Tabletop exercise is aimed to direct the discussion towards the depiction of how the surveillance should be performed after the disaster. The previous experience shows that the condition after disaster has allowed the disease development. Surveillance is the main way to perform early identification towards the diseases which has potential growth into WABAH, in addition, it gives advantages as a response to anticipate the diseases, to establish the planning and evaluation.

Objectives

After performing such exercise, the participants would be able to overcome the problems of after disaster surveillance.

•  Basic competency for compiling after disaster surveillance system until resulting disease data for surveillance :

1. To acknowledge the purposes of after disaster disease surveillance
2. To acknowledge that occurring disaster may cause communicable diseases
3. To describe kinds and causes of disease which have potential increasing cases after disaster
4. Compiling the disease list for after disaster surveillance data based on the group of causes

•  Preparing the requirements, instruments, the implementation of after disaster surveillance and closing it :

1. Compiling the requirement list for after disaster surveillance implementation
2. Determining when the surveillance should be ended

•  The difficulties during after disaster condition and the correct analysis for surveillance data :

1. To identify the kinds of health problems and kinds of difficulties in after disaster surveillance performance based on kinds of disaster affects
2. To identify the correct analysis methods towards after disaster data

•  Conclusion, recommendation and POA :

• Providing recommendation according to the threats in working area

Earthquake was occurred at 5.53 A.M in 5.9 Richter's Scale. The epicenter, earthquake center was approximately at 33 kilometers below, nearly close to the inhabitant residents. Many buildings were affected followed by various kinds of minor, medium, major of damages. Soon after it was followed by mechanical physical damages and injuries or hundreds of thousands of inhabitants. Sudden instant deaths were everywhere. Damages were also affected the health service buildings located at around the epicenter or even further. The basic public facilities such as electricity, water, telecommunication and transportation were severely damaged. Well remaining health center buildings and makeshifts were fully occupied with patience then soon after providing immediate medication after disaster. Medication procedures were being shortened conducted by limited number of health professional and instruments.

Due to the affect of aftershocks and pieces of building drops, nurses and patients in the wards were removed to the ground yards, corridors, and other open spaces in hospital. The earthquake victims occupied the hospitals with family as well as the relatives, the volunteers and medical staffs. Medical activities and responses in the hospital were more likely chaotic and far from being sterilized.

Supporting aids form other regions were soon reached the health centers in the evening. With a large number of victims, the medical responses then increasingly needed. Victims with minor injuries who should not stay in the hospital were mostly chose to stay in the hospital (since they have lost their houses) with their families and relatives. The victims were placed on bed or emergency mattress. Personal physical needs such as urinating and defecating of the family and their relatives could not be done in orderliness as it was in normal condition.

Question

1. What kinds of information must be gathered as the database for the needs of surveillance and how the methods should be applied to gather such information?
2. What kinds of diseases should be listed in the after disaster surveillance monitoring system?

Medical emergency statement remained. The treatment for victims directly affected by disaster had been the major priority as it affected a large number of people. Emergency medical supports began to be continuously given from all sources of community, supporting institutions, and government elements. The support included the daily basic needs, first aid support for disaster affects, and physical biological needs such as consuming foods, drinks, and body protection aids (tents, blankets, mattress). In many places, temporary shelters were built, however many supporting facilities for daily activities (public toilets, clean water, public kitchen) had not made. The conditions of common diseases were decreasingly being complained in healthcare center. Since the first day retriage was done. Condition monitoring given to the patients.

Questions

1. What are kinds of potential diseases occurred in the second day?
2. What kinds of medication should be performed in order that surveillance system may support the need of information after such disaster ?
3. How was the system applied to gain information and responding quickly when extraordinarily potential disease were found in public?

Emergency medical responses were given to the victims. There were many injured victims who have not gained any medical responses the immediately were delivered to the healthcare posts. Medical support units began to work both in healthcare posts or places like clinic or emergency hospital.

Polly clinic in health center could not perform its normal medical function. The administration and reportage function could not either. The efforts for listing the disease cases were conducted accordingly. There was actually some awareness towards the needs to record and report frequently. In this case, in fact different opinions occurred upon what kinds of diseases should be recorded and reported daily; all kinds of disease, or certain ones and which the certain one is.

Moreover, with increasing number of emergency medical service spots located in the remaining health care buildings and inhabitants' temporary residents, health centers and health staffs were not able to cover them all. In addition, all the healthcare centers were using the recording methods according their own habits.

FETP of UGM in cooperation with WHO and Provincial and District Health Office were involved in the joint design or in the surveillance implementation into the analysis.

Until the day 7, the disease list for after disaster surveillance has not been decided. The disease data collected was only data of common diseases in which it became a burden during disaster condition since the number of diseases was too large.

In day 8, Health Centers Head was not able to perform some medical duties. There was an awareness to acknowledge the development of diseases around the Health Clinic territory as well as its various medical supporting unit, however more supporting staffs are highly needed to collect data.

Questions

1. What is the correct method should be applied to implement such surveillance system?
2. When should the after disaster surveillance be ended? What are the criteria should be used?

The efforts to decide the kinds of disease for after disaster surveillance remained in the progress. It was due to the opinion differences upon the importance of disease data. One side required a complete data, while others required short ones in which other thought they were incomplete. There was also a willingness to use certain software. In the mean time, tetanus case has shown a significant increase.

Question

1. Could the list of typical diseases caused by certain disaster be made? What should we know about the implications of surveillance implementation?

2. What analysis should be applied upon the surveillance data ?

The important reason points of surveillance are: what the advantages of after disaster surveillance are for, how they are compiled, how it must be conducted, who does it, what are the instruments.

What the kinds of process of after disaster surveillance should be done best so it could contribute a well disaster response, etc. other recommendation matrix for region can be arranged as follow :