B health operations protocol 20140331

National Disaster Response Plan for Hydro-Meteorological Disaster (DRAFT) MAR2014
CLUSTER B: Health (WASH, Medical and Public Health, Nutrition, Mental
Health and Psychosocial Support) Cluster Operations Protocol
Copy Number:
Issuing Agency: National Disaster Risk Reduction and Management Council
Place of Issue: Camp General Emilio Aguinaldo, Quezon City
Date of Issue:
Integrated Plan: National Disaster Response Plan
1. RATIONALE
In emergencies and disasters, delivery of appropriate and timely public health
and medical interventions is critical in order to save lives and decrease
preventable mortalities, morbidities, injuries and disabilities. The Health Cluster
is comprised of the health emergency management systems of the Department of
Health which was tasked to lead four (4) key sub-clusters: 1) Water, Sanitation
and Hygiene (WASH), 2) Medical and Public Health, 3) Nutrition and 4) Mental
Health and Psychosocial Support (MHPSS) clusters each of which answers
defined outcomes and objectives in the response plan working harmoniously with
one another and with other clusters in large scale disaster response in the
country.
The DOH will lead the cluster in coordination and collaboration with local,
regional, national and international partners shall ensure to provide related
services in accordance with legal frameworks and acceptable standards.
2. OBJECTIVE
The Health Cluster comprised of the WASH, Medical and Public Health, Nutrition
and Psycho-social sub-clusters of the DOH aims to provide support for the
delivery of appropriate and timely public health and medical services to the
affected population.
In the National Disaster Risk Reduction and Management Plan, the DOH is
answerable to the following objectives and indicators in the response phase:
DISASTER RESPONSE INDICATORS
1. To establish an effective
and efficient health sector
response operations
Activated functional ICS on site
Well –established system of information gathering,
reporting and dissemination
Established and functioning system for coordinated
and efficient medical and public health operations
2. To ensure adequate and
prompt assessment of
health needs and damages
at all levels
Timely and appropriate and consolidated health
assessment and needs assessment reports
Cluster B-1

MAR2014 National Disaster Response Plan for Hydro-Meteorological Disaster (DRAFT)
3. To ensure that basic health
services are provided to
affected population inside or
outside evacuation centers
All patients seen/treated and epidemics and
diseases prevented
Data-base of hospitals and other health care
providers maintained
Timely access to appropriate and adequate public
health services established
Lifelines restored
4. To ensure coordinated and
integrated system for early
recovery
Mechanisms for coordinated and integrated early
recovery established and essential health services
restored
To address these, the response plan of the DOH follows the framework of
management to cover the following aspects: Event, Cases, Environment,
Services, and Public Health Implications as follow:
1. Managing the event (command, control, coordination)
2. Managing the cases (clinical management)
3. Managing the environment (environmental sanitation)
4. Managing the services (response services)
5. Managing the properties (diagnostic tools, the hospital, laboratories, and
logistics)
6. Managing public health implications (community)
All of these are contributory to the attainment of the ultimate goal of health
response in emergencies and disasters: To save lives and decrease preventable
mortalities, morbidities, injuries and disabilities in emergencies and disasters.
3. CONCEPT OF OPERATIONS
All requests for additional emergency health services will be coordinated to the
Health Cluster Lead or focal person assigned at the NDRRMC OpCen during the
disaster. Validation of the requests will be done by the DOH National Cluster
through their counterpart focal person on ground. The DOH will be the Lead and
will assign its Focal Coordinator/s for all government and non-government (local
and International) emergency health teams and volunteers.
Deployment of DOH Team will be done through the directive of the DOH,
NDRRMC Chairperson or the President. The DOH Team will coordinate with the
LCE of the affected areas or the Incident Commander as directed by the LCE.
Demobilization of the DOH Team will come from the LCE or Incident
Commander.
Cluster B-2

ClusterB-3
NationalDisasterResponsePlanforHydro-MeteorologicalDisaster(DRAFT)MAR2014
Warning
Agencies
PAGASA
Directive from
the President
ACTION:
Receives and
disseminates warning
message. All
instructions and updates
on request made on
ground will be coursed
through the Health
Cluster.
DOH Teams
deployed to
affected areas.
ACTION:
DOH Teams coordinates
with EOC and reports to the
Incident Commander for
deployment.
ANNEX 1: Operations Flow for Health Cluster.
ACTION:
Coordinates with all
Health Cluster member
agencies with DOH
Teams on nearby areas
(Region, Province,
City/Municipal) for
possible mobilization to
the affected area.
Emergency
Operations Center
(EOC)
ACTION:
EOC will determine the
Incident Command Posts
needing emergency health
support and coordinate
with the DOH Team.
Selected
Incident
Command Posts
Health
Focal Person
NDRRMC
OPCEN

The following are the key players and actors in the implementation of this
concept.
A. Lead Cluster Agency
a) Department of Health (DOH)
i. Pre-Disaster Phase
Medical and Public Health
a. Early Warning and Alerting System (EWARS)
1. Organize ERT and put them on standby status
2. Hospital to enhance Surge capacity
3. Team Mobilization
b. Pre-Emptive Evacuation Phase
1. Provision of health service (Deployment Hospital Emergency
Response Team and evacuation center clinic)
2. Provide patient transport services
WASH
1. Alert WASH Team both at national and regional level.
2. Establish contact with WASH cluster at national level
3. Prepare list of available WASH logistics.
MHPSS
1. Re-orient LGU officials and responders on MHPSS
2. LGU to prepare to mobilize MHPSS teams,
3. LGU to activate MHPSS teams; CHD and National to support and
augment LGUs when necessary
4. LGU, CHD and National to coordinate with partners on the
following:
a. Conduct of MHPSS assessment
b. Preparation of teams
c. Delivery of appropriate MHPSS services.
d. Activation of MHPSS resources (experts, partners, facilities)
5. Assist LGU in reviewing resource map and inventory of resources
(health facilities, psychiatric facilities, rehab centers, trained
MHPSS providers, experts, drugs and medicines)
6. Assist LGU in mapping partners
7. Assist LGU in coordinating with partners
8. Assist LGU in activating screening and referral system
9. Assist LGU in monitoring event and providing alert notifications
10.Assist LGU in deployment of MHPSS teams
11.Prepare to augment MHPSS teams
12.Assist LGU in the conduct of coordination meetings
Nutrition
1. Update resource inventory/mapping of micronutrients by Nutrition
Clusters at all levels
Cluster B-4

a. Vitamin A capsules
b. Multiple micronutrient powders
c. Ferrous sulfate and iron with folic acid
d. IECs for Nutrition
e. MUAC Tapes
f. Weighing scale
g. Weight for height reference table
h. Height Board
i. Ready-to-Use Therapeutic Food (RUTF)
j. Ready-to-Use Supplementary Food (RUSF)
k. Antibiotics, deworming tablets (for routine acute malnutrition
management, to be coordinated with the health office/centers)
l. Human milk banks (inform them ahead for proper coordination)
m. Breastfeeding Kit (container/katsa, feeding cup with cover, food
container with spoon and fork, 1 liter glass tumbler with cover,
IEC materials, birth registration form)
2. Mapping of partners (4Ws- Who, what, when, where) by
Nutrition Clusters at all levels
3. National/Regional Nutrition Clusters providing augmentation to
LGU Nutrition Clusters on the following:
a. Conduct of general and blanket supplementary feeding for 6
to 59 months old children, and pregnant and lactating women
b. Setting-up of breastfeeding corner/space in evacuation
center
4. Support LGU in giving alert notification to health facilities with
capacities for SAM (severe acute malnutrition “severe wasting”
management)
5. Augment activation of the following:
a. Joint Rapid Nutrition Assessment Teams, if necessary
b. Infant feeding/ Breastfeeding Support Groups, if necessary
6. Support LGU in the conduct of Intra/InterCluster Coordination
Meetings
ii. During Disaster Phase
a) 0-24 Hours
1. Rapid Health Assessment (RHA) Team and Team deployment
2. Patient Referral /conduction to Hospitals
3. Hospital Care and support to pre-hospital care
4. Deploy Emergency Response Teams (Command team/ Incident
Management Team, Medical Team, Technical Team, support
service team)
5. Transport services
6. Augment cadaver bags and other logistics (medical station tent,
medical supplies, Drugs and medicines etc.)
7. Establish Health Command Post ( ACP for Health Services)
8. Establish disease surveillance system – Surveillance in Post
Extreme Emergencies and Disasters (SPEED)
Cluster B-5

WASH
1. Monitor on the overall situation and possible impact on
WASH facilities in the area.
2. Establish initial information from the regional counterpart on
the extent of WASH condition in the affected areas
3. Dispatch team to conduct rapid WASH Assessment as per
request of the LGU concerned.
MHPSS
1. Coordinate with LGU on team deployment
2. Assist LGU in data gathering, prioritization of targets and
planning for MHPSS services
3. Assist and support LGU on MHPSS needs assessment and
information management using 4Ws
4. Assist LGU in provision of MHPSS services:
• Psychological First Aid (PFA) and facilitation for provision
of basic services and security
• Community and family support
5. Assist LGU in activating referral system
6. Augment LGU resources in terms of manpower,
infrastructure, logistics.
7. Assist LGU in organizing cluster meetings
Nutrition
1. Augment team deployment by LGU
2. Assist LGU in establishing contacts, gathering critical
information (baseline) and identifying immediate
priorities to include areas that situation may worsen.
3. Support LGU in the conduct of gap analysis and in the
prioritization and planning/ scheduling of nutrition
interventions
4. Support LGU in the preparation and submission of daily
situation report
b) 25-48 Hours
1. Deploy Medical Teams
2. Augment additional logistics
3. Cleaning & clearing of health facilities
Cluster B-6

4. Repair of facility damage
5. Coordinate Health Sector Response (Emergency meeting)
6. Definitive treatment of injured victims continued
7. Support continuation or restoration of health services in
affected areas
8. Proper recording and timely reporting
WASH
1. Facilitate the provision of potable water (bottled water, water
rationing/trucking, water treatment) by LGU and partners.
2. Monitor the LGU activities to respond to WASH needs such as
to the following:
a. water quality monitoring
b. provision of toilet facilities
c. solid waste management
d. hygiene promotion
3. Coordinate WASH team deployment (CHD and national) to
LGU.
4. Provide water kits, hygiene kits and other WASH commodities to
LGUs.
5. Continue monitoring and coordination regarding status/needs
through CHDs by national
MHPSS
1. CHD and National to support and augment team deployment as
necessary.
2. LGU, CHD and or National to coordinate with partners
3. Organize and call MHPSS cluster meeting
4. LGU to conduct and review MHPSS Assessment to gather
baseline and identify needs
5. Prepare MHPSS action plan with all stakeholders
6. Support LGU in providing appropriate MHPSS services as
follow:
a. Psychological First Aid (PFA)
b. Community and Family Support
c. Focused, non-specialized services
d. Specialized services including referral to specialists and
treatment
7. Set up MHPSS referral system
8. Attend meetings of other clusters (Health, Education and
Protection) together with LGUs
9. Prepare 4Ws (Who, What, When, Where)
10. LGU to collate and submit MHPSS report to cluster lead.
Nutrition
1. Augment team deployment by LGU
2. Assist LGU in establishing contacts, gathering critical
information (baseline) and identifying immediate priorities to
include areas that situation may worsen.
Cluster B-7

3. Support LGU in the conduct of gap analysis and in the
prioritization and planning/ scheduling of nutrition interventions
4. Support LGU in the preparation and submission of daily situation
report
c) More than 72 Hours
1. Augment medicines & supplies
2. Health Education, Promotion and
3. Distribution of IEC materials
4. Continue Health sector Coordination to include resource sharing
and mapping
5. Continue provision of Consultations , case treatment, referral to
hospitals and Hospital care services
6. Organize and deploy public health and medical mission teams
7. Conduct DANA/DALA (at 1 week)
8. Prepare Early Recovery to Rehab Plan ( 2nd-3rd week)
9. Activate SPEED.
10.Support to continue or restore health services of health facilities
(hospital, Health Center, Rural Health Units, Barangay Health
Stations, etc)
11.Submission of reports and updates.
WASH
1. Continue the WASH assessment in cooperation with LGU and
WASH partners.
2. Coordinate WASH team deployment (CHD and national).
3. Ensure that provision of potable water (bottled water, water
rationing/trucking, water treatment) by LGU and partners are
continuously managed.
4. Continue water quality monitoring by WASH Team and LGU.
5. Continue provision of water kits and hygiene kits and other
WASH commodities (water testing reagents, waste receptacles,
etc.) by national and regional if available.
6. Extend assistance on the installation/construction of toilet
facilities (in case of gaps) by LGUs and partners.
7. Conduct hygiene promotions.
8. Monitor the repair/ restore water facilities by LGU or water
providers.
9. Continue monitoring and coordination regarding status/needs
through CHDs by National.
10.Timely reporting. .
Nutrition
1. Augment LGU’s logistics on the following:
a. Implementation of nutrition interventions
b. Information management (e.g. 4Ws, use of data tracking
matrix of DSWD)
c. Monitoring and evaluation
Cluster B-8

d. Documentation
2. Support LGU in policy monitoring of EO51
3. Support LGU in the conduct of Intra/Inter-Cluster Coordination
Meetings
4. Assist LGU in the advocacy for services related to mental health
and psychosocial care, water, sanitation and hygiene,
health, and others
5. Technical assistance for “exit” strategy
6. Continuous collation of updates and reporting
MHPSS
1. Provide technical assistance to LGU on team deployment and
provision of MHPSS services:
• Psychological First Aid (PFA) and facilitation for provision of
basic services and security
• Community and family support
• Focused, non-specialized services
• Specialized psychological and mental health services
2. Assist LGU in activating the referral system
3. Augment LGU resources in terms of manpower, infrastructure,
logistics.
4. Coordinate with LGU on cluster activities
5. Assist LGU in the accomplishment of the 4Ws
6. Assist LGU in organizing cluster meetings
7. Assist LGU in the conduct of continuous MHPSS needs
assessment and planning for services
iii. Post Disaster Phase
1. LGU to Continue provision of Medical and Public Health Services
2. Participate in Conduct of PDNA
3. Prepare and submit recovery plan
4. LGU to Continue Disease Surveillance and monitoring in
Evacuation Centers
Cluster B-9

5. Emergency Health Teams to demobilize and report to mother unit
under the instructions of the Incident Commander or LCE.
6. Post operation assessment and report to be prepared and
submitted to the National Cluster Lead.
MHPSS
1. LGU to provide MHPSS services as needed; CHD and National to
support and augment
2. Continuously coordinate with partners to resolve MHPSS issues
3. Implement recovery and rehabilitation plan.
B. Cluster Member Agency
a) Office of the Civil Defense (OCD)
1. Forward all alerts and warnings to all government and local
government units.
2. Alert all Regional Offices to put on stand-by mode all available
resources for possible deployment.
1. Assist in establishing priorities and coordinating the transition of
mass care operations with recovery activities based on disaster
situation information and the availability of resources that can
be appropriately applied.
1. Provide assistance in the demobilization of emergency health
teams to mother unit.
b) Armed Forces of the Philippines (AFP)
1. All available medical teams/supplies placed on stand-by for
possible deployment under the directive of the Health Cluster
Lead.
2. Monitoring of available medical teams and submitting the list to
the National Health Cluster Lead for possible deployment.
3. Prepositioning of medical teams and supplies at the UC and or
Infantry Division Station Hospitals.
1. Deployment of available medical teams and supplies in
coordination with the National Health Cluster Lead and the
LCE/Incident Commander of the affected areas.
2. Deployed medical teams to report to the LCE or Incident
Commander for proper deployment.
3. Status reporting to the Health Cluster Lead and IC/LCE.
Cluster B-10

1. Recall of deployed medical teams on the instructions/approval
of the LCE/IC and return to mother unit.
2. Submit post disaster operations report to the Cluster Lead.
c) Philippine Coast Guard (PCG)
1. All available medical teams placed on stand-by for possible
deployment under the directive of the Health Cluster Lead.
2. Monitoring of available medical teams and submitting the list to
the National Health Cluster Lead for possible deployment.
1. Deployment of available medical teams in coordination with the
National Health Cluster Lead and the LCE/Incident Commander
of the affected areas.
2. Deployed medical teams to report to the LCE or Incident
Commander for proper deployment.
3. Status reporting to the Health Cluster Lead and IC/LCE.
1. Demobilization of deployed medical teams on the instructions of
the LCE/IC and return to mother unit.
2. Submit post disaster operations report to the Cluster Lead.
d) Bureau of Fire Protection (BFP)
Shall support the provision of assistance to the affected LGU within
their area of jurisdiction to facilitate the operations of the medical
teams deployment on ground.
e) Department of the Interior and Local Government (DILG)
Shall assist the Emergency Health Teams in coordinating with the
LCEs of the affected LDRRMCs.
f) Philippine Red Cross (PRC)
i. Pre Disaster Phase
1. Continuous monitoring and reporting
2. Readiness of status check of all resources including manpower,
supplies, equipment and tools.
3. Coordinate with chapters to verify and identify needs of
operation
4. Coordinate with partner agencies at the national level such as
NDRRMC, PAGASA, DOH, DSWD, etc.
1. Rapid assessment and coordination
2. Develop PRC operational action plan
3. Provide pre-hospital care for injured and ill –persons
(ambulance-patient transport if needed)
4. Continuous monitoring of the situation
Cluster B-11

5. Conduct after operation de-briefing
1. Conduct post-disaster and need assessment
2. Conduct of inventory of resources
3. Prepare and submit operation report
4. Conduct debriefing
j) Volunteers/Civil Society Organizations
All Volunteer Medical Teams will coordinate with the National
Health Cluster Lead for proper deployment to the affected areas.
m) National Bureau of Investigation (NBI)
Shall provide assistance in the identification of casualties. (See
MDM Cluster)
n) Department of Foreign Affairs (DFA)
Shall provide assistance in the processing of incoming Health
Emergency Teams from regional and international community
o) Philippine National Police (PNP) through the Health Service and
Women and Children Protection Center.
1. Alert all teams to be ready for deployment in affected
regions.
2. Ensure Disaster Teams Safety by providing safety
equipment & nutritional needs.
1. Deployment of medical teams to affected areas
2. Provide transportation to medical teams and patients.
3. When available, keep medical doctors, nurses,
psychologists, dentists, etc to help assess & treat disaster
victims in the evacuation areas.
4. Record all actions per case including follow-up
5. Report to Women Children Protection Center Desks on a
daily basis on GBV incidents
6. Ensure availability of women health staff.
1. Provide security to medical teams and patients to affected
areas.
2. Assign personnel to assist in the Evacuation Centers.
3. Ensure updated reports to provide assistance, manpower for
rescue and relief operations and medical services.
p) Department of Social Welfare and Development (DSWD)
Cluster B-12

Shall assist in the provision of medical and health emergency
services to the affected population in coordination with the Health
Cluster Lead or the head of the deployed emergency health teams.
4. CONCEPT OF SUSTAINMENT
a) The DOH as Cluster Lead will coordinate all support and
requirements of response cluster in their activities to augment the
requirements at the affected areas during disasters.
b) Concerned government agencies and their subordinate offices shall
utilize their respective internal personnel. Additional personnel
requirements shall be coordinated through the NDRRMC in
collaboration with all Council members.
5. COMMAND AND CONTROL
A. Command Relationship – all DRRM actors and key players will refer and
based their actions as prescribed in IRR of R.A. 1021, Rule 3, Section 2.
Composition
B. Command Center – National Disaster Risk Reduction and Management
Operations Center (NDRRMOC), Camp General Emilio Aguinaldo, Quezon City.
a) Succession of Command:
(1) Chairperson, NDRRMC (S, DND)
(2) Vice-Chairperson for Disaster Response (S, DSWD)
(3) Health Cluster Lead (DOH)
(4) Health Cluster Members
a) Interagency Communication System Support
For the entire duration of the operations, the existing means of
communications shall be utilized whatever is applicable. However, the
Emergency Telecommunication Cluster will be activated once communication is
cut-off from the affected areas.
FOR GUIDANCE AND STRICT COMPLIANCE
SEC VOLTAIRE GAZMIN
Chairperson, NDRRMC
Department of National Defense
Cluster B-13

B health operations protocol 20140331

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