4. Health sector interventions and operations
4.1. National health response teams (NHRTs) for emergencies
National-level health response teams are comprised of professionals of various health backgrounds that has been organized and trained in advance. These teams can be rapidly mobilized to emergency areas to support the efforts of local health authorities in activities such as sectoral damage assessment and needs analysis (DANA). They can also propose and support action to strengthen the health response, facilitate intersectoral coordination, and help meet other needs that arise. An NHRT should have contingency plans that clearly set out procedures, protocols, and lines of action for emergency interventions.
Mobilizing an NHRT requires a full support structure. This means equipment and logistics, including adequate transportation to the areas of operation, items of personal use to ensure minimum autonomy for the team members, telecommunications, and alternative energy sources. This is in addition items required for the health mission itself, such as mobile medical equipment and clinical laboratory equipment, materials and equipment for taking samples and monitoring water and food quality, drug kits, and other essentials. Administrative arrangements for payment of salaries and per diem, as well as accident insurance, should be a part of the support structure provided for response teams.
4.1.1. Organization, integration, and functions
The organization and deployment of the NHRT should be handled at the highest level of the health ministry or secretariat, since the NHRT requires institutional validation and administrative support to carry out its work in the affected areas.
The NHRT’s work complements the work normally done by the different health actors during emergencies, which means the team is expected to be a source of support and advice, but not replace the authorities in charge.
The tasks of the NHRT focus on the health aspects of the emergency. Although the group will usually be made up of health professionals, some emergencies may require additional staff from other sectors and institutions join the team.
The composition of the group that is deployed, in terms of disciplines and number of members, depends on the needs, although the tasks that typically require support include:
- Coordination
- Epidemiology
- Water and sanitation
- Health services
- Mental health
- Information/comunications
- Logistics/administration
- Specialists in other disciplines such as nutrition, structural engineering, or chemical/technological accidents will be integrated into the team as the situation warrants.
4.1.2. The functioning and operational mechanisms of the NHRT in response
The Health Sector Emergency Operations Committee takes the decision to activate and deploy the NHRT to an emergency area, in response to the evidence-based needs. The disaster office of the ministry/secretariat will supervise the operations, while the NHRT coordinator is responsible for representing the team and conducting liaison with the actors involved in the response at field level.
a. Activation
Upon receiving notification of a disaster event or a warning that could require mobilizing the NHRT or a part of it, the disaster office of the health ministry or secretariat and the NHRT coordinator should:
- Compile preliminary information on the event; contact the local health authorities in the affected or at-risk areas to make a preliminary determination of the needs that may be required.
- Share the information compiled with the heads of the appropriate areas within the ministry/secretariat of health; present proposal for response actions that ensure coordination and support mechanisms.
- Mobilize the logistician(s) on the NHRT to begin whatever preparations are needed.
- Define the type of intervention to be carried out, the composition of the team that should be alerted or deployed, and bring its members together.
On being advised of an imminent deployment, the members of the NHRT should:
- Inform themselves on the situation on the ground, with special attention to the area where they will be working
- Insofar as possible, establish contact with their colleagues in the emergency zone to obtain more specific information
- Be ready to leave within 12 hours; get together the basic personal items that they may need on site.
- Confirm with the person in charge of logistics that the equipment and materials needed for their area of work are at hand, along with other useful tools.
VERY IMPORTANT: Before dispatching the team, the coordinator should ensure that the mission’s strategy and objectives have been defined and communicated to the NHRT, that coordination with local authorities has been arranged, and that the local authorities are informed of and well disposed toward the mission and the arrival of the team.
b. Mobilization
On arrival at the emergency area, the coordinator will contact the health sector authority in charge to exchange information and coordinate the support activities. The members of the NHRT will contact their counterparts according to the work plan or decisions that are made with the local health authority.
The basic support work of the NHRT includes the following:
- If a Health Sector Emergency Operations Committee is in operation, the coordinator should join it and ensure that the work of the NHRT is coordinated with the various operational health entities responding to the emergency.
- The situation should be analyzed jointly with the local counterparts in order to propose ways of strengthening the response and define courses of action for the various specialty areas.
- Support should be provided for the preparation of proposals, with a view to seeking resources.
- The team members should provide support for their counterparts who are conducting/supervising activities in their area, while maintaining frequent communication with all the members of the team to share findings, exchange impressions, and impart other information that contributes to a comprehensive view of how health needs are being addressed.
c. Demobilization
At the conclusion of the mission, the members of the NHRT should be sure to:
- Give their local counterparts all relevant information compiled during the mission.
- Complete the transition by leaving a mission report and providing detailed information on pending tasks, and explaining precautionary measures and other details that might be important or of interest to anyone replacing them.
- Return the equipment and other articles that were their responsibility during the mission
- Make all necessary personal payments (hotels, rentals, etc.), and inform the logistics person of payments that remain for the mission itself to make, so that these can be followed up on and liquidated.