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
3
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
4
5
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
6
7
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
8
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
9
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
10
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
11
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
12
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.
Mortuary Affairs
13
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
14
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
15
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
16
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
Mortuary Affairs
17
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
Mortuary Affairs
18
QUESTIONS?QUESTIONS?