DRR Mainstreaming Into Health Sector

DRR Mainstreaming Into Health Sector

By Yuniarti Wahyuningtyas

Following the earthquake and tsunami that struck Aceh and Nias few years behind, the concept of Disaster Risk Reduction (DRR) has been a popular program trend that is developed by nearly all NGOs, Government agencies, and Private Sector. It is not just dealing with the context of the hazard itself, but also being linked to other development issues, such as: education, health, poverty, etc. In this article, i would like to highlight and emphasize the DRR mainstreaming into health sector. This article i wrote based on my experiences working with the health agencies at the national and local level, these include: the Centre for Health Crisis of Ministry of Health (PPKK Kemenkes), Health Bureau (Dinkes), Community Health Centre (Puskesmas), and Mother and Child Health Centre (Posyandu).

Refers to my experience working in Flood Risk Reduction Project that was implemented in DKI Jakarta Province by an International NGO few years behind, the role of health cadres and health officer at local level in DRR is crucial. These actors play major role in term of not just responding but also in preparedness. They operate under the directions of Ministry of Health through Center for Health Crisis or known as CHC/PPKK (Pusat Penanggulangan Krisis Kesehatan). This center has 9 regional crisis centers that located in some provinces (North Sumatera-Medan, South Sumatera-Palembang, DKI Jakarta-Jakarta, Central Java-semarang, East Java-Surabaya, South Kalimantan-Banjarmasin, Bali-Denpasar, North Sulawesi-manado, and South Sulawesi-Makassar) and 2 sub-regional (located in Padang and Jayapura) that assisted them in monitoring the crisis and emergency situation at local level across the country. Its main functions, are as:

1) health operational support center,
2) health relief control center,
3) health reference center, and
4) media center

Based on its functions, the CHC develops program activities related to DRR, these include: prevention, mitigation, preparedness, response, and recovery. Few actors know well what achievements that have been achieved by this technical unit, one of them is the development of contingency planning in health sector that already done in nearly 150 districts/cities. Unfortunate, that according to its staff, the health sector contingency plan is rarely to be incorporated into the local disaster management contingency planning that BPBD developed. Other thing that CHC is developed that interest me, is that they support the Emergency Management Medical System that linked up 92 hospitals in Jakarta through 119 Call Centre. Nevertheless rest assure that this system would work if the hospitals start to improve their services instead of taken advantage from the patients.

Personally, i am more interesting to discuss about the health services and facilities at ground level and on how to connect them with DRR. i always have a fond on the work mechanism of Posyandu and Puskesmas, as an individual who aside in suburb, these health facilities definitely play important role in providing health services to the communities, especially for those who are not afford, have limited access to it and vulnerable groups who are the utmost needed. Experiences tell me that it is better to improve these facilities instead just focus on the major issue at national level. In term of Posyandu, a lot of its health services that ease the burden of communities to get a good qualified basic health needs, such as immunization, additional foods/nutrition, free milk, and fulfillment of elderly needs. The Posyandu at RW/Hamlet level usually assisted by the women group, a doctor and midwife with monthly schedule.for health service provision. During the weekend, the women group also monitoring and checking the water storage and household hygiene door to door by visiting each household house. Surprjisingly, according to them, all of these activities come from their collective voluntary fund.Nevertheless,the present of NGOs,local or international, also health volunteer practitioners and private sector that work in health sector also give valuable contribution to improve health condition of communities, in regards to limites resources that health officials have.

The needs to have a strong collaboration and joint efforts from health actors can be fulfilled through the establishment of health sector coordination, either at nationl or international levels. The health sector usually establishes during emergeny or crisis situation instead of normal situation, this paradigm of coordination should be shifted by developing more sense on developing cooperation through real actions and joint resources in order not just to improve the communities health condition, but also to build public awareness and support the government for health program. 

Education in Emergencies, How to Link Them?

What is Education in Emergencies?
Within past years, i have been worked in building the capacity of either communities, youth, or even the local government. Mostly, i tried to build their awareness and improve their understanding for better respond in disasters, through training, workshop, campaign and other socialization activities. I tend to use the existing tools and just recycle them...that seems far much easier and somehow effective and efficient rather than create ea new tool, beside there are a lots of tools for emergency education out there that people do not recognize or familiar, by using them we can also help those organizations who have been worked very hard to develop tools to be worth to use. Anyway, let's go back to our main topic: Education in Emergency...it is surely a common and familiar term that we often heard, what would be the 1st thing appear in your mind when you hear this???children in school trained to be better respond in facing disaster?school is well equipped and prepared to facing the hazards? the teachers and all schools actors know what to do during the emergency or crisis situation? or the government guarantee protection and needs of education sector during the emergency?well, if that are the ones that you are thinking...congratulation you have pass the basic test on knowledge and common understanding in Education in Emergencies.

How to Do It?
Lets get rid of those theories and return to our main root as human, common sense. The way i see it Education in Emergency (EiE) is not just talking about Education, School, Students, Disaster Preparedness or Response. EiE is more a wide concept on how the communities, government, schools and other actors, even private sectors that are located around the school area, respected each other role and function and support each other in assuring their safety and security from potential or existing threats and how they cope in managing the threats themselves. I would definitely disagree to put weight in our children or students and trained them to be the front liners in responding to disasters. Sometimes, we want them to be independent, knowledgeable and have the ability to self rescue and or as the responders, we often forget that they have RIGHTS, especially for those students at schools that are considered as children based on law. as children they have the rights to be protected, to be fulfilled their needs and security, to be heard their voices and to make their own minds. Most organizations will be proud displaying the hazard map that these children made, showing the ability and skills that these children have in term of response through drill and simulation that they done after attended training. Frankly speaking i would say that it kind of an exploitation for them. Why we should force them in a soft way to have the ability as a respond team?if you are thinking "well, we just want them to be saved and save the others" or even "we want them to have more knowledge on disasters", well there is another way to reflect your objective. Try to think these following ways:

1. Remember Never to Use Disaster as Your Entry Point
Sometimes we never think about the needs of other and justs straight focus on our program or projects and how to meet the deadline, first mistake and the fatal one that you made when you want to do a Education in Emergency, is by saying "do you know that your school/area is prone to disaster?" or the worst ever "we will manage the disasters in your school/area"....in some areas/communities/schools, disaster is not the only or main threat that they are facing. Try to be more sensitive and have a closer look in the area where you are working. Sometimes health is the main issues; bad sanitation, lack/limited access to clean water, bad hygiene, etc or other development issue; access to education due to limted eduication facility/infratsructure, low family income, poverty, nutrition...lots of problems that are more priors instead of disaster, fix them first and build the community then you can start to promote the term "Education in Emergencies"
2. Think Them as Subjects not Objects
They are not puppets that you can direct and toy them. threat them as human, do not show your sympathy or spoil them. Try to hear their voices and sit with them equally discussing the better and greater program that you want to develop together.
3. Never Work Alone
You never success if you are alone. think about a extended family that you have, the more organizations or actors that you involve, the more achievements that you will get from the project. Do not think about big investment from major companies, try to think big from a small group that you gather. instead of having 1 private sectors invest in your program, why not gather home industries, commmunity groups and faith based organizations?
4. Collective Ownership
This is not talking about "X Project Implemented by Y Organization that funded by Z Donor", when you start from zero and develop partnerhsip, it measn you have to take the risk of sharing, not just resources but also expertise, knowledge and everything that you have, but of course in proper way
5. Never Promise, Never Say Goodbye
When you get too attach, it is difficult to release. So, try to re-position yourself. Don ot act as hero, but also do not be a coward. give them fact instead of promise that you cant keep. It is better to have a bitter sweet memory rathar than swallow a guilty pleasure by taking the credits and left them behind
6. Maintain Relationship
Even a SMS or a phone call can make a different. Try to have a time to visit them and look their progress, also if you have a wide network, why dont promote them to other actors that have interest for the project?

Anyway, the tips above may not give you details on what you should do for Education in Emergencies, but as the key points, think about these keywords: School, Communities, Government, Policies, Infrastructure, Network, Resources, Development, Partnership, and nevertheless Transparency.