Indonesia: Improving health services during emergencies

When Mount Merapi in Central Java, Indonesia, erupted in October 2010, the lava flows and ash plumes hit many people unprepared. Around 350 000 people who lived on the slopes of the volcano within a radius of 10 km were evacuated to emergency shelters. But because they refused to leave their homes or returned while the eruptions were still continuing, more than 300 people were killed during the disaster.

Indonesia with more than 17 000 islands is sitting on the so-called "ring of fire" of the Pacific, Eurasian and Australian tectonic plates and is one of the world's most disaster-prone countries. The archipelago is frequently hit by floods, earthquakes, volcano eruptions, tsunamis, storms and landslides. It is also at risk of man-made disasters such as mudslides, as well as chemical and nuclear accidents. In addition, Bali, Indonesia's favourite tourist destination, has been a target of terrorist attacks in the past.

"Most of the disasters cannot be predicted but we learned our lesson from past experiences and are much better prepared today," says Dr Lies Untari, the focal person for Emergency at the Tebet Community Health Centre. "The local centres are on a 24-hour alert and have all the necessary material including for example boats, medicines and generators on stock, ready for deployment at any time."

Including crisis prevention in development planning

Disaster risk reduction is a high priority for the Indonesian Government. As disasters have the potential to stop and even reverse a country's development in its tracks, Indonesia has integrated crisis prevention, emergency response and recovery measures into its development planning and budgeting.

Already in 2007, the government adopted a Disaster Management Law that made disaster risk reduction activities mandatory. Supported by WHO and other agencies, the Government has since expanded its emergency preparedness and response programme. A National Disaster Management Agency coordinates the response to all disasters and produces risk maps for many provinces. Within the Ministry of Health, the Centre for Health Crisis Management was established and designated a WHO Collaborating Centre for Training and Research on Disaster Risk Reduction in 2012 due to its extensive knowledge and experience in emergency risk management.

"We hope that the training and research conducted by the Collaborating Centre will provide Indonesia with more evidence and innovative solutions, enabling this high-risk country to better protect its people from disasters," says Dr Khanchit Limpakarnjanarat, the WHO Representative in Indonesia.

Engaging with communities

To ensure immediate health assistance in case of an emergency, WHO supported the Ministry of Health to create 9 regional centres across the country.

"The main goal was to bring health services closer to the affected population," explains Dr Indro Murwoko from the Centre for Health Crisis Management. "The regional centres were established to overcome some of the typical obstacles that often delay assistance, such as destroyed infrastructure, disrupted communications and lack of resources."

In recent years, the Government is focusing more on disaster prevention and damage mitigation. To increase resilience to natural disasters within the mainly rural communities, the Ministry of Health is engaging with community health centres. It revitalized for example Alert Village, a government programme to promote healthy living that was introduced in 2006. Today, this programme teaches young people how to deal with disaster and trains them in basic skills, including first aid, so that when disaster happens they know how to save themselves and their families.

When Mount Merapi became active again in December 2013 and started to spew ashes and volcanic material, the residents living on the slopes of the volcano immediately gathered at designated assembly points. All people were evacuated on time and were able to go back home after the situation had returned to normal.

source: www.who.int