Humanitarian

Emergencies
Public Health in Action
(GEH1049/GEC1015)
Dr Liow Chee Hsiang
Session Outline
1. Definitions and 3. Humanitarian
2. Determinants of
Characteristics of Coordination
Disaster Risk
Disasters Architecture

4. Disaster
Management Cycle

5. Example
1. Definitions and
Characteristics of
Disasters
Humanitarian Emergencies Definition

“An event or series of events that represents a critical threat to the

health, safety, security or wellbeing of a community or other large
group of people, usually over a wide area.” (Humanitarian Coalition)

• Types:
o Natural (earthquakes, floods, hurricanes, volcanoes, landslides, wildfires etc)
o Man-made (conflict, environmental degradation, pollution, industrial
accidents)
o Complex (disaster + conflict/political instability)
Hazards
Characteristics of Disasters
1. Large displaced population
2. Population usually settled in temporary locations
• High population densities
• Inadequate food/shelter
• Unsafe water
• Poor sanitation
• Infrastructure compromised or destroyed
3. Increase risk of transmission of “epidemic-prone diseases”
(mainly infectious diseases) → increase mortality
 Public Health International Health Global Health

Geographical Focuses on issues that affect the Focuses on health issues of Focuses on issues that directly or
reach health of the population of a countries other than one’s own, indirectly affect health but that
particular community or country esp those of low-income and can transcend national
middle-income boundaries

Level of Does not usually require global Usually requires binational Often requires global cooperation
cooperation cooperation cooperation

Individuals or Mainly focused on prevention Embraces both prevention in Embraces both prevention in
populations programmes for populations populations and clinical care of populations and clinical care of
individuals individuals

Access to Health equity within a national or Seeks to help people of other Health equity among nations and
health community is a major objective nations for all people is a major objective

Range of Encourages multidisciplinary Embraces a few disciplines but Highly interdisciplinary and
disciplines approaches, particularly within has not emphasised multidisciplinary within and
health sciences and social multidisciplinarity beyond health sciences
sciences

Koplan et al. Lancet 2009; 373: 1993-95.

Key Elements of Global Health (Review)
1. Transcends national boundaries
2. Requires global cooperation
3. Prevention and clinical care
4. Health equity for all
5. Interdisciplinary, multidisciplinary within and beyond health
sciences
Session Outline
1. Definitions and 3. Humanitarian
2. Determinants of
Characteristics of Coordination
Disaster Risk
Disasters Architecture

4. Disaster
Management Cycle

5. Example
2. Determinants of
Disaster Risk
Determinants of Disaster Risk

Resilience

World Risk Report 2021, Bündnis Entwicklung Hilft

 Risk = Exposure x Vulnerability
Probability Natural hazards Societal sphere
of loss sphere

Resilience

Vulnerability = (Susceptibility – Coping – Adaptation)÷3

Public Infrastructure (access to basic sanitation and drinking services Govt & Authorities (corruption + fragility)
Housing conditions (slums, fragile dwellings) Medical Services (physicians + hospital beds)
Nutrition (undernourished) Material Coverage (insurance)
Poverty & Dependency
Economic Productivity & Income Distribution (GDP + Gini Index)

Education & Research (literacy)

Gender Equality
Ecosystem Status & Environmental Protection
Investments (public/private health expenditure)
Singapore
2.5
Session Outline
1. Definitions and 3. Humanitarian
2. Determinants of
Characteristics of Coordination
Disaster Risk
Disasters Architecture

4. Disaster
Management Cycle

5. Example
3. Humanitarian
Coordination
Architecture
IASC Humanitarian Coordination Architecture

Most senior UN official dealing HC Humanitarian Coordinator

with humanitarian affairs RC Regional Coordinator
ERC Emergency Relief Coordinator
Key UN and non-UN ECOSOC Economic and Social Council
humanitarian partners (FAO, GA General Assembly
UNDP, UNFPA, UNICEF, WFP, OCHA UN Office for the
WHO etc) Coordination of Humanitarian
Affairs
Assumes leadership of HCT in
crisis. Appointed by ERC/IASC

In-country decision making

forum. Membership mirrors
IASC at country level.

Disaster Response in Asia and the Pacific. OCHA 2013

Emergency Preparedness & Response Plan. OCHA (Pacific). 2013
Reference module for cluster coordination at country level. IASC 2015
Session Outline
1. Definitions and 3. Humanitarian
2. Determinants of
Characteristics of Coordination
Disaster Risk
Disasters Architecture

4. Disaster
Management Cycle

5. Example
 4. Disaster
Management Cycle
Training, policy and

DISASTER
procedure creation,
relationship building
among service providers Rescue, medical
and communities attention, food, water,
temporary shelter

Day 0
Public health reduces
risks by assessing needs,
Public health can Media
targeting responses,
mitigate risks to prepare Coverage ensuring quality of care
for next disaster
Engagement of local
population in planning
and reconstruction of Food, water, long-term
communities shelter, sanitation,
healthcare, return to
school and work

Based on the “Disaster Management Cycle”: Craig Williams (OCHA RO-AP), Cynthia Strauss (Fidelity Charitable), Gilbert Burnham (JHU), LCH 2017
Training, policy and

DISASTER
procedure creation,
relationship building
among service providers Rescue, medical
and communities attention, food, water,
temporary shelter

Day 0
Media
Coverage

Engagement of local
population in planning
and reconstruction of Food, water, long-term
communities shelter, sanitation,
healthcare, return to
school and work

Based on the “Disaster Management Cycle”: Craig Williams (OCHA RO-AP), Cynthia Strauss (Fidelity Charitable), LCH 2017
Response Phase
• Emergency Classifications (IASC/IOM)

• Level 1: National Emergency Response

• Level 2: Regional Emergency Response
• Level 3: Global Emergency Response

• Based on:
1. Scale
2. Urgency
3. Complexity
4. Capacity
5. Reputational Risk
 Response/Recovery Phase
Super Typhoon Haiyan (2013)

• One of the most powerful

tropical cyclones ever
recorded.
• Winds of >240 km/h
• >4.1 million people displaced
• >6000 people killed and
1800 missing
• 1.1 million houses damaged
• Overall damage $5.8 billion
USD
Gocotano A et al. Is the response over? The transition
from response to recovery in the health sector post-
Typhoon Haiyan. Western Pacific Surveillance and
Response Journal, 2015, 6(Suppl 1):5–9.
doi:10.5365/wpsar.2015.6.2.HYN_007
 International View
(IASC deactivated L3 National View
response) – 50% of (Philippines official
medical team left transitioned)

When did
Response Phase
ends and Recovery
Phase begin?
Transition Phase = 5 months

SPEED = Surveillance in Post Extreme Emergencies and Disasters

Response/Recovery Phase – Surveillance
• Monitoring a population’s health and identifying priority
immediate and long-term health needs
• Following disease trends for early detection and control of
outbreaks (Early Warning Alert and Response Network – EWARN)
• Assisting in planning and implementing health programmes
• Ensuring resources are targeted to the most vulnerable groups
• Monitoring the quality of health care
• Evaluating the coverage and effectiveness of programme
interventions
Disaster prevention,
resilient and sustainable Rebuilding Phase
development:
“Building Back Better”

Adapted from Lloyd-Jones et al. “Effective Post-disaster Reconstruction Programmes”. 2016

1 year after Super
Typhoon Haiyan

Magallanes district,
Tacloban
1 year after Super
Typhoon Haiyan

Magallanes district,
Tacloban
Reuters/Kyodo

2 years after Japan

tsunami (2011)

Kesennuma,
Miyagi Prefecture

12 March 2011 4 March 2013

 10 years after
Earthquake in
AFP/Getty, 2010

Haiti (2010)

Orlando Barria/EPA-EFE/Shutterstock, 2020

 Preparation Phase
1. Outputs and experience of recovery should feedback into
improving resilience and to reduce future risks.

“Do no harm”. “Build back better”.

2. Many natural hazards that cause disasters re-occur

periodically in the same location, most notably floods and
weather-related event.
 Haiti – 14th August 2021 Earthquake
• 7.2 Magnitude
• Hundreds of landslides and many aftershocks (magnitude >5)
• >2,207 died
• 320 missing
• 12,268 injured
• >130,000 houses damaged/destroyed
• 17th August, Tropical Storm Grace hit same areas affected by
earthquake
 Haiti – 24th-25th Jan 2022 Earthquake
• >30 earthquakes (aftershocks of 5.45 to 5.6 magnitude)
• 190 houses destroyed, 590 damaged
• 834 families affected
• Displaced 39.000 people.
Session Outline
1. Definitions and 3. Humanitarian
2. Determinants of
Characteristics of Coordination
Disaster Risk
Disasters Architecture

4. Disaster
Management Cycle

5. Example
5. Example
Great Sichuan Earthquake
(Wenchuan Earthquake)
 Great Sichuan Earthquake
(Wenchuan Earthquake)

• 12 May 2008, 02:28:01, 8.0 Magnitude

• More than 90,000 dead or missing, 374,176 injured
• 158 earthquake relief workers killed in landslide
• 4.8 million homeless (up to 11 million)
• Up to 104 major aftershocks (4.0 – 6.1 Magnitude)
Do’s and Don’ts
1. Don’t work solo – work with other relief teams,
especially the local teams
2. Don’t be too gung-ho (don’t put yourself or others at
risk)
3. Do be sensitive on:
• Photo-taking
• Eating
4. Do take care of yourself and your team-mates
(physically and mentally)
5. Do hand-over/ exit well (external support → “local”
capacity)
Further Information
• https://reliefweb.int/