(P1-80) Issues and Challenges in Preparedness and Response to Infectious Public Health Emergencies in Hospitals of Developing Countries

Abstract

India has witnessed many major infectious public health emergencies (PHE) during 21^st century. They include outbreaks of Severe Acute Respiratory Syndrome (SARS) 2002–03, avian flu in 2006, chikungunya in 2006–07, and the H1N1 pandemic in 2009. Periodic dengue and Japanese Encephalitis epidemics also are common. The premier institute of the country, PGIMER Chandigarh, always has received a huge inflow of patients from North India during such emergencies. These patients pose special challenges to hospital administration in terms of effective and efficient management of crisis situation, and require special measures. The authors' experience has shown that the major challenges faced are allocation of scares resources, capacity building, motivation of employees, infection control, and inter-sectoral coordination. The response during the initial phase is erratic due to a lack of clear guidelines and prior preparedness. Learning from these experiences, a contingency plan was prepared after consultation with all stakeholders. It was implemented during 2009 influenza pandemic. The contingency plan identifies: (1) area responsibilities; (2) disaster and screening areas for the handling of patients; (3) isolation and critical care facilities; (4) deployment of manpower; (5) allocation of drugs, consumables, equipment, and sterile supplies; (6) communication and reporting system; (7) awareness, education, and training; and (8) decision-making hierarchy and effective inter-sectoral collaboration. Also, a disaster plan has been prepared that includes standard operating procedures (SOPs) to be followed during infectious PHEs. A hospital infection control manual also has been prepared to address the issue of hospital acquired infections. The contingency plan and SOPs were effective during recent 2009 influenza pandemic in streamlining the response.

Conclusion

A well-documented contingency plan prepared in consultation with concerned stakeholders and implemented by a motivated and committed administration is essential in ensuring uninterrupted services during PHEs. It emphasizes that sound PHE plan is never an accident; it is always a result of high intentions, sincere efforts, intelligent direction, and skillful execution.