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Even if all risks have been taken into account in developing a plan, a plan may not operational until it has been tested. The plan should be evaluated and updated periodically through simulations.

Simulation exercise is a useful tool to familiarize personnel with the contents of the plan and with the roles and responsibilities of the health team. Through a fictitious scenario, the team’s performance on assigned roles can be observed and gaps identified in the operationalizing the plan.

No plan will succeed unless it considers the continuing education and training of health workers and the general population. The health sector’s national disaster management program is responsible for promoting ongoing training activities in different areas:

The activation of a plan is not automatic. Health workers have to be trained for the processes involved. The mechanisms for implementing the response plan should be clearly formulated. Depending on nature of the disaster, different phases can be defined:

a) Alert phase: Once an emergency is occurs, a telephone chain should operate based on registered names, addresses and telephone numbers. There should be alternate mechanisms for contact in case of power outage or interruption of telephone service. The plan should include warning systems as a part of intersectoral plans for different types of emergency, so that the public can take preventive and protective measures in coordination with national disaster management agencies or civil defense institutions. Where appropriate, this may include evacuation to temporary shelters or camps.

The training to implement the plan should clearly define the roles and responsibilities of each member of the health team. “Action cards” supplied to each member should clearly and simply describe the actions that he or she is to carry out, the information to be obtained, and the chain of command the person need to follow, as well as important telephone numbers for immediate contact.