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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.

A preparedness plan in the health sector encompasses the national, regional, and municipal/local levels. At each level, depending on the degree of complexity of the health institutions involved, the plan assigns a team leader, or “emergency coordinator.” This person has the primary responsibility for coordinating activities within the scope of the authorities set out in the plan.

Coordination activities and mechanisms are fundamental parts of a plan, and must be established before a disaster occurs. This means establishing relationships with those responsible for different areas and activities, and being familiar with the capacities of each institution. Coordination requires harmonization and mutual understanding between different actors and institutions, all of whom are expected to act according to their respective capacities and authority.

No plan can be effective if human, natural, and financial resources are not in place for operation. A health disaster plan should take account resources in the sector’s institutions. A national disaster plan should also consider potential resources by civil society and international organizations that are active in the country and linked to the health sector.