i

Republic of the Philippines

Province of Quezon
Municipality of Tagkawayan

OFFICE OF THE MUNICIPAL HEALTH OFFICER

OPERATIONAL DISASTER RISK

REDUCTION MANAGEMENT FOR
HEALTH PLAN (ODRRM-HP)

Prepared by:

MARIFE M. DIZON,RN
NURSE I

Noted by: Reviewed by:

JEHZEL M. AQUINO, MD FRANCIS M. VILLANUEVA

Doctor to the Barrio Head MDDRMO/ OIC MPDC

Approved by:

Hon. JOSE JONAS A. FRONDOSO

Municipal Mayor
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TABLE OF CONTENTS

I. BACKGORUND v
1. Name of the RHU, category and address v
2. Geographic description of the RHU and its catchment area vi
 Topographic description
3. Demographic profile vii
 Population
 Number of households
 Number of barangays
 Number and names of health emergency-related agencies in the catchment area
4. Health Statistics x
 Leading causes of morbidity and mortality
 Infant mortality rate
 Maternal mortality rate
 Malnutrition rate
 Vaccination coverage
 Indicators for basic hospital services and basic health services
5. Health facilities in the catchment area xiv
6. RHU with special areas/services xv
7. Health human resource xvi
8. Emergency/incident that have occurred xvii
9. Legal issuances detailing the roles and functions of the RHU xvii

II. PLAN DEFINITION xix

A. Content of plan Xix
B. Scope of plan xix

III. GOALS AND OBJECTIVES xix

A. Goals xix
B. Objectives xx

IV. PLANNING COMMITTEE xxi

V. RESPONSE TEAM COMPOSITION 22

VI. ROLES AND RESPONSIBILITIES 23

VII. HEALTH EMERGENCY PREPAREDNESS PLAN 33

A. Hazard assessment 34
B. Hazard reduction/prevention plan 36
C. Vulnerability assessment 37
D. Risk assessment 40
E. Health emergency capacity development plan 43
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VIII. HEALTH EMERGENCY RESPONSE PLAN 47

A. Policies, guidelines, protocols for activation of the developed systems 48
B. Activation 53
1. Activation of the alerting process 53
1.1. Declaration 53
1.2. Notification 54
2. Activation of the plan 55
3. Activation of the RHU operations center 55
4. Activation of the RHU emergency incident command system 56
C. Operations/support management 58
5. Implementation of the response standard operating procedures/protocols for 58
internal and external emergencies
5.1. Callback/management of staff 58
5.2. Management of field/on-site activities 58
5.3. Management of emergency department/unit 63
5.4. Management of casualties 63
5.5. Timely provision of 24-hour services 64
5.6. Maintenance of 24-hour supply of drugs, medical supplies, diagnostic supplies 64
and equipment
5.7. Management of logistic and personnel support by concerned units 65
5.8. Management and use of ambulance 65
5.9. Assessment and maintenance of security services 66
5.10. Assessment and maintenance of communication services 66
5.11. Management of internal and external traffic flow and control 66
5.12. Management of RHU evacuation/relocation of staff 68
5.13. Management of volunteers for medical and other services 69
6. Provision of the public health services of the RHU 70
6.1. Damage assessment and needs analysis/rapid health assessment 71
6.2. Establishment and maintenance of epidemiologic surveillance system 71
6.3. Immunization 71
6.4. Therapeutic nutrition services 71
6.5. Water, sanitation and hygiene 72
6.6. Provision of blood services 73
6.7. Communicable disease prevention and control 74
6.8. Management of the dead (Identification of the dead/mortuary) 74
6.9. Health promotion and advocacy/risk communication in public information and 75
in media management
7. Initiation and maintenance of coordination and networking for referral of cases 75
8. Initiation and maintenance of mental health and psychosocial support services for 76
casualties, patients, hospital staff, other responders and the bereaved
9. Management of information – Monitoring of plan 76
10. Activation of plan in the event of complete isolation of hospital for auxiliary power, 77
water and food rationing, medication/dressing rationing, waste and garbage
disposal, staff and patient morale
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D. Extension/Termination 79
11. Declaration and notification process 79
12. Conduct of post-incident evaluation 80
13. Review and updating of plan including amendments to policies and procedures 80

IX. HEALTH EMERGENCY RECOVERY AND RECONSTRUCTION PLAN 82

APPENDIX 86
A. Job action sheet 86
B. Standard operating procedures and policies 99
C. Abbreviations 164
D. Glossary 167
E. Hazard maps 172
F. Flow charts 181
G. HEMS forms 192
H. Directory of contact persons of the RHU 213
I. Directory of Quezon hospitals and members of MDRRRMC and ILHZ 214
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I.BACKGROUND

1. NAME OF THE RHU, CATEGORY AND ADDRESS

 RHU:
Tagkawayan,
Quezon

 Land Area:
53,435 hectares

 Total # of
barangays:
45 Barangays

 Income class:
st
1 Class
Municipality
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2. GEOGRAPHIC DESCRIPTION OF THE RHU AND ITS CATCHMENT AREA

Topography:
Tagkawayan fishing ground is the Ragay Gulf
which thrives on all kinds of marine life. Almost two-
third of its lands lies in the mountain side. A strip level of
land extends from the mouth of the Cabibihan River to
Del Gallego, Camarines Sur facing the Ragay Gulf. The
highest mountain is Mt. Bayabas which is 1048 ft., Cadig
is 726 ft., SusongDalaga Mt. is 400 ft., and Mt. Tubo is
189 ft. above sea level.

Source of Livelihood:
1. Agriculture (farming, fishing, forestry)
2. Industry (mining, quarrying, manufacturing,
construction, transportation, storage,
communication & others.)

Location:
Tagkawayan is 132 kilometers away from Lucena,
the capital town of Quezon Province, and 276 kilometers
away from Manila.
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MUNICIPAL PROFILE

Total Land Area = 53,435hectares

Gross Urban Density= 30.578

Gross Rural Density=0.6620

Demographic Profile

 Average Growth Rate:2.74 %

 Total population:52,740

The Municipality of Tagkawayan

Founded on January 1, 1941, under presidential Decree No. 316, Tagkawayan is the last
town of Quezon Province going south to the Bicol Region. It is bounded on the North by the
Province of Camarines Norte, to the South by Ragay Gulf and to the West going northwest by
the Province of Camarines Sur and to the South going southwest is the watershed of Cabibihan
River, Municipality of Guinayangan and Calauag, both of Quezon Province.
It has a total land area of 53,435.07 hectares comprising 45 barangays and 64 sitios.
watersheds, forests, plateaus and valleys interlinked with rivers and springs and coastal areas
with mangroves; it is characterized with rural landscapes with a rare and unique combination of
complete ecosystem. Tagkawayan is predominantly an agricultural and fishing community.
Tagkawayan is now a first class municipality under Department of Finance Order (DOF)
no. 23-08, dated July 29,2008, moving onwards not only to better address the needs of its
people but to further serve the best of its constituency.

3. DEMOGRAPHIC PROFILE

TOTAL POPULATION (2015 KC Database) 52,740 (Male – 27,166; Female – 25,574)

LAND AREA 53,435 hectares
NO. OF HOUSEHOLD 11,807
INCOME CLASS 1ST Class
NO. OF BARANGAYS 45
NO. OF BUSINESS ESTABLISHMENTS 1,071 (2015)
ECONOMIC RESOURCES Agriculture, Mining and Fishing
FINANCIAL INSTITUTION Cooperative Bank of Quezon Province
Quezon Capital Rural Bank, Inc.
Ating Kooperatiba M P C
CARD Bank
Sama-Sama Sa Kaunlaran M P C
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HEALTH FACILITIES Maria Eleazar District Hospital

Municipal Health Center with Lying in Clinic
Barangay Health Centers
Private Practitioners
COMMUNICATION PLDT/Smart Telecommunication
Globe
SANTELCOR/Sun Cellular
POWER Quezon Electric Cooperative, Inc.
WATER Tagkawayan Water District
HEALTH EMERGENCY RELATED AGENCIES Bureau of Fire Protection 1
MSWDO 1
PNP 1
Philippine Army
NGO’S
KabalikatCivicom
KB Net
Association of Concerned Citizen of
Tagkawayan
Other Government Agencies DepEd
Comelec
Municipal Trial Court
Department of Agrarian Resources
Transportation:
Via Railway Philippine National Railway
By Land Quirino Highway
By Sea Ragay Gulf
Distance Lucena- 184 kms.
Manila- 316 kms.
Tourist Destination MataasnaBato Beach Resort
Mt.Baliwag and Mt. Cadig
Maguibuay Falls
Sibalon Island

POPULATION AND HOUSEHOLD PER BARANGAY

LOCATION POPULATION (as of 2015 NO. of HOUSEHOLD

based on KC Database)
ALDAVOC 1,358 (M – 702; F – 656) 279
ALIJI 1289 (M – 649; F - 629) 288
BAGONG SILANG 1,278 ( M – 609; F - 541) 261
BAMBAN 1,525 ( M – 794; F - 731) 356
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BOSIGON 433 ( M – 304; F - 239) 116

BUKAL 680 ( M – 304; F - 239) 151
CABUGWANG 554 ( M – 281; F - 273) 106
CABIBIHAN 743 ( M – 376; F - 367) 135
CAGASCAS 261 ( M – 141; F - 120) 57
CANDALAPDAP 726 ( M – 420; F - 357) 188
CASISPALAN 923 ( M – 396; F - 244) 177
COLONG-COLONG 772 ( M – 476; F - 296) 146
DEL ROSARIO 427 ( M –179; F - 248 ) 94
KATIMO 2,058 ( M-1,024; F–1,034) 397
KINATAKUTAN 2,019 ( M-1,025; F - 994) 488
LANDING 1,197 ( M – 585; F - 612) 260
LAUREL 942 ( M – 491; F - 451) 194
MAGSAYSAY 2,474 ( M-1,275; F – 1,199) 528
MAHINTA 398 ( M- 204; F- 194) 98
MALBOG 520 ( M- 254; F- 266) 101
MANATO CENTRAL 301 ( M- 151; F- 150) 63
MANATO STATION 301 ( M- 552; F- 547) 258
MANGAYAO 448 ( M- 261; F- 187) 135
MAGUIBUAY 448 ( M- 306; F- 271) 133
MANSILAY 761 ( M- 370; F- 391) 215
MAPULOT 2,702 ( M- 1,501; F- 1,201) 728
MUNTING PARANG 878 ( M- 470; F- 408) 224
PAYAPA 762 ( M- 385; F- 383) 189
POBLACION 4,400 ( M- 2,176; F- 2,224) 910
RIZAL 3,779 ( M- 1,977; F- 1,802) 741
SABANG 923 ( M- 476; F- 447) 211
SAN DIEGO 520 (M- 266; F-254) 118
SAN FRANCISCO 1,099 (M- 569; F-530) 240
SAN ISIDRO 1,176 (M- 606; F-570) 262
SAN ROQUE 343 (M- 190; F-153) 75
SAN VICENTE 1,186 (M- 629; F-557) 261
SEGUIWAN 633 (M- 310; F-323) 154
STA.MONICA 1,028 (M- 502; F-557526) 246
STA. CECILIA 4,610 (M- 2,241; F-2,369) 246
STO.NINO 1 500 (M- 257; F-243) 115
STO.NINO II 375 (M- 176; F-199) 125
STO.TOMAS 1,061 (M- 587; F- 474 228
TABASON 1,933 (M- 980; F- 953) 418
TUNTON 762 (M- 536; F- 487) 226
VICTORIA 301 (M- 157; F- 144) 79
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TOTAL 52,740 11,807

SOURCE: KC- DATABASE

4. HEALTH STATISTICS

10 LEADING CAUSE OF MORBIDITY (2016)

NAME of DISEASE MALE FEMALE TOTAL

RO5: Cough 1274 1706 2980
R50: Fever of Unknown Origin 634 945 1579
I10: Essential (Primary) Hypertension 407 563 970
R03: Abnormal Blood Pressure Reading, 250 402 652
Without Diagnosis
J11: Influenza, Virus Not Identified 225 251 476
R42: Dizziness and Giddiness (Vertigo) 112 331 443
R51: Headache (Cephalgia) 136 300 436
C39: Malignant Neoplasm of Other and Ill- 192 233 425
Defined Sites in the Respiratory System and
Intrathoracic Organs
J00: Acute Nasopharyngitis (Common Colds) 109 193 302
K58: Irritable Bowel Syndrome 115 174 289

10 LEADING CAUSE OF MORTALITY (2016)

NAME OF DISEASE MALE FEMALE TOTAL

I46: Cardiac Arrest 24 14 38
I10: Essential (Primary) Hypertension 13 14 27
R50: Fever of Unknown Origin 11 16 27
R10: Abdominal and Pelvic Pain 10 15 25
R09: Other symptoms and Signs 11 13 24
Involving the Circulatory and
Respiratory System
I21: Acute Myocardial Infarction 11 10 21
J18: Pneumonia, Organism Unspecified 9 12 21
J11: Influenza, Virus Not Specified 9 11 20
R51: Headache (Cephalgia) 3 16 19
D64: Other Anemias 3 12 15
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2016 NUMBER OF MORTALITY CASES

MORTALITY CASES NO. OF CASES

Infant Death 5
Maternal Death 1
Neonatal Death 4
Perinatal Death 1
Death among Children under 5 6
years old

VACCINATION COVERAGE

INDICATORS MALE FEMALE TOTAL

BCG 295 263 558
PENTA 1 756 657 1413
PENTA 2 640 565 1205
PENTA 3 492 442 934
OPV 1 482 448 930
OPV 2 411 380 791
OPV 3 335 316 651
HEPA BI w/in 24 HRS. 190 159 349
HEPA BI > 24 HRS. 28 29 57
MCV 1 (AMV) 388 338 726
MCV 2 (MMR) 83 72 155
FULLY IMMUNIZED CHILD 146 125 271
COMPLETELY IMMUNIZED CHILD 117 92 209
CHILD PROTECTED AT BIRTH 200 205 405

INDICATORS OF BASIC HEALTH SERVICES AND PREVENTIVE HEALTH PROGRAMS

HEALTH PROGRAM INDICATORS ACCOMPLISHMENT ACCOMPLISHMENT %

MATERNAL CARE
1.Pregnant women w/4 or more 247 16.63%
prenatal visit
2.Pregnant women given 2 doses of 263 17.71%
Tetanus Toxoid
3.Pregnant women given TT2 plus 656 44.17%
4.Pregnant women given complete Iron w/ 212 14.27%
Folic Acid
5.PostPartum women w/ at least 2 PPV 300 20.20%
6.PostPartum women given complete iron 108 7.27%
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7.PostPartum women given Vitamin A 355 23.90%

8.PostPartum women initiated 387 26.06%
breastfeeding
FAMILY PLANNING PROGRAM
Contraceptive Prevalence Rate 1817 26.80%
EPI-EXPANDED PROGRAM ON
IMMUNIZATION
Infant Exclusively Breastfeed until 6 71 4.78%
months
6-11 months given VAC 409 55.08%
12-59 months given VAC 2088 35.15%
ENVIRONMENTAL HEALTH
SANITATION
Household with access to improved or 9366 81.94%
safe water supply
Level I 4744 41.50%
Level II 1367 11.96%
Level III 3255 28.48%
Household with complete basic 7475 65.39%
sanitation facilities
Food Establishment 96
Food Establishment with sanitary 96 100%
permit
Food Handlers 99
Food Handlers with Health Certificate 96 96.97%

INVENTORY OF RESOURCES OR ASSETS OF THE HEALTH FACILITY IN VARIOUS SERVICES:

MATERNAL CARE AND NEWBORN CARE Delivery table

Recovery bed
BP Apparatus
Tape Measure
Vitamin A for postpartum women
Complete Iron with folic acid (postpartum
women)
Tetanus toxoid vaccines
Auto disposable syringes
Cotton
70% Alcohol
Antiseptic solution
Gloves (sterile)
 xiii

Suture materials for tear or episiotomy repair

Urinary catheter
Vaginal speculum
IV Tubing
Supplies for Newborn Screening
FAMILY PLANNING PROGRAM Weighing scale
BP apparatus
Oral contraceptive(pills)-
microgynon&excluton
Condom
Intra Uterine Device
EXPANDED PROGRAM ON IMMUNIZATION Weighing scale
(EPI) Growth Monitoring Scale
Thermometer (digital)
Alcohol
Cotton balls
Syringes
Vaccine refrigerator
Vaccine thermometer
Diluents
BCG vaccines
PENTA Vaccines (out of stock)
Hepatitis b vaccines
Measles vaccines
MMR vaccines
Safety collector boxes
Vitamin A capsules
CERVICAL CANCER CONTROL PROGRAM- Delivery table
VISUAL INSPECTION WITH ACETIC ACID Drop light
Cotton Applicators
Gloves
Speculum
Glass Slides
NATIONAL TUBERCULOSIS PROGRAM Sputum cups
Microscope
Glass slides
Re-agents
FDC TB drugs
Weighing scale (for monthly weight
monitoring)
PT- OPERATION TIMBANG Weighing Scale (for infants)
Salter weighing scale (for pre-schoolers)
ENVIRONMENTAL SANITATION PROGRAM Chlorine granules
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Hyposol
LABORATORY EQUIPMENTS Urine strips
NSS
WBC diluting fluid
Blood chemistry reagents
RDT (Rapid Diagnostic Test) for Malaria
Giemsa stain
Methanol

5. HEALTH FACILITIES FOUND IN THE CATCHMENT AREA

HOSPITAL Maria Lourdes L. Eleazar Memorial District (GOVT.HOSPITAL)

BRGY.HEALTH STATION 13

PRIVATE CLINIC Endaya Children and Family Clinic

Dela Cruz-Yongco Medical Clinic

DENTAL CLINIC Rural Health Unit of Tagkawayan

PRIVATE DENTAL CLINIC Verceluz-Espinola Dental Clinic

St.Vincent Dental Clinic
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REFERRAL SYSTEM

BHS
PRIVATE HOSPITAL
PRIMARY/ SECONDARY

TERTIARY HOSPITAL
MAGSAYSAY MEMORIAL DISTRICT
HOSPITAL

PUBLIC HOSPITAL
Primary/ Secondary
MARIA LOURDES ELEAZAR
DISTRICTHOSPITAL
RHU

6. RHU WITH SPECIAL AREAS/SERVICES

1. Maternal Care Package:

 Pre Natal
 Normal Spontaneous Delivery
 Post Natal Care
2. Newborn Screening
3. General Consultation, Treatment and Referral
 xvi

4. Well Baby Clinic

5. Expanded Program on Immunization, Health Education and Counselling
6. Dental Service
7. Reproductive Health
8. Cervical Screening; Breast Examination
9. Laboratory Examination
10. Rabies Program
11. TB DOTS
12. Diagnostic Examination:
 Complete Blood Count
 Urinalysis
 Fecalysis
 Sputum Microscopy
 Fasting Blood Sugar
 Lipid Profile
 Blood Chemistry
13. Preventive Services:
 Visual Inspection
 BP Measurements
 Breastfeeding Program Education
 Periodic Clinical Breast Examination
 Counselling for Lifestyle Modification
 Counselling for Smoking Cessation

7. HEALTH HUMAN RESOURCE

HEALTH CARE PROVIDER RATIO ACTUAL (2016)

Physician 1:20,000 1
Nurses 1:20,000 2
Midwives 1:5,000 13
Barangay Health Workers 1:171 365
Sanitation Inspectors 1:20,000 3
 xvii

8. EMERGENCY/INCIDENT THAT HAVE OCCURRED IN 2016

Disaster Lesson Learned Gaps

Typhoon Glenda Preparedness in every situation is important in Inter-and intra-local
– August 2014 combatting possible morbidities and mortalities coordination of various
associated with a certain emergency or disaster. agencies both NGO and
GOs.
Given the topographic characteristic of Tagkawayan
(as a flashflood prone area due to nearby bodies of
water), anticipation is crucial. Safety of constituents
must come first, hence systematic evacuation and
planning must be immediately institutionalize.
Typhoon Karen – Deployment and action of response team among Municipal departments
October 2016 afflicted areas requires concerted efforts from various (MDRRMO, MHO, MSWD
municipal departments MAO, Budget, etc) as key
players in developing a
systematic approach in a
given emergency situation.
Typhoon Nina – Referral system is an important factor in the success Frontline workers (health
December 2016 of response process in a given circumstance/situation personnel such as BHWs,
barangay officials) are
Anticipation, preparedness and systematic approach significant in the hierarchy
are key factors in alleviating a certain emergency of response
situation

9. LEGAL BASIS OF FACILITY AUTHORITY TO ACT IN DISASTER SITUATIONS ARE:

LEGAL BASIS OF FACILITY AUTHORITY TO ACT IN DISASTER SITUATIONS ARE:

REPUBLIC ACT 10121

The enactment of Republic Act 10121 otherwise known as the Philippine Disaster Risk
Reduction Management Act of 2010 approved by former President Gloria Macapagal Arroyo
on May 10,2010 has laid the basis for a paradigm shift from just disaster preparedness and
response to disaster risk reduction and management (DRRM).An act strengthening the
Philippine Disaster Risk Reduction and Management System, providing for the national disaster
risk reduction and management framework and institutionalizing the national disaster risk
reduction and management plan, appropriating funds therefore and for other purposes. It
entitles to reinforce the capacity of the National and Local Government Units. On Sec. 4, it
 xviii

scopes the policies, plans, implementation of actions/measures to all aspects of DRRM such as
good governance, risk assessment, early warning knowledge building, increasing awareness,
mitigation, preparedness, response and recovery. Whereof the Organization at the Local
Government level includes the municipal DRRMCs and Barangay Development Council shall
serve as the LDRRMC in every barangay. Moreover maintain a database of human resource,
equipment’s, and directories, critical infrastructures (hospital and evacuation centers). These
conclude the declaration and lifting of the state of calamity may also be issued by the Local
Sanggunian upon the recommendation of the LDRRMC.
 Administrative Order 182 s.2001: Adoption and Implementation of Code Alert
System for the DOH Facility during Emergencies and Disasters
 AO No.168 s. 2004: National Policy on Health Emergency and Disasters
 Order No.2008-2004: Adoption and Institutionalization of Integrated Alert
System within Health Sector
 AO No.155 s. 2004: Implementing Guidelines for Managing Mass Casualty
Incidents during Emergencies and Disasters

LEGAL ISSUANCES DETAILING THE ROLES AND FUNCTIONS OF THE FACILITY IN MANAGING
ALL PHASES OF DISASTER

The municipal health system plays an important role in reducing the communities’
vulnerability to disasters prior to its occurrence via prevention or mitigation of the potential
effects of hazards. Following the crisis phase of disaster, public and environmental health
services play an important integral part in physical disaster recovery by ensuring:
 The safety, quality and supply of water and food is maintained
 Adequate shelter is available
 Sanitation arrangements prevent the transmission of disease and enable the safe
disposal of hazardous waste; and
 The possibility of epidemics of infectious diseases is prevented.

The Municipal Health Officer, together with the Local Government Unit is said to be
responsible for the management of community’s health. Therefore experience in public health
management is directly transferable to disaster situations. Public health officials can make a vital
contribution to emergency management through the following functions:
 Observe all the requirements and standards (emergency plan, HEICS, Code alert,
etc.)
 Ensure enhancement of their facility to respond to the needs of the communities
especially during emergencies.
 Network with other facility/hospital in the area to optimize resources and
coordinate transferring of victims to the appropriate facility.
 Report all emergencies to the operation center.
 Document all incidents responded.
 xix

Major disasters presents in various forms. Despite planning for every possible
eventuality, unexpected circumstances in emergency management may arise. In this regard,
subsequent adjustment of facilities’ function must follow.

II. PLAN DEFINITION/DESCRIPTION

A. CONTENT OF PLAN

The Tagkawayan MHO Preparedness Plan contains a number of strategies and activities
that the health facility will carry out for building and enhancement of facility capacity to respond
to emergency or disaster, whereas it’s Response Plan includes strategies and activities in utilizing
facility resources for effective and efficient response during emergency or disaster. Likewise, this
response plan includes protocol, guidelines and procedures pertaining to various emergency
management system for more efficient response. The third set is the Recovery or Rehabilitation
Plan which entails strategies and activities in mainstreaming the facility back to its prepared
position for any forthcoming eventuality.
The Tagkawayan MHO HEPRRP includes inventory of its internal and external resources
in terms of list and directories, human resources, logistics, financial existing systems and services.

B. SCOPE OF THE PLAN

The plan shall be implemented by the Tagkawayan MDRRMC/MHO together with all
other members of the MDRRMC network concerned with emergency or disaster management.

III. GOALS AND OBJECTIVES

A. GOALS

To decrease morbidity and mortality during disaster through facility preparedness for
emergency response.

 To develop policies, guidelines, protocols, SOP’s and plans

 To establish emergency management systems
 To create and enhance the competency of facility response team
 To upgrade the facility service areas for better emergency management
 To ensure a stockpile of medicines, drugs, supplies, and materials for
emergency operation.
 xx

B. OBJECTIVES

General Objectives

To build the facility capacity for effective and efficient response to recovery from
emergency or disaster.

Specific Objectives

 To strengthen the facility emergency, preparedness, response and recovery plan.

 To develop systems for emergency management
 To update existing guidelines, procedures, protocols of developed
emergency/disaster management systems
 To develop human resource competencies for emergency response
 To upgrade the facility services for better emergency management
 To ensure availability of logistics, funds and other resources in times of
emergencies
 To build partnership or network of hospitals for a more effective and efficient
response and for provision of appropriate health care.
 xxi

IV. PLANNING GROUP COMMITTEE

HON.JOSE JONAS A. FRONDOSO

Municipal Mayor

FRANCIS M. VILLANUEVA
OIC-MDRRMC

FRANCIS PCI JEHZEL M. GLENDA C. ARAÑA GENEDINA ENGR.JOSE ROLANDO S.

M.VILLANUEVA DANDY P. AGUILAR AQUINO, MD MunIcipal Budget R.PENOLIO M.AQUINO MENDOZA
OIC-MPDC PNP DTTB Officer MSWDO Municipal Engineer Municipal
Agriculturist
 22

V. RESPONSE TEAM COMPOSITION

Rapid Health Assessment/Damage Analysis and Needs Assessment (RHA/DANA) Team

 Engr. Jose M. Aquino

 Francis M. Villanueva
 Dr. Jehzel M. Aquino

Nutrition Team

 GenedinaR.Penolio
 Dr. Jehzel M. Aquino
 Ivan Lorenz D. Go, RN
 Rebecca L. Castillo, RN
 RHMs
 BNS President

Water, Sanitation and Hygiene (WaSH) Team

 Maria Polly A. Albacea

 Ivan Lorenz D. Go, RN
 Princess Ghey C. Nova, RN

Municipal Epidemiology & Surveillance Unit (PESU) Team

 Marife M. Dizon, RN
 Maria Polly A. Albacea
 Rodelo V. Teopy,RMT
 RHMs
 BHWs

On Scene Response Team

 Dra. Jehzel M. Aquino

 Dra. Coraciel Y. Lim
 Francis M. Villanueva
 John Irvin Pineda
 Rex T. Bacuño
 Rafael Guiller Bacuño
 23

 RHMs
 BHWs

FIRST RESPONSE TEAM

 John Irvin Pineda – Team Leader

 Rafael Gueller C. Bacuno – Emergency Response Vehicle Driver
 Recson Jovene G. Lagua - Responder
 Owen R. Ona – Responder
 Kervin D. Milan– Responder
 Alvin Canteveros – Responder
 Tomas Bello - Responder
 Lloyd Layosa – Communication
 Marife M. Dizon – Nurse

SECOND RESPONSE TEAM

 Emil Papa – Team Leader

 Rex T. Bacuno – Emergency Response Vehicle Driver
 Marvin Noveno – Responder
 Jose D. Esmani – Responder
 Nestor Nabuhay - Responder
 Mark Moico - Responder
 Marvin Solis – Volunteer
 Edgar De Mesa – Communication
 Princess Ghey Nova – Nurse

VI. ROLES AND RESPONSIBILITIES

Roles and Functions of the Planning Group/Committee

1. Develops, reviews, and updates the Provincial Health Emergency Preparedness and
Response Plan (HEPRRP);
2. Gathers required information and gains commitment of key people and
organizations
3. Lobbies/secures adequate funding for the required logistics for the Health
Emergency Plan;
4. Initiates testing of the plan for its functionality and adaptability to the present
situation and revises it as necessary;
 24

5. Develops annual Operational Plan and other plans relevant to Health Emergencies or
Disaster
6. Review HEMS Annual Work and Financial Plan
7. Monitors and evaluate the implementation of HEMS plans.

WASH Team

1. Conducts/assists in the conduct of WASH Assessment

2. Ensures Safe Water
a. Inspection of water sources
b. Advocacy on water disinfection (like boiling of water, etc)
c. Provision/Augmentation of chlorine granules
d. Water testing and monitoring
3. Assists in providing sanitary toilets
a. Assist in the construction of sanitary toilets or appropriate alternatives
b. Provision/augmentation of materials (toilet bowls, lime and others)
4. Ensures environmental sanitation including vector control
a. Ensure cleanliness of surroundings by mobilizing the community (de-clogging of
canals, etc)
b. Advocacy on hygiene practices
c. Provision/augmentation of materials: refuse bins, sanitation kits, etc.
Nutrition Team

1. Assists in nutritional assessment using MUAC

2. Assists in food for work program
3. Assists in supplementary feeding
4. Assists in the provision of micronutrients
5. Refers patients / victims / family members for therapeutic care
6. Promotes breastfeeding
 25

Municipal Disaster Risk Reduction and Management Council

HON.JOSE JONAS A. FRONDOSO - Chairman

MR. FRANCIS M. VILLANUEVA - MDRRMO/MPDC/Member

MEMBERS:

MR. ANTONIO A. ABRIL - Sec. to the SB/Mun. Administrator Designate

Engr. JOSE M. AQUINO - Municipal Engineer

Mr. WENCESLAO M. MATIBAG - Municipal Assessor

Mr. ROLANDO S. MENDOZA - Municipal Agriculturist

Mrs. GENEDINA R. PRENOLIO - MSWDO

Mrs. HAIDEE D. PAPA - Administrative Officer V/ MGSO Designate

Mrs. CONCEPCION M. MESTIDIO - Municipal Civil Registrar

Mrs. ANITA A. JAGONOY - Municipal Treasurer

Mrs. MARIA JUDITH D. BATALLA - Municipal Accountant

Miss. GLENDA C. ARÑA - Municipal Budget Officer

Mrs. MA. SARINA G. AÑONUEVO - HRMO

PCI DANDY R. AGUILAR - Police Chief Inspector

Mr. NOEL P. MAGSINO - MLGOO

SFO3 BERNARD ALDIN A. PANALIGAN - OIC – BFP

Mr. GILBERT FRONDOSO - CSO/ACCT President

Mr. ROWEL SALVADOR - CSO/ KABALIKAT President

Mr. RUDY GERALDES - CSO[/ KB Net President

Mr. GUILLERMO SARNE - CSO/ KABAYAN President

 26

Mr. RODULFO H. UY III - Business Sector Representative

DRA. JEHZEL M. AQUINO - Doctor to the Barrio

TASKS OF THE MEMBERS OF THE COUNCIL

The Municipal Mayor as the Chairman of the Municipal Disaster Risk Reduction and
Management Council shall:

1. Coordinate on the municipal level, the activities of the various agencies and
instrumentalities of the national and local government, private institutions and civic
organizations to implement the policies set by the National and Regional Disaster Risk
Reduction and Management Council relative to disaster management.

2. Convene the Council as often as necessary to effectively coordinate municipal efforts on

disaster preparedness and response, emergency operations, relief and rehabilitation
activities.

3. Call on heads of office of the government and private sector assigned in the municipality
for assistance in preparing for, reacting to and recovering from the effects of civil
contingencies.

4. Prepare and disseminate disaster control manuals and other publication related to
measures on disaster control, prevention and mitigation.

STAFF ELEMENTS

INTELLIGENCE AND DISASTER UNITMEMBERS

Dept. of Interior and Local Government

Office of the Municipal Administrator
Municipal Engineering Office
Philippine National Police

This unit evaluates disaster situations, determine courses of an action to follow in times of
emergency and formulate guidelines in evaluating disaster situations:

 Evaluates warning information and advises the members of the Municipal Disaster
Coordinating Councils on impending disaster
 27

 Makes recommendations on how to prevent disaster, if possible and / or suggest

precautionary measures to minimize the effects of disaster.

 Submits recommendations for allocations of needed resources.

 Prepares appropriate recommendations to proper authorities for possible declarations

of the existence of state of calamity in affected areas. These recommendations shall
serve as basis for request in the release of Calamity Funds to ameliorate the sufferings
of disaster victims.

PLANS AND OPERATIONS UNIT MEMBERS

Municipal Social Welfare and Dev’t.Office

Office of the Municipal Planning & Dev’t.Coordinator
Municipal Agriculture Office
Municipal Engineering Office

 Determines the courses of action to be taken on the recommendations of the

Intelligence and Disaster Unit
 Determines the type of number operating teams to be utilized in the disaster area
 Recommends implementation of the existing plans
 Maintains and/or supervises the programs of operations and the necessity of utilizing
additional teams
 Prepares appropriate reports upon termination of Disaster Operations

RESOURCE UNIT MEMBERS

Municipal Health Office

Municipal Budget Office
Office of the Municipal Accountant
Office of the Municipal Agriculture

a. Undertakes a survey of urgent items needed in helping the victims/sufferers of

disaster/calamities as well as gather the necessary statistics on resources such as:

1. Foods – rice, corn, meat, vegetables, fish, drinks, and other grocery items
2. Clothing – clothing materials and footwear
3. Construction Materials – cement, lumber, roofing materials and hardware
4. Medical supplies – medicines
5. Transportation – government and private vehicles available
6. Other rehabilitation items – seeds, planting materials, pesticides, fertilizers, livestock
and fingerlings.
 28

Resource survey will include the names and addresses of dealers, agencies or persons
who may donate, contribute or make available such resources which may be needed to
ameliorate natural disaster or calamity victims/sufferers and to release data for immediate
reference to those who are called upon to render assistance and relief to the victims/sufferers.

b. It shall have the continuing task of updating its data and shall furnish it to all concern for
ready reference and guidance

TASKS OF EACH MEMBER COMMITTEE/OFFICES OF THE MUNICIPAL DISASTER AND

COORDINATING COUNCIL

THE MUNICIPAL SOCIAL WELFARE AND DEVELOPMENT OFFICE

On pre disaster period, the MSWDO;

 Continuous identification, assessment of disaster prone areas within the coverage of
the whole municipality in coordination with the BDCC’s;
 Continuous provision of training to different technical persons of M/BDCC’s;
 Maintenance of necessary food stockpile at the Disaster Operation Center;
 Providing necessary advanced forecast to different M/BDCC members

On the onslaught of Disasters, the MSWDO;

 Will make available the service of the Municipal Disaster Operation Center on
twenty-four (24) hours services;
 Will coordinate with the forty five (45) BDRRMC’s of the municipality collating all
advanced and available disaster monitored reports for proper utilization of the
Office of the Municipal Mayor and the Sangguniang Bayan;
 Will provide necessary relief assistance to affected populace in the whole
Municipality of Tagkawayan;
 Will continue monitoring the different disaster prone areas of the municipality,
coordinate these with the Communication, Rescue and Recovery Committee;

After the Perils of disaster, the MSWDO;

 Will submit the final reports to the Office of the Municipal Mayor such as the final
disaster affected population and properties;
 Will make proper assessment report for preparation of Project Proposals for the
Rehabilitation of affected population and properties.

THE DEPARTMENT OF INTERIOR AND LOCAL GOVERNMENT

 29

On Pre-Disaster Phase, the DILG thru its Municipal Local Government Operation Officer
(MLGOO) shall;
 Assist the establishment and operation of the disaster operation centers;
 Assist in the conduct of training especially those of LDRRMCs;

During disasters, the DILG will;

 Oversee the disaster council’s activities thru situationer/monitoring reports from the
LGU’s;
 Assist in the mobilization of officials thru communication, networking and linkages;
 Assist in the survey of disaster areas and in the distribution of relief goods.

After the Disaster, the DILG’s;

 Make a post – disaster report coming from different LGU’s incorporated with
possible recommendations and immediate action;
 Coordinate with the other government agencies/ non-government organizations to
help the victims by providing them self-helped projects on livelihood projects.

OFFICE OF THE MUNICIPAL ADMINISTRATOR

Before disaster strikes;

 Identification of communities for possible occurrence of different types of disaster;
 Formulation and receives contingency plan
 Step up preparedness thru:
- Creation of Quick Response Team (QRT);
- Coordination and networking with other members of MDRRMC’s;
- Information, Education Campaign to “would-be-affected” communities;
- Emergency Action Team for emergency response to disaster and calamities
distress call.

During Disaster Phase;

 Activation of Quick Response Team (QRT)
 Assign and identify staff elements for disaster for the following services:
- Evacuation Services
- Rescue and Recovery Services
- Relief and Rehabilitation
- Emergency Services
- Communication and Warning Services

On Post Disaster Activities

 Mobilization of staff to validate and report disaster related damages
 Provision of available and capable assistance

THE MUNICIPAL AGRICULTURIST OFFICE

 30

On Pre-Disaster, among the activities are:

 Information campaign regarding crop diversification; repairs of irrigation canals,
desilting of irrigation canals, provision of vegetable seeds.
 Coordinate with the counterpart and local officials of disaster prone areas regarding:
- Information campaign
- Preventive measures
- Contingency plans

During Disaster Period

 Damaged assessment and monitoring
 Fielding of personnel to initially assess the damage incurred in the affected areas.
 Report incurred damages to the MDRRMC for proper information.
 If necessity permits, emergency purchase of drugs and biological to prevent the
spread of animal diseases and treatment of affected animals.
 If needs warrant, placing a particular affected area under quarantine to prevent the
transfer of infectious diseases from one place to another, thus, includes the
restriction of movement of animals and to some extent of people to control the
spread of diseases.
 Monitor the prices of animal products and by products in the market to prevent
unscrupulous businessmen from taking advantage of the situation

After the Disaster

 Rehabilitation of damaged plantation thru seeds and seedling distribution or thru
financial assistance
 Rehabilitation of damaged fields thru fingerlings dispersal
 Assist in the sourcing of funds for the rehabilitation of the livestock industry in the
affected areas.

THE MUNICIPAL ENGINEERING OFFICE

Before the coming of Disaster, the MEO is in-charge of:

 Preparation of heavy equipment like dump trucks, pay loaders, road graders, trailer
trucks, power saw and other equipment needed;
 Assess and monitor possibilities of occurrence of road breaks;
 Stand by vehicles for possible rescue operations in case of disasters;
 Preposition all personnel for immediate dispatch to needed disaster areas;

During disasters, MEO staff and personnel,

 Dispatch all communication systems to identify possibilities of landslides,
roadblocks;
 Dispatch all vehicles and equipment necessary for disaster related activities such as
road clearing and transfer of possible evacuees for safer grounds.
 31

After the Disaster,

 The presence of operation clearing of still un-cleared road blocks; landslides and
fallen tree cuttings for road clearing;
 Prepare project/program proposal for rehabilitation of damaged properties, roads,
and other government-owned infrastructures.

MUNICIPAL HEALTH OFFICE

Before the Disaster Strikes

 Establish a planning team
 Review and develop Municipal Health Office Disaster Plan
 Identify and estimate available medical resources
 Test plans, identify deficiencies and corrective actions
 Set up emergency management center

During Occurrence of Disaster

 Make initial response
 Make personnel notification
 Reception of patients
 Treat Victims
 Provision of Assistance Center

After the Disaster

 Incident Report
 Restocking of Supplies
 If needs arises, decontamination of immunization of exposed personnel
 Cleaning up of affected community
 Monitoring of sites for sentinel events
 Recovery
 32

HEALTH EMERGENCY
PREPAREDNESS PLAN

VIII. HEALTH EMERGENCY PREPAREDNESS PLAN

 33

RISK ASSESSMENT AND MANAGEMENT PLAN

Definition - Risk Management is a comprehensive strategy for reducing threats and

consequences to public health and safety of the community by:

a. preventing exposure to hazards (target = hazards)

b. reducing vulnerabilities (target group = community)
c. developing response and recovery capacities
(target group = response agencies)

Risk management includes a number of components namely:(1) the process of selecting a

hazard, (2) identifying the communities exposed to that hazard, (3) predicting the consequences
of that hazard interacting with that community, (4) analysing each of the 5 elements of
community in relation to the hazard to identify the factors which will lead to each consequence
(i.e. determines the vulnerabilities of each element), and (5) identifying the capacities within the
community to respond to that hazard.

The formula observed in Risk Management is as follows:

Risk = Hazard x Vulnerability

Capacity

This implies that even if there is high possibility of hazard and there is high vulnerability of the
community, if the community’s capacity to manage is also high, then the probability or risk to
occur is low. Therefore it takes a high capacity or preparedness of the community to prevent
hazard and reduce vulnerability so that risk can be managed. We equate the capacity with
preparedness of the community in risk management.

Emergency Preparedness Plan (Risk Reduction Plan)

Geographically and strategically Tagkawayan is prone to different types of natural and man-
made disaster.
 34

A. HAZARD ANALYSIS/ ASSESSMENT

HAZARD SEVERI FREQUENCY EXTE DURATION Manageabil TOTAL=(A+B+C

TY (A) (B) NT (C) (D) ity (E) +D)-E

NATURAL
Typhoon 4 3 3 3 6 7
Earthquake 4 2 3 2 5 6
BIOLOGIC
Disease 4 2 3 3 6 6
Outbreak
TECHNOLOGI
CAL 5 0 3 3 6 5
Fire

AREAS PRONE TO HAZARDS

HAZARDS AFFECTED HEALTH FACILITY/SERVICE

AREAS
FIRE RHU/Environmental section, kitchen,
laboratory
TYPHOON RHU/all areas
EARTHQUAKE RHU/ all areas
DISEASE OUTBREAK RHU/receiving area, MHO’s room,
laboratory
 35

Tagkawayan RHU: Areas Prone to Hazard

 36

B. HAZARD REDUCTION/PREVENTION PLAN

Hazard Strategies Time Resource Requirement Person Indicators

Frame Required Available Source Responsible
1. Fire Compliance with ASAP Safe facility Fire dept. MHO Fire safety
fire safety policy checklist tool policy complied
Building Quarterly Safe facility Municipal Municipal Fire Building
inspection for checklist tool engineering Dept. inspected
fire hazard areas
Inspection of Quarterly Safe facility Municipal Municipal Facility
facility electrical checklist tool engineering Engineering electrical
wirings wirings
inspected
Conduction of Annually Fireman Municipal Fire Fire drill
fire drill Dept. conducted
Provision of fire Annually Fire Fire
extinguisher extinguisher extinguisher
provided
Implementing All year No Smoking
“No Smoking” round Policy
Policy implemented
2. Typhoon Availability of All year Directory MHO MHO Telephone nos.
contact round available
numbers of fire
and police dept.
Provide Evacuation plan
evacuation plan provided
3. Earthquake Building All year DOH Municipal Building
inspection round Engineering inspection done
 37

Conduct Twice a Earthquake drill

earthquake drill year conducted
4. Disease Provision of PPE ASAP Equipment LGU/DOH LGU PPE provided
Outbreak and supplies
Observance of All year All facility Asepsis and
proper hygiene round personnel hygiene
and asepsis provided
Composition of Local Chief LDWQMC
Local Drinking Executive created
Water Quality
Monitoring
Committee
Early diagnosis Infectious
and treatment diseases
of infectious detected and
diseases managed

C. VULNERABILITY REDUCTION PLAN MATRIX

Hazard Vulnerability Prevention Time Resource Requirement Person Indicator

Strategies/Activities Frame Required Available Source Responsible
1. Fire Lack of Conduct fire drill ASAP Fire LGU Funds LGU Availability of
knowledge extinguisher fire
using fire extinguisher
extinguisher
Exposed Building inspection ASAP Electrical LGU Funds Electrician Checked and
electrical including electrical supplies fixed
wirings wirings electrical
wirings
2. Leaking roofs Repair of leaking roofs ASAP Repairing LGU Funds LGU; Repaired
 38

Typhoons and ceiling and ceiling materials Municipal roofs and

Engineering ceiling
3. With visible Cracks must be ASAP Repair and LGU; With safe
Earthquake cracks immediately assessed assessment Municipal RHU and
and reported for Engineering totally
immediate corrective rehabilitated
maintenance
4. Disease Lack of PPE Provision of PPE ASAP PPE LGU MHO PPE provided
Outbreak materials Funds/DOH

VULNERABILITY ASSESSMENT

 RHU is vulnerable to fire due to presence of volatile and flammable gases or reagents
 Hazard is fire; the vulnerable area is the entire facility of RHU
 Vulnerability of property is the use of flammable gases or reagents
 Vulnerability to services; there is no alternate place of service delivery
 RHU has no existing fire exit

VULNERABILITY ASSESSMENT MATRIX

Hazard Vulnerable Vulnerabilities

Area People Properties Services Environment Livelihood
1. Fire All facility Inadequate Equipment that is Disruption of Lack of Decreased
areas knowledge in using prone to fire not services implementation of income
fire extinguisher inspected fire safety
procedures and
precautions
 39

2. Typhoons All facility Facility Disruption of Lack of Low or no

areas personnel/injured health implementation of income at all
patients/displaced services safety procedures
3. All facility Health Building Disruption of Lack of Low or no
Earthquake areas personnel/injured damaged/collapsed services implementation of income at all
patients/displaced safety procedures
4. Disease All patients’ No standard Absence of triage area Inadequate Inadequate Low facility
Outbreak area operating diagnostic disinfection income
procedures on procedures in
infection control case
program of health detection of
personnel infectious
diseases
Inadequate Inadequate medical No facility Inadequate
knowledge on proper supplies surveillance proper
hygiene system environment
sanitation
Patients, all age Inadequate PPE Inadequate
groups, inadequate laboratory
knowledge on and medical
handwashing services
Inadequate
awareness on
communicable
disease
 40

D. RISK ASSESSMENT

Risk Capacity Strategies/Activities Time Resource Requirement Indicators

Preparedness Fram Required Availabl Source Person
e e Responsibl
e
Probability Policies Development update All Plan Budget MHO and Policies
of death a. Sanitation year Funds from the all developed
b. Infection control roun Materials municipal employees and
Probability c. Waste management d Laborer governmen implemented
of disease or d. Therapeutic Plan t
injury e. Preventive Materials
(mental, maintenance of facilities and
physical) and equipment manpower
f. Vermin and termite Funds Facility
Probability control maintenan
of secondary ce
hazards (fire, g. Facility maintenance Facility
disease, etc) maintenan
ce
Probability
of Plan To develop facility ASAP HEPRRP MHO and Plan
contaminati emergency all developed
on preparedness, response employees
and financial plan
Probability
of Protocols, Development of Policy of HEMS System that
displacemen Procedures guidelines on: the Coordinato develop
t and 1. Evacuating of patients following r reliable and
Guidelines during emergency to efficient
Probability strengthen emergency
 41

of loss of 2. Guidelines of logistics capacity response

income or management
property
3. Guidelines on resource
Probability mobilization
of
breakdown 4. Guidelines on
in security communication and
media management
Probability
of damage 5. Guidelines on
to information
infrastructur dissemination/managem
e ent

Probability 6. Guidelines on
of incidents command
breakdown system
in essential
services 7. Guidelines on internal
and external
management disaster

Partnership Referral system and MOA All Referral

Building networking with ILHZ employees system
Development network of strengthened
the whole hospital in the
community
Development network
with private hospital and
laboratory in
 42

Tagkawayan
Conduct networking
activities
Identify alternative
health facility in case of
patients needing surgery

Program Strengthen the infection ASAP Protocol, LGU Infection Infection

Developme control of the facility guidelines Control Control
nt and Committee strengthened
Develop/strengthen policies Nutrition Strengthened
nutrition program in Cluster Nutrition
emergencies Program
Develop/strengthen WASH Strengthened
water sanitation and Cluster WASH
hygiene promotion Program
during emergencies

Physical Assessment of existing ASAP List of Municipal MHO and Physical

Infrastructu facility (structural, non- problems governmen all Infrastructure
re structural, functional) and budget t employees Development
Developme repair
nt

Practices Documentation of good ASAP Logbook of MHO MHO and Good practice
practices and lessons activities all documentatio
learned for every and employees n
emergency and disaster documente
respondent d report

Peso and Allocation of funds and Whol Funds Municipal MHO Funds
 43

Logistics requisition of: e Governme allocated and

- Communication year nt communicatio
- Equipment roun n, transport
- Transport d supplies and
- Supplies and materials materials,
- Drugs and Materials drugs and
medicine
requested

Health Dissemination of Whol IEC MHO/DOH MHO and Health

Promotion materials for Health e Materials all Education
Education Activities year employees Materials
roun Disseminated
d
Conduct health Plans and MHO and Health
education and programs all Education
promotion activities employees activities done
regarding emergency in
the facility

HEALTH EMERGENCY CAPACITY DEVELOPMENT PLAN

CHANGE MATRIX
PERFORMANCE
Possible State Desired State
Incidence of morbidities and/or mortalities associated with emergency Decreased number of morbidities and/or
occurrence mortalities

Incidence of communicable diseases within relocation/evacuation site 80% reduction of communicable disease cases
 44

Possible stock-out of food, water, medical supplies and other basic necessities No stock out of necessary supplies

Lack of coordinated response and referral system due to possible absence of Coordinated referral and response mechanism
communication lines through a systematic approach

Performance Capacity Capacity Expected Output Target of CapDev Process Source of

Objectives Development Development Owner/Offic Support/
Objectives Interventions e Technical
(Desired Responsible Assistanc
State) e
Incidence of Decreased Coordinated HEPRR Plan Afflicted MDRRMO, GF, PHO,
morbidities and/or number of response areas/barangays MHO DOH
mortalities morbidities mechanism
associated with and/or among Trained staff
emergency mortalities responsible
occurrence departments Response team
such as
MDRRMO, MHO,
MSWD
Incidence of 80% Health Masterlist of Patients afflicted MDRRMO, GF, PHO,
communicable reduction of information cases with communicable MHO DOH
diseases within communicabl dissemination disease especially in
relocation/evacuatio e disease HEPRR Plan relocation/evacuatio
n site cases Provision of n site
separate areas
for
communicable
disease cases
Possible stock-out of No stock-out Procurement of MOA between Number of possible MDRRMO, GF, PHO,
food, water, medical of necessary supplies responsible targets MHO, MAO, DOH,
supplies and other supplies agencies MSWD, MB, private
 45

basic necessities Coordinated NGOs sectors

response HEPRR Plan
mechanism from
responsible
departments,
GO’s and NGO’s
Lack of coordinated Coordinated Affiliation, Quarterly Response team MDRRMO, GF, DOH
response and referral referral and meetings and meetings/minute MHO, MSWD
system due to response subsequent plan s of meetings
possible absence of mechanism among involved
communication lines through a departments
systematic
approach
 46

HEALTH EMERGENCY
RESPONSE PLAN
 47

VIII. HEALTH EMERGENCY RESPONSE PLAN

In the onset of mass casualties/ disaster, the Tagkawayan Health Emergency

Management Staff (Tagkawayan HEMS) will be activated and will adapt the code of alert system
and triaging of victim or casualties. The Tagkawayan HEMS will establish a station hospital
whereby victims are categorized thru a TRIAGE system.

TRIAGE is a process wherein patient or victims’ priority of treatment is categorized on

the basis of the severity of their condition. Victims are divided into 3 categories:

 Those who are likely to live, regardless of what they receive

 Those who are likely to die, regardless what care they receive
 Those for whom immediate care might make a positive difference in outcome

After victim is categorized, tag is attached to patients or victim. Triage tag are
prefabricated label place on each patient/victim that serves to accomplish several objectives:

 Identify the patient

 Bear record of assessment findings
 Identify priority patient in need for medical treatment and transport from the
emergency scene
 Track the patients’ progress through the triage process
 Identify additional hazard such as contamination

Sets of guidelines for evacuation and transport are as follows:

 Deceased are left where they tell. These are people not breathing and efforts to
reposition their airway has been unsuccessful
 Immediate or Priority 1 (RED) evacuation by ambulance as they need advance
medical care at once or within 1 hour. These people are in critical condition and
would die without immediate assistance.
 Delayed or Priority 2 (YELLOW) can have their medical evacuation delayed until
all immediate persons have been transported. These people are in stable
condition but require medical assistance.
 Minor or Priority 3 (GREEN) are not evacuated until all the immediate and
delayed persons have been evacuated. These will not need advanced medical
care at least several hours. These people are able to walk and may only require
bandage and antiseptics.
 48

A. POLICIES, GUIDELINES, PROTOCOLS FOR ACTIVATION OF THE DEVELOPED

SYSTEMS

EARLY WARNING AND CODE ALERT SYSYTEM

A. CODE WHITE
This is automatically declared in the following conditions:
 A strong possibility of military operation; coup attempt/armed conflict which have a
municipal implication
 Any planned mass action or demonstration and reliable information of terrorist/attack
activities within the area
 Forecast typhoons, the path of which that will affect the area
 National or local elections and other political exercises
 National and local holidays or celebrations especially New Year’s Eve, Labor Day,
Independence Day, All Saints Day, Holy Week, etc. for potential MCI
 Any emergency with potentially 10-50 casualties (deaths, injuries)
 Any other hazard that may result to emergency
 Unconfirmed report of reemerging diseases eg. Bird flu, SARS
 Other conditions that may be declared as disasters by the MHO or other appropriate
authority

Human Resources during Code White:

 The decking of EOD based on the prescribed schedule.

 The scheduled Driver and security guard will be present to assist at the Operations Center

 The Reliever 1 and 2 (next shift EODs) will be on standby

 Response Division Chief or alternate to perform continuous monitoring and will serve as
Medical Controller for Mass Casualty Incident

First Response Team: (See Response Team Composition p. 22)

Second response team will be on call: (See Response Team Composition p. 22)
 49

 RHU personnel residing at the near the hospital shall be placed on call status for immediate
mobilization.

Functions:
 EOD1 shall check all available medicines and supplies

 EOD1 & EOD2 will perform proactive monitoring within their catchment area

 EOD2 shall alert the barangays, municipal/city, hospitals and other facilities within the
catchment area that might be affected or needed to respond or receive patients

 HEMS Coordinator or Response Division Officer shall alert key officials as needed

 EOD will inform the Provincial Epidemiology and Surveillance Unit (PESU) regarding
outbreaks for confirmatory report

The HEM Coordinator shall:

 Activate the Hospital Operations Center.

 Continuously report and coordinate with the PHO HEMS Operations Center.

 Prepare the personnel department for mobilization of additional staff

 Activate Bird Flu/SARS Plan etc, if needed

 Enforce and monitor use of personal protective equipment (PPE) for all health personnel.

 Activate the triage system

The supply officer shall ensure that emergency medicines (especially for trauma needs) be
made available

Finance officer shall ensure availability of funds in cases of emergency purchases and the like.

Logistics officer shall coordinate with possible suppliers for additional requirements.

Dietary/Nutrition officer shall open and meet the need of the victims as well as the health
personnel on duty.

Security force shall institute measures and stricter rules in the RHU.
 50

B. CODE BLUE
This is automatically declared in the following conditions when:

Any condition mentioned in Code White plus any of the two below:
 Mobilization of MHO resources is needed (manpower, materials, etc.)
 30-50% of health facilities in the area are affected or damaged.
 Lack of capability of the LGU/and/or lack of resources of the municipality to respond to the
affected area.
 Magnitude of the disaster based on geographic coverage and number of affected
population is more than 30%.
 Any Mass Casualty Incident with 50-100 casualties irrespective of color code.
 High case fatality rate for epidemics.
 Confirmed human-to-human cases of avian flu or SARS.

Human Resources during Code Blue:

 HEM Coordinator or Response Division Chief should be physically present at OpCen

EOD 1 and 2 (See Response Team Composition p. 98).

 Driver and Security Guard to assist at the Operation Center

 Incoming EOD’s are on call for immediate mobilization

 Logistics Officer or alternate must be on duty

 At least one municipality representative to go on duty to MDRRMC if required and or

requested

 On scene Response Team (See Response Team Composition p. 21)

Functions during code Blue:

 The EOD shall coordinate with the following:
- Implementing agencies (PHO, hospitals, barangays) for possible dispatching of teams or
experts
- MDRRMC and other sectors for other concerns e.g transportation etc.
- Materials and Management Division (MMD) regarding supplies available at the MHO,
PHO and different MHO for personnel augmentation to the Operation Center for other
technical support.

 The EOD shall prepare possible drugs and medicines needed for movement to affected
area
 51

 The supply officer or logistics officer or designate shall prepare emergency purchase upon
the approval of the Local Chief Executive (LCE) if needed drugs/medicines are not available
and request from the PHO HEMS for possible assistance.

 The Response Division Chief and logistic officer will check all possible means of
transportation ex. with MDRRMC, ambulance, air lift.

 The Response Division Chief must anticipate need of medical teams and other experts.

 The EOD will prepare all needed reports and presentation required especially for
emergency MDRRMC meetings.

 The HEMS Coordinator or Response Division Chief must orient staff to be deployed to
MDRRMC and those additional staff to augment the OpCen

 The HEMS Coordinator or Preparedness Division Chief will prepare plan for support to the
affected areas in cases of long term emergencies

 The HEMS Coordinator or Response Division Chief shall activate Code Alert Blue for HEMS
and prepare necessary documentation

 The HEMS Coordinator will initiate the conduct of coordinative meeting of the national
clusters: Health, Nutrition and WASH

All those mentioned in Code White plus:

The HEMS Coordinator shall:

 Activate RHU Emergency Incident Command System

 Shall report regularly to PHO HEMS OpCen and as much as possible have regular press
releases or briefings.

 The MHO or his designate shall make proper coordination with other hospitals for
networking and/or possible transfer of patients.

 The Supply Officer shall ensure that other needs of victims apart from medicines and
supplies depending on the disaster should as much as possible be made available.

 Incident Commander shall assign a Safety Officer, Liaison officer to coordinate with other
agencies, and Public Information Officer to serve as the spokesperson of the RHU.

 Mortuary Officer shall anticipate dead victims for proper care and identification.
 52

 The security team, in anticipation of possible influx or patients, relatives, responders,

police, press, etc. shall ensure smooth flow of traffic inside the compound especially for the
ambulances.

C.CODE RED
This is automatically declared in the following conditions when any natural, manmade,
technological or societal disaster, where ALL of the following are present:
 Declaration of disaster
 100 or more casualties in one area
 Health personnel in the municipality are not capable to handle entire operation
 Mobilization of health sector are needed
 Mobilization of key clusters in MHO
 Uncontrolled human to human transmission of SARS/Avian Flu

Human Resources during Code Red:

The HEMS OpCen personnel and staff augmentation from other offices shall be divided into 3
teams to go on a 24 hour rotation every 3 days. The team shall be composed of the following:

 Team Leader
 Data Collector/Encoder
 Logistics
 Communication
 Administrative Officer
 Support Staff/Clerk
 Driver
 At least 1 staff to be assigned at the MDRRMC OpCen on 24 hours duty
 All RHU Personnel

Functions during Code Red:

 HEM shall represent the Municipal Health Office to the MDRRMC and other agencies

 HEM Coordinator shall lead in the coordination with the provincial partners in the Health,
Nutrition and WASH Clusters

 HEM Coordinator shall lead in the coordination with the donor agencies both international
and local

 HEM Coordinator shall prepare updated reports for use of Provincial and Municipal Health
Officer and other partners
 53

 HEM Coordinator shall assist in the preparation of the rehabilitation and recovery plan;
represent the MHO in the local Damage Assessment and Needs Analysis (DANA) Team

 HEM OpCen will be serve as MHO Command Post

All those mentioned in Code Blue plus:

The MHO shall:

 Cancel all types of leaves and can order all personnel to report to the RHU.

 Shall anticipate requests for additional manpower and specialists not available in the RHU.
He/she is further authorized to accept medical volunteers and other professionals to
augment the RHU’s manpower resources.

 Network with other hospitals for augmentation of resources and transfer of patients in
special cases.

 Answer all queries of the media pertaining to patients.

 Anticipate evacuation and/or use of field RHU; closure and/or quarantine of the RHU.
specifically be concerned with safety and security, not only of the patients but of the
personnel as well

B. ACTIVATION

1. ACTIVATION OF THE ALERTING PROCESS

1.1. DECLARATION

Declaration of RHU Alert

 In the event of an incident with a potential or threat to become emergency or disaster

or if emergency has occurred and patients arrive in the RHU for definitive treatment, the
“RHU Alert Code” will be raised or declared by the MHO or the HEMS Coordinator,
whereas when threat is no longer present, or when no significant incident is monitored
and the hazard or coordination is finished the RHU Alert Code is suspended.
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Dissemination of the Alert Code

 Meeting or conference will be conducted by the MHO or HEMS Coordinator for proper
notification to all staff and authorities especially the planning committee.

 It will be properly followed by an administrative order from the MHO so that the staff
personnel can be well prepared, synchronized, timely and with appropriate response
actions.

1.2. NOTIFICATION

Mode of Notification

 All RHU staff/personnel’s personal contact numbers and addresses should be

listed/posted at the Municipal Bulletin Board and Disaster Committee Members. They
will be texted by liaison officer if they are needed in the operation center.

 In cases that the place of the personnel concerned is secluded or difficult to reach thru
cellular phone/landline or radio communication, notification must be made thru the
Barangay Official or any relatives or neighbors near or close to personnel.

 Banging

a. First Alert will be done by continuous banging sound of the flag pole and megaphone
announcement, paging system or siren for one full minute to notify that disaster
may strike anytime, and all concerned are advised to prepare.

b. Second Alert will be done by successive banging sound of the flag pole and
continuous megaphone announcements, paging system or siren for five minutes to
mean that a disaster is occurring. Double time is needed to safeguard patient’s life,
equipment and important papers/documents.

 The Liaison Officer and Security Guard will personally notify personnel in the absence of
response from personnel via cellular phone or radio. In this regard, there should be
readily available service vehicle for the purpose.

The Alert Status shall continue to be in effect until cancelled by the MHO or HEM Coordinator.
 55

2. ACTIVATION OF THE RHU RESPONSE PLAN

Immediately upon declaration of the RHU Code Alert, the plan is subsequently activated.
The logistics and other human resource requirements will be positioned or made available and
accessible for mobilization depending on the alert level status and on the role of the RHU that it
has to assume.

Activation of the Response Plan

a. When Code Blue and Red is declared by the MHO or HEM Coordinator
b. Upon declaration of Code Blue or Red by the Municipal Health Officer or Municipal
HEMS Coordinator.

Deactivation or Termination of the Plan

When the HEM coordinator determines that the stage of emergency no longer exists, an
announcement to terminate the disaster operation will be made.

 The “Information Officer” shall be notified by the HEMS Coordinator that the
disaster plan is no longer in effect.

 The Information Officer shall inform all units/ departments of the termination of the
disaster operation plan.

 A report on the disaster operation will be prepared by the individual units and
submitted to the Disaster Committee/HEMS Coordinator for evaluation, records
keeping and reporting.

3. ACTIVATION OF THE RHU OPERATION CENTER

 Operation Center will be activated once CODE WHITE has been declared. It will serve as
the COMMAND POST when code blue is raised.

 The Operation Center will be located at the office of the Municipal Health Officer
 56

The manpower and decking of EODs and ERTs will be based on the level of code
alert raised (See Response Team Composition p. 98)

 Functions of Operation Center and Personnel (See Annex B p. 97)

 The established Emergency Operation Center will provide overall command and
coordination of the RHU’s disaster response activities such as:
a) Activation of the plan
b) Coordination of RHU activities with those at the disaster site and adjusting the plan
as necessary.
c) Include opening of addition, obtaining hospital wards or clinic, obtaining assistance,
evacuation of endangered patients.
d) Assignment of staff to treatment areas
e) Revision of original job assignments

 Standard Operating Procedure for Emergency Operation Center (See Annex B p. 102)

4. ACTIVATION OF THE RHU EMERGENCY INCIDENT COMMAND SYSTEM

The RHU Emergency Incident Command System is an emergency management system

which employing a logical management structure, defined responsibilities, clear reporting
channels, and as common nomenclature, help unify the RHU emergency management system.
It is made up of positions on a functional organization. Each position has specific functions and
responsibilities to address an emergency situation.

The overall Incident Commander shall be stationery in the command post to make
timely decisions, information and requests. The “Operational Commanders” and “Logistics” will
have the role to evaluate the entire Health Services Condition. These Commanders need not to
be completely stationary to be effective in directing their specific roles.

 They shall have radio and mobile communications in the command post at all times.
 They shall be the eyes and ears of the Incident Commander
 It is only through proper evaluation of the ongoing incident and constant feedback
to the command post that the incident can be best managed.
 Telephone calls shall be maintained and kept up to date with current staffing needs
and information.
 The recall of personnel should be as directed by the Incident Commander.
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 Certain areas of the RHU should be designated for specific functions such as area of
casualties, discharge of patients, stockroom for medicines, supplies, treatment and
etc.
 It should be specified as to the purpose and function, staffing requirements and
basic supplies to be utilized.

When Code Blue has been declared, the RHU Emergency Incident Command System
shall be established to have proper command and control over the situation.

The Incident Commander (IC) will initiate the following:

Step I -
Assume command
Step II -
Assess the situation
Step III -
Identify and set perimeters
Step IV -
Establish / activate the pre-designated or alternative
Command Post
Step V - Identify safety Area and Safety Officers
Step VI - Identify Staging Area and Staging officer

1. Job Action Sheet shall contain the designated personnel and their function,
responsibilities and activities to be carried out for emergency response (See p. 83)

2. Incident Management Process – the Incident Commander will initiate the incident
management process which is composed of an ordered sequence of actions:

 Establishment of the incident goals which will determine where the system wants to
be at the end of response.

 Definition of the incident objectives and strategy which will determine how to get
there.

 Dissemination of information which will include situation status reports, resource

status updates, safety issues for responders and communication method for
responders.

 Evaluation of strategies and tactics for effectiveness in achieving objectives and

monitoring ongoing circumstances.
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 Revision of the objectives, strategies and tactics will be dictated by incident

circumstances.

B. OPERATIONS/SUPPORT MANAGAMENT

5. IMPLEMENTATION OF THE RESPONSE STANDARD OPERATING PROCEDURES/PROTOCOLS

FOR INTERNAL AND EXTERNAL EMERGENCIES

5.1. CALLBACK/MANAGEMENT OF STAFF

 The MHO or HEM Coordinator shall recall and suspend off duties and leave of
absences and ensure 100% attendance of hospital personnel during emergency
unless affected by present disaster

 The RHU personnel shall wear their prescribed uniform and identification/ marks as
emergency responders.

 The RHU personnel shall report to Operation Center (OPCEN) daily for pre-
conference to include instructions, new assignments and updates from the Incident
Commander and HEM Coordinator.

 There will be a post-conference after the end duty of the day for the evaluation of
the whole day activities/ operation

 There will be a disciplinary action to personnel for failure to report to an urgent call

5.2. MANAGEMENT OF FIELD/ON-SITE ACTIVITIES

 As a Responding RHU to an External Emergency

a. Development of On-Scene Response Team (See Response Team Composition p. 21)

 The RHU and OPCENs shall dispatch teams within their catchment areas upon
monitoring or receiving a call confirming a Mass Casualty Incident (See Flowchart
p. 179).
 59

 The RHU/hospital shall also be dispatched even outside the catchment areas
upon a request of help from neighboring facilities or upon instructions of the
PHO HEMS OPCEN (See Annex C-1 p. 102)

 While the initial team was dispatched, the RHUOPCEN anticipates the sequence
of events and alerts additional teams that might be needed, other nearby health
teams in the community such as barangay health centers and shall start
reviewing the logistics needed.

b. Information and Dispatch

Information is not only limited between rescue staff and media at the damage area.
Information flow is very important within the RHU.

Information concept consists of:

 Information of staff
 Information of neighboring hospitals and operation centers such as ambulance,
police etc.
 Information of friends and relatives
 Information of media

c. Standard Operating Procedures (See Annex C-2 p. 106)

d. Predetermination of Field Areas

1. SOP on Site Selection, Signage and Logistics

1.1 Selection of the Advance Medical Post (AMP)

 The Field Medical Commander shall identify the location of the AMP with
the concurrence of the Incident / Scene Commander upon considering
the following criteria:

1) Safety form the disaster impact and from natural factors

2) Security
3) Proximity, easy route access and upstream
4) Accessible / available water source (preferably potable) and
provision for waste disposal
5) Communication access
6) Route
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1.2 Signage
 The RHU team shall have the following signage to provide when
responding. It will be reflectorized, written and readable at 20feet.

1) Advance Medical Post or Field Medical Commander

2) Triage Area, Triage Officer
3) Treatment Area, Treatment Officer (red, yellow, green, black flags
and banner)
4) Ambulance loading area, Transport Officer
5) Staging Area, Staging Officer
6) Mortuary Area, Mortuary Officer

1.3 Logistics Needed at the Site

 The logistic officers shall prepare the following for on scene use:

1) Personnel
2) Communication equipment
3) Medical Equipment and Supplies(toxicology and trauma kit)
4) Emergency drugs and Emergency Kit
5) Defibrillator, Suction Machine
6) Electrical Supplies / Generator
7) Cot bed, IV Stand, tents
8) Food and water provision
9) Personnel protective equipment

e. Assessment of Scene using Rapid Health Assessment& Damage Analysis and Needs
Assessment (RHA/DANA) (See Annex D p. 108)

1. Composition of RHA/DANA Team (See Response Team Composition p. 21)

2. The RHA/DANA Team shall perform the following initial assessment:

 Identify immediate extent and potential risk of the problem

 Mobilize adequate resources to correctly organize field management
 Conduct immediate assessment of the initial incident

3. The RHA/DANA Team shall collect the following Data for Initial Assessment and
Reporting:

 Precise location of the event

 Time of the event
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 Type of incident
 Estimated number of casualties
 Added potential risk
 Expand population
 Right resources needed

4. The RHA/DANA Team shall report the gathered data and information to RHU
OpCen

 The RHA/DANA Team shall submit immediately initial assessment and refrain
from starting haphazard work to avoid delay in the mobilization of resources.

 The RHU OpCen shall process the initial assessment and perform the following:

 Dispatch the necessary teams required and immediate resources needed

 Alert and put on stand-by additional responders that might be required.
 Coordinate with the hospital to prepare for the overwhelming / deluge of
patients
 Prepare other places or evacuation sites of health centers in the event
that the volume of patient is beyond the capacity of the hospital.
 Review logistical requirements
 Report to superiors
 Report to PHO HEMS OPCEN/Municipal Health Officer or to MDRRMC.

f. Establishment of Command Post or Linkage (Unified Medical Command)

 The Incident & Medical Commanders will identify the Field Areas for various
purposes prior to dispatch and operation which will allow various incoming
resources to reach their places rapidly and efficiently.

 The following that will be wrapped out and identified by the Incident & Medical
Commanders:

 Impact Zone
 Command Post Area
 Advanced Medical Post Area
 Evacuation Area
 Staging Area
 VIP & Press Area
 Access Roads
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g. Conduct of Measure for Site Safety

 Safety measures will be implemented by the Safety Officer and Medical

Commander to protect victims, responders and exposed population from
immediate or potential risk (extension of the accident, responding to traffic
accident, hazardous materials etc) which will perform the following:

i. Direct action includes risk reduction by firefighting, confinement of

hazardous materials, use of protective clothing, and evacuation of exposed
population.
ii. Preventive actions (WMD) include the establishment of the following
restricted areas:

 Impact Zone / Hot Zone – strictly restricted to professional rescuers

who are adequately equipped

 Secondary Area / Warm Zone – restricted to authorized staff working

in rescue operation, care delivery, command and control,
communications, ambulance services and security / safety.

The Command Post, Advance Medical Post, Evaluation Center and

Parking for the various emergency and technical vehicles will be set
up and this is approximately 100 meters from the impact zone &
depends on the wind direction.

 Tertiary Area / Cold Zone – access by press officials and serves as

“buffer” zone to keep onlookers out of danger. Approximately 50-100
meters away from the Warm Zone, and also depending on wind
direction.

iii. The Medical Commander and Team Leaders shall ensure that the responders
has Minimum Personal protective Equipment (PPE) who is in contact with the
patient, these includes the following:
 Gloves
 Goggles
 Mask
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vi. For suspicious Weapons of Mass Destruction incidents, medical respondents

will only be allowed at the Cold Zone with proper protective clothing. Only
those with protective clothing and with proper training will be allowed entry
in to the Hot and Warm Zone (See Flow Chart p. 60).

vii. Priority for Evacuation (On-Scene)

“Common Standard Color in “color tagging of victims” (See Annex E p. 112)

h. Evaluation, care (first aid, medical etc.) stabilization of casualties at the impact
site, advance medical post and during evacuation /transport.

i. Continuing Coordination/Monitoring with the receiving hospital and PHO HEMS -

OPCEN.

5.3. MANAGEMENT OF EMERGENCY DEPARTMENT/UNIT

Management of Surge of Patient

 When sudden surge of patients comes in, the Tagkawayan Municipal Covered Court
will serve as the triaging area.

 The OPD consultation will immediately be suspended and be used to accommodate

the influx of patients.

 Treatment area will be at the Tagkawayan Municipal Health Office.

 The Maria Eleazar District Hospital is intended for the red tagged patients or critical
patients.

 The Tagkawayan Municipal Covered Court will accommodate yellow tagged patients
while waiting for the ambulance conduction or patients who is needed to be
transferred to other hospital.

 Triaging will be used and become functional in order to maximize efficiency, entry of
all patients should be restricted to only one location, the triage area. The Disaster
Triage Function will have the following functions:
a. Rapid assessment of all incoming casualties.
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b. The assignment of priorities for management, and classification of disposition

(See Annex E p. 118)

5.4. MANAGEMENT OF CASUALTIES

 The GREEN TAG patient shall receive first aide while the YELLOW and RED TAG
patient shall be brought to Maria Eleazer District Hospital

 The hospital staff shall perform proper handling of patients with attached equipment
(See Annex F p. 119)

 The security on duty will clear all non-emergency patients and visitors from the RHU

5.5. TIMELY PROVISION OF 24-HOUR SERVICES (See Annex G p.114)

 Services will be for mass casualties, patients, hospital staff and responders

 In situation that may arise when there would be a need to change the alert status
from white to blue to red. The MHO or HEMS Coordinator shall cancel all leave of
personnel and oblige them to report to the hospital.

 The RHU staff shall perform their duties for a maximum of 24 hours as per order by
the HEMS Coordinator

 In case that the RHU staff are unable to go to the RHU to perform their duty due to
seclusion of their area, they may be picked by the service vehicle as approved by the
HEMS Coordinator/MHO

 The HEMS Coordinator/MHO shall inform the PHO HEMS OpCen in request for
augmentation and additional manpower.

5.6. MAINTENANCE OF 24-HOUR SUPPLY OF DRUGS, MEDICAL SUPPLIES, DIAGNOSTIC

SUPPLIES, AND EQUIPMENT INCLUDING MANAGEMENT OF DONATIONS

 Health Cluster Team Leader shall prepare inventory of supplies and equipment and
shall submit “Request for Materials/Supplies Form” to the Supply/Logistics Officer
 65

 The Supply/Logistics Officer shall compile all the “Request for Materials/Supplies
Form” from the Health Cluster Team Leader and release the available supplies and
materials.

 In case of there is a need for additional supplies and materials, the MHO/HEMS
Coordinator shall have an emergency purchase upon the approval of the Local Chief
Executive

 The HEM Coordinator/MHO shall inform the PHO HEMS OpCen in request for
additional supplies and materials.

5.7. MANAGEMENT OF LOGISTIC AND PERSONNEL SUPPORT BY CONCERNED UNIT (See Annex
H p. 115)

 The MHO/HEM Coordinator shall order preparation of additional and available of

beds and rooms to accommodate the surge of patients.

 The Security on duty shall be responsible for the retention and safe-keeping of
personal items removed from casualties. It must be packed and sealed with proper
identification if available.

 The Medical Officer on Duty and Nurse on Duty shall isolate victims with
communicable diseases.

 The Medical Officer on Duty and Nurse on Duty shall segregate/isolate victims
contaminated with hazardous materials.

 In case of epidemic cases especially communicable diseases, vacate rooms and

transfer or discharge patients to avoid contamination and admit patients needing
immediate confinement.

 The Medical Officer on Duty and Nurse on Duty shall separate patients categorized
as non-communicable

5.8. MANAGEMENT AND USE OF AMBULANCE (See Annex J p. 120)

 The HEMS Coordinator and driver shall ensure availability of service ambulance and
team responsible for transporting victims for further definitive care
 66

 The driver shall ensure that the ambulance is functional, maintained, and kept
cleaned/sanitized before use for service delivery.

 Ambulance must be properly equipped and manned

 Ambulance team shall be well trained and knowledgeable in handling emergency

and available at all times

 The Team Leader and Emergency Response Team shall observe proper protection
and safety for both patient and the team and observe proper use of Pertinent
Physical Examination and aseptic techniques.

5.9. ASSESSMENT AND MAINTENANCE OF SECURITY SERVICES, PARTICULARLY THE

PROTECTION OF CRITICAL SERVICES

 The Security on duty shall maintain security of the facility, patients, personnel and
responders by cordoning the area.

 Also Security on duty shall implement hospital security measures such as:
i. Securing all points of entrance and exit of the hospital.
ii. Wearing of ID’s of personnel to distinguish them from non-hospital person.
iii. Visitor must register and sign in the visitor’s logbook.
iv. Observe and limit strictly visiting hours schedule
v. Patient’s relatives, watchers and visitors must secure watcher’s and visitor’s ID.
vi. Activate all CCTV cameras for monitoring purposes (if available).

5.10. ASSESSMENT AND MAINTENENANCE OF COMMUNICATION SERVICES INCLUDINGG THE

ACTIVATION OF AN ALTERNATIVE COMMUNICATION SYSTEM

 The HEMS Coordinator/MHO shall maintain open lines of communications during

the entire operation

 Hand held radios, cellular phones, telephones, internet connections shall be used as
back up communications.

 All Emergency Response Team on the field shall have a hand held radios (if available)
 67

5.11. MANAGEMENT OF INTERNAL AND EXTERNAL TRAFFIC FLOW AND CONTROL, INCLUDING
SECURED TRAFFIC ACCESS TO THE EMERGENCY DEPARTMENT AND CONTROLLED ACCESS TO
ALLOW TIMELY AMBULANCE TURNAROUND

 The Security on duty shall control the traffic control and cordon and block access to
certain areas to help avoid chaos in the case of a mass place and exit.

 The Security on duty shall coordinate with police forces on all accidents and for
medico legal cases.

 External Traffic Flow

The Security Guards shall perform the following:

i. Control and direct the flows of going out or exit of responding ambulance teams.
ii. Maintain, secure and control separate entrance and exit gates for the
responding ambulances.
iii. Control and secure the entry points of other vehicles at the height of ambulance
response operation.
iv. Maintain, secure and control the traffic access to the Emergency Room.
v. Maintain, secure and control a separate access route for the walking pedestrians
inside the hospital, away from the ambulance routes.
vi. Provide available parking lots for the disabled
vii. Ensure available, safe and well-lighted parking lots

 Internal Traffic Flow

i. The HEMS Coordinator and Security on duty shall provide post directional
signage at strategic areas to guide the patients and responders.
ii. Security guard shall
- Secure, maintain and control separate entrance and exit doors.
- Assist, guide and direct the incoming victims and responders to appropriate
designated areas.
- Maintain, secure and control separate routes of incoming or arriving victims
from the general patients or hospital visitors.

 Crowd Control
The Security Guards shall perform the following:
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i. Cordon the area

ii. Ensure that entry of unauthorized people inside the cordoned are not allowed.
iii. Tagkawayan Municipal Lobby will be designated area for the on lookers and
crowd and must be away from the cordoned area.

 Establish Public Assistance Desk

i. Public Assistance Desk shall be established near the designated place for the
crowd, away from the cordoned area and shall be manned by the Information
Officer and always available to address public queries.
ii. Bulletin board will be provided with information posted for general public
consumption.
iii. IEC materials will be provided for the public awareness

5.12. MANAGEMENT OF RHU EVACUATION/RELOCATION OF STFF, INCLUDING USE OF

ALTERNATIVE SITES WHEN ORIGINAL AREA IS UNAVAILABLE (See Annex K & L p. 120)

 Evacuation Plan shall be activated by the MHO/HEMS Coordinator upon the

recommendation of the RHU technical staff taking into consideration of the
following principles:

i. In case of fire, all patients and personnel will be evacuated.

ii. In case of earthquake and other hazards, external evacuation of personnel and
patient’s relocation sites near the hospital will be made to assure the continuity
of care to manage the patients.
iii. Mobilize all hospital resources for evacuation in terms of manpower, logistic
and others.
iv. Prioritization of patients to be evacuated will be observed
v. Ensure availability of ambulance, back-up services from PHO or other health
services that can be utilized to transport/transfer patients.
vi. Definite evacuation site will be arranged prior to evacuation.
vii. Establishment of an alternate or field hospital shall be ensured as per order of
the Hospital Chief on the following conditions:

 If the affected hospital is very far from the neighboring hospitals.

 69

 There is an immediate need to accommodate surge of patient admission.

 The nearest evacuation site which is Tagkawayan Central Elementary School
and shall be readily available to accommodate as hospital extension or
alternate field hospital during disaster.
 Available, self-sufficient and sustainable facility, manpower, machinery,
budget, logistic and management system.
 Act as temporary facility to substitute damaged installations pending final
repair or reconstruction

5.13. MANAGEMENT OF VOLUNTEERS FOR MEDICAL AND OTHER SERVICES (See Annex M p.
121)

 The MHO shall allow medical responders from PHO hospitals to render services, as
needed and with the proper supervision from the concerned department heads, for
augmentation of manpower of the hospital during disaster or with MOA and proper
coordination

 Other volunteer responders will be allowed to render hospital services during

disaster upon approval of the HEMS Coordinator/Chief of Hospital.

 Volunteers are required to register/log-in and out for future reference.

Management of the Media (See Annex N p. 122)

 The designated place for the media will be Municipal Executive Hall which is away
from the treatment area.

 The Municipal Health Officer or the Information Officer will be the specific
spokesperson to deal with the media regularly.

 The Information Officer shall maintain a regular media/press release schedule for
incident update and ensure that up to date incident reports shall approved by the
MHO and are available and posted for media reference every day.

 The Municipal Health Officer or the Information Officer may transmit thru media the
hospital urgent messages, identify available resources, venue to seek assistance by
stimulating and directing disaster needed, warning of impending disaster, alerting of
response personnel and instruction on ways to minimize effects of disaster.
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6. PROVISION OF PUBLIC HEALTH SERVICES

6.1. DAMAGE ASSESSMENT AND NEEDS ANALYSIS/RAPID HEALTH ASSESSMENT (See Annex D
p. 108)

a. The HEM Coordinator shall deploy the RHA/DANA Team (See Response Team
Composition p. 21)

b. The RHA/DANA Team shall perform the following initial assessment:

 Identify immediate extent and potential risk of the problem

 Mobilize adequate resources to correctly organize field management
 Conduct immediate assessment of the initial incident

c. The RHA/DANA Team shall collect the following Data for Initial Assessment and
Reporting:

 Precise location of the event

 Time of the event
 Type of incident
 Estimated number of casualties
 Added potential risk
 Expand population
 Right resources needed

d. The RHA/DANA Team shall report the gathered data and information to RHUOPCEN

e. The RHA/DANA Team shall submit immediately initial assessment and refrain from
starting haphazard work to avoid delay in the mobilization of resources.

f. The RHU/Hospital OpCen shall process the initial assessment and perform the
following:

 Dispatch the necessary teams required and immediate resources needed

 Alert and put on stand-by additional responders that might be required.
 Coordinate with the hospital to prepare for the overwhelming / deluge of
patients
 Prepare other places or evacuation sites of health centers in the event that the
volume of patient is beyond the capacity of the hospital.
 Review logistical requirements
 Report to superiors
 71

 Report to PHO HEMS OPCEN Municipal Health Officer or to MDRRMC.

6.2. ESTABLISHMENT AND MAINTENANCE OF EPIDEMIOLOGIC SURVEILLANCE SYSTEM (See

Annex O p. 123)

 The HEM Coordinator/MHO shall deploy the Epidemiology and Surveillance Team

 Epidemiology and Surveillance Team shall conduct hospital disease surveillance

services and provide records and reports of injuries secondary to the disaster to
HEM Coordinator/MHO

 HEM Coordinator/MHO shall provide report/database of injuries and reportable

disease to the PHO HEMS OpCen.

6.3. IMMUNIZATION (See Annex P p. 124)

 Upon the initial report from the RHA Team regarding the health condition of the
vulnerable groups, all the necessary data shall be reported to the HEMS Coordinator
and implement appropriate interventions immediately.

 The Emergency Response Team shall provide immunization to children, adolescents,

and adults to protect them against vaccine-preventable diseases

 The HEM Coordinator shall implement the guidelines regarding Vaccine Storage
during Power Outages

 EPI Coordinator shall ensure that there are sufficient vaccines

 If there is insufficient stock, the MHO/HEM Coordinator shall coordinate and request
with the PHO HEMS OpCen for additional vaccines

6.4. THERAPEUTIC NUTRITION SERVICES (See Annex Q p. 127)

 The HEMS Coordinator/Municipal Health Officer shall deploy the Nutrition Team

 Dietitian will be the responsible in setting of menus in disaster situation.

 The dietitian and the emergency response team shall provide therapeutic nutrition
to malnourished patients affected by the disaster and establish surveillance for
patients for priority to additional supplementation.
 72

 In case of insufficient food, the Dietary Department head shall inform the HEMS
Coordinator/Municipal Health Officer

 The HEM Coordinator/Municipal Health Officer shall request for assistance regarding
additional food supply to the Local Chief Executive and PHO HEM OpCen.

6.5. WATER, SANITATION AND HYGIENE (See Annex R p. 132)

 Upon the results of the RHA, the HEM Coordinator shall mobilize and deploy
Nutrition Team to further assess the WASH status of the evacuation center

 The WASH team shall prepare report regarding the WASH Status of evacuation
center

 The HEM coordinator shall mobilization and deliver of WASH Services

 If needed, the HEMS Coordinator shall ask technical assistance with the PHO HEMS
OpCen.

DISINFECTION OF WELL AND WATER CONTAINER

Amount of Calcium Hypochlorite (70%) available chlorine required to provide a dosage 50ppm
to 100ppm available chlorine.

Diameter of Casing Capacity in gallons Amount of Calcium Hypochlorite in

per foot of depth ounces/grams per foot of depth
50ppm 100ppm
Column 1 Column 2 Column 3 Column 4
2 inches 0.16 0.001152/0.0432 0.00306/0.0866
4 inches 0.66 0.00628/0.1783 0.01256/03587
6 inches 1.47 0.001397/0.3967 0.02799/0.7949
8 inches 2.61 0.02484/0.7054 0.04969/1.4112
10 inches 4.08 0.038884/1.10305 0.07768/2.2061
12 inches 5.88 0.0557/1.5895 0.11196/3.7096

Chlorine (60%-70% Calcium Hypochlorite) requirements for well disinfection, dosage – 100ppm

Depth of 50mm 75mm 100mm 150mm 200mm 250mm 300mm

Water
Column
1 - ¼t ¼t ½t ¾t 1½t 2t
 73

2 ¼t ¼t ½t 1t 1¾t 2¾t 4t
3 ¼t ½t ½t 1½t 2½t 4¼t 6t
4 ¼t ½t ¾t 2t 3½t 2½t 8T
5 ¼t ½t 1¼t 2½t 4½t 7t 5T
6 ½t ¾t 1½t 3t 5½t 8½t 6T
7 ½t ¾t 1½t 3½t 6¼t 9¾t 7T
8 ½t 1t 1¾t 4t 7¼t 5½t 8T
9 ½t 1¼t 2t 4½t 8t 6¼T 9T
10 ½t 1¼t 2¼t 5t 9t 7T 10 T
20 1¼t 2½t 4½t 5T 9T 14 T 20 ¼ T
30 1½t 3¾t 6¾t 7½T 13 ½ T 21 T 30 ¼ T
40 2¼t 5t 9t 10 T 18 T 28 T 40 ½ T
50 2¾t 6½t 5½t 12 ½ T 22 ½ T 35 T 50 ½ T
60 3½t 7½t 6¾t 15 T 27 T 42 T 60 ½ T
70 4t 8¾t 8t 17 ¾ T 31 ½ T 49 ½ T 60 ¾ T
80 4½t 5t 9t 20 ¼ T 36 T 68 T 80 ¾ T
90 5 5¾t 10 t 22 ¾ T 40 ½ T 63 ½ T 91 T
100 5½t 6¼t 11 ¼ t 25 ¼ T 45 T 70 T 101 T

Legend:
1 t – leveled teaspoon = 5 grams
2 T – leveled tablespoon = 10 grams

6.6. PROVISION OF BLOOD SERVICES (See Annex S p.136)

 The blood and blood product stocks at the blood bank shall be mobilized to address
the needs of the victims.

 Elective surgeries shall be postponed and the blood and blood products intended for
these cases can be utilized for the disaster victims if deemed necessary.

 Victims who are in dire need of blood transfusion shall be given even in the absence
of blood donors from the end of the victim.

 Blood transfusion protocol shall be observed even in the emergencies.

 The Laboratory Department Head will coordinate with the QMC Blood Bank, Quezon
Provincial Blood Bank and Philippine National Red Cross – Lucena City Chapter for
assistance in the event of unavailability of blood.
 74

 The Laboratory Department Head will coordinate with the hospital network in cases
of blood and blood product assistance.

6.7. COMMUNICABLE DISEASES PREVENTION AND CONTROL (See Annex T p. 141)

 The HEMS Coordinator shall activate the SPEED team to early detect unusual
increases or occurrence in communicable and non-communicable diseases/health
conditions.

 The SPEED Team shall collect, organize, interpret the surveillance data and report all
available essential information to the HEMS Coordinator.

 The HEMS Coordinator shall implement appropriate epidemic control measures

immediately

 The HEMS Coordinator shall facilitate submission of report to the PHO HEMS OpCen

6.8. MANAGEMENT OF THE DEAD (IDENTIFICATION OF THE DEAD/MORTUARY) (See Annex U

p. 148)

The HEMS Coordinator/Municipal Health Officer shall observe the following:

 Dead victims from the disaster site shall not be brought to the hospital.

 Hospital shall manage the victims who died in the hospital.

 Hospital staff/ personnel are not allowed to refer the dead victims to any mortuary
service without the consent of the immediate family.

 Post mortem care should be rendered.

 Be sure appropriate paper work is filled out.

 All possessions of the dead victims shall be preserved or shall be subject to proper
sake keeping.

 List of hospital dead victims shall be submitted to the proper authorities such as
PHO-HEMS OpCen, PNP, etc, MDRRMC.
 75

 Dead victims shall be released only to the legitimate claimants after proper
identification being established.

6.9. HEALTH PROMOTION AND ADVOCACY/RISK COMMUNICATION IN PUBLIC INFORMATION

AND IN MEDIA MANAGEMENT (See Annex V p. 153)

The Health Education and Promotion Team shall:

 Provide necessary IEC materials regarding management of emergencies and disaster

after the incident

 Conduct information and education activities in times of emergency or disaster.

 Establish IEC corner accessible to the public.

 Present information on disease condition prevention rather than cure.

7. INITIATION AND MAINTENANCE OF COORDINATION AND NETWORKING FOR REFERRAL OF

CASES (See Annex W p. 155)

 Initial and regular coordination shall be done by the receiving/ affected hospital with
the PHO HEMS-OPCEN to alert the neighboring hospitals and for assistance.

 The information officer shall coordinate with the members of the ILHZ network

 The Resident on Duty shall inform the receiving hospital the status and possible plan
of actions of the patient.

 Proper communication and coordination will be done by the MHO or designate with
the other referral hospital prior to transport of patient for diagnostic purposes or for
admission.

 Two-way referral form shall be properly and completely filled up by the referring
physician signed by the resident on duty.

 Request for medical assistance like medical teams, ambulance service, logistics, etc.,
to be used for emergency or disaster operations which are available within the PHO
hospital network shall be coursed directly to the network of hospital concerned.
 76

Requests not within the capacity of the network to accommodate shall be relayed to
the Operation Center for Central Coordination, response and reporting.

8. INITIATION AND MAINTENANCE OF MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT

SERVICES FOR CASUALTIES, PATIENTS, HOSPITAL STAFF, OTHER RESPONDERS, AND THE
BEREAVED (See Annex X p. 156)

 Mental Health and Psychosocial Support Service shall be provided to the casualties,
patients, hospital staff, other responders, and bereaved.

 Stress management activities shall be done for all the responders including other
hospital staff directly or indirectly involved in the response operation

 In the absence of psychosocial personnel to provide MHPSS, coordination must be

done with the National Center for Mental Health and/or other DOH hospitals thru
the PHO HEMS OpCen for assistance.

9. MANAGEMENT OF INFORMATION (See Annex Y p. 160)

 The Field Teams shall submit initial rapid assessment to the RHU OpCen

 The HEM Coordinator shall record all required information and submit report regularly
to PHO HEM Operation Center.

 Significant information shall be posted on the bulletin board at the RHU OPCEN.

 Maintain information that can be readily shared with proper authorities shall be
approved by the MHO/HEM Coordinator

 All final documentations of the incident shall be stored in the RHU OPCEN, or
“Administrative Records” with a copy furnished to the PHO HEM OPCEN.

 Information to be shared shall limit to the following:

i. Names of person and their respective contact numbers
ii. Health and non-health sectors directing PHO, PNP, Civil Defense, PNRC, weather
Reports, maps and hospital and other health facilities
iii. Health providers and shelter location
 77

iv. Information regarding health operation

v. Such as supplies that are not in the hospital and need for blood
vi. Information that should not be shared;
vii. Sensitive information that is not related to health operation that might
compromise the response operation such as security measures ex: biological and
chemical warfare
viii. Revelation of the identification of casualties pending notification of their next kin

10. ACTIVATION OF PLAN IN THE EVENT OF COMPLETE ISOLATION OF HOSPITAL FOR

AUXILIARY POWER, WATER AND FOOD RATIONING, MEDICATION/DRESSING RATIONING,
WASTE AND GARBAGE DISPOSAL, STAFF AND PATIENT MORALE

a. In the event of electrical power disruption

 The municipality’s emergency lights shall be activated in all critical areas while waiting
for the functionality of the power generator.

 The municipality’s power generators will be activated to provide 100% electrical

demand during disaster/block out

 The HEM Coordinator shall coordinate with the LGU and QUEZELCO for immediate and
timely power restoration.

 The supply/logistic officer shall ensure presence of alternative portable lights, power
and batteries for operation of essential equipment needed.

 The supply/logistic officer shall ensure availability of fuel reserves at all times.

 In case of insufficient fuel the HEM Coordinator shall perform emergency purchase upon
the approval of the Local Chief Executive

b. In the event of water supply disruption

The HEM Coordinator shall:

 Provide safe water for drinking to all hospital patients, personnel and others.

 Activate the water tanks to provide 100% hospital demand for water.
 78

 Coordinate with the Tagkawayan Bureau of Fire Protection for possible water rationing.

 Coordinate Tagkawayan Water District for immediate and timely water restoration.

 Coordinate with Aquabest, Momom and other refilling stations and other local business
establishments for support for potable water.

 Provide alternative water source deep well

c. In the event of hospital isolation with shortage of food supply.

The HEM Coordinator shall:

 Coordinate with PHO-HEM OpCen for networking assistance.

 Coordinate with MSWD, LGU, MDRRMC, other GO’s and NGO’s for assistance.

 Perform emergency purchase upon the approval of the Local Chief Executive

d. In the event of lack of source of drugs, medicines, medical supplies

The HEM Coordinator shall:

 Coordinate with private pharmaceutical companies and PHO-HEM for assistance.

 Perform emergency purchase upon the approval of the Local Chief Executive

e. In the event of disrupted waste management system.

The HEM Coordinator shall:

 Coordinate with General Services Office and MENRO for waste management assistance

 Activate the pre-designated temporary collection and storage areas for wastes pending
functionality of the system.

 Dumpsite at Brgy. Munting Parang shall be the temporary waste disposal area

f. In the event that hospital personnel are getting overburdened, over fatigued and cannot
function well
 79

The HEM Coordinator shall:

 Coordinate with PHO HEM OpCen for personnel augmentation assistance.

 Coordinate with other PHO hospital network members for assistance.

g. In the event of absence of electricity and cold chain management

 All hospital staff shall limit the opening of vaccine refrigerator except emergency

 Activate generator

 If there is no available generator, the vaccine refrigerator shall be brought to Maria

Eleazar District Hospital.

 If Maria Eleazer District Hospital (1st option) has bugged down its electric power/
generator, all vaccines shall be brought to Quezon PHO for safe keeping.

C. EXTENSION/TERMINATION

11. DECLARATION AND NOTIFICATION PROCESS

When the HEM coordinator determines that the stage of emergency no longer exists, an
announcement to terminate the disaster operation will be made.

 Command Post/Operation Center shall be terminated/closedown

 The “Information Officer” shall be notified by the HEMS Coordinator that the disaster
plan is no longer in effect.

 The Information Officer shall inform all units/ departments of the termination of the
disaster operation plan.

 A report on the disaster operation will be prepared by the individual units and
submitted to the Disaster Committee/HEMS Coordinator for evaluation, records keeping
and reporting.
 80

12. CONDUCT POST – INCIDENT EVALUATION

 Post-incident evaluations (PIE) shall be conducted during the debriefing of the deployed
teams at the end of the response phase or at the end of the emergency/disaster.

 The PIE shall center on the following

a) What worked well? Why did these work well?
b) What did not work well? Why not?
c) What are the insights from these experiences in the context of the present event, as
well as past events?
d) What are the recommendations for future response work?

13. REVIEW AND UPDATING OF PLAN INCLUDING AMENDMENTS TO POLICIES AND

PROCEDURES

Effective emergency planning requires a continuous process of reviews and updates. It

can be noted that hazard vulnerability, organizational staffing and structure, facilities and
equipment alter over time; therefore, review and update of plan must be executed as a
response to the possible changes.

Truly, one prerequisite of planning is a written documentation as a representation of the

emergency planning process; however, it can be pointed out that effective planning also
includes development of: 1. Emergency responder’s knowledge on the availability of resources
both from government and private organizations; 2. Acquisition of knowledge with regards to
emergency demands and other agencies’ capabilities, and; 3. Establishment of collaborative
relationships across organizational boundaries. Given the potential for changes in hazard
exposure, population vulnerability and staffing; organization and resources of emergency
response organizations require emergency plans and procedures to be reviewed periodically.
 81

HEALTH EMERGENCY
RECOVERY PLAN
 82

IX. HEALTH EMERGENCY RECOVERY AND RECONSTRUCTION PLAN

 The Municipal Engineering Office will do the damage assessment and needs analysis including
cost of reconstruction.

 Reports/ Program of Works will be submitted to the Local Chief Executive.

 Referral of direct/ indirect /hidden victims for Psychiatric evaluation and management.

 Relocation of health facility site/construction of new facility

 83

Rehabilitation Time Resource Requirement Person Indicators

strategies/ Activities Frame Required Available Source* Responsible

1. Damage and needs assessment w/in 1 Inventory of On-site Medical MHO, LGU Available Incidental
week damages inspection Services Reports

2. Post Mortem Evaluation 1 to 2 List of names Reports Medical MHO Available Research
days Services

3. Documentation of Lessons w/in 2 Incidental Reports Reports Medical MHO/ PHN Available
Learned weeks Services Documents

4. Research and Development w/in 1 Budget Allocation Reports Medical MHO/ PHN Available Plans
month Services
after the
incident

5. Repair of damaged health facilities w/in the Program of Works Carpentry MOOE MEO/ LGU Rehabilitated
1st Qtr Tools Health Facilities

6. Replenishment of Utilized w/in the Purchase Request Budget MOOE MHO/ LGU Replacement
Resources 1st Qtr

7. Provide Overtime compensation w/in the Pay Cheque Budget MOOE LGU Compensation given
to the respondents 1st month
after the
incident

8. Review and update of RHU Health w/in the HEPRRP Available MOOE HEM Coordinator Revised and
Emergency Preparedness and 1st month Updated HEPRRP
Response Plan after the
 84

incident

10. Awarding and recognition rites w/in the Plaque of Available MOOE HEM Coordinator Available
for the major key players 1st month Appreciation Recognition of
after the Responders
incident
 85

ODRRM-H
APPENDIX
 86

APPENDIX A

JOB ACTION SHEET

INCIDENT COMMANDER
Hon. Jose Jonas A. Frondoso

Mission:
Perform overall direction for the field and/or facility operations and if needed, authorize
evacuation.

Functions &Responsibilities:
 Initiate the Incident Command System (ICS) by assuming the role of the Incident
Commander and put any identification mark.
 Designate a Command Post to include required logistical needs.
 Carefully assess the situation and the magnitude of the casualties.
 Secure the area, preventing entry of unauthorized people and designate staging and
transport area for Field Operations.
 Depending on the number of responders and the magnitude of the emergency, fill up
the organization assignment list, the needed positions relevant to the situation.
 Announce an action plan meeting and identify the general objective of the operations
including alternatives, and the incident communication plan.
 Assign someone as Documentation Recorder/Aide.
 Authorize resources as needed or requested by managers.
 Designate routine briefings with managers to receive status reports and update the
action plan regarding the continuance and termination of the action plan.
 Communicate status to higher authority.
 Approve media releases.

Identification:
 Proper signages (hard hat with mark of Incident Commander or a vest)
 87

SAFETY AND SECURITY OFFICER

PCI DANDY P. AGUILAR

Mission:
Monitor and have authority over the safety of rescue operations and hazardous conditions.
Organize and enforce scene/facility protection and traffic security.

Functions &Responsibilities:
 Obtain appointment and briefing from the Incident Commander.
 Implement the emergency lockdown policy and personnel identification policy.
 Establish Security Command Post.
 Remove unauthorized persons from restricted areas.
 Establish ambulance entry and exit route in cooperation with Transportation and
Staging Officers.
 Secure the Command Post, Advance Medical Post, Triage and Treatment Areas including
the Morgue Area and all other sensitive or strategic areas from unauthorized access.
 Fully understand the importance of his roles especially in the safety of the responders.
 Secure and post non-entry signs around unsafe areas.
 Always alert to identify and report all hazards and unsafe conditions to the Incident
Commander.
 Secure areas evacuated to and from, to limit unauthorized personnel access.
 Initiate contact with fire, police agencies through the Liaison Officer, when necessary.
 Advise the Incident Commander and others immediately of any unsafe, hazardous or
security-related conditions.
 Confer with Public Information Officer to establish areas for media personnel.
 Establish routine briefings with Incident Commander.
 Provide vehicular and pedestrian traffic control.
 Secure food, water, medical, and blood resources.
 Document all actions and observations.
 Can order stoppage of operation if unsafe.

Identification:
 Use of any identification hat or vest.

PUBLIC INFORMATION OFFICER (P.I.O)

 88

Genedina R. Penolio

Mission:
Provide information to the public and the media.

Functions &Responsibilities:
 Obtain appointment and briefing from the Incident Commander.
 Ensure that all news releases have the approval of the Incident Commander.
 Responsible for collating relevant information needed to inform the public and for
media releases; obtain progress reports from respective areas as appropriate.
 Issue an initial incident information report to the news media especially on the casualty
status and the actions being done.
 Schedule press conferences on a regular basis.
 Inform on-site media of the physical areas that they have access to, and those which are
restricted. Coordinate with Safety and Security Officer.
 Contact other scene agencies to coordinate released information.
 Direct calls from those who wish to volunteer to Liaison Officer. Contact Operations to
determine requests to be made to the public via the media.

Identification:
 Proper signages (hard hat with a mark of Public Information Officer or a vest).

LIAISON OFFICER
Maria Polly A. Albacea

Mission:
Function as incident contact person for representatives from other agencies (government or
private).

Functions &Responsibilities:
 Obtain appointment and briefing from the Incident Commander.
 In coordination with the Public Information Officer should always be knowledgeable on
the following:
 The number of “Immediate” and “Delayed” patients that can be received and
treated immediately (Patient Care Capacity); also the status of all other victims,
especially in mass dead situations.
 Any current or anticipated shortage of personnel, supplies, etc.
 89

 Number of patients transferred to hospitals.

 Any resources which are requested by each area (i.e., staff, equipment, supplies).
 Establish contact with liaison counterparts of each assisting and agency.
 Keep appropriate agency Liaison Officers updated on changes and development of
response to incident.
 Request assistance and information as needed through the different networks of
government and private organizations responding to emergencies and disasters.
 Respond to requests and complaints from incident personnel regarding inter-
organization problems.
 Prepare to assist Labor Pool with problems encountered in the volunteer credentialing
process.

Identification:
 Use of any identification (hat or vest).

LOGISTIC SECTION CHIEF

Rolando S. Mendoza

Mission:
Organize and direct those associated with maintenance of the physical environment, and
adequate levels of food, shelter, supplies and other resources needed to support the objectives
of the incident.

Functions &Responsibilities:
 Obtain appointment and briefing from the Incident Commander.
 Establish Logistics Section Center in proximity to the Command Post.
 Brief all his staff on current situation; outline action plan and designate time for next
briefing.
 Attend damage assessment meeting with Incident Commander.
 Coordinate with companies regarding stock level, available supply and equipment.
 Anticipate needed logistical requirements.
 Obtain information and updates regularly; maintain current status of all areas;
communicate frequently with Emergency Incident Commander.
 Obtain needed supplies with assistance of the Finance Section Chief and Liaison Unit
Leader.

Identification:
 90

 Proper signage (hat or vest).

PLANNING SECTION CHIEF

Francis M. Villanueva

Mission:
Organize and direct all aspects of Planning Section operations. Ensure the distribution of critical
information/data. Compile scenario/resource projections from all areas and effect long-range
planning. Document all activities.

Functions &Responsibilities:
 Obtain appointment and briefing from the Incident Commander; have regular updates
as appropriate.
 Brief members of the staff after meeting with Incident Commander.
 Provide for a Planning/Information Center.
 Recruit a documentation aide from the Labor Pool. Appoint Planning Unit Leaders,
Situation Status Leader, Labor
 Pool and other appropriate positions as needed. Ensure that all appropriate agencies
are represented in this section.
 Ensure the formulation and documentation of an incident-specific action plan.
Distribute copies to Incident Commander and all areas.
 Call for projection reports (Action Plan) from the Planning Unit Leaders for scenarios
within 4, 8, 24 and 48 hours from time of incident onset. Adjust time for receiving
projection reports as necessary.
 Instruct staff to document/update status reports from all areas for use in decision-
making and for reference in post-disaster evaluation and recovery assistance
applications.
 Schedule planning meetings to include Planning Section Unit Leaders, Section Chiefs and
the Incident Commander for continued update of the Action Plan.
 Coordinate with the Liaison Officer and Labor especially with regards to manpower
requirements.

Identification:
 Proper signage (hat or vest).
 91

FINANCE SECTION CHIEF

Glenda C. Arana

Mission:
Monitor the utilization of financial assets. Oversee the acquisition of supplies and services
necessary to carry out the objective of the incident. Supervise the documentation of
expenditures relevant to the emergency incident

Functions &Responsibilities:
 Obtain appointment and briefing from the Incident Commander.
 Appoint members of his staff preferably the following: Time Unit Leader, Procurement
Unit Leader, Claims Unit Leader, Cost Unit Leader and other appropriate positions as he
desires.
 Establish a Financial Section Operations Center. Ensure adequate
documentation/recording personnel. His station need not be within the area of incident.
 Confer with Unit Leaders after meeting with Incident Commander and develop an action
plan.
 Approve a “cost-to-date” incident financial status report eight hours summarizing
financial data relative to personnel, supplies and miscellaneous expenses.
 Obtain briefings and updates from Incident Commander as appropriate. Relate
pertinent financial status reports to appropriate chiefs and unit leaders.
 Schedule planning meetings to include Finance Section unit leaders to discuss updating
the section’s incident action plan and termination procedures.

Identification:
 Proper signage (hat or vest)

OPERATIONS SECTION CHIEF

Francis M. Villanueva

Mission:
Organize and direct aspects relating to the Operations. Carry out directives of the
Incident Commander

Functions &Responsibilities:
 Obtain appointment and briefing from the Incident Commander.
 92

 Responsible for all specific sections of the operations (ex. Medical, Search and Rescue,
Fire Suppression and others) depending on the incident.
 Establish Operations Section in the Command Post preferably with the Incident
Commander.
 Brief all Operations Officers on current situation and develop the section’s initial plan.
 Designate times for briefings and updates with all Operations Officers to
develop/update section’s action plan.
 Ensure that all areas are adequately staffed and supplied.
 Brief the Emergency Incident Commander routinely on the status of the Operations
Section especially on the status of all patients, problems encountered, resources
needed, etc.
 Ensure that all actions and decisions are documented.
 Observe all staff and personnel for signs of stress and inappropriate behavior and report
concerns to Psycho-social Supervisor. Ensure rotation of all personnel to prevent
burnout among personnel

Identification:
● Proper signage (hat or vest)

TREATMENT TEAM LEADER

Jehzel M. Aquino, MD

Mission:
Responsible for the management of the Treatment Area and assigning of responsible supervisor
for specific areas (Red, Yellow and Green subsections). Assure treatment of casualties according
to triage categories. Provide for a controlled patient discharge and transfer to appropriate
hospitals

Functions &Responsibilities:
 Receive appointment and briefing from Incident Commander/Operations Chief/ Field
Medical Commander.
 Organize the treatment area assigning all members to their specific assignments and
responsibilities. In cases of WMD, treatment area should be at the cold zone.
 Appoint unit leaders for the following treatment areas in pre-established locations:
Second Triage; Immediate Treatment (Red); Delayed Treatment (Yellow); Minor
Treatment (Green); Discharge.
 93

 Supervise the receiving of patient from the Initial Triage from the site, re-triage the
victims and institute measures to stabilize the victims; ensure that all victims are
continuously monitored.
 Assess problems and treatment needs, and customize the staffing and supplies in each
area.
 Receive, coordinate and forward requests for personnel and supplies to the Field
Medical Commander and/or Staging officer.
 Contact the Safety and Security Officer for any security needs in the area.
 Establish 2-way communication (radio or runner) with Field Medical Commander,
Triage, Transport and Staging Officers.
 Coordinate with Transport Officer, decide on the order of transfer of victims, the mode
of transport, escort and place of transfer.
 Document everything with regards to every individual patient brought to the area using
the individual treatment form.
 Regularly report to the Field Medical Commander.
 Observe and assist any staff that exhibits signs of stress and fatigue. Report any
concerns to Psychological Supervisor. Provide for staff rest periods and relief

Identification:
 Proper signage (hat or vest)

TRIAGE (INITIAL) TEAM LEADER

Rebecca Castillo,RN

Mission:
Sort casualties at the site according to priority of injuries, and transfer (according to tagging
priorities) to the treatment area.

Functions &Responsibilities:
 Receive appointment and briefing from the Field Medical Commander or previously
designated by the Incident commander.
 Assess first the safety in entering the incident area; note abnormalities in the
surrounding, any untoward manifestations of the victims and approximate number of
casualties and the type of injuries.
 Protect self by using the appropriate Personal Protective Equipment (PPE).
 In cases of WMD, ensure that decontamination is present before entering the incident
site.
 Report first to authority and request for additional help before proceeding to actual
triaging.
 94

 Quickly brief members of the Triage Team and assign areas for triaging.
 Tag the appropriate color to every patient as follows:
✔ RED–immediate stabilization necessary
✔YELLOW –close monitoring, care can be delayed
✔ GREEN – minor; delayed treatment or no treatment
✔BLUE – near or almost dead
✔BLACK – dead
 Document important things to consider in the site for purposes of evidence by use of
camera, by mapping or sketching, etc. especially in WMD.
 Ask first all walking wounded to go to an identified place.
 Provide and administer life sustaining support to the patient in extreme cases (only for
bleeding and respiratory problems).
 Bring patients to the Treatment Area according to priority.
 Assess problem, triage treatment needs relative to specific incident.
 Identify a Morgue Manager and a Morgue Area for black-coded patients.
 Coordinate with Field Medical Commander and Treatment Team Leader to report
number and types of casualties, including equipment needs.
 Contact the Safety and Security Officer regarding security and traffic flow needs in the
Triage Area.
 End his services once all patients are out of his area and receive another assignment
from the Field Medical Commander

Identification:
 Proper signage (hat or vest)

TRANSPORT GROUP SUPERVISOR

Rex T. Bacuno

Responsibilities:
 Receive appointment and briefing from the Incident Commander/Field Medical
Commander.
 Establish immediately an ambulance loading zone, observing principles on way traffic
flow; identify access routes and communicate traffic flow to drivers.
 Coordinate and supervise transport of victims from the Treatment Area.
 Ascertain all information relating to receiving hospital (as to type of facility, bed
availability, hospital capability, contact ER medical officer, etc.).
 Supervise all available ambulance drivers; assign appropriate vehicle in accordance with
status of patients.
 95

 Receive requests for transportation; maintain a log of the whereabouts of all vehicles
under his control.
 Ensure all patients transferred are tagged and with their treatment form.
 Brief ambulance crew as to the condition of the patient, care required, access routes,
traffic flow, location of the receiving hospital and the procedures in the endorsement of
the patient.
 Coordinate regularly with the Treatment Team Leader/Staging Officer and report all
patients transferred and when the last person is transported.
 Document all activities in his area, including a complete record of all patients

Identification:
 Any identification mark (hats or vests)

STAGING OFFICER
Rodel V. Teopy, RMT

Mission:
Coordinate all resources arriving at the scene. For manpower resources, referring them to
appropriate area of assignment. For transportation resources, organizing them and dispatching
them as required.

Functions &Responsibilities:
 Receive appointment and briefing from the Incident Commander/ Operations Section
Chief.
 Identify suitable place for the Staging Area usually away from the incident.
 Organize, classify all transportation resources.
 Coordinate with Transport Supervisor.
 Dispatch appropriate vehicle as requested by Transport Supervisor.
 Coordinate with appropriate agencies with regards to traffic flow and access routes
within the site.
 Direct all incoming responding teams to the Field Medical Commander.
 Document all resources.

Identification:
 Any identification mark (hats or vests)
 96

FIELD MEDICALCOMMANDER
Jehzel M. Aquino, MD

Mission:
Organize, prioritize and assign officers under its jurisdiction to areas where medical care is
being delivered. Advice the Operations Section Chief/Incident Commander on issues related to
handling of the victims.

Functions &Responsibilities:
 Receive appointment from the Incident Commander/Operations Section Chief.
 Identify the suitable site for the Advance Medical Post and inform everybody.
 Responsible for the different members of his team (if not yet identified): Triage Officer,
Treatment Officer, Transport Officer, Mortuary Officer.
 Responsible that all the needed medical resources be mobilized and available.
 Report and coordinate with the Operations/Incident Commander; likewise attend
meetings and press conferences.
 Ensure the welfare and safety of the medical team, including relief and sustenance
(decking, scheduling, pullback, etc.)
 Conduct regular meetings with his designated officers in the area.
 Anticipate other concerns and regularly confer with the Operations Officer/Incident
Commander.
 Responsible that all the necessary recording of the events be done and all required
reports to all the authorities be submitted on time.
 Evaluate the whole activity and make the necessary recommendations to improve
future responses.
 Coordinate and regularly report to the Medical Controller of the DOH Operations
Center/Regional Operation Center

Identification:
 Proper signages (hat or vest).

MORGUE MANAGER
 97

PCI Dandy P. Aguilar

Mission:
Collect, protect and identify deceased patients

Functions &Responsibilities:
 Receive appointment and briefing from the Triage Officer/Field Medical Commander.
 Identify and establish the Morgue Area; coordinate with the Triage Officer and
Treatment Officer.
 Maintain master list of deceased patients with time of arrival.
 Assure that all personal belongings are kept with deceased patients and are secured.
 Assure that all deceased patients in Morgue Area are covered, tagged and identified
when possible.
 Provide a system or procedures for identifying and endorsing the body of the deceased
to authorized members of the family.
 In medico-legal cases consult with PNP and NBI with regards to procedures necessary
for proper identification and for evidence collection and preservation.
 Keep Triage/Treatment officers appraised of number of deceased.
 Contact the Safety and Security Officer for any morgue security needs.
 Arrange for frequent rest and recovery periods as well as relief for staff.
 Schedule meetings with the Psychological Support Unit Leader to allow for staff
debriefing.
 Observe and assist any staff that exhibits signs of stress or fatigue. Report any concerns
to the Treatment Area Supervisor.
 Review and approve the area documenter’s recording of actions/decisions in the
Morgue Area.

Identification:
 Proper signage (hat or vest)

MEDICAL CONTROLLER
Jehzel M. Aquino,MD

Mission:
Coordinate all activities of the Municipal Health Office/hospital/Health Sector in response to
the Mass Casualty Situation

Functions & Responsibilities:

 98

 Designated by the office and assume the position in case of Mass Casualty Situations.
 Supervise the Operation Center and make all decisions in relation to the dispatch and
subsequent fielding of additional teams.
 Assist in the scheduling of rotation of the medical teams at the site in the event of
prolonged operations in coordination with the Field Medical Commander.
 Coordinate with the different receiving hospitals to prepare their facilities.
 Coordinate with other agencies, DCC agencies, response units, etc.
 Review resources not only within the MHO/Hospital OPCEN but of the other facilities of
the MHO/hospital; likewise mobilize resources if needed.
 May respond to queries by officials, media in relation to MHO/Hospital response.
 Update superiors especially the Provincial Health Officer.
 Document and record the event.
 Evaluate the proceedings and make some necessary input for policy amendments or
recommendations.
 Schedule and lead postmortem evaluation within one week of the event for the Health
Sector.

Identification:
 Proper signage (hat or vest)

INCIDENT MEDICALCOMMANDER
Marife M.Dizon, RN

Mission:
Represent the Municipal health/hospital Office in the Field Command Post and coordinate all
health activities/requirements in cases of Municipal Emergencies/Disasters

Functions &Responsibilities:
Designated by the MHO and assume the position in case of Mass Casualty Situations.
 Report to the Incident Commander in the Command Post.
 Usually will be part of the Planning Committee.
 Keep constant coordination with the Field Medical Commander and the Medical
Controller.
 Anticipate other concerns such as public health concerns (sanitation, nutritional needs,
and needs of evacuees) or psychosocial concerns, especially in situations of Mass Dead.
 Lead in public health information and the provision of needed IEC materials.
 99

 Organize all reports coming from the Field Medical Commander and attend all press
briefings and conferences.
 Document and make his own evaluation of the incident

Identification:
 Proper signage (hat or vest)

APPENDIX B

STANDARD OPERATING PROCEDURES

ANNEX A: Guidelines on On-Scene Response Team

 On-Scene Response Team is a small group of competent and certified physicians, nurses,
administrative workers (utility workers) and drivers deployed to the emergency/
disaster site outside the hospital for external emergencies and/or inside the hospital for
internal emergencies.

 They are responsible for the management of the field/on-site activities from
assessment, triage, treatment, evacuation and transport in coordination with the
Command Post/ RHU/Hospital Operation Center, Receiving Hospital Facility and HEMS
Operation Center. The following are the ideal composition of human resource
requirement in different code alert:

CODE ALERT WHITE:

 First response team ready for dispatch to include the following:
 2 doctors preferably Surgeon, Internist, anesthesiologist, etc.
 2 nurses
 First Aider/EMT
 Driver

 Second response team should be on call

The following should be available for immediate treatment of incoming patients:
 General Surgeons
 Orthopedic Surgeons
 Anesthesiologists
 Internists
 O.R. Nurses
 100

 Ophthalmologists
 Otorhinolaryngologists
 Infectious Specialists
Emergency service personnel, nursing personnel and administrative personnel residing
at/near the hospital shall be placed on call status for immediate mobilization.

CODE ALERT BLUE:

 HEM Coordinator will be physically present at the hospital.
 On scene Response Team
 Medical Officer on Duty
 All residents of the Department of Orthopedics
 Medical Officer in charge of the Operating Room
 Surgical Team on duty for the day
 Surgical Team on duty the previous day
 All anesthesiology residents
 Administrative Officer or designate
 Nursing supervisor on duty
 All OR nurses
 Social workers
 Dietary personnel
 Officer in charge of supplies at the CSR
 The entire security force
 Institutional workers on duty

CODE ALERT RED:

All personnel enumerated under Code Blue and the following:
 All medical officers
 All nurses
 All nursing attendants
 All institutional workers
 All administrative staff

ANNEX B: Guidelines on Establishing of Operation Center during Emergencies and Disasters

1. Hospital/Municipal/City may or may not establish 24/7 HEM Operation Center.

2. If the hospital/municipal/city has no designated room for HEMS Operation Center
during emergency and disaster, the office of the Chief of Hospital, City/Municipal Health
Officer will be the designated HEMS Operation Center.
3. Post Incident Evaluation after every major emergency and disaster shall be conducted to
identify gaps and lessons for improvement of the systems and procedures.

Functions:
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1. Monitors all health and health related events or situations during emergency and
disaster.
2. Follow the established protocol alerts and advisory
3. Conduct rapid health assessment, mobilization of logistics and human resources in the
affected municipality/city.
4. Networks will all other others involved in health emergency response.
5. Provide timely, appropriate information to media and the public upon clearance from
proper authorities.
6. Documents all emergencies and disaster within their jurisdiction and submits final
report to Prov. HEM Operation Center.
7. Serves as the center of command, control and coordination of the
hospital/municipal/city
8. Coordinates with Quezon IPHO HEM Operation Center, LGUs and other partners in their
community.
9. Coordinates with other hospitals regarding transfer and referral of patients.
10. Prepares and submit reports to Quezon IPHO HEM Operation Center and LGU.

Staff Compliment:
 Operations Center Supervisor
1. Oversee the operations of the OpCen.
2. Review, analyze and correct the following:
• Daily HEARS and other reports of EODs
• Accomplishment report of EODs
3. Review the following:
• Endorsement logbook
• Radio check monitoring checklist
• Incoming and outgoing communications logbook
• Incoming and outgoing text messages logbook
4. Attend endorsement of EODs
5. Prepare the duty schedule of the OpCen staff
6. Report directly to the Division Chief for any problems encountered at OpCen

 Emergency Officer on Duty (EOD)

DUTIES/ Emergency Officer on Duty - Emergency Officer on Duty -
RESPONSIBILITIES 1 (EOD1) 2 (EOD2)
Upon assumption of Receive endorsements from the Together with the EOD1 receive

duty outgoing EODs and lead in the
endorsement to incoming EODs.
• Orient him/herself on what
transpired in the past few days.
• Review the following:
- Endorsement logbook
- Previous HEARS Plus
• Know the Prov. HEMS OpCen
EOD during weekends and
holidays.
• Be aware of the stock level of
logistical supply of the office.
• Answer/log incoming and out-
going telephone, cell phone calls,
radio and text messages.
• Answer all calls coming from
superiors and important persons.
• Answer inquiries from the public
and refer accordingly when
necessary.
• Decide on all issues in
coordination with EOD2 or with
superiors if necessary.
• Refer matters that need the
attention or action of the Division
Chief or designate.
• Review the completeness of the
reports prepared by the EOD2.
• Report and document any
problems encountered during the
tour of duty to the Division Chief or
designate.
• Personally have the HEARS
signed by the Director or
designate and answer any
inquiries on the HEARS
Monitoring Monitor the following:
• Reports coming from UHF/ VHF
radio
• Telephone calls requiring
MHO/Hospital intervention
• Emergencies and disasters by
personally calling regions, hospitals
and other agencies affected
102
endorsements from the outgoing
EODs.
• Review the endorsement
logbook and previous HEARS on
what have transpired during the
past few days.
• Know the Prov. HEMS OpCen
EOD during weekends and
holidays.
• Answer/log incoming and
outgoing telephone, cell phone
calls and radio messages.
• Answer inquiries from the public
and refer to superior accordingly
when necessary.
• Relay information/matters that
need immediate action to the
EOD1.
• Perform functions in close
coordination with the EOD1.
Monitor the following:
• Radio
• Television
• News/print media
• Status of communication by
conducting daily radio checks;
refer any radio communication
problems encountered during the
 103

• Internet reports related to health tour of duty to the

from local as well as international Communication Officer/designate.
sources
• OCD website, GMA, ABS- CBN
and other TV and radio network
websites

Reporting/ Report to EOD1 on the incidents

• Report to Division Chief at 6:00am
Documentation and 6:00pm and to the Prov. HEMS he/she had monitored.
OpCen at 8:00am and 8:00pm, with • Prepare the following reports
or without monitored events. for review by EOD1 for its
• In coordination with the EOD2,
completeness and veracity:
prepare the following reports: Flash
- Daily HEARS Plus
Reports, HEARS, Typhoon Alerts.
- Flash Report
• Review, analyze and evaluate, for
- Memorandum, etc.
24 hours, rapid assessment reports,
• File and update documents and
follow-up reports, delayed reports
and other reportable events. data
• Determine necessary data to be • Make detailed documentation of
incorporated into all reports; ifall reportable events
needed, verify reports. • Put detailed important
• Ensure proper documentation of information on the white board
all reportable events, including on all ongoing operations
the updating of the monthly
monitoring board.

Coordination/ • Be responsible for coordinating • Assist the EOD1 in contacting

Dispatching with the following: agencies and facilities.
- PHO & Prov. HEMS OpCen • Update database of important
- DOH implementing arms: regions facilities and organizations.
and hospitals • Get continuous updates until
- Field Medical Commander in case of final report is submitted.
Mass Casualty Incidents
- Other members of the NDCC family
- Private hospitals regarding status of
patients including needs/concerns
- Other GOs, NGOs, private
organizations, etc.
• For Metro Manila, lead in the
dispatching of teams for MCI to
the site in coordination with the
Medical Controller or Division
Chief; for regions, lead in the
dispatching of rapid assessment
teams.
 104

Administrative duties • Be responsible for other • Be responsible for faxing,

administrative concerns after office
hours, during weekends and holidays,
such as:
- Signing of trip tickets for
urgent/official trips
- Approval of the Requisition & Issue
Request of drugs/medicines & other
medical supplies
- Preparing Travel Order (TOs) of
teams dispatched
• Perform other duties stated in
the endorsement checklist.
documenting reports,
memorandums, etc. to concerned
agencies.
• Check/record cell phone ac- count
balance and incoming text messages
• Follow up status of the fol- lowing:
- Department Order
- Memorandum
• Update report, etc.
• Encode PLDT bills.
• Cut newspaper clippings.
• Prepare Request & Issuance Slip
(RIS).
• Prepare daily accomplishment
report.

Other duties • Ensure proper decorum in the • Ensure orderliness/ cleanliness of

office after office hours and during
the Operations Center.
weekends and holidays. • Perform other errands as- signed by
• Recommend raising and lifting of the EOD1 in relation to office work.
Code Alert. • Conduct researches on the
Internet.

 Administrative Aide/Driver
The responsibilities of the driver who also serves as the administrative aide are as follows:
• Evaluate pre-needs of vehicles for maintaining good condition.
• Transport officials and staff on official travel and during emergencies and disasters.
• Prepare report of gasoline expenses (RIS, trip tickets and summary report).
• Maintain and ensure the serviceability of the vehicles.
• Perform other related functions as may be assigned.

Other responsibilities:
• Assist the EOD in monitoring.
• Answer telephone and radio transceivers.
• Report to the EOD on the incidents he had monitored.

Facility - General Attributes:

General guidelines for permanent and non-permanent Operations Center are as follows:
1. Safe from hazards
2. Adequate electrical, water and sewage systems
3. Sufficient space for all functions – a mix of open and closed work spaces
 105

• Secured storage area

• Secured space for staging materials and human resources pending deployment
• Open work space for management, operations, logistics and planning functions
• Closed work space available for teleconferences, break-out groups, policy group
meetings. This can be in nearby rooms.
• Controllable space for media briefings. This may be nearby or off-site.
• Staff rest area with food preparation and storage, clean-up and eating areas
4. Data telephone and electrical connections
5. Adequate wall space for big whiteboards or equivalent
6. Adequate lighting, ventilation, heating and cooling capacity
7. Equipped with:
• Floor plans, mapping of work stations, and wiring
• Well-posted fire evacuation plans and assembly areas
• With available EOC protocol plans (flowcharts) (hard and soft copies)
• Staff roles and standard operating procedures
8. Toilet/personal hygiene area

Standard Operating Procedures For Emergency Operation Center:

Activation Operation Closing Down
Open EOC Message flow File messages and other
documents
Mobilize staff Information display
Release staff
Activate communications Information processing
Close down communications
Prepare post up maps and Control and rescue
display boards mobilization and deployment Close down EOC

Draw up support staff roster Draft of situation reports Organize

Decision making Debrief

Briefings

Reporting to higher authority

ANNEX C-1: Protocols on Mobilization of Human Resources

BEFORE HEM HOSPITAL TEAM

1. Prepare and send 1. Submit team All Team members:
communication to composition, their 1.Facilitate the following:
 106

head of office specialties, a. Undergo briefing at PHO-HEM.

requesting for a designation and b. Attend briefing orientation conducted
medical team. contact numbers to by requesting agency.
HEM-OpCen, c. Minimal supplies and drugs (20 kilos)
including contact including the jump kits
numbers of d. Personal Protective Equipment (PPE)
relatives (in cases e. Bring vest or DOH bib and identification
of emergency) card.

2. Coordinate with 2. Provide the 2. Be ready with the following:

requesting CHD for following: a. Light clothing good for minimum of
details of a. Cash advance for two weeks mission
assignment. per diem, food, b. Food, preferably canned goods
communication c. Bottled drinking water
allowance d. Jacket/sweat shirt/raincoat/single
(cell card), blanket
transportation, toll e. Cellular phone with charger and spare
fee (e.g., for trip via battery
Clark Airbase f. Backpack to carry the following:
terminal fee) and - personal medicines
other incidental - flashlight with spare batteries
expenses - whistle
b. Transport vehicle (Do not put the ff. in hand-carried
to and from the bag/backpack:
airport/pier/bus - insect repellant
terminal - multi-tools
c. Uniform/T- - can opener
shirt/vest as - personal hygiene supplies)
necessary g. Authorization letter for any legal
d. Medicines matters

3. Administrative 3. Bring necessary forms (can be secured

Officer from HEM-OpCen)
to do the following: a. Post-Mission Report form
a. Prepare b. List of Consultations form
Department
Personnel Order.
b. Canvass fares for
plane, boat or bus.
c. Travel reservation
d. Process vouchers
for plane/ boat/ bus
fare per diem and
cash advance.
 107

e. Purchase tickets
(plane/ boat/ bus)
f. Coordinate with
airline authorities
for exemption in
case of excess
baggage.

4. Response Division 4. Inform the relatives about the mission:

to initiate the site, HEM contact numbers, satellite
conduct of briefing/ phone number, etc.
orientation of the
teams.

5. Provide the 5. Always standby for emergency dispatch

following: schedule.
a. Necessary
reporting forms and
other documents
b. Necessary
medicines and
medical
supplies for the
mission
c. Identification
cards for the team
members
d.
Tarpaulin/streamer
as identification of
PHO teams on-site

6. Make 6. Team Leader:

arrangement with a. Inform HEM-OpCen before leaving the
airport authorities mother unit (e.g., hospital, CHD, etc.)
for sending off the
team.

7. Organize the
team, identify team
leader and key
positions.
 108

DURING HEMS HOSPITAL TEAM

1. Monitor the team 1. Inform HEM- Team Leader and
regularly. OpCen Members:
a. Before leaving 1. Keep a copy of the following:
the Mother unit a. Plane ticket
b. Boarding pass
c. Terminal fee stub
d. Certificate of appearance

2. Prepare daily Team Leader:

reports 1. Inform HEM-OpCen:
based on template a. Before leaving the mother unit
given. b. On the road
c. Upon arrival to the place of assignment
d. For every movement/change of area of
assignment when necessary

3. Make 2. Coordinate with the

arrangements following:
for rotation of a. Provincial Director or his/her
teams and representative
scheduling. b. Incident Commander
c. Field Medical Commander
d. Other officials

4. Coordinate with 3. Regularly advise HEM-OpCen through

PHO on issues and text or email on the following:
other concerns. • The status of the team on-site or as
necessary.
• List of medical consultations on-site

5. Coordinate with 4. Inform HEM and other concerned

MDRRMC. officials regarding schedule of return trip,
including changes in schedule.

6. Report to Team Member:

superiors. Report to the team leader regularly

AFTER HEM HOSPITAL TEAM

1. Administrative Team Leader and
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Officer to process Members:

liquidation and 1. Accomplish itinerary of travel.
payment/
Reimbursement

2. Response Division 2. Submit to HEMS the travel

to conduct Post documents, such as plane ticket,
Incident Evaluation boarding pass, terminal fee stub, and
(PIE). certificate of appearance.

3. Conduct Team Leader:

Psychosocial 1. Inform the following:
Debriefing in a. Provincial Coordinator or his designate
coordination with before leaving the area of assignment.
the PHO Mental b. HEM-OpCen immediately before
Health Program. leaving the site/place of assignment and
upon arrival in Quezon.

4. Document output 2. If there is an excess in cash advance,

of the PIE and other return immediately to the proper
lessons learned for authority with complete liquidation
future reference. papers, such as official receipts and RER

5. Identify issues to 3. Submit Post-Mission Report to HEM

be used for OpCen within 24 hours after
preparing deployment.
protocols,
procedures,
etc.

6. Make official 6. Make official report to

report to supervisors,
supervisors

ANNEX C-2: Standard Operating Procedure in Information and Dispatch of Teams

Steps Procedures
1. Verification of Reports  Proper message handling and verification of the
details of the caller and the incident (type, place,
magnitude)

2. Whom to Inform
3. What to do first and initially
4. Alerting other hospitals/ and
health rescue teams
5. Preparations done while waiting
the supplies to be prepared by
the OPCEN and responding teams
110
 Verify through MDRRMC’s, PHO and Local
Agencies etc.
 Set limit how long to verify and decide needed
action to be taken.
 Municipal Health Officer and HEM Coordinator,
LGU’s, MDRRMC – if within the catchments area
 Call the Dispatch Assessment Team
 Depending on the request of assessment, the On-
Scene Response Team
 Inform PHO HEM OpCen and other appropriate
agencies.
 Monitor the incident and have continuous
 Coordination with the On-Scene Response Team.
 If indeed, additional teams maybe dispatched
 Monitor schedule of duties and shifting of the
team considering their capability.
 Document/record for reporting and analysis.
 Answer inquiries of press and higher officials
 Inform and alert Local Health agencies,
 Centers and Health Personnel from and
government sectors for possible assistance
 Continuous reassessment of the situation.
 Notify and alert the Provincial, Regional, and
National Health Agencies and hospital when the
incident necessitates their participation.
 Ensure availability of advance cardiac life support
medicines and supplies.
 Appropriate vehicle / ambulance and
communication equipment.
 Inventory of emergency drugs / supplies
 Standardized recording sheets (patients, response
groups, problem, actions taken, locator chart
and maps etc.
 Briefing of the team members
 Provisions like food etc.
 Operations Center
 Inventory of Resources/manpower etc.
 Monitoring and review of drugs/supplies
 Locator maps etc. (if outside the catchments area)
 Communication equipment
 111

 Status of access routes in the area.

6. Coordination with the Field  Information needed

Commander (during the 1st  Location of the event, time, type of the incident.
24hours)  Estimate number of casualties, nature of injuries,
disposition
 Added potential risk
 Expand population
 Resources needed (public health team, sanitation
or psychological teams etc.)
 List of response group and their capabilities.
 Problems and action taken
 Coordination especially in transporting
 victims to hospital

7. Endorsement of Staff  Status of incident and resources

 Activities that transferred during the tour of duty
 Problems encountered and current actions being
done
 Other special concerns

ANNEX D: Guidelines in Rapid Health Assessment (RHA) & Damage Assessment and Needs
Analysis (DANA)

1. Hospital/Municipal/City must compose RHA/DANA Team in their institution.

2. The assessment involves the collection of information regarding classification of the
victims and classification of damage to infrastructure and/or interruption of services

Classification of Victims
To prioritize the allocation of scarce resources in the soonest possible time, it is
essential to classify the victims. The following are considered essential to survival and
are called lifelines:
 Water
 Food
 Shelter
 Energy

Victims can be classified according to their access to lifelines. The following is used to
describe the severity of the impact on people:
 Affected - all those living within the geographical area involved
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 Severely affected - those who have lost one or more of their lifelines
 Critically affected - those who have lost all of their lifelines or who have been
displaced (and therefore are totally dependent on others to supply them)

Therefore, a report describing the impact of a hazard provides the number of:
 Casualties (killed, injured, sick)
 Affected (total, severe, critical)

Classification of Damages in Emergency Situations

The following are the physical elements that require assessment by the health sector
after a disaster:
 Integrity of infrastructure
 Capacity of service delivery
 Access to services
 Essential supplies – water, energy
 Capacity for distribution of essential health supplies

For each facility or service in the affected area, the assessment grades function
according to a predefined scale. The following is an example of a grading scale:
 Destroyed or unavailable
 More than 50% reduction in capacity
 Less than 50% reduction in capacity
 Undamaged

3. For RHUs, RHA Team shall determine the health impact to the community considering
the people, properties, environment, services and livelihood.

Five (5) Elements of the community/hospital to be consider in determining health

needs of affected population
 People – number of injuries, number of deaths, number of missing, and number of
affected population
 Properties – number of affected/ damaged health facilities such as hospitals, rural
health centers, laboratories
 Environment – description of changes in land, soil, air, water
 Services – type of disruption of specific services
 Livelihood – damage to sources of livelihood, etc.
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4. For hospitals, RHA Team shall determine the health impact to the hospital considering
people, properties, environment and services and derives the health needs of the
affected population
5. The health sector carries out activities and interventions according to priorities
identified in the assessment.

Determining Response Priorities

1. Priority Relief Needs
• Assistance in search and rescue (not a PHO/MHO role, except when requested for
in special circumstances)
• First aid
• Acute medical and surgical care
• Care of the displaced and vulnerable
• Security of water supply
• Assistance in provision of shelter, warmth and clothing

2. Secondary Relief Needs

The health sector acts to improve the capabilities of services where deficiencies are
indicated. This is accomplished by:
(a) Increasing stocks of materials and supplies;
(b) Developing auxiliary power sources, and providing supplies of fuel, and acquiring
additional repair equipment, and
(c) Recruiting and briefing personnel, volunteers, retired professionals, and other
similar workers.
• Control of communicable disease
• Mental Health and Psychosocial services

3. Management of Logistics, Transport, Communications

4. Epidemiological Surveillance
• Morbidity – number of illnesses – priorities include trauma, diarrhœa, ARI,
measles, notifiable diseases
• Mortality – number of dead
• Laboratory support
• Water quality
• Nutrition
• Vectors

5. Public Information and Community Participation

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6. Monitoring, Evaluation and Reporting

7. Rehabilitation and Reconstruction (for internal disasters)

• Replacement and repair
• Restocking
• Review of emergency plan, local policy and administrative procedures
• Overall development policy and planning review
• Retraining – technical and administrative

6. After the assessment, RHUs and hospitals should accomplish and submit it to Quezon
Provincial HEM Operation Center (OpCen) using appropriate HEM forms on Rapid
Health Assessment Forms; for an MCI, for an outbreak and for a natural disaster within
24 hours upon the occurrence of the event.

7. Corresponding Health Situation Updates for Natural Disasters, MCI and Outbreak are
submitted twice a week for the first two weeks and once a week thereafter until
termination of response activities.

8. The hospital/RHU shall assess the impact of the health emergency/disaster in terms of
damages and losses created by the new situation and identify the future areas where
risks may evolve.

9. The DANA Team shall prepare secondary damage assessment and secondary
vulnerability assessment provide the information base for the recovery planning

Damage Assessment and Vulnerability Assessment

Primary damage assessment -involves rapid appraisal of deaths, injuries and disease
and identification of damage to infrastructure, material resources and services.

Secondary damage assessment - is concerned with the impact of the primary damage
on the economic, social and cultural life of survivors. Since sustainable livelihood
security is the goal of both recovery and sustainable development, the assessment is
concerned with three kinds of losses or disruption – loss of livelihood, loss of social
cohesion, and loss of cultural identity.

Secondary vulnerability assessment -These losses can create new vulnerability to

future disasters or make existing vulnerability worse. Failure to recover or partial
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recovery makes it more likely that people will be more vulnerable to the next stressful
situation

ANNEX E: Prioritization for In-Hospital Care (Tagging)

RED – Priority One: Life-threatening / Immediate Care

The patient requires immediate attention. The following factors should be used to
determine when a mass casualty incident (MCI) Victim is a Priority One.

a) Obstruction or damage to airway

b) Disturbance of breathing – respiration above 30/min.
c) Disturbance in circulation – capillary refill greater than 2 seconds or carotid pulse is
weak, irregular or absent and radial pulse-absent
d) Does not follow command or altered level of consciousness
e) Need for life-saving measures (BLS and ALTS) and urgent hospital admission
f) Victims whose injuries demand definitive treatment in the hospital but which
treatment may be delayed without prejudices to ultimate recovery

YELLOW – Priority Two: Urgent

Patient has passed primary survey, but major system injury limits delay of transport to
one hour. Any one of the following factors could take place a victim into a Priority Two
category.

a) Needs to be treated within 4-6 hours otherwise delay will become unstable.
b) Severe burns involving hands, feet or face ( not including the respiratory tract )
complicated by major tissue trauma;
c) Hospital admission is required.
d) Moderate blood loss; back injuries; head injuries with normal level of consciousness.

GREEN – Priority Three: Delayed

An injury exists but treatment can be delayed for two to six hours. Generally (but not
always), anyone can walk to a designated area for treatment will be a Priority Three.
The following injuries are example.
a) Minor injuries not threatened by airway, breathing, circulation instability.
b) Minor fractures, minor soft tissue injuries, minor burns
c) Victims whose injuries are so severe that survival cannot be expected even under
the most ideal conditions; obviously mortal wounds where death is certain (such as
had injuries or massive burn.
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BLACK – Priority Four

a) Patients is dead.
b) Victims who are clinically dead
c) Those who die while awaiting treatment, and those in cardiac arrest following
trauma.

Legend:
A = Airway B = Breathing C = Circulation
BLS = Basic Life Support
ACLS = Advance Cardiac Life Support
ATLS = Advance Trauma Life Support

The following information shall be hand printed on the Patient’s Color tag:
 Patient’s sequence number
 Name of patient
 Tentative diagnosis or suspected injury
 Previous treatment as stated on the tag which was placed on the patient at the
scene of the disaster
 Blood type ( cross matching / signature )
 X-ray number

ANNEX F: Handling of Equipment Attached to the Patient

STEPS PROCEDURES
1. Role or responsibility of the 1. There should be proper documentation.
receiving RHU/hospital in the 2. Equipment should be properly labeled.
handling of medical 3. Standard form should be used for retrieval purposes.
equipment hooked/ attached 4. There should be a standing agreement between the
or connected to the victims receiving hospital and responding units for temporary non-
disposable gadgets/supplies and equipment, and for final
turnover at a later time.
5. In case receiving hospital has no available gadgets/
equipment for exchange, proper documentation using
standard form should be accomplished for easy retrieval.
6. Form should be accomplished and duly signed by the nurse
supervisor and by the team leader of the responding unit.
7. The hospital should designate an area/person where the
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referring team can retrieve such equipment later.

8. A person should be assigned to handle the equipment.

2. Equipment/ gadgets that 1. Splint

should not be removed from a. Traction splints
the patient unless advised by b. Foam-padded splints
the doctor c. Cravats
d. Vacuum splints
e. Air splints
2. Cervical collar
3. Bag valve apparatus
4. Thoracostomy bottle
5. ET and oral airway
6. Spine board
7. Medical anti-shock trouser
8. Kendricks extrication device
9. Thoracostomy and tracheostomy tubes
10. Traction device
11. Vacuum mattress
12. Foley catheter
13. NGT
14. Monitoring patches
15. Bandages
16. Needles

ANNEX G: SOP on Personnel Schedule and Personnel Support During Emergency/ Disaster

 Determine number of workforce needed in every hospital facility to respond and the
number of patients needed for emergency care.
 Determine competency of staff to area assigned and cases to handle in the area.
 Consider time when more than one person may be needed at the same time due to
heavy workloads.
 Expand number of hours of duty and provide coverage in dividing 3 shifts or from eight
(8) to twelve (12) hours duty and consider staff capability for the change in number of
hours.
 Monitor staff productivity, competency and efficiency for the change of schedule.
 Identify constraints which restrict work done productivity.
 Request for support after assessment of the situation, analysis of the impact of disaster,
its effects to the community and the surge of patients, then decide to and make request
if how many support personnel are needed.
 Off duties may be scheduled based on the patient’s ration and urgency of the situation.
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 Request for augmentation of personnel/ support services thru ILHZ, PHO, CHD and other
volunteers if after assessment that the need for support is deemed necessary.

Administrative Service

 Provision of support services to different hospital unit in terms of logistics personnel and
documentations.
 Recording and reporting of needed required data
 Maintenance of administrative functions for the entire operation
 Any other functions to support emergency and recovery beyond its capacity to function.

ANNEX H: SOP on Dietary Service

 Maintenance of dietary food supplies to patients, including visitors, personnel,

volunteers/ responders.
 Coordinate with logistic/ finance officers for back-ups and allocation of funds for
sustenance of operation.
 Request for manpower support if deemed necessary.
 Strict sanitation in food preparation, cleaning of utensils and serving of foods.
 Ensure availability of cooking gas/ fuel reserves.
 Accurate recording, reporting and inventory of expenditures.

ANNEX I: Guidelines on Logistics Management

A.O. 168 s. 2004 Section V-C: Policy Statements on Support Systems provides:

Logistics Management shall be developed for health emergency with the aim of providing the
right requirement, with the right amount at the right time and the right place. A system for
procurement and delivery shall be developed wherein the logistical needs are identified at the
different levels of health facilities.

 Logistics management refers to a system that provides the means to acquire and deliver
resources:
• to the Right Place
• at the Right Time
• in the Right Quantity
• at the Right Quality
• at the Right Price

 Basic Principles
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• Centrally coordinated logistics management with standardized operating procedures

(SOPs) should be in place
• Supply of goods and services meets specifications and is readily available when
needed
• Source and delivery operations are simple, economical, equitable and transparent
• Transport and storage must have spare capacity

Key Functions in Logistics Management System:

 Planning

In the preparation of the Annual Preparation Plan, the HEMS Coordinator of the RHU/
hospital will have to consider the following:
- Inventory of available stocks including the expiry date of drugs, medicines, supplies
and materials including equipment.
- Utilization of the past years.
- Postmortem analysis of disasters specifically for logistics.
- All drugs and medicines should be found in the Philippine National Drug Formulary
(PNDF) latest edition. If not included look for an alternative or request for exemption
from the drug committee.
- Projected needs.
- Projected emergencies and kinds of hazards in the hospital or catchment area.
- Leading causes of morbidity and mortalities during the past emergencies or disasters
and other relevant health indices.
- Appropriate storage facilities and alternate backups.

 Procurement, receiving/delivery, storage

a. The hospital/RHU can procure emergency drugs/medicines and supplies. However, if

the hospital/RHU can make arrangements with pharmaceutical companies and other
suppliers during emergencies there might be no need to procure large amount of drugs
and medicines.

b. In the event that supplies and materials are not available locally or the RHU/hospital’s
supply was depleted because of the emergency and ongoing operation, they can
request for augmentation from PHO HEM OpCen. A letter of request or just a call,
especially during emergencies, will suffice. The request shall be supported by a report
on the emergency.

Preparedness
The HEM Coordinator shall look at various storage/warehouse areas in and outside the
hospital/RHU. Ideal storage areas may include warehouses and other suitable buildings
where storage management procedures already exist during pre-disaster phase.
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Emergency/Response Phase
When ideal storage is not available, especially during emergency or response phase,
available space in the field shall be utilized. The minimum requirement for storage includes:
• Lockable transport container that can be left near the site or stricken areas
• Temporary storage for stocks in transit
The following are some guidelines to be observed to ensure proper storage and to
minimize wastage of drugs/medicines, compact food, medical supplies and reagents:
• Store foods in a dry, well-ventilated area free from insects and rodents.
• Boxes, bags and containers must not be placed directly on floor. Use pallets or boards
underneath piles.
• Keep items at least 40 cm away from the wall and do not stock them too high.
• Replace damaged boxes, bags and containers.
• Pile boxes, bags and containers two by two crosswise to permit ventilation.
• Observe ”First in-First Out” principle and dispose of food supplies at least one (1) year,
and medicines at least six (6) months, before the expiry date.
• Vaccines should be stored at the cold storage with a temperature of 2-8 degrees
centigrade.
• Do not store food and vaccine together in one cold storage.
• Keep the medicines away from sunlight.
• It is necessary to categorize and record what might be termed as logistic tools to
address needs for disaster situations.

 Allocation, distribution,

The HEM Coordinator can request their own supply for use in the emergency room or for
the use of the response teams in responding to the site. They have to make their own
listings for these, considering that they should be able to handle at least 5 red victims during
response. Majority of the needs of the hospitals/RHU are for trauma management, so this
should be considered. The resources are distributed to the concerned department/unit.

In the event of augmentation from PHO, emergency drugs, medicines, supplies (including BP
Compact Food) shall be provided to the Response Teams so they can respond immediately
during emergencies in their areas.

 Monitoring, tracking, inventory, utilization report

a. To ensure that essential items are always available, incoming supplies, supplies
distributed, and stock levels should be closely monitored. It is important to:
• Record the end destination for items in the stock records.
• Monitor that they are being used appropriately.
• Provide reliable reports.
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b. The Hospital/RHU Supply Officer together with the HEM Coordinator shall prepare the
following:
• Monthly Inventory Report of available stocks in the warehouse, the expiry date, and
the location of delivery of the items every first week of every month.
• Annual Utilization Report of the distributed drugs and medical supplies. This should be
received by PHO-HEM OpCen on or before January 15 of the succeeding year. This is to
be submitted if the funds came from HEM.
• In Postmortem Analysis of every emergency and disaster, logistical problems and
issues should be discussed and evaluated. Recommendations can be used as inputs in
the crafting and amendment of logistics for RHU/Hospital SOP/Protocol for
Emergencies.
• Monitoring of the units should be done regularly.

Logistics Framework
1. Supplies and Equipment

• In support to the emergency response operation:

Initial procurement of supplies/ equipment should be completed BEFORE and in
anticipation of any emergency response operation. Stockpile composed of:
- PPE/Antiviral Medicines
- Medical-laboratory test/specimen kits
- Disinfectants
- (Possibly) vaccine and/or medical interventions requiring cold chain management
• In support to the Rapid Response Team (RRT):
Make inventory of available resources and make sure of availability during emergency
response operation:
- Transportation
- Communication Equipment
- Deployment Kit for the Response Team
- Administrative Supplies/Equipment
- Food/Water
- Shelter/accommodations for staff/team
• Ensure optimal airport/seaport operation
• Advanced planning and good relationship with all partners (dealers/suppliers) and
consider emergency response simulation exercises
• Ensure availability and replenishment of supplies
• Above minimum requirements must be observed at central, regional, provincial and local
levels
• Safe, secured and optimal supply chain (ware housing, transport, distribution)
• Ensure good quality of supplies
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2. Transportation

• Refers to movement of team, patients, supplies and samples

• Plan in advance for the right kind of transport that may be necessary to transport what
kind of cargo and make sure it stays available all throughout the operation
• Fleet management to include daily maintenance of vehicles and level of spare parts and
fuel
• Choose routes according to security situation, road condition, distance, urgency of
delivery
• Consider transportations ranging from 4 wheels to vans, trucks, helicopters, planes, boats,
motorcycles, bicycles

3. Communication

• Ensure the right equipment for the right place and situation (equipment ranging from
landlines, mobile phones to satellite phones, satellite computer connections, VHF/HF radio
equipment, two-way radios, and video conferencing)
• Ensure proper installation, use and maintenance of communication equipment
• Training of team members including drivers
• List of contact numbers of other agencies and suppliers
• Communicate with the public

4. Security and Well-being

 Security related to the logistics operation:

- Ensure secured warehousing and movement of supplies to avoid looting and

wastage:
- Warehouse with competent and reliable staff, security personnel and security alarm
system
- Warehouse must be clean, free from pests and leaks
- Transport supplies at day time

 Security of the Rapid Response Team (RRT)

- Secured and comfortable work and living space

- Guarded environment, uncontaminated workplace and staff
- Sufficient supply of food and drinking water
- Safe work practices
- Proper waste management and safe burials
- Proper distribution and correct use of PPE
- Correct isolation and disinfecting practices
- Safe travel of staff
- Safe personal well-being with respect to local culture, religion, rules and regulations
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ANNEX J: Personnel and Ambulance Services for Emergencies and Disasters

 Hospitals/RHU should have assigned personnel and ambulance for emergencies/

disasters.
 The ambulance must have the necessary equipment, medicines, supplies and necessary
communication system for proper coordination.
 The authority to dispatch ambulance is the responsibility of the HEMS Coordinator.
 In case there is no ambulance driver, any of the response team is given authority to
drive the ambulance vehicle
 Ambulance vehicle must have license, properly marked and identified (passive and
active, visual and audible)
 Ambulance staff must be properly manned with trained and competent personnel
cognizant of their roles and responsibilities
 Ambulance must be equipped according to the type, classification of level of hospital
and ambulance service
 It must be regularly maintained, properly cleaned, sanitized and decontaminated,
before and after patient and medical care provider transport.
 The word “AMBULANCE” can only be used by licensed ambulance service provider.
 All ambulance medical care providers must be concerned by appropriate insurance.

ANNEX K: Guidelines and Procedure in Evacuation of Patient on Internal Emergency

 To remove patient from actual threat and danger such as fire, explosion, enemy attacks.
 Evacuate patients form stricken areas in the hospital that are depicted as “safe”
 Remove patients from immediate danger area to safer section of the building behind
fire doors or remove from the building.
 Systematic and gradual moving of patients closest to the danger first behind the fire
door or the same floor if the emergency continue to escalate to lower floors or outside
the building.
 Call for help to nay rescue teams for assistance such as Fire Department, PNP or trained
personnel.

ANNEX L: Guidelines on Transfer of Emergency Patient During Disasters

 Transferring emergency patients is based on fast and efficient triaging – prioritization

scheme.
 Medical officers assigned as the Triage Officer will determine priority to dispatch for
transfer.
 First-aid treatment must be done in Emergency Room.
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 Established procedures and guidelines between referring and receiving hospital (if
available) must be followed.
 Referral form with return slip will be given to patient’s relatives and to be with proper
instruction.
 Inform/ call properly receiving hospital for the case to be transferred, and if failed,
notify the PHO HEMS -OPCEN to facilitate such needs.
 During emergency situation, all patient/victims can be accommodated by the receiving
hospital without the proper procedure for transfer must be followed.
 Facilitate MOA to all possible referring hospital outside the locality.

ANNEX M: Guidelines and Policy on Donations

(Drugs, Medicines, Supplies and Equipment) (AO No. 2007-0017)

 Donated products should meet BFAD & DOH requirements.

 Labeling with English translation in language that is understood by health practitioners.
 Donated items should have proof of compliance to applicable existing standards and
from reliable source.
 Donated items should have labeling of expiration dates, four (4) months and below
before expiration should not be accepted.
 Distributed of supplies and equipment should be under supervision of Supply Officer/
Storekeeper.
 Drugs and medicines should be endorsed immediately to the Pharmacist and other
supplies needed by concerned unit with proper recording for inventory, auditing and
reporting purposes.
 All issued donated supplies should be properly recorded including complete name and
address of patients/ receipts for proof of such donation.
 The hospital should not participate in any promotional activity if manufacturers donated
products.
 No charges or payment should be made from donated products.

Guidelines on Acceptance
• PHO shall limit its monetary obligations to the payment of logistics for the transfer of donated
items to emergency and disaster areas. Custom duties, brokerage fees, handling fees,
warehousing fees, and others shall be borne by the Donor.
• Acceptance of donations shall be based on the expressed needs of the beneficiaries and be
relevant to the disease pattern and health concerns that are prevailing in the area.
• Infant formula, breast milk substitute, feeding bottles, artificial nipples and teats will not be
accepted.
• Foodstuffs should have a shelf life of at least 3 months from the time of arrival in the
Philippines.
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• Drugs/medicines for donation should comply with the following:

- Shelf life of at least 12 months from the time of arrival to the Philippines.
- Labeling with English translation or in a language that is understood by Philippine health
professionals
- Packaging that complies with international shipping regulations accompanied by a
detailed packing list
- Weight per carton does not exceed 50 kilograms
- Exclusive packaging with regard to other supplies
- Documentary proof of compliance to internationally accepted standards
- Documentary proof that the items were obtained from reliable sources
• Medical equipment for donation should comply with the following:
- Attached manual of instruction for installation or operation translated in English
- Accompanied by list of service centers in the Philippines where services/spare parts are
available

Guidelines for Distribution

• The PHO/MHO/Hospital shall distribute the donated items to emergency and disaster
affected areas. The distribution of items for election purposes shall not be allowed nor the
repackaging thereof in consideration of elective or appointive government officials.
• The PHO/MHO/Hospital reserves the right to distribute and utilize excesses of donated items
that results from:
- Situations wherein the donation exceeds the requirement in affected areas
- Delays in the arrival of donated items to the Philippines

ANNEX N: Guidelines on Media Management

 There is no such thing as ‘off-the-record’. Everything you say and do can be reported. Be
careful with what you say in the presence of journalists, even after a formal interview is
finished and at social gatherings.
 Never make disparaging or critical remarks about local authorities or international
partners.
 Do not mention weaknesses they might be all that is reported.

 Working with the Media

• One individual or organization should have overall responsibility for public comment
and information
• Spokespeople are identified to speak to the media for specific topics
• Arrangements are made with electronic and print media to advise the public of
imminent or actual emergencies
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• Activities are carried out to build relationships with the mass media, such as
participation in planning, seminars and exercises, and staff training
• Messages (and background information) are pre-prepared for specific types of risks
and situations
• Media people are informed and aware of its roles and responsibilities, national plans,
preparedness activities and decision-making processes for managing all types of risks
and the operating practices of organizations, including health organizations
• Past experience has shown the value of immediately dealing with the following points:
- Control access to the disaster site
- On-site facilities for issuing passes to media personnel (or accrediting media
representatives)
- Establishing a media liaison point
- Nominating a media spokesperson
• The media will welcome any factual statements particularly from emergency services’
eye witness
• Care should be taken that information about casualties is not released until details
have been confirmed and next of kin informed
• Avoid prejudicing what may become a criminal prosecution
• The first consideration should always be given to the individual (reporters look for
survivors and emotional issues)

ANNEX O: Guidelines on Epidemiology and Surveillance

Surveillance System Development

1. Establish Objectives regarding the following:
- Detect epidemics - Access to food
- Monitor changes in the population - Access to water
- Numbers - Shelter and sanitation
- Health status including nutritional - Access to health services
conditions - Facilitate the management of relief
- Security
2. Develop Case Definitions (Request PESU)
3. Choose the Indicators
- Illustrate the status of the population (ex. death rates)
- Measure the effectiveness of relief (ex. immunization coverage)
4. Determine Data Sources
- Data can come from health-care facilities (“passive surveillance”) and from surveys in
the community (“active surveillance”)
- Involve those who provide health care
- Health surveillance in an emergency requires input from all sectors
5. Develop Data Collection Tools and Flows
- Use pre-existing local formats and/or international standards
- Use formats the facilitate data entry (EpiInfo)
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- Utilize existing process flows

6. Field-Test and Conduct Training
- Can these data produce the information required?
- Training field workers will improve data facility and local analysis
7. Develop and Test the Strategy of Data Analysis
Data analysis should cover:
- Hazards and impact on the population’s health
- Quality and quantity of services provided
- Impact of services on population’s health
- Relation between services provided to different groups (evacuees and hosts)
- Deployment and utilization of resources
- Major operations may require a central epidemiological unit
8. Develop Mechanisms for Disseminating Information (Risk Communication)
- For the information to be useful, it must be disseminated widely and in a timely fashion:
- Feedback will sustain data collection and the performance of field workers
- Health information is important for the activities of other sectors.
- Sharing information is good coordination
- Share information to authorities who manage the cases and the incident
9. Monitor and Assess Usefulness of the System

ANNEX P: Guidelines on Immunization During Disaster

The HEM Coordinator shall:

1. provide immunization to children, adolescents, and adults to protect them against

vaccine-preventable diseases

2. shall implement the guidelines regarding Vaccine Storage during Power Outages

 Recommended Immunizations
a. If immunization records are available:
 Children and adults should be vaccinated according to the recommended child,
adolescent, and adult immunization schedules.

b. If immunization records are not available:

 Children aged 10 years and younger should be treated as if they were up-to-date
with recommended immunizations and given any doses that are recommended for
their current age. This includes the following vaccines:

i. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) for all children
through 6 years of age; tetanus and diphtheria toxoids and acellular pertussis
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vaccine (Tdap) for children 7 -10 years of age if they did not complete the DTaP
series
ii. Inactivated Poliovirus vaccine (IPV)
iii. Haemophilusinfluenzae type b vaccine (Hib)
iv. Hepatitis B vaccine (HepB)
v. Pneumococcal conjugate vaccine (PCV)
vi. Measles-mumps-rubella vaccine (MMR)
vii. Varicella vaccine unless reliable history of chickenpox
viii. Influenza vaccine for all children 6-59 months of age, and all children 6 months - 10
years of age with an underlying medical condition that increases the risk for
complication of influenza
ix. Hepatitis A vaccination is recommended for children 1 year of age and older
x. Rotavirus vaccine

 Children and adolescents should receive the following recommended

immunizations:

i. Adolescent/adult formulation tetanus and diphtheria toxoids and acellular pertussis

vaccine (Tdap)
ii. Meningococcal conjugate vaccine (MCV) (recommended first dose at ages 11-12 and
a booster dose at 16)
iii. Influenza vaccine for all children 6-59 months of age, and all children 6 months
through 10 years of age with an underlying medical condition that increases the risk
for complication of influenza

 Immunocompromised individuals, such as HIV-infected persons, pregnant women,

and those on systemic steroids, should not receive the live viral vaccines, varicella
and MMR. Screening should be performed by self-report.

c. Rabies
 Rabies vaccine should only be used for post-exposure prophylaxis (e.g., after an
animal bite or bat exposure) according to CDC guidelines.

d. Tetanus: responders should receive a tetanus booster if they have not been vaccinated
for tetanus during the past 10 years. Td (tetanus/diphtheria) or Tdap
(tetanus/diphtheria/pertussis) can be used; getting the Tdap formula for one tetanus
booster during adulthood is recommended to maintain protection against
pertussis. While documentation of vaccination is preferred, it should not be a
prerequisite to work.

e. Hepatitis B: Hepatitis B vaccine series for persons who will be performing direct patient
care or otherwise expected to have contact with bodily fluids.
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f. Documentation
g. Immunization cards should be provided to individuals at the time of vaccination.

 Guidelines Impact of Power Outages on Vaccine Storage

a. Do not open freezers and refrigerators until power is restored.

b. Most refrigerated vaccines are relatively stable at room temperature for limited periods
of time. The vaccines of most concern are MMR and Varivax, which are sensitive to
elevated temperatures.

c. Monitor temperatures; don't discard; don't administer affected vaccines until you have
discussed with the Municipal and Provincial Health Officer

d. If the power outage is on-going:

1. Keep all refrigerators and freezers closed. This will help to conserve the cold mass of
the vaccines.

2. Continue to monitor temperatures if possible. Do not open units to check

temperatures during the power outage. Instead, record the temperature as soon as
possible after the power is restored, and the duration of the outage. This will
provide data on the maximum temperature and maximum duration of exposures to
elevated temperatures.

3. If alternative storage with reliable power sources are available (i.e., hospital with
generator power), transfer to that facility can be considered. If transporting vaccine,
measure the temperature of the refrigerator(s) and freezer(s) when the vaccines
are removed. If possible transport the vaccine following proper cold chain
procedures for storage and handling or try to the record the temperature the
vaccine is exposed to during transport.

e. When power has been restored:

1. Record the temperature in the unit as soon as possible after power has been
restored. Continue to monitor the temperatures until they reach the normal 2–8
degrees Celsius range in the refrigerator, or -15 degrees C or less in the freezer. Be
sure to record the duration of increased temperature exposure and the maximum
temperature observed.

2. If you receive vaccine from your state or local health department, they may be
contacting you with guidance on collecting information on vaccine exposed to
extreme temperatures.
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3. If you are concerned about the exposure or efficacy of any of your vaccine stock, do
not administer the vaccine until you have consulted your state or local health
department.

4. Keep exposed vaccine separated from any new product you receive and continue to
store at the proper temperature if possible.

5. Do not discard any potentially exposed vaccine. We will be working with the vaccine
manufacturers to determine which vaccines may be viable.

ANNEX Q: Guidelines on Nutrition in Emergency and Disaster

Nutrition Preparedness
1. Coordination and Networking
- Nutrition cluster established at all LGU levels
- Local nutrition cluster membership strengthened and linked with other clusters such as
WASH, psychosocial, social protection, food and nonfood clusters under the NDCC

2. Planning
- Nutrition management integrated into local disaster preparedness plan, with the
following components identified:
a. Nutrition package and services to be delivered, including estimated requirements of the
following: Food rations for mass and supplementary feeding; supplements such as Vitamin
A, iron, zinc, multiple micronutrients; assessment tools and equipment
b. Target groups
c. Logistics management (e.g. sources, delivery networks and warehousing)
d. Service providers (volunteers, health staff, private practitioners, referral units)
e. Funding requirements and sources
f. Capacity building on nutrition management, nutritional assessment, and monitoring and
evaluation schemes

3. Capacity Building
- Training on nutrition management to cover the members of the nutrition cluster, service
providers, volunteer workers, designated personnel for special assignments (warehouse,
desk officers, etc.), and other personnel involved in nutrition management in
emergencies and disasters.
- Orientation on nutrition management in disaster among local officials and disaster
brigade members
- Community assemblies to orient community members on nutrition preparedness in
disaster
- Conduct nutrition preparedness in disaster drills (table top drills)
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4. Organizational Support
- LGUs to adopt or pass local ordinances to support compliance to national laws and
policies related to nutrition management
- Mobilize existing calamity fund and lobby for increased allocation of budget for nutrition
activities
- Designate infrastructures and equipment which can serve as centers for nutrition
management.

5. Social Mobilization
- Establish rapport with potential allies (e.g. donors, NGOs including civic organizations,
church groups, private companies) and seek commitments for assistance.
- Establish regular communication with stakeholders to sustain partnership.
- Capacitate community in planning, response rehabilitation, monitoring, evaluation and
provision of long-term interventions for sustainability.
6. Advocacy
- Identify appropriate nutrition interventions based on implications for immediate
nutritional needs.
- Promote resource generation and social mobilization.
- Utilize a central database of relevant nutrition and related information for
dissemination.

7. Logistics Management
- Ensure availability of essential supplements, supplies, tools, equipment (weighing scale,
mictoise or infantometer or MUAC for the rapid assessment), and materials for nutrient
management during the pre-emergency period.
- Make special arrangements with selected donors and suppliers to have a credit set-up
during disaster and emergency for immediate purchases.
- Preposition items for supplementary feeding before the disaster season.
- Prepare a monthly inventory report or database of supplies and materials including
expiry dates which shall be circulated to all concerned offices.
- Ensure that identified evacuation centers or transit centers have provisions for feeding
centers and breastfeeding areas.

8. Surveillance, Monitoring and Evaluation

 Pre-emergency stage or “normal” times:
- LGUs conduct Operation Timbang (OPT) with results organized into a database that
can be used for planning and program monitoring and evaluation.
- Growth charts used in recording the results of regular weighing.
- Information on the prevalence of underweight preschool children with respective
rankings for each barangay ready at the municipal level.
 Early stage of the emergency:
- Conduct nutritional assessment to identify and locate preschool children with
weights below the standard weight-for- height indicative of wasting (watch out for
presence of bilateral edema).
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-If measuring weight and height not possible, the mid-upper arm circumference
(MUAC) could be used as index for screening preschool children.
- Weighing and height measurement of preschool children done monthly until “full
normalcy” achieved, by which time the OPT system can be used for nutritional
assessment.
 Nutritional assessment should be complemented with:
- Profiling of the population affected in terms of no. of pregnant women, no. of
infants not exclusively breastfed, no. of infants 6 months and older who are not
receiving complementary foods, and extent of practice of proper complementary
feeding
- Determining the presence of other risk factors (e.g., child-headed households,
orphan-hosting households (substitute households), elderly headed households
(caring for grandchildren), households caring for chronically sick members, high
prevalence of HIV further exacerbated by the foregoing risk situations)
- Assessment of food security status
- Extent of diarrhea and acute respiratory tract infection among preschool children
- Child mortality
 Monitor the extent of implementation of interventions at all stages of an emergency to
determine needed adjustments in targeting, intervention design and implementation,
and resource allocation.

9. Service Delivery
 Early Phase
- Mitigate hunger
- Re-establish body reserves for micronutrients
- Provide comfort and improve morale
- Help counteract shock
 Intermediate and Extended Phase
- Maintain/Improve the nutritional status of the malnourished
- Prevent deterioration in the nutritional status of the affected population

10. Psychosocial Care

- Supporting play-sessions for mother and child, and ensuring that a play area with toys is
available to parents and staff to interact with malnourished children.
- Offering breastfeeding corners for pregnant and breastfeeding women to provide
mothers with a space to share experiences receive advice and reinforce self-esteem in
the evacuation areas.
- Facilitating discussions between the families and the staff when a severely malnourished
child has to be treated in an inpatient facility to clarify who will take care of the rest of
the family and the household in the absence of the mother.
-
Nutrition Activities and Key Services During Disaster
1. Breastfeeding program
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- Protection and reinforcement of breastfeeding in the general population (including HIV-

positive females)
- Infants less than 6 months old are exclusively breastfed, and older children up to 2 years
old continue to be breastfed while complementary food is given starting at 6 months
- Provision of “safe havens” or designated special area in evacuation centers for pregnant
and lactating women, as well as counseling services for relactation
- Discourage use of infant-feeding bottles and artificial teats during emergencies and
disasters
- In the very extreme and unlikely case of breastfeeding not being possible, breast milk
substitutes may be used provided that it is given using properly sterilized cups/spoons
and with safe drinking water

2. Complementary feeding
- Complementary foods should be nutritionally adequate, safe/hygienically prepared,
easy-to-eat and digest, given to the infant in a caring manner, and introduced at 6th
month of life onwards.
- Preparation and giving of complementary foods should be the responsibility of the
family even in evacuation centers or camps. However, caregivers should have a secure
and uninterrupted access to appropriate ingredients with which to prepare and feed
nutrient-dense complementary foods.
- When available, food aid in the form of blended foods, especially if fortified with
essential nutrients may be used provided the child’s caregiver is informed on its proper
use.

3. Food rations/Mass feeding

- Meals to be given are easy to prepare, practical, can satisfy hunger and nutritious that
commonly include boiled rice, cooked sardines, boiled root crops or one dish meals
(sinigang, nilaga, munggo).
- To the extent possible, food provided either in cooked or dry-ration form should contain
100 percent of the RENI for calories and protein, and at least 80 percent of vitamins A,
B1, B2, niacin, iron, and calcium.
- For HIV or HIV-AIDS cases, calorie allowance increased by 10% for asymptomatic and 20-
30% for symptomatic HIV-infected adults; and 50-100% for children with acute weight
loss and infection
- Smaller (2 week) rations particularly for child- and elderly-headed households, if
feasible.

4. Vitamin A supplementation
- High-dose vitamin A supplements should be given to all victims of disasters or
emergencies.
- If the supply is limited, the following target groups will be prioritized:
- 6-11 months old infants (1 capsule of 100,000 IU, 1 dose only)
- 12-71 months preschoolers (1 capsule of 200,000 IU, 1 capsule every 6 months)
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- High-risk cases with severe pneumonia, persistent diarrheas, under nutrition and
capsule 200,000 IU for young children regardless of when the last dose was given)
- Lactating mothers (1 capsule of 200,000 IU)

5. Iron or multi-vitamin supplementation

- For pregnant mothers, iron-folate or multi-vitamin supplements (composed of vitamins
A, D, E, C, thiamine, riboflavin, niacin, B12, B6, folic acid and minerals iron, zinc, copper,
selenium and iodine) should be given.

6. Supplementary feeding
- Targeted supplementary feeding for 10-14% wasting prevalence
- Blanket approach if >14% wasting prevalence
- May be given in dry or wet (cooked food eaten in a centralized location) form

7. Therapeutic treatment
- Consists of feeding with a high-energy liquid diet such as milk, soup, juice, and nutritious
drinks at 3-hour intervals daily for 3 to 5 weeks
- Therapeutic treatment for all preschool children who show wasting, with or without
bilateral edema
- Moderate acute malnutrition but have no medical complication: Supplementary feeding
program (dry take-home rations and standard medicines)
- Severe acute malnutrition (SAM) with no medical complications: Outpatient care sites
- with medical complications or infants with SAM: Inpatient care (until well enough to
continue being treated in outpatient care)

Meal Considerations for Disaster Periods

• For early emergency period, characterized by stress and anxiety, serve a stimulating warm
drink and light snacks.
• Avoid very hot or iced beverages. Milk is best for infants and children. Coffee or fruit juice
for adults. Easy to serve snacks which are high in carbohydrates are preferred.
• For the intermediate period, when cooking facilities are available, a full meal may be
served, usually a nourishing one-dish hot meal which is easy to prepare, transport and
serve, otherwise, meals from packaged, or canned foods may be planned, or fresh fruits
which do not require heating.
• For extended operations, when cooking facilities are already set-up, one-dish meals with
fruit and rice/bread may be served. Two or 3 meals a day may be served.

Post-Disaster Nutrition Activities

• Provision of food for work activities
• Supplemental feeding to vulnerable individuals
• Complementary feeding for 4-6 month-old infants
• Provision of seedlings for crop production
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ANNEX R: Guidelines on Water, Sanitation and Hygiene

 Hygiene Promotion

A. Program Design and Implementation

- An assessment is needed to identify the key hygiene behaviors to be addressed and the
likely success of promotional activity. Key risks of public health focusing on WASH must
be identified so that messages are relevant and practical.
- Programs shall include an effective mechanism for participatory input from all users,
other organizations/ clusters during the initial design of facilities.
- All groups within the population shall have equitable access to the resources of facilities
needed to continue or achieve the hygiene practices being promoted. In evacuation
centers, there should be at least one (1) hygiene promoter/community mobilizer per
1,000 population.
- Hygiene promotion messages and activities shall address key behaviors and
misconceptions and are targeted for all user groups. Representatives from these groups
must participate in planning, training, implementation, monitoring and evaluation
- Users must take responsibility for the management and maintenance of facilities and
different groups must contribute equally

 Water Supply

A. Water Supply Standard

1. Access and Water Quantity
- Average water use for drinking, cooking and personal hygiene in a camp/evacuation
center is at least 15 liters per person per day for the first one week
• The quantities of water needed may vary according to the climate, the sanitation
facilities available, people practices, and the food they cook, among others.
• Water use/demand increases due to prolonged encampment period
• The maximum distance from the users to the nearest water point is 500 meters
• Queuing time at a water source is no more than 15 minutes
• It should take no more than three minutes to fill a 20-liter container
• The number of people per source depends on the yield and availability of water at
each source.
• Until minimum indicators are met, the priority should be equitable access to an
adequate quantity of water even if of intermediate quality.

2. Water Quality

a. Microbiological
- A sanitary survey should indicate a low risk of fecal contamination.
- Sampling and testing for presence-absence of E.coli/ fecal coliform should be done
before delivery of emergency supplies of drinking water to users
- There should be no fecal coliform per 100 ml at the point of delivery.
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b. Physical and Chemical

- Where hydrological records or knowledge of industrial or military activities suggest that
water supplies may contain chemical health risks, those risks should be assessed by
carrying out chemical water analysis.

c. Post-delivery Contamination
- Steps should be taken to minimize post-delivery contamination such as improved
collection, proper storage practices, and distribution using clean and appropriate
containers.

d. Water Treatment/Disinfection
- Water should be treated when found contaminated or positive for E. coli/ fecal coliform.
Water is treated with a disinfectant so that there is a chlorine residual at the tap of at
least 0.3 mg per liter and turbidity is below 5 NTU.

Water Treatment Options for Household Drinking Water:

- Use of water disinfectant (tablet form), Sodium dichloro-isocyanurate a) 3.5 mg tablet
(free available chlorine 2mg) for one (1) liter water, or b) 67 mg tablet (free available
chlorine 40mg) for twenty (20) liters water
- Use of water disinfectant ( liquid form), 3.5ml of 1.25% Sodium Hypochlorite Solution
for every twenty (20) liters water
- Use water disinfectant (granular form), Calcium hypochlorite 65-70% available chlorine
to be prepared as ‘Stock solution’. Stock Solution must be prepared by mixing one (1)
teaspoon or five (5) grams of Calcium hypochlorite in a one liter water. (NOTE: The
solution must be keep out of direct sunlight and is effective for one week). Mix two (2)
teaspoon ‘Stock Solution’ for twenty (20) liters water and let it stand for at least 30
minutes before using.

Disinfection of Level 1 Water Supply Facility (e.g. Deep Well)

- The following tables give the amount of Calcium Hypochlorite in preparing chlorine
solution. Allow the chlorine solution to remain in the well for 12 hours, then draw out
water until the water is free from chlorine odor.

3. Water Use Facilities and Goods

- Each family has at least two clean water containers (with narrow necks and covers) of
10-20 liters capacity for collecting clean water, plus enough clean water storage
- For communal water storage tank: 10 liters per person per day. Volume of tank good for
two days demand, half full in the evening; with residual chlorine of 0.7 ppm
- There is at least 250 gram of soap available for personal hygiene per person per month
- Sufficient bathing cubicles must be available, with separate cubicles for males and
females, and they are used appropriately and equitably.
- Private laundry areas must be available taking into consideration the needs for women
to wash and dry undergarments and sanitary cloths, and have at least one washing basin
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per 100 people

- Participation of all vulnerable groups and concerned clusters is actively encouraged in
the siting and construction of bathing facilities, production and distribution of soaps,
and promotion of suitable alternatives.

 Excreta Disposal

A. Accessibility and Number of Toilets

- Separate toilets for women and men must be available

- Toilets must be cleaned and properly maintained in such a way that they are being used
by all intended users.
- Toilets are no more than 50 meters from dwellings.
- Toilets are used in the most hygienic way and children’s feces are disposed of
immediately and hygienically.

B. Design, Construction and Use of Toilets

- Users (especially women) have been consulted relative to the design of the toilet.
Coordination with concerned cluster must be done prior to construction of toilet
facilities in the camps/evacuation centers.
- Toilets are designed in such a way that can be used by all sections of the population,
including children, older people, pregnant women, and physically and mentally disabled
people.
- Toilets are sited in such a way as to minimize threats to users, especially women and
girls, throughout the day and night.
- Toilets provide a degree of privacy in line with the norms of the users.
- Toilets allow for the disposal of women’s sanitary protection, or provide women with
the necessary privacy for washing and drying sanitary protection cloths.
- All toilets constructed that use water for flushing and hygienic seal have an adequate
and regular supply of water.
- Toilets, septic tanks and soak a ways (for most soils) shall be located not less than 25
meters from any groundwater source and bottom of any pit/septic tank is at least 1.5
meters above the water table. Drainage or spillage from defecation systems must not
run towards any surface water source or shallow groundwater source.
- People wash their hands after defecation, hence toilet must be provided with soap and
water
- People are provided with tools and materials for constructing, maintaining and cleaning
their own toilets if appropriate.

 Vector Control

A. Individual and Family Protection

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- All populations at risk from vector-borne disease must understand the modes of
transmission and possible methods of prevention, and are protected as well by
appropriate vector control measures.
- People must avoid exposure to mosquitoes during peak biting times by using all non-
harmful means available to them (insecticide-treated tents, curtains, bednets, etc.).
Special attention is paid to the protection of high-risk groups such as pregnant and
feeding mothers, babies, infants, older people and the sick.
- People must use treated mosquito nets effectively when necessary.
- Food must be protected at all times from contamination by vectors such as flies, insects
and rodents.

B. Physical, Environmental and Chemical Protection Measures

- Affected populations must be settled in locations that minimize exposure to mosquitoes
(e.g., camps located 1-2 km upwind from large breeding sites)
- Intensive fly control must be carried out in high density settlements when there is a risk
or presence of a diarrhea epidemic
- Environmental control measures must be instituted to minimize the impact on the
population density of some vectors as follows:
a. Proper disposal of human and animal excreta
b. Proper disposal of refuse/garbage to control flies and rodents
c. Proper drainage to control breeding place of mosquitoes
d. Cover water storage container and latrines to prevent them of becoming mosquito-
breeding places

Chemical control measures will be instituted only when environmental control measures
failed and these must be done under the supervision of a Sanitary Engineer.

C. Chemical Control Safety

- Personnel must be protected by provision of training, protective clothing, use of bathing
facilities, supervision and restriction on the number of hours spent handling chemicals.
- Choice, quality, transport and storage of chemicals used for vector control, application
equipment and disposal of substances follow international norms, and can be accounted
for at all times.
- Communities are informed about potential risks of substances used in chemical vector
control and about schedule for application. They are protected during and after the
application of chemicals or pesticides.

 Solid Waste Management

A. Segregation, Collection and Disposal

1. Segregation and Collection
- People from affected population shall be involved in the solid waste program design and
implementation (e.g. organize a Refuse Collection team among evacuees for daily
collection of wastes)
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- Provide at least one 100-liter refuse container per10 families

- All households must have access to a refuse container and no more than 100 meters
from a communal refuse pit_ Segregation of health care wastes shall be done.
- Infectious wastes, pathological wastes and sharps shall be treated prior to final disposal.

2. Disposal
- Wastes musts be disposed of properly from the camp/evacuation center before it
becomes a nuisance or a health risk, especially health care wastes
- If off-site final disposal is not feasible, on-site disposal of domestic wastes may be
allowed using a properly located compost/communal pit (1.2 x 1.2 x 1.8 meters in size
for every 500 persons)
- Treated health care wastes shall be disposed of in a sanitary landfill, safe burial pit
within health care premises and septic/concrete vault specifically designed for sharps.

 Drainage

A. Drainage Works
- Areas around dwellings and water points must be kept free of standing wastewater
- Shelters, paths and WASH facilities must not be flooded or eroded by water
- Water point drainages from washing/bathing areas and water collection points must be
well planned, built and maintained in coordination with concerned cluster.

ANNEX S: SOP on Blood Transfusion

a. The hospital has no blood bank for the purpose. If there is a patient that needs for
immediate blood transfusion, the hospital allows the patient to secure from the
following services:

1. DOH accredited blood bank

2. Philippine National Red Cross
3. Quezon Medical Center Blood Bank

b. All blood procured will be cross-matched and blood typed again prior to use or blood
transfusion.

c. The hospital allows blood procured from commercial blood bank.

d. All procured blood are transported in a cold-chained & if there’s a break in the cold
chain the blood will be rejected.

Policy and Procedures:

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Policy Statement:

1. The Attending Physicians must order the type of blood products, number of
units/volume and specific product requirements.
2. Consent to treatment must be signed prior to the administration of blood components.
3. Normal saline is used to prime tubing, Improve flow rate or clear lines after transfusion.
4. At the bedside or in the OR, verification of blood components must be performed in the
presence of the patients.
5. The BT Report/tag must remain attached to the product until the transfusion is
complete.
6. A physician/nurse must directly observe the patient for any signs of an adverse
transfusion reaction for the first 5 minutes, then every 5 minutes for a total of 10
minutes every 1 hour thereafter. These observations must be documented and referred
immediately.
7. Patient must be assessed including vital signs & recorded, as per procedure.
8. Patient should remain in the wad during the administration of the blood component.
9. Blood administration must not exceed 4 hours from the time it is dispensed from the
Blood Bank. If a unit is still hanging at the end of 4 hours it must be discontinued and the
remaining component discarded.
10. The blood administration set must be changed after 4 consecutive units have been
transferred or after 8 hours of use if more than 60 minutes have elapsed before another
transfusion is initiated.

Procedures:

Pre-Administration
1. Consent is required for all blood components for patients refusing a blood transfusion, a
written refusal is required.

2. Review the physician’s order for transfusion and pre medication.

3. Confirm the patient has signed the consent to treatment, the IV site is patent and the
patient will be on the unit for the duration of the transfusion.

Administration of Blood Component

1. Obtain and record baseline vital signs (TPR,BP)

2. Provide and document patient teaching (apply to conscious patient only)

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 Explain the nature and purpose of the transfusion and the monitoring to be done
during procedures.

 Instruct the patient to notify the nurse on duty if the following occurs: Pain, nausea,
chills, dizziness, weakness or sweating or any change before the transfusion.

3. Visually inspect products for clots, clamps and discoloration (if present, notify blood
bank and return the product).

4. Verify the specific product requirements.

5. Gently agitate blood components to mix thoroughly.

6. Prime the appropriate tubing with normal saline.

7. Verify the following in the presence of the patient:

a. Patient’s full name and unit number in the BT Report/Tag and the patient’s arm
band match

b. That the ABO Group, Rh type and blood serial number on the BT report matches
with the ABO group, Rh type and serial number in the label.

8. Sign the BT Report/Tag that is attached to the product and fill in the start time.

9. Remain with the patient for the first 5 minutes of the transfusion then assess every 5
minutes for 10 minutes and every 1 hour thereafter. When more than 1 unit of PRBC or
plasma is to be given, then each bag which monitored as previously describe.

10. Check and record patient vital signs:

 Within the hour prior to starting the transfusion

 After the first 15 minutes of the transfusion
 Every hour during the transfusion
 One hour following completion of the transfusion

11. Monitor for any untoward reaction such as:

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 Fever
 Chills
 Nausea
 Back/ flank pain or IV site pain
 Respiratory distress
 Skin changes
 Diarrhea
 Uriticaria
 Oligurioa
 Shaking
 Headache
 Hyper/hypotension
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 Chest pain
 Urine color changes
 Tachycardia
 Jaundice

Patient complains of any feeling other than the usual.

12. Obtain vital signs and assess patient every 1 hour until complete and 1 hour post
transfusion and document.

Post Administration

Transfusion Reaction

1. If the patient experiences any signs and symptoms of a transfusion reaction, stop the
transfusion immediately and refer to the algorithm.
2. Complete the information requested on the back of the BT report/tag specific for
suspected transfusion reaction.
3. Separate the report tag. Place chart copy in appropriate location in the patient’s chart
4. Discontinue transfusion.

If No Transfusion Reaction

1. Flush IV line with Normal Saline following solution.

2. Disconnect the blood component and administration set.
3. Remove the BT Report/Tag and complete the required information on the font.
4. Separate the report. Place chart copy in the appropriate location of the patient’s chart.
5. Discard empty blood bags with attached blood bags with attached blood infusion sets in
the patient unit in a biohazard waste container such as red bag.

Documentation

1. Teaching provided to the patient and/or significant other.

2. Nurse presence during first 5 minutes.
3. How patient tolerated the transfusion.
4. Presence/ absence of a transfusion reaction.
5. Vital signs.

In the event of a transfusion reaction, document these additional items.

1. Signs and symptoms and time of reaction

2. Name of physicians notified
3. Notification on the laboratory
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4. Specimen set
5. Treatment and administered response

During Disaster:

1. Notify the Quezon Medical Centre/ Provincial Blood Council for the urgent need of
blood.
2. Maintain a list of PNRC blood bank, commercial banks and other possible blood bank
contact persons.
3. Lobby support to send necessary blood for victims of disaster.
4. Replacement of safe blood with unsafe blood.

ANNEX T: Guidelines on Prevention and Control of Communicable Diseases

Vaccine Preventable Diseases

• Measles, Hepatitis A, Haemophilus Influenza Type B, Hepatitis B
• Tetanus, Rabies, Rubella, Typhoid Fever, Japanese Encephalitis, Influenza
• A single suspected measles case is sufficient to prompt an immediate immunization
response. Life-saving measles vaccine should be made available immediately targeting all
infants and children 6-59 months of age (may be expanded up to 15 years old in areas with
substantial crowding).
• Each visit to health care facilities should be an opportunity to vaccinate for routine EPI
regardless of reason for visit. Vaccination program activities should be part of basic
emergency health care services.
• If there are cases, vaccinate non-immunized high risk groups (Diphtheria, Poliomyelitis,
Rubella, Pertussis, Influenza)
• Mass immunization is not recommended for cholera, typhoid, tetanus (booster for the
injured) and hepatitis A
• Health education

Food and Water-borne Diseases

• Acute Gastroenteritis (Diarrhea), Cholera, Hepatitis A and E, Food Poisoning, Typhoid/
Paratyphoid
• Diseases of immediate concern
• May occur anytime during disaster
• Related to unsafe drinking water and inadequate sanitation
• Diagnosis and specific treatment based on standard protocols
• Chlorination of drinking water, appropriate and sufficient water containers, and proper
handling of food
• Adequate sanitation facilities-latrines or designated defecation areas, proper garbage
collection and disposal
• Continuous health education especially personal hygiene
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Vector-borne Diseases
• Dengue Fever/ Dengue Hemorrhagic Fever, Malaria, Japanese Encephalitis, Filariasis,
Chickungunya
• Diseases posing threats in 3-4 weeks
• Related to ecological changes that favor breeding of vectors
• Diagnosis and specific treatment based on standard protocol
• Eliminate/modify breeding places
• Appropriate collection and disposal of garbage
• Personal protection
• Vector control and control of animal reservoirs
• Health education and social mobilization Respiratory Diseases
• Pneumonia, Influenza, Tuberculosis, Meningococcal Diseases
• Diseases posing threat in 3-4 weeks
• Related to overcrowding
• Diagnosis and specific treatment based on standard protocol
• Ensure proper living conditions – well spaced, good ventilation, proper clothing and use of
sleeping blankets
• Vaccinate, if necessary
• Continuous provision of drugs for TB
• Health education

Zoonotic Diseases
• Leptospirosis, Rabies, Typhus
• Diseases posing threat in 3-4 weeks
• Related to rains and flooding or accumulation of refuse, displacement of domestic and
wild animals
• Diagnosis and specific treatment based on standard protocol
Immunize if necessary
• Use of personal protection
• Control of animal carriers and animal reservoirs
• Health education and community mobilization

Treatment Protocol for Selected Diseases

General Signs Warning Signs Local Measures Emergency

and Symptoms Measures
Measles • Fever • Tachypnea or • Isolate patient • Assess ABC
• Maculopapular difficulty of • Paracetamol and monitor
rash starts breathing (10-15 mkd) for vital signs
from face then • Seizure or fever • Do CPR for
spreads to changes in • Vit. A CP arrest
body/extremities sensorium 100,000u • Start IV line –
• 3Cs (cough, • Dehydration for 6-12 mos Plain LR/ pNSS
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colds, • Immunocompromised and 200,000u if with shock

conjunctivitis) status (malignancy, for >12 mos <12y/o: D5
• May have AIDS, asthma, • Repeat dose 0.3% NaCl
Koplik Down’s) next day and 4 >12y/o:
spots on buccal • Grossly weeks after for D5NM
mucosa malnourish pts with ophtha • Give O2 (2-4
• History of evidence of Vit. L/min by nasal
coriander A deficiency prong)
(kulantro, uansuy) • Do measles inhalation
Intak IgM • Salbutamol
inhalation
Acute • >3 episodes • Severe • Give home (2 puffs) or
Gastroenteritis liquid stools in dehydration fluids (soups, nebulization
(AGE) 24 hours plus: signs (lethargic or rice gruel) (1/2-1 neb)
• Fever unconscious, floppy • Give ORS Q20
• Vomiting infant, sunken eyes, • Continue mins for
• Abdominal drinks poorly, poor feeding or wheezes
pain skin elasticity increase until arrival at
• Poor appetite • Cold clammy frequency of hospital
• Signs of some extremities, pallor, breastfeeding • Diazepam
dehydration weak pulse • Do not give (0.2-0.4
(increase thirst, • Difficulty of anti-diarrheal or mkd, max 10
irritability, breathing anti-spasmodic mg) for seizure
sunken eyeballs, • Seizure drugs • Refer to
poor skin • Absent or hospital with
turgor) decrease urine referral note
output
• Persistent
vomiting
• Persistent
diarrhea >14 days
with dehydration

• Bloody stools or • Zinc 20 mg/ Additional for

rice watery day for 10-14 AGE:
voluminous stools days for • Start 2 IV
• Abdominal children lines for pts w/
distention and 10mg/day possible
• Muscle cramps for infants <6 cholera
• Grossly mos old) • Give ORS by
malnourish • Paracetamol NGT (20ml/kg
• No clinical (10-15 mkd) for for 6 hrs) if IV
improvement after fever Q4 hrs therapy not
4-6 hours of ORS • Do rectal feasible for
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swab pts who can’t

(c/o NEC) drink
• Advise good
personal
hygiene
• Observe for
warning signs

Dengue • Fever of 2-7 • Spontaneous • Paracetamol Additional for

days plus 2 or bleeding (10-15 mkd) for Dengue:
more of ff: • Pallor/ cyanosis/ fever • Do nasal
• Headache/ eye DOB • Do not give packing
pains • Hypotension and Aspirin for nose
• Arthralgia/ weak pulses/ • ORS by mouth bleeding,
myalgia/ frequent at 3 cc/kg/hr Epinephrine
generalized dizziness & fainting • Assess patient –soaked nasal
body malaise (for 5 y/o) cold daily until 3 pack in severe
• General clammy skin days without bleeding
flushing of the • Plasma leakage: fever
skin/ rash cherry red lips, • Request CBC,
• Positive pleural effusion, platelet count
tourniquet ascites and monitor
test (≥ 20 • Restlessness/ hematocrit and
petechiae/in2) listlessness/ seizure platelet daily, if
• Severe persistent feasible
abdominal pain and • Observe for
tenderness warning signs
• Dehydration signs
2° to vomiting,
diarrhea
or poor fluid intake
• Jaundice/ tea-
colored urine
• Platelet
ct<100,000

Pneumonia • Cough • Worsening VS • Isolate patient Additional for

• Any abnormal (RR≥30 breaths/min, and observe Pneumonia:
VS: CR≥125 beats/min, proper bed • Place patient
• Tachypnea (RR T< 35°C or ≥40°C) spacing on moderate
> 20 breaths/ or no improvement • Low Risk CAP high back rest
min) of condition for 3 • Drugs of
• Tachycardia days choice:
(CR > 100/min) • Respiratory failure Amoxycillin 1gm
 148

• Fever (T> (RR≤12 breaths/min PO every 8 hrs x

37.8°C) or cyanosis) 7 days
• With at least • Suspected • Alternative
one abnormal aspiration drugs:
chest finding: • Azithromycin
• Diminished Hypotension/altered 500mg PO 1x/
breath sounds mental state day x 3-5 days
• Rhonchi • Extrapulmonary • Clarithromycin
• Crackles evidence of sepsis 500mg PO 2x/
• Wheezes (bleeding/jaundice) day x 7 days
• Co-morbid/ • Roxithromycin
debilitating 150mg PO 2x/
conditions (DM, day or 300mg
malignancies, PO 1x/day x
neurologic disease, 7 days
heart diseases on • Cotrimoxazole
prolonged steroid 160/800mg PO
use, renal failure, 2x/day x 7 days
COPD) • Salbutamol
• Inability to take in 2mg
food or medicine tab 3-4x/day for
• Severe wheezing
malnutrition • Paracetamol
500mg/tab Q4
hrs for fever
• Increase oral
fluid intake
• Balanced
nutrition and
regular exercise

Leptospirosis •Fever (T> 38°C), • Hypotension

headache/ • Cold, clammy skin
body malaise/ • Difficulty of
abdominal breathing/cyanosis
discomfort in • Seizure or
patient plus changes in
• Red eyes sensorium
(conjunctival • Decrease or no
suffusion) urine
• Yellow skin output
• Calf pain/ • Bleeding
tenderness manifestations
• History of
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exposure to
contaminated
water (flood/
ponds/sewage)
or infected urine
droplets in
ratinfested areas

Preventive Measures for Common Diseases

Disease Major Contributing Factors Preventive Measures

Diarrheal diseases • Overcrowding • Adequate living space
• Contamination of food and • Hygiene/public health education
water • Distribution of soap
• Lack of hygiene • Good personal and food hygiene
• Safe water supply and sanitation

Measles • Overcrowding • Minimum living space standards

• Low vaccination coverage • Immunization of children with
distribution of Vitamin A

Acute Respiratory • Poor housing • Minimum living space standards

Infections • Lack of blankets and clothing • Proper shelter, adequate clothing,
• Smoke in living area sufficient blankets

Malaria • Stagnant water which becomes a • Inhibiting mosquito breeding by

Dengue breeding area for mosquitoes
• For displaced people, a new
environment with a strain to which
they are not immune
draining stagnant water, covering
stored water, using larvicides, etc.
• Killing larvae and adult
mosquitoes
by spraying

Meningococcal • Overcrowding in areas where • Minimum living space standards

meningitis disease is endemic (often has local • Immunization only after expert
seasonal pattern) advice when surveys suggests
necessity

Tuberculosis • Overcrowding • Minimum living space standard

• Malnutrition (but where it is endemic it will
• High HIV prevalence remain a problem)
• Immunization

Typhoid • Overcrowding • Minimum living space standards

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• Poor personal hygiene • Safe water, proper sanitation

• Contaminated water supply • Good personal, food and public
• Inadequate sanitation hygiene and public health education

Worms (especially • Overcrowding • Minimum living space standards

hookworms) • Poor sanitation • Proper sanitation, good personal
hygiene
• Wearing shoes

Scabies • Overcrowding • Minimum living space standards

• Poor personal hygiene • Enough water and soap for
washing

Xerophthalmia • Inadequate diet • Adequate dietary intake of

(Vitamin A • Following acute prolonged Vitamin A. If not available, provide
deficiency) infections, measles and diarrhea Vitamin A supplements
• Immunization against measles
• Systematic prophylaxis for
children, every 4-6 months

Anemia • Malaria • Prevention/treatment of

• Hookworm contributory disease
• Poor absorption or insufficient • Correction of diet including food
intake of iron and folate Fortification

Tetanus • Injuries to unimmunized • Good first aid

individuals • Immunization of pregnant
• Poor obstetrical practice causes women and subsequent general
neonatal tetanus immunization within EPI
•Training of midwives and clean
ligatures, scissors, razors, etc.

Hepatitis • Lack of hygiene • Safe water supply

• Contamination of food and • Effective sanitation
water • Safe blood transfusion

STDs/HIV • Loss of social organization • Test syphilis during pregnancy

• Poor transfusion practices
• Lack of information
• Test all blood before transfusion
• Ensure adherence to universal
precautions
• Health education
• Availability of condoms
• Treat partners
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List of Measures for Communicable Disease Control

1. The use of interview for rapid assessment of communicable disease problems in emergency

2. Immunization
Indications for an immunization program
Implementation for an immunization program
Evaluation of an immunization program

3. Chemoprophylaxis
Right choice of drug
Length of use of the drug
Proper use of the drug
Distribution of drugs

4. Therapeutic Approaches
Mass treatment
Short treatment versus long treatments

5. Health Education
Have the community identify its problems
Study a population’s behavior and customs when faced with the problems identified
Set objectives
Determine the appropriate measures
Evaluate the impact of a health education program

ANNEX U: Guidelines in Management of the Dead and Missing

Search and Recovery Operation

• Search and Rescue (SAR) Commander to establish and disseminate unified and
standardized tagging system of bodies and body parts recovered
• All dead bodies/body parts retrieved onsite should be placed in cadaver bags (NOTE:
place one retrieved body per bag or one retrieved body part per bag, as one body part is
considered one dead body) during transport to collection points or storage areas
(preferably refrigerated) for identification/ examination
• Local Health Office (with support from DOH) to look after health conditions and needs of
responders and volunteers
• Protection and safety of responders/volunteers must be observed in entire MDM and
should be the primary consideration of sending agencies
• Local chief executive to coordinate all MDM processes Identification of the Dead
Operation
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• For disaster victim identification (DVI), the Local Government Unit (LGU) shall request NBI
(in cases of natural disasters) or PNP Crime Laboratory (in cases of mass fatality incidents
caused by human generated activities)
• NBI or PNP to provide Local Health Officer an official list of identified & unidentified
victims
• Local health officer to issue Death Certificate based on the Certificate of Identification
issued by NBI or PNP Medico-Legal Officers
• LGU to provide list of missing/dead persons for the NBI and PNP; and list of identified and
unidentified dead foreigners for the DFA
• Local Health Office to monitor proper sanitation of collection and storage areas, and
maintain sanitary retrieval and disposal of body parts/dead bodies
• Retrieved body parts/corpses waiting for examination should be preserved properly
preferably by refrigeration (will resort to temporary burial if not available)
• Chemical preservatives (quicklime, formol, zeolite) and common disinfectants
(hypochlorite) may be applied only after DVI
• NBI and PNP may request fingerprints, dental and medical records of the missing/dead in
custody of other government agencies (GSIS, SSS, etc.) for the purpose of identifying dead
bodies only
• Interpol Identification System for the Ante Mortem (Dead/Missing Persons Form) and Post
Mortem (Dead Bodies Identification Form) may be use for MDM data
• LGU, in coordination with NBI, PNP, DOH, DILG, and other agencies, shall conduct trainings
regarding proper handling of the dead/missing
• All concerned agencies to undertake Forensic Research regarding DVI

Final Arrangement for the Dead

• For identified remains:
Turned over to rightful/legitimate claimants, who will be responsible for the ultimate
disposal of identified cadavers
No embalming procedures shall be done without permission from the nearest of kin
(bereaved)
Respective embassies of identified dead foreigners shall be informed and will be
responsible for repatriation of their bodies
• For unidentified remains:
Turned over to LGU after thorough postmortem examinations
Final disposition c/o LGU, with religious and ethnic considerations and consultation with
the community
Shall be buried in collective or individual graves, marked with their unique case numbers
Cremation will not be allowed
Exhumation shall be done in the presence of local health officials
• Disinterment areas should be decontaminated or disinfected
•Burial of bodies in mass graves or the use of mass cremation/burning shall be avoided in all
circumstances
• MDM related to infectious diseases and Biological, Chemical, Radiological, Nuclear, and
Explosive Emergencies (BCRNE) shall be done in accordance with existing DOH guidelines
 153

Management of the Missing Persons Operation

• Provincial/City/Municipal Social Welfare Office shall:
Establish the Social Welfare Inquiry Desks for data generation and information
management of missing persons and their surviving families
Manage information regarding the Identification of Retrieved Bodies/Body Parts using
the Interpol

Identification System
• Validate and process documents of missing persons for issuance of Certificates of Missing
Person Believed to be Dead during Disaster and submit to LCE
• DSWD, DOH and PNRC to assist in medical, psychological, and physiological needs of the
families of missing persons The NDCC through OCD as per recommendation of the LGU shall
issue Certificates of Missing Persons Believed to be Dead during Disaster

Management of the Bereaved Families

• Provincial/City/Municipal Social Welfare Office (P/C/MSWDO) is the lead agency in the
over-all management of bereaved families
• DSWD to assist in terms of food, finances, livelihood, clothing, shelter; management of
orphans; and food/cash for work
• DSWD, PNRC, and NGOs to assist P/C/MSWDO in the ff:
Social needs of the bereaved in terms of family/peer support system; social welfare
inquiry desk/info center; educational assistance; legal needs
Psychological needs of the bereaved in terms of CISD training, counseling; and other
special needs (psychiatric/mental services)
• DOH to assist in medical and psychological needs of the bereaved, and PNRC for provision
of a support system from volunteers

Other Concerns in Cases of Mass Fatalities

1. Initial Concerns
Type of incident (natural hazards, e.g., flood, landslide, earthquake, epidemics; human-
generated, e.g., fire, land/sea/air transport crash, accidental or deliberate use of
biochemical/radio nuclear agents)
Probable condition of remains (e.g. burnt, with severe trauma, decomposed, contaminated)
Estimated number of fatalities
Location of incident
Local authority in-charge
Budget

2. Personnel
Tap medico-legal officers from the NBI, PNP and local government doctors.
Mobilize volunteers like medical and dental students or specialists from the area.
 154

Ideally a list of the people involved and their contact numbers should have been prepared
beforehand.

3. Handling of the Bodies at the Scene

Before anything else, observe and document the location and position of each body/body
part at the scene prior to removal.
Sketch and photograph for documentation.
Every effort must be taken to identify the bodies at the site where they are found. Tags
should be attached to the bodies that provide the name (if known), approximate age, sex,
and location of the body.

4. Evidence and Property

All items of property that are on the body should remain on it. Other items associated with
a body should be collected as property and tagged with the body.
Location of loose items (e.g., proximity to which body) should be documented prior to
collection.

5. Removal and Transport of Remains

Care must be taken not to lose, contaminate or switch such body, body parts or property to
be removed and transported.
Properly labeled separate bags must be used.
Be particularly careful of potential loss of teeth if they are loose (e.g., badly burned or
crushed remains); put a bag around the head.
When choosing vehicles to transport dead bodies, it is advisable to use trucks or vans,
preferably closed, with floors that are either waterproof or covered with plastic.

6. Temporary Mortuary Facility

Identify a place that can be converted into a makeshift morgue (e.g., empty warehouse,
covered basketball court).
Basic requirements:
Security
Adequate lighting, ventilation, water supply
Examining tables
Instruments for examining the remains and documentation
Ideally, should consist of a reception, a viewing room, a storage chamber for bodies not
suitable for viewing and a room to store personal possessions and records.

7. Examination of Remains
Objectives of the Postmortem examination:
Identification of the remains
Cause of death determination
Manner of death determination
Collection of forensic evidence
 155

Identification through visual identification by the next-of-kin should be limited to bodies

that are suitable for viewing (i.e., not decomposed, burnt or mangled) and should be
subject to verification by other means.
Because of limited resources, not all bodies can undergo a full autopsy; priority may be
given to certain remains (such as those of transport operators driver, pilot/ship captain and
crew).
A detailed examination of the external body is done; marks such as tattoos, scars, moles and
deformities are searched.
Fingerprints are obtained and dental charting is done.
Blood and other tissue/fluid samples are collected or possible tests (e.g., histopathology,
DNA analysis, toxicology).
Property collected from each body (e.g., clothes, jewelry, wallets, IDs) must be described
and inventoried.

8. Preservation of the Body

Remains are best stored refrigerated (e.g., in rented refrigerated storage trucks) while
awaiting examination.
After the postmortem examination, embalming can be done.

9. Dealing with Claimants

Notify family members of the death or disappearance of victims in a clear, orderly, and
individualized manner.
Organize a separated area where the next-of-kin can be systematically interviewed for data.
Useful antemortem information to get:
Name, age, sex, height, build
Appearance when last seen
Distinguishing features (tattoos, scars, moles, deformities, etc.)
Significant medical history
Ask the next-of-kin to submit the following:
Medical records including x-ray films
Dental records
Clear photograph with teeth bared
Fingerprints on file Note that personal items that a person believed to be among the victims
could have used (e.g., toothbrush, hairbrush, other items), could potentially contain
reference fingerprints or DNS samples.

10. Death Certification and Release of Bodies

Properly identified victims shall be issued death certificates and the bodies released to the
next-of-kin.
Maintain a record of how the bodies are disposed of including information regarding the
claimant’s names, addresses and contact numbers.
Bodies could remain unidentified in case of insufficient antemortem and postmortem data;
these remains should be buried separately (not cremated!) and their postmortem records
stored for future evaluation.
 156

Court proceedings could be initiated according to Philippine laws that would legally
declared dead the unidentified and missing victims.

11. Disposal of Dead

Respond to the wishes of the family and provide all possible assistance in final disposition of
the body.
Burial is the preferred method of body disposal in emergency situations unless there are
cultural and religious observances that prohibit it.
The location of graveyards should be agreed upon by the community and attention should
be given to ground conditions, proximity to groundwater drinking sources (which should be
at least 50m) and to the nearest habitat (500m).
Burial depth should be at least 1.5m above the groundwater table, with at least 1m of soil
cover.
If coffins are not available, corpses should be wrapped in plastic sheets to keep the remains
separate from the soil.
Burials in common graves and mass cremations are rarely warranted and should be
avoided.
Reject unceremonious and mass disposal or unidentified corpses. As a last resort,
unidentified bodies should be placed in individual niches or trenches, which is a basic
human right of the surviving family members
.
12. Physical and Psychological Care of Relief Workers
Ensure a plan for physical and psychological care of relief workers because handling a large
number of corpses can have an enormous impact on the health of the working team.

ANNEX V: Guidelines on Risk Communication

Principles of Risk Communication

• Accept and involve the public as a legitimate partner
Fundamental right to information about risks
Share dilemmas
Share responsibilities to arrive at better choices

• Listen to the public’s concerns

Don’t ridicule the public’s emotions
Legitimize people’s fears
Tolerate early overreactions but warn against their possible negative consequences
Establish your own humanity
Speak clearly and with compassion

• Be honest and open. Do not mislead by providing incomplete or false information

Don’t over-reassure
Err on the alarming side
 157

Acknowledge uncertainty

• Coordinate and collaborate with other credible sources

Name a “primary” or a “spokesperson”
Network should be established and formal communication channels developed
Joint planning
Regular communication

• Warn people about uncertainty

• Plan carefully and evaluate your efforts

Gauge public’s level of knowledge about risks and events
Consider “teachable moments”
Solicit feedback

• Meet the needs of the media to ensure that they provide accurate and useful information

Steps in Communicating Risks

1. Verify situation
Get the facts.
Obtain information from additional sources to put the event in perspective.
Review and critically judge all information. Determine credibility.
Clarify information through subject matter experts.
Begin to identify staffing and resource needs to meet the expected media and public
interest.
Determine who should be notified of this potential emergency.

2. Conduct notifications

3. Activate crisis plan

Ensure direct and frequent contact with the EOC.
Determine what your organization is doing in response to the event.
Determine what other agencies/organizations are doing.
Determine who is being affected by this crisis. What are their perceptions? What do they
want and need to know?
Determine what the public should be doing.
Determine what’s being said about the event. Is the information accurate?

4. Organize assignments
Identify the spokesperson for this event.
Determine if subject matter experts are needed as additional spokesperson.
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Determine if the organization should continue to be a source of information to the media

about this emergency, or would some issues be more appropriately addressed by other
government entities?

5. Prepare information and obtain approvals

6. Release information to media, public and partners through arranged channels

Provide only information that has been approved by the appropriate managers. Don’t
speculate.
Repeat the facts about the event.
Describe the data collection and investigation process.
Describe what your organization is doing about the emergency.
Describe what other organizations are doing.
Explain what the public should be doing.
Describe how to obtain more information about the situation.

7. Conduct public education

8. Monitor events

9. Obtain feedback and conduct communication evaluation

ANNEX W: Guidelines in Coordinating with Other Agencies

Prepare internal arrangements within MHO/hospital and with other public health related
government entities, NGOs, and other institutions in the country whose expertise and/or
services may be called upon during emergencies.

Establishing Good Working Relationships with Other Groups

1. Have a common goal
2. Have a good and strong facilitator
3. Define parameters. With consensus on objectives, strategies and plans
4. Discuss needs and lines of action
5. Identify strengths and capabilities before dividing work and responsibilities
6. Encourage member participation
7. Clear range of services each agency can provide
8. Document agreements and arrangements with memoranda of understanding
9. Build trust among members. Fix issues early on
10. Regular communication among members
11. Have operating guidelines
12. Respect organizational mandates.
13. Establish and maintain effective communications.
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When to apply Networking and Coordination

Networking and coordination cut across all the activities in each of the three phases of health
emergency management, particularly for these areas of concern:
• Organization
• Systems implimentation
• Resource mobilization
• Tasking and responsibility sharing of partners and sectoral workers

1. Health Emergency/Disaster Preparedness

• Do collaborative planning (e.g., preparation of preparedness and contingency plan, plans
for shared use of facilities, investments in infrastructure, evacuation and transportation)
• Organize emergency response teams in hospitals, clinics and other health institutions.
• Prepare and stockpile medicines and supplies.
• Pre-identify, pre-designate and prepare potential evacuation centers.
• Conduct sanitary and environmental inspections to designated evacuation centers.
• Conduct inventory of all available resources: clinics, hospitals and medical institutions in
the area; services, logistics.
• Establish Municipal Epidemiology Surveillance Unit/Local Epidemiology Surveillance Unit.
• Organize the health sector in the region and establish a regional network.
• Act as the cluster focal points at the regional level.
• Develop a functional referral system.

2. During Health Emergency/Disaster Response

• Activate emergency response teams.
• Provide medical care/assistance to victims during evacuation operations.
• Initiate and coordinate evacuation operations.
• Monitor occurrence of epidemics in evacuation centers and undertake the necessary
measures to control and prevent spread of diseases.
• Provide warning to the public on occurrence of epidemics.
• Conduct daily inspection on the state of sanitation in the evacuation center.
• Submit periodic reports to the council.

3. Post Health Emergency/Disaster Recovery

• Provide psychological debriefing to victims and bereaved families.
• Continue to provide direct service and/or technical assistance on sanitation.
• Submit after operation reports to the council.

ANNEX X: Guidelines on Mental Health and Psychosocial Support

A. Common Functions
1. Coordination
Establish coordination of multi sectoral mental health and psychosocial support
 160

2. Assessment, Monitoring, and Evaluation

Conduct assessment of mental health and psychosocial issues
Initiate participatory systems for monitoring and evaluation
3. Protection and Human Rights Standards
Apply a human rights framework through mental health and psychosocial support
Identify, monitor, prevent and respond to protection threats and failures through social
protection
Identify, monitor, prevent and respond to protections threats and failures through legal
protection
4. Human Resources
Identify and recruit staff and engage volunteers who understood local culture
Enforce staff codes of conduct and ethical guidelines
Organize orientation and training of aid workers in mental health and psychosocial well-
being among staff and volunteers
Prevent and manage problems in mental health and psychosocial well-being among staff
and volunteers

B. Core Mental Health and Psychosocial Supports

1. Community Mobilization and Support
Facilitate conditions for community mobilization, ownership and control of emergency
response in all sectors
Facilitate community self-help and social support
Facilitate conditions for appropriate communal, spiritual, religious and healing practices
Facilitate support for young children (0-8 years) and their care-givers

2. Health Services
Include specific psychological and social considerations in provision of general health care
Provide access to care for people with severe mental disorders
Protect and care for people with severe mental disorders and other mental and neurological
disabilities living in institutions
Learn about and, where appropriate, collaborate with local indigenous and traditional
health systems
Minimize harm related to alcohol and other substance abuse

3. Education
Strengthen access to safe and supportive education

4. Dissemination of Information
Provide information to the affected population in the emergency, relief efforts and their
legal rights
Provide access to information about positive coping methods

C. Social Considerations in Sectors

1. Food Security and Nutrition
 161

Include specific social and psychological considerations (safe aid for all in dignity,
considering cultural practices and household roles) in the provision of food and nutrition
support
2. Shelter and Site Planning
Include specific social considerations (safe, dignified, culturally and socially appropriate
assistance) n shelter planning and site planning, in a coordinated manner
3. Water and Sanitation
Include specific social considerations (safe and culturally appropriate access for all in
dignity) in the provision of water and sanitation

Steps in Promoting MHPSS

1. Assess psychosocial and mental health concerns. Schedule consultative meetings with the
provincial and municipal health workers in the affected area to:
Estimate the psychosocial problems experienced by the people, guided by the classification
of people at high risk
Estimate available resources for mental health/social services
2. Brief field officers in the areas of health and social welfare regarding issues of fear, grief,
disorientation and need for active participation. Mobilize informal human resources in the
community (e.g., Red Cross volunteers, religious and political leaders).
3. Conduct mostly social interventions that do not interfere with acute needs such as the
organization of food, shelter, clothing, PHC services, and, if applicable, the control of
communicable diseases.
4. Establish contact with PHC.
Develop the availability of mental health care for a broad range of problems through
general health care and community-based mental health services.
Manage urgent psychiatric complaints (i.e., dangerousness of self or others, psychoses,
severe depression, mania, epilepsy) within PHC.
Endure availability of essential psychotropic medications at the PHC level. Many persons
with urgent psychiatric complaints will have pre-existing psychiatric disorders and sudden
discontinuation of medication needs to be avoided.
5. Start planning medium- and long-term development of community-based mental health
services and social interventions needed during recovery and rehabilitation. This is vital since it
is during this phase that survivors will be rebuilding their lives amidst the grief from the loss of
loved ones, property, and livelihood.
6. If the acute phase is protracted, start training and supervising PHC workers and community
workers (e.g., provision of appropriate psychotropic medication, ‘psychological first aid’,
supportive counseling, working with families, suicide prevention, management of medically
unexplained somatic complaints, substance use issues and referral).
7. Educate other humanitarian aid workers as well as community leaders (e.g., village heads,
teachers, etc.) in core psychological care skills (e.g., ‘psychological first aid’, emotional support,
providing information, sympathetic reassurance, recognition of core mental health problems)
to raise awareness and community support and to refer persons to PHC when necessary.
 162

8. Carefully educate the public on the difference between psychopathology and normal
psychological distress, avoiding suggestions of wide-scale presence of psychopathology and
avoiding jargon and idioms that carry stigma.
9. Facilitate creation of community-based self-help support groups. The focus of such self-help
groups is typically problem sharing, brainstorming for solutions or more effective ways of
coping (including traditional ways), generation of mutual emotional support and sometimes
generation of community level initiatives.
10. Provide support to caregivers who, because of the exhaustion and enormity of the job, may
experience “burn-out.”

Early Social Interventions for Children and Families

Measures should be taken to ensure that, to the extent possible:
• People have access to an ongoing reliable flow of credible information on:
The nature and scale of the emergency
Efforts to establish physical safety of the population
Relief efforts, including what each government department and aid organization is doing
and where they are located
• Normal cultural and religious events are maintained (including grieving rituals by relevant
spiritual and religious practitioners); people are able to conduct ceremonious funerals
• Death certificates are available to avoid unnecessary financial and legal consequences for
relatives
• Children have access to formal or informal schooling and to normal recreational activities
• Adults and adolescents have access to participate in concrete, purposeful, common interest
activities, such as emergency relief and recovery activities
• Isolated persons, such as orphans, widows, widowers, or those without their families,
haveaccess to activities that aim for their inclusion in social networks
• When necessary, a family tracing service is established
• Uncomplicated, reassuring, empathic information on normal stress reactions is available to
the community at large
• Where people are displaced, shelter is organized to keep members of families and
communities together, there is provision for recreational and cultural space, and the people are
consulted regarding the location of religious places, schools, water points and sanitation
facilities

Guidelines for Delivering Psychological First Aid

1. Politely observe first; don’t intrude. Then ask simple respectful questions to determine how
you may help.
2. Often, the best way to make contact is to provide practical assistance (food, water, blankets).
3. Initiate contact only after you have observed the situation and the person or family, and have
determined that contact is not likely to be intrusive or disruptive.
4. Be prepared that survivors will either avoid you or flood you with contact
5. Speak calmly. Be patient, responsive, and sensitive
6. Speak slowly, in simple concrete terms; don’t use acronym or jargon
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7. If survivors want to talk, be prepared to listen. When you listen, focus on hearing what they
want to tell you, and how you can be of help.
8. Acknowledge the positive features of that the survivor has done to keep safe.
9. Give information that is accurate and age-appropriate for your audience.
10. Remember that the goal of psychological first aid is to reduce distress, assist with current
needs, and promote adaptive functioning, not to elicit details of traumatic experience and
losses.

Management of Burnout
• Be aware of, be alert for, and recognize the symptoms
• Official temporary relief from work
• Rotation of workers to low/moderate/high stress tasks
• Briefing/debriefing
• Buddy-buddy system
• Limit exposure to high stress assignments
• Counseling and/or referral to psychiatrist

ANNEX Y: Guidelines on Information Management

1. All data and information are important in health emergency management. All reporting
units at all levels shall devise mechanisms to obtain, review, analyze, and use the
information gathered to determine the best possible actions and interventions for their
level at any given time.
2. The Health Emergency Management (HEM) OpCen or designate at all levels shall be the
repository of information in relation to health emergencies and disasters.
3. All reports for emergencies and disasters shall follow templates officially released by
PHO-HEM. As such, PHO-HEMS shall regularly review, amend the existing, and develop
new forms and guides as needed for this purpose. The office shall also be responsible
for ensuring that these documents are appropriately disseminated to all potential users
and agencies concerned.
4. All reporting field units shall develop strategies and corresponding mechanisms to
ensure that the needed information is obtained accurately and on time from their areas
of jurisdiction.
5. Reporting units shall utilize any of the available forms of information and
communication technology (ICT) to ensure the timeliness of reports. These include, but
are not limited to, short messaging service (SMS)/ text, telephone call, electronic mail
(e-mail), two-way radio transceiver and others.
6. When information is urgently needed and vital to operations required by rapidly
evolving conditions secondary to an emergency or disaster of a significant magnitude,
reports may be obtained or relayed directly across any level.
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TYPE OF DESCRIPTION/ RATIONALE FREQUENCY

REPORT
Flash Report This report is prepared for every major health Within 1-2 hours upon the
emergency/ disaster and contains occurrence of a major event or
information that must at once be brought to disaster.
the attention of the superiors and/ or
decision makers.
24 Hour Event This report includes all monitored reportable Daily
Monitoring events within the last 24 hours, updates on
previously reported major events, and
delayed reports.
Rapid Health This report gathers initial information on the Within 24-48 hours upon the
Assessment magnitude of any major event or disaster and occurrence of a major event
(RHA) the extent of its impact on both the and disaster
population and the infrastructure of the
community. It provides decision-makers and
leaders with references for determining next
steps in the response operation.
Health This reports covers follow up information Daily for the first two weeks
Situation (after 24 hours and beyond) on major events after the disaster, twice a
Updates and disaster and provides detailed updates week for the next two weeks,
on the event and ongoing response and once a week thereafter
operations.
List of This is a comprehensive list that includes the Daily for the first two weeks
Casualties names, age, sex and cause of death/ injury of upon the occurrence of event;
the victims as often as necessary to
supplement health situation
update.
Final Report Upon termination of response activities and Within one week after the
closure of an event, all information shall be termination of operations
consolidated in a final report. This also serves
as the documentation of the event.
Post –mission This is submitted by all teams deployed by Within 24 hours after mission.
report HEMS as response to a particular event. It
provides a summary of the team’s mission
and accomplishment.
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APPENDIX C

ACRONYMS

AFP - Armed Forces of the Philippines

AO - Administrative Order
ATO - Air Transportation Office
ATTF - Anti-Terrorism Task Force
BFAD - Bureau of Food and Drugs of the DOH
BFAR - Bureau of Fisheries and Aquatic Resources
BFP - Bureau of Fire Protection
BFP -EMS Bureau of Fire Protection Emergency Medical Services
BHDT -Bureau of Health Devices and Technology of the DOH
BIHC -Bureau of International Health Cooperation of the DOH
BLS -Basic Life Support
CHD -Center for Health Development of the DOH
DBM -Department of Budget and Management
DFA -Department of Foreign Affairs
DMU -Disaster Management Unit of the DOH
DND -Department of National Defense
DOH -Department of Health
DOT -Department of Tourism
DSWD -Department of Social Welfare and Development
EHS -Environmental Health Services of the DOH
EO -Executive Order
EOC -Emergency Operations Center
EOD -Emergency Officer on Duty
FIMO -Field Implementation Management Office
GA -Government Agency
HAZMAT -Hazardous Materials
HEARS -Health Emergency Alert Reporting System
HEICS -Hospital Emergency Incident Command System
HEM -Health Emergency Management
HEMS -Health Emergency Management Staff of the DOH
HEPR -Health Emergency Preparedness and Response
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HEPRRP -Health Emergency Preparedness, Response and Recovery Plan

HRD -Human Resource Development
HRM -Human Resource Management
ICS -Incident Command System
JOC -Joint Operations Command
LCF -Local Calamity Fund
LDRRMC -Local Disaster Risk Reduction and Management Council
LGU -Local Government Unit
MCH -Maternal and Child Health
MCI -Mass Casualty Incident
MCM -Mass Casualty Management
MDM -Management of the Dead and Missing Persons
MFI -Mass Fatality Incident
MIS -Management Information System
MMD -Materials and Management Division of HEMS
MMDA -Metro Manila Development Authority
MOA -Memorandum of Agreement
MOU -Memorandum of Understanding
NBI -National Bureau of Investigation
NCDPC -National Center for Disease Prevention and Control
NCHFD -National Center for Health Facilities Development
NCF -National Calamity Fund
NDCC -National Disaster Coordinating Council
NEC -National Epidemiology Center of the DOH
NGO -Nongovernment Organization
NMHP -National Mental Health Program
NPCC -National Poison Control Center
NSC -National Security Council
NTC -National Telecommunication Commission
OCD -Office of Civil Defense
OIC -Officer-in-Charge
OpCen -Operations Center
OSEC -Office of the Secretary of Health
PAG-ASA -Philippine Atmospheric, Geophysical and Astronomical Services Administration
PAR -Philippine Area of Responsibility
PCG -Philippine Coast Guard
PD -Presidential Decree
PET -Pocket Emergency Tool
 167

PGH -Philippine General Hospital

PHEMAP -Public Health and Emergency Management in Asia and the Pacific
PHIVOLCS -Philippine Institute of Volcanology and Seismology
PIE -Post-Incident Evaluation
PNP -Philippine National Police
PNRC -Philippine National Red Cross
PNRI -Philippine Nuclear Research Institute
PO -People’s Organization
PPE -Personal Protective Equipment
RA -Republic Act
RDCC -Regional Disaster Coordinating Council
RESU -Regional Epidemiologic Surveillance Unit
RHEMS -Regional Health Emergency Management Staff
RIS -Request Issuance Slip
SDP -Stop Death Program
SEARO -Southeast Asia Regional Office of WHO
SOP -Standard Operating Procedures
STOP DEATH-Strategic Tactical Option for the Prevention of Disasters, Epidemics, Accidents and
Trauma for Health
TNA -Training Needs Assessment
UN -United Nations
UP-PGH -University of the Philippines-Philippine General Hospital
WHO -World Health Organization
WMD -Weapons of Mass Destruction
WPRO -Western Pacific Regional Office of WHO
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APPENDIX D

GLOSSARY

All-Hazards– An approach to emergency management based on the recognition that there are
common elements in the management of responses to virtually all emergencies, and that by
standardizing a management system to address the common elements, greater capacity is
generated to address the unique characteristics of different events

Capacity/Readiness– An assessment of local capacity to respond to an emergency (a risk

modifier)

Casualty– Victims both dead and injured, physically and/or psychologically

Code Alert System– An agreed system among offices as a tool to alert the department to
prepare and respond during emergencies and disasters (internal and external) in terms of an
organizational shift in management and mobilizing its resources (manpower and logistics)

Command Post– Form of site-level emergency operations center, assembled as needed by the
first agencies to respond to an event

Community – Consists of people, property, services, livelihoods and environment; a legally

constituted administrative local government unit of a country, e.g., municipality or district, that
is small enough to be able to identify its own leaders (to make participation meaningful) and
large enough to control its resources, e.g., village, district, etc.

Coordination– Bringing together of organizations and elements to ensure effective counter

disaster response. It is primarily concerned with the systematic acquisition and application of
resources (organization, manpower and equipment) in accordance with the requirements
imposed by the threat of impact of disaster.

Complex Emergency– A state where the normal social or economic order has collapsed to the
extent that the national authorities are no longer able to guarantee security or provide services
to all or part of the country.

Disaster– Any actual threat to public safety and/or public health where local government and
the emergency services are unable to meet the immediate needs of the community; an event in
which the local emergency management measures are insufficient to cope with a hazard,
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whether due to lack of time, capacity or resources, resulting in unacceptable levels of damage
or numbers of casualties; an emergency in which the local administrative authorities cannot
cope with the impact of the scale of the hazard and therefore the event is managed from
outside of the affected communities; any major emergency where response is also constrained
by damage or destruction to infrastructure, i.e., the lack of resources plus loss of infrastructure
overwhelms local capacity and event management from outside the affected area is needed to
direct and support local response efforts.

Disaster Recovery– The coordinated process of supporting disaster-affected communities in the

reconstruction of the physical infrastructure and restoration of emotional, social, economic and
physical well-being.

Donation – Act of liberality whereby a foreign or local donor disposes gratuitously of cash,
goods, articles, including health and medical-related items, to address unforeseen, impending,
occurring or experienced emergency and disaster situations, in favor of the Government of the
Philippines which accepts them.

Donors – All persons, countries or agencies that may contract and dispose of cash, goods or
articles, including health and medical-related items, to address unforeseen, impending,
occurring or experienced emergency and disaster situations.

Emergency – Any situation in which there is imminent or actual disruption or damage to

communities, i.e., any actual threat to public health and safety

Emergency Management– A management process that is applied to deal with the actual or
implied effects of hazards.

Emergency Operations Center– A place activated for the duration of an emergency within
which personnel responsible for planning, organizing, acquiring and allocating resources and
providing direction and control can focus these activities on responses to the emergency

Emergency Preparedness – An integrated program of long-term, multi sectoral development

activities whose goals are the strengthening of the overall capacity and capability of a country
to be ready to manage efficiently.

Field Management – Encompass the procedures used to organize the disaster area to facilitate
the management of victims
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Formal Acceptance– An instrument – Deed of Acceptance – issued by the Secretary of Health

or his designated representative that acknowledges the consummation of the donation and the
transfer of the ownership or interest over the donated item to the Department of Health.

Hazard – Any potential threat to public safety and/or public health; any phenomenon which has
the potential to cause disruption or damage to people, their property, their services or their
environment, i.e., their communities. The four classes of hazards are natural, technological,
biological and societal hazards

Hazard-prone Community– A community that experiences a large number of hazard

eventsHealth Emergency Management Health Sector– An organization of agencies each with a
health unit primarily devoted to and united to provide state-of-the-art, appropriate and
acceptable technical assistance and/or direct services on health emergency preparedness and
response to any entity – international or national.

Incident Medical Commander– The highest representative of the Department of Health or

Local Health Office as designated by the city/town local executive (depending on the extent of
the disaster) who shall serve as the liaison officer of the Health Sector to the Command Post
headed by the Incident Commander. For regional disasters, it should be headed by the highest
representative from the DOH CHD.

Major Emergency– Any emergency where response is constrained by insufficient resources to

meet immediate needs.

Mass Casualty Incident– Any event resulting in a number of victims large enough to disrupt the
normal course of administrative, emergency and health care services.

Mass Casualty Management– Management of victims of a mass casualty event to minimize loss
of lives and disabilities.

Mass Casualty Management System – Groups of units, organizations and sectors that work
jointly through standard consensus procedures to minimize disabilities and loss of life in a mass
casualty event through the efficient use of all existing resources.

Medical Controller– A designated senior Department of Health officer appointed to assume the
overall direction of the medical response to mass casualty incidents and disasters. Control is
established from a designated Operations Center, either in the Central Operations Center or the
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Regional Operations Center, and whose main responsibility is to coordinate all the services of
the sector.

Mental Health – A state of well-being in which the individual realizes his or her own abilities,
can cope with the normal stresses of life, can work productively and fruitfully, and is able to
make a contribution to his or her community.

Networking – An approach to broaden the resources available to a person to achieve his

personal and professional goals while supporting others to achieve their

Preparedness – Measures taken to strengthen the capacity of the emergency services to

respond in an emergency. Emergency preparedness is done at all levels.

Rapid Health Assessment – The collection of subjective and objective information to measure
damage and identify those basic needs of the affected population that require immediate
response

Recovery Management– A process by which a disaster-affected community is restored to an

appropriate level of functioning.

Risk – Anticipated consequences of a specific hazard affecting a specific community (at a

specific time); the level of loss of damage that can be predicted to result from a particular
hazard affecting a particular place at a particular time; probable consequences to public safety
of a community being exposed to a hazard (i.e., death, injury, disease, disability, damage,
destruction, displacement)
• Type of hazard determines the kind of risks, e.g., floods cause few deaths but earthquakes
cause many
• Vulnerabilities and capacity to respond determine how much risk is in the community,
i.e., how many deaths are likely, where they will occur and the kind of people likely to be killed
(e.g., old, disabled)

Risk Management – A comprehensive strategy for reducing risk to public safety by preventing
exposure to hazards (target group – hazards), reducing vulnerabilities (target group – elements
of community), and enhancing preparedness, i.e., response capacities (target group – response
agencies); a strategy for identifying potential threats and managing both the source of threats
and their consequences.
 172

Single Command System– A system whereby the incident is managed by a leader coming from
a single response unit or agency. This is based on first-arriving emergency unit. Initial Incident
Commander begins assessment of incident. Deals with rescue, triage, treatment and transport.

Strategic– Deals with the concepts of relatively long term and big picture in relation to the
pattern or plan that integrates an organization’s major goals, policies and action sequences into
a cohesive whole. Concept is always relative – what a local level of government sees as strategic
from their perspective is likely perceived as tactical from the perspective of a more senior
government.

Stress – A state where one’s coping mechanism is not enough to maintain balance or
equilibrium

Surge Capacity– The health care system’s ability to rapidly expand beyond normal services to
meet the increased demand for qualified personnel, medical care, and public health in the
event of large-scale public emergencies or disasters (Agency for Healthcare Research and
Quality, USA, 2005)

Tactical – Refers to those activities, resources and maneuvers that are directly applied to
achieve goals. Compare with “strategic” above.

Terrorism – The premeditated use or threatened use of violence or means of destruction

perpetrated against innocent civilians or non-combatants, or against civilian and government
properties, usually intended to influence an audience (Memorandum No. 121)

Triage– The process of sorting victims needing immediate treatment and transport to health
facilities and those whose care can be prioritized

Unified Command System – A system whereby the incident is managed by a group of

individuals coming from several units or agencies with jurisdiction over the incident, and are
involved in the decision-making and planning process. Insures plan is communicated and
supported by all resources

Vulnerabilities – Factors that increase the risks arising from a specific hazard in a specific
community (risk modifiers)Weapons of Mass Destruction – Radiological, nuclear, biological or
 173

chemical elements in nature used for large-scale damage to life and property, usually by those
perpetrating terrorist activities

APPENDIX E

HAZARD MAPS
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APPENDIX F

FLOW CHARTS

ALERT AND VERIFICATION PROTOCOL

Natural Hazard: Biological Hazard: Technological Hazard: Societal Hazard:
 Weather disturbance  Increasing trends of  Fire  Blast/ explosion
 Flood communicable disease  Transportation accidents  Rallies/strikes
 Flashflood  Disease outbreak  Chemical leak/spill/poisoning  Mass gatherings
 Landslide  Red tide  Industrial accidents  Stampede
 Earthquake  Food poisoning  Radio nuclear incidents  Armed conflict
 Volcanic activity  Spread of any substance  Damage infrastructure
 War
 Mudflow coming from living  Other actions resulting in major
 Other naturally organism population displacement  Terrorist related event
occurring event  Ambush incident etc.

Coordinated Agency: Events Monitored at HEMS OPCEN Negative/ Unconfirmed

1. Mayor’s Office Verify with coordinated Record to monitoring

2. Municipal/City PNP agency logbook
3. Municipal/City BFP
4. Municipal/City
Social Welfare and
Development MAJOR MINOR
5. Municipal/City Criteria: Criteria:
Health Office ( any 2 of the ff. are present)
 Less than 10 MCI
6. Municipal/City  10 or more MCI cases
 If situation could be handled alone by
Public Health  Cannot be handled by LGU
LGU
 Affects critical infrastructure
Nurse  PHO intervention is needed  PHO intervention not needed
  No declaration of calamity/ disaster
7. Municipal Disater Declaration of a calamity/ disaster.

Risk Reduction ACTIONS:

Office -Identify the Nature, Place and Time of Incident, & Needs
-Ask if there is a presence of Flood, Landslide, Casualties, Family
8. Government/ Affected, Evacuation Centers by the Typhoon/ Earthquake etc.
Private Hospital -Ask if presence of electrity in their area.
-Follow up the next day after the Incident/ Emergency/Disaster
*Text the Officer in (Post-Evaluation)
-Text RHEMS Coordinator, PHO, PHEMS Coordinator, Logistics
Charge of the Officer every update of events
coordinated agency
 If monitored within 1-2 hours upon the occurrence of a  If monitored within 1-2 hours
*After 15mins major event or disaster prepare FLASH REPORT prepare FLASH REPORT
 Then within 24-48 hours upon the occurrence of major
without reply, call event or disaster prepare HEARS FIELD , RAPID HEALTH
thru cellphone or ASSESSMENT (RHA) REPORT,
 If delayed monitor event
prepareHEARS PLUS REPORT
land line the Officer  Then HEALTH SITUATION UPDATES, LIST OF CASUALTIES
for the next two week after the occurrence of event WITH LIST OF CASUALTY.
in Charge
 Record to Monitoring Logbook
 FINAL REPORT  Record to Monitoring Logbook

Submit to PHO HEMS-OPCEN

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REPORTING PROTOCOL

Natural Hazard: Biological Hazard: Technological Hazard: Societal Hazard:

 Weather disturbance  Increasing trends of  Fire  Blast/ explosion

 Flood communicable disease  Transportation accidents  Rallies/strikes
 Flashflood  Mass gatherings
 Disease outbreak  Chemical leak/spill/poisoning
 Landslide  Stampede
 Red tide  Industrial accidents
 Earthquake  Armed conflict
 Volcanic activity  Food poisoning  Radio nuclear incidents
 War
 Mudflow  Spread of any substance  Damage infrastructure
 Terrorist related event
 Other naturally coming from living  Other actions resulting in major
 Ambush incident etc.
occurring event organism population displacement

Events Monitored at DOH-HEMS OPCEN

If sources are: If sources are:

Determine Reliability
1. HEMS Director 1. Concerned citizen
2. Hospital 2. Media ( unconfirmed)
director/coordinator RELIABLE NON- RELIABLE
3. Others
3. Media (confirmed)
4. Other concerned
offices (PHIVOLCS,
Assess
PAG-ASA, AFP, PNP, MAGNITUDE Verify/ Confirm with:
BFP, PNRI, PDRRMC
5. Members of the 1. HEMS Director
health cluster MAJOR MINOR 2. Hospital
Criteria: Criteria: director/coordinator
( any 2 of the ff. are present) 3. Media (confirmed)
 Less than 10 MCI
 10 or more MCI cases  If situation could be 4. others concerned
 Cannot be handled by LGU handled alone by LGU offices (PHIVOLCS, PAG-
 Affects critical infrastructure  PHO intervention not ASA, AFP, PNP,BFP,PNRI,
 PHO intervention is needed needed
 Declaration of a calamity/  No declaration of PDRRMC
disaster. calamity/ disaster 5. members of the
health cluster

 If monitored within 1-2 hours upon the occurrence of a

 If monitored within 1-2
major event or disaster prepare FLASH REPORT
hours prepare FLASH
 Then within 24-48 hours upon the occurrence of major
event or disaster prepare HEARS FIELD , RAPID HEALTH
REPORT
NOT CONFIRMED
ASSESSMENT (RHA) REPORT,
 Then HEALTH SITUATION UPDATES, LIST OF CASUALTIES  If delayed monitor event
for the next two week after the occurrence of event prepareHEARS PLUS
 FINAL REPORT REPORT WITH LIST OF Hold until events are
CASUALTY. confirmed

Submit to PHO HEMS-OPCEN

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PROTOCOL IN ISSUANCE OF ALERT MEMORANDUM

Received report/update through website/radio on the ff. hazards:

A. Weather disturbance
(PAG-ASA)
B. Earthquake/tsunami (PHILVOCS)
C. Red tide (BFAR)
D. Others

Take note of the ff:

EOD2 to prepare a. Active low pressure
alert memo based area
on the hazard Yes b. Tropical depression No
monitored. c. Public storm warning
signal
d. Tsunami warning Do not
e. Gale warning prepare alert
f. Others. memo
EOD2 to seek
approval
from HEMS
Yes director or No Do not send alert memo.
designate

EOD2 to send the approved memo through fax,

email or sms mail to the ff:
EOD2 to inform/confirm
For weather disturbance – to all MHO, ,RHU, with HEMS Coordinator the
Criteria: if one or more
District Hospitals alert memo sent through
phone or text messaging/ typhoons enter
For redtide& tsunami- to concerned Municipality (Quezon Province)
only
w/ in 24hours, issue
one alert memo only

EOD2 to confirm receipt of the alert memo by

To record in the
respective offices; to log in the prescribed
endorsement logbook the
confirmation checklist and to the file in the
time and date
designated folder.
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PROTOCOL IN RESPONSE TO TRAUMA EMERGENCIES

Transportation Accidents/ Mass Casualty Incidents Civil Disturbance/Mass

Natural Disaster Emergencies with Mass Dead Gatherings/ Coup D’etat

Municipal Natural and Human Municipal

Generated

Coordinate with Coordinate with PNP/ AFP

Municipal PNP Health Service
>Coordinate with
PNP Health Service
Deploy 1 District and NBI Medico- >Alert Provincial and District Hospital
Hospital or MHO Legal to assemble a team ready for dispatch
Team nearest to site >Prepare the receiving Hospital
for assessment >Coordinate with
PHO for appropriate
action
>Alert Provincial and
>Alert Provincial and District Hospital
District Hospital to
to assemble a team ready for
assemble a team dispatch
ready for dispatch >Prepare the receiving Hospital
>Prepare the
receiving Hospital

If dispatching of teams is needed

>Dispatch team in coordination with PNP/AFP.
>Instruct dispatched team to maintain position at the
Deploy number of
cold zone (i.e. the upwind of spill where there’s no
teams according to the possibility of contamination) and receive patients only
first team’s from PNP/AFP and other medical first responders
assessment.
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PROTOCOL IN RESPONSE AND COORDINATION OF MAJOR MEDICAL

EMERGENCIES

CLUSTERING OF CASES/ REEMERGING POISONING/ HAZARDOUS

DISEASES MATERIALS

Municipality

Coordinate with PHO HEMS OpCen

Coordinate with PHO HEMS
to deploy PESU and Environmental
OpCen to deploy PESU team
team for investigation.
for investigation.

Inform the following:

Inform CHD IV ARESU 1. Hospital Poison Control or
Poison Control Manager
2. DOH NEC
3. UP PGH NPCC
4. DOH EHS
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PROTOCOL IN RESPONSE TO WEAPONS OF MASS DESTRUCTION

Municipal Quezon

If monitored a suspected WMD If monitored a suspected WMD

incident incident

Dispatch assessment team from the

WMD team of the MHO/Hospital and Coordinate with CHD IV A
look for indicator of WMD

Indicators of WMD
1. Sick or dying animals
2. Suspicious devices or packages
3. Droplets, oily film
4. Unexplained odor
5. Low clouds or fog unrelated to weather
6. Unusual numbers of patients with very similar symptoms seeking care virtually simultaneously
7. Cluster of patients arriving from a single locality
8. definite patterns of symptoms clearly evident

If Positive (+) for indicators of WMD: If Negative (-) for

1. Report immediately to MDRRMC, NSC, ATTF and other indicators of
designated agencies. WMD:
2. Remind all that team safety is of utmost priority, which 1. Refer to appropriate
means: flowchart
a. Hospital teams must not proceed to and must stay 2. Continue monitoring
away from the Hot Zone. cases
b. Hospital teams must stay at the Cold Zone and/or
Treatment Area only.
c. Use proper PPE (Level A, B, C).
3. Prepare receiving hospitals based on their capability.
4. Remind that all receiving hospitals should receive
decontaminated patients only, but they must also
prepare their own decontamination area.
5. Instruct hospital team leaders to continuously coordinate
with the fiels medical commander.
6. Coordinate continuously with other agencies, especially
the security-related agencies.
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PROTOCOL IN RESPONSE TO FIRE

Municipal Quezon

Coordinate with CHD IV A for

appropriate action.
Coordinate with BFP-EMS.
Deploy team only if:
1. Affected area is in any of the ff: hospital,
dormitories, schools (during school
hours), hotels, malls and other areas
which may involve MCI.
2. BFP-EMS requests, i.e., when there are
more than 5 red tags or when BFP can no
longer handle the situation.

Alert all PHO District Hospitals to prepare a

team ready for dispatch.

Prepare the receiving hospital.

Deploy number of teams according to the

first team’s assessment.
 189

PROTOCOL IN NOTIFYING SUPERIORS

Emergencies/
Disaster monitored
at OpCen

Major Minor

Inform the PHEMS Inform the PHEMS

Inform PHO
Coordinator ASAP Coordinator:
Dr. Agripino P. Tullas
Engr. Daniel W. Urgelles Engr. Daniel W.
Urgellesevery 6 hours.

Inform PHO:
Dr. Agripino P. Tullas every
12 hours.

Inform the
RHEMSCoordinator
Dr. Noel Passion
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PROTOCOL ON MOBILIZATION OF LOGISTICS(EXCEPT HUMAN RESOURCES) DURING

EMERGENCIES AND DISASTERS

Provincial HEMS OPCEN

During the actual disaster/emergency
 EOD coordinates with the HEMS coordinator of the affected Municipality or City on their specific needs/assistance, or
 HEMS Coordinator of affected Municipality/City request Provincial HEMS for the specific assistance they need.

EOD evaluates the requests to determine things needed(drugs,medicines,supplies,etc.) and evaluates quantity based on:
 Type of Hazard-trauma,medical,mass,dead,WMD(still to be developed),fire
 Number of affected population:consultations/patients and/or mass dead
 Checking of inventory report
Whether approved or not approved,notify HEMS coordinator of the action taken.

AVAILABLE STOCKS IN THE INVENTORY NO AVAILABLE STOCKS IN THE INVENTORY

 Inform and seek clearance(Division Chief or Head of Office).  Source out goods from different district
 Prepare Requisition and Issuance Slip(RIS). hospitals, PHO,and CHD IV A.
 Submit RIS for signature of the Division Chief/Head of office(EOD1 to sign during  If not available,have emergency purchase
weekends and holidays). through the logistics unit of the Response
 Inform recipient of available stocks to be given and furnish a copy of RIS Division
 Fax the approved RIS to the Material Management Division(MMD).
 File the RIS in the designated folder.

MATERIALS MANAGEMENT DIVISION(MMD)

 Prepares te Invoice Receipt(IR) based on the approved IRS from Opcen

 Arranges the delivery of goods to the affected area.
 Informs EOD of the date of shipment,and expected date of delivery.
 Furnishes HEMS Opcen a copy of the IR sent to the recipient

In major disasters,the EOD: EOD1:

 Coordinates with PDRRMO for permission to include PHO goods in the flight  Informs HEMS coordinator
manifest regarding the delivery of
 Prepares letter of request of request to PDRRMO with cargo manifest and sends this goods:date,mode of shipment,and
by fax expected date of delivery.
 Coordinates with Joint Operations Command(JOC) for the schedule of  Instructs HEMS coordinator to:
flights,weight,height,width and number of boxes,contents,total A.Furnish receiving copies of the IR
 amount and acoompanying person. to HEMS Opcen and MMD through
either fax or mail as soon as the
Usually the JOC receives cargo wthoutcompanion.In the event a companion to the goods are received.
goods is needed,HEMS designates the person.EOD calls the Region for the schedule B. Submit utilization report one
of arrival and for the HEMS Coordinator to receive at the point of entry month after the eventor as needed.
MMD to deliver the medicines,drugs,supplies,etc.to the assigned hangar,and gives
instructions in regards to contact person.
 191

RADIO CALLS PROTOCOL

START

Making/answering a radio Making radio checks Interrupting unofficial

call unauthorized call

MAKING A CALL Say whom you
wish to speak to and who you
are, e.g., “Fabella Base, this is
OpCen.”
ANSWERING A CALL Reply by
identifying your call sign, e.g.,
“Go ahead Starsky, this is
OpCen.”
Say what you have to say
briefly.
EOD2 conducts the radio check
every 8:00 in the morning
Start by saying “Good morning
to all monitoring stations, this is
OPCEN. Please acknowledge as
we call your base call sign one
after the other. This is EOD (say No response
your name) for radio check,”
EOD calls the attention of
caller by saying “break,
interruption, this is OpCen,
please identify your call.”
Checks Response
No
response

Record in Communication Inform caller Log incident

Logbook.
Checks Response not to make - date, time and
unofficial call by mes- sage. Press
saying “Please radio microphone
avoid thrice (3x) at an
No response With response unofficial calls interval of 2
to the Radio Big seconds to detect
Tango!” the unidentified
radio user.
EOD2 makes the second Mark a check on the
round call after finishing all radio monitoring Record in the
the base stations. checklist. Prepare incident
communication report.
logbook and
report to HEMS
If still no response, EOD2 calls Coordinator. Request activity
the attention of HEMS report from service
Coordinator through their provider for proper
landline or cell phones. identification and
other prompt
actions needed.

After calling, record in the

logbook and mark a cross on The Response
the radio monitoring Division Chief will Record in the Make official
checklist provided. take action of the Communication report of the
incident. Logbook. incident
 192

PROTOCOL ON THE CONDUCT OF DRILL

BEFORE
1. HEMSOpCen receives communication from the requesting party.
2. Response Division –
• Prepares letter with attached memo to inform cluster.
• Prepares memo to all concerned offices to be signed by cluster head.
3. Response Division coordinates with:
• Concerned offices for information and for their involvement.
• Drill master for the details on the drill (date, time and scenario) and the number of teams.
4. EOD notes all the details of the medical team to be deployed and prepares directory containing names and contact
numbers, with identified team leader.
5. Response Division coordinates and monitors the dry runs before the actual drill, including briefing, assignment of teams,
and identification of team leaders.
6. Response Division orients all the EODs regarding responsibilities during the dry runs and actual drill. Preferably, conducts
tabletop drill exercises for all EODs.
7. Response Division conducts an assessment of the performance during the dry runs and identifies areas for
improvement.
8. Information Management Unit documents the proceedings of tabletop exercises and dry runs.
9. Response Division uses the results for improvement and/or formulation of policies, protocols and procedures.

START OF DRILL

DURING
1. Division Chief should be physically present at OpCen.
2. EOD ensures that all preparations are in place.
3. EOD participates according to the assigned role and follows the prescribed protocolfor the scenario including:
• Notification of the Head of Office.
• Suspension of radio checks and other transmissions except for emergency situation requesting permission to transmit
messages and for the ongoing drill.
• Recommending to the Division Chief the raising of alerts. The Division Chief orHead of Office declares appropriate code.
4. EOD reminds all participating units that “This is a drill” when dispatching the team.All documents pertaining to the drill
should be labeled as “This is an exercise.”
5. EOD monitors and documents the movement of the team deployed until the activity isterminated.
6. Division Chief raises or lifts the code alert.
7. Division Chief conducts debriefing of the EODs and identifies areas for improvement.
8. Information Management Unit prepares documentation for submission to the Head ofOffice.

END OF DRILL

AFTER
1. In HEMS-organized drills, the Head of Office conducts postmortem evaluation.
2. Deployed teams submit post-evaluation report to HEMS OpCen.
3. HEMS OpCen consolidates the reports for analysis by the Division Chief. Division Chief prepares final report with
transmittal letter for the concerned office to be signed by the Head of Office.
4. Information Management Unit documents the process and results.
5. Response Division uses the results for improvement and/or formulation of policies, protocols and procedures.
 193

APPENDIX G

HEM FORMS

DAILY MONITORING & ENDORSEMENT LOG SHEET

(This form shall be accomplished by the Emergency Officer on Duty (EOD) and submitted to the Division Chief or Officer in Charge everyday)

A. Radio Check
Time Started: No. of Bases Checked: No. Who Responded
PROBLEMS ENCOUNTERED (To be filled out only if there are problems with the radio bases checked)
Call Sign Nature of Problem Action Taken
1.  No Response  Poor Reception
 Others (specify):
2.  No Response  Poor Reception
 Others (specify):
3.  No Response  Poor Reception
 Others (specify):
4.  No Response  Poor Reception
 Others (specify):

B. Resources Utilization
Local No. Incoming: Long Distance No. Incoming: Text No. Incoming:
Calls No. Outgoing: Calls No. Outgoing: Messages No. Outgoing:
Local No. Incoming: Long Distance No. Incoming: Mobile No. Incoming:
Fax No. Outgoing: Fax No. Outgoing: Calls No. Outgoing:

C. New Events Monitored(This section is for new events only. Old (previously discovered) events shall be monitored using Template B)

Name/Title Type of
Mode of Date
of Event Time Emerg./ Time Location Classification Action Taken
Discovery Occurred
Disaster
1. Trans. Radio Minor Template B
2-Way Radio health initiated
TV emergency Others(specify)
Phone Major ______________
Other______ health
emergency
Disaster
2. Trans. Radio Minor Template B
 194

2-Way Radio health emerg. initiated

TV Major Others(specify)
Phone health emerg. ______________
Other______ Disaster
3. Trans. Radio Minor Template B
2-Way Radio health emerg. initiated
TV Major Others(specify)
Phone health emerg. ______________
Other______ Disaster
4. Trans. Radio Minor Template B
2-Way Radio health emerg. initiated
TV Major Others(specify)
Phone health emerg. ______________
Other______ Disaster
5. Trans. Radio Minor Template B
2-Way Radio health emerg. initiated
TV Major Others(specify)
Phone health emerg. ______________
Other______ Disaster
6. Trans. Radio Minor Template B
2-Way Radio health emerg. initiated
TV Major Others(specify)
Phone health emerg. ______________
Other______ Disaster
7. Trans. Radio Minor Template B
2-Way Radio health emerg. initiated
TV Major Others(specify)
Phone health emerg. ______________
Other______ Disaster

D. Response Received (This section is for new and old events shall also be reflected on form 2)
Received From Received Thru
1.  Phone  Fax  Email  Other_______  HEARS  Rapid Assessment  Update No.
 Final with Postmortem  Other__________
2.  Phone  Fax  Email  Other_______  HEARS  Rapid Assessment  Update No.
 Final with Postmortem  Other__________
3.  Phone  Fax  Email  Other_______  HEARS  Rapid Assessment  Update No.
 Final with Postmortem  Other__________
4.  Phone  Fax  Email  Other_______  HEARS  Rapid Assessment  Update No.
 Final with Postmortem  Other__________

E. Email Check (The EOD shall check and print incoming emails and endorse to concerned units or individuals everyday)
Time Started: No. of New Emails Total No. Endorsed:
EMAIL ENDORSED
Endorsed To: No. Endorsed: Endorsed To: No. Endorsed:
1. 4.
2. 5.
3. 6.

F. Request for Assistance Received (If Any)

Received Time Name Requesting Contact No. Assistance Requested Action Taken
Thru Party Office
 2-way Radio
 Landline
 Cellphone
 Fax
 195

 Walk-in
 Other, Specify
 2-way Radio
 Landline
 Cellphone
 Fax
 Walk-in
 Other, Specify

G. Other Activities
OpCen Boards Updated  Yes  No | HEARS Report Sent Time sent: Sent to:
1. 4.
2. 5.
3. 6.

H. Issues and Problems

1.
2.
3.

I. Other Endorsements
1.
2.
3.

J. Endorsement K. Acknowledgement
EOD Name: Incoming EOD Name:
Signature: Signature:
Date: | Time Date: | Time
 196

Endorsement Checklist

ACTIVITY 7am-3pm 3pm-11pm 11pm-7am

A. Reports
- New events monitored
- Old events monitored
- Other activities required follow-up or
reminder
- Problems encountered and remedial
actions taken (if any
B. Supplies/Equipment and Medicines
- Cellphone balance inquiry
☺ Smart
☺ Globe
- Functionality of the following:
1. Telephones/Fax Machine
2. Base Radio
3. Transistor radio (schedule 7am-
7pm)
4. Aircon
5. Generator
6. Electric fans
- Cellphone units (fully charged)
- Light bulbs for generator
- Rechargeable emergency lights for
charging
- Vaccines in the refrigerator
- Sphygmomanometer
- Stetoscope
- Flashlight
- Calculator
- Cellphone Charger
- Thermometer
C. Radio Base/Landlines
- Daily Radio Checks
- Hospital who were not able to respond
daily radio checks
- Radio Interceptors (time & date)
- Prank callers (time and date)
D. Administrative Concerns
- Recorded incoming and outgoing text
messages (Smart and Globe)
- Alert memos prepared and sent
- PLDT Bills-identified called parties (when
necessary)
E. Others as may be necessary:
- After care of the Operation Center
(Cleaned EODs table arranged the logbook
and directories properly filed the reports
received)
EMERGENCY OFFICER ON DUTY
Date and Time
 197

MESSAGE INFORMATION SHEET

(For Emergency Calls)

MESSAGE: (Nature of Incident)

Name of Caller
Return Call No.
Location (Reference Landmark)

No. of Possible Casualties:

Access Routes:
Date:
Time of Call:
Routing Copy to:

Classification:
Urgent:
Non-urgent:
For information only
For file:

__________________________
Emergency Officer on Duty
 198

MAJOR EVENT MONITORING SHEET

Event Title: ____________________________________
(This template shall be initiated by the EOD for every major health emergency or disaster recorded in Template A, Section C.
It shall be updated by all EODs and remain active until the case is closed and the Final Report (Template F) is prepared)

A. Initial Report About the Events and Its Health Consequences

Date of Initial Report: EOD:
Type of Event: GEOLOGIC WEATHER BIOLOGIC MAN-MADE
 Volcanic Eruption  Typhoon  Red Tide  Epidemic  Poisoning, specify _________
 Earthquake  Storm Surge  Fish Kills  Fire  Mass Action, specify ______
 Tsunami  Drought  Locust  Explosion  Accident, specify _________
 Landslide  Cold Spell Infestation  Armed Conflict  Other, specify _________
 Lahar  Flashflood  Terrorism
Date of Time of  AM Exact Location:
Occurrence: Occurrence:  PM Region: Province: Municipality/City:
Brief Description:

HEALTH IMPACT POPULATION DISPLACEMENT HEALTH FACILITIES/SERVICES

No. of Deaths: ____________ Population displaced?  Yes  No Number Number
No. of Admitted Patient: _________ No. of Displaced  Actual Present Functional
No. of Outpatients: ____________ Families:  Estimated Public:
No. Missing: ___________
No. of Displaced  Actual Hospitals:
Individuals:  Estimated RHUs:

B. Updates on the Health Consequences (This section shall be used to update health consequences as reports are received from the field)
As of Displaced Displaced Other Source EOD
Date Deaths Admitted Outpatients Missing Families Individuals Information

C. Report Received
REGULAR REPORTS Date Received EOD Other Reports Received Date Received EOD
HEARS Field Report
Rapid Health Assessment
Health Situation Update No. 1
Health Situation Update No. 2
Health Situation Update No. 3
HEMS Coordinator’s Final Report

D. Report Prepared
REPORTS PREPARED Date Prepared Submitted To EOD
Flash Reports Time Prepared:_______
Briefer
Final Report
OTHER REPORTS PREPARED Date Prepared Submitted To
1.
2.
3.

E. Issues and Problems

Issued and Problems Encountered Date EOD
1.
2.
 199

HEARS PLUS REPORT

FOR : Tiong Eng Roland Tan, MD
PHEM Coordinator/OIC Head, Technical Services

FROM : <Name of Municipal Health Officer>

Municipal Municipal Health Officer

: <Name of Municipal HEM Coordinator>

Municipal Municipal HEM Coordinator

SUBJECT : HEALTH EMERGENCY ALERT REPORTING SYSTEM

(HEARS) REPORT

DATE : <Date>

There was/were <###> new incident/s of health emergency monitored at the Quezon HEMS Operation Center from 8:00am of
<starting date> to 8:00 of <ending date>:

No. New Incident Brief Description Health Effect Action Taken

1 <Title: What and where of <Nature of emergency, <No. of deaths, ill, injured, <Agency, actions>
the incident> time, exact location, how missing>
the incident started>
2
3

Quezon HEMS-OpCen is continuously coordinating with the Regions to gather updates on previously reported incidents. The
following updates are available:

No. Old Incident Update Follow-up Actions

1 <Title: What and where of <Updated information on casualties, action taken, <Follow-up actions needed>
the incident> problems encountered>
2
3

For your information.

Cc: <Name of Office 1>

<Name of Office 2>
 200

FLASH REPORT

FOR : Agripino P. Tullas, MD, MHA

HEMS Provincial Coordinator
Provincial Health Officer II

FROM :

SUBJECT : FLASH REPORT ON <NAME OF THE EVENT>

DATE : <Date>

This is to inform you about the occurrence of the following incident, as well as the initial action taken:

I. Situationer

Provide a summary of the event that includes the following information:

- The type of event/emergency disaster
- Exact location (address, facility, municipality/city province, region)
- Date of occurrence
- Number of casualties (deaths, ill, injured, missing). Mention special vulnerable groups affected (children,
elderly, women)
- Chief complaints
- Current status of victims (indicate as of date)

Name Age Address Chief Complaint Disposition

II. Action Taken

List down in concise bullet points the action taken as of the date of report. For each action, indicate the agency
involved.

For your information.

Cc: <Name of Office 1>

<Name of Office 2>
 201

FINAL REPORT
<Title of Event/Emergency/Disaster>
(The final report comes in three parts: Part 1 consist of a one-page Executive Summary, Part 2 consists of the Detailed Report,
and Part 3 contains the annexes, such as tablets of raw data, maps, pictures, etc. The purpose of diving the final report into
these three parts is to make it more reader-friendly. Readers who only want to get an overview of the event can just read Part 1.
Those who need more detailed information can proceed to read Part 2 without being over whelmed with raw data. Those who
need the raw data can see them in Part 3.)

Part 1 – Executive Summary

A. Description of the Emergency/Disaster

(This briefly answer the questions: What, When, Where of the emergency disaster)
- Title of event
- Site (Region, Province, City/Municipality, Barangay, Institution if applicable)
- Date and time of occurrence, Duration of event, Duration of response
- Population affected

B. Health Impact of Emergency/Disaster

(This contains the number of casualties resulting from emergency/disaster. Only figures should be included; the names should be
found in the annexes.)
- Number of dead
- Number of injured/ill(Provide morbidity rate if possible)
- Number of missing

C. Summary of Response and Coordination Activities

(This contains a summary of actions taken by the different levels of responding agencies.)
- HEMS
- CHD
- LGU
- Others

D. Cost of Assistance Rendered

(This contains a summary of the financial value of assistance provided to the local agencies and victims from various sources
that were monitored or brought to the attention of the DOH-HEMS)
- Logistics support
- Support from other agencies, if available

Part 2 – Detailed Report

A. Background of the Emergency/Disaster

General information about the event
- Name of event
- Date and time of occurrence, Duration of event, Duration of response
- Site (Region, Province, City/Municipality, Barangay, Institution if applicable)
- Population affected
- Nature of emergency/disaster
Detailed description of event
- Chronology of events, if applicable
Background literature on the event
- Causative agent
- Mechanism
 202

- Expected affects (human, infrastructure, environment)

B. Consequences of Emergency Disaster (Sources of all the data, especially figures of mortality, morbidity, cost estimates should
be properly cited and acknowledged)
Health Consequences
- Deaths injuries, illness (This should contain references to list of names and other details in the annexes)
- Health infrastructure damaged, description of damage (This may contain references to detailed lists, maps or pictures
in the annexes)
Other Consequences
- Number of displaced families and individuals, if applicable (This should contain references to list of names and other
details in the annexes)
- Other infrastructure damaged, description of damage (Power, water, communication, transportation, major buildings)
- Cost of damage (if available)

C. Response and Coordination Activities Undertaken by HEMS

Chronology of Activities undertaken (This should contain detailed information of all activities undertaken in responding to
the event, including coordination and monitoring of dispatch of teams at the local, regional, national and international
levels)
- Table: Date, Description of Activity, Responding Agency, Remarks (The first entry on the table should contain a
narration of the alert process, i.e. the series of activities leading to the OpCen staffs’ initial awareness about the
existence of the emergency/disaster; and the last entry should describe the events leading to the decision to close the
case and write the final report.)
Mobilization of Teams (Refers to teams mobilized by HEMS only. Those mobilized by region and LGU would reflect in the
chronology of activities above and actions taken by other agencies below)
- No. of teams mobilized
- Purpose of mobilization
- Result of mobilization (Should contain to mission report which should be found in the annexes)
Logistics Support
- Cost of medicines and supplies
- Source of medicines and supplies
- Recipients

D. Action taken by other Agencies

Response Activities by CHD, LGU, Other Agencies (Should contain brief description of the activities and the results of the
activities. May include references to reports submitted by the agencies e.g. RESU Report etc. Which should be included in
the annexes)
Evacuation Center Activities, if applicable
Rehabilitation Phase Activities

E. Problems Encountered

F. Lesson Learned (Should include post mortem evaluation)

G. Recommendation (Group recommendation by agencies that must take action)

Part 3 – Annexes
A. Tables
B. Graphs
C. Maps
D. Pictures
E. Report from the field
 203

HEARS FIELD REPORT

(Upon learning about the occurrence of an event, the HEMS Coordinator shall immediately inform the DOH-HEMS Operation Center through the
fastest communication means available. Then this Form 1 shall be filled out and sent ASAP or within 24 hours upon occurrence of the event)

A. Event Information
Type of Event: GEOLOGIC WEATHER BIOLOGIC MAN-MADE
 Volcanic Eruption  Typhoon  Red Tide  Epidemic  Poisoning, specify _________
 Earthquake  Storm Surge  Fish Kills  Fire  Mass Action, specify ______
 Tsunami  Drought  Locust  Explosion  Accident, specify _________
 Landslide  Cold Spell Infestation  Armed Conflict  Other, specify _________
 Lahar  Flashflood  Terrorism
Date of Time of  AM Exact Location:
Occurrence: Occurrence:  PM Region: Province: Municipality/City:
Brief Description:
________________________________________________________________________________________________________
________________________________________________________________________________________________________

B. Consequences (Supply as much data as possible within 24 hours)

HEALTH IMPACT POPULATION DISPLACEMENT HEALTH FACILITIES/SERVICES
No. of Deaths: ____________ Population displaced?  Yes  No Number Number
No. of Admitted Patient: _________ No. of Displaced  Actual Present Functional
No. of Outpatients: ____________ Families:  Estimated Public:
No. Missing: ___________ No. of Displaced  Actual Hospitals:
Individuals:  Estimated RHUs:

C. Action Taken (Include information on number and types of services, manpower and supplies provided in the field)
1.
2.
3.
4.
5.

D. Assistance Needed (Include information on number and types of services, manpower and supplies needed in the field)
1.
2.
3.
4.

Prepared and Submitted by:

Date Prepared: Mobile No.:
Signature: Landline:
Printed Name: Fax No.:
Designation/Office: Email:
 204

MATERIALS UTILIZATION REPORT

(This report shall be prepared by HEMS Coordinators that have received logistics support from DOH-HEMS for redistribution. It shall submitted to
DOH-HEMS every last working day of the month, until reports shows that there are no more items to be redistributed. Each table below shall be
copied for every copied for every batch of an item received)

ITEM 1
A. Item Information
Item Total No.
Tracking Unit of Unit Date No. of
Name Specifications Expiry Received
No. Measure Cost Received Remaining

B. Distribution List
Recipient Quantity Date Purpose (Title of
Facility Municipality/City Province Issued Issued Emergency/Disaster)

ITEM 2
A. Item Information
Item Total No.
Tracking Unit of Unit Date No. of
Name Specifications Expiry Received
No. Measure Cost Received Remaining

B. Distribution List
Recipient Quantity Date Purpose (Title of
Facility Municipality/City Province Issued Issued Emergency/Disaster)

Prepared and Submitted by:

Date Prepared: Mobile No.:
Signature: Landline:
Printed Name: Fax No.:
Designation/Office: Email:
 205

INVENTORY
Checklist

Name of Patient: _______________________ Date: ____________

Name of EMS Unit: _______________________ Time: ____________
Address: _____________________________
Telephone No._____________________________

Name of Receiving Hospital: ___________________________________

Item Qty. Unit Description Cost Owner

No.

Total

Endorsing Personnel: Receiving Personnel:

_________________________ _________________________
Name (Print/Signature) Name (Print/Signature)
DESIGNATION DESIGNATION
 206

RAPID HEALTH ASSESSMENT

Event Title: ____________________________________
(This form shall be filled out and submitted by the HEMS Coordinator to the DOH-HEMS within 24 hours upon occurrence of a major health
emergency or disaster, except for mass casualty incidents and outbreak, for with form Form 3-B and Form 3-C shall be used respectively)

A. Event Information
Type of Event: GEOLOGIC WEATHER BIOLOGIC MAN-MADE
 Volcanic Eruption  Typhoon  Red Tide  Epidemic  Poisoning, specify _________
 Earthquake  Storm Surge  Fish Kills  Fire  Mass Action, specify ______
 Tsunami  Drought  Locust  Explosion  Accident, specify _________
 Landslide  Cold Spell Infestation  Armed Conflict  Other, specify _________
 Lahar  Flashflood  Terrorism
Date of Time of  AM Exact Location:
Occurrence: Occurrence:  PM Region: Province: Municipality/City:

B. Magnitude of Event
Number Affected Evacuation Centers
Province Municipality/City No. of No. of
Families Individuals No. of EC
Families in EC Individuals in EC

C. Health Consequences
Total no. of ill/injured
Total No. (excluding those who have died) Total No. of
Province Municipality/City Missing
of Deaths Admitted then Not Admitted
Admitted
Discharged

Attachments to this Report: Form 5 (List of Casualties) Others (Specify): _________________________

D. Health Facilities in the Affected Areas

DOH Hospital/s: Fully Functional Partly Functional Remarks:
Totally Non-Functional
LGU Hospital/s: Fully Functional Partly Functional Remarks:
Totally Non-Functional
Private Hospital/s: Fully Functional Partly Functional Remarks:
Totally Non-Functional
RHU/Health Center: Fully Functional Partly Functional Remarks:
Totally Non-Functional
BHS: Fully Functional Partly Functional Remarks:
Totally Non-Functional
 207

Other:________ Fully Functional Partly Functional Remarks:

Totally Non-Functional

E. Lifelines in the Affected Areas

Communication Fully Functional Partly Functional Remarks:
Totally Non-Functional
Electric Power Fully Functional Partly Functional Remarks:
Totally Non-Functional
Water Fully Functional Partly Functional Remarks:
Totally Non-Functional
Roads/Bridges Fully Functional Partly Functional Remarks:
Totally Non-Functional
Other:________ Fully Functional Partly Functional Remarks:
Totally Non-Functional

F. Status of Essential Drugs and Supplies in the Affected Areas

No. of Cases No. of Days Remarks

Stock Level Good for:

G. Action Taken
1.
2.
3.
4.

H. Problems Encountered
1.
2.
3.
4.

I. Recommendations
1.
2.
3.
4.

Prepared and Submitted by:

Date Prepared: Mobile No.:
Signature: Landline:
Printed Name: Fax No.:
Designation/Office: Email:
 208

RAPID HEALTH ASSESSMENT (MCI)

Event Title: ____________________________________
(This form shall be filled out and submitted by the HEMS Coordinator to the DOH-HEMS within 24 hours upon occurrence of a major health
emergency or disaster resulting to mass casualty)

A. Event Information
Type of Event: GEOLOGIC WEATHER BIOLOGIC MAN-MADE
 Volcanic Eruption  Typhoon  Red Tide  Epidemic  Poisoning, specify _________
 Earthquake  Storm Surge  Fish Kills  Fire  Mass Action, specify ______
 Tsunami  Drought  Locust  Explosion  Accident, specify _________
 Landslide  Cold Spell Infestation  Armed Conflict  Other, specify _________
 Lahar  Flashflood  Terrorism
Date of Time of  AM Exact Location:
Occurrence: Occurrence:  PM Region: Province: Municipality/City:

B. Health Consequences
Total no. of ill/injured (Excluding those who have died)
Total No. of Treated on Brought to hospital- Brought to hospital- Brought to hospital- Total No. of
Deaths Site Managed OPD Admitted then Still admitted Missing
discharged

Attachments to this Report: Form 5 (List of Casualties) Others (Specify): _________________________

C. Action Taken
1.
2.

D. Problems Encountered
1.
2.

E. Recommendations
1.
2.
3.

Prepared and Submitted by:

Date Prepared: Mobile No.:
Signature: Landline:
Printed Name: Fax No.:
Designation/Office: Email:
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RAPID HEALTH ASSESSMENT (OUTBREAK)

Event Title: ____________________________________
(This form shall be filled out and submitted by the HEMS Coordinator to the DOH-HEMS within 24 hours upon occurrence of the outbreak)

A. Event Information
Type of Event:  Epidemic, specify: _____________________
Date of Time of  AM Exact Location:
Occurrence: Occurrence:  PM Region: Province: Municipality/City:

B. C.Health Consequences
Total No. of Total no. of Cases (Excluding those who have died)
Persons Total No. of Treated on Brought to hospital- Brought to hospital- Brought to hospital-
Exposed Deaths Site Managed OPD Admitted then discharged Still admitted

Attachments to this Report: Form 5 (List of Casualties) Others (Specify): _________________________

D. Action Taken
1.
2.
3.
4.

E. Problems Encountered
1.
2.
3.
4.

F. Recommendations
1.
2.
3.

Prepared and Submitted by:

Date Prepared: Mobile No.:
Signature: Landline:
Printed Name: Fax No.:
Designation/Office: Email:
 210

LIST OF CASUALTIES
Event Title: ____________________________________
(This form shall be used by the HEMS Coordinator to report ALL (old and new) cases of deaths, illnesses, injuries and missing individuals related
to the particular health emergency of disaster. When used to supplement Form 4 (Rapid Health Assessment) or Form 5 (Health Situation Update)
corresponding notation that this list is attached shall be indicated on the said forms)

A. Deaths (Old and New Cases)

Name Age Sex Address Cause of Date of Death Place of
Death Death
1.
2.
3.
4.

B. Injured/Ill - Admitted (Old and New Cases)

Name Age Sex Address Hospital Diagnosis Date Date
Admitted Discharged
1.
2.
3.

C. Injured/Ill –Not Admitted (Old and New Cases)

Name Age Sex Address Hospital Diagnosis Date Seen
1.
2.
3.
4.

D. Missing (Old and New Cases)

Name Age Sex Address Remarks
1.
2.
3.

Prepared and Submitted by:

Date Prepared: Mobile No.:
Signature: Landline:
Printed Name: Fax No.:
Designation/Office: Email:
 211

LIST OF CASUALTIES
DISPOSITION REMARKS
NAME OF PATIENT ADDRESS AGE SEX DIAGNOSIS (Name of hospital,
H T D funeral parlor, others)

Legend:
H- Home
T- Transferred Field Medical Commander: ________________________
D- Died (Signature over Printed Name)
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Provincial Health Office ALLERGIES

HEALTH EMERGENCY MANAGEMENT STAFF
 No  Yes (specify):
Province of Quezon

MASS CASUALTY MEDICAL CASE

CHIEF COMPLAINT (SYMPTOMS)
RECORD
 Cardiac Arrest
 Head  Neck  Chest
General Data  Pain  Abdomen  Back  Extremities
NAME:  Others:
 Vomiting
 Weakness  CVA Others (Specify):
AGE/GENDER/CIVIL STATUS:
ADDRESS:  Diarrhea
 Pain  Nose  GIT  Urogenital
 Others:
CERVICAL
AIRWAY BREATHING
SPINE INJURY
 Breathlessness  Asthma  COPD  Cardiac
 Clear  Yes  Normal Failure
 Partial  No  Shallow  Others (specify):
Obstruction
 Epilepsy
 Complete Retractive
 Altered Mental  Hypoglycemia  Alcoholic
Obstruction
State Intoxication
 Stridor  Tachypnea
 Others:
Matenity/Childbirth
CAPILLARY  Others:
SKIN CONTOUR
REFILL
 Normal  Normal  Diaphoretic CHIEF COMPLAINT (If Trauma)
 Delayed  Pale  Jaundiced  Blunt  Amputation
 None  Cyanosed  Deceleration  Burns/Electrocution
 Falls  Poisoning
PAST MEDICAL HISTORY  Crush Injury  Drowning/Asphyxiation
 Diabetes  Asthma  Blast
 Others:
 Hypertension  Renal Failure
 Cancer (site):
VITAL SIGNS
 Others (specify):
TIME PR RR BP SaO2

MEDICATIONS TAKEN
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PHYSICAL ASSESSMENT
Functional Injury
Head
Neck
Chest
Abdomen
Pelvis
Lower
Limb
Upper
Limb
Skin

APPENDIX H

DIRECTORY OF HEALTH PERSONNEL

NAME DESIGNATION CONTACT NO.

Jehzel M. Aquino, MD DTTB 09434411325

Rebecca L. Castillo Nurse III 09196720091

Marife M. Dizon Nurse I 09997889517

Coraciel Y. Lim Dentist II 09487099929

Rodelo V. Teopy MedTech II 09282943641

Elisa P. De Mesa Midwife III 09461350741

Melva G. Corpus Midwife II 09476065810

Edna A. Bisa Midwife II 09092934643

Imelda S. Serdena Midwife II 09106204100

Teresita G. Zara Midwife II 09461815448

Emeliana H. Juacalla Midwife II 09093304851

Delia L. San Diego Midwife II 09100741779

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Dentenciana I. Silva Midwife I 09106013171

Eva L. Margallo Midwife I 09108584081

Noemi C. Gratuito Casual Midwife 09070415402

Pilar J. De Gracia Casual Midwife 09289929403

Carolina R. Desdir Casual Midwife 09186303031

Maritess B. Mercado Casual Midwife 09286236031

Sonimar O. Malubag Admin Aide II

Rex T. Bacuno Admin Aide I 09212854457

Maria Polly A. Albacea Sanitation Inspector II 09103713974

Ivan Lorenz D. Go Sanitation Inspector I 09479532714

Princess Ghey C. Nova Sanitation Inspector I 09293624899

Rafael Guiller C. Bacuno Ambulance Driver 09477369362

APPENDIX I

DIRECTORY OF QUEZON HOSPITALS AND

MEMBERS OF MDRRMC AND ILHZ

District I

Location Name of Hospital Category Medical Director/

Chief of Hospital
Infanta Claro M. Recto Memorial Government Dr. Hilario M. Mercado
Quezon District Hospital (042)5352882

Lucban Lucban MMG Hospital Private Dr. Myrna I. Cabungcal

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Quezon (042)9111353
(042)5408312
Mauban Mauban District Hospital Government Dr. Wennie P.
Quezon Alcantara
(042)7840216
(042)7840313
Pagbilao Jane County Hospital, Private Dr. Jasmin Andaman-
Quezon Inc. Garcia
(042)7311295

Sampaloc Sampaloc Medicare Government Dr. Jesus M. Calayag

Quezon Community Hospital (042)7160323
09088639834

Tayabas City Tayabas Community Private Dr. Avelino A. Obispo

Hospital (042)7932216

District II

Location Name of Hospital Category Medical Director/

Chief of Hospital
Candelaria Municipal Government Dr. Grace S. Mirando
Hospital (042)5858327
(042)7411742

Peter Paul Philippine Private Dr. Rolando A. Padre

Candelaria Corporation Hospital (042)5854531
Quezon (042)7411857

United Candelaria Private Dr. Romeo Maaño

Doctors., Inc (042)5852114/
(042)5852116

Camp Nakar Station Government LTC Erlinda S. Balaan,

Hospital MC
(042)7102531
(042)3733339

Lucena MMG General Private Dr. Edgardo Mar M. Elbo

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Hospital (042)3735926
(042)6603815

Lucena City Lucena United Doctors Private Dr. Juan Eugenio Fidel B.
Hospital and Medical Villanueva
Center (042)3736161
(042)3736321

Mount Carmel Diocesan Private Dr. Ma. Delta A. Canela

General Hospital (042)7102576
(042)3737139
(042)6607868

Quezon Medical Center Government Dr. Agripino C. Tullas

(042)7102440
(042)7103444

Lucena City St. Anne General Private Dr. Elvira A. Andaman

Hospital, Inc. (042)7102218
(042)7105234

Sariaya Greg Hospital-Sariaya Private Dr. Caroline A. Andaman

Quezon Inc. (042)6511162/
(042)5258387
(042)6511162

Liwag Medical Clinic Inc. Private Dr. Ruel Ferdinand A.

Gonzales
(042)5457672
Tiaong
(042)5459700
Quezon
St. Cecilia Hospital Private Dr. Cesar B. Mayuga
(042)5459217

District III

Location Name of Hospital Category Medical Director/

Chief of Hospital
Catanauan Bondoc Peninsula Government
 217

Quezon District Hospital

San San Francisco Municipal Government Dr. Mario L. Lopez

Francisco Hospital 9196824025
Quezon

San Narciso San Narciso Municipal Government Dr. Rosaline Ojastro

Quezon Hospital 9209011818

Unisan Medicare Government Dr. Marilyn D. Zubiri

Community Hospital (042)5498362
Unisan
Quezon Dr. ErlindaTolentino Private Dr. Jesus M. Comia
Medical Clinic & (042)5498511
Hospital

District IV

Location Name of Hospital Category Medical Director/

Chief of Hospital
Alabat Alabat Island District Government Dr. Teodoro R. Serrano,
Quezon Hospital Jr
(042)3028028 /
(042)3028148
Doña Marta Memorial Government Dr. Arnulfo O. Imperial
District Hospital (042)3165326
Atimonan
Quezon Emil-Joanna General Private Dr. Romane Jesus E.
Hospital Pilar
(042)3165390
(042)5111092

Del Carmen Medical Private Dr. Julito L. Caña

Clinic (042)3017156
Calauag
Quezon St. Peter General Private Dr. Dinna Blanca L.
Hospital Valeña
(042)3017304
(042)3017834

Guinayangan Guinayangan Medicare Government Dr. Florencia A. Vergara

Quezon Community Hospital (042)3034462
 218

Gumaca District Hospital Government Dr. Purita T. Tullas

(042)3177535
(042)3174818
Gumaca
Quezon RAKKK Prophet Medical Private Dr. Angelina L. Tan
Canter Inc. (042)3177857

San Diego De Alcala Private Dr. Allan L. Hilario

General Hospital (042)3174829

Holy Rosary Hospital Private Dr. Joel E. Arago

(042)3025255
(042)3027158
Lopez
Quezon Lopez St. Jude General Private Dr. Enrique D. Agra, Sr.
Hospital, Corp. (042)3025244
(042)8411015

Magsaysay Memorial Government Dr. Wilson T. Rivera

District Hospital

Tagkawayan Maria L. Eleazar Government Dr. Reynaldo Florido

Quezon Memorial District (042)3048738
Hospital

MUNICIPAL DISASTER RISK REDUCTION MANAGEMENT COUNCIL MEMBERS

DIRECTORY
NAME AGENCY CONTACT NO.

Jose Jonas A. Frondoso Office of the Mayor 09297088447

Antonio S. Abril SB Secretary 09394631246

Jose M. Aquino Municipal Engineering Office 09088602236

Wenceslao M. Matibag Assessor’s Office 09476065825

Rolando S. Mendoza Municipal Agriculture Office 09085285111

Genedina R. Penolio MSWD 09096175353

 219

Haidee D. Papa MGSO 09231979424

Concepcion M. Mestidio LCR 09226118422

Office of the Municipal
Anita A. Jagonoy 09214061404
Treasurer
Office of the Municipal
Maria Judith D. Batalla 09209489522
Accountant
Glenda C. Arana Office of the Budget 09212125856

Ma. Sarina G. Anonuevo HR 09088729964

Dandy P. Aguilar PNP 093999336928

Noel P. Magsino DILG 09231597514

Bernard Aldin A. Panaligan BFP 09085894059

Gilbert Frondoso ACCT 09209504891

Guillermo Sarne Kabayan 09099084832

Rowel Salvador Kabalikat 09994180829

Rodulfo Uy III Business Sector 09199100431

Francis M. Villanueva MDRRMO/MPDC 09993488791

INTERLOCAL HEALTH ZONE MEMBERS DIRECTORY

NAME AGENCY CONTACT NO.

Municipal Mayor
Hon. Rachel A. Ubana 09088883850
Lopez, Quezon
Chief of Hospital – MMDH
Wilson T. Rivera, MD, MHA 09209615282
Lopez, Quezon
Municipal Health Officer
Jose M. Mercado 09175608472
Lopez, Quezon
Public Health Nurse
Laida Mique, RN 09289461482
Lopez, Quezon
Municipal Mayor
Hon. Cezar J. Isaac III 09199100612
Guinayangan, Quezon
 220

SB Chair, Com. On Health

Hon. Eugene Cambronero 09477882163
Guinayangan, Quezon
Brgy. Capt. Francisco Cruzat Guinayangan, Quezon 09999938079
Chief of Hospital – GMCH
Florencia A. Vergara, MD 09175014400
Guinayangan, Quezon
Municipal Health Officer
Annabel T. Ardiente, MD 717-7805
Guinayangan, Quezon
Public Health Nurse
Myrna Ornedo, RN 09086048489
Guinayangan, Quezon
Municipal Mayor
Hon. Luisito S. Visorde 09999921182
Calauag, Quezon
SB Chair, Com. On Health
Hon. Angelo P. Eduarte 09198157776
Calauag, Quezon
Brgy. Capt. Jose Jeliang Jr. Calauag, Quezon 09309061484
Medical Director – Calauag
Alexander P. Ibay, MD Municipal Hospital 09228214332
Calauag, Quezon
Municipal Health Officer 02-717-7129
Katherine P. Ruby, MD
Calauag, Quezon 09985757163
Public Health Nurse
Leticia Caña 09255111530
Calauag, Quezon
Municipal Mayor
Hon. Alexander Rivera 09498973373
Buenavista, Quezon
Municipal Health Officer
Herminigildo T. Siat, MD 09999395102
Buenavista, Quezon
Public Health Nurse
Annabel Andaya 09202038699
Buenavista, Quezon
Municipal Mayor
Hon. Jose Jonas. A. Frondoso 09297088447
Tagkawayan, Quezon
SB Chair, Com. On Health
Hon. George A. Lopamia 09255118239
Tagkawayan, Quezon
Brgy. Capt. Merlita Bendicto Tagkawayan, Quezon 09186898862
Chief of Hospital – MLEDH (042)3048738
Reynaldo Florido, MD
Tagkawayan, Quezon
Doctor-to-the-Barrio
Jehzel M. Aquino, MD 09434411325
Tagkawayan, Quezon
Public Health Nurse III
Rebecca L. Castillo, RN 09196720091
Tagkawayan, Quezon
Public Health Nurse I
Marife M. Dizon, RN 0997889517
Tagkawayan, Quezon
 221

DMO V, PDOHO
Fatima M. Ocampo, MD 09175608236
Quezon
DMO IV, PDOHO
Engr. Rico B. De Leon 09998891357
Quezon
IPHO Representative
Mercedes Cera 09423877535
Quezon