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Izzeldin F. Adam; Tokyo Medical and Dental University

PUBLIC HEALTH IN COMPLEX
HUMANITARIAN EMERGENCIES

By: Adam F. Izzeldin; BPEH, MPH, PhD candidate.
Department of International Health, TMDU

2/6/2014

1
Contents
Izzeldin F. Adam; Tokyo Medical and Dental University

Definitions of public health and emergency
Mission of public health

Types of emergency
Functions of public health in emergency

2/6/2014

2
History of public health
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข The Black death in the 14th
century

โ€ข Edward Jenner 1802
โ€ข John Snow 1854
โ€ข Alexander Fleming (1881 โ€“1955)

โ€ข Robert Koch (1843 โ€“ 1910)
โ€ข Paul-Louis Simond 1898
โ€ข Sir Ronald Ross, (1857 โ€“ 1932)

โ€ข Etc.
2/6/2014

3
What is Public health?
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€œThe science and practice of
protecting and improving
the health of a
community, as by preventive
medicine, health
education, control of
communicable
diseases, application of
sanitary measures, and
monitoring of environmental
hazards.โ€ Medical dictionary
2/6/2014

4
What is Public health?
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€œthe science and art of disease prevention,
prolonging life, and promoting health and
well-being through organized community
effort for the sanitation of the environment,
the control of communicable infections, the
organization of medical and nursing
services for the early diagnosis and
prevention of disease, the education of the
individual in personal health and the
development of the social machinery to
assure everyone a standard of living
adequate for the maintenance or
improvement of health.โ€ (Winslow,1920)
2/6/2014

5
What is your own concept for
public health?
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข From social perspective?

โ€ข From economic perspective?
โ€ข From political perspective?
โ€ข From cultural perspective?

โ€ข Others ?
โ€ข http://www.youtube.com/watch?v=
oQkGx6gRGIY&feature=c4overview&list=UUHlzppBTg2w8Nb
ZOIWbb5Yg
โ€ข http://www.youtube.com/user/ThisI
sPublicHealth
2/6/2014

6
Public health mission
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข The assessment and monitoring of the
health of communities and populations at
risk to identify health problems and
priorities;
โ€ข The formulation of public policies
designed to solve identified local and
national health problems and priorities;
โ€ข To assure that all populations have
access to appropriate and cost-effective
care, including health promotion and
disease prevention services, and
evaluation of the effectiveness of that
care.
2/6/2014

7
Public health system process
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข Public health is always
evaluating the health
of the community.
โ€ข A continuous cycle of
gathering
information, deciding
on effective
solutions, acting, evalu
ating interventions
โ€ข Setting partnerships
and intersectoral
coordination
2/6/2014

8
The Ten Essential Public Health
Functions
Izzeldin F. Adam; Tokyo Medical and Dental University

6. Enforce laws and regulations
that protect health and ensure
safety
7. Link people to needed personal
health services and assure the
provision of health care when
unavailable
8. Assure a competent public
health and personal health care
workforce
9. Evaluate effectiveness,
accessibility, and quality of
personal and population-based
health services
10. Research for new insights and
Public Health Functions Steering Committee, innovative solutions to health
2/6/2014
9
problems
1994
1. Monitor health status to
identify community health
problems
2. Diagnose and investigate
health problems and health
hazards in the community
3. Inform, educate, and
empower people about health
issues
4. Mobilize community
partnerships to identify and
solve health problems
5. Develop policies and plans
that support individual and
community health efforts
Ten great public health achievements
2001-2010
Izzeldin F. Adam; Tokyo Medical and Dental University

1. Reductions in Child
Mortality
2. Vaccine-Preventable
Diseases
3. Access to Safe Water
and Sanitation
4. Malaria Prevention and
Control
5. Prevention and Control
of HIV/AIDS

2/6/2014

6. Tuberculosis Control

7. Control of Neglected
Tropical Diseases
8. Tobacco Control
9. Increased Awareness
and Response for
Improving Global Road
Safety
10. Improved Preparedness
and Response to Global
Health Threats

CDC, Morbidity and Mortality Weekly Report, June 24, 2011.

10
Who are involved in public health ?
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข Many professional disciplines
such as
medicine, dentistry, nursing, opt
ometry, nutrition, social
work, environmental
sciences, health
education, health services
administration, and the
behavioral sciences.

โ€ข

Its activities focus on entire
populations rather than on
individual patients.

2/6/2014

11
Public health network
Izzeldin F. Adam; Tokyo Medical and Dental University

Home Health
Police/ security

Information
communication

Community
Centers

agriculture

Health
Department

Religious
leaders
politicians
Social welfare

Elected
Hospitals
Schools/
Officials Nursing Mass Transit
industries
universities
Homes
Philanthropist
Environmental
Civic Groups
Health
CHCs
Fire/emerg.
Tribal leaders
Economic
Laboratory
Drug
Mental
Employers Development
Facilities
Treatment
Health
2/6/2014

12
Public health and clinical professions
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข Doctors usually treat individual
patients one-on-one for a specific
disease or injury.
โ€ข Public health professionals monitor
and diagnose the health concerns of
entire communities and promote
healthy practices and behaviors to
assure our populations stay healthy.

โ€ข

It has been said that: "Health care is
vital to all of us some of the time, but
public health is vital to all of us all of
the time."
2/6/2014

13
What is emergency?
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข The word disaster implies a
sudden overwhelming and
unforeseen event.
โ€ข At the household level, a disaster
could result in a major illness,
death, a substantial economic or
social misfortune.
โ€ข

At the community level, it could be
a flood, a fire, a collapse of
buildings in an earthquake, the
destruction of livelihoods, an
epidemic or displacement through
conflict.
2/6/2014

14
Public health challenges in emergency
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข In in emergency settings the
mission of public health will be
intensified and more
complicated where :
โ€ข Resources and infrastructure
are destroyed
โ€ข Supply and communication
chains are disrupted
โ€ข Populations are massively
affected
โ€ข Health personnel are often
displaced, assaulted, infected
or injured.
2/6/2014

15
Natural Types of Disasters
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข Agricultural
diseases & pests
โ€ข Damaging Winds
โ€ข Drought and water
shortage
โ€ข Earthquakes
โ€ข Diseases (pandemic
influenza)
โ€ข Extreme heat
โ€ข Floods and flash
floods
โ€ข Hail
2/6/2014

โ€ข Hurricanes and
tropical storms
โ€ข Landslides &
debris flow
โ€ข Thunderstorms
and lighting
โ€ข Tornadoes
โ€ข Tsunamis
โ€ข Wildfire
โ€ข Ice storms
โ€ข Sinkholes
โ€ข volcano
16
Man-Made and Disasters
Izzeldin F. Adam; Tokyo Medical and Dental University

โ€ข Hazardous materials

โ€ข Chemical threat

โ€ข Power service
disruption &
blackout

โ€ข biological
weapons

โ€ข Nuclear power plant
and nuclear blast
โ€ข Radiological
emergencies

2/6/2014

โ€ข Cyber attacks
โ€ข Explosion
โ€ข Civil unrest
โ€ข war

17
Cycle of emergency management
Izzeldin F. Adam; Tokyo Medical and Dental University

2/6/2014

18
Public health in emergencies
Izzeldin F. Adam; Tokyo Medical and Dental University

2/6/2014

19
Functions of Public health in
Emergency Response
Izzeldin F. Adam; Tokyo Medical and Dental University

1. Assess the situation
2. Contact key health
personnel
3. Develop initial health
response plan
4. Communication with
health agencies
5. Address requests for
assistance and
information
6. Risk communication
activities
7. Apprised of legal issues
2/6/2014

8. Collect and analyze data
through surveillance
9. Address the needs of
special populations
10. Organize health-related
volunteers and donations
11. Collaborate with state
and federal on-site
assistance
12. Assess health resource
needs.
13. Document all response
activities
20
Ongoing Public Health
Emergency Response
Izzeldin F. Adam; Tokyo Medical and Dental University

1. Environmental hazard
identification
2. Hazards consultation
3. Epidemiological
services
4. Health and medical
needs assessment
5. Identification of
affected individuals
6. Contamination control
7. Health surveillance
8. Laboratory specimen
collection and analysis
2/6/2014

9. Infectious disease control
8. Quarantine/isolation
9. Public health information
10. Risk communication
11. Responder safety and
health
12. Medical equipment safety
and availability
13. Health-related volunteer
and donation
coordination
14. In-hospital care
15. Evacuation
21
Continued-Ongoing Public Health
Emergency Response
Izzeldin F. Adam; Tokyo Medical and Dental University

1. Sheltering
2. Special populations
needs and assistance
3. Mass trauma
4. Mass fatalities
5. Mortuary services
6. Mental/behavioral health
care and social services
7. Potable water
8. Food safety
9. Vector control and pest
management
2/6/2014

10.Wastewater and solidwaste disposal
11. Building/facility
assessment
12. Sanitation/hygiene
services
13. Continuity of public
health programs/ services
14. Veterinary services
15.Animal rescue/control
16. Long-term community
recovery
22
Conclusion
Izzeldin F. Adam; Tokyo Medical and Dental University

1. Public health is a large field of multi-disciplines
that requires collaborations with other sectors
and intersectoral coordination across health
and medical agencies.
2. Humanitarian emergencies urge the needs for
public health interventions in mitigation,
preparedness, response, and recovery phases
of emergency.
3. Public health emergencies is always evaluating
the needs of vulnerable communities, deciding
on effective health response, providing
recovery for populations and health system
2/6/2014

23
Some references in Public health
emergencies
Izzeldin F. Adam; Tokyo Medical and Dental University

2/6/2014

24
Izzeldin F. Adam; Tokyo Medical and Dental University

Wish you long
life free of
emergencies

2/6/2014

25

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Public health emergencies

  • 1. Izzeldin F. Adam; Tokyo Medical and Dental University PUBLIC HEALTH IN COMPLEX HUMANITARIAN EMERGENCIES By: Adam F. Izzeldin; BPEH, MPH, PhD candidate. Department of International Health, TMDU 2/6/2014 1
  • 2. Contents Izzeldin F. Adam; Tokyo Medical and Dental University Definitions of public health and emergency Mission of public health Types of emergency Functions of public health in emergency 2/6/2014 2
  • 3. History of public health Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข The Black death in the 14th century โ€ข Edward Jenner 1802 โ€ข John Snow 1854 โ€ข Alexander Fleming (1881 โ€“1955) โ€ข Robert Koch (1843 โ€“ 1910) โ€ข Paul-Louis Simond 1898 โ€ข Sir Ronald Ross, (1857 โ€“ 1932) โ€ข Etc. 2/6/2014 3
  • 4. What is Public health? Izzeldin F. Adam; Tokyo Medical and Dental University โ€œThe science and practice of protecting and improving the health of a community, as by preventive medicine, health education, control of communicable diseases, application of sanitary measures, and monitoring of environmental hazards.โ€ Medical dictionary 2/6/2014 4
  • 5. What is Public health? Izzeldin F. Adam; Tokyo Medical and Dental University โ€œthe science and art of disease prevention, prolonging life, and promoting health and well-being through organized community effort for the sanitation of the environment, the control of communicable infections, the organization of medical and nursing services for the early diagnosis and prevention of disease, the education of the individual in personal health and the development of the social machinery to assure everyone a standard of living adequate for the maintenance or improvement of health.โ€ (Winslow,1920) 2/6/2014 5
  • 6. What is your own concept for public health? Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข From social perspective? โ€ข From economic perspective? โ€ข From political perspective? โ€ข From cultural perspective? โ€ข Others ? โ€ข http://www.youtube.com/watch?v= oQkGx6gRGIY&feature=c4overview&list=UUHlzppBTg2w8Nb ZOIWbb5Yg โ€ข http://www.youtube.com/user/ThisI sPublicHealth 2/6/2014 6
  • 7. Public health mission Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข The assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities; โ€ข The formulation of public policies designed to solve identified local and national health problems and priorities; โ€ข To assure that all populations have access to appropriate and cost-effective care, including health promotion and disease prevention services, and evaluation of the effectiveness of that care. 2/6/2014 7
  • 8. Public health system process Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข Public health is always evaluating the health of the community. โ€ข A continuous cycle of gathering information, deciding on effective solutions, acting, evalu ating interventions โ€ข Setting partnerships and intersectoral coordination 2/6/2014 8
  • 9. The Ten Essential Public Health Functions Izzeldin F. Adam; Tokyo Medical and Dental University 6. Enforce laws and regulations that protect health and ensure safety 7. Link people to needed personal health services and assure the provision of health care when unavailable 8. Assure a competent public health and personal health care workforce 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services 10. Research for new insights and Public Health Functions Steering Committee, innovative solutions to health 2/6/2014 9 problems 1994 1. Monitor health status to identify community health problems 2. Diagnose and investigate health problems and health hazards in the community 3. Inform, educate, and empower people about health issues 4. Mobilize community partnerships to identify and solve health problems 5. Develop policies and plans that support individual and community health efforts
  • 10. Ten great public health achievements 2001-2010 Izzeldin F. Adam; Tokyo Medical and Dental University 1. Reductions in Child Mortality 2. Vaccine-Preventable Diseases 3. Access to Safe Water and Sanitation 4. Malaria Prevention and Control 5. Prevention and Control of HIV/AIDS 2/6/2014 6. Tuberculosis Control 7. Control of Neglected Tropical Diseases 8. Tobacco Control 9. Increased Awareness and Response for Improving Global Road Safety 10. Improved Preparedness and Response to Global Health Threats CDC, Morbidity and Mortality Weekly Report, June 24, 2011. 10
  • 11. Who are involved in public health ? Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข Many professional disciplines such as medicine, dentistry, nursing, opt ometry, nutrition, social work, environmental sciences, health education, health services administration, and the behavioral sciences. โ€ข Its activities focus on entire populations rather than on individual patients. 2/6/2014 11
  • 12. Public health network Izzeldin F. Adam; Tokyo Medical and Dental University Home Health Police/ security Information communication Community Centers agriculture Health Department Religious leaders politicians Social welfare Elected Hospitals Schools/ Officials Nursing Mass Transit industries universities Homes Philanthropist Environmental Civic Groups Health CHCs Fire/emerg. Tribal leaders Economic Laboratory Drug Mental Employers Development Facilities Treatment Health 2/6/2014 12
  • 13. Public health and clinical professions Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข Doctors usually treat individual patients one-on-one for a specific disease or injury. โ€ข Public health professionals monitor and diagnose the health concerns of entire communities and promote healthy practices and behaviors to assure our populations stay healthy. โ€ข It has been said that: "Health care is vital to all of us some of the time, but public health is vital to all of us all of the time." 2/6/2014 13
  • 14. What is emergency? Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข The word disaster implies a sudden overwhelming and unforeseen event. โ€ข At the household level, a disaster could result in a major illness, death, a substantial economic or social misfortune. โ€ข At the community level, it could be a flood, a fire, a collapse of buildings in an earthquake, the destruction of livelihoods, an epidemic or displacement through conflict. 2/6/2014 14
  • 15. Public health challenges in emergency Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข In in emergency settings the mission of public health will be intensified and more complicated where : โ€ข Resources and infrastructure are destroyed โ€ข Supply and communication chains are disrupted โ€ข Populations are massively affected โ€ข Health personnel are often displaced, assaulted, infected or injured. 2/6/2014 15
  • 16. Natural Types of Disasters Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข Agricultural diseases & pests โ€ข Damaging Winds โ€ข Drought and water shortage โ€ข Earthquakes โ€ข Diseases (pandemic influenza) โ€ข Extreme heat โ€ข Floods and flash floods โ€ข Hail 2/6/2014 โ€ข Hurricanes and tropical storms โ€ข Landslides & debris flow โ€ข Thunderstorms and lighting โ€ข Tornadoes โ€ข Tsunamis โ€ข Wildfire โ€ข Ice storms โ€ข Sinkholes โ€ข volcano 16
  • 17. Man-Made and Disasters Izzeldin F. Adam; Tokyo Medical and Dental University โ€ข Hazardous materials โ€ข Chemical threat โ€ข Power service disruption & blackout โ€ข biological weapons โ€ข Nuclear power plant and nuclear blast โ€ข Radiological emergencies 2/6/2014 โ€ข Cyber attacks โ€ข Explosion โ€ข Civil unrest โ€ข war 17
  • 18. Cycle of emergency management Izzeldin F. Adam; Tokyo Medical and Dental University 2/6/2014 18
  • 19. Public health in emergencies Izzeldin F. Adam; Tokyo Medical and Dental University 2/6/2014 19
  • 20. Functions of Public health in Emergency Response Izzeldin F. Adam; Tokyo Medical and Dental University 1. Assess the situation 2. Contact key health personnel 3. Develop initial health response plan 4. Communication with health agencies 5. Address requests for assistance and information 6. Risk communication activities 7. Apprised of legal issues 2/6/2014 8. Collect and analyze data through surveillance 9. Address the needs of special populations 10. Organize health-related volunteers and donations 11. Collaborate with state and federal on-site assistance 12. Assess health resource needs. 13. Document all response activities 20
  • 21. Ongoing Public Health Emergency Response Izzeldin F. Adam; Tokyo Medical and Dental University 1. Environmental hazard identification 2. Hazards consultation 3. Epidemiological services 4. Health and medical needs assessment 5. Identification of affected individuals 6. Contamination control 7. Health surveillance 8. Laboratory specimen collection and analysis 2/6/2014 9. Infectious disease control 8. Quarantine/isolation 9. Public health information 10. Risk communication 11. Responder safety and health 12. Medical equipment safety and availability 13. Health-related volunteer and donation coordination 14. In-hospital care 15. Evacuation 21
  • 22. Continued-Ongoing Public Health Emergency Response Izzeldin F. Adam; Tokyo Medical and Dental University 1. Sheltering 2. Special populations needs and assistance 3. Mass trauma 4. Mass fatalities 5. Mortuary services 6. Mental/behavioral health care and social services 7. Potable water 8. Food safety 9. Vector control and pest management 2/6/2014 10.Wastewater and solidwaste disposal 11. Building/facility assessment 12. Sanitation/hygiene services 13. Continuity of public health programs/ services 14. Veterinary services 15.Animal rescue/control 16. Long-term community recovery 22
  • 23. Conclusion Izzeldin F. Adam; Tokyo Medical and Dental University 1. Public health is a large field of multi-disciplines that requires collaborations with other sectors and intersectoral coordination across health and medical agencies. 2. Humanitarian emergencies urge the needs for public health interventions in mitigation, preparedness, response, and recovery phases of emergency. 3. Public health emergencies is always evaluating the needs of vulnerable communities, deciding on effective health response, providing recovery for populations and health system 2/6/2014 23
  • 24. Some references in Public health emergencies Izzeldin F. Adam; Tokyo Medical and Dental University 2/6/2014 24
  • 25. Izzeldin F. Adam; Tokyo Medical and Dental University Wish you long life free of emergencies 2/6/2014 25

Editor's Notes

  1. Most disasters result in the inability of those affected to cope with outside assistance
  2. Most disasters result in the inability of those affected to cope with outside assistance
  3. Most disasters result in the inability of those affected to cope with outside assistance
  4. Most disasters result in the inability of those affected to cope with outside assistance
  5. The mission of public health is to "fulfill society's interest in assuring conditions in which people can be healthy." The three core public health functions are:
  6. Most disasters result in the inability of those affected to cope with outside assistance
  7. There are many distinctions that can be made between public health and the clinical health professions
  8. Most disasters result in the inability of those affected to cope with outside assistance