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.

Indonesia National Platform on DRR

    For most or all of us that work in DRR sector, the name of National Platform or PLANAS PRB might be familiar for us. Yet, for some or most people outside the sector, this name surely brings some question marks in their minds. What PLANAS PRB stands for?what does it function?and how does it operate?after done some readings and reviews on some articles and presentations about it, i decided to summary it in my blog.

    National Platform for DRR or in bahasa is known as Platform Nasional Pengurangan Resiko Bencana (PLANAS PRB) is a forum that concerns on DM/DRR which opens for public and volunteering. As a forum, it is a media that makes its members possible to give inputs, involve in discussion, make decision and gain effort from its existing. The members of this forum mostly are local/national NGOs, private sectors, academician/universities, mass media, and also community groups. As mentioned in the Global Platform for DRR, the National Platform for DRR or PLANAS PRB is foreseen as the principle national institutional arrangement to:

• Improve the coherence of international action on DRR at all levels;
• Advocate and share knowledge among practitioners and experts; and
• Provide reviews and evaluations of national progress in DRR

      Furthermore, in the Guidelines for National Platforms for DRR), explained that “Multi-sectoral and multi-stakeholder National Platforms are understood as providing  coordination, analysis and advice to help governments mainstream Disaster risk reduction into development and sectoral programmes, plans and policies, thus, having the potential to be a key instrument for the implementation of the Hyogo Framework for Action at the national level". Also as part of the recommendations of National Platforms to the Chair and participants of the second session of the Global Platform for Disaster Risk Reduction (Geneva, 16-19 June 2009), stated that "the Nations should facilitate and co-ordinate links between climate change adaptation focal points, and National Platforms for DRR, to avoid parallel mechanisms and to link existing expertise in order to reduce the human impact of climate change".

         The establishment of PLANAS PRB in Indonesia is supported by the legal frame, as it is mentioned in the Indonesia Law Number 24 Year 2007 on Disaster Management (article 4.e, 26.1, 28 & 30.1) which is explained the rights and obligations of various stakeholders in disaster management. It is also described in the Resolution of Economic and Social Council of the United Nations Number 1999/63, and Resolution of the United Nations General Council Number A/RES/59/231. The historical background of its establishment as following:

• Sari Pan Pacific Hotel Agreement in Esatblishment of PLANAS PRB on November 20th 2008 in Jakarta
• Early Meeting of Formatting Team in Jakarta on December 22nd 2008
• 1st Discussion Meeting in Ibis Arcadia, Jakarta on January 15th 2009
• 2nd Discussion Meeting in Ibis Tamarin, Jakarta  on January 23rd 2009
• 3rd Discussion Meeting in Sari Pan Pacific, Jakarta on February 6th 2009
• 1st Meeting of Formatting Team in Jakarta on February 12th 2009
• 4th Discussion Meeting in Sofyan Betawi, Jakarta on February 20th 2009
• 2nd Meeting of Formatting Team in Jakarta on March 4th 2009
• 5th Discussion Meeting in Sofyan Betawi, Jakarta on March 5th 2009
• 1st Multistakeholders Consultancy Meeting on March 19th 2009
• 3rd Meeting of Formatting Team on March 31st 2009
• 2nd Multistakeholders Consultancy Meeting on April 1st 2009 
• 4th Meeting of Formatting Team on April 14th 2009
• Socialization of PLANAS PRB Concept Note on April 22nd 2009
• PLANAS PRB Public Expose on April 28th 2009
• Participation of PLANAS PRB in the 1st Global Platform Conference, Geneve on June 16th to 19th 2009

     Based on the series of meeting on the establishment of PLANAS PRB in Indonesia, it is being agreed that it holds its vision in creating nations' resiliency towards disasters by carries its missions in increasing awareness on DRR, improving knowledge and skills on DRR, supporting people participation and ownership in DRR issues, ensuring smart resources for DRR, and building networking in DRR. Hence, it develops its program in some key actions below: 

• Giving inputs for the policy of development planning and institutional issues
• Encouraging education sector and the development of science and technology
• Raising Public awareness, and sharing information and communication
• Developing wider network and cooperation
• Developing Resources to meet the needs of DRR issues

     Its activities are mainly focus on meetings discussing the progress on HFA achievement and sharing lesson learnt from DRR Programs/Projects in Indonesia, linked to climate change adaptation process and involvement of stakeholders from the environmental civil society groups and others, also inclusion of the DNPI (Indonesian National Council of Climate Change) into PLANAS PRB. Yet, it has other activities that are mainly done through the existing working groups that are set, include:

- Education sector : Prior to the formation of the NP, this sector has formed the Consorsium of Disaster Education, which fits well with the NP in encouraging education sector on DRR issues

- The Civil Society, Higher Education and Research Institution, as well as Private Sectors have been quite active and have set up their own platforms prior to the formation of the NP, and therefore these sectors are involved in the respective areas of the NP’s work plan and priorities

- Local platforms : at the local level, four local platforms have been established prior to the establishment of the NP (Yogyakarta LP, West Sumatra LP, Eastern Nusa Tenggara LP, and Merapi Forum), discussing and supporting local and specific DRR issues

      
      As time goes by, the PLANAS PRB has entered its 3rd year and some advantages having this kind of forum are beginning to show some results, such as: better coordination and communication of all sectors in DRR, sharing of resources among the multistakeholders, an the inclusion integration of all existing potency/resources in Indonesia. Further, there are also some challenges that being face, particularly in term of coordination and integration also better networking at regional, provincial, and district level. Some works that need to be done by PLANAS PRB are: to support and assist the establishment of local platform for DRR and reach wider communities in raising and promoting DRR. Since the establishment of PLANAS PRB until 2011, based on the BNPB (National Disaster Management Body for Disaster Management) Report on HFA Progress Report and Achievement in 2011, there are only 5 thematic forum and 7 local platforms that already established, these include: West Sumatera, Bengkulu, Jogjakarta-Central Java, Central Sulawesi, NTT, Molluca, and East Java Provincial Platforms, and Talang Volcano, Merapi Volcano, Bennenain River, Semeru Volcano, and Bengawan Solo River Thematic Platforms, also Palu City Platform. In regards to the limitation of resources, knowledges, and skills that these platforms have, PLANAS PRB as a national forum has the mandate to give technical assistance and consultations to them as well as supporting their programs and working mechanisms. It is also important for PLANAS PRB to encourage other provinces and districts/cities in set up their platforms. Nevertheless the works on DRR sectors will never work or success without the contribution and fully participation from the local level.

Looking the another way on children and DRR

    Few days ago, my dearest ex-supervisor asked me to write an article on children and DRR and gave me a day to complete it. i spent hours and hours searching the internet about any information on it, surprisingly nearly or most of the information refers to disaster education in school/children disaster education, formally. i must admitted that education is the main issue and probably the best media to incorporate DRR into it, but i cant stop wondering about those children who out of school or dont have chance to be educated or those who are living in street or even those who live in isolated, small or outer island.
    Children are part of the vulnerable group, yet even in this category, there is also children that are marginalized. It comes to realize me that we must also aware that not all children able to speak, read or write, with the limitation and access that they have, we must also consider various way to promote DRR. i notice that some NGOs create game and fun activities such as story telling and song that enable these children to aware and respond to any disaster signs, but still how far do the activities effectively affect these children in term of their respond mechanism?
    Furthermore, i was browsing to all policies related to children and DRR, until now, i did not find any specific policies that mentioned about children's role in DRR. in Bill Number 23 year 2002 on Child Protection, only stated special protection for children as disaster victims by fulfilling their needs. i am aware about children rights and their needs, but rarely we see them as a subject rather than object, we even rarely heard their voices. i found a good concept which i think can be applied for DRR-Children approach, a concept known as Growing Up in Cities (GUC)/Child Friendly City Initiative (CFC). i know that this concept is an urban context, but with some modification it is also suitable for rural and coastal too. anyway, CFC is the embodiment of the Convention on the Rights of the Child at the local level, which is practice means that children’s rights are reflected in policies, laws, programmes and budgets. In a child friendly city, children are active agents; their voices and opinions are taken into consideration and influence decision making processes (www.childfriendlycities.org). Imigine that the children can participate in the development planning process, can decide what is best for them (in term of education, health, etc), can give their opinion and feedback to government policies, and so on. lets try to think as children rather than adults, we do experiencing our childhood, when the adults rarely heard our opinion, understanding our act and thought. it might a good way to learn more about them and involve them actively into our program, there's no early age for them to understand adults like us, so let's them speak!.