan sebagai dapur atau gudang. Untuk tempat tidur, ruang keluarga atau yang sering buat aktivitas juga harus jauh dari tebing.

“Merelokasi mereka untuk pindah bukanlah hal yang mudah. Makanya kami sarankan agar mereka mengatur tata letak rumah mereka. Tujuannya untuk meminimalisir korban jiwa jika terjadi bencana,” ujarnya.

Camat Prambanan Abu Bakar menyontohkan, sejumlah titik lokasi yang berpotensi longsor meliputi Desa Gayamharjo, Wukirsari, Madurejo, Sambirejo, Bokoharjo hingga Sumberharjo. Potensi bencana itu mengancam ribuan jiwa mereka tersebar di hampir seluruh desa.

“Keberadaan perbukitan di Prambanan rawan tanah longsor. Berdasarkan pemetaan yang kami lakukan dari 62 padukuhan, 18 di antaranya rawan longsor. Selama musim penghujan ini, bencana yang sering muncul justru pohon tumbang akibat angin kencang,” katanya.

sumber: Harianjogja.com

Seminar Persiapan Rumah Sakit Dalam Penanggulangan Bencana

bencana-asm

“Pemantapan Konsep HDP: Analisis Kesenjangan HICS, HOSDIP dan HOPE”

bencana-asm

Dalam seminar ini, bersama-sama kita membahas mengenai pendekatan klaster dalam penanggulangan bencana, salah satunya klaster kesehatan. Materi ini akan dibahas oleh Pusat Krisis Kesehatan Kemenkes RI, kemudian didukung juga oleh upaya Dinas Kesehatan dalam mensosialisasikan penanggulangan bencana di daerah untuk mendorong rumah sakit membuat HDP-nya, dan diisi juga oleh pengalaman PKMK dalam pendampingan HDP bagi rumah sakit.
Materi sesi pertama di atas mengantarkan kita untuk masuk pada materi berikutnya mengenai Pemantapan Konsep Hospital Disaster Plan. DI sesi ini akan dibahas lebih detil mengenai Modul HDP, bagaimana penerapannya di rumah sakit, hingga bagaimana kaitannya dengan K3 di rumah sakit. Pembaca sekalian, selamat menyimak Klik Disini

Mendefinisikan Bencana: Kebutuhan Harmonisasi Terminologi

Ada kebutuhan untuk menyelaraskankan definisi bencana dari banyak kamus dan sumber lainnya, hal ini penting sebagai dasar ke depan untuk praktek, kebijakan dan penelitian. Sebagai langkah awal, tim peneliti menganalisis definisi bencana, yang ditemukan dari buku, laporan dan website. Salah satu sumber ini adalah Perpustakaan Nasional Kedokteran (National Library of Medicine/NLM), Amerika Serikat yang berisi 62 definisi terkait bencana. Selengkapnya Klik Disini

Can Health Care Providers Afford to be Ready for Disaster?

Description: <a href=

Selamat berjumpa pembaca website bencana kesehatan. Bagaimana jawaban kita dari pertanyaan di atas? Bahkan negara seperti US saja, sektor kesehatannya kewalahan dalam mempersiapkan dan menghadapi bencana. Artikel berikut ini baik sekali untuk kita baca, Klik Disini

Sektor kesehatan tidak lagi bergerak pada saat respon, melainkan harus ikut merencanakan penanggulangan bencana di daerah dan nasional. Di Indonesia, ada dinas kesehatan, rumah sakit, puskesmas, klinik kesehatan, perguruan tinggi kesehatan, dan masyarakat relawan terlatih kesehatan harus terlibat dalam perencanaan dan mempersiapkan diri. Berulang kali dalam tulisan di atas, penulis dan narasumber menyebutkan mengenai latihanlah yang dapat mendidik kita untuk agar siap dalam menghadapi bencana dan kekacauan yang ditimbulkannya.

Pembaca sekalian, dua minggu lalu telah diselenggarakan juga seminar nasional yang berjudul Kebijakan, Implementasi, dan Kendala dalam Pelaksanaan SPGDT Pra Rumah Sakit. Secara ringkas dalam seminar ini disosialisasikan mengenai National Command Center yang berpusat di Kementerian Kesehatan untuk kasus kegawatdaruratan di Indonesia. Pelaksanaan ini akan dilakukan bertahap bagi daerah-daerah di Indonesia yang dimulai dari daerah yang telah siap secara fasilitas, sarana dan prasarana. Ini merupakan kabar gembira bagi penggiat bencana kesehatan di Indonesia bahwa upaya kita untuk menyiapkan pemerintah, swasta, dan masyarakat sudah mulai mendapat dukungan.

Pembaca sekalian, masih ingat mengenai salah satu agenda kebijakan dalam penanggulangan bencana yang dirumuskan oleh Pusat Kebijakan Manajemen Kesehatan FK UGM dalam Diskusi Outlook 2016 Januari lalu mengenai Kebijakan Kurikulum Manajemen Bencana Kesehatan di Perguruan Tinggi Kesehatan di Indonesia? Upaya kami untuk mempublikasikan dan mengadvokasi kebijakan ini bersambut baik oleh redaksi World Association on Disaster and Emergency Medicine (WADEM) Newsletter OCEANIA pada 5 Februari lalu, pada terbitan kedua di 2016 ini artikel kami yang berjudul Challenges for Curriculum Development in Disaster Health Management: What we Can Do? Telah diterbitkan bersama artikel lainnya. Silakan download dan simak Klik Disini

Preparing for disaster in Tokyo / Apartment residents take initiative in preparedness

http://crossroads.org/images/full/MI-Disaster%20Preparedness%20Team%20-Emergency-Checklist-Web-LG.jpg

The Rune Kichijoji 14-story apartment, located in the Kichijoji-Minami district of Musashino, Tokyo, is home to approximately 150 households. One weekday afternoon in late February, walkie-talkie training was held at the apartment for members of its self-appointed disaster-preparedness committee. About 30 members participated: two or three per floor, with most of them women in their 60s and 70s.

Five years ago, in the aftermath of the Great East Japan Earthquake, the building’s elevators stopped working. “What will happen if an even worse quake hits?” said worried resident Keiko Adachi, 64. In response to her appeals, the committee was formed in 2013.

Adachi was partly spurred by a disaster-preparedness session held by the city, at which she was told, “If a building isn’t damaged, we want residents to stay at home instead of going to a shelter.”

The committee took half a year to create two handbooks: a general one for residents and one for committee members. They contain important points to note in times of disaster, such as “the elevators, water and toilets will be out of service” and “every household will be expected to store their own food and water supplies.” They also provide instructions on using the emergency dialing service.

Residents formulated an emergency action plan. If a quake measuring at least lower 5 on the Japanese seismic intensity scale of 7 hits, the committee will establish a task force headquarters in the assembly hall on the building’s first floor.

The cost of the 14 walkie-talkies, one for each floor, that the committee purchased was covered by the apartment’s administrative fees and Land, Infrastructure, Transport and Tourism Ministry subsidies.

The apartment was constructed 38 years ago, and has long seen strong interaction among its residents through events such as parties in the assembly hall.

“The planning is like an extension of our everyday chitchat, so we’ve been able to keep it up and move forward,” Adachi said with a smile.

Shelters prioritized     

According to a 2013 Tokyo metropolitan government survey, there are 133,000 apartments in Tokyo. Housing estimates compiled by the Internal Affairs and Communications Ministry the same year say that 3 million households, or 46 percent of the overall total, live in apartments. In Chuo Ward, the percentage is 88 percent.

If the power goes out and elevators stop functioning, residents of a building will need to go up and down the stairs in order to access restroom facilities and water supplies. Shelters will have priority for aid supplies, and it is not believed such supplies will be distributed to apartments.

Rune Kichijoji’s initiative is being supported by the Mansion Life Continuity Association based in Chiyoda Ward, Tokyo. Its managing director, Taro Iida, 73, said: “Authorities will concentrate lifesaving efforts on areas with a high density of wooden residences, and apartments won’t receive assistance until later. Residents of apartments need to train on a regular basis and store emergency reserves so they can survive on their own.”

Tokias is a 20-story condominium located near JR Minami-Senju Station in Arakawa Ward, Tokyo. One Sunday in late February, about 15 residents whose ages ranged from middle school age to their 90s gathered in the first-floor meeting room to discuss plans.

“When you are unaware of what kind of people are living in a place, you can’t guess whether there might be injured people in a given room,” one of them said. After it was decided that the residents should meet and become acquainted with one another, a meet-and-greet event was proposed.

The building is 11 years old and has 620 households. Yuji Hirasawa, 52, became the community association’s chairman in 2008. In exchanging information with other apartments, Hirasawa became aware of the importance of making an effort in disaster preparedness. In 2014, he began his second term as chairman and launched a variety of initiatives.

To draw up a list of the building’s residents, he revised the management agreement so it requires residents to provide occupant information annually. He also introduced a system for residents to confirm their safety via the Internet.

There is still much to be done. About 300 people gather every October for the disaster drill — a big increase compared to previous years, which attracted only dozens of residents — but the overall participation rate is still only 17 percent. According to a survey conducted among the tenants in December, only 60 percent have stockpiled enough food and water for three days.

Hirasawa said passionately: “We don’t have a goal in addressing disaster preparedness. I’m just going to stay tenacious and keep calling everyone together. Little by little, I want to create a disaster-preparedness plan that suits our needs here at Tokias.

Reportase Sesi 1: Seminar Persiapan Rumah Sakit Dalam Penanggulangan Bencana

sesi-1

Reportase Sesi 1:

Seminar Persiapan Rumah Sakit Dalam Penanggulangan Bencana

sesi-1

Dalam rangka Annual Scientific Meeting (ASM) 2016 FK UGM, Pokja Bencana Kesehatan bekerjasama dengan PKMK FK UGM turut berpartisipasi melalui penyelenggaraan seminar sehari dengan tema Persiapan Rumah Sakit dalam Penanggulangan Bencana. Kegiatan ini digelar di FK UGM Jumat 18 Maret 2016.

Dalam sambutannya, Dekan FK UGM, Prof. DR. dr. Teguh Aryandono, SpB(K)Onk mengapresiasi kegiatan ini karena perlu kiranya sikap sadar bencana dipraktekkan oleh semua pihak, terutama di negara Indonesia yang merupakan daerah bencana. Dekan FK UGM juga berharap Hospital Disaster Plan (HDP) ini dimiliki oleh rumah sakit di seluruh Indonesia, agar risiko bencana dapat diminimalisir.

Membuka sesi 1, dr. Handoyo Pramusinto, SpBS selaku moderator menjelaskan bahwa sekitar 70% rumah sakit yang ada di DIY memang sudah memiliki HDP, tetapi bagaimana standar dan kualitas HDP nya perlu dievaluasi lagi?.

Sementara itu, bergabung via Webinar (teleconference) dari Jakarta pembicara Sesi 1 dr. Achmad Yurianto selaku Kepala Pusat Krisis Kesehatan Kemenkes RI, yang mempresentasikan tentang Klaster Kesehatan. HDP muncul karena terjadinya pergeseran paradigma dalam pengelolaan bencana, yang sebelumnya lebih difokuskan pada penanggulangan pasca bencana, kini bergeser ke manajemen risiko pra bencana yang ternyata lebih efektif dalam pengurangan risiko. Kaitannya dengan sistem klaster, sistem klaster dibuat berdasarkan keputusan kepala BNPB no. 173 tahun 2014, agar tidak terjadi tumpang tindih dalam proses penanggulangan bencana sehingga masing-masing pihak terkait dapat bekerja secara cepat, tepat, dan akurat sesuai tupoksi masing-masing. Saat ini terdapat 8 klaster dalam mekanisme PRB, dan klaster kesehatan termasuk salah satu diantaranya. Tugas utama klaster kesehatan meliputi layanan kesehatan, DVI, kesehatan reproduksi, kesehatan jiwa, gizi, air, dan sanitasi. Namun dari sistem klaster ini permasalahan yang masih ada diantaranya belum dibuatnya ketentuan terkait tata kerja antar klaster sehingga overlap masih kerap terjadi, dan belum disosialisasikan ke tingkat pemda sehingga koordinasi dengan lembaga lain terkait di tingkat daerah masih kurang baik.

Kemudian Kudiana, SKM,MSc dari Dinkes DIY menyebutkan bahwa Hospital Disaster Plan (HDP) telah diatur dalam Permenkes No. 64 tahun 2013; yang esensinya memperkuat koordinasi dan kemitraan antar sumber daya, optimalisasi sarana prasarana yang ada, dan informasi penanggulangan krisis kesehatan secara cepat-tepat-akurat. Bahkan menurut Permenkes No.12 tahun 2012, HDP sudah masuk dalam DEP Akreditasi rumah sakit. Adapun peran Dinkes dalam HDP adalah mendorong terbentuknya HDP di rumah sakit di wilayahnya dengan memberikan pelatihan HDP bagi rumah sakit.

Berdasarkan pengalaman saat turun langsung ke lapangan pasca bencana, dr. Sulanto Saleh Danu, SpFK selaku konsultan bencana kesehatan dari PKMK FK UGM menjelaskan, bahwa dari sisi kesehatan ada 2 hal yang perlu diperhatikan. Yakni setelah terjadi krisis atau bencana, apakah rumah sakitnya hancur atau rumah sakitnya utuh tetapi menerima banyak korban bencana. Hal ini penting untuk merumuskan HDP yang tepat untuk masing-masing wilayah karena karakteristik bencana antar wilayah tentunya berbeda. Dr. Sulanto juga membagikan berbagai pengalaman menarik selama mendampingi pembuatan HDP, mulai dari fase persiapan yang ternyata tidak semua RS siap karena hanya ingin memiliki HDP sebagai syarat akreditasi, baik dari sisi infrastruktur maupun tingkat pengetahuan SDM nya. Hal-hal tersebut diharapkan dapat menjadi lesson learned agar rumah sakit dapat memperbaiki HDP nya.

Berbagai pertanyaan turut mewarnai sesi diskusi, seperti bagaimana efektivitas SPGDT online yang saat ini sedang dirintis oleh Dinkes DIY? Perumusan anggaran PRB? Koordinasi klaster kesehatan dengan lembaga lain antar klaster? Serta mengapa simulasi bencana yang sepertinya sudah sangat baik tidak sejalan dengan praktek di lapangan saat bencana terjadi?.

Reportase oleh Edna

Reportase Sesi 2: Seminar Persiapan Rumah Sakit Dalam Penanggulangan Bencana

adib

adib

Bom Sarinah Thamrin yang terjadi beberapa waktu lalu membuat salah satu RS di sekitar lokasi menerapkan Hospital Disaster Plan (HDP) yang sempat disusun sebelumnya. Bahkan, tiga hari sebelum terjadinya bencana bom (teror) ini, RS tersebut melakukan simulasi terror. Sehingga, terror Sarinah menjadi simulasi kedua bagi staf medis di RS tersebut. Mereka menyebut system komando saat bencana di RS-nya dengan nama White Code. Hal ini dituturkan oleh dr. Adib Abdullah Yahya, MARS (PERSI). Catatannya, penting untuk melakukan latihan atas HDP yang disusun suatu RS.

Apa yang harus disiapkan saat masa Response ini? Hal pertama yang harus dipikirkan ialah bagaimana sistem komando yang harus dilakukan seluruh pihak dalam penanggulangan bencana ini. lalu apa yang harus disiapkan uuntuk menyusun HDP? Pertanyaan ini terjawab dalam  sesi penyusunan dan penerapan HDP dalam Seminar Penerapan Hospital Disaster Plan di Rumah Sakit.

Materi dalam penyusunan HDP antara lain, kebijakan direktur, sistem komando, protap (SOP), dukungan administrasi, denah RS dan sekitar, fasilitas (pos komando saat bencana seharusnya ditaruh di depan RS, mudah diakses, dan ada sarana komunikasi), lalu kapasiitas darurat. Hal yang perlu dipahami bersama ialah HDP bukan untuk menghindari chaos, tapi memperpendek masa chaos tersebut, ungkap dr. dr.Hendro Wartatmo, SpB, KBD (Pokja Bencana FK UGM).

Saat bencana terjadi, harus ada disaster commander yang mengepalai seluruh kegiatan tanggap darurat atau penanganan pasien di suatu RS. Untuk RS yang kecil, disaster commander ini bisa dijabat orang lain, selain Direktur RS. Namun untuk RS besar dengan pasien yang sangat banyak, disaster commander-nya ialah direktur RS, ungkap dr. Adib Abdullah Yahya, MARS (PERSI). Adib menjadi pembicara kedua di sesi ini.

Saat penanggulangan bencana, harus menggunakan kartu tugas dalam penanganan pasien. Kartu tugas ini mencakup job action sheet, perlu diatur tanggung jawab masing-masing, perlu ditulis garis kewenangan yang jelas (lengkap, disimpan di posko dan bisa ditaruh di IGD), serta identifikasi personel yang akan bergerak saat penanggulangan bencana.

Catatan penting lainnya yang harus disiapkan antara lain: pusat komando, sistem komunikasi, manajemen lalu lintas, keamanan, pengunjung, sukarelawan, penerimaan korban, lokasi utama. Tim lapangan, daftar kontak, RS yang terisolasi dan training. Selain itu, harus ada peta Jawa, wilayah kejadian bencana, serta peta RS per ruangan atau bagian.

Hal lain yang perlu diperhatikan, perlu regulasi yang mengatur persediaan obat saat terjadi bencana. Dulu, persediaan obat semacam ini dianggap inefisiensi oleh Badan Pemeriksa Keuangan (BPK) dan akhirnya menjadi temuan auditor. Kita perlu belajar dari pergudangan yang dimiliki tentara nasional Indonesia. Sekitar sepertiga dari gudang mereka diperhitungkan untuk masa-masa perang, antara lain suplai obat-obatan, amunisi, bahan makanan dan lain-lain (Wid).