Pandemic Influenza International Response

and Civil-Military Coordination; Exercise

Andrew Bates Andrew Bates

June, 2011June, 2011

FEMA Higher FEMA Higher

Education ConferenceEducation Conference

Adapted from Kira Kay - HandswithHands

Pan American Health Organization

and the World Health Organization Volume #5

International Pandemic International Pandemic ResponseResponse National/Province/local Response National/Province/local Response

mechanismsmechanisms SurveillanceSurveillance Containment Containment ResponseResponse Essential servicesEssential services

Regional Response mechanismsRegional Response mechanisms Neighbors & Borders; People and Neighbors & Borders; People and

CommerceCommerce Regional assistance organizations; ASEAN, Regional assistance organizations; ASEAN,

EU, African Union, etcEU, African Union, etc2

International Pandemic International Pandemic ResponseResponse

United Nation mechanismsUnited Nation mechanisms Int’ Health Regulations 2005Int’ Health Regulations 2005 UN Cluster modelUN Cluster model The Big three; WHO, WFP, OCHAThe Big three; WHO, WFP, OCHA

FAO, UNHCR, UNICEF, IOM, IFRC FAO, UNHCR, UNICEF, IOM, IFRC

One Health and Emerging Infectious One Health and Emerging Infectious DiseasesDiseases

Climate Changes and Population Climate Changes and Population trendstrends

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Civil-Military Civil-Military CoordinationCoordination

When does civil-military coordination When does civil-military coordination become a requirement?become a requirement?

Whole-of-Government response Whole-of-Government response Complex Emergencies; The long Complex Emergencies; The long

disaster!disaster! NGOs and Do No HarmNGOs and Do No Harm Phased transitions and friction points Phased transitions and friction points

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PlanningTask DivisionInformation SharingCMCOORD slide

Information SharingTask DivisionPlanningCommand & Control

Relief Recovery

Transitions during Civil-Military Responses

Foreign Military and Civil Defence Assets

International Civilian ReliefLocal/National Response incl. military

Time

Need for Assistance

Essential Services Essential Services ExerciseExercise

Eight Critical Infrastructure Sectors Eight Critical Infrastructure Sectors Food/AgricultureFood/Agriculture Water/SanitationWater/Sanitation TransportationTransportation TelecommunicationsTelecommunications Rule of Law & DefenseRule of Law & Defense Healthcare/Public HealthHealthcare/Public Health Banking/CreditBanking/Credit Power/ElectricityPower/Electricity

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Learning objectivesLearning objectivesYou will be able to:You will be able to: Define what is meant by mass gravesDefine what is meant by mass graves Explain the role of the community Explain the role of the community

and military in mass graves situationsand military in mass graves situations Define the legal, social, and Define the legal, social, and

psychological impacts psychological impacts Determine planning initiatives Determine planning initiatives

Mortuary Affairs

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Disaster Response Disaster Response Priorities Priorities

Authorities must look for and care for Authorities must look for and care for the living firstthe living first

Secondly; the authorities must restore Secondly; the authorities must restore essential services to support the essential services to support the living; Power, Water, Food, living; Power, Water, Food, transportation, telecommunications, transportation, telecommunications, and shelterand shelter

Authorities must work to identify and Authorities must work to identify and process the deadprocess the dead

Mortuary Affairs

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Characteristics in Characteristics in Mass Casualty Mass Casualty

SituationsSituationsWhat happens? What happens? Relatives and friends are looking for Relatives and friends are looking for

the deadthe dead Authorities are searching for victims Authorities are searching for victims

who are alivewho are alive Mortuaries are overwhelmedMortuaries are overwhelmed Police and medical personnel must Police and medical personnel must

provide information to maintain orderprovide information to maintain order

Mortuary Affairs

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Preparing for Mass Preparing for Mass DeathDeath

Identify coordinating institutions in Identify coordinating institutions in advance – mortuaries, religious groups, advance – mortuaries, religious groups, hospitals, police & military and others hospitals, police & military and others as appropriateas appropriate

Provide technical training for body Provide technical training for body identificationidentification

Develop relations with the Media per Develop relations with the Media per roles and responsibilitiesroles and responsibilities

Mortuary Affairs

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Public Perceptions Public Perceptions and Community Relationsand Community Relations

What are some ways to assist?What are some ways to assist? Any identifying items must be saved; photos, cards, Any identifying items must be saved; photos, cards, and documents: They must be logged with the and documents: They must be logged with the

location of where the body was foundlocation of where the body was found Get the local religious leader to declare a special Get the local religious leader to declare a special

situation in order to expedite graves: Hindu, situation in order to expedite graves: Hindu, Buddhist, Moslem, ChristianBuddhist, Moslem, Christian

Why?Why? Emotional response of friends and familyEmotional response of friends and family Impact of media difficult to quantifyImpact of media difficult to quantify Increase in political complexity = increase in Increase in political complexity = increase in

controversy controversy Civilians can hinder rescue operations and logisticsCivilians can hinder rescue operations and logistics

Mortuary Affairs

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Planning Operational Planning Operational Public Health ItemsPublic Health Items

Organized shifts and reservesOrganized shifts and reserves Prepare the workers to deal with mass casualties Prepare the workers to deal with mass casualties Get supplies stored and pre-positioned; Body Get supplies stored and pre-positioned; Body

bagsbags Can alternative sites be acquired to avoid mass Can alternative sites be acquired to avoid mass

grave situations. Consider refrigeration if grave situations. Consider refrigeration if possiblepossible

Only preserve bodies that are not identifiedOnly preserve bodies that are not identified Request ICRC assistance to provide guidance on Request ICRC assistance to provide guidance on

mass graves. mass graves.

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Cultural ConsiderationsCultural Considerations

Get local religious leaders engaged in the Get local religious leaders engaged in the communications process communications process

If the cultural norm is cremations do it If the cultural norm is cremations do it quickly and away from the population quickly and away from the population centerscenters

Allow for limited mourning and ritualsAllow for limited mourning and rituals Determine the level of family Determine the level of family

authorization authorization

Mortuary Affairs

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Psychological AspectsPsychological Aspects Shock and Trauma for victimsShock and Trauma for victims Post Traumatic Stress Syndrome Post Traumatic Stress Syndrome Notification processNotification process Counseling servicesCounseling services Importance of truth and a structured Importance of truth and a structured

process for accounting of the deadprocess for accounting of the dead

Mortuary Affairs

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Religious and cultural Religious and cultural considerations considerations

Involve community leaders and Involve community leaders and educate them with ICRC standards educate them with ICRC standards which provide proper mass grave which provide proper mass grave markingsmarkings

Group religious types in the same Group religious types in the same grave or storage areas if possible grave or storage areas if possible

Do not physically disrespect a dead Do not physically disrespect a dead body if possible body if possible

Mortuary Affairs

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Legal ConsiderationsLegal Considerations

Legal implications of unidentified bodiesLegal implications of unidentified bodies Missing persons Missing persons National and International legal issues National and International legal issues Mass Graves markings; ICRC Mass Graves markings; ICRC

International standardsInternational standards Return of foreign nationals to their Return of foreign nationals to their

homeland during a pandemichomeland during a pandemic

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SummarySummary Treat bodies with respectTreat bodies with respect Provide training and exercises for burial Provide training and exercises for burial

tasks that are part of the disaster plantasks that are part of the disaster plan Work through the local authoritiesWork through the local authorities Involve religious people when you canInvolve religious people when you can Identify and record body remains and Identify and record body remains and

personal effectspersonal effects Involve the media if possible in exercisesInvolve the media if possible in exercises Mass grave sites must be planned for in Mass grave sites must be planned for in

advance advance Take care of your people Take care of your people

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QUESTIONS?QUESTIONS?