Technical Guidelines

Training of community health workers

Information Sheet for Health Facilities in Emergencies

Health workers must be able to perform critical roles and responsibilities in emergencies. Emergencies, disasters and crises translate into extraordinary working conditions for the health workforce. Routine procedures must be temporarily put aside and emergency procedures quickly ramped up. The ability to provide health services, both at the site of an emergency, in the health facility and in the community requires health workers to assume new roles and responsibilities.

Health facilities are not only providers of in-facility services during major emergencies but also provide qualified healthworker staff who are sent to out to contribute to the management of patients in the pre-hospital phase. The focus is usually on training these qualified medical and paramedical staff to be integrated into response teams (e.g. disaster teams for triage and management of medical emergency; hazardous materials teams, search and rescue teams). Specialized medical teams are highly useful to:

Health Facility Emergency Response Planning

Information Sheet for Health Facilities in Emergencies

Health facility emergency response must address two basic types of emergencies: 

  • A community emergency: where there is an emergency in the community which requires and immediate response to reduce morbidity and mortality
  • An internal emergency: where the emergency has occured within or to the health facility itself

In both situations the health facility's resources ofthen become overwhelmed and normal procedures will need to be adapted to cope.  

Emergency response planning must take into account each of the roles and responsibilities, which a health facility  may have to undertake in an emergency.  In addition, health facilities in an area affected by a sudden emergency (such as a transport crash, an earthquake or an explosion) should anticipate receiving a wide range of casualties who may arrive very quickly.  A health facility must, therefore, be able to react rapidly as well as appropriately. The health facility must be able to maintain its essential functions and services while also fulfilling its role in an emergency or disaster.

Special considerations for chemical emergency

Information Sheet for Health Facilities in Emergencies

Chemical production and use is continuously increasing worldwide and accounts for approximately 7% of global income and 9% of international trade. More and more chemicals are being produced and/or used in developing countries that are often lacking capacities for their sound management (including toxic waste disposal). Incidents and emergencies involving toxic chemicals happen frequently. Recent events have been witnessed in all parts of the world, including natural events (e.g. capsized ferry boat transporting pesticides during tropical storms in the Philippines; damaged chemical installation, Sichuan earthquake in China) and technological disasters (the Songhua river accident, China and the Buncefield fire, UK) and disease outbreaks (e.g. mass bromide poisoning, Angola; mass lead poisoning, Senegal):

Infection prevention and control:

a key consideration for preparedness of health facilities for communicable disease emergencies

Information Sheet for Health Facilities in Emergencies

The emergence and re-emergence of severe communicable diseases, such as SARS and avian flu and the threat of an influenza pandemic among other situations, highlight the need for effective emergency preparedness, including contingency planning for communicable disease crises in health care settings. Although during epidemics the buildings are not primarily affected, health care settings may face major challenges maintaining regular services and providing safe care for patients, health care workers and visitors.  During epidemics there may be considerable disruption of health care services generated by a widespread societal crisis (e.g. coordination, communications, chains of supplies, transport), increased demand for care services (i.e. sick patients and suspect cases), and sometimes a decreased workforce (e.g. absenteeism due to illness or the need to take care of relatives, fear of being exposed to a life-threatening communicable disease).

Developing partnerships between health facility and the community

Information Sheet for Health Facilities in Emergencies

  • Health facilities are critical community assets in every emergency situation. They are at the interface between the community and the health sector (public and private) and perform many different functions, such as contributing to:
  • critical care delivery for patients in disasters and for acute patients of routine emergencies (including obstetrical emergencies), supported by technical services such as laboratories and pharmacies
  • public health programmes in emergency and non-emergency situations
  • the vulnerability and capacity assessment of hospital or health facility, the health system and the community,
  • the development of emergency risk management systems, in particular, health and intersectoral response systems;  
  • surveillance systems and health information systems
  • public information (including risk communication).


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