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ASEAN Leaders’ Declaration on Disaster Health Management (ALD on DHM) (2019-2025) was adopted by the ASEAN Summit in November 2017 to strengthen the DHM system at national and regional levels, and the Plan of Action (POA) to implement the ALD on DHM was endorsed by the ASEAN Health Ministers Meeting in August 2019. Knowledge Management (KM) is one of the five priority areas in the POA with the relevant targets including the regional academic network establishment, organization of regional academic conferences, publication of the ASEAN academic journal on DHM, and so forth. The ARCH Project Phase2 (ARCH2), which started in January 2022, focuses on aiming to support implementation of this POA.
The ARCH2 will support the establishment of the ASEAN Academic Network on DHM (AAN-DHM) and the ASEAN Institute for DHM (AIDHM). In addition, the ARCH2 will support the promotion of academic activities on DHM which shall be conducted under the AAN-DHM in collaboration with the AAN member institutes and AIDHM.
Terms of Reference (TOR) of AAN-DHM was endorsed by the 15th ASEAN Health Ministers Meeting in May 2022. Afterward, the National Focal Point (NFP) institutes for the AAN were nominated among all ASEAN Member States (AMS). The first meeting of representatives of the NFP was held in September 2022 to discuss several areas such as governance of the AAN-DHM, the organization plan for the ASEAN Academic Conference (AAC), and the publication plan of the ASEAN Journal. Simultaneously, the TOR of the AIDHM was prepared for further discussion of its establishment.
The AAN has already been established to initiate the preparation of its academic activities. The AAC on DHM is scheduled to be held in November 2023 in Indonesia as the first regional event for accelerating academic activities toward enhancing KM on DHM in the region under the AAN-DHM.
Knowledge management on Disaster Health Management (DHM) is one of the priority areas in the Plan of Action to implement the ASEAN Leaders’ Declaration on DHM (POA/ ALD DHM) (2019-2025). The Japan International Cooperation Agency (JICA) has been implementing the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) since 2016 to assist the ASEAN region in strengthening coordination capacity on DHM. A regional training course on DHM for ASEAN member states (AMS) in Japan was proposed to be implemented in 2022 as a JICA’s Knowledge Co-creation Program (KCCP).
The training curriculum of the KCCP included emergency and disaster medicine in Japan, international trends on DHM, and underwent reviews by AMS representatives of the ARCH Project. Prior to the training, participants were required to prepare country reports (CRs) outlining information on legislation, system and structure related to emergency and disaster medicine, as well as systems to receive international emergency medical teams (I-EMTs).
The four-week KCCP course contained a trial implementation of a four-day training program for receiving I-EMTs and coordination among stakeholders in ASEAN disaster response, based on the regional standard curriculum developed by the ARCH Project, and invited experts in DHM not only from Japan but also from AMS as instructors. Participants analyzed and identified challenges on DHM in their countries, and developed draft action plans (APs) to improve the situation through the knowledge obtained from the program.
The draft APs, the training deliverables, will be shared with the ARCH Project, and used to build a support mechanism to achieve national level targets of the POA/ ALD DHM, and the progress will be reflected in the CR in the subsequent year. The KCCP on DHM is expected to facilitate knowledge sharing in AMS and Japan, and contribute to fostering the culture of mutual learning.
The Standard Operating Procedure for Coordination of Emergency Medical Teams in ASEAN (EMT SOP) was developed to facilitate the swift deployment of I-EMTs by ASEAN Member States (AMS) to disaster-affected countries in the ASEAN region and to effectively provide appropriate medical services to the affected population. It is one of the various products and activities by the ARCH Project, which was implemented in collaboration between ASEAN and Japan from 2016 through 2021. The EMT SOP was developed in line with the WHO EMT Initiative, and various WHO forms have been incorporated as ASEAN official forms for the management and coordination of I-EMT.
On the other hand, disaster management in ASEAN is conducted by National Disaster Management Organization (NDMO) of each AMS under the coordination of the ASEAN Coordinating Centre for Humanitarian Assistance on disaster management (AHA Centre) in accordance with the Standard Operating Procedure for Regional Standby Arrangements and Coordination of Joint Disaster Relief and Emergency Response Operations (SASOP), the sole official document for ASEAN regional collaboration in disasters, and AMS I-EMTs are required to follow the SASOP for their deployment to the affected AMS.
Discussions were held between the NDMOs and MOHs, and a table-top exercise to test the EMT SOP was conducted involving NDMOs and MOHs with the facilitation of the AHA Centre.
The EMT SOP has been incorporated as an additional chapter of the SASOP.
The institutionalization of the EMT SOP is an important milestone in strengthening the ASEAN regional cooperation mechanism on disaster management.
The Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) developed Regional Collaboration Drills (RCDs) and is proposing an ASEAN Academic Network to strengthen capacity in disaster health management (DHM) in ASEAN Member States (AMS), as well as developing a standard training curriculum in DHM. This study aims to clarify the impacts and sustainability of the ARCH Project.
The four previous RCDs and the enhancement of academic activities were reviewed.
The ARCH Project developed the RCDs with simulation exercises based on possible disaster scenarios in each host country to test and validate the capacity of AMS International Emergency Medical Teams (I-EMTs), the Standard Operating Procedure (SOP) for I-EMT coordination, and regional tools, as well as the relevant domestic SOPs of the host countries for receiving international assistance. Following the RCD in Thailand, three AMS: Viet Nam, Philippines, and Indonesia, all of which are considered disaster-prone, successfully hosted RCDs with significant improvements. The project also established a sub-working group (SWG) to develop a standard curriculum in DHM. Two curricula developments, the Basic Course on DHM and In-Country Course for Coordination on EMTs, are on-going as part of the project activity. The establishment of the ASEAN Academic Network and the ASEAN Institute for DHM (AIDHM) are currently in the endorsement process of the ASEAN health sector.
The RCDs are very effective to test and to validate the SOP and regional tools developed, providing opportunities for AMS I-EMT to familiarize the tools, as well as for host countries to assess their coordination capacity for receiving international assistance and identifying the country’s specific challenges, and verifying ASEAN regional coordination mechanism. The development of the standard curriculum can enhance regional capacity both in supporting disaster-affected countries and in receiving international assistance. A sustainable capacity development mechanism in DHM is envisaged through the establishment of the ASEAN Academic Network and AIDHM toward the goal of One ASEAN One Response.
This report tries to capture the impact of the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) in each ASEAN Member State (AMS) and Japan as a result of the ARCH Project implementation since July 2016.
Impact on AMS: The analysis of the impact on AMS was based on a comparison of the impact of the project on management and coordination of Emergency Medical Teams (EMTs), and application of the project outcome in actual emergency operations compared to the previous status in each AMS.
Impact on Japan: The history of the development of disaster medicine in Japan was reviewed, with an aim to analyze the impact of supporting AMS through the ARCH Project on Japan, and the possibility of bi-directional cooperation in the future.
Impact on AMS: Since the initiation of the ARCH Project, AMS has made significant progress in WHO EMT accreditation, strengthening EMTCC capacity for receiving international assistance, as well as the development of legislation or strategic plans related to DHM, and application of the Project products such as standard operating procedures or regional tools in actual disasters/emergencies.
Impact on Japan: Disaster medicine in Japan originated from the Cambodian refugees’ relief mission in 1979. Since then, the management system has been strengthened including the foundation of the Japan Disaster Relief (JDR) Team, a structure with a legal foundation. The experience gained through international operations has contributed to the development of Japan’s domestic disaster response system. Japan learned the operational effectiveness of the post-disaster health surveillance system through the disaster response operation in 2013 Typhoon Yolanda Disaster in Philippines and introduced a modified system in Japan for domestic disaster response, which was later refined and proposed for an international standard.
ARCH Project is highly appreciated by AMS as the opportunity to share knowledge and experience among countries and thereby contributing to achieving the “One ASEAN, One Response” concept, as well as the driving force for each AMS to develop its capacity in DHM. While the ARCH Project started to support AMS to strengthen its regional capacity in disaster health management, it is important to build a bi-directional relationship between ASEAN and Japan in terms of mutual learning and support to tackle future disasters.
Southeast Asia is the second biggest region in the world in terms of the total number of natural disasters since 1900. Therefore, the Association of Southeast Asian Nations (ASEAN) initiated regional challenges toward strengthening regional collaboration for disaster prevention and response since the earthquake of Sumatra in Indonesia occurred in 2004. Moreover, ASEAN Leaders signed “the ASEAN Declaration on One ASEAN, One Response” in 2016. Under these circumstances, ASEAN decided to implement the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project).
The objective of the ARCH Project is to strengthen coordination on disaster health management (DHM) for rapid and effective response to disasters occurring in the ASEAN region and to enhance the capacity of each ASEAN Member State (AMS) on DHM. This article aims to overview the outline and its strategy, and review the progress of the project.
ARCH Project is an ASEAN official project supported by Japan’s official development assistance. Five outputs were launched for: (1) coordination platform on DHM; (2) framework of regional collaboration practices; (3) tools for effective regional collaboration; (4) enhancement of academic network on DHM; and (5) capacity development activities for each AMS. The Project was reviewed in terms of accomplishment and evaluation criteria.
Regional Coordination Committee on DHM was established as a coordination platform to: Oversee the implementation of the ARCH Project for the Output 1; Regional Collaboration Drill was developed and conducted for the Output 2; The standard operating procedure for coordination of emergency medical teams (EMTs) in ASEAN was developed for the Output 3; Various presentations on ARCH were made in academic conferences for the Output 4; and Several training programs and educational curricula were developed for the Output 5. The Project has accomplished its Project Purpose and satisfied all the indicators set. ARCH Project has high Relevance, Impact, Sustainability, and Effectiveness, while some improvements in Efficiency are needed.
ARCH Project is the first-ever successful regional cooperation mechanism and standardization of DHM in ASEAN, one of the most disaster-prone regions. It also contributes to the capacity building of AMS. The ARCH Project has a remarkable impact on the resilience and flexible medical response to disasters, although continuous efforts of stakeholders to make this initiative sustainable are necessary.
This paper aims to clarify how the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) strengthened regional collaboration mechanisms on disaster health management (DHM) in ASEAN.
The political process and the relevant documents of the ARCH Project were reviewed.
The ARCH Project established the Regional Coordination Committee as a coordination platform for providing strategic direction to the project and strengthening the regional coordination of DHM. Also, the Project Working Groups and Sub-Working Groups were set up as implementation bodies for the project activities with representatives of ASEAN Member States (AMS). With support from DHM experts of Japan and Thailand, a series of discussions were conducted for the development of a Standard Operating Procedure (SOP) for the Coordination of International Emergency Medical Teams (I-EMTs), regional tools, and collective measures supporting AMS to overcome challenges, and thereby meeting the minimum requirements set by the WHO EMT Initiative. The progress and outputs of the ARCH Project are subsequently elevated to the ASEAN Health Sector for endorsement, the updates are further shared to the Joint Task Force to Promote Synergy with Other Relevant ASEAN Bodies on Humanitarian Assistance and Disaster Relief (JTF-HADR) for the implementation of the ASEAN Declaration on One ASEAN One Response. The initiation of the ARCH Project in July 2016 has resulted in the development of the ASEAN regional collaboration framework, including the establishment of the Regional Coordination Committee on Disaster Health Management (RCCDHM), the SOP for ASEAN I-EMT coordination, and regional tools, such as forms for Medical Record for Emergency and Disaster and Health Needs Assessment. Moreover, further discussions on ASEAN Collective Measures that aim to support AMS to meet the WHO EMT minimum standards and strengthening I-EMT coordination capacity were also conducted. As adopted by the ASEAN Health Ministers Meeting (AHMM) in 2019, the RCCDHM was established as one of the mechanisms to operationalize the Plan of Action to implement the ASEAN Leaders’ Declaration on DHM.
The contribution of the ARCH Project to strengthen the ASEAN regional capacity in DHM has enhanced the regional coordination platform, with a formalization of RCCDHM as ASEAN’s official regional mechanism, and of the on-going integration process of the SOP for EMT coordination into the ASEAN SASOP.
The Project for Strengthening the Association of Southeast Asian Nations (ASEAN) Regional Capacity on Disaster Health Management (ARCH Project) is the project under the collaborative framework between the National Institute for Emergency Medicine, Thailand, Ministry of Public Health, and Japan International Cooperation Agency. The project aims to strengthen disaster health management focusing on the International Emergency Team (I-EMT) operation and coordination in ASEAN by using various mechanisms, for example, regional collaboration meeting, regional collaboration drill, training, etc.
The study aims to evaluate the outcomes which ARCH Project’s activities have been facilitating to strengthen the ASEAN disaster health management.
A comparative study is utilized to see the improvement of the ASEAN disaster health management of the current situation and the project’s outputs compared to the previous survey in 2015.
Recent ASEAN disaster health management has been strengthened in three distinctive dimensions: (1.) national capacity of each ASEAN Member States is being strengthened through the project’s training courses; (2.) the ASEAN I-EMT coordination platforms have been set up to the extent that the progress of developing the toolkits such as the Standard Operating Procedures for the Coordination of EMT in ASEAN is at its eighty percent, while the Database of the EMT and their Minimum Requirements and Qualifications are now at its ninety percent; and (3.) Standard reporting forms (medical record and health need assessment form) for all ASEAN member state (AMS) has been developed and fully completed.
The ARCH Project has been facilitating the strengthening of the ASEAN disaster health management through its capacity building endeavors and the creation of collaborative mechanisms for operations and coordination. These activities should be maintained either under the existing or newly created mechanisms in order to build a sustainable collaborative framework.
The Minimum Data Set (MDS) developed by the World Health Organization (WHO) has been widely used among medical practitioners in International Emergency Medical Team (I-EMT) as tools to collect health information and statistics in disaster health management. The I-EMT submits MDS to the Emergency Medical Team Coordination Cell (EMTCC) for the planning of responses. The Project for Strengthening the Association of Southeast Asian Nations (ASEAN) Regional Capacity on Disaster Health Management (ARCH Project) is the ASEAN’s project that has applied MDS to its activities with the main purpose of strengthening informational management during a disaster.
The study aims to evaluate the performance of MDS after being utilized in the Regional Collaboration Drill (RCD) organized by the ARCH Project in July 2017.
The performance of MDS has been evaluated by ten International Emergency Medical Team (I-EMT) of ASEAN Member States who participated in the RCD.
The assessment forms were returned by ten I-EMTs, and all respondents addressed several points for the revision of MDS (10/10), including the format and the content of the MDS. Concerning the format, respondents stated that the fonts are too small (3/10), and spaces for recording additional information are needed (3/10). On the other hand, the majority of respondents suggested that some of the contents within the MDS are still unclear or some terminologies are needed to be further clarified (6/10), especially with the referral form (5/10).
The current version of the MDS utilized for the EMT coordination should be edited and revised for its optimal usage. Applying MDS to disaster simulation is an efficient approach to test its application.