BACKGROUND:

Nepal is ranked as one of the most disaster prone countries in the world. The country suffers from a range of geophysical and hydro-meteorological hazards with the loss of hundreds of lives. Nepal is in the most seismically active regions in the world, the risk of a major earthquake always looms large on the country and is ranked 11th in terms of risk from earthquake and 30th in terms of flood risk (global report on disaster risk, 2003). Earthquake, floods, landslides, lightning, Glacial Lake Outburst Flood (GLOF), avalanche, epidemics often occur causing enormous physical damages and losses of human lives. Annually, the country suffers from a range of geophysical and hydro-meteorological hazards with the loss of hundreds of lives. Being one of the most seismically active regions in the world, the risk of a major earthquake always looms large on the country.

The main responsibility of HEOC will be to coordinate with the NEOC at all times for any health related disaster response. For example, in a mega disaster, NEOC will be the commanding center with high level committee including Secretary from the Ministry of Health and Population. In case there is any need for health related human resources, materials or hospitals, then the Health Minister / MoHP will call HEOC for data on any health related resources and if required will mobilize it in coordination with NEOC.

Current assessments on the seismic vulnerability of the capital city (Kathmandu Valley) suggest that occurrence of intensity IX earthquake would result in 100,000 deaths, 300,000 injured, and more than 1.5 million people displaced. One of the most devastating earthquakes in the recent past (1934: magnitude 8.4) caused serious damages to around 60% of the buildings and killed 8519 people, out of which 4269 were from the Kathmandu Valley – capital of the country (SAARC Workshop Report on Earthquake Risk Management 8-9 October 2009). Moreover, various seismic assessment conducted by Ministry of Health and Population (MoHP), WHO and other highlighted that 80% of the health facilities demonstrated weakness in their physical infrastructure which will lead to the interruption of critical and lifesaving medical intervention during and immediately after emergency. Such numbers pose a critical challenge to the health services of the country, equally in rural and urban context.

 

HEALTH EMERGENCY OPERATION CENTRE (HEOC):

Coordination and information management becomes a major challenge in the event of or immediately following a large scale disaster in Nepal. To address this issue, Ministry of Health and Population (MoHP), in 2012, decided to establish HEOC within the MoHP premises.

HEOC will operate under Secretary and function as a secretariat of Ministry of Health and Population during health emergencies and disasters; also act as a high level operational center for the MoHP’s various divisions, such as Department of Health Services particularly Epidemiology and Disease Control Division. The HEOC operates and function as a high level operational command center for the MoHP. The center hosts necessary resources and data for effective coordination of response in emergencies. During emergency, the center functions 24/7 with trained and dedicated staff. It is equipped with communication and information management infrastructure including landline, cellular and satellite telephones, internet, radio frequency based wireless sets; television, computers etc.

The HEOC became the nerve center for coordination of the health sector response to the Nepal Earthquake 2015. The lesson learnt conference for health sector response to Nepal Earthquake 2015 has clearly highlighted the importance of the HEOC during response and led to recommendations for the establishment of such centers at the sub-national level for effective decentralized preparedness and response coordination. The then Health Minister requested WHO, during his WHA participation in 2015, for establishing such HEOCs in each region in Nepal.

To the immediate response and management of health related implications of any disaster, the HEOCs will play a pivotal role in facilitating and maintaining operational linkages between Health sector multi-hazard preparedness and response mechanism and with the existing and emerging institutions/ mechanisms for community, province and the central level disaster management initiatives in other sectors.

HEOCs while discharging the key mandate of operational coordination during emergency will also during the non-emergency periods, build on and facilitate the implementation of policies and strategies develop and update planning tools, database etc for multi-hazard health sector emergency risk assessment, risk mitigation, preparedness, and response readiness. After the response period, the HEOC will undertake after-action reviews, facilitate and document learning, update plans, strategies and tools; and coordinate and monitor the implementation of recovery interventions.

The main responsibility of the HEOC is to act as information repository in the respective provinces and to maintain horizontal coordination health sector partners and with other sectoral EOCs to collect and analyze data, make decisions that protect life and property, maintain continuity of MoHP interventions, within the scope of applicable laws and disseminate those decisions to all concerned agencies and individuals. To maintain the HEOC database and information portal, HEOC at the central level will coordinate with NEOC, PHEOCs, MoHP (Divisions, Centres and Departments), Central Referral Hospitals, Health Sector and External Development Partners to collect and update the information portal. Provincial HEOC will coordinate with the Provincial EOCs, health sector and external development partners, hub and satellite hospital networks, regional, sub-regional, zonal hospitals and medical colleges to maintain the coordination and collect information for timely response to any disaster caused by variety of hazards – biological, climatological, geological and man-made.

 

Regular activities

The overall functions of all HEOC is to collect, gather and analyze data; make decisions that protect life and property, maintain continuity of the Ministry, within the scope of applicable laws; and disseminate those decisions to all concerned agencies and individuals. The specific function of HEOC will include:

 

Terms of Reference (ToR)

Health Emergency and Disaster Management Unit

  1. To work as a secretariat of Ministry of Health and Population during health emergencies and disasters
  2. To work with the National Disaster Management Center under the Ministry of Home Affairs and other related bodies as a health sector center point.
  3. During health emergencies and disasters; coordination with the National Disease Control Center for rapid response.
  4. To work as a central communication body with the provincial and local level during health emergencies and disaster.
  5. Operating necessary assistance by coordinating with the affiliated international bodies, non-governmental organizations and organizations during emergency and disasters.
  6. Necessary coordination with the Hub and satellite hospital networks to facilitate service during emergencies and disasters.
  7. Collect, store database or data relevant to health disaster.
  8. To coordinate with the National Disease Control Center for Criteria Determination and capacity development.