Qualification requirements - World Health OrganizationApply course concepts to case studies and in ?class exercises .... on
assignments or examinations; accessing computer systems or computer files
without authorization; stealing a problem solution ..... Women and Language, 24(
2), 47-51. ... In M. L. Hummert and J. F. Nussbaum (Eds.), Aging, communication
and health (pp.
un extrait du document
ristensen, Johanna Larusdottir, Laura Londen, Jean-Paul Menu, Dominique Metais, Luigi Migliorini, Najibullah Mojadiddi, MSF, Enrique Munoz, Gabriel Mweluko, Evaristo Njelesani, Eric Noji, Mastaneh Notz, Peter McAleese, OCHA, Enrico Pavignani, Pierre Perrin, Francoise Hery-Persin, Jean-Luc Poncelet, Gulam Popal, Garry Presthus, Trish Prosser, Margareta Rubin, Rino Scuccato, Archena Shah, Khalid Shibib, Rumishael Shoo, Luzitu Simao, Antonio Sitoi, Idrissa Sow, Julia Stuckey, Ganesan Sundaram, Daniel Tarantola, Yonas Tegegn, Nerayo Teklemichael, Jan Theunissen, Michel Thieren, Mike Toole, UNHCR, USAID, UNSECOORD, Stephan Van Dam, Hannu Vuori, WFP, Hillary Wild, Brad Woodruff, and Nevio Zagaria,
This document is not issued to the general public, and all rights are reserved by the World Health Organization (WHO). The document may not be reviewed, abstracted, quoted, reproduced or translated, in part or in whole, without the prior written permission of WHO. No part of this document may be stored in a retrieval system or transmitted in any form or by any means electronic, mechanical or other without the prior written permission of WHO.
The views expressed in documents by named authors are solely the responsibility of those authors.
Table of Contents TOC \o "1-3" LIST OF ANNEXES PAGEREF _Toc456434527 \h 4
INTRODUCTION PAGEREF _Toc456434528 \h 1
AUDIENCE PAGEREF _Toc456434529 \h 1
PURPOSE PAGEREF _Toc456434530 \h 1
CONTENTS PAGEREF _Toc456434531 \h 2
READINESS PAGEREF _Toc456434532 \h 4
1.1 MISSION READINESS PAGEREF _Toc456434533 \h 4
1.2 WHAT TO CARRY ALONG PAGEREF _Toc456434534 \h 5
A. PERSONAL ITEMS PAGEREF _Toc456434535 \h 5
B. OPERATIONAL EQUIPMENT PAGEREF _Toc456434536 \h 6
C. ESSENTIAL DOCUMENTATION PAGEREF _Toc456434537 \h 6
1.3 ESSENTIAL BRIEFINGS PAGEREF _Toc456434538 \h 7
GETTING TO THE FIELD PAGEREF _Toc456434539 \h 8
2.1 DEPARTURE PAGEREF _Toc456434540 \h 8
2.2 ARRIVAL PAGEREF _Toc456434541 \h 9
2.3 FIRST CONTACTS PAGEREF _Toc456434542 \h 9
2.4 FIRST ASSESSMENTS PAGEREF _Toc456434543 \h 10
A. ASSESSING THE SITUATION AND THE TRENDS PAGEREF _Toc456434544 \h 10
B. ASSESSING NEEDS PAGEREF _Toc456434545 \h 11
C. ASSESSING RESOURCES PAGEREF _Toc456434546 \h 11
D. LOOKING FOR INFORMATION PAGEREF _Toc456434547 \h 12
2.5 THE MEDIA PAGEREF _Toc456434548 \h 14
PREPARING FOR THE OPERATIONS PAGEREF _Toc456434549 \h 16
3.1 INFORMATION NEEDED PAGEREF _Toc456434550 \h 16
3.2 SETTING UP AN OFFICE PAGEREF _Toc456434551 \h 17
3.3 STAFF PAGEREF _Toc456434552 \h 17
RECRUITMENT PAGEREF _Toc456434553 \h 18
3.4 PROCUREMENT PAGEREF _Toc456434554 \h 19
A. LOCAL PROCUREMENT PAGEREF _Toc456434555 \h 20
B. EXTERNAL PROCUREMENT PAGEREF _Toc456434556 \h 21
C. STANDARDIZATION AND COMPATIBILITY PAGEREF _Toc456434557 \h 21
D. FURNITURE PAGEREF _Toc456434558 \h 22
E. OFFICE EQUIPMENT PAGEREF _Toc456434559 \h 22
F. VEHICLES PAGEREF _Toc456434560 \h 22
3.5 CUSTOMS PAGEREF _Toc456434561 \h 22
CLEARING AND FORWARDING PROCEDURES. PAGEREF _Toc456434562 \h 22
INSURANCE CLAIMS PAGEREF _Toc456434563 \h 24
3.6 ASSET TRACKING PAGEREF _Toc456434564 \h 24
3.7 FINANCE PAGEREF _Toc456434565 \h 24
A. BANK ACCOUNT PAGEREF _Toc456434566 \h 24
B. WHERE THERE IS NO BANK PAGEREF _Toc456434567 \h 25
C. THE IMPREST ACCOUNT PAGEREF _Toc456434568 \h 25
D. ESTIMATING MONTHLY EXPENDITURES PAGEREF _Toc456434569 \h 26
E. ESTIMATING THE LEVEL OF THE IMPREST ACCOUNT PAGEREF _Toc456434570 \h 26
3.8 COMMUNICATIONS PAGEREF _Toc456434571 \h 27
BRIEF OVERVIEW PAGEREF _Toc456434572 \h 27
POSSIBLE ACTIONS PAGEREF _Toc456434573 \h 28
STARTING THE OPERATIONS PAGEREF _Toc456434574 \h 30
4.1 OPTIONS FOR ACTION PAGEREF _Toc456434575 \h 30
4.2 IDENTIFYING PARTNERS PAGEREF _Toc456434576 \h 31
A. NATIONAL PARTNERS PAGEREF _Toc456434577 \h 31
B. INTERNATIONAL PARTNERS PAGEREF _Toc456434578 \h 32
4.3 COORDINATION PAGEREF _Toc456434579 \h 32
A. UNITED NATIONS PAGEREF _Toc456434580 \h 33
B. GOVERNMENT PAGEREF _Toc456434581 \h 33
C. NGOs AND OTHERS PAGEREF _Toc456434582 \h 34
4.4 PLANNING PAGEREF _Toc456434583 \h 36
A. THE MASTER PLAN FOR HEALTH RELIEF PAGEREF _Toc456434584 \h 36
B. THE PLANS OF ACTION PAGEREF _Toc456434585 \h 38
4.5 MOBILISING RESOURCES PAGEREF _Toc456434586 \h 39
A. EXTERNAL ASSISTANCE - THE UN CONSOLIDATED APPEAL PAGEREF _Toc456434587 \h 39
B. LOCAL RESOURCE MOBILIZATION PAGEREF _Toc456434588 \h 40
4.6 RECRUITING PAGEREF _Toc456434589 \h 43
RUNNING THE OPERATIONS PAGEREF _Toc456434590 \h 46
5.1 ESTABLISHING AND RUNNING A SURVEILLANCE SYSTEM PAGEREF _Toc456434591 \h 46
5.2 MANAGING THE INFORMATION PAGEREF _Toc456434592 \h 50
A. THE USE OF DIFFERENT INFORMATION PAGEREF _Toc456434593 \h 50
B. ESTABLISHING YOUR FILING SYSTEM PAGEREF _Toc456434594 \h 51
5.3 ESTABLISHING THE OPERATIONS ROOM PAGEREF _Toc456434595 \h 52
A. MAPS PAGEREF _Toc456434596 \h 52
B. CHARTS PAGEREF _Toc456434597 \h 52
C. USING THE OPERATIONS ROOM PAGEREF _Toc456434598 \h 56
5.4 FIELD TRIPS PAGEREF _Toc456434599 \h 56
5.5. REPORTING PAGEREF _Toc456434600 \h 57
A. INTERNAL REPORTING PAGEREF _Toc456434601 \h 58
B. EXTERNAL REPORTING PAGEREF _Toc456434602 \h 59
5.6 OTHER OPERATIONAL CONSIDERATIONS PAGEREF _Toc456434603 \h 61
A. PROVIDING SERVICES TO YOUR PARTNERS PAGEREF _Toc456434604 \h 61
B. SECURITY PAGEREF _Toc456434605 \h 62
C. INTERNATIONAL COORDINATION PAGEREF _Toc456434606 \h 62
D. NATIONAL STAFF PAGEREF _Toc456434607 \h 63
E. 'LATERAL' ASSISTANCE PAGEREF _Toc456434608 \h 63
F. COMMUNICATIONS PAGEREF _Toc456434609 \h 63
G. ENVIRONMENTAL CONSIDERATIONS PAGEREF _Toc456434610 \h 63
H. SUPPORTING HEALTH COORDINATION
AT SUB-NATIONAL LEVEL PAGEREF _Toc456434611 \h 63
I. DEVELOPING MANUALS PAGEREF _Toc456434612 \h 64
PHASING OFF PAGEREF _Toc456434613 \h 65
6.1 PHASING OFF PAGEREF _Toc456434614 \h 65
6.2 EVALUATION PAGEREF _Toc456434615 \h 67
6.3 PREPARING FOR YOUR DEPARTURE PAGEREF _Toc456434616 \h 71
6.4 RETURN TO REGIONAL OFFICE PAGEREF _Toc456434617 \h 72
A. PLANNING FOR YOUR RETURN PAGEREF _Toc456434618 \h 72
B. FURTHER CONSIDERATIONS PAGEREF _Toc456434619 \h 73
C. PERSONAL ADMINISTRATION PAGEREF _Toc456434620 \h 74
LIST OF ANNEXES
MISSION READINESS CHECKLISTS
RULES AND TESTS FOR DRIVERS
REQUEST FOR CONSULTANT
MISCELLANEOUS PERSONNEL FORMS
NOTES ON POLICIES AND PROCEDURES FOR SPECIAL CONTRACTS
WHO MANUAL II.19
UN STAFF COUNSELLING
CHOLERA DIAGNOSTIC KIT
EPIDEMIC RESPONSE KIT PART A & B
ITALIAN EMERGENCY KIT
REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT IN AFRICA
SAMPLE FORMS FOR COORDINATION I AND II
SAMPLE FORM FOR HEALTH SURVEILLANCE SUMMARY
GUIDELINES FOR SUPPLIERS
DRUG DONORS GUIDELINES
METRIC CONVERSION TABLES
PRICE LIST OF KITS
RAPID EPIDEMIC RESPONSE KIT
WHO GENERAL PRICE LIST
LOGISTIC INFORMATION ON KITS
SAMPLE: HEALTH CARD/MONTHLY ACTIVITY REPORT/MORTALITY RATE
SECURITY CLEARANCES REQUEST/FORMS
PERSONAL AND TEAM SECURITY
STAFF RADIO CALL SIGNS
CROSS BORDER PROCEDURES
MEDICAL EVACUATION PROCEDURES
DEATH OF A COLLEAUGUE
INFORMATION AND DOCUMENTATION
UN AGENCIES AND INTERNATIONAL ORGANISATIONS
WEB SITES OF INTERESTANNEX. 5
SELECTING AND RENTING THE OFFICE
FORMS AND CONTRACTS
VEHICLES AND DRIVERS
FINANCES (SUB ANNEX)
INSTRUCTIONS FOR TRAVEL CLAIM
The annexes come in two formats: as printed documents or in Word 7 files on the diskettes attached to the Handbook.
The criteria used for including an annex as printed or Word files are the following:
PrintedDiskette (Word 7 files)Needed for quick and easy referenceFrequently updatedFrequent useNeeds to be adapted to local conditionsEssentially for individual consultationLikely to have wide circulationForms that can be filled in electronicallyNOTE: For some documents, both formats are used as they fulfil both sets of criteria. Should you lose any of the diskettes you can download them from WWW.WHO.INT/EHA/resource/disks.INTRODUCTION
The Handbook for Emergency Field Operations is a management and reference tool for who staff working in complex emergencies or other situations where customary working conditions and normal procedures are suspended. Its content is based on the experiences of WHO staff, UN and Non Government Organizations. Its intended audience, purpose and contents are summarised below.
The handbook is written with different perspectives in mind. Accordingly, the audience and use of the Field Emergency Handbook will vary relative to the individuals situation and needs:
WHO Country Representatives, facing complex emergencies, may find useful the references and suggestions for coordinating and managing international response efforts in Chapters 4 & 5.
Professional health staff would benefit by referring to the last four chapters, annex. 2 (Technical Notes) and annex. 5 (Information and Documentation).
Administrative and logistic staff will find chapter three and annex. 1 (Personnel) and annex. 5 (Miscellaneous) particularly relevant to their duties.
Consultants, with little or no knowledge of WHO procedures, will profit by reading the entire handbook and the annexes.
This handbook is designed with field conditions in mind; it implies a worst-case scenario where WHO staff have to start from scratch to establish a WHO presence. It gives an overview of the different players in the response effort and their individual responsibilities. It is also a ready reference to the WHO regulations and administrative procedures necessary to facilitate your work; it explains how to apply them appropriately, in good time and effectively. However, it is essential that all field activities are carried out in close collaboration and under the supervision and responsibility of the WHO country and regional offices.
The chapters follow a logical sequence of events: from preparation for a field assignment, to operating in the field, through to your departure. At the back of the handbook you will find annexes containing guidelines, references, templates and checklists (referred to in the main text).
Chapter. 1 Readiness, contains practical advice on how to prepare for the assignment and will help you identify administrative and technical issues to raise with your Desk Officer and Logistics Officer. It includes advice on equipment and essential documentation that you may need.
Chapter. 2 Getting to the Field, starts with practical hints for your travel to the country of assignment; lists the most useful contacts and sources of information with suggestions for locating and interacting with national or international counterparts. You will get a better idea of the overall response effort, the different players involved and, most importantly, the part you will play.
Chapter. 3 Preparing for Operations, will help you determine which resources and logistic infrastructures are available locally. What can you utilise? Which international and national organizations provide what services? Methods of assessment are proposed. There are also detailed instructions for establishing an office, recruiting national staff, procuring supplies and importing goods.
Chapter. 4 Starting the Operations, gives you ideas on finding partners, coordinating with them, preparing a plan of action and mobilising resources. You will also find guidelines for ensuring standards for health care and relief items.
Chapter. 5 Running the Operations, provides suggestions for standardising, collecting, collating and disseminating data. How to use maps, charts and organigrams to track health activities and direct response efforts. Templates, suggestions and formats for the many different reports necessary are included.
Chapter. 6 Completing your Assignment, helps you prepare for your departure. How to hand over your work to national professionals, WHO staff or other organisations?
Planning and operational steps for the completion of your mission are detailed.
This chapter includes advice on preparing for debriefings at the Regional Office.
Getting prepared for an emergency assignment is not easy. No matter what information you have, no matter how good the source, you will always meet with the unexpected. However, by careful preparation, you can be equipped and ready to manage unforeseen events, and eliminate many problems before they arise.
This chapter gives you some indications on how to prepare yourself for the mission. Of course, they are just general indications. Each mission has its own requirements, and you will have to discuss with the Desk Officer and the Logistics Officer in order to understand the task ahead, and have an idea of your needs in the area of assignment.
Nonetheless, take some time to read the section on Mission Readiness as it contains many useful tips to ensure peace of mind while on assignment. In Annex. 4 you will find a section on stress containing useful guidelines for separating, and eventually reuniting, with your family.
Consider copying and distributing the pre-departure information sheets to staff members preparing to join you in the emergency area.
1.1 MISSION READINESS
Read this chapter and go through the Mission Readiness Checklists in Annex 1. Some points are so common and self-evident that they are often overlooked. Others are very important to your peace of mind, but they are uncommon and thus they are often forgotten. Read this chapter and go through the following Mission Readiness Checklists in Annex 1:
FAMILY WELFARE. Discuss the Readiness Checklist with your spouse or another responsible adult. This can help avoid many unnecessary problems.
BANKING INFORMATION. If your bank records are in order before you leave, deposits, withdrawals and payments while you are on mission will be easier.
BUSINESS AND FINANCE. Make sure your finances are in good order before you leave.
AUTO REPAIRS AND MAINTENANCE. Avoid automobile worries during your absence.
HOME SECURITY, REPAIRS AND MAINTENANCE. Feel at ease about home security during your absence.
1.2 WHAT TO CARRY ALONG
Each mission has its own peculiarities. The lists below are indicative and should be adapted to the individuals' choice.
A. PERSONAL ITEMS
Keep personal items within acceptable weight and value limits. Consider that you may have to leave your luggage behind.
Suitcase should be solid and lockable to prevent theft and damage.
International driver's license.
National passport: ensure validity for the duration of assignment; carry at least 12 spare passport photographs for additional visas or ID cards.
Valid International Vaccination Card with all necessary shots for your destination.
Sufficient per diem advance for duration of mission, some of it in cash: US$ or a medium of exchange that is accepted in the area of assignment. Vary the denominations and enquire whether date of issue is a consideration - consult Desk Officer for more information.
Travellers cheques. Ask your Desk Officer if they can be easily exchanged at destination. Keep separate record of cheque numbers.
Credit cards. As above, plus closest contact number in case of theft or loss.
Clothing appropriate to location, season and assignment. Take sturdy walking shoes with good ankle support, water proofing & comfort. Don't forget hat, sunglasses and sunscreen for protection from sun, or gloves for cold weather. Rubber sandals for showering.
Toiletries (soap, razors, tampons, etc.) - do not assume availability of anything at destination.
Watch. An inexpensive digital is generally ideal; take also an alarm clock.
Any medications you may need; inform WHO of any relevant medical history that may affect treatment in case of accident (e.g. allergies and/or any prescription medicines). Make sure you have enough prescription medicine for the duration of your mission.
WHO medical kit.
Condoms.Waterproof flashlight and spare batteries.
Short-wave radio and spare "long life" or rechargeable batteries.
Camera, film and batteries.
Swiss Army Knife or similar.
Adapters for all electrical appliances and voltage converters (110v ( 220v or vice versa).
Travel/language books for the region will greatly assist you.
Mosquito repellents and net, if required.
TIPS: Photocopy important documents (Travel Authorisation; Laissez-Passer; vaccination card; drivers license etc.) and keep separately in safe place. Note your Blood Type on your vaccination card. If carrying valuables, arrange for extra insurance on your Travel Authorisation.
B. OPERATIONAL EQUIPMENT
Study the list of emergency equipment available at HQ and at the Regional Office and decide what you will need for the mission in consultation with Logistics Officer.
Laptops and printers are a priority and, if you have a team, each team member should have his/her own. Ensure they are functioning and comply with the configuration and software requirements required for the mission. Ensure there are no passwords on the computer or the software programs.
Satellite telephone can be another priority at the emergency site. Ensure it is fully functioning and that it interfaces with the issued laptops for data transfer. Test the data and fax capability of the sat-phone before departure. Check that the user manual is enclosed.
Operating manual for the e-mail software package used by WHO and the access numbers and codes, if any, to operate it.
A video camera, batteries and film to record activities in the field.
Ensure all electronic devices have appropriate power supply and plugs for destination country.
Stationery: paper, ink jet cartridges, notebooks, pens, pencils, WHO official stamp, travel claims, letterhead stationery, etc.
Identification: WHO armbands, T-shirts, pennants, vehicle decals, etc.
Ask what is available at WHO office in affected country. Co-ordinate with the Logistics Officer for extra freight allowance if needed.
C. ESSENTIAL DOCUMENTATION
Read as much as you can on the country of assignment and on the features of the emergency before you leave. This will greatly facilitate your work once you are there.
Ask your Desk Officer for:
situation reports sitreps and any documents relevant to the country and the emergency;
all WHO correspondence pertaining to your mission and to the emergency;
reports from other UN agencies and NGOs involved;
reference material on the country and the surrounding region: history, demography, economy, etc.;
maps of the country and the surrounding region; have digitised maps installed in your laptop;
the list of national and international contact persons in the affected country and surrounding region;
the WHO technical divisions' guidelines that you may need according to your terms of reference;
reports of other WHO emergency operations (Lessons Learnt, Annex. 4).
Look on the Web for additional information on the country and the current crisis (see list of web sites Annex. 4).
If you are to work in a team, familiarise yourself with the CVs of the other team members.
1.3 ESSENTIAL BRIEFINGS
The first briefing may take place at WHO Headquarters. After this, it is WHO procedure that before proceeding to the country of assignment, every staff member has a briefing at the Regional Office concerned. Upon arriving at the Regional Office you should:
review with your supervisor and have a clear understanding of:
your Terms of Reference
the aims and objectives of the mission
whom to report to and the frequency and format of reports;
be briefed by the Desk Officer for the affected country or sub-region; ask for the latest security update from UNSECOORD, including which means of transport you are entitled to use locally;
discuss administrative and logistical matters with the Administrative/Logistics Officer;
be briefed by the Regional Logistics Officer on the state of logistics in the affected country and get a list of equipment available at HQ for emergency operations;
be briefed by Finance on imprests and proper financial reporting;
get clear information on focal points, mechanisms and procedures for the mobilisation of technical and administrative assistance from the Regional Office;
get a realistic estimate of the lead-time that will pass between your request and the Regional response;
be briefed by the EHA focal point on methods of focusing donor attention. How you can assist one another in coordinating donor appeals; get a clear understanding on the information that you can release to the media.
GETTING TO THE FIELD
You are now ready to leave for the site of your assignment. If the destination is designated as being in an emergency phase, you may need to have security clearances (see Annex. 3). If you do not have the security clearance to enter a country, where this is required by the UN, you will not be covered by insurance.
In situations where security is an issue, you are advised to read the contents of Annex. 3 for guidance on protective and precautionary measures.
If you travel in a team, when checking-in try to book seats so you can all sit together during the journey and discuss last minute details. Always re-confirm flights before departure.
Make sure that the WR and the UN Resident Coordinator in the country of assignment are informed of your arrival time and flight number. Where possible, ensure that hotel bookings and transportation from airport are pre-arranged.
It is advisable that you travel carrying the following on you or in your hand luggage:
Travel tickets and confirmation of hotel bookings;
National passport, Laissez Passer, driving license and vaccination card;
Currency, travellers cheques and credit cards;
Travel Authorisation, terms of reference and contract;
All satellite phones and laptop computers;
Spare set of clothing and toilet bag;
Prescription medicines and malaria prophylaxis if necessary;
Any item of personal value.
IMPORTANT: when you are on mission, the following expenses are reimbursable:
transportation expenses (i.e. carrier fare);
terminal expenses (e.g. taxi fare, airport taxes);
necessary additional expenses incurred during travel.
Keep the receipts for these expenses and attach them to your Travel Claim when you submit it at the end of mission.
WORST CASE SCENARIOS. Do not assume that you will be always able to travel by regular, commercial means of transport. There may be cases where you will have to negotiate your transportation with other UN agencies, NGOs, the Military, etc. In these cases consider that:
special flights or convoys can often accommodate only a limited number of passengers and require special clearances; often they are very costly and payment has to be in cash;
depending on the mean of transport, you may have to travel especially light. In this case, consider carefully which are the essential items to carry with you;
cargo flights are uncomfortable and can be very cold, even in the tropics. Take a sweater with you and do not assume that you will find water or a toilet on board;
you may have to sign a waiver, discharging the organisation that provides the transport, of any responsibility concerning accidents during the travel: discuss this possibility with your supervisor.
If you are travelling in a team, on arriving at your destination, complete all immigration and customs formalities together. Look for a UN protocol officer (from any agency) who can assist in speeding-up formalities.
After clearing the entry procedures be on the lookout for WHO staff or for other UN staff. They can help you get a lift from the airport.
Go immediately to the hotel and ensure a room is available. If necessary, the accommodation can serve as a temporary office until more suitable premises can be found.
2.3 FIRST CONTACTS
The WHO staff in country are the first partners that you must get on your side for your mission to be successful. Have a first briefing with them. Then contact the Regional Office and report safe arrival to your supervisor there. Give hotel/home/office contact numbers.
In the WHO office, you will find reports and files with additional information on the country and the current situation. After this, you should:
meet with the Government officials concerned with the emergency;
meet with the UN Resident Coordinator and explain your mission;
identify and meet with other UN agencies and NGOs currently working in the area;
identify and meet with national experts who may be able to assist you.
2.4 FIRST ASSESSMENTS
The first item in your working agenda is to assess the situation. You have to conduct your own Rapid Health Assessment, or participate in a multi-sectoral assessment. The more effective you are in collecting and circulating information at this stage, the easier it will be to assert WHO's role in coordinating Health relief later (see Chapter 4).
get a general view of the situation,
identify groups and areas most at risk,
identify the vital needs that require immediate response,
evaluate the resources available,
identify the critical gaps.
The assessment can be carried out at national level, or it may have special focus on particular areas or groups (e.g. Internally Displaced Persons or refugees). Information can come from official records, informal interviews and from a variety of other sources, some external to the Health Sector. Just on the basis of secondary data you can get a fair picture of the global situation. In most cases you will not start from zero; more often than not, your task will be to order and understand available information rather than to collect new data.
A. ASSESSING THE SITUATION AND THE TRENDS
Look at the causes, the magnitude, the affected areas, the likely evolution of the emergency and its impact on human beings, environment, infrastructures, services, property, etc.
You need data on the following:
population affected/at risk
crude and Under-5 Mortality rates
security and accessibility of the territory affected
displacement and migration of the population
state of national economy and people's purchasing power
state of production, of stocks and commerce
state of communications
global patterns of external assistance
If you are working in a war-affected country, you also need data on the patterns of violence: attacks against the population, the Health facilities and other infrastructures. Military operations and the presence of landmines will be an important consideration.
You will find part of these data in WHO, in reports or bulletins from the Ministry of Health, UNICEF and NGOs. For others, you will have to consult the reports of UNDP, WFP, UNHCR and FAO, or the media, and you may have to make do with proxy indicators.
B. ASSESSING NEEDS
Look at the vital needs of the affected population and 'contextualize' the Health situation in the global picture.
Populations affected by an emergency, be they displaced by floods or drought, fleeing from war, etc., all have the same vital needs:
shelter and sanitation
clothes, blankets and essential domestic items
Precise information requirements will vary according to the nature of the emergency, but you want to know at least:
what are the main causes of illness and death,
what are the acute malnutrition rates and if micro-deficiencies are being reported,
whether epidemics or starvation are occurring,
what are the country's endemic diseases,
state of relief operations (Health and other sectors): i.e. resources, general performance and Health-related programmes,
performance of the national Health services, i.e. adequacy of resources, coverage and concentration of activities.
C. ASSESSING RESOURCES
Look whether there are gaps in the response capacity of the Health sector. In order for the vital needs to be satisfied, resources are needed for specific relief and support activities. You want to ensure that there is no duplication of effort, that costs are minimised, and that the capacities of the national authorities for relief and recovery are strengthened. In particular, determine what resources may already be available in the country. So, what you want to know is what is in place and what is missing in terms of:
security, water, food, shelter and sanitation, blankets, buckets, soap, pots and fuel for cooking;
surveillance and epidemic preparedness;
measles immunisation and Vitamin A;
basic curative care for diarrhoeas, ARI, malaria;
nutritional screening and therapeutic feeding;
health referral and support systems: cold chain, laboratory, essential drugs, heath information system and supervision;
mechanisms for information and coordination;
logistics (capability of Government and other organisations, situation of ports of entry, warehousing and access routes);
For each item of equipment and supplies, determine the present and future resources of local authorities, UN agencies, NGO's and donor groups. If resources are being mobilised, determine the scheduled arrival time.
Draw conclusions on the immediate and critical shortfalls in resources. Make a distinction between requirements that are mission critical and those that are mission enhancements. Be realistic in stating your needs and consider trade-offs when presented with operational alternatives.
D. LOOKING FOR INFORMATION
At the National level, a list of contacts and sources of information includes:
MOH: emergency coordination unit, departments of planning, epidemiology and
UN Coordinator for Humanitarian Assistance and staff;
National Relief Agency;
UNDP Resident Representative and staff;
UNICEF Representative and programme staff (health, nutrition, water);
WFP Director of Operations and staff;
UNHCR Representative and medical coordinator;
Major international NGOs, at least those active in the Health sector;
National NGOs, at least the national Red Cross Society;
World Bank Rep. and staff;
Major Donors, through their embassies or their Aid agencies;
ICRC Head of Mission.
If you can extend the assessment to the Provincial/Regional level, you will have less time there, typically one or few working days. Contact the following:
the Administration (Governor or equivalent, and staff);
the MOH Provincial Directorate (Director, staff and PHC programmes);
the provincial referral hospital (MO in Charge and registry);
the provincial office of the National Relief Agency, if any;
UN offices (UNHCR, UNICEF and WFP are frequently represented);
DOING THE RIGHT THING THE RIGHT WAY
Associate to the assessment as many partners as possible. ALWAYS work together with national or local staff.
Your task will be easier if you use standard formats. In Annex. 5, you will find forms that you may use to collect data on:
resources immediately available from other organisations
future international resources
For assessment at field level, use the forms of the national Health Information System or develop something similar. This will make it easier for local health workers to answer to you, and for officials at the central level of MOH to understand your findings.
In an emergency, hard data are mostly unattainable, but
figures of population are essential for calculating indicators and for planning; these "denominators" must be estimated, discussed and accepted by all involved in relief;
cross-match data in order to get one idea of the overall quality of information and to arrive at educated estimates;
do not let necessary action be blocked by shortage of data; be content with estimates and trends rather than insisting on hard data that may be unattainable;
by shuttling from one possible source to another, you can put together an unexpected quantity of secondary data;
the very lack of information is information; a sector/area, which does not report, is a sector/area that has a problem.
Inaccessibility due to security reasons is typically the greatest constraint to the assessment. Try and quantify how much of reality is actually reflected by your data, define the accessible areas, the 'grey zones' and the 'black holes' on the map.
Collect, analyse and present the data desegregated, according to the smallest administrative division (i.e. block, village, ridge, location, etc.).
In armed conflicts, some agencies, like ICRC, have greater freedom of cross-line movements. They can provide insights on what's going on in inaccessible areas; respect their need for discretion.
Information is scanty and precious; throw nothing away, in terms of sources or data, and make the best of what is available:
look for yourself, use media clippings, individual interviews and hearsay as well as official records. Be aware of biases;
be creative when looking for sources: local churches, mosques, village elders, community organisations can provide useful data and information on population figures, movements, mortality, etc.
try and order the various data into a general consistent picture; link information to reality using maps.
Information is an asset for decision-making and a commodity that you can trade; information that does not circulate is not being used. Exchange your data for more information or other forms of collaboration.
Once needs and resources have been assessed, priorities can be defined. Develop an initial plan with your partners. Define who does what, where, when and how. Donors can then be alerted to the type of assistance needed and the urgency of the requirements.
The ultimate responsibility for the information that you produce is yours.
Copy your assessment to WHO/HQ and the Regional Office.
In an emergency, reality changes quickly; be prepared to update your assessment at regular intervals.
2.5 THE MEDIA
You will undoubtedly meet the media. The media are important partners in an emergency. They have a most powerful means at their disposal. In seconds they can summarise an emergency and inform every household with a television or radio. You can affect how they summarise that emergency.
The imagery transmitted by the media evokes enormous response. It focuses world attention and mobilised the conscience of nations to deliver humanitarian relief. Work with them to facilitate the response. Seek them out, dont wait for them to come to you, you need them on your side and they must know how to contact you. Focus on the prominent media groups CNN, BBC etc. they have worldwide coverage and are well respected.
Look at the national media; they too are essential in the emergency response. They can broadcast health and advisory messages in the local language. Cultivate them, keep them informed of developments, bring them in and make them partners of the response.
The media can also give you information; they may have been in an area inaccessible to you. They may have vital information. Encourage them to keep you informed of what they see, respond where possible. At all times foster goodwill and cooperation with the media. Give them constant updates, informal interviews etc. They will respond with informed reporting. Encourage them to share your vision for long term effective assistance.
Use them to help coordinate the emergency. Tell them what you are doing and why. Explain what is needed, where concerned organisations can obtain information on essential health items needed for the response.
In major operations, consider whether to recruit or appoint one of your team members as Information officer on a permanent basis. Consult with the Regional Office whether they can assist you.
As a general rule, try and clarify with your supervisor the policy to adopt as far as your relations with the media are concerned: is a clearance required? By whom?
Prepare yourself before an interview:
Anticipate the questions they will ask and think of the message you want to convey. Work out exactly what you are going to say. Stick to it.
Never assume the media understands the terminology you are employing. Remember that their audience is the average man in the street - the more understandable you are, the more time they will give you.
Simplify and summarise your basic points, repeat them with emphasis during the interview.
Take command of the interview. If you have something important to say, say it. Do not be side-tracked into answering other questions which you feel are not relevant.
Prepare handouts, empasising the main points of your statements.
The media may request an accompanied tour of the emergency area. If so, plan in advance where to go and prepare handouts for them.
Some important points:
All declarations to the media should be by/with the WR. If this is impossible, remember that you are representing WHO. When questioned by reporters, be careful what you say, it might be construed as official WHO policy.
There is no such thing as 'off the record'. Everything you say and do can and will be reported. Be careful of what you say in the presence of reporters. Remember: an interview is finished only when you cannot be heard or seen.
Never make disparaging or critical remarks about local authorities or international partners.
Never criticiser WHO or your team. Do not mention weaknesses - which might be all that is reported.
If you are unsure about WHO's position on a particular issue, say so. Don't guess, you cannot be expected to know everything.
After any encounter with the media, report back to the Regional Office and WHO/HQ. They will review the interview and follow-up as necessary.
Issuing a press release: hints.
your key point should be in the first paragraph
the text needs to be brief (maximum one A4 page)
the title and the opening line are the most important part: they need to grab attention
and encourage people to read on
avoid referencing academic work or text, refer to people or researchers
use a language that is appropriate for the audience
if you are working with a particular newspaper or radio/television station, you may
need to do some research about their editorial styleChapter 3
PREPARING FOR THE OPERATIONS
The capacity to mobilise and deliver the right supplies,
in a timely and appropriate manner,
is critical to your mission.
You will need a logistics system first to support you and your team (e.g. in setting up the office) and then to provide emergency services and supplies to the beneficiaries.
Local conditions in the affected region will determine what arrangements are required for logistical support. Emergencies occur more often in remote and under-developed areas where logistics will be difficult, requiring innovation and flexibility. In the interest of speed and economy, adapting systems already in place is preferable to establishing new systems. A good knowledge of the available infrastructure and services is essential to ensure a cost-effective response.
TIPS. Don't try to reinvent the wheel. If some other agency has assessed the capability of the country, use their data to design the WHO logistics. If another UN agency has already established a system for importing and distributing relief goods, use it.
3.1 INFORMATION NEEDED
From your first assessment, you have a good general idea of what is available. Now you need to extend your information base to incorporate all actors who may be able to assist with logistical support. You need to know:
·ð The support (vehicles, airfreight, communications, warehouses etc.) WHO can get from Government, UN agencies, bilateral donors and NGOs. See 4.5 Mobilising Resources for more information.
·ð The existing transportation infrastructure in the country/region. Emphasis must be put on ports of entry and access routes to emergency sites.
·ð Customs procedures for bringing goods into the country, including costs and the possibility of delays.
·ð The storage and distribution systems, including logistics capabilities of other organisations that WHO could make use of.
In order to gather this information, start from the basics: what are the key requirements for your mission to achieve its goal? Prioritise your immediate needs.
The most important sources of information will be the logistics officers already working in the country. Explain what you are doing and ask for their assistance in pooling all available information.
The following assessment forms are useful tools for compiling information to determine the best course of action within the framework of given resources and infrastructure:
-ð Logistics capability of other organisations (Annex. 5).
-ð Port of entry assessment (Annex. 5).
Once you have your information, copy it to WHO/HQ and the Regional Office for distribution to Supply Services and other interested parties. The information will help them fine-tune the response from their end.
3.2 SETTING UP AN OFFICE
If the WHO office is too small to accommodate new staff, or if you must work out in the field, e.g. in an epidemic affected-area or close to an Internally Displaced Persons (IDP) camp, a new office may be necessary.
With the assistance of the administrative/logistics officer, you must define the office and staffing requirements for your mission. A template is provided (STAFF PLAN Annex. 1).
It is strongly recommended that WHO Manual II.19 (Annex.1) is consulted before commencing any recruitment. Staff can be divided into two groups:
·ð CORE staff (secretarial, drivers, watchmen etc.): their recruitment and selection is dealt with in some detail in this section.
·ð PROGRAMME staff (medical professionals, health workers etc.): their recruitment is dealt with in chapter IV.
Together with the administrative/logistics officer you should first draw up a list of core staff positions and the consequent skills needed. Job descriptions for secretaries, receptionists, interpreters, drivers, guards and cleaners are available in Annex.1.
You should be closely involved in all aspects of recruitment. Refer to the UNDP office regarding local laws and regulations governing employment of staff.
In the initial phase of an emergency, all new national staff will be given Special Services Agreement (SSA) contracts. At a later stage, these contracts may be reviewed and, if deemed appropriate, converted to short-term staff contracts.
Core staff will be needed urgently and there is often insufficient time to find and recruit personnel along 'normal' guidelines.
Local resource mobilisation is your primary course of action: you should see whether you can get staff on loan, secondment or as in-kind donation from other WHO programmes, local authorities or other UN agencies. Even if you find that you have to recruit and pay for your staff, the best potential sources for good quality personnel remain:
·ð WHO office. Records of former staff (from former projects or programs), including performance appraisals and job descriptions, will be on file. They can be reviewed to find suitable candidates. The advantage of hiring former WHO employees is self-evident.
·ð UN agencies. Similarly, any agencies established in the area before the emergency will have records of former employees.
·ð Local authorities. They will have long lists of potential employees. Specify that you need staff with previous work experience on UN projects or programmes. Detail the type of experience and qualifications you require.
Particular attention must go to the selection of staff. Use as much time as possible to conduct interviews, to check backgrounds and to test the skills of each applicant. National staff can be the greatest asset in emergency operations, their local knowledge and commitment is often invaluable. Time spent in selecting staff is seldom regretted.
Advertising for staff can be done through newspapers, radio or notices posted outside Government and UN offices. List the education, minimum skills, languages, previous experience and legal requirements.
In countries where ethnic/religious divisions exist, political sensitivity is critical in local recruitment. You have to ensure a balanced representation of all parties in your team, in order to avoid conflicts. Ask for the advice of local staff whom you can trust.
In crisis areas, unemployment is generally high, people are anxious to find work and will respond in droves to vacancy notices. To ensure that your office is not inundated with applicants and that they are treated with respect, take the following steps:
·ð when advertising, clearly state that curriculum vitae and/or personal history forms (PHF) only will be accepted and that applicants will be contacted in due course;
·ð brief the receptionist to accept only curriculum vitae/PHF.
·ð reply to each unsuccessful applicant using the standard form (JOB REPLY Annex.1.). This can be posted or left with the receptionist for pick-up. It is courteous to reply to applicants, and it stops them from hanging around the office waiting for a reply.
Each applicant should complete the Personal History Form available in Annex.1. Birth certificate, identity document, curriculum vitae and references are photocopied and placed in the applicant's file.
Skill testing is a useful tool for evaluating the applicant's ability to perform to the standards required. Selective skill tests appear in Annex.1. However, the score obtained in these tests should be considered as indicative only. Other qualities, i.e. personality, appearance, work experience and teamwork capacity must be taken into account. Applicants must be informed that a high score in a skill test does not necessarily mean employment.
Employment must be subject to the successful completion of a medical clearance by a UN accredited physician. If this is not possible, direct the candidate to the nearest clinic or hospital with x-ray facilities. Regional Office will inform you of the type of examination necessary and the financial limits on any costs involved.
In Annex .1 you can find models of the following contracts, that you can stipulate, for limited periods not exceeding six months:
·ð SPECIAL SERVICES AGREEMENT (SSA).
·ð AGREEMENT FOR PERFORMANCE OF WORK (APW).
An outline of terms and conditions relating to this type of contract, and detailed guidelines on all issues pertaining to staff (salaries, leave, travel, per diem, etc.) are available in Annex.1.
The procurement guidelines in this handbook are intended to help you purchase items without inhibiting your use of creative and innovative strategies. You should tailor this guidance to your particular circumstances. Focus on the goals of your mission.
To facilitate and speed-up emergency activities, you may have the authority to make local and direct purchases from neighbouring countries within fixed monetary amounts. Whenever available, supplies that meet WHO criteria could be obtained locally. Purchasing from local vendors stimulates the local economy and improves relations between participants and the local government.
When the required items are not available locally or regionally, then priority purchase assistance will be provided by Supply Services at WHO Headquarters or Regional Office.
WHO procurement services can be made available to the national authorities, the UN system and donor agencies. WHO may also procure services, medical supplies and equipment on behalf of a government, a UN agency or an NGO in official relations with WHO, if the government or organisation deposits funds in an acceptable currency in advance for this purpose.
Most emergencies are short term. Thus, purchasing of equipment must be restricted to minimal needs to complete the task. The option of renting equipment should be considered in all cases where significant expenditure is involved (items such as vehicles, computers, photocopiers etc.).
The administrative/logistics officer advises on procedures and regulations governing the procurement of goods and services.
Every financial transaction must be supported by documentation (receipts, proformas and purchase orders). If specific ceilings for expenditure and procedures have not been authorized, the following must be adhered to for the procurement of all goods and services:
A. LOCAL PROCUREMENT
(goods must be readily available within the country)
·ð If Dollar amount is less than US$500: Competitive quotes or proformas are not necessary. Receipts are required.
·ð If Dollar amount is over US$500 but less than the limit specified in your delegation of authority:
1. Make a requisition (sample in Annex. 5). The requisition clearly describes, in detail, the goods or services required.
2. Obtain three proformas. Each proforma must clearly describe the goods or services, the total price including taxes, delivery charges and any other costs. Quotes should be in local currency wherever possible.
3. Once a decision is reached, a local purchase order (sample in Annex. 5) is issued to the successful vendor. The order must clearly describe the goods or services, the total price to be paid by WHO and the terms of delivery (time frame, delivery costs etc.). Always put allotment numbers and the project identification, for which the goods are destined, must be identified. Signed by the WR (or someone delegated the responsibility) and the administrative /logistics officer.
4. Once goods are received, complete a Received & Inspected form (sample in Annex.5) and file for future reference.
5. Pay the vendor in local currency wherever possible and obtain a signed receipt.
6. Enter durable goods onto inventory and determine the need for insurance.
In some instances, local prices may seem excessive. If you have doubts on the price, refer to 'WHO general price list' in Annex. 2. However, before procuring through WHO/HQ or the Regional Office, the following should be taken into consideration:
·ð How urgently is the item needed?
·ð What is the time delay to receive it?
·ð What will be the freight costs?
Remember that any exception to the standard procedures (such as a higher ceiling for local purchases, or a waiver of the bidding requirements) must be permissible in the Delegation of Authority, issued by HQ/RO.
Human life is a priority.
If you feel that the item is urgently needed, despite the excessive price,
then document the reasons and proceed with the purchase.
In an emergency, a degree of flexibility and innovation can also be used in procuring services. For example, if WHO were asked, by other agencies, to share the costs of hiring an aircraft, you would have to decline. The reason is that only the WHO Director General can authorize the hiring of an aircraft. However, you may agree with the other agencies that WHO will purchase an airline ticket (the ticket cost being equal to your share of the plane rental).
B. EXTERNAL PROCUREMENT
WHO Supply Services will assist in all external procurements. They have long-established lists of reliable suppliers who can readily provide standardised equipment that meets WHO specifications.
1. Make a requisition (Annex. 5). The requisition should clearly describe each item required in as much detail as possible. The Health Coordinator and the administrative/logistics officer sign the requisition.
2. Transmit the requisition to WHO/HQ through the Regional Office for distribution to Supply Services. If necessary, ensure that the item is clearly marked URGENT.
3. If they have any doubt as to the description or details of the item requested, Supply Services will contact you for clarification.
4. Once the goods are received, fill the Received & Inspected form (Annex. 5). File and send copy to Supply Services, WHO/HQ and RO.
5. Enter goods into inventory and determine the need for insurance.
C. STANDARDIZATION AND COMPATIBILITY
When purchasing equipment ensure it is compatible with similar WHO/UN equipment. Of course, this is particularly important for items such as software and communications equipment.
As for medical equipment, your first concern will be compatibility with the standards of the national Ministry of Health.
The WHO general price list in Annex.2 contains some configuration examples for WHO. Standardisation of equipment will give economies of scale as, for example, with consumables such as ink cartridges or fax paper.D. FURNITURE
Plan office needs in advance; determine the type and quantity of furniture that you will need to complete the mission. Take into account the expected duration of the mission and the number of staff working in the office. The nudge form provided in Annex. 5 can assist in determining the furniture requirements for the office.
Where furniture is not provided by a third party (in the form of a loan or gift) procurement will be necessary. The following points should be considered:
·ð Emergency missions are mostly short-term and funding is limited. New furniture is expensive and unnecessary in an emergency operation.
·ð Investigate the possibility of renting furniture.
·ð Is there a used furniture market?
·ð Purchase from local vendors as much as possible as this helps the local economy.
·ð Lockable furniture (i.e. drawers and cabinets) is needed for security purposes. Make sure you have keys and spares.
Refer to the procurement guidelines in the Logistics section before purchasing any furniture.
E. OFFICE EQUIPMENT
Photocopiers, facsimiles, printers, computers, etc. are an integral part of the office. Before purchasing any equipment, conduct a local market survey to assess in-country supply availability. This can be particularly useful for determining the availability of an office safe and consumables (fax paper, ink cartridges etc.) and urgently required supplies.
When getting equipment, emphasis should go to servicing, warranty and back-up. Another consideration is standardisation: is the locally procured equipment compatible with that of the office? Does it meet WHO guidelines? Refer to the Logistics section for more information and guidance before finalising your purchase.
You will find detailed information regarding vehicle procurement, driver recruitment and general driving rules in Annex. 5.
Where there is a Government or UN system to clear the importation of medical supplies, use it. There may be a national pharmaceutical agency that imports medical supplies and equipment: they know the government and customs procedures, more importantly, the Government and customs know them.
CLEARING AND FORWARDING PROCEDURES
Before bringing supplies into the country make contact with the customs office at the airport and ensure they understand and appreciate the role WHO has in the emergency response. Secure their assistance to facilitate the entry, clearing and forwarding of emergency supplies. (Always warn customs in advance that cargo is expected and ask for full co-operation).
You may need an 'Attestation of Exoneration' from taxes and duties to clear goods through customs. Such Attestation states that the goods are for humanitarian assistance and will be used for the emergency (full description is needed including airway bill, value and destination). For durable goods, e.g. vehicles or radios, you have to state that the goods will be exported after the emergency is over. The Attestation must be signed by you and stamped with the WHO official seal. A sample Letter of Attestation comes in Annex .5.
If a freight agent is required, ask other agencies for recommendations and shop around for competitive quotes before making a decision.
In situations where WHO is not known to the customs department the following procedures should be adopted until such time as WHO can establish its credentials with the authorities:
1. See which UN agency has established credentials with the customs officials and is familiar with the procedures (UNDP usually).
2. Approach the agency in question and ask to use their system to bring in WHO supplies under the agency's name.
3. Determine this agency's requirements to bring in humanitarian goods.
4. Inform Supply Services of the situation and have them ensure that all packages are clearly marked as destined for WHO care of the agency in question.
If the supplies were lost in transit or damaged, you must make an insurance claim. These are the procedures to follow:
1. Make a report stating the extent of damage or nature of the loss.
2. Estimate the cost of repairing the damage (attach invoices). If the supplies are urgently needed and it is possible to replace the items through local suppliers, attach an invoice and note explaining the reasons for the new purchase.
3. Deliver the above to the local representative of the insurance agent, with supporting documentation: copy of original shipment invoice, copy of short landing certificate (or certificate of loss from freight agent/bond warehouse) and airway bill. If there is no local agent, send the documents to WHO/HQ or Regional Office for forwarding to insurance agents.
3.6 ASSET TRACKING
Basic controls on the issue and storage of WHO assets must be established from the onset of your operations. Effective stock control and security are imperative and should be put into effect from the time each asset arrives through to the eventual departure of the team.
The administrative/logistics officer is responsible for tracking all your equipment and supplies. To this end, a simple database is provided on diskette. This database can be used to track all assets and assist with issues and returns.
You may receive a cash advance from the Regional Office to cover the running costs of your mission. You are responsible for this money and you must be able to account for it, at all times.
IMPORTANT. Document every transaction that you make using these funds. You will be required to submit a full acquittal of all in-coming and out-going funds.
A. BANK ACCOUNT
Normally, if you need an account for your project, you will use the same bank as the WHO office. If that bank is not operating, determine which banks are used by other UN agencies. Ask the agency in question to introduce you to the bank.
The bank must have good standing in the country and be linked internationally. All pertinent information should be transmitted to Coordinator Treasury (TRY), HQ, who is responsible for issuing the clearance necessary to open a bank account.
HQ will fax you a special form, which you and any other certifying officer must sign with your specimen signatures. Send one copy back by Fax and the original by pouch. Before the bank can proceed, the Coordinator Treasury must give permission for the account to be opened and issue a letter certifying who may operate the account (to the bank manager) with a copy of the relevant signatures.
You will operate the bank account by cheques and through the petty cash. Follow-up and clear promptly all debits and credits.
At the end of each calendar month, the bank statement must be reconciled with the imprest account to ensure that it balances.
B. WHERE THERE IS NO BANK
If you are assigned to a country where banks are not operating, you will need to take with you funds from the Regional Office. Before leaving, obtain insurance by contacting Coordinator HIP (Health Insurance and Pension) HQ for any WHO funds you are carrying. In extreme situations, it may be dangerous to carry money even when travelling to your duty station. In this case, contact the Representative/Logistic Officer of other agencies present in the area, and ask him/her which arrangements can be used. For ad hoc arrangements, such as the utilisation of money vendors, you need to request the Coordinator Treasury for Authorisation. Remember that in areas where no money circulates, you may be forced to pay in kind for services and goods (soap, clothes, etc.)
On arrival, get a safe, either in the WHO office, another UN office or at your hotel; otherwise, purchase one. Until you have access to a safe, you must keep the money on your person, or split it among the members of your team - document appropriately.
If there is no bank, it will be difficult to replenish your impress. Newly arriving WHO staff can bring funds. Otherwise, see which UN agencies employ professional couriers and use the same arrangement. Decide and advise the Regional Office accordingly.
C. THE IMPREST ACCOUNT
The imprest account is used to track all movements of WHO funds. If the impress account is your responsibility:
·ð Keep a separate imprest for each currency unit that you use (USD, currency of the Country of assignment, etc.).
Each imprest account (if you have more than one) has its own separate bank account Don t confuse them!
·ð Record all disbursements in the Imprest Account CashBook. Obtain receipts for all expenditures, no matter how small. Update the imprest book daily.
·ð Use vouchers with every payment. Number and date them chronologically and mention the appropriate sticker number for each expenditure.
·ð Within seven days after the end of each month, the imprest account must be sent to the Regional Office or HQ. Funds will be replenished only after you have submitted the monthly imprest.
Self-imposed discipline is the secret to accurate accountability.
D. ESTIMATING MONTHLY EXPENDITURES
With the WR determine the funds that you will need to meet the running costs related to your work. Consider the costs related to the office, personnel, vehicles, activities and possible local procurements. Once you have your calculations, add another 50% to the total. Use this as a first estimate that you can fine tune later. A form exists for this purpose in Annex. 5.
E. ESTIMATING THE LEVEL OF THE IMPREST ACCOUNT
Once you have worked out your monthly expenditure you need to establish the level of your imprest account (i.e. how much do you need as available funds?). This is normally set at 3 times the level of monthly expenditures so as to allow for the shortfall in time for reporting and reimbursement purposes.
REMEMBER. At the end of your mission, you will return to Regional Office for a debriefing. This will include justifying all expenditures to the Finance office. Keep copies of all your financial records and take them with you when your mission ends.
If you are unfamiliar with financial procedures, or are new to WHO procedures: you will find the following guidelines and copies of useful forms in Annex 5:
·ð GUIDELINES FOR IMPREST ACCOUNT AND PETTY CASH
·ð IMPREST ACCOUNT CASH BOOK
·ð PETTY CASH RECEIPT
·ð CASH COUNT CERTIFICATE
·ð PROJECT FUNDS RECEIPT
·ð RECEIPT OF WAGES
·ð PER DIEMS
·ð GUIDELINES ON OPENING AND OPERATING BANK ACCOUNTS
·ð GUIDELINES FOR WHERE THERE IS NO BANK
·ð MONTHLY EXPENDITURE ESTIMATE FOR BUDGET PURPOSES
A good communications system can be crucial to the success of your mission; it ensures the flow of information to and from the field. Without it, your work will be seriously impaired, or impossible. Furthermore, where security is an issue, each staff member must have a means of communicating with the office or the designated security officer.
symbol 33 \f "Symbol" \s 11You must have a good grasp of what a communications network is and of how to establish one. There are many different types of communication devices; you may need only one or a combination of some or all available. No matter what the combination your priority is being able to communicate with your fellow actors and with Regional Office.
In major emergencies, telephone lines tend to be unreliable. However, if they are working, consider setting up an electronic network through computers, modems and appropriate software for E-mail, accessing Internet, etc. Thus, you will be able to complement telephone conversations and faxes and reduce the costs.
If telephones are not working, and anyway whenever security, reliability and speed are important considerations, think of a radio network and/or satellite communication systems, dedicated or commercial.
IMPORTANT. The UN Resident Coordinator and UNSECOORD may refuse you permission to work in the emergency area if you (or fellow staff) do not have a radio. Don't overlook the importance of radio communications, particularly in regard to security considerations.
A radio network consists of two or more radios operating on the same frequency. Most UN radio networks operate on Very High Frequency (VHF), Ultra High Frequency (UHF) or High Frequency (HF).
VHF/UHF radios (e.g. MOTOROLA hand-held) have the advantage of being small and light. They are excellent for security purposes as individual staff members can easily carry and operate them. They can be interfaced to computers; access telephone exchanges and be fitted to vehicles. However, they are limited in range and need costly repeater stations to boost the range of their signal.
HF radios (e.g. CODAN, BARRETT and MOTOROLA) do not need repeaters, and can transmit signals over thousands of kilometres. They can access international telephone lines, can be fitted to vehicles, can access the Internet or E-mail servers, and can be linked to Fax machines.
Where WHO does not have an already established radio network, you will have to move quickly to find means of communicating with your colleagues and partners in the field. In an emergency, you may not have the time to conduct surveys and determine which regulations and licenses rule telecommunications. In this section you will find shortcuts to establish an interim solution to your communication problems.
Your first course of action is to see which communication devices are being used by sister UN agencies. In particular, you should consult OCHA, WFP, UNICEF, UNHCR and UNDP. If they have established a network ask to 'piggyback' on their system. This will avoid you applying for permits and frequencies from the government, as you will be covered by their agreement.
If OCHA is involved, they will set up a communication centre. They will provide you with the information and specifications you need to order radios. In some cases, they may have radio equipment you could borrow for the duration of the emergency.
WFP, UNICEF and UNHCR generally enter emergencies with fully-fledged communication departments staffed with competent technicians. They can be very helpful and give you good advice on the type of equipment you need to get onto their network. They often carry extra radio equipment, which you may well be able to borrow from them in the short term.
The UN Resident Coordinator (UNDP) may also have extra communication equipment. Note also that the Resident Coordinator is responsible for coordinating a consolidated approach by all agencies on the type of equipment to be used and the allocation of frequencies for work and security.
More detailed information and guidelines can be found in the security Annex and are as follows:
·ð OVERVIEW AND DESCRIPTION OF HOW RADIOS WORK
·ð ESTABLISHING A COMMUNICATIONS NETWORK
·ð DETERMINING YOUR REQUIREMENTS
·ð IMPROVING COMMUNICATIONS
·ð PROCEDURES FOR USING RADIOS
·ð CALL SIGNS
·ð ALPHANUMERIC PHONETICS
·ð WHAT TO DO IN AN EMERGENCY
·ð MAINTENANCE OF RADIO
·ð FIRST TIME USERS
·ð SATELLITE PHONES
STARTING THE OPERATIONS
From your initial assessment (Chapter .2) you have drawn preliminary conclusions on what is needed and what WHO can do. However, in an emergency there will be many actors on stage; you must move quickly to identify potential partners and to bring them together under one umbrella.
Outline your plans and develop them with the potential partners. Look at the immediate priorities - saving lives and reducing suffering - without losing sight of the longer-term scenarios. WHO's technical mandate in Humanitarian Assistance goes hand-in-hand with the task of strengthening national and regional capacities for Health - or preserving them, as is more often the case in severe emergencies.
4.1 OPTIONS FOR ACTION
When identifying options for action, consider that the partners expect WHO to:
1. take the lead in
·ð rapid health assessment,
·ð epidemiological & nutritional surveillance,
·ð epidemic preparedness,
·ð essential drugs management,
·ð tuberculosis control,
·ð control of HIV/AIDS & sexually transmitted diseases,
·ð physical & psychosocial rehabilitation.
2. provide guidelines and advice on:
·ð nutritional requirements & rehabilitation,
·ð medical relief items,
·ð reproductive health.
As WHO is the health adviser and coordinator for the UN system, this may imply:
·ð ensuring that:
- Health needs are properly assessed and are reflected in requests for international assistance, e.g. in UN Appeals.
- Humanitarian Assistance applies the best health practices, reflects the Country's priorities and respects its capacities
·ð providing to partners:
- Information on the Country's epidemiological profile, the pre-emergency health coverage, etc.
- Facilitating collaboration between international and national partners.
- Mobilising national and international expertise to meet specific health hazards, e.g. tropical diseases that can exceed the capacities of even the most experienced international NGOs.
Probably, your best point of entry is through Health and Nutrition Surveillance. This will put you in contact with a variety of partners at field level, and will provide the information that you want to circulate at central level (see Coordination, 4.3).
4.2 IDENTIFYING PARTNERS
You must build up your network of national and international partners. Ask the WHO country staff for advice and information. They have the contacts, the knowledge and the experience.
A. NATIONAL PARTNERS
The most important partner is the Government, its agencies, departments and representatives.
Gauge their resources and capacities at central and local levels in various parts of the country. Identify the resources that can be temporarily mobilised to respond to the emergency without affecting normal services.
Look beyond the health sector. Other ministries and departments can assist. For example, the Ministries of Defence or Transportation may be able to provide trucks, warehousing, temporary shelters, etc. Seek assistance from all levels of government, including local and municipal authorities.
Other entities that may provide assistance, or be contracted by you for provision of services:
·ð National NGOs, first of all the National Red Cross/Crescent
·ð Private hospitals and clinics
·ð Private consultant companies
·ð Professional associations
·ð Religious organisations
·ð Pharmaceutical companies
·ð Large corporations
·ð Research laboratories
Usually, the ICRC and the international NGOs are the main providers of health services in areas of armed conflict or where there is no government. Nonetheless, in the context of UN humanitarian operations, WHO may be called upon to provide assistance in these areas. WHOs main role in these circumstances is to ensure that health care reaches all the people in need and that it maintains acceptable standards in spite of the circumstances. In such situations, health activities need even greater coordination within the general humanitarian response.
B. INTERNATIONAL PARTNERS
Your most important international partners are the sister UN agencies. The UN will be the largest single entity involved in the emergency and will have funds and other resources readily available. Look at the role of each agency. Identify the focal points for health issues or logistical matters and make contact with each accordingly.
Embassies, Bilateral Aid agencies (e.g. Sida, DFID, NORAD, USAID) and inter-Governmental bodies (e.g. EU-ECHO) will be present. Are they willing to provide funds, material, health or logistical support? What are their priorities? Have they a specific interest in the Country? Special policies for some vulnerable groups? Are they supporting other WHO programmes? What level of support can they provide?
International NGOs will be there, too, and many of them. There may be an NGO coordinating body already in place, which can provide information on their overall capacities. See with the UN Resident Coordinator if there is some institutional framework governing NGO operations. Some NGOs will have independent projects and funding. Others will work under special agreements with UN agencies such as UNICEF or UNHCR. Can WHO contract their services?
In major emergencies, one particular UN agency will be appointed as Lead Agency in the affected country, while international appeals (UN Consolidated Appeals) are coordinated by the UN Office for Coordination of Humanitarian Assistance (OCHA).
In some cases, WHO may be the Lead Agency. Even if this role is with another agency, WHO retains a mandate in health relief coordination and, as WHO, you may be appointed as UN Health Coordinator. Whatever the setting, the WR is the top WHO official in the country emergency health coordinators are under her/his direct supervision.
Coordination is difficult, but vital to the success of emergency relief, where needs are extensive while resources and time are limited. If each player works alone at his/her own thing, relief will rapidly turn into a disaster on its own. It is essential that each partner's responsibilities be clearly defined at all levels.
Coordination must be supported by clear lines of authority and by the functions of command and control, but it should never be confused with them. To coordinate is to facilitate:
·ð the circulation of information
·ð discussion on needs and lines of action
·ð reaching a consensus on objectives and strategies
·ð the adoption of responsibilities in the context of that agreed.
Take a non-threatening approach. Be assertive, not aggressive. Make clear that your technical expertise is there to serve your partners. Do not feel threatened if, by some circumstance, you happen to be coordinated' by somebody else. It may be in the best interests of the response to support this person. But remember one thing: if you are too shy in asserting technical correctness, you may end up endorsing somebody elses mistakes.
Start coordination by looking at the potential partners. Divide health relief into key areas of responsibility (nutrition, sanitation, health care, etc.) and see which organisations are most relevant. Establish a plan of work for meetings and mutual briefings. Do not hesitate to expend effort to build-up your networks and status as coordinator.
Arrange a meeting with the UN Resident Coordinator. Establish your credentials as focal point for health co-ordination as mandated by the UN General Assembly. Enlist the support of the Resident Coordinator in your next tasks: bringing the UN agencies, the Government and the NGOs firmly on your side.
A. UNITED NATIONS
Some UN agencies identify with certain areas of responsibility. For example:
- UNDP: economics, capacity building, long-term development,
- UNHCR: refugees,
- UNICEF: women, children, education, water,
- WFP: food relief and nutrition.
See how you can accommodate these special concerns in your plans.
Ask the UN Resident Coordinator to introduce you at the Heads of Agencies meeting. Be ready to give a short statement on your terms of reference, your previous experience, your assessment of the situation, your plans, and your views on the role of emergency health coordinator. The Heads of Agencies will then instruct their health programme officers that they are to report to WHO on all matters related to health assistance. Ideally, this should include movements of health staff, medical supplies, health programmes and operations.
Together with the UN Resident Coordinator and your counterpart in the Ministry of Health, arrange a meeting with the Government official who is in charge of emergency relief. Establish your credentials as the UN Health Coordinator. Ask him/her to endorse your appointment and to be proactive and support you in your work. Expose WHO's comparative advantages:
a. WHO is best placed to provide technical assistance and mobilise external resources, not only for the short-term emergency solution, but also for the long-term.
b. WHO is an Organization of Member States: it gives the best guarantees of respecting national priorities, of collaborating with the Government and of fostering the same attitudes in all international partners.
c. National capacities are always priorities for WHO, even in an emergency. WHO can ensure that nationals are given preference for recruitment and training by international partners; that health information/warning systems and health facilities are strengthened and rehabilitated.
d. WHO can tap into a vast network of technical expertise, and ensure that response is professional and meets with established international standards.
C. NGOs AND OTHERS
Next you must coordinate with international and national NGOs. Most organisations understand the need for coordination. Recent major initiatives, fostering a common Code of Conduct and Minimum Standards of Humanitarian Assistance, have been accepted by most major players (see the Sphere project, reference in Annex .4). However, there will also be some that believe they can act alone and they may not take kindly to any hint of control. Avoid confrontation but discourage solo acts. Foster consensus on the fact that only coordination can ensure an effective humanitarian response. Make of WHO an indispensable source of information and technical advice.
Get the point across that WHO has the full backing of the Government and the UN system. As agency in charge of the health aspects of response coordination, WHO has the responsibility of:
- providing leadership and direction in all aspects of health
- assisting the partners in defining their role in health relief
- providing technical guidance on all health issues
- assessing the suitability of all medical donations
- clearing the arrival of all medical supplies
- ensuring that a professional code of conduct is adhered to
- collecting and clearing all health information.
CENTRAL HEALTH COORDINATING COMMITTEE
If a Central Health Coordinating Committee (CHCC) is not already in place, work toward it with the Government and the UN Resident Coordinator. You may have to start with an informal working group, but some sort of CHCC is essential for coordination.
The CHCC must be small to be manageable - you cannot have 50 organisations at each meeting. In most situations you will act as the chairman of the committee. Although this committee will have no authority over national agencies, it is important that the Ministry of Health participates in the meetings together with the relevant UN agencies. Include NGOs who have a longer presence in the country, are trusted by the host Government, have a good track record, have the resources to implement large-scale programmes and the capacity to lead smaller organisations.
·ð Use Health information as a 'lubricant'. Make sure that surveillance data are fed regularly into each CHCC. This will give concrete and relevant matter for discussion.
·ð Your role in coordination must be supported by a clear understanding of what is within your range of decision-making. Get clear instructions on this from your direct supervisor at HQ, Regional office or in the Country.
·ð Manage the meetings; they must be short and focused. Each speaker should be limited in time and content of presentation. Establish an agenda and timetables from the start.
·ð Design forms that will help you organise the exchange and collection of information on who is doing what, when and where . In annex 2 you will find samples to give you ideas.
·ð Insist on clarity. Make your points and be ready to give clarifications. If you do not understand, say so.
·ð Give positive feedback. Be always ready to recognise merit when due. Be tactful in your criticisms.
·ð Ensure secretariat and documentation. After each meeting, minutes must be recorded, edited and circulated together with a health update. Publish newsletters that reach all the partners and the different levels of the relief system. See that a summary of health information is fed into general UN situation reports ('sitreps').
·ð Coordination implies, and is also made of, inter-personal relations and social events. Beware of what you say and how you act at cocktails and receptions.
Depending on the scale of the emergency, de-centralised sub-committees may be needed. Coordination is as important in the field as it is at central level.
Establish committees at sub-national level. They will be chaired by a WHO staff member or another professional, chosen from the most active organisation in the area. A system for channelling information between the sub-committees and the CHCC must be put in place and stuck to.
Coordination is teamwork: build up your team and make each partner feel part of it. Without being too strict on the sequence, you can adopt a gradual approach.
1. As a start, have the partners sharing information:
·ð on their mandates, objectives, roles and responsibilities
·ð on their resources and capabilities
·ð on the type and quantity of assistance that they can provide
·ð on their areas of operations
·ð on the priorities that they want to address
·ð on their projects
·ð on their sources of data
·ð on their perception of the general context.
2. As next step, have the partners working together
·ð at assessing needs
·ð at setting the standards of assistance
·ð at mobilising external resources
·ð at ensuring access to the beneficiaries
·ð at building local and national capacities
·ð at training their own staff.
3. In a more advanced phase, you will find that the team can share plans and resources:
through joint contingency planning ('..what if ?')
through joint strategic planning
through joint operational planning
by sharing their experts
by sharing security systems
by sharing logistics (communication and transport)
by implementing joint operations.
You can measure your success at coordination by:
the frequency of contact with all partners, at all levels
the frequency of joint assessment/relief field missions
the catchment area and the diffusion of the information/dissemination system
the clarity of objectives and
the clarity of procedures for
mobilising and deploying
the optimisations of efforts and
a plan of action and the
resources to implement it
the participation of partners at central and local level.
You have made an assessment of the situation, you have a global understanding of what could be WHO's action in the emergency, and you have brought the main partners together. Now, you must develop a master plan that, through good coordination, will accommodate and optimise your partners ðplans.
Consult with the WR and the UN Resident Coordinator. The entire UN system is working at strengthening coordination and collaboration at country level between its various agencies. UN inter-Agency initiatives such as: the Country Strategy Note (CSN) or the Common Country Assessment (CCA), the UN Development Assistance Framework (UNDAF) and the Consolidated Appeal Process (CAP), are becoming more and more frequent. They provide opportunities to access good baseline information and create a good working environment for the planning process.
A. THE MASTER PLAN FOR HEALTH RELIEF
1. Discuss the context with your partners in the CHCC.
·ð Review and consolidate the findings of your need assessments with those of other agencies and organisations.
·ð List the stakeholders, i.e. the persons, groups and institutions that are, or may be affected by changes in the situation. These include the affected population as well as the relief workers, with their needs and plans. You may decide to include more stakeholders in the planning group. If this is not feasible, at least keep referring to the list of all the stakeholders for the following steps.
2. Focus on the problems. You can clarify each problem by analysing it in terms of:
§ð hazards that need tackling, e.g. measles and/or malaria,
§ð vulnerabilities that need reducing, e.g. people living in camps,
§ð capacities that need strengthening, e.g. health posts in camps,
§ð constraints that need addressing, e.g. military insecurity,
§ð expectations that must be met. Analyse the policies and the values that govern the various stakeholders. They will reflect on the evolution of the global situation, and affect the implementation of the plan.
Look at the relationships and interactions between these items and between different problems. Organise a 'tree' of problems according to their cause-effect relationships.
3. Set global objectives. Describe the state that you desire to achieve, or the direction you want to move in. You do not need to specify how far you want to go. E.g. ' Mortality Reduced ', will be an acceptable global objective in many emergency contexts.
4. Set immediate objectives. They must reflect what you want to achieve within a given time frame in order to benefit a target group and to get closer to the global objective. Preferably, immediate objectives should be S.M.A.R.T., that is Specific, Measurable, Accurate, Realistic and Time-bound (e.g. risk for diarrhoea reduced by 50% in the target population in 6 months).
5. Set the outputs that will be required to concretise the immediate objectives. Outputs must always be S.M.A.R.T: e.g. Number of safe water sources, latrines, and garbage pits made available to the beneficiary population;
6. Describe the activities that will be required to produce the outputs. Be specific: use verbs that indicate actions. Typical language for activities: set up...., conduct..., advise..., develop..., hold.... , identify...., train..., establish..., run...
7. Define the competencies and responsibilities of each partner as far as activities and outputs are concerned. Leave scope for changes, as flexibility is essential.
8. List the material, human and financial inputs needed to implement the activities. See what is available and what will have to be mobilised through external assistance. Identify the potential sources and determine time lapse before response can be expected.
9. Identify pre-conditions and assumptions. These are the conditions, events or decisions that are necessary for the success of the plan but that are outside of your control. E.g., availability of inputs is a clear pre-condition for the activities to be undertaken. In turn, for the activities to produce outputs and for the outputs to concretise the objectives, other assumptions about the context must remain valid. Some assumptions are critical: If they don't prevail the entire plan will fail. Set in place mechanisms to monitor these assumptions. Identify the risks and prepare contingency plans.
List the uncertainties and the risks: i.e. lack of information, unsolved conflicts in the planning group, potential conflicts between beneficiaries and national or international agencies, the natural and the man-made hazards etc.
10. Identify the indicators needed to monitor and evaluate the process and the success of the plan. Discuss them and agree on them with all your partners. Define the sources of this information, and identify the responsibilities for monitoring the plan.
B. THE PLANS OF ACTION
Plans of action can be prepared using the same process and framework as for the Master Plan. They should contain the following elements:
·ð Area of operations and beneficiaries within the area
·ð 'Sector' (or sub-sector) of responsibility
·ð Summary of the situation as far as the sector is concerned
·ð Objective (consistent with those of the Master Plan )
·ð Outputs, activities and strategies
·ð Details on the technical procedures
·ð Definition of the responsibilities of each organisation involved
·ð Brief description of the resources available (this includes funds)
·ð Description and ETA of known resources en route
·ð Description of logistical and administrative support systems
·ð Description of the resources that need to be mobilised
·ð Description of mechanisms for monitoring and evaluation.
You can deploy WHO staff to assist the various partners according to their specialities. If you are operating with minimal staff, you can at least assist by:
·ð Reviewing each plan and ensuring it fits in the Master Plan;
·ð Providing technical guidelines for specific cases, some of which may be found in Annex. 2;
·ð Reviewing the plans globally to avoid contradictions or overlapping of work;
·ð Presenting the plans in the CHCC, so that everybody is aware of who does what, where and how.
At any moment and at all levels, you should have a good overview of each partner's course of action and the resources they have to carry it out. Look for areas of weakness, if necessary ask other organisations to 'loan resources' to fill the gaps. Encourage partners to be forthcoming on their needs. 'We are all in this together'.
1. If you are working in the context of a big inter-agency operation for humanitarian assistance, the plans for Health must fit with those of the other sectors in the global strategy framework. Use consistent time frames, focus on synergistic objectives. Optimise resources. Avoid overlapping, duplication of efforts and waste.
2. Be fully aware of the role of Health in the general framework of humanitarian assistance, and convey your awareness to your partners in other sectors. By keeping people alive and healthy, health care increases the cost-effectiveness of the entire relief effort.
3. Beneficiaries are 'stakeholders' too. The plans will have better chances of success if they reflect their perceptions of the situations and expectations.
4. If all the concerned partners participate in preparing the Plan, it will be easier for them to coordinate and collaborate in the implementation phase.
5. All plans should be shared with and endorsed by the national authorities and should comply with the government's requests.
6. The WR must endorse all plans and they should be copied to the Regional Office and WHO/HQ.
7. The plans should be flexible. Constantly review the situation as data comes available; ensure that relief suits the new needs.
8. Be ready to meet any contingency. Have systems for the early detection of anticipated health emergencies and specific plans for prompt response. Identify options for rapid deployment of personnel and health supplies.
9. Sooner or later, the emergency will be over. Avoid creating dependency on foreign assistance. Plan for response with a view to the eventual transition to rehabilitation. Plan to protect and strengthen the national capacities.
4.5 MOBILISING RESOURCES
WHO's role in emergencies includes the coordination of health relief assistance from all sources: bilateral donors, NGOs, UN agencies and other organisations.
A. EXTERNAL ASSISTANCE - THE UN CONSOLIDATED APPEAL
In major or complex emergencies, which require a system-wide approach, the typical framework for mobilising international humanitarian assistance will be a UN Consolidated Appeal.
Through the Consolidated Appeal, the UN presents to the international community a strategy for emergency humanitarian relief in a country (or sometimes an entire sub-region) and asks for the necessary assistance. The UN Consolidated Appeal is inter-sectoral, covering the entire range of needs of the affected population. Together with immediate relief it can also consider the rehabilitation phase. The actual Appeal document consists of the following:
i. executive summary (inter-Agency)
ii. problem analysis (inter-Agency)
iii. review of previous year (inter-Agency)
iv. beneficiaries & locations (inter-Agency)
v. assumptions (inter-Agency)
vi. humanitarian strategy (inter-Agency)
vii. UN project summary sheets (individual Agencies)
viii. an appendix, specifying ICRC, IFRC, EC, IOM, etc. and NGOs plans.
UN Consolidated Appeals are coordinated by OCHA. But preparing an Appeal is more than just formulating projects. It takes a long process of collaboration within the UN Country Team.
First a UN inter-Agency strategy is developed, then the appeal document is prepared. After the launch of the Appeal, the UN Country Team must monitor the impact of the humanitarian operations and review the strategy accordingly. This cycle is called the CONSOLIDATED APPEAL PROCESS (CAP). Many of the steps and methods of the CAP are the same that we have seen under section 4.4 for the preparation of the Master Plan for Health.
In the UN Country Team, you are the Health focal point for the Consolidated Appeal Process. Usually, WHO will be asked to coordinate with UNICEF and work on the health aspects of background (problem analysis, previous year's review, beneficiaries, etc.) and strategy, and then to develop its own projects. All this will have to be consistent with the documents prepared by the other UN agencies for the other sectors, and will need the endorsement of the national authorities. Once again, continuous dialogue, coordination and collaboration with all the partners is essential.
The Master Plan for Health can help you work at the Consolidated Appeal. You can use highlights from the context, the problems, the objectives and the outputs for the sections on Problem Analysis, Review of previous year, Beneficiaries & Locations, Assumptions and Humanitarian Strategy, respectively.
Once you come to developing WHO's individual projects, look again at your Master Plan. Which priority objectives/outputs/activities need external resources? Develop your projects accordingly. Consider that in order to be integrated in a Consolidated Appeal, a project must satisfy the following criteria:
1. Relief projects must have
·ð a clear relationship with the survival of beneficiaries
·ð demonstrated implementation capacity by the concerned agency within the appeal's time frame.
2. Rehabilitation projects must have
·ð a clear supportive relationship to relief
·ð demonstrated in-country capacity for implementation within appeal's time frame.
Projects must be presented as summaries, highlighting a) the title, b) SMART objectives, c) key strategies for implementation, and d) budget. A facsimile of a Project Summary Sheet comes in Annex .5.
Through the CHCC, make sure that there is no duplication or overlapping of projects, and that no major gap is left uncovered. Keep in constant contact with Regional Office and HQ in Geneva, so that they can lobby for your projects in the Inter-Agency Standing Committee and with the donors' Permanent Missions in Geneva.
B. LOCAL RESOURCE MOBILIZATION
You may be able to mobilise international assistance directly in your country of assignment.
·ð From WHO. Investigate the possibility of:
- Tapping into the resources of other WHO country programmes which might be stalled by the emergency and might be re-geared towards the new needs.
- Mobilising assistance from Regional Emergency funds or from the Emergency Revolving Fund of HQ.
·ð From the UN Country Team. WHO is a member of the UN family. You can tap into the services and resources of the UN system (see also Annex.4). They are there for the emergency and may be used by all partners. Sister agencies will do their best to assist (likewise, if you are asked for assistance by another UN agency, you should oblige).
·ð From embassies and bilateral aid agencies. Embassies keep discretionary funds that can be mobilised with a minimum of paperwork to assist the Country in case of emergency. They are limited amounts but they can help for short-term solutions. The same goes for major aid agencies, e.g. USAID, or NORAD. Remember, they are there to assist and they have a professional interest in being seen to do something for the emergency.
You can make your needs known by:
·ð Discussing your plans and requirements in the coordination meetings of the WHO country office.
·ð Drawing up a list of your requirements. Present the list to the UN Resident Coordinator who will ask the Heads of Agencies to assist.
·ð Presenting your needs to the national emergency coordinator.
·ð Making a direct appeal through the CHCC.
·ð Approaching organisations on a personal as well as on a formal level (Heads of Agencies and Resident Co-ordinator).
·ð Using the CHCC newsletters and the UN emergency sitreps to highlight areas of WHO's priority concern and to sensitise donors and inform them in advance of your plans and requirements.
·ð Keeping standard formats ready to prepare short project proposals.
The arrival of large quantities of inappropriate medical relief donations can cause major logistic disasters. In order to avoid this, WHO has published a set of Guidelines for Drug Donations (WHO/DAP, May 1996). As Health Coordinator and WHO staff member it is your responsibility to see that they are circulated and respected.
1. Ensure that donors and operational agencies observe, and the Government enforces, the WHO drug donation guidelines. Distribute the guidelines to all concerned. A copy of the guidelines can be found in Annex .2.
2. Through the CHCC, distribute the Ministry of Healths list of essential drugs and medical supplies that will be the most appropriate for the Country. If the Government cannot provide such list, have the CHCC draw one up, in consultation with the MoH.
3. Ensure that the operational partners clear any purchasing or importing of health supplies through the CHCC.
4. Guidelines for suppliers can also be found in Annex. 2 and should be widely distributed to all partners and suppliers.
COORDINATING EXTERNAL ASSISTANCE
There will be an abundance of assistance coming in. You must move quickly to establish a clearinghouse for resources to ensure proper distribution and quality control.
1. For financial assistance, consider establishing a Health Emergency Trust Fund, alone or integrated in a wider UN trust fund for Humanitarian Assistance. From the start, the trust fund must have clear criteria for defining priorities, selecting the projects and managing/accounting for the funds. These trust funds must be negotiated with donors and implementing partners on the basis of the Health Master Plan. Then, the trust fund is used to channel resources to health relief projects cleared by the CHCC.
2. Emergency relief items may be obtained at very short notice through the UN Warehouse in, Italy. See Annex.2 for more details.
3. To facilitate clearing and distributing material assistance, PAHO has elaborated a computer programme, SUMA, which has proved very effective in emergency operations in Central and Latin America. This software consists of three components, Central, Field and Warehouse:
(i) Central. Designed to operate from the site national authorities manage the emergency, it creates Field units and establishes their parameters. Central consolidates information from Field and Warehouse units and prepares reports critical to emergency supplies management.
(ii) Field. This component operates from points of entry for emergency relief (airports, harbours, etc.) and categorises supplies as they arrive (urgent, immediate delivery, non-urgent, etc.). This data is forwarded to Central.
(iii) Warehouse. Registers arrival and departure of supplies from storage centres.
Copy of the software comes in the cover of this Handbook.
4. Similarly, when dealing with logistic support items, ensure that capabilities are shared among all partners according to their needs and that they are utilised to the fullest extent possible.
ACCOUNTABILITY AND TRANSPARENCY
You have a duty to ensure that donor money is used wisely and to the benefit of the country. Waste and unnecessary duplication of resources must be avoided at all cost.
Develop standard procedures for accessing resources for health relief, make them widely known and ask each partner to comply with them.
You are responsible for any items borrowed from other organisations (e.g. radios, vehicles, furniture etc.). When taking possession, do the following:
1. Check that the item is in good working order and corresponds to your requirements.
2. Ensure that the serial numbers or identification marks match those you sign for.
3. Immediately enter the item onto the asset database for tracking purposes.
As Coordinator, you should work at ensuring that only necessary and competent health staff are recruited. Redundant or incompetent personnel can be more costly than useless supplies. Usually, the Ministry of Health and/or the UN agencies or NGOs involved will draw up a list of essential staff. If this is not the case, staffing requirements should be determined by the CHCC, and not by individual partners, in the development of the plans of action
RECRUITMENT FOR THE WHO PROGRAMME
As far as WHO is concerned, you will propose the recruitment of the person(s) that you deem most suitable for a given task. It is you who approves and recommends contracts for the Regional Office's final clearance.
It is in the affected country's interest that WHO recruits nationals and nationals should be your first choice. However, outside specialist support and the recruiting of short-term consultants (STC) should be considered where necessary.
Types of contract
For programme staff, for limited periods not exceeding six months, you can stipulate the three types of contract used for the core staff ( SSA and APW), plus another: RECRUITMENT OF SHORT-TERM CONSULTANT. The terms and conditions of these types of contract can be found in Annex.1.
Where to find candidates
See whether you can get staff on loan, secondment or as an in-kind donation from WHO, local authorities, UN agencies or other organisations.
Local resourcing is your primary course of action:
·ð The best source will be the WHO office. Records, including performance appraisals and job descriptions, will be on file. The advantage of hiring former WHO employees is self-evident.
·ð UN agencies. Similarly, any agencies established in the area before the emergency will have records of former employees.
·ð Local authorities. They will have long lists of candidates. Specify that you need staff with experience of working with the UN. Detail the type of experience you require.
·ð Universities, research institutions, national NGOs etc. are good sources for short-term staff.
Use as much time as possible in selecting staff. Study the qualifications of each applicant, check backgrounds and conduct interviews. They may eventually replace you and the other international staff.
Remember, careers and lives change dramatically in an emergency. Many qualified professionals may be ready to accept any job to survive. As a colleague, you may feel obliged to recruit them, so as to help them. Do not be too hasty. Your task is to re-establish systems that will continue working after you have gone. Highly qualified individuals will return to their 'normal' jobs as soon as they can. All your hard work and the experience they acquired with WHO will be wasted.
Recruitment of programme staff is subject to the usual procedures for medical examination and clearance by a UN accredited physician
It may be necessary to bring in outside specialists to assist with specific problems or in certain phases of the emergency operations.
In these cases, recruitment is undertaken by you through the Regional Office. Regional Offices are aware of the urgency of the need and may allow exceptions to the normal procedures. If necessary, they may let them be completed at a later stage.
Terms of Reference
Specify exactly what the incumbent's position entails and the conditions he/she will be working under. For example, the staff may be expected to work in an area with no electricity and water. The incumbent should be made aware that he/she will need a degree of fortitude under difficult and uncomfortable circumstances. The post description should allow for some flexibility for unforeseeable developments.
Try to ensure that all partners adopt the same salary scale for national staff. This is important, as staff will always check their terms of employment against those prevailing. Standard salaries sustain the morale of national workers. They also eliminate poaching and career moves among agencies.
Salary scales for nationals are available from the WHO or UNDP office. Distribute them to all partners with a note explaining the importance of standardising salaries. Remember, the goal is to overcome the emergency not to enrich staff.
Long term planning
Although you are recruiting for emergency relief, you should keep in mind the rehabilitation phase as well. Consider long-term recruitment's. If the funding is in place and the staff are qualified for the position, why not give them the security of a longer-term contract? However, never make any promises you may find these cannot be kept.
Volunteers will come forward in an emergency. For the most part, you should refer them to organisations such as the Red Cross who will have the resources to equip and supervise them.
Volunteers may come from prestigious universities or hospitals. A high calibre volunteer may not need supervision and could be useful. Nonetheless, be cautious. Remember that a volunteer working for WHO will be perceived to be acting on behalf of the Organization, and may later expect to get paid.
RUNNING THE OPERATIONS
Establishing a Surveillance System for Health and Nutrition is one of your operational priorities. But, the key to your success will be good information management. You need to have facts and figures at your fingertips not only to manage WHO's own relief effort but also to assist your partners. At this stage of your mission, you have gathered much information and more is coming. You will soon be inundated with information that you must organise into a consistent, logical picture of the situation at hand. Don't try to keep everything in your head, establish a good filing system to easily store and retrieve information. You will also need an Operations Room where you can organise and display information in an accessible format.
The operations room will become the information centre for emergency health response. It will be invaluable in activities ranging from the initial deployment of human and material resources to overseeing the organisational, technical and financial arrangements once relief is on going
"Errors using inadequate data are much less
than those using no data at all".
5.1 ESTABLISHING AND RUNNING A SURVEILLANCE SYSTEM
Your primary concern is to ensure that the affected population receive appropriate health care, and that their other vital needs - security, water, food, sanitation, etc. - are satisfied through the intervention of your partners from other sectors and agencies.
To this end, you need a surveillance system for Health and Nutrition that must interface with other monitoring systems, e.g. the one for Food relief distribution. The evolution of the situation and the progress of relief must be tracked all along, from the first emergency phase through to rehabilitation and eventual normalisation.
Surveillance is 'the on-going systematic collection, analysis and interpretation of data about specific events. These data are used in planning, implementing and evaluating programmes' (E.Noji).
Different emergencies require specific methods of surveillance. WHO has produced various technical guidelines for different systems, but the ruling principles remain the same for any of them:
Standardisation, because you need to compare, compile and analyse data from different sources;
Continuity, because you need to know how things are evolving during a period of time; and
Simplicity, because you want the widest catchment area and the smoothest flow of data with the least effort and cost.
Do not re-invent the wheel. Where a surveillance system exists - and in most countries it will - adapt it to the current situation and to possible future developments. Avoid offending national sensitivities, by imposing new systems/formats, when not necessary. Remember, national professionals must always participate in re-designing the system or establishing it anew. Likewise, national professionals should associate local and district staff in the exercise.
Establishing a surveillance system involves consultations with all partners at all levels. All decisions should be by consensus. The CHCC will offer an ideal forum for these consultations, but don't forget to listen to the beneficiaries. What do they feel is their primary concern? Involve them.
ESTABLISHING THE OBJECTIVES
Identify the areas of concern. Given the situation, what must be monitored in order to (a) satisfy the people's current vital needs, and (b) prepare for new emergencies?
Remember the principle of Simplicity. Essentially, the surveillance system must:
monitor changes in the population:
health and nutrition status
access to health care
access to food
access to water
shelter & sanitation
facilitate relief management.
DEVELOPING CASE DEFINITIONS
Standard case definitions simplify reporting and analysis only if they have the consensus of all involved. 'Beneficiaries' or the Affected Population' must be defined at this stage, as well as the standards of relief; e.g. what do we mean by 'Emergency Drugs Kit'? What are the contents of the Food-Relief ration? These decisions can be highly political; use the relevant WHO guidelines for scientific backstopping during the discussions.
CHOOSING THE INDICATORS
The clearer you have been in identifying your objectives, the easier it will be to choose the indicators. Essentially, indicators must:
illustrate the status of the population (e.g. Death rates)
give early signs for alert (e.g. signs of epidemics)
differentiate between crisis and normal seasonal variations
measure the effectiveness of relief (e.g. low fatality rates in epidemics, trends in vaccine-preventable diseases, trends in malnutrition rates, etc.).
Through the CHCC, you must develop guidelines to assist health personnel, at all levels, to recognise and report the indicators.
DETERMINING DATA SOURCES
Data can come from health facilities ('passive surveillance') or from surveys in the community ('active surveillance'). Through the CHCC, ensure that all national and international Health Relief organisations are 'plugged in'.
Also, what are the 'non-health' organisations doing? How do their activities impact on health? Integrate health data with data from other sectors.
DEVELOPING DATA-COLLECTION TOOLS & INFORMATION FLOWS
As far as possible, use pre-existing local formats for data collection. If these are not available or inadequate, design or adapt new standard forms following international standards. Use formats that facilitate data entry for computer analysis (e.g. by Epi Info). Make sure that the forms are distributed widely and in sufficient quantities. Remember, when the forms run out, data-collection will stop.
Then decide how data will be transmitted? Who will process the information? Where? How? Through the CHCC, establish methods and timetable for collecting data from the field, and ensure that they are adhered to.
FIELD-TESTING and TRAINING
Make sure that field workers know how to collect data. Also verify that the data can produce the information required. Strengthen the system by training as many field workers as you can. This will improve the quality of the data and also create capacities for local analysis.
DEVELOPING & TESTING THE STRATEGY OF ANALYSIS
Major operations may require a central epidemiological unit. Even limited resources allow for analysing and interpreting data in a quick and efficient manner. The strategy of analysis must be outlined before deciding on data-collection tools and methods. Most of all, the analysis must be simple and answer the questions posed by the objectives of the system.
DEVELOPING MECHANISMS FOR DISSEMINATING INFORMATION
In consultation with the CHCC and the UN Resident Coordinator, decide who will receive the information. For the information to be useful, it must be disseminated appropriately and quickly:
feedback will sustain data-collection and the performance of field workers
health information is important for the activities of the other sectors
health information is essential for the mobilisation of resources.
Distribute sitreps, publish newsletters and encourage all partners to attend meetings and briefings in the operations room (see 5.3).
MONITORING & ASSESSING THE SYSTEM
The surveillance system itself needs monitoring. Keep track of in-coming information on a tally sheet. Is everybody reporting on time? Which data are missing? Conduct field visits and on-site evaluations to ensure compliance with established guidelines.
Finally, after a trial period, assess: Is the system useful? Is the information generated by the system being used for decision-making? If not, adjust the system.
By definition, systems evolve, re-adjust and change. Work together with the CHCC at expanding the catchment area and at improving tools and procedures. Information, during the first phase of the emergency, will be sketchy. As time progresses, insist on more precision in gathering data and presenting information.
5.2 MANAGING THE INFORMATION
Good information management is the key to your success. You will get much credit vis-à-vis your partners as soon as they realise that they can count on you for quick access to information.
You need to manage information for WHO's own relief effort as well as in order to assist your partners in applying the best health practices. Furthermore, organising apparently chaotic information into a logical picture, can go a long way in reducing your own stress.
A. THE USE OF DIFFERENT INFORMATION
The surveillance system will inform you on the manifestations of the emergency, e.g. death, illness, malnutrition, violence, displacement of population. This information must be complemented through other agencies' reports, the media and also non-confirmed rumours (never discount them without checking), older reports, Ministry of Health studies, other UN documents and country briefs. Even some high-school Geography and History books can be useful to understand the context.
You need to have a clear idea of the use and limitations of these different sets of information:
Absolute figures of morbidity and mortality indicate an on-going crisis. They reflect what you must address with emergency response, but they are not early warnings. They are snap-shots, manifestations of on-going phenomena: once you register them, the damage is already there.
Trends in data on illness and death can have a predictive value, e.g. an increase in cases of infectious disease. Still, it would be unwise to rely only on them for early warning. They are only as good as your surveillance system: What is the catchment area? How well does the system work? Do you get a full weekly update from all the affected areas?
The best indicators for early warning against Sudden-onset Emergencies are data on the underlying causes, e.g. shortage of water, pollution of sources, lack of sanitation, etc. They can also form the basis for contingency planning.
Early warning on Slow-onset Emergencies is more likely to come from indicators that pertain to the structural (i.e. economic, social, organisational) or infra-structural (i.e. demography, environment and resource-base) causes. The same information can also help you plan for reconstruction once the emergency is over.
Most of these indicators are available through official sources at country level. The rest can usually be obtained from UN sources, NGO's and national media. Many consist of hard, quantitative data, adequate to support decisions, or, at least, to justify serious consultations with the national authorities and your partners at the CHCC.
B. ESTABLISHING YOUR FILING SYSTEM
You cannot remember everything you hear or read. Keep Notes for the Record of all-important meetings. Together with collecting factual information, keep a separate diary of your impressions and opinions. You will find this advantageous when the time comes to write a final report.
*Organise your own filing system for all the documents that you produce or receive. This will greatly facilitate your technical, administrative and advocacy work.
Filing systems differ greatly. A relatively simple one could be as follows:
Programme files (for all documents related to WHO activities, by geographical area).
Fact-sheets files containing baseline information (one for each geographical area of the Country, and one for each one of your operational partners).
Subject files (for general reference documents, guidelines, etc.).
One file with descriptions of different Relief kits, price lists, names of suppliers, etc.
One file with rosters of experts, reference centres, CVs and addresses.
Correspondence in/out files for covering memos, letters, etc.
Security files containing sitreps and biodata of staff.
Donor files, list the resources donated to the response, track their usage and location.
Financial files, to keep track of expenditures and imprest accounts.
Asset file for tracking WHO assets loaned or donated to/from other organisations.
When in doubt where to file something, e.g. a WHO report that also contains factual information on a certain area and some NGOs, make copies and file each of them in their respective file, highlighting the relevant passages.
*Likewise work out a system to keep an inventory of the contents of your floppy disks.
5.3 ESTABLISHING THE OPERATIONS ROOM
You will need a room large enough to hold meetings, give briefings and stock reference material. Preferably, this room will be located either in WHO or in the UN Resident Coordinator's offices.
The most important feature of the operations room will be the display of information. You must, at the very least, show where you are working, what assets you have, where they are and how they are being used. You can use maps and charts to track the response:
1. Large scale map of the country and bordering countries showing major cities, main transportation routes (airports, highways, railways and shipping ports), national and district boundaries.
2. Smaller scale maps of each affected region showing settlements, water sources, main routes and health facilities. You can use colour-coded pins or markers to show where relief organisations are working.
Details on demography, climate, economy etc. will be useful.
Use markers to identify problem areas - new epidemics, direction of spread of diseases, etc.
Consider security. Mark mined areas and 'no go' zones on the map.
Maps can be obtained from government departments, the national survey office, other UN agencies or the military. Tourist maps from hotels and service stations are sometimes more detailed than one would think.
If possible, laminate the maps and mount them on the wall in a coordinated pattern. Always display information for effect.
Charts can graphically display information and help determine present and future resource requirements. They can help you track the progress of the operations and predict future difficulties.
Charts can be placed on the walls as well. They can be linked to the maps by lines of coloured thread, to demonstrate which area they pertain to. CHCC members can assist in regularly updating the charts to ensure a constant appraisal. Below are examples of different charts you may use or adapt as you see fit.
Use the information that you receive through the surveillance system. Plot on different chart data of mortality, or incidence of especially relevant health conditions, e.g. malnutrition, measles or diarrhoeas.
This chart is used to track the location, responsibility and activity of each partner.
This chart can then be broken down into sub-committee locations as required.
Use A4 printouts to display your information as they duplicate the boxes on a chart and can easily be taped or pinned into a structured pattern on the wall. When updating information it is quick and easy to pin or tape it over the existing information where relevant.
Improvise as necessary. The important thing is that the information is up-to-date, easy to read and quick to assimilate.
This type of chart will clearly outline the system of command and responsibility of each organisation at every level of response.
Encourage partners to keep you constantly updated on the lists of the leaders and members of their field teams. You need to know what skills are available before determining recruitment requirements.
Use these charts to familiarise yourself with the names and skills of the team members in various areas and locations. This information can be very useful, particularly before going on a field trip.
Supplies and logistics chart
It is important that you know the status of the logistics in each area. Especially important are the levels of medical stocks and supplies, the type of medical equipment available and the means of transporting personnel and supplies around the emergency site.
To start your display, you can copy the original 'Immediate medical resource assessment' and 'Logistical capability of organisations' forms discussed in Chapter 2 and Annex. 5. Use them to display the relevant information. Later, you can create your own assessment forms, fine-tuned to the needs of your operation, and distribute them to the participants to ensure a constant update of information. Thus, you will be able to quickly assess:
Overall capability for transporting, storing and distributing essential supplies. Avoid wastage and spoiling of supplies.
Allocation of equipment and supplies corresponds with the activity of the organisation.
That each organisation has sufficient transportation and fuel to distribute the required supplies to the targeted population.
The charts will also help you determine maintenance and servicing schedules and 'downtime' for assets, e.g. vehicles.
Bar or pie charts can display the progress of response. E.g., percentage of target population inoculated over the last week or percentage of target population receiving water etc.
These charts will show the progress of the response in simple graphic details. This is useful for briefings, reports and press conferences. They also have a feel-good factor, copy them to the field staff, let them see the overall progress being made.
They can be generated by computer or simply drawn on poster paper; they don't have to be exact.
Communication chartsTC \l1 "5.Communication charts
Communications are vital to coordination. You must be able to receive and disseminate information regularly from all levels of operations. To this end you need forms displaying the location, the contact person and their radio address (call sign, selcall etc.), the method of communication (HF radio, VHF radio, satellite phone, satellite facsimile, etc.) and emergency contacts. List any and all methods for every location. It may be needed urgently. Good coordination goes hand in hand with good communication.
The 'resources required' chartTC \l1 "5.The 'resources required' chart
This can be a simple whiteboard on which everyone lists their requirements for their area of responsibility. Prioritise this list and use it for reports to donors.
Local structures chartTC \l1 "5.Local structures chart
At every level of operations there will be a local authority that can be involved and actively participate. Some international organisations tend to ignore local structures. List all the relevant authorities, their names and contact numbers, on a chart in the operations room. Encourage partners to know which authority is relevant to which location or programme of theirs. Get them to make contact. Bring them together.
Future resource chartTC \l1 "5.Future resource chart
Chart showing arrival dates of supplies will help you muster the appropriate logistics and distribution systems to move the supplies quickly and efficiently.
Strategic chartTC \l1 "5.Strategic chart
Chart the long-term goals of your operations, and the resources needed to put them into effect. Highlight the need for stockpiling resources vis-à-vis new anticipated trends in the emergency. Sketch scenarios and highlight plans for the rehabilitation and reconstruction phases.
C. USING THE OPERATIONS ROOM
Restrict everyday access to the room to your closest partners. The operations room will quickly become the information centre for the response, you don't want it cluttered up unnecessarily.
On the other hand, don't hesitate to organise events where you can demonstrate your work and your grasp of the situation to all involved in the relief operations.
Use the operations room for:
technical briefings: e.g. presenting new WHO guidelines
information centre for new arrivals
Consider equipping the room with whiteboards, flip charts, overhead projector, TV, VCR etc. for presentations and briefings.
5.4 FIELD TRIPS
Once the roles and responsibilities of the different partners have been established, it is critical to monitor the progress of the relief operation and supervise the field workers. Field trips are an essential part of monitoring and vital to your global understanding of the situation.
Before embarking on a field trip, know exactly what it is you want to achieve. Get familiar with the names of the leader, members of the team and the situation at the location you will visit. Bring yourself up-to-date on their work and sitreps.
Whenever possible, to facilitate interaction between different levels, travel together with an officer from the Ministry of Health, or from the national emergency-coordinating agency.
Inform the field team in advance of your visit and of its purpose - give them an opportunity to prepare. Take with you appropriate technical guidelines, training tools and reference material for their programmes. Ensure that you carry identification (passport etc.) and that you have WHO badges.
Enquire from their head office if there is any personal mail or official correspondence you can carry to them. You may want to take some fresh bread, fruit or vegetables as a gift and a reminder that you understand their privations.
Meet the team and outline quickly the objectives of your visit and the information you seek. Do not intimidate them with unheard-of UN or NGO names or abbreviations. Carry visiting cards stating your name and how you may be contacted.
Field workers are the cutting edge of relief. They live and work under considerable stress and strain, bearing the brunt of the response effort. Be sensitive to their situation, use diplomacy and tact to achieve your goals. Show interest in their welfare and the nature of work they are doing. Do not create expectations with promises and commitments you are not sure you will be able to deliver. Thank them for their contribution to the response. Pose your questions so that they do not sound threatening or critical. Don't lose sight of the objective of your trip, but be diplomatic in your methods.
Use the opportunity to provide in-service training and trouble-shooting, especially as far as surveillance is concerned. Give suggestions and hints on methods of operating. Leave behind copies of your formats for reporting. Bring back ideas on how to fine tune the methods employed in gathering and displaying information.
Ask what can be done to improve the emergency response and what can be done to make field tasks easier. Listen. Get the information you want and thank them for it. Let the field workers know what you are going to do with the information gathered.
Before leaving, make sure that the field team:
clearly understands operating and reporting procedures;
has no doubts on relevant technical issues;
has an efficient system of managing emergency health resources;
has a strict system of accountability.
Do not take field workers' information at face value, without cross-checking other sources. Ask each partner to do the same before passing it on.
Emergency management is adapting plans and re-directing resources to meet a crisis in an orderly and efficient manner. Information must be quickly analysed, interpreted, acted upon and circulated, in order to ensure an effective response both at field level and externally.
To do this, you need to develop standard formats for reporting. Through the CHCC, you must ensure that every partner agrees on the layout for presenting data, the terminology and the language.
The members of the CHCC will be responsible for:
distributing the report formats to all operators.
gathering the reports at predetermined intervals.
circulating the reports on time.
assisting in the analysis of the data.
A. INTERNAL REPORTING
You need constant information from the field. It is in your interest to devise forms that present this information in the best possible way, yet simple enough for partners to collect and summarise data on all issues. You may have more than one hundred organisations reporting back to the CHCC. Only if they all report using identical forms can you analyse the data speedily and make quick, informed decisions. As much as possible, link the forms to the presentation of information in the operations room. There are several report formats included in the Annexes that can be adapted as needed:
This can be used to report an organisations initial field findings. It can also be used to report on any new emergencies that may arise within the area. This report is preliminary and the information can be sketchy. The information can then be passed verbally back to the Regional Office until more detailed reports come in. A template is available for adaptation in Annex.5.
These can be sent from the field at regular, established intervals to update programme resource requirements and to indicate progress of the response. You will find these useful when allocating resources. (See Annex. 5).
Health card/Monthly activity report/Mortality rate (Annex. 2)
These do not necessarily reflect the forms used by the countrys health information system. However, they can be adapted for use as required.
CHCC member reports
Each partners who has a particular responsibility (e.g. WFP = nutrition) should produce regular reports outlining their progress, requirements and future activities. Each report should carry the following information:
Description of area of operations (add at least a sketch map);
Description of the affected population: number, breakdown by age, sex and by special risk or vulnerability factors;
Estimated total number of deaths and injuries;
Other indicators such as malnutrition rates, losses in vital infrastructures, financial losses and other socio-economic data;
Existing Response Capacity (in terms of human and material resources):
local, sub-national and national
international (bilateral, NGO, intergovernmental)
overall authority and national focal point
distribution of tasks and responsibilities
logistics, communications and administration;
Plans to reinforce and rehabilitate existing infrastructures;
immediate vital needs of affected population
immediate and medium-term needs for national capacity building
implementation, monitoring and evaluation mechanisms
(Whenever possible, this section should include medium and long-term outlines for rehabilitation and vulnerability reduction);
priority actions by projects
responsible office; national focal point and other partners (national and international)
breakdown of requirements by projects: estimated costs.
To the extent possible, crosscheck reports from different partners. This way, you may discover any differences and inconsistencies in baseline information. These differences must be quickly addressed and resolved to ensure a common approach.
RETURN INFORMATION TO THE FIELD. Information from the field should be shared and information and decisions from the Central Health Coordination Committee should be fed-back to the field regularly.
B. EXTERNAL REPORTING
Throughout the duration of the emergency, WHO has an important role in the dissemination of information to donors and other partner agencies on overall response requirements. You will be the principal provider of this information. All reports, oral or written must be copied to the Regional Office and WHO HQ. There are many reports you will have to produce:
Overall response report ðtc \l 1 "Pð Overall response report"
You will clearly identify priority needs and present a cohesive humanitarian strategy. This strategy will elaborate on the smooth transition from relief to rehabilitation, reconstruction and long-term development. Attach an outline of your plan of response, estimate the resources needed to accomplish it and the time frame for completion. Where possible, enclose photographs or videotapes illustrating the scale and impact of the emergency. See report guidelines in Annex. 5.
Situation report (Sitreps)
In the acute phase of an emergency, a sitrep (summarising the current situation) should be submitted to the Regional Office and EHA HQ at least once a week. Highlight any new development. At the start of operations, sitreps should be given daily and can be given verbally. Detail your actions and emphasis your priorities in regard to staff and resources. What are WHO's activities? How are needs being met? What is the level of cooperation among participants? Mention also anything in regard to security, administration, finance and local conditions that may be of interest to an imminently arriving staff member or to WHO as a whole.
Anything, which can be construed as progress, should be reported back to Regional Office and WHO HQ as soon as possible. Arrival of assets; stabilising of population; restoration of utilities; political stability; cease-fire declared etc.
Donor report tc \l 1 "Pð Donor report"
Good reports ensure donors' backing for the relief effort. In close coordination with the Regional Office and EHA HQ, develop and maintain contacts with principal donors, keep them informed of progress and make suggestions for long-term rehabilitation projects. Highlight specific areas that require funding.
Donors also have accountants and taxpayers they must answer to. Accountants need justification and documentation for every penny spent. The more detailed and accurate the accounting to donors the more likely it is they will be more forthcoming. Speeding up the delivery of donations is critical to your success and the ultimate benefit of the affected population.
Don't forget the feel-good factor. Donors are not faceless financiers doling out money from bottomless purses. They like to know that their funds have had a positive effect and that something is accomplished. Report back on the benefit the funds have achieved. If you can, enclose photographs or video footage of inoculation campaigns, new clinics or hospitals. Donors welcome acknowledgement as much as anyone and, if they have something to show their people, they will be pleased.
PROLONGED EMERGENCIES REPORT
In an emergency with slow onset and of prolonged duration, the WHO representative or the WHO-designated officer should, after the initial report:
send a monthly report to the emergency and humanitarian action unit or focal point at the regional office and to the Division of Emergency and Humanitarian Action at headquarters;
send quarterly by pouch to the emergency and humanitarian action unit or focal point at the regional office and to the Division of Emergency and Humanitarian Action at headquarters, a concise review of developments in the health sector during the previous quarter and a prognostication of the activities envisaged for the next quarter.
In addition to the reports referred to above, the WHO representative should send any other pertinent information to the emergency and humanitarian action unit (or focal point) at the regional office and to the Division of Emergency and Humanitarian Action at headquarters. This includes expenditures, purchase of supplies, recruitment of personnel related to the emergency and any response by the government and/or international community. Also, after the emergency is over or after a special project (if established for the emergency) is completed, a final report will be prepared.
Copies of the WHO representatives' correspondence are transmitted to the United Nations Resident Coordinator to ensure that assessments of the health situation and of health needs are appropriately included in DHA situation reports.
5.6 OTHER OPERATIONAL CONSIDERATIONS
A. PROVIDING SERVICES TO YOUR PARTNERS
As a Technical Agency, WHO must provide services to its partners.
DISTRIBUTING TECHNICAL GUIDELINES. Make sure that you receive all WHO technical documents that may be relevant to the situation at hand. Each organisation involved in the relief operation must receive technical guidelines appropriate to their specific task. They should check that the procedures, protocols, equipment and medical supplies they use are consistent with WHO and national standards. Guidelines must be disseminated to every level of fieldwork and strictly adhered to.
LOOKING AT THE WELFARE OF THE RELIEF WORKERS. Pass out health advice to all organisations. Their welfare is in your best interest. Keep them informed of the best prophylaxis for malaria; underscore messages on Safe Sex. You have a moral obligation to actively pursue the welfare of the teams working in the emergency. Specifically, you should:
through the CHCC, look at the possibility of rotating staff between hard and lighter duty postings.
advise the UN Resident Coordinator on R&R breaks for relief workers.
reassure relief workers that a system for Medical Evacuation is in place. See Annex. 3 for more details.
Are relief workers properly housed, fed and supplied with water ? How can you improve their situation? Stress is another important issue. Hand out fact sheets on identifying and coping with stress (see Annex. 4).
HUMANITARIAN ADVOCACY. In complex emergencies, make representation to Member States and/or special groups to spare and protect health personnel and infrastructure, and to facilitate access by all to essential health assistance.
BRIEFING NEW ARRIVALS. In situations where new organisations suddenly appear, you will have to orient them rapidly to the situation. Prepare standard briefs that you or the CHCC can handout and inform them of:
the Country's epidemiological profile, the pre-emergency health coverages, etc.
national and international expertise available e.g. for tropical diseases, specific to the Country and beyond the capacities of international NGOs.
the structure of Ministry of Health and health focal points in other organisations, to facilitate the collaboration between international and national partners.
You may also be requested to quickly assess their capabilities and resources to deploy them appropriately.
You are expected to participate in UN security meetings, or you may delegate a staff member to attend. Daily briefings on the security situation can be obtained from the Field Security Officer at UNDP. As the security situation changes adapt your operations to meet the changed conditions. Prepare contingency plans for possible scenarios and discuss them with your partners at the CHCC.
C. INTERNATIONAL COORDINATION
Constantly monitor and facilitate the working links between MOH, national relief organisations, UN, bilateral and intergovernmental agencies. Only their close cooperation will ensure success.
One of your objectives is to avoid duplication, i.e. wastage of resources. But you cannot determine, nor predict which organisations will enter the arena and with what. Most external organisations will inform the government of their wish to assist. Maintain close contact with the relevant officials (usually the Ministry of Foreign Affairs) and ask them to keep you advised on new developments. Keep them informed on the resources and skills needed so that they may pass on this information.
Where there is no government structure, consider the possibility of using the services of the media. Ask them to assist. It is a simple message and they will be willing to propagate it "WHO is coordinating the medical response and, in order to prevent wastage of resources, any organisation preparing to participate in the response, whether it be supplies, staffing or funding should contact the WHO Regional Office (give the name of the EHA focal point, contact numbers, web sites etc.) for more information."
Thus, you can stipulate in advance the type of assistance that you require, know who/what is coming and plan accordingly. Furthermore, the Regional Office can give the donors more comprehensive briefings on what exactly is required. By assisting donors to better place their resources you ensure a more cohesive and cost effective response.
Another objective is to ensure that operations proceed smoothly. In emergency operations, many agencies, especially international NGOs undergo very frequent turnovers of field staff. Consider that your concerns in this regard will be shared by the NGO staff themselves. Facilitate their hand-over, e.g. by stipulating a standard package of information on the country and the health relief operations that you can share with all newcomers.
D. NATIONAL STAFF
Strengthening and preserving national capacities is part of WHO's mandate. If the crisis is a major one and national institutions are collapsing, what is happening, for instance, to Ministry of Health personnel? Are they leaving the country? Are they lost among the population in refugee and internally displaced camps? Are they being recruited by some NGOs? Are their skills and professional qualifications duly recognised? How can WHO assist?
From the start of your mission, you have advocated the recruitment, training and mobilisation of nationals. You must continue to promote this at all levels of operations. In time, nationals must resume their role in their country's structures. It is important that their progress and performance be monitored. Are they receiving training and acquiring appropriate skills? Is their level of capacity such that they can eventually replace the international staff? How can WHO assist?
E. 'LATERAL' ASSISTANCE
You can assist other organisations involved in other aspects of relief. For example, IOM may be short of trucks to move people from one camp to another, and you may find that you have trucks suitable to assist, which at the moment are idle. It is always good to keep in mind the global picture, not just the health aspects. When you need help, you'll find everyone just that little bit more willing.
Monitor the establishment of communication systems. Ensure a common approach at all levels. This includes compatibility of systems and user's procedures.
International organisations enter a country loaded with high tech communications equipment. They set up excellent communication networks and systems that as long as the emergency lasts provide invaluable information to the national authorities. A sad aspect of the matter is that as soon as the emergency is over, the international organisations leave with all their communication equipment and the information system collapses.
From the onset, push for organisations to establish permanent communication centres. Recruit and train nationals to operate them. Secure the agreement of the government to assimilate these centres into national structures after the emergency. Consider also the possibility of establishing these communication centres in hospitals or clinics located in key areas.
G. ENVIRONMENTAL CONSIDERATIONS
Monitor the disposal of used medical supplies. Are they being disposed of correctly? Ensure that guidelines for the proper disposal of used equipment and medical waste are distributed at all levels.
H. SUPPORTING HEALTH COORDINATION AT SUB-NATIONAL LEVEL
Needs for humanitarian assistance arises at sub-national level, and it is there that coordination is easier. While monitoring national and international activities for health relief, you can work at bringing together resources and experience and enhance capacities close to where the needs are.
National health workers, who remain in the field in spite of the difficulties, demonstrate high motivation and commitment to the welfare of their people. Their professional skills are enriched by their knowledge of the local epidemiology, of thepeople's behaviours and attitudes, and of the fabric of the country in general. On the other hand, international organisations, NGOs, etc., while providing humanitarian assistance, also bring to the country opportunities for scientific update, exchange of experience, and/or in-service training for nationals.
A good way of facilitating liaisons, dialogue, coordination and collaboration is to organise sub-national workshops involving local MOH staff, NGOs and those UN agencies, such as UNICEF and UNHCR that may be present. These will benefit all involved in relief and, of course, the beneficiary population. The subjects of the workshops will vary according to the situations: from epidemic control, to health district management, including, for instance, project formulation, or immunisations, water & sanitation, nutrition, etc.
Involving the central levels of Ministry of Health in these activities will strengthen functional linkages and facilitate the collection of data on health problems and the state of the health network.
I. DEVELOPING MANUALS
It may be necessary to adapt WHO guidelines into emergency manuals specifically suited to the country. Manuals can deal with:
Actions, e.g. triage, immunisation or rapid assessment,
Situations, e.g. specific procedures for immunisations in internally displaced populations, and
Levels, e.g. emergency management at district or community levels.
First, set up a core team with WHO and Ministry of Health. This team will then establish liaisons with the technical sections within MOH for specific assistance as required.
The team should look at the situation, the needs and the actors, outline scenarios and identify who will use the manual and in which circumstances. Technical priorities should be defined on the basis of (a) the affected people's vital needs and (b) MOH strategies & guidelines. This will represent the ' What to Do', the body of the Manual.
Then it will be matter of advising on 'How to Do It', and here WHO guidelines will be the priority consideration, together with MOH's technical procedures. This second part will constitute the technical Annexes of the manual. The preparation of a manual is a good example of activity that you can implement through an Agreement for Performance of Work (APW, Annex. 1).
The emergency has peaked, the situation has stabilised and rehabilitation is in progress.
You are at a crucial point of your mission - the phasing off and withdrawal of international partners. It is vital that you coordinate this stage of the operations and ensure that it is properly conducted and organised.
Parallel to this withdrawal is the evaluation of the response. What lessons can WHO and the international community draw from this emergency? These and many other questions will be asked of you. Now is the time to consolidate information and experiences, discuss them and formulate recommendations which will help fine tune future responses.
One faces the future with one's past.
-Pearl S. Buck-
6.1 PHASING OFF
Whatever your perception of the situation, i.e. even if you feel that the emergency is still not over, as a matter of fact you must face the process of phasing off the moment a partner cuts back or decides to leave the operations all together.
Different agencies have different mandates. Some will feel entitled to leave before others, e.g. because their mandate covers only the most acute phase of an emergency. In other cases, it may be a decision of the donors to stop supporting one or more organisations. Criteria for deciding when the emergency is over should be negotiated with all major partners. In consultation with the UN Resident Coordinator and through the CHCC, you must ensure that these criteria are consistent with those ruling the entire relief programme.
The untimely departure of one organisation can have a devastating effect on the entire programme of humanitarian assistance. Relief organisations must depart the emergency in an orderly, structured and appropriate manner. They must leave behind identifiable and workable systems; they cannot leave behind vacuums or inconsistencies. By definition, response is effective - and credible - only insofar it opens the road to rehabilitation and reconstruction.
As the response structure shrinks, so too the emergency infrastructure decreases. You must ensure that the smaller structure is at least as effective, proportionally, as the previous.
Therefore, support systems and infrastructures must be re-adjusted in a calculated manner and only when the needs of the beneficiaries are reduced. Not before, nor vice -versa.
As long as Health Coordination is necessary, you will be responsible for the orderly phasing off of all health partners. The downsizing must be properly managed and health activities must be transferred smoothly from international to national operators in the most cost-effective manner.
INSTITUTIONAL AND ADMINISTRATIVE REQUIREMENTS
Each organisation is expected to give adequate notice of their departure. Where the role of some agencies is critical to the relief operation, their withdrawal should be discussed and agreed with by the Government and the UN Resident Coordinator.
Once the decision of departure is taken, the organisation should provide:
- A detailed inventory of assets staying behind and assets leaving with them. This should be submitted to the CHCC (Important - obtaining this inventory can be very difficult, but you need to know what is left behind in terms of operational resources).
- A full report on their activities from their date of arrival.
- An evaluation of their activities.
OPERATIONAL AND MANAGERIAL REQUIREMENTS
There are many things to consider before an organisation can depart:
1. Area of operations
(i) Was the organisation working alone in the area?
(ii) Was it working in a refugee or IDP camp or among the resident population?
(iii) What will be the political impact on the beneficiaries when they are left with no visible focal point for humanitarian assistance?
(iv) Has the withdrawal been discussed with the beneficiaries?
(v) Was it working together in collaboration with other agencies?
(vi) Will the local systems be able to re-adjust themselves?
2. Delivery of services and/or relief goods
(i) Was the organisation delivering services or goods (e.g. health care or food aid) to the affected population? Are these services/goods redundant?
(ii) Have the activities been handed-over to another organisation? Are they trained and equipped for the task? Are they nationals? Are they funded for the task? For how long? Are there support systems in place?
(i) What was the organisations role in the surveillance system? What were their activities? Were they collecting, analysing or interpreting data?
(ii) Who will replace them? Are the replacements trained and equipped for the position? Are they nationals?
(iii) Are they funded for the position? If so, for how long?
(iv) Are they familiar with the system (lines of authority; formats of reporting and interpreting data; means of communication)?
4. Logistics - Review the logistics capability. What equipment will be left behind? Can this equipment be used and maintained by nationals? Is it appropriate to the infrastructure? Are there trade-off's? Is this equipment sufficient to complete rehabilitation?
5. Building national capacities and handing over - Is the organisation leaving behind some support infrastructure for the national Health System? In which areas? Of which kind? Are nationals ready to take over? According to whom? Using which criteria?
6. Programmes- What programmes were implemented? Are they complete? What programmes are continuing? Who will monitor them? Supervise? Fund?
7. Administration- Is there sufficient administrative management in place to establish rehabilitation and maintain the staff? Are job descriptions for each staff member in place?
If you judge that the departure of one organisation is inconvenient to the response, you should intercede on a personal level and ask the team leader to reconsider the decision. Explain clearly why you want them to stay. Ask that they wait until a suitable replacement or solution is found. Be tactful. Try to determine their reason for leaving. Is it funding? Political? Resources? What can WHO do to keep them in the field? Would it help to contact her/his headquarters? The Donor?
Those who cannot remember the past are condemned to repeat it.
By definition, in Public Health, needs are always greater than resources. The same applies to Humanitarian Assistance: needs are great and must be addressed, but resources are increasingly difficult to come by. WHO has a responsibility in improving the quality and enhancing the cost-effectiveness of health relief. Costs must be reduced without compromising technical standards. This can only be achieved by working at improving the health practices and the standards of cooperation of all involved.
A key requirement for better future performance is that the current one be evaluated. WHO must identify critical health issues, fine-tune the techniques to address them, evaluate activities and implementing arrangements. Areas of weakness must be exposed and steps taken to rectify them. Evaluation ultimately leads to policy, operational and technical recommendations that will produce a faster and more effective response to emergencies.
To this end, you must, in conjunction with the CHCC and UN Resident Coordinator, spearhead a comprehensive evaluation of the response at all levels.
In some cases, evaluations may be conducted by outsiders. WHO Regional Office might decide to send an evaluation team, or HQ may contract the services of a Collaborating Centre. Plan accordingly.
DEVELOPING A METHOD FOR EVALUATION
Let's be frank, the word evaluation is somehow threatening. Nobody likes being 'evaluated'. It is like sitting for a school exam. Evaluation is often perceived as being subjective and has the potential to strain partner relationship.
Present evaluation as WHO's technical SERVICE. How you present the evaluation is critical to the reaction that you will receive. You should:
·ð Underline the importance of evaluation in regard to future operations. Stress that the exercise is useful for the participants' own capacity building (some agencies pay to be evaluated by external consultants - your services are free).
·ð Discuss the exercise with as large an audience as possible. Have the CHCC agree on criteria, formats and methods. Use performance benchmarks to alleviate concerns. Have complete transparency in the implementing arrangements. Give the CHCC responsibility for disseminating formats and guidelines for the exercise.
·ð Encourage the participants to take a comprehensive view of the events. Give them the opportunity to point out where factors outside their control prevented them from meeting the stated objectives. (Remember the 'pre-conditions' and the 'assumptions' of the Master Plan).
·ð Encourage suggestions on the quality of WHO's support. As a matter of fact, you also want to be helped to evaluate yourself. Specifically you want feedback on your performance in coordination and technical assistance.
Always highlight the positive aspect of evaluations. Work with your partners to create an atmosphere of cooperation and universal willingness to improve health relief.
THE EVALUATION FORMAT
You cannot evaluate each single organisation, particularly in complex emergencies where more than a hundred organisations may be involved.
Go for self-evaluation. Give each organisation the responsibility for evaluating itself in the context of its operational responsibilities, and provide standard criteria for them to do so.
Don't be intimidated by the amount of information required. Most of it is already available: operational history is with the team leaders; resource information with logistics; financial and organisational information may be with one agencys HQ, but sometimes it is with the administration in the field.
The general outline format for the evaluation can be as follows (a form is available in Annex. 5 and can be adapted by you according to your specific needs):
For future operations, WHO needs to know where each organisation comes from, their mandate and the type of personnel they recruit. Essential data:
·ð Name of Organization (other information such as directors, foundation date, principal donors, mission statement etc.).
·ð Home Office address and contact numbers (phone, fax, e-mail etc.).
·ð Main field of expertise and work.
·ð Team leader's name.
·ð Names and functions of team members (additional information such as CVs etc can be attached to the form).
·ð Turnover of field staff; teams' average length of stay in country.
2. Present and future response details
WHO can use this information to streamline emergency notification procedures and to predict response times of different organisations.
·ð Date the Organization was first notified of the emergency.
·ð From which source (Media, other organisations, embassies etc.).
·ð Date of arrival on-site.
·ð Focal point(s) for emergency notification/call (names and contact numbers).
·ð Resources on stand-by for emergencies (personnel, supplies, logistics, etc.).
·ð Lead-time to deploy these resources (hours, days, weeks etc.).
·ð Are there countries or types of emergencies the Organization will not work or respond to.
3. Work accomplished
·ð Nature of work undertaken.
·ð Area of operations (add map of the area).
·ð Population in the area.
·ð Beneficiary population.
·ð Date started.
·ð Date finished.
·ð Programmes and projects in place.
·ð Campaigns or works completed (immunisations, buildings etc.).
·ð The Organisation s own evaluation of their activities, professional standards observed,
general policy considerations (environment, gender, etc.)
·ð Were the beneficiaries happy with end result? If not, why not?
4. Surveillance systems
·ð Are they in place and operational?
·ð Who is running them? (Names and contacts)
·ð Are lines of communication open? (What are they, who runs them?)
·ð Are indicators understood by replacement team?
·ð Is the analysis of data available and in accordance with guidelines?
5. Building national capacities
·ð Level of expertise among nationals on arrival, on completion of mission.
·ð The Organisation s contribution to capacity building (in-service and formal training
activities, scholarships, investments in equipment and infrastructures, etc.).
·ð Standards achieved.
6. Resources. You need a clear grasp of the assets expended, the assets left in the area and the assets that will be leaving with the Organization.
·ð What resources did they enter the emergency with?
·ð Detail of the supplies used.
·ð What is left behind? With whom?
7. Funding. This is a tricky subject. But the information is important to estimate costs and make planning for future operations easier. Try to obtain the following data:
·ð What amount was requested for operations?
·ð The source(s) of funding
·ð How much was received?
·ð Breakdown of expenditures during response.
8. Overview. Give the Organisation s views on the emergency. Why did it happen? How could it have been prevented? How can repeats be avoided? Which were the major constraints in the relief operations? How could they have been avoided?
VERIFYING THE EVALUATION
Each organisation should, where applicable, attach its final report. Also reports from workshops and seminars, local testimonies, and thematic studies are important. On your side, ask the opinion of other partners, donors and national authorities.
Evaluations can be cross-checked against the information in your files and in the operations room. By comparing data, reports, assessments and charts, you can quickly determine the precision of the information returned to you. Use the findings from the periodic assessments undertaken during the operations as a baseline for determining the accuracy of each participant's self-evaluation. Where there are inaccuracies or grey areas you should resolve them as soon as possible.
The data generated by the evaluation is critical to the overall assessment of the response. The analysis of the information will help highlight any constraints encountered in implementation and the quality of WHO support and guidance.
Once you have assessed the validity of the evaluation you should copy them to the Regional Office and WHO HQ. Otherwise, treat the evaluations as confidential. You may wish to remark on the general performance and capability of an organisation or individual. Where you feel specific comments will be useful, make a note on the relevant evaluation.
6.3 PREPARING FOR YOUR DEPARTURE
As far as WHO is concerned, your performance in phasing off is as important as in any other moment of your mission. You must agree on your departure with the CHCC, the UN Resident Coordinator and the Government. You may be replaced by either a WHO staff member or a national. Factor in the time for finding and inducting your replacement before you can leave.
Your final report is the official memory of all your activities, and provides WHO with a global evaluation of the response. It must help you order your experiences and ideas, and help others take action on the basis of what you recommend. Keep the report short, but use Annexes to include all that you feel is important. We suggest the following format.
1. Start with an Executive Summary. Then proceed with:
2. The findings. This part must be factual. Avoid adjectives and adverbs: all of them, not only the 'unnecessary' ones.....! As a rule of thumb, if you really feel that a certain statement requires an adjective or adverb, think again: maybe it is an opinion of yours rather than a fact, and it should go in the part of the report, that deals with conclusions and evaluation.
2.1. Give a summary of how the emergency started, and which factors contributed to its evolution. Describe the impact on the environment, economy, infrastructure, population etc. Refer to the Annexes, where you will add maps, charts and even copies of more exhaustive documents (e.g. another Agency's report), in order to illustrate and substantiate your information.
2.2. Summarise your first rapid assessment. Describe the situation as you found it on your arrival in country. Describe the conditions and identify the partners operating in the area. Give a detailed account of health issues (mortality rate, epidemics, nutrition etc.)
2.3. Summarise your initial Master plan. A full copy of it can go in the Annexes. Describe the methods used to bring together and coordinate your partners, the main constraints and how they were tackled.
2.4. Describe the evolution of the emergency - new diseases, the interaction of other natural hazards, e.g. floods, social, political or military changes - and of the response operations. How they were coordinated and implemented. Describe major changes in strategies or procedures. Logistical changes. Obstacles and solutions. List your partners and give objective information on their capacities.
2.5. Describe the systems that WHO set in place. Illustrate the surveillance system, what was done to establish or expand it, the training given; illustrate the catchment area, the indicators, methods of reporting, analysing and diffusing the information. Describe the communications and the logistics networks, the equipment used, how effective was it, what will be left in place. Were nationals trained to take over?
2.6. Human resources and supplies. Give an estimate of the total resources brought into the emergency, in terms of personnel, expendables and equipment. Illustrate what is left in place for rehabilitation and contingencies. Refer to the Annexes for the relevant lists.
2.7. Funds. Of the total funding received for response, how much was specified for health? How much was used, including funds already earmarked for ongoing projects/programmes etc.? What remains to be used? What remains in the pipeline?
3. The conclusions and the evaluation. This part of the report must reflect your professional opinions. Be diplomatic but sincere. You must evaluate the following:
3.1. Your work- Was your mission a success? Qualified or absolute? Do you feel you achieved of your general objectives? Which lessons have you learnt?
3.2. Health issues and practices- Did you come across some health aspects of the emergency that call for further investigation from the technical divisions at WHO/HQ? In terms of fieldwork, is there the need for special 'emergency' technical protocols?
3.3. WHO country office - Given the country's profile, how can the WHO office better prepare itself for new emergencies? Are there lessons for other country offices?
3.4. Regional Office and HQ - From your initial briefing through to your departure, how can their procedures for emergency response be streamlined or improved?
3.5. International partners, UN and NGOs - How did they do? Were they responsive and cooperative to coordination? What are their strengths and weaknesses?
3.6. National authorities - How the health system has improved from your arrival to departure. How did they respond to international intervention? What can WHO do to strengthen international agreements on emergency health issues?
3.7. National NGOs and other national partners - How did they do? Were they responsive and cooperative to coordination? What are their strengths and weaknesses?
3.8. UN Resident Coordinator - Was he/she familiar with health intervention policies? What assistance did you receive from him/her in relation to the coordination and implementation of the response?
3.9. Donors - How can they respond more efficiently in the future? What do they need in the way of feedback from the field? Was their reaction positive to your coordination? What concerns, if any, did they express?
3.10. Resources - What can be done with the resources delivered and not yet utilised? What about the pending pledges and resources that remain in the pipeline?
4. The recommendations. On the basis of your conclusions, make recommendations. From the experience and insight you have gained, you can facilitate decisions for additional programmes or activities, changes in policies and methods, streamlining of procedures and cuts in costs. Be clear and practical in your recommendations. Avoid vague statements and wishful thinking. Use short sentences to indicate actions and not objectives. Indicate who should implement these actions; suggest timetables; identify partners.
5. The Annexes. The Annexes will include a copy of your terms of reference, more background data on the country and the emergency (e.g. maps, samples of the formats used to collect data and reporting, charts, graphs, lists of personnel, medical equipment and supplies, tables with financial summaries, copies of the most important correspondence, notes for the record, etc.).
Expand the Annexes as much as you have to. Your report is important to WHO. In many ways, it may end up being the principal piece of WHO's institutional memory on the emergency. No detail is too small. Use the Annexes to include anything and everything that you feel is important.
6.4 RETURN TO REGIONAL OFFICE
Your first stop on the return route is the Regional Office. There you will undergo various debriefings and complete several administrative tasks.
A. PLANNING FOR YOUR RETURN
Once a date for your return is agreed on, arrange things to make your life easier. In particular, try to book your flight for a Friday. This will give you a weekend to relax and prepare yourself for working at the Regional Office on Monday. You may even contact your partner and suggest a reunion on the weekend.
Prepare yourself for the debriefing. Have your reports and paperwork to hand. Decide in advance which message you want to transmit. Try to determine which information the Regional Office requires. Consider preparing a short presentation on transparencies summarising your report. You may find yourself repeating the same thing again and again to many different people. Bear with it, the more people you talk to the more likely the lessons you learnt will be passed on.
·ð contact your Regional Desk Officer and ask him/her to do the following:
- to let you know how many days you will have to stay at the Regional Office.
- to let you have a schedule of your meetings, detailing names, office address and contact numbers.
- to arrange hotel bookings (double room if your spouse intends meeting you).
- to arrange for your air ticket to be endorsed, if, for instance, it has expired or you need to change airlines.
- to fax you a list of what he/she requires in the way of information or reports.
·ð contact the people that are on the list you received from the Desk Officer and ask:
- What is the format for the meeting
- What do they need from you
- Expected duration of the meeting
·ð talk to the Desk Officer. He/she will have experience of debriefing in the Regional Office. Get some advice on the format of these sessions and how best to prepare for them.
REMEMBER: you must return any piece of equipment you signed for to the Regional Office or HQ, or demonstrate its present location.
B. FURTHER CONSIDERATIONS
1. Rental equipment. You may have rented office equipment, vehicles, generators etc. Return all equipment and settle the bill, obtain a paid-in-full receipt from each vendor. If it is not possible to return an item as a programme is using it, then sign over responsibility for it to the programme team leader.
2. Office. If the office is closing, give adequate advance notice to the landlord. Arrange a date to walk through the premises with the landlord. Have the landlord give written receipt for the premises, stating that all is in order. If it is necessary to repaint or repair parts of the office, obtain quotes from three contractors and then go ahead. Make sure the landlord gives written confirmation that all that was needed has been done and the premises are returned in good shape.
3. Salaries. Ensure that programme and general support staff have received their salary in full and that there are no outstanding wage claims against WHO. Obtain a release letter from each staff.
4. Pay all accounts for services, e.g. electricity, water, gas, and have the services terminated accordingly.
5. Logistics equipment. You have probably signed for a fair amount of equipment, most of which you may have passed on to someone else. Clear this up before leaving. Ensure that every piece of equipment is accounted for and no longer attached to your name. Otherwise, if one vehicle is involved in a crash, they will come after you!
6. Fuel. Your team may have established an account in the field with another UN agency or an NGO. Ask that the full amount be calculated and make sure that this amount is paid before you leave.
7. Donations. You may be authorized to donate some of your equipment to a national organisation. In such cases, prepare a certificate describing clearly each item: model, manufacturer, serial number etc. Have the certificate signed by the head of the recipient organisation. Give one copy of this receipt to the Regional Office and keep another for your records.
8. Hotel bill. Pay the day before you leave. Ask in advance for the bill to be prepared and ascertain in which currency you are to pay it. Make sure that the hotel can give change in that currency and what will be the rate of exchange if applicable. You may want to change money at a bank to get a better rate of exchange: give yourself time to arrange this.
9. Air ticket must be booked in advance. Once the emergency is over, you will be surprised how rapidly everyone wants to leave - reserve and re-confirm your seat!
C. PERSONAL ADMINISTRATION
1. Think of your finances. You deserve to be paid and recompensed for your work or expenses. You will need:
·ð Original of your Travel Authorisation
·ð Travel Claim form (this can be obtained from any WHO administrative officer)
·ð Your bank account number and bank address
·ð Air ticket stubs or any unutilised ticket
·ð Original receipts of all reimbursable expenses
·ð Dates of travel to, within and from operational area
·ð Copy of Laissez-Passer
Complete the Travel Claim, listing all necessary information and expenses. Make sure you attach all receipts (including air ticket stubs) and that your banking information and dates of travel are accurate. Simple instructions on how to fill a Travel Claim come in Annex 5. Have your immediate supervisor sign it.
Make a photocopy of the Travel Claim and all attachments before you submit the originals for payment. Thus, if the original gets lost you have a back-up copy. It is strongly suggested that you present the Travel Claim personally to the Finance office. Generally, you will receive full compensation by the end of the next calendar month.
2. Think of your welfare. Do not under -estimate your mental and physical exhaustion. You are coming out of a stressful situation. Give yourself the time to relax and adjust to a normal environment.
You deserve a break.
Take time out for yourself.
If you feel that you need counselling, a list of UN staff counsellors comes in Annex. 1.
TOC \o "1-3" \h \z 1.1 MISSION READINESS CHECKLISTS PAGEREF _Toc455523711 \h 77
HYPERLINK \l "_Toc455523712" A-FAMILY WELF PAGEREF _Toc455523712 \h 77
HYPERLINK \l "_Toc455523713" B-BANKING INFORMATION PAGEREF _Toc455523713 \h 77
HYPERLINK \l "_Toc455523714" C-BUSINESS AND FINANCE PAGEREF _Toc455523714 \h 77
HYPERLINK \l "_Toc455523715" D-AUTO REPAIRS AND MAINTENANCE PAGEREF _Toc455523715 \h 78
HYPERLINK \l "_Toc455523716" E-HOME SECURITY, REPAIRS AND MAINTENANCE PAGEREF _Toc455523716 \h 78
HYPERLINK \l "_Toc455523717" H-TRANSPORTATION AND COMMUNICATION SKILLS PAGEREF _Toc455523717 \h 78
HYPERLINK \l "_Toc455523718" F-GEOPOLITICAL AND CULTURAL AWARENESS PAGEREF _Toc455523718 \h 78
HYPERLINK \l "_Toc455523719" G-HEALTH PAGEREF _Toc455523719 \h 79
HYPERLINK \l "_Toc455523720" H-WHO ADMINISTRATIVE ISSUES PAGEREF _Toc455523720 \h 79
HYPERLINK \l "_Toc455523721" 1.2. STAFF ISSUES PAGEREF _Toc455523721 \h 80
HYPERLINK \l "_Toc455523722" 1.3. UN STAFF COUNSELLORS PAGEREF _Toc455523722 \h 80
Annexes in diskette (and in this document)
FILE NAMEAGREEMENT FOR PERFORMANCE OF WORK CONDITIONSA1.4.DOCAGREEMENT FOR PERFORMANCE OF WORK CONTRACTA1.5.DOCATTENDANCE RECORDA1.6.DOCRULES FOR DRIVERSA1.7.DOCDRIVING SKILLS TESTA1.8.DOCJOB DESCRIPTION ADMINISTRATIVE/LOGISTICS
COORDINATORA1.9.DOCJOB DESCRIPTION ADMIN ASSTA1.10.DOCJOB DESCRIPTION DRIVERA1.11.DOCJOB DESCRIPTION SECRETARYA1.12.DOCJOB DESCRIPTION SENIOR DRIVERA1.13.DOCJOB REPLYA1.14.DOCPERSONNEL HISTORY FORMA1.15.DOCREQUEST FOR CONSULTANTA1.16.DOCSPECIAL SERVICES AGREEMENT CONTRACT AND
CONDITIONSA1.17.DOCOTHER TYPES OF CONTRACT WITH INDIVIDUALS
(WHO MANUAL II.9)A1.18.DOCSTAFF PLANA1.19.DOC1.1 MISSION READINESS CHECKLISTS
Go through these checklists. Some items are so common and self-evident that they are often overlooked. Others are very important to your well being, but they are uncommon and thus they are often forgotten. As you work toward being mission-ready, each completed item can be checked off the list.
Discuss and complete the following items with your spouse or another responsible adult (r.a.). This can help avoid many unnecessary problems.
YES NOa.Mission discussed with family?b.Mission extension possibilities discussed?c.Family support system established? d.Quick access to emergency phone numbers?e.Family communication plan established, including the use of e-mail, fax, etc. (mission address, phone/fax numbers, UN pouch)?
f.Guardianship agreements completed?g.Passports and visas current for all family?h.Power of Attorney currently completed?i.Wills: yours and spouses completed?j.UN insurance beneficiaries designated?k.Pension fund number available to responsible adult (r.a.)?l.Birth certificate available to r.a.?m.Social Security numbers recorded and known to r.a.?n.Marriage certificate available to r.a.?o.High-risk-mission insurance current?p.All insurance policy data available to r.a.?B-BANKING INFORMATION
If your bank records are in order before you leave, deposits and withdrawals from your mission location will be easier.
YES NOa.Name and address of all banks or credit union accounts available to r.a.?b.Direct-deposit account established?c.Savings/checking accounts established? d.Is r.a. able to access bank accounts?e.Credit card numbers known to r.a.?f.Other important banking information reported?C-BUSINESS AND FINANCE
Make sure your finances are in good order before you leave.
YES NOa.Stockbroker name and certificate numbers available?b.Bond company and certificate numbers available?c.Mutual fund company and certificate numbers available?d.Business and finance records in a safe place where r.a. has access?e.Family budget well planned?f.Outstanding bill/loan payment method current?g.Signed UN contract available to r.a.?h.Income-tax data available to r.a.?i.Home/apartment: sold? rented? Sublet?j.Personal property high-dollar-item insurance?
D-AUTO REPAIRS AND MAINTENANCE
Avoid automobile worries during your absence.
YES NOa.Auto repair book available to r.a.?b.Next service on auto due?c.Warranty book available to r.a.?d.Tire rotation due?e.Oil change due?f.Tune-up required?g.Dealers address available?h.Vehicle insurance and registration current?
E-HOME SECURITY, REPAIRS AND MAINTENANCE
Feel at ease about home security during your absence
YES NOa.Heating & refrigeration repair phone Numbers?b.Plumbing repair phone numbers?c.Electricity repair phone numbers?d.Small appliance repair phone numbers?e.Roofing repair phone numbers?f.Keys secure with responsible adult?g.Mail and newspapers re-routed?h.Phone calls forwarded/answering machine updated?H-TRANSPORTATION AND COMMUNICATION SKILLS
Gaining skills in these areas will enable you to be independently mobile and to communicate well in an emergency situation.
YES NOa.Operation of a vehicle with manual transmission?b.Operation of 4-wheel-drive vehicle?c.Auto-repair trouble-shooting ability?d.Two-way-radio operation ability?e.Satellite telephone operation skills? f.Knowledge of e-mail and data transfer package?
F-GEOPOLITICAL AND CULTURAL AWARENESS
Investigating the items listed in this section will help you integrate more quickly and comfortably into the new work environment.
YES NOa.Geographical location known? b.Government type known? c.Major ethnic groups known?d.Traditions and customs (do's and don'ts) known?e.Major religions known?g.Primary languages spoken?h.Basic language skills developed?i.Basic language skills training material obtained?j.Major industries known?k.Income per capita known?l.Natural resources known?m.Health and disease patterns known?
Physical fitness and a healthy lifestyle do not come overnight, so you should act on the points in this section well before you leave. This will increase your effectiveness and your sense of well being once you are in the field.
YES NOa.UN medical and vaccines for area?b.Is anti-malaria prophylaxis indicated?c.Sufficient prescription medicines ?d.Stress management information?e.Substance-abuse awareness: The Big Three (nicotine, alcohol & caffeine)?g.Awareness of sexually transmitted diseases (STD) prevention? h.Lifestyle balance (work, play, rest, sleep)?i.Recreational and educational need awareness?j.Extra pairs of eyeglasses or contact lenses?k.Did you have a dental check ?l.Health and dental care plans established for your family?
H-WHO ADMINISTRATIVE ISSUES
The following WHO administrative procedures must be completed before leaving on mission.
YES NOa.Does your contract cover the duration of mission?b.Does Finance have your personal banking details?c.Have you received your Travel Authorization? d.Is Laissez-Passer valid to end of mission?e.Necessary visas for affected area?f.Letter of introduction to WR or host government ?g.Next-of-kin details are with Desk Officer?h.Per diem received in suitable medium of exchange?i.Medical/Pension/Life insurance forms completed?
1.2. STAFF ISSUES
The remuneration of persons employed under special services agreements should be based on the best prevailing conditions in the country applicable to nationals carrying out functions at the same level. UNDP country office can be a useful source of information on standard salaries for locally recruited staff.
The normal working hours for the UN are determined by the Secretary-General, as applicable to each duty station; they are available from the UNDP office. However the employees must understand that during an emergency working hours are flexible and that staff may be required to work longer hours than normal. Subject to local conditions and practices, the official working hours for drivers and guards are 48 hours per week.
Attendance cards (sample in Annex.1) must be kept and referred to for pay and leave issues.
Official holidays for WHO offices are the official holidays of the country in which the offices are situated, up to a maximum of nine days in a year including Christmas Day. If an official holiday falls within an important conference period or on a non-working day, you may, at your discretion, declare an alternative day an official holiday. The WHO or UNDP office will have a list of official holidays for the year. In certain circumstances staff working on official holidays may be granted compensatory leave.
Provisions for Annual, Sick and Maternity Leave (Article 4 of the Special Services Agreement) should be the same as those applicable to government civil servants associated with the project or other activity. If the mission is of long duration, it will be advisable to work with the staff and create a leave plan.
Overtime work is recognised for purposes of compensation only when the supervisor has requested it and it is approved by the Health Coordinator. Overtime pay is assessed in accordance with the locally established conditions of employment. Either the government or WHO office can provide the rates and rules governing the payment of overtime. An alternative form of compensation for overtime work is compensatory time off; again, subject to local custom. Compensatory time off is given at the same rate which would have been applicable to the overtime payment, e.g. time and a half rate, double rate, etc.
Travel per diem rates for locally recruited staff are established at each duty station by the designated lead agency (normally UNDP). These rates and the formula for computing them can be obtained from the lead agency administration office.
1.3. UN STAFF COUNSELLORS
The UN Office of Human Resources Management keeps Staff Counsellors at the following UN duty stations:
Geneva: Staff Counsellor, HO-UNOG, 41-22-917-3136
Social Welfare Office, UNHCR, 41-22-739-8275
New York: Staff Counsellor, UNHO-NYC, 01-212-963-2530
Staff Counsellor, UNHO-NYC, 01-212-963-7092
Nairobi: Staff Counsellor, UNEP, 254-2-622-749
Staff Counsellor, UNICEF, 254-2-622-066
Vienna: Staff Counsellor, HQ-UNOV, UNIDO, IAEA, 43-1-2360-6065
1.4 AGREEMENT FOR PERFORMANCE OF WORK
It is understood that the execution of the work does not create any employer/employee relationship. In this respect, the contractual partner shall be solely responsible for the manner in which the work is carried out. Thus, WHO shall not be responsible for any loss, accident, damages or injury suffered by any person whatsoever arising in or out of the execution of this work, including travel.
All rights in the work, including ownership of the original work and copyright thereof, shall be vested in WHO, which reserves the right (a) to revise the work after consultation with you, (b) to use the work in a different way from that originally envisaged, or (c) not to publish or use the work.
If the option, on the face of this agreement, for payment of a fixed sum applies, that sum is payable in the manner provided, subject to proper performance of the work. If the option for payment of a maximum amount applies, the funds shall be used exclusively for the work specified in this agreement and any unspent balance shall be refunded to WHO. In this latter case, any financial statement required shall reflect expenditures according to the relevant main categories of expenditure.
If the work is not satisfactorily completed (and, where applicable, delivered) by the date fixed in this agreement, WHO may specify an additional period within which this agreement must be satisfactorily performed. Normally such additional period should be of at least one week duration, unless it is clear from the agreement that it was particularly important that the performance be completed on the date specified, in which case WHO may specify a shorter period or refuse to grant any additional period at all. In the event that the work is not satisfactorily performed on the date fixed, or any additional period granted by WHO, WHO may rescind this agreement (in addition to other remedies), subject to an equitable arrangement being made in the case of delay caused by force major.
Any technical report or financial statement required shall be submitted upon completion of the work and, at the latest, within 90 days of the normal date for completion.
Any dispute relating to the interpretation or execution of this agreement shall, unless amicably settled, be subject to conciliation. In the event of failure of the latter, the dispute shall be settled by arbitration. The arbitration shall be conducted in accordance with the modalities to be agreed upon by the parties or, in the absence of agreement, with the Rules of Arbitration of the International Chamber of Commerce. The parties shall accept the arbitral award as final.
1.5. AGREEMENT FOR PERFORMANCE OF WORK
The WORLD HEALTH ORGANIZATION (WHO)and.
(the contractual partner)
Project: ............................................................................Department: ......................................
Address: ...........................................................................Address: ....................................................
Telephone: .....................................................................Telephone: ..............................
For the performance of: .......................................................................................................................................
WHO will, in consideration for the work, pay a fixed sum of:** Cross-out one of the two lines marked by an asterisk See General Condition 3. .........................................................................................
WHO will support the work by providing a maximum amount of: *
In instalments of: .............................................................Payable on: ...........................................
(Payment to individuals on signature is limited to 25% of the total value)
The detailed statement of the work to be performed and any related budget is contained in/set out below: ............................................................................................................................................................
The contractual partner will complete and deliver the work by: ..........................................
A technical report is required: Yes_ No_
A financial statement is required: Yes_ No_
Payment is to be made into the following bank account of the contractual partner (to be completed by the contractual partner):
Bank account name and number: ................................................................
Bank address: .............................................................................................................................
The undersigned parties hereby conclude the present agreement consisting of the above terms and the General Conditions overleaf.
For the WORLD HEALTH ORGANIZATION For the CONTRACTUAL PARTNER
Signature: ............................................................... Signature: ....................................
Name and title: ....................................................... Name and title: ........................
Date: ....................................................................... Date:.......................................
1.7 RULES FOR DRIVERS
Immediate dismissal may result from the following:
Drinking alcoholic beverages, being in a drunken state, showing characteristics of drug or other substance abuse, working without sleep or exhibiting any other behaviour which produces a physical condition not suitable for driving.
Theft of any equipment, commodity or item carried in or on the vehicle.
Gross negligence resulting in an accident causing damage or injury.
Drivers must also obey the following rules and are subject to disciplinary action for falling to do so:
Perform daily checks on their vehicles and confirm compliance by signing the daily log sheet on receipt of the vehicle and upon the return of the vehicle at the end of the shift. Reporting deficiencies or problems as soon as possible to the supervisor. Keep the inside and outside of the vehicle clean and in good order.
Comply with all local traffic rules. No passenger or superior may authorise or order violations. In the case of an emergency, the driver alone may decide to disregard any rules (and be responsible for the consequences).
Do not leave a vehicle unattended, unless it is parked or locked in a place considered safe under the given local circumstances.
Drivers are not responsible for personal belongings or baggage of passengers left in the parked vehicle unless specifically requested to guard them.
Ensure the fuel tank is always full.
Observe the periodic maintenance schedule for the vehicle. Inform the fleet manager in advance when maintenance is due, so that vehicle operations can be scheduled accordingly.
Safety belts should be worn at all times by the driver and any passenger(s) in the front seat. Use of seat belts in the rear seat is recommended.
Passengers, other than staff members or persons authorized by the fleet manager, are not allowed on board the vehicle, except in an emergency.
No packages or parcels, except those authorized by the driver supervisor, may be carried at any time.
1.8 DRIVERS TEST
There are four phases to this test.
Mark the box next to each question if the answer is affirmative. Each mark represents one point. Points are totalled at the bottom of the page.
1. APPEARANCEtc "APPEARANCE"
Is the applicant: Neatly dressed _ Courteous _ Older than 30yrs _
2. PRE-TRIP INSPECTIONtc "PRE-TRIP INSPECTION"
(Allow the applicant time to get familiar with the vehicle. Then, he/she must demonstrate the inspection procedures followed each day after arriving for work). During this phase of the test the applicant should be encouraged to elaborate on each check he/she makes.
Were the following checks completed?
Tyres _Suspension _Bodywork _Chassis _Oil _Coolants _Fanbelts _Brake fluid _Lights _Fuel _Gauges _Battery Acid _Spare tyre _Jack and tools _Vehicle papers _
3. DRIVING ABILITYtc "DRIVING ABILITY"
The assessor should have a predetermined route for this phase of the test. The applicant should be put at ease.
Did the applicant, before starting the engine:
Check handbrake is on _Put vehicle in neutral _Check mirrors _Put on their seatbelts _Check and insist that each passenger has seatbelts on _
Whilst driving did the applicant:
Stop completely at stops _Change gears smoothly _Obey speed limit _Indicate when turning _Indicate when changing lanes _Yield to pedestrians _Concentrate on the road _Show courtesy to other drivers _Drive defensively _Maintain a safe distance from the vehicle in front _Brake smoothly _
4. AFTER TESTtc "AFTER TEST"
Did the applicant:
Park the vehicle appropriately _Apply hand brake and leave the vehicle in gear _Secure the vehicle and hand back the keys _
Thank the applicant for taking the test and explain that a decision will be made in due course
and he/she will be informed accordingly.
Total up the checked boxes and use the score as an indication when making your decision.
TOTAL POINTS: ____________tc "TOTAL POINTS: ____________" \l 2
1.9 JOB DESCRIPTION - ADMINISTRATIVE/LOGISTICS OFFICER
Job descriptiontc "Job description" \l 2
Under the direct supervision of the WR is responsible for managing the administrative and logistical requirements of the team.
Ensures the smooth running of the office by procuring furniture, office supplies and equipment.
Recruits and supervises local staff.
Implements, controls and maintains an effective communications system.
Liases with UN agencies on administrative and security matters
Facilitates the arrival and departure of WHO staff.
Locates and establishes an office.
Responsible for maintaining an inventory of all assets.
Advises the WR on budgets and produces monthly financial reports on all expenditures by the team including projects
Opens and controls an imprest account.
Responsible for all financial reporting (through WR) to WHO/HQ.
Arranges importation of goods and ensures clearance through customs.
Manages vehicle fleet and drivers.
1.10 JOB DESCRIPTION-ADMINISTRATIVE ASSISTANT
Duties and responsibilities
Under the direct supervision of the WR and/or administrative/logistics officer, the incumbent performs administrative support functions, which may include supervision of clerical and administrative staff in fields of work such as personnel, finance, registry, supply and transport. Performs the following duties:
Performs personnel work including interpretation and processing of entitlements, issuance of contracts and maintenance of various personnel records and files;
Assists in the recruitment of special service agreement staff for non-specialized work including evaluating candidatures, administering typing exams, conducting preliminary interviews; assigns junior staff to meet work requirements; reviews work of subordinates;
Briefs international personnel on general administrative matters relating to visas, licenses, security; provides advice and ensures administrative support as required;
Advises and assists other staff in the area of office management. Arranges for and/or attends meetings on day-to-day administrative matters, participates in discussion of new or revised procedures and practices, interprets and assesses the impact of changes and makes recommendations for follow-up action;
Prepares, on own initiative, correspondence, reports, evaluations and justifications as required on general administrative or specialized tasks that may be of a confidential nature within assigned area of responsibility;
Assists in the preparation of office budgets applicable to staff and servicing costs and maintains necessary budgetary control records;
In addition to general administration responsibilities, may also supervise directly or indirectly, activities concerned with office and grounds maintenance, security, transport and similar services.
1.11 JOB DESCRIPTION -DRIVER
Duties and responsibilities
Under the direct supervision of the administrative/logistics officer, the incumbent performs the following functions:
Responsible for the day-to-day maintenance of the assigned vehicle, checks fuel, oil, water, battery, brakes, tyres, front/rear lights, etc., performs minor repairs and arranges for other repairs and ensures that the vehicle is kept clean and mission ready;
Drives office vehicles, in a safe and careful manner, for the transport of authorized personnel and delivery and collection of mail, documents and other items;
Logs official trips, daily mileage, fuel consumption and purchases, oil changes, greasing, etc.;
Meets WHO personnel at the airport and facilitates immigration and customs formalities as required;
Ensures that the steps required by rules and regulations are taken in case of involvement in accident;
Performs other duties as required.
Primary education, drivers license,
Knowledge and skills:
Knowledge of driving rules and regulations and skills in minor vehicle repair. Able to satisfactorily pass the WHO driving test.
Minimum three years work experience as a driver; safe driving record
Good knowledge of the local language and knowledge of the working language of the duty station.
1.12 JOB DESCRIPTION - SECRETARY
Duties and responsibilities
Under the direct supervision of the WR provides secretarial assistance to one or more team members.
Takes dictation, using shorthand, and transcribes, ensuring that spelling, punctuation and format are correct; prepares correspondence for supervisors signature, checking enclosures and addresses;
Arranges appointments, receives visitors, places and screens telephone calls, responds to routine requests for information and assists in making travel arrangements for team members;
Types a variety of material from drafts, printed texts and dictation machines. Operates word-processing equipment;
Maintains minimum stock-level of essential stationary and office supplies;
Incepts and maintains a filing system;
Drafts correspondence on routine matters;
Receives and screens correspondence and attaches necessary background information;
Maintains office records and reference files on various subjects;
Takes notes at meetings as required;
Performs other duties as required.
Completion of secondary education,
Knowledge and skills:
proven shorthand and typing ability and knowledge of modern office procedures. Ability to operate word-processing equipment.
Three years secretarial experience.
Very good knowledge of the working language of the duty station.
1.13 JOB DESCRIPTION SENIOR DRIVER
Duties and responsibilities
Under the direct supervision of the administrative/logistics officer, the incumbent performs the following functions:
Responsible for the day-to-day maintenance of the assigned vehicle, checks fuel, oil, water, battery, brakes, tyres, front/rear lights, etc., performs minor repairs and arranges for other repairs and ensures that the vehicle is kept clean and mission ready;
Logs all trips, daily mileage, fuel consumption and purchases, oil changes, greasing, etc.;
Assists and advises junior drivers on vehicle maintenance and driving skills;
Advises supervisor of the need for servicing and maintenance of vehicles;
Drives members of the team and other officials;
Meets WHO personnel at the airport and facilitates immigration and customs formalities;
Collects and delivers mail or documents when required;
Ensures that the steps required by rules and regulations are taken in case of involvement in accident;
Performs other duties as required.
Primary education, drivers license
Knowledge and skills:
knowledge of driving rules and regulations and chauffeur courtesies, skills in minor vehicle repair, initiative and discretion. Must satisfactorily pass the WHO drivers test.
Minimum four years work experience as a driver; safe driving record.
Good knowledge of the local language and knowledge of the working language of the duty station.
1.14 MODEL FOR JOB APPLICATION REPLY
Thank you for coming in for the job interview of ___________________ for the World Health Organization. Unfortunately on this occasion you were unsuccessful.
We will however keep your details on our files should another vacancy arise within our Organization.
We wish you luck in finding employment in the very near future.
1.15 PERSONNEL HISTORY FORM
FIRST NAME: _____________________ FAMILY NAME: ________________________tc "FIRST NAME: ___________________ FAMILY NAME: _______________________________"
DATE OF BIRTH: ____/___/___ NATIONALITY: ______________ SEX: _____
MARITAL STATUS: SINGLE _ MARRIED _ SEPARATED _ WIDOWED _ DIVORCED _
ADDRESS: _____________________________________ TELEPHONE:____________________
IDENTITY DOCUMENT: ______________ NUMBER:____________________
LANGUAGES: Mother Tongue: _________________
Name/Place/Country FromToQualificationMain field of study
SECONDARY or PRIMARY SCHOOL
Name/Place/CountrySubjects studiedFromToCertificates obtained
EmployerFromToDescription of work and responsibilities
Please give 3 referees (not related) we may contact for work references:
NAMEADDRESS AND PHONEPOSITION
I certify that the above statements made by me are true to the best of my knowledge
DATE: ________________ Signature: _________________________
1.16 REQUEST FOR CONSULTANT
WORLD HEALTH ORGANIZATIONREQUEST FOR RECRUITMENT OF CONSULTANTFrom:
Tel. No.:To: PER/ASCDate:Name, contacting address (telephone, fax) of consultant. DATE OF BIRTH:
NATIONALITY:PLEASE ATTACH PERSONAL HISTORY FORM OR CURRICULUM VITAE IF PHF NOT AVAILABLEAllotment No:
Activity Id No:Proposed grade levelProposed pay rate
DatePurpose of appointmentFrom
Date and place of reporting for duty Candidate specifications
Education and special training
Experience (length and type)
Knowledge, abilities and skills
Indicate why the expertise required is not available from existing staff resources
Justification for proposed grade level equivalent and rate of pay
Originating unitAuthorized byBUDPER1.17 MODEL SPECIAL SERVICES AGREEMENT FOR USE ON
PROJECTS OR OTHER ACTIVITIES
MEMORANDUM OF AGREEMENT made this day of _______20 , between the World Health Organization, hereinafter referred to as WHO and __________________________, hereinafter referred to as the signatory, whose address is:________________________________________ ____________________________________________________________________________________
WHEREAS WHO desires to engage the services of the signatory ...........................................................................................
WHO will support the work by providing a maximum amount of: *
.......................................................... in instalments of: ....................................
Payable on: .....................................................................
(Payment to individuals on signature is limited to 25% of the total value)
The detailed statement of the work to be performed and any related budget is contained in/set out below:
The contractual partner will complete and deliver the work by: .........................
A technical report is required: Yes_ No_
A financial statement is required: Yes_ No_
Payment is to be made into the following bank account of the contractual partner (to be completed by the contractual partner):
Bank account name and number: ............................................................................
Bank name: .............................................................................................................
Bank address: ..........................................................................................................
The undersigned parties hereby conclude the present agreement consisting of the above terms and the General Conditions overleaf.
For the WORLD HEALTH ORGANIZATIONFor the CONTRACTUAL PARTNERSignature:Signature:Name and Title:Name and Title:Date:Date:
MODEL SPECIAL SERVICES AGREEMENT FOR USE
ON PROJECTS OR OTHER ACTIVITIES
MEMORANDUM OF AGREEMENT MADE THIS DAY OF__________________20 ,
between the World Health Organization, hereinafter referred to as WHO and
____________________________________, hereinafter referred to as the signatory, whose address is:
WHEREAS WHO desires to engage the services of the signatory on the terms and conditions hereinafter set forth, and
WHEREAS the signatory is ready and willing to accept this engagement of service with WHO on the said terms and conditions,
NOW, THEREFORE, the parties hereto agree as follows:
1. TERMS OF REFERENCE
The signatory will be assigned to (project or activity) _________________ and will have the following terms of reference: _______________________________________________________
The signatory will work under the direction of and will report to
Subject to the agreement of both parties, these terms of reference may be modified from time to time, as required in the interest of the project/activity.
2. DURATION OF AGREEMENT
This agreement will come into effect on the ______ day of___________ 20 , and shall expire on the ___________day of ______________20 , subject to the provisions of Articles 7 and 8 below.
This agreement carries no expectation of renewal.
As full consideration for the services performed by the signatory under the terms of the Agreement, WHO shall pay the signatory the sum of_______________ (local currency) per annum payable monthly.
The cost of authorized official travel and related expenses shall be borne by WHO up to its normal standards.
The signatory confirms that he holds adequate health insurance for the duration of this Agreement.
Health insurance is provided for the signatory in accordance with the applicable rules as described in the extract from the policy attached to this Agreement, provided that the signatorys classification by the WHO Joint Medical Service is either la or 1b. Any other classification could exclude coverage for health insurance through WHO.
Illness and accident insurance
Coverage is provided against accidents which result in death or disablement, according to the extract from the policy attached to this Agreement.
4. OTHER ENTITLEMENTS
The signatory shall be accorded the following annual, sick and maternity leave provisions:__________________________________________________________________________
Working hours and holidays shall be those applying to the project/activity to which the signatory is assigned.
5. STATUS OF THE SIGNATORY
The signatory shall have the status of a contractor and shall not be considered in any respect as a staff member of WHO.
6. RIGHTS AND OBLIGATIONS OF THE SIGNATORY
The rights and obligations of the signatory are strictly limited to the terms and conditions of this Agreement. Accordingly, the signatory shall not be entitled to any benefit, payment, subsidy, compensation or pension from WHO, except as expressly provided in this Agreement.
The signatory shall not be exempt from taxation and shall not be entitled to reimbursement of any taxes, which may be levied on the remuneration received.
Either party may rescind this Agreement at any time by giving the other party at least _______ days notice in writing.
WHO may rescind this Agreement with immediate effect subject to the payment of _______ days remuneration.
In the case of rescission by WHO, the signatory shall receive compensation amounting to one week's remuneration for each unexpired month of the agreement.
In case of improper conduct by the signatory, having regard in particular to paragraphs 12 and 13, WHO may terminate this Agreement; no compensation shall be payable in such cases.
9. DESIGNATION OF BENEFICIARY
The signatory has designated ______________________________________ whose address is __________________________________________________________ as his beneficiary for all amounts standing to the signatorys credit under the terms of this Agreement in the event of the signatory's death.
10. INTELLECTUAL PROPERTY
Industrial property rights, copyright and all other rights of whatsoever nature in any material produced in the framework of this Agreement shall be vested exclusively in WHO.
11. UNPUBLISHED INFORMATION
The signatory shall exercise the utmost discretion in regard to all matters of official business. He shall not communicate to any person any information known to him by reason of his official position which has not been made public, except in the course of his duties or by authorisation of the Director-General. At no time shall he in any way use to private advantage information known to him by reason of his official position, These obligations do not cease with separation from service.
The signatory shall disclose to WHO any business or professional employment or activity in which he may be engaged prior to or at any time in the course of the present Agreement, These activities shall not be incompatible with the performance of the services outlined under 1.
13. PERFORMANCE OF DUTIES AND STANDARDS OF CONDUCT
In the performance of his duties under this Agreement, the signatory shall be exclusively responsible to WHO and shall neither seek nor accept instructions from any authority external to WHO, unless otherwise specified in the exchange of letters with the govemment1.
The signatory shall conduct himself at all times with the fullest regard for the purposes and principles of the United Nations and its Agencies, and in a manner befitting his relationship with WHO under this contract. The signatory shall not engage in any activity that is incompatible with those purposes and principles or the proper discharge of his duties with WHO. He shall avoid any action and in particular any kind of public pronouncement which may adversely reflect on WHO or on the integrity, independence and impartiality that are required by his relationship with WHO. While the signatory is not expected to give up any national sentiments or political and religious convictions, he shall at all times bear in mind the reserve and tact required by reason of his relationship with WHO.
Any favour, gift or remuneration from any source external to WHO which could give rise to the impression that it is connected with the performance of the signatory's duties shall not be accepted unless WHO's approval has been obtained beforehand
All notices and other communications required or permitted under this Agreement shall be sent to the following addresses:
In the care of WHO:
In the care of the signatory:
SETTLEMENT OF DISPUTES
Any claim or dispute relating to the interpretation of the execution of the present Agreement which cannot be settled amicably or through conciliation procedures shall be settled by arbitration unless the parties agree on another mode of settlement. The arbitral panel shall be composed of one member nominated by the signatory, one member nominated by WHO and a Chairman agreed to by the two other members. The parties shall accept the arbitral award as final.
On behalf of WHO The signatory
1.18 OTHER TYPES OF CONTRACT WITH INDIVIDUALS
10 The purpose of this section of the Manual is to establish the policies and procedures applicable to persons whose services are hired by the Organization under a special form of contract and who are not considered as staff members covered by the Staff Rules of the Organization.
SPECIAL SERVICES AGREEMENT FOR NATIONALS
WORKING ON PROJECTS OR OTHER ACTIVITIES
20 A special services agreement may be entered into with nationals of a host country for the use of their services on either short-term or long-term assignments similar to those carried out by internationally recruited staff, on a specific national project or other activity. However, such an agreement should only be concluded when the government is not able to second national civil servants or undertake the direct recruitment of national project personnel under a reimbursable loan agreement, or when it is considered essentia1 to have a direct national, as opposed to an international, input.
30 The persons with whom such a special services agreement is concluded may be nationals of the host country, including nationals living abroad (non-resident nationals), or expatriates resident in the host country. They do not have the Status of WHO staff members and are not covered by the WHO Staff Rules. Neither may they participate in the United Nations Joint Staff Pension Fund. Their rights and obligations are strictly limited by the terms and conditions of the special services agreement to which they are signatories.
40 If the services of a national are to be made available by WHO direct to a government, there should be an exchange of letters between WHO and the government to agree on the national's duties and status and the applicable terms and conditions.
50 When, in the circumstances described in paragraph 20, the services of nationals of the host government are to he hired under a special services agreement for a project, the appropriate project document should contain the following standard provisions setting out the government's responsibilities in relation to this type of contractor:
"The Government agrees to the recruitment of national professional contractors required for the implementation of this project, in accordance with established WHO policies and procedures for this purpose. These services constitute an addition to the regular resources of the Government and will be available only for the duration of WHO's participation in the project. Thus, WHO's resources will be used to finance such contractors, including non-resident nationals, as an alternative to internationally recruited professional staff. The remuneration of WHO financed contractors will be determined in consultation with the Government, and should, at all times, be at the best prevailing rates for comparable functions in the country. Total remuneration should not exceed that applicable within the United Nations system.
"The Government recogniser that the national professional contractors shall be exclusively responsible to WHO with respect to the performance of their duties in the project and that they may not receive instructions concerning such performance from any authority external to WHO.
"The Government agrees to treat the national professional contractors as officials of the World Health Organization for the purpose of the application of Section 19(a) of the Convention on the Privileges and Immunities of the Specialised Agencies.
"The Government agrees to accord them also inviolability for all papers and documents connected with their duties and, for the purpose of their communication with WHO, the right to receive papers and correspondence by courier or in sealed bags."
60 The curricula vitae of persons being considered for service under a special services agreement should be given full technical examination in order to ensure that such persons meet the highest standards of competence.
70 Government clearance of persons whom WHO intends to hire as national contractors for project activities should be obtained by the regional office concerned.
80 Special services agreements must be cleared in draft by Budget.
90 When drafting a special services agreement, the main principle to be borne in mind is that the remuneration, allowances and other conditions of service of national contractors should reflect the best applicable practices of the country concerned. They are not intended to replicate in any way the conditions of service of internationally recruited staff. The following paragraphs enlarge on some of the points that have to be covered in an agreement.
TERMS OF REFERENCE
100 The terms of reference (Article 1 of the model agreement in Annex A) should define the tasks to be performed by the signatory clearly and realistically, identifying those elements that require national expertise or knowledge and that represent a national input into the activity in question. If a report is expected, this should be stated. The officer to whom the signatory will report (e.g. WHO Representative) should he specified.
DURATION OF AGREEMENT
110 The duration of the agreement (Article 2) should not exceed one year but it may be renewed for further maximum periods of one year at a time. Any decision not to renew the last of successive one-year agreements should be notified to the signatory at least two months before the expiration of that agreement. If only part-time employment is envisaged, this must be clearly stated.
120 The remuneration of persons employed under special services agreements (Article 3) should be based on the best prevailing conditions in the country applicable to nationals carrying out functions at the same level. It is normally expressed as a single annual amount, which may incorporate an element representing a children's or spouse allowance, if these are provided for in national legislation or are paid by external local employers. Should signatories have continuing pension fund, health and/or life insurance commitments, WHO may meet the cost of their contributions to these commitments for the duration of the agreement up to the maximum applicable locally (see also para. 130). Remuneration levels are cleared with the government.
130 Remuneration is normally paid monthly in local currency. When the remuneration of non-resident nationals includes compensation to cover continuing commitments in the country of residence, this compensation may be paid in the currency of the country of residence on the basis of clear evidence provided by the person concerned.
140 The cost of authorized official travel and related expenses will be borne by WHO up to its normal standards. Since contractors are not staff members within the meaning of the WHO Staff Regulations, they cannot be issued with a laissez-passer.
ACCIDENT AND ILLNESS INSURANCE
150 Nationals who hold a special service agreement are covered by a commercial group accident and illness insurance policy (see Annex B) which provides compensation for accidental disablement or death and coverage of medical expenses incurred by illness (if requested by the person concerned in the absence of other adequate health insurance and approved by the joint Medical Service at headquarters), irrespective of whether or not an accident or illness is service-incurred. A copy of extracts from this policy is attached to each agreement.
160 The agreement must state whether or not the national wishes to take advantage of the coverage of medical expenses offered by the Organisations policy. If coverage is desired, the national must undergo a medical examination by the local United Nations examining physician, whose report is submitted to the Joint -Medical Service at headquarters for clearance. Coverage is granted only if the Medical Service classifies the national 1a or 1b. The decision is communicated in writing to the person concerned and a copy of the communication kept in his or her file.
*170 The premium for accident and illness insurance, with effect from 1 January 1996, is 3.95% of remuneration excluding war risk or 4.345% including war risk, whether or not the national desires coverage of medical expenses, and is paid in its entirety by the Organization, the amount being charged to the allotment to which the agreement is charged. For periods of coverage of less than one year, the premium per day of coverage is 1/365th of the annual amount.
*175 Special service agreement holders working in high risk areas (according to the UN Security Officer) can have additional insurance coverage for service-related accident/illness medical expenses, after the initial coverage of US$ 10 000 up to a maximum of $ 100 000. The premium is 4.345% (for war zone areas) plus $ 28.75 per month. There is no reduction for periods of less than one month. Such additional insurance coverage should be requested, at least 48 working hours before travel, by sending a memorandum to Chief, Pension and Insurance at headquarters, attaching a copy of the travel authorisation or contract and indicating the sticker number.
180 At the beginning of the contract the regional budget and finance officer prepares a journal voucher covering the full period of the contract. The total of the collected premiums are transferred to Accounts at headquarters once a month (see IV.1.810.5), with each individual's name listed on the transfer voucher. A copy of the transfer voucher and a list giving, for each individual: the full name; full period of contract; working capacity; honorarium; location and amount of premium collected; must also be sent to Chief Pension and Insurance.
190 Benefits due from the insurance company for medical bills may be advanced to the signatory by the Organization, through Pension and Insurance at headquarters, if the entitlement has been established, pending settlement when payment is received from the insurance company.
*200 In case of the insured's death, the benefit is paid to the beneficiary designated by the insured.
*210 In case of an accident or illness likely to result in a claim, and particularly of death or disablement through an accident, the insurance company must be notified as soon as possible on exactly the same basis as described in 11.7.500-525 but not later than within three months of the event, the report being made in the first Instance by the supervisor of the insured person to the regional personnel officer (see also para. 230).
*220 Claims for the reimbursement of medical expenses should be made on form WHO 845 F/E PEN and sent at the end of the treatment, with the approval of the regional staff physician, to Chief Pension and Insurance at headquarters through the budget and finance officer. Supporting bills must be attached accompanied by proof of payment. The full name and address of the claimant's bank and the bank account number must be given on the form WHO 845. Claims for medical expenses must be received within three months of the end of treatment and the number of the journal voucher, by which the premium was transferred, must be indicated.
225 The regional budget and finance officer should complete the claims as follows before forwarding them to Chief Pension and Insurance:
225.1 for all claims, add the number of the inter-office voucher and the date when the insurance contributions were transferred to Pension and Insurance at headquarters;
225.2 for claims related to an illness, attach a copy of the pre-recruitment medical form WHO 223 or WHO 16-4 and ensure that the regional staff physician completes and sends the confidential medical report form WHO 450.2 direct to the Director of the Joint Medical Service at headquarters.
230 A list of all new signatories of special service agreements must be sent not later than the fifth of each month by the regional personnel officer to Chief Pension and Insurance at headquarters, in order that these persons maybe covered by the insurance policy. The list should include: the full name; the full period of the contract; capacity in which the person is working; honorarium; location. Only those persons whose names appear on the list received by headquarters within the time-limit mentioned above will, in case of accident, be eligible for benefit under the insurance policy.
THIRD PARTY LIABILITY
240 When a national contractor's services are-hired to perform, under direct WHO supervision, duties that could involve risk of serious damage or injury to third parties, WHO must ensure that the contractor is adequately insured against such eventualities, failing which WHO may have to accept responsibility for them. When a contractor's services are hired to perform such duties under the direct supervision of the government, specific reference to third party liability should be made in the exchange of letters mentioned in paragraph 40. This reference could in most cases be to paragraph 6 of Article I of the basic agreement (see XII.l. Annex A). If this is not possible, equivalent wording may be used to reflect the government's agreement to accept such liability.
250 Annual, sick and maternity leave provisions (Article 4 of the model agreement in Annex A) should be the same as those applicable to government civil servants associated with the project or-other activity.
260 The following notice periods would be appropriate should either party wish to rescind the agreement (Article 7 of the model agreement):
260.1 for agreements of less than six months, up to 15 calendar days;
260.2 for agreements of six months to one year, 30 calendar days, or 60 calendar days where the signatory has served on the project or other activity for a continuous period of at least two years.
270 In exceptional circumstances such as cessation of all or part of the project or other activity, or for health reasons when WHO is forced to rescind the agreement, ad hoc compensation over the limit set out in the agreement may be considered. This should not however exceed the standard WHO contractual practice whereby the minimum indemnity is six weeks, and the maximum, three months' remuneration.
SETTLEMENT OF DISPUTES
280 Every effort should be made to obtain an amicable settlement to any dispute (Article 15) by referring to the WHO representative, the regional office or headquarters, as necessary.
DISTRIBUTION OF COPIES OF AGREEMENTS
290 After signature, one copy of each special services agreement should be sent to Personnel at headquarters, marked for the attention of Contract Administration. For UNDP financed projects, one copy should also be given to the UNDP resident representative in the country in question.
1.19 OFFICE PLANNING
TOTAL STAFF AND OFFICE REQUIREMENTS
INTERNATIONAL STAFFQUANTITYOFFICE REQUIREMENTSTOTALWR
Total International staffTotal office space
Total national staffTotal office space
TOTAL STAFF OFFICE SPACEtc "15. TOTAL STAFF OFFICE SPACE"
OTHER REQUIREMENTStc "OTHER REQUIREMENTS"DESCRIPTIONtc "DESCRIPTION"REQUIREMENTSTOTALtc "15. TOTAL"Logistics storeCommunications roomMeeting roomHF antennaVehicle compoundOverall TotalsTotal officesTotal storageTotal outside area
TOC \o "1-3" 2.1. WHO MEDICAL KITS PAGEREF _Toc456329376 \h 107
2.2 LIST OF REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT IN AFRICA PAGEREF _Toc456329377 \h 108
2.3 SAMPLE FORM FOR COORDINATION 1 PAGEREF _Toc456329382 \h 108
2.4 SAMPLE FORM FOR COORDINATION 2 PAGEREF _Toc456329383 \h 114
2.5 SAMPLE FORM FOR HEALTH SURVEILLANCE SUMMARY PAGEREF _Toc456329384 \h 115
2.6 METRIC CONVERSION TABLES PAGEREF _Toc456329385 \h 117
2.7 LOGISTIC INFORMATION ON KITS PAGEREF _Toc456329389 \h 119
2.8 PISA WAREHOUSE PAGEREF _Toc456329391 \h 120
Annexes in diskette (and some in this document)FILE NAMESAMPLE FORMS FOR COORDINATION I AND II
(see printed annexes 2.3 and 2.4)
2.8.DOCSAMPLE FORM FOR HEALTH SURVEILLANCE SUMMARY
2.9.DOCDRUG DONOR GUIDELINES
2.10.DOCWHO GENERAL PRICE LIST
2.11.DOCSAMPLE HEALTH CARD
2.12.DOCSAMPLE MONTHLY ACTIVITY REPORT
2.13.DOCSAMPLE MORTALITY RATE
2.14.DOC2.1. WHO MEDICAL KITS
WHO has distributed most of its medical supplies for its emergency humanitarian assistance activities in the form of pre-packaged kits. Some of the kits have been specifically designed by WHO for emergency situations in countries such as the former Yugoslavia; some of them, however, have been used in other countries and are based on the experience of other medical organisations.
The decision to use kits as a primary form of distribution for medical aid is based mainly on logistical considerations. In conditions of unpredictable access and transport, the supply of drugs in the form of standardised packages is easier and quicker. This is especially important for patients requiring regular medication and treatment.
The medical kit is a supply tool. The kit concept is based upon the selection of essential medical equipment and drugs estimated to be needed by a defined population size for a set period of time, distributed as a standardized package. The kits are targeted to provide wide scale population coverage. In this scope, kits contain basic but essential medicines in large quantities rather than small quantities of highly specialized drugs for the treatment of relatively rare diseases. In accordance with the WHO Essential Drugs concept, kits aim to make available effective, safe, and essential drugs of good quality to as many people in need as possible.
WHO strives to make the kits flexible and adaptable for the rational coverage of priority needs. The kit contents have been reviewed according to feedback from the field. In addition, some kits are referred to by more than one name on the field.
Some kits are structured into smaller units or sub-kits, which can be distributed independently. These sub-units are used to re-supply the portion of the kits comprised of disposable material and allow for flexibility and rational coverage of specific need. A number of kits are also provided with supplemental literature or educational material. Some of the kits require special handling as they include controlled substances or items requiring cold storage. Exporting and receiving countries must ensure that appropriate documentation is completed for controlled substances according to customs requirements and end users must be aware of the need for proper handling. Kits containing items requiring cold storage must adhere to proper cold chain and storage procedures. Kits with these requirements are marked in the following lists.
The information provided gives approximate costs. Because kits are packaged by different suppliers, costs may vary. In addition, the prices may vary according to the exchange rates between the US Dollar and purchasing currencies.
All comments and suggestions on the kits provided are welcome as they will help us to improve the quality and appropriateness of WHO supplies. Requests for more information should be addressed to the Procurement Services in HQ (fax: +41-22- 791 4196) or ROs.
2.2 LIST OF REFERENCE VALUES FOR RAPID HEALTH ASSESSMENT
1. General Cut off Values for Emergency warningMORE THANHealth Status Daily Crude Mortality rate1 x 10,000 population Daily Under-5 Mortality rate2 x 10,000 children U-5Nutrition Status Acute Malnutrition (W/H or MUAC) in
Under-510% of children U-5 Growth Faltering Rate in Under-530% of monitored children Low Weight at Birth (less than 2.5 Kg)7% of live birthsStandard structure of population
Average in the population in % 0 4 year12.4 5 9 years11.7 10 14 years 10.5 15 - 19 years 9.5 20 - 5948.6 Pregnant women 2.4
2. Vital Needs
(emergency requirements)WaterIndicatoraverage requirement QuantityNP of litters/person/day20 1/p/day QualityNP of users/water point200 people/point(1 Cubic Meter = 1 Ton
= 1,000 litters)(not more than 100 M from housing)FoodKcal contentRation, KG/person/Month Cereals350/100g13.5 Pulses335/100g1.5 Oil (vegetable)885/100g0.8 Sugar400/100g0.6Kcal value of recommended ration, person/day:2,116 KcalTotal Kg/person/month for alimentation16.4 KgMicro-nutrients (e.g. iodine, Vit A) are important. Consult nutritional guidelines.SanitationLatrine: ideally one per family; minimum, one seat per 20 people (Max 50 M, min 6 M from housing)
Refuse disposal: one communal pit (2mx5mx2m) per 500 people
Soap: 250 g/per person/per month
Household fuelaverage needKg of firewood15 Kg/household/dayNote: with one economic stove per family, the needs may be reduced:
5 Kg/stove/daySpace for accommodationAverage needsIndividual requirements (shelter only)4 sq. meters/personCollective requirements, including Shelter, sanitation, services, community Activities, warehousing and access
30sq.meters/person3. Health Needs and CarePrevalent Health HazardsExpected attack rate in emergency situationsAcute Respiratory Infections in children U-510%/month in cold weatherDiarrhoeal diseases in children U-5 (other than dysentery and cholera)50%/monthMalaria, in total non-immune population50%/monthMeaslesCholera5-30% in acute phase (in first days)
Health Personnel requirements
Output of one person/hour
of worke.g. refugee camp: services, management and
clerical duties60 staff x 10,000 population
Health Supplies requirements
Essential Drugs and Medical Equipment
NeededWHO Basic Emergency Kit1 kit for 10,000 pop/3 monthsWHO Supplementary Emergency kit1 kit for 10,000 pop/3 months
Safe WaterAmountPreparing 1 liter of stock solution 1%Calcium hypochlorite 70%15 grams/liter of waterOrBleaching powder 30%33 grams/one liter of waterOrSodium hypochlorite 5%250 ml/one liter of waterOrSodium hypochlorite 10%110 ml/one liter of waterb) using the stock solutionfor one liter of water 0.6 ml, or 3 dropsfor 100 litres60 ml(Note: allow the chlorinated water to stand at least 30 minutes before using)
4. Needs for Epidemic Response for planning purposes
DysenteryLikely maximum attack rate25% over three months25% cases needing IV fluids3 litres/patient100% cases needing antibacterials:Choice according to antimicrobal resistance pattern
If not available, target high risk populations100% cases needing ORS6.5 packet/patient
Meningococcal meningitis Likely rate before vaccination0.1- 1 %100% cases treated with with e.g. oily chloramphenicolChildren
Adults100 mg per kilo
3 g single dose100% population to be vaccinated1 dose/person
MeaslesLikely maximum attack rate in no-immunized Under-1210%100% non-immunized Under-12 to be vaccinated1 dose/child100% Under-12 to be given Vitamin AChildren under 1 year100,000 IU/childChildren 1 year and over200,000 IU/childTyphus100% population to be de-lousedSoak clothes and bedding in e.g. Permethryn solution doxycycline1 dose of 400 mg
Important: for safe vaccinations auto-destruct syringes and alcohol swabs are needed
5. Essentials of LogisticsWeights and volumesUnitStandard FoodStandard individual ration16.4 kg/month
41 tons/10,000 people/ week
(1 ton of food grains/beans in standard 50 kg bag occupies 2 cubic mts) Drugs & supplies:1 WHO basic emergency kit45 Kg 0.2 m31 WHO suppl. emergency kit410 Kg 2 m3 Vaccines:1,000 doses of Measles3 litres1,000 doses of DPT2.5 litres1,000 doses of BCG1 liter1,000 doses of Polio1.5 litres1,000 doses of Tetanus2.5 litres Food for Therapeutic Feeding:Standard U-5 patient ration2 kg/week
Family-size tents:35-60 Kg unit1 metric ton 4.5 m3 BlanketsCompressed1 metric ton 4.5 m3loose1 metric ton 9 m3Warehouse requirementsApproximately 25 sq.m for 1,000 populationAverage truck capacity30 metric tons (between 2 and 50 metric tons)Small aircraft capacity3 metric tons
2.3 SAMPLE FORM FOR COORDINATION 1
1. Vital needsHealth activitiesDisplaced persons/Host Community(Ministry of Health and NGOs)RefugeesOVERVIEW. Monitor the trend of population size. Monitor the daily mortality. Record the first causes of death1.1.SECURITY. Record the new cases of victims of deliberate violence. Record the new cases of anti-personal mines victims. Assistance to non-accompanied children1.2 WATER. Surveillance of diarrhoeas. Water distribution. Water points treatment 1.3 FOOD. Nutritional surveillance. Identification of vulnerable groups for supplementary feeding. Therapeutic feeding. Micro-nutrients distribution1.4 SHELTER &. Participation in sites planning SANITATION. Health and environment education. Diarrhoeas surveillance. Setting up latrines1.5 SOAP,
BUCKETS. Health education AND PANS. Distribution of buckets, soap and chlorine.../2Vital needsHealth ActivitiesDisplaced persons/Host Community(contn.)(Ministry of Health and NGOs)Refugees 1.6 Health Care. Rehabilitation of health facilities. Supply of equipment &
essential drugs. Immunisation. Maternal and Child care. Strategic Stocks against epidemics of: measles, cholera, dysentery and meningitis. Education, diagnostic and management of common diseases. Condoms and education for HIV infection . Referral system: state of functioning & accessibility2.Support activities2.1.INFORMATION. Epidemiological surveillance. Nutritional surveillance2.2.LOGISTIC &. Medical evacuations managementCOMMUNICATIONS. Investment in transport means. investment in communication means2.3.COORDINATION. Health coordination meetings. Inter-sectoral coordination meetings. Handing over to new teams2.4. TRAINING. Continuous training. Supervision2.5.RESOURCES. Identification of needs and projects MOBILISATION
2.4 SAMPLE FORM FOR COORDINATION 2
3. Database of NGOs and projects in the Health sector
Health District/Region of
(project form attached)Implementation
starting dateCommitment statePledgedObligedOn-goingimplemented
2.5 SAMPLE FORM FOR HEALTH SURVEILLANCE SUMMARY
4. Health Information for monitoring the needs and for coordination of activities during the return and/or resettlementHealth District/Region of .......Date..........1. Vital needsEssential and complementary dataAvailable ?Periodicy of yes/notransmission . N. of populationOVERVIEW . N. of arrivals/week . N. of deaths/day . N. of deaths/day for under-5 children . First causes of mortality1.1.. N. of victims of deliberate violence (new cases)SECURITY. N. of victims of anti-personal mines (new cases). Attacks against health centres and agencies1.2.. N. of cases of diarrhoeaWATER. Distance between the settlement and water sources/points. Type of water sources. N. of families per water point. Projects for the chlorination of sources. Availability of Chlorine/Bleach1.3.. N. of cases of acute malnutritionFOOD. N. of cases of growth faltering. N. of cases of low-weight at birth. Distribution State of general and selective rations. N. of vulnerable cases for supplementary feeding. N. of cases requiring therapeutic feeding. N. of cases of clinical deficiency in micro-nutrients1.4.. N. of cases of diarrhoeaSHELTER &. Shelters conditionsSANITATION. Environment conditions. Projects for setting up latrines. Availability of tools and material for the construction of shelters and digging latrines, etc. Health education activities1.5.. N. of cases of diarrhoeaSOAP, BUCKETS. State of basic needs of familiesAND PANS. N. of cases of eye and skin infections. Health education activities1.6. . State of infrastructures and equipmentHEALTH CARE. State of supply of drugs and material. State of personnel . N. of immunisations per antigen and age-group. N. of MCH activities . N. of cases of measles, cholera, dysentery and meningitis. State of strategic stocks for epidemics. N. of cases of ARI, malaria and STDs. N. of cases of tuberculosis under treatment. Availability of condoms. Referral system: state of functioning and accessibility.../22. Support Essential and complementary dataAvailable ?Periodicy of activities yes/notransmission2.1.. Functioning of epidemiological and nutritional surveillance systemsINFORMATION . Circulation of health information among the other sectors2.2. . State of the reception, distribution and storage systemLOGISTIC & of medical materialsCOMMUNICATIONS. N. of and state of means of transport of the Agency. N. of and state of communication means of the Agency2.3.. Periodicity of coordination meetings:COORDINATION - Sectoral - inter-sectoral. Circulation of sector meetings acta. Circulation of bulletins, newsletters, etc2.4. . Training activities organised by the health centres or the agenciesTRAINING. Training activities attended by health centres or agencies (including Supervision2.5. . List of health projects submitted for financingRESOURCE . Funding confirmedMOBILISATION . Funds disbursed2.6 METRIC CONVERSION TABLEStc \l1 "METRIC CONVERSION TABLES
METRIC TO ENGLISH ENGLISH TO METRIC
tc \l1 "
To convertintomultiply byTo convertintomultiply byLengthLengthmminches0.03937Inchesmm25.4cminches0.3937Inchescm2.54metersinches39.37Inchesmeters0.0254metersfeet3.281Feetmeters0.3048metersyards1.0936Yardskm914.4kmyards1093.6Yardsmeters0.9144kmmiles0.6214Mileskm1.609Surfacestc \l1 "SurfacesSurfacescm2Square inches0.155square inchescm26.452m2square feet10.764square feetm20.0929m2square yards1.196square yardsm20.8361km2square miles0.3861square mileskm22.59hectaresacres2.471Acreshectares0.4047Volumestc \l1 "VolumesVolumescm3cubic inches0.06102cubic inchescm316.387cm3liquid ounces0.03381cubic incheslitres0.016387m3cubic feet35.314cubic feetm30.028317m3cubic yards1.308cubic feetlitres28.317m3gallons (USA)264.2cubic yardsm30.7646litrescubic inches61.023liquid ouncescm329.57litrescubic feet0.03531gallons U.S.A.m30.003785litresgallons (USA)0.2642gallons U.S.A.litres3.785mlteaspoon0.2Teaspoonsml5.0mltablespoon0.666Tablespoonsml15.0mlfluid ounces0.333fluid ouncesml30.0litrescups4.166Cupslitres.24litrespints2.128Pintslitres0.47litresquarts1.053Quartslitres0.95Weightstc \l1 "WeightsWeightstc \l1 "Weightsgramsgrains15.432Grainsgrams0.0648gramsounces0.03527Ouncesgrams28.35kgounces35.27Ounceskg0.02835kgpounds2.2046Poundskg0.4536kgtons (USA)0.001102Poundstons (metric)0.000454kgtons (long)0.000984tons (U.S.A.)kg907.2tons (metric)pounds2204.6tons (U.S.A.)tons (metric)0.9072tons (metric)tons (USA)1.1023tons (long)kg1016.0tons (metric)tons (long)0.9842tons (long)tons (metric)1.0160
Centigrade to Fahrenheit: Multiply by 1.8 and add 32tc \l2 "Centigrade Bð Fahrenheit: Multiply by 1.8 and add 32
Fahrenheit to Centigrade: Subtract 32 and multiply by 0.555
Weight of water by volume (at 16.7 degrees C or 62 degrees F):tc \l2 "Weight of water by volume (at 16.7 degrees C or 62 degrees F):
1 liter = 1 kilogram 1 U.K. gallon = 10 pounds
1 U.K. gallon = 1.2 U.S. gallons 1 U.K. gallon = 4.54 litres
1 U.S. gallon = 0.833 U.K. gallons 1 U.S. gallon = 8.33 pounds
1 U.S. gallon = 3.79 litres 1 liter = 0.26 gallons
1 cubic foot of water = 62.3 pounds
Distance: 1 Nautical mile = 1.152 statute miles = 1.852 kilometres
2.7 LOGISTIC INFORMATION ON KITStc \l1 "LOGISTIC INFORMATION ON KITS
KITNumber of cartonsWeightVolumeANAESTHETIC KIT343 Kgs0.24 cbmSUPPLEMENTARY ANAESTHETIC KIT244.4 Kgs0.176 cbmSUPPLEMENTARY BANDAGE KIT6116 Kgs1.21 cbmCHOLERA DIAGNOSTIC KIT134 Kgs0.312 cbmCHRONIC DISEASE KIT (BALKAN BOX)129 Kgs0.120 cbmAðCIC@ð (CLEAN INTERMITTENT CATHETERISATION) KIT1120 Kgs0.941 cbmCLINICAL CHEMICAL LAB. KIT (PERISHABLE AND DANGEROUS)
4.38 cbmCLINICAL MICROBIOLOGY LAB. KIT2261 Kgs4.320 cbmCOMMUNITY HEALTH WORKER KIT6.9 Kgs0.027 m3DIPHTHERIA Bð VOLUME:
TOTAL VOLUME: BIOREAGENTS:
EPIDEMIC RESPONSE KIT:
72 Kgs0.1968 cbm
0.1808 cbmFAMILY DOCTOR=ðS PRACTICE KIT421 Kgs3.49 cbmHEALTH POST KIT113 KgsHYGIENE KIT17 Kgs0.035 cbmINSULIN KIT PART AðA@ð
0.197ITALIAN EMERGENCY KITS:
F:1138 Kgs0.970 cbmMENTAL HOSPITAL KIT110 Kgs0.037 cbmNEONATAL KIT14.5 KgsNEW EMERGENCY HEALTH KIT
(complete for 10,000 people containing 10 basic units and 1 supplementary unit)
For 10 000 persons for 3 months.
10 x 1 basic unit - 1 unit
1 Supplementary unit -
410 Kgs4 m3
2 m3PARENTERAL FLUID KIT776 Kgs1.628 cbmPERINEAL/VAGINAL/CERVICAL REPAIR KIT12 KgsPNEUMONIA KIT
(PART A-BOX 1 & PART B-BOX 1)
(PART A-BOX 2 & PART B-BOX 2)
0.134 cbmPOLIO CASE INVESTIGATION KIT10.5 Kgs0.1 m3REPRODUCTIVE HEALTH KIT286 Kgs1.161 cbmSTITCH PACK-EPISIOTOMY SET1 KgsSURGICAL SUPPLY KIT29607 Kgs6.420 cbmTRANSFUSION KIT
PART A :
0.030 cbmTUBERCULOSIS KIT
PART A & PART B
845 Kgs0.536 cbmVITAMIN KIT10170 Kgs0.370 cbm
2.8 PISA WAREHOUSE
The Office of the Coordinator of Humanitarian Affairs (OCHA), in collaboration with the Italian Government, maintains a warehouse containing essential emergency relief items in Pisa, Italy. From there, OCHA is able to respond immediately to calls for aid. It can send, free-of-charge and by the fastest possible means, assistance to disaster-stricken areas, particularly those in developing countries.
Furthermore, Pisa is well placed for access to major disaster-prone regions, particularly those in Africa and the Middle East. The airport, where even the largest aircraft can land, operates on a year-round basis. There is very little risk that bad weather will ground flights or hamper other means of transport. It is easily accessible to the headquarters of major humanitarian organisations.
The warehouse, climate-controlled for the storage of medicines and other perishable items, keeps an estimated 70 to 80 tons of relief goods. The goods are quality-controlled and appropriately packed, ready for immediate dispatch to wherever they are needed: this saves time-consuming and expensive market research into the cost of individual items at the time of a disaster. While the OCHA Warehouse is not designed to provide relief in all emergency situation, it can be used to ensure a smooth flow of goods in relief operations, avoid waste, and save on the costs of transport and services. It is also an assembly point for shipments, which come either directly from donors or from other warehouses, for delivery to affected areas.
WHO, in order to enhance its ability to respond speedily to emergencies, signed in 1994 a Memorandum of Understanding with OCHA for the stockpiling of medical items in Pisa.
TYPE OF SUPPLIES AVAILABLE
Medical supplies: New Emergency Health Kits and Italian Emergency Kits A, B, D and F
( from WHO stocks: see technical notes for more details).
Shelter : large-size community tents, plastic sheeting, building materials ( from OCHA stocks).
Water supply equipment: tanks, purification devices, pumps ( from OCHA stocks).
Basic household items: cooking utensils, water containers etc. ( from OCHA stocks).
Emergency rations and food (from WFP stocks).
Miscellaneous relief items : hand tools, shovels, hammers, saws, generators etc. ( from OCHA stocks).
OBTAINING RELIEF ITEMS
DHA operations out of Pisa are usually planned in co-operation with the office of the UN Resident Co-ordinator in the disaster-affected country and/or the local Disaster Management Team. Customarily, this take place within the framework of an appeal for international assistance. All goods and freight costs up to the destination are free of charge to the consignee (United Nations Office/Agency, governmental relief authorities, NGOs, etc) which then takes care of local handling and distribution.
United Nations Office of the Coordinator of Humanitarian Affairs (OCHA), Geneva Office
Palais des Nations CH-1211 Geneva 10
Tel (+4122) 917 3290-3515-3512
Emergency only (+4122) 917 2010
Fax (+4122) 917 0023
Telex 41 42 42 dha ch
2. 10 GUIDELINES FOR DRUG DONATIONS
These Guidelines for Drug Donations have been developed by the World Health Organization (WHO) and reflect a consensus between the major international agencies active in humanitarian emergency relief (World Health Organization, Office of the United Nations High Commissioner for Refugees, United Nations Children's Fund, International Committee of the Red Cross, International Federation of the Red Cross and Red Crescent Societies, Medecins sans Frontieres, Churches' Action for Health of the World Council of Churches and OXFAM). In several rounds of consultation, comments by over 100 humanitarian organisations and individual experts were taken into consideration.
The guidelines aim to improve the quality of drug donations, not to hinder them. They are not an international regulation, but intended to serve as a basis for national or institutional guidelines, to be reviewed, adapted and implemented by governments and organisations dealing with drug donations. They are issued as an interagency document and will be reviewed after one year on the basis of comments received during their use.
There are many different scenarios for drug donations. They may take place in acute emergencies or as part of development aid in non-emergency situations. They may be corporate donations (direct or through private voluntary organisations), aid by governments, or donations aimed directly at single health facilities. And although there are legitimate differences between these scenarios, there are many basic rules for an appropriate donation that apply to all. The guidelines aim to describe this common core of "Good Donation Practice
This document starts with a discussion on the need for guidelines followed by a presentation of the four core principles for drug donations. The guidelines for drug donations are presented in Chapter III. When necessary for specific situations, possible exceptions to the general guidelines are indicated. Chapter Iv presents some suggestions on other ways that donors may help, and Chapter V contains practical advice on how to implement a policy on drug donations.
I The need for guidelines
In the face of disaster and suffering there is a natural human impulse to reach out and help those in need. Medicines are an essential element in alleviating suffering, and international humanitarian relief efforts can greatly benefit from donations of appropriate drugs.
Unfortunately, there are also many examples of drug donations which cause problems instead of being helpful. A sizeable disaster does not always lead to an objective assessment of emergency medical needs based on epidemiological data and past experience. Very often an emotional appeal for massive medical assistance is issued without guidance on what are the priority needs. Numerous examples of inappropriate drug donations have been reported (see Annex). The main problems can be summarized as follows:
Cð Donated drugs are often not relevant for the emergency situation, for the disease pattern or for the level of care that is available. They are often unknown by local health professionals and patients, and may not comply with locally agreed drug policies and standard treatment guidelines; they may even be dangerous.
Cð Many donated drugs arrive unsorted and labelled in a language which is not easily understood. Some donated drugs come under trade names which are not registered for use in the recipient country, and without an International Nonproprietary Name (INN, or generic name) on the label.
Cð The quality of the drugs does not always comply with standards in the donor country. For example, donated drugs may have expired before they reach the patient, or they may be drugs or free samples returned to pharmacies by patients or health professionals.
Cð The donor agency sometimes ignores local administrative procedures for receiving and distributing medical supplies. The distribution plan of the donor agencies may conflict with the wishes of national authorities.
Cð Donated drugs may have a high declared value, e.g. the market value in the donor country rather than the world market price. In such cases import taxes and overheads for storage and distribution may be unnecessarily high, and the (inflated) value of the donation may be deducted from the government drug budget.
Cð Drugs may be donated in the wrong quantities, and some stocks may have to be destroyed. This is wasteful and creates problems of disposal at the receiving end.
There are several underlying reasons for these problems. Probably the most important factor is the common but mistaken belief that in an acute emergency any type of drug is better than none at all. Another important factor is a general lack of communication between the donor and the recipient, leading to many unnecessary donations. This is unfortunate because in disaster situations and war zones inappropriate drug donations create an extra workload in sorting, storage and distribution and can easily overstretch the capacity of precious human resources and scarce transport volume. Often, the total handling costs (duties, storage, transport) are higher than the value of the drugs. Stockpiling of unused drugs can encourage pilfering and black market sales.
Donating returned drugs (unused drugs returned to a pharmacy for safe disposal, or free samples given to health professionals) is an example of double standards because in most countries their use would not be permitted due to quality control regulations. Apart from quality aspects, such donations also frustrate management efforts to administer drug stocks in a rational way. Prescribers are confronted with many different drugs and brands in ever changing dosages; patients on long-term treatment suffer because the same drug may not be available the next time. For these reasons this type of donation is forbidden in an increasing number of countries and is generally discouraged.
In the early 1980s the first guidelines for drug donations were developed by international humanitarian organisations, such as the International Committee of the Red Cross (ICRC) and the Christian Medical Commission (CMC) of the World Council of Churches, later called Churches' Action for Health.1 In 1990 the WHO Action Programme on Essential Drugs, in close collaboration with the major international emergency aid agencies, issued a first set of WHO guidelines for donors, later refined by the WHO Expert Committee on the Use of Essential Drugs. In 1994 the WHO office in Zagreb issued specific guidelines for humanitarian assistance to former Yugoslavia.
In view of the existence of these different drug donation guidelines the need was felt for one comprehensive set of guidelines that would be endorsed and used by all major international agencies active in emergency relief. For this reason a first draft was prepared by the WHO Action Programme on Essential Drugs and further refined in close collaboration with the division of Drug Management and Policies and the division of Emergency and Humanitarian Action, major international relief organisations and a large number of international experts. The final text represents the consensus between the World Health Organization, UNICEF, the Office of the United Nations High Commissioner for Refugees, the International Committee of the Red Cross, the International Federation of Red Cross and Red Crescent Societies, Churches' Action for Health of the World Council of Churches, Medecins sans Frontieres and OXFAM. In the process comments by over 100 humanitarian organisations and individual experts were taken into consideration.
The examples of inappropriate donations quoted above constitute ample reasons to develop international guidelines for drug donations. In summary, guidelines are needed because:
Donors intend well, but often do not realise the possible inconveniences and unwanted consequences at the receiving end.
Donor and recipient do not communicate on equal terms. Recipients may need support in specifying how they want to be helped.
Drugs do not arrive in a vacuum. Drug needs may vary between countries and from situation to situation. Drug donations must be based on a sound analysis of the needs, and their selection and distribution must fit within existing drug policies and administrative systems. Unsolicited and unnecessary drug donations are wasteful and should not occur.
The quality requirements of drugs are different from other donated items, such as food and clothing. Drugs can be harmful if misused, they need to be identified easily through labels and written information, they may expire, and they may have to be destroyed in a professional way.
II Core principles
The twelve articles of the Guidelines for Drug Donations are based on four core principles. The first and paramount principle is that a drug donation should benefit the recipient to the maximum extent possible. This implies that all donations should be based on an expressed need and that unsolicited drug donations are to be discouraged. The second principle is that a donation should be given with full respect for the wishes and authority of the recipient, and be supportive of existing government health policies and administrative arrangements. The third principle is that there should be no double standards in quality: if the quality of an item is unacceptable in the donor country, it is also unacceptable as a donation. The fourth principle is that there should be effective communication between the donor and the recipient: donations should be based on an expressed need and should not be sent unannounced.
III Guidelines for Drug Donations
Selection of drugs
1.All drug donations should be based on an expressed need and be relevant to the disease pattern in the recipient country. Drugs should not be sent without prior consent by the recipient.
Justification and explanation
This provision stresses the point that it is the prime responsibility of the recipients to specify their needs. It is intended to prevent unsolicited donations, and donations which arrive unannounced and unwanted. It also empowers the recipients to refuse unwanted gifts.
In acute emergencies the need for prior consent by the recipient may be waived, provided the drugs are amongst those from the WHO Model List of Essential Drugs, that are included in the UN list of emergency relief items recommended for use in acute emergencies.
2. All donated drugs or their generic equivalents should be approved for use in the recipient country and appear on the national list of essential drugs, or, if a national list is not available, on the WHO Model List of Essential Drugs, unless specifically requested otherwise by the recipient.
Justification and explanation
This provision is intended to ensure that drug donations comply with national drug policies and essential drugs programmes. It aims at maximising the positive impact of the donation, and prevents the donation of drugs which are unnecessary' and/or unknown in the recipient country.
An exception can be made for drugs needed in sudden outbreaks of uncommon or newly emerging diseases, since such drugs may not be approved for use in the recipient country.
3. The presentation, strength and formulation of donated drugs should, as much as possible, be similar to those commonly used in the recipient country.
Justification and explanation
Most staff working at different health care levels in the recipient country have been trained to use a certain formulation and dosage schedule and cannot constantly change their treatment practices. Moreover, they often have insufficient training in performing the necessary dosage calculations required for such changes.
Quality assurance and shelf-life
4. All donated drugs should be obtained from a reliable source and comply with quality standards in both donor and recipient country. The WHO Certification Scheme on the Quality of Pharmaceutical Products Moving in International Commerce should be used.
Justification and explanation
This provision prevents double standards: drugs of unacceptable quality in the donor country should not be donated to other countries. Donated drugs should be authorized for sale in the country of origin, and manufactured in accordance with international standards of Good Manufacturing Practice (GMP).
In acute emergencies the use of the WHO Certification Scheme may not be practical. However, if it is not used, a justification should be given by the donor. When donors provide funds to purchase drugs from local producers, those which comply with national standards should not be excluded on the sole grounds that they do not meet quality standards of the donor country.
5. No drugs should be donated that have been issued to patients and then returned to a pharmacy or elsewhere, or were given to health professionals as free samples.
Justification and explanation
Patients return unused drugs to a pharmacy to ensure their safe disposal; the same applies to drug samples that have been received by health workers. In most countries it is not allowed to issue such drugs to other patients, because their quality cannot be guaranteed. For this reason returned drugs should not be donated either. In addition to quality issues, returned drugs are very difficult to manage at the receiving end because of broken packages and small quantities involved.
6. After arrival in the recipient country all donated drugs should have a remaining shelf life of at least one year.
Justification and explanation
In many recipient countries, and especially under emergency situations, there are logistical problems. Very often the regular drug distribution system has limited possibilities for immediate distribution. Regular distribution through different storage levels (e.g. central store, provincial store, district hospital) may take six to nine months. This provision especially prevents the donation of drugs just before their expiry as in most cases such drugs would only reach the patient after expiry.
An exception should be made for drugs with a total shelf life of less than two years, in which case at least one-third of the shelf life should remain. An exception can also be made for direct donations to specific health facilities, provided the responsible professional at the receiving end is aware of the shelf life and the remaining shelf-life allows for proper administration prior to expiration. In all cases it is important that the date of arrival be communicated to the recipient well in advance.
Presentation, packing and labelling
7. All drugs should be labelled in a language that is easily understood by health professionals in the recipient country; the label on each individual container should at least contain the International Nonproprietary Name (INN, or generic name), batch number, dosage form, strength, name of manufacturer, quantity in the container, storage conditions and expiry date.
Justification and explanation
All donated drugs, including those under brand name, should be labelled also with their INN or the official generic name. Most training programmes are based on the use of generic names. Receiving drugs under different and often unknown brand names and without the INN is confusing for health workers and can even be dangerous for patients. In case of injections, the route of administration should be indicated.
8. As much as possible, donated drugs should be presented in larger quantity units and hospital packs.
Justification and explanation
Large quantity packs are cheaper, less bulky to transport and conform better with public sector supply systems in most developing countries. This provision also prevents the donation of drugs in sample packages, which are impractical to manage. In precarious situations, the donations of paediatric syrups and mixtures may be inappropriate because of logistical problems and their potential misuse.
9. All drug donations should be packed in accordance with international shipping regulations, and be accompanied by a detailed packing list which specifies the contents of each numbered carton by INN, dosage form, quantity, batch number, expiry date, volume, weight and any special storage conditions. The weight per carton should not exceed 50 kilograms. Drugs should not be mixed with other supplies in the same carton.
Justification and explanation
This provision is intended to facilitate the administration, storage and distribution of donations in emergency situations, as the identification and management of unmarked boxes with mixed drugs is very time and labour intensive. This provision specifically discourages donations of small quantities of mixed drugs. The maximum weight of 50 kg ensures that each carton can be handled without special equipment.
Information and management
10. Recipients should be informed of all drug donations that are being considered, prepared or actually under way.
Justification and explanation
Many drug donations arrive unannounced. Detailed advance information on all drug donations is essential to enable the recipient to plan for the receipt of the donation and to coordinate the donation with other sources of supply. The information should at least include: the type and quantities of donated drugs including their International Nonproprietary Name (INN or generic name), strength, dosage form, manufacturer and expiry date; reference to earlier correspondence (for example, the letter of consent by the recipient); the expected date of arrival and port of entry; and the identity and contact address of the donor.
11. In the recipient country the declared value of a drug donation should be based upon the wholesale price of its generic equivalent in the recipient country, or, if such information is not available, on the wholesale world-market price for its generic equivalent.
Justification and explanation
This provision is needed in the recipient country to prevent drug donations being priced according to the retail price of the product in the donor country, which may lead to elevated overhead cost for import tax, port clearance, and handling in the recipient country. It may also result in a corresponding decrease in the public sector drug budget in the recipient country.
In case of patented drugs (for which there is no generic equivalent) the wholesale price of the nearest therapeutic equivalent could be taken as a reference.
12. Costs of international and local transport, warehousing, port clearance and appropriate storage and handling should be paid by the donor agency, unless specifically agreed otherwise with the recipient in advance.
Justification and explanation
This provision prevents the recipient from being forced to spend effort and money on the clearance and transport of unannounced consignments of unwanted items, and also enables the recipient to review the list of donated items at an early stage.
IV Other ways donors can help
The New Emergency Health Kit
In the acute phase of an emergency, or in the case of displacements of refugee populations without any medical care, it is better to send a standardised kit of drugs and medical supplies that is specifically designed for this purpose. For example, the New Emergency Health Kit, which has been widely used since 1990, contains drugs, disposable supplies and basic equipment needed for general medical care for a population of 10,000 for three months. Its contents are based on a consensus among the same group of major international aid agencies that also issued the drug donation guidelines. It is permanently stocked by several major international suppliers (for example, UNICEF and IDA) and can be available within 48 hours. It is especially relevant in the absence of specific requests.
Donations in cash
After the acute phase of the emergency is over, a donation in cash for local or regional purchase of essential drugs is usually much more welcome than further drug donations in kind. Such a cash contribution is very supportive to the activities of the local government or coordinating
committee, it is supportive to the local and regional pharmaceutical industry and it may also be more cost-effective. In addition, Prescribers and patients are usually more familiar with locally produced drugs.
Additional guidelines for drug donations as part of development aid
When drug donations are given between governments as humanitarian support to long-lasting complex emergencies and as regular development (commodity) aid there is usually more time to consider specific demands from the side of the recipient. On the other hand, there is also time to link more restrictions to the donation, e.g. to products from manufacturers in the donor country, and to drugs registered for use in the recipient country.
It should be recognised that drugs do not arrive in an administrative vacuum. Drug donations should not create an abnormal situation which may obstruct or delay national capacity building in selection, procurement, storage, distribution and rational use of drugs. Special care should therefore be taken that the donated drugs respond to an expressed need, comply with the national drug policy, and are in accordance with national treatment guidelines in the recipient country. Administratively, the drugs should be treated as if they were procured. This means that they should be registered or authorized for use in the country through the same procedure that is used for government tenders. They should be entered into the inventory, distributed through the existing distribution channels and be subject to the same quality assurance procedures. If cost-sharing procedures are operational in the recipient country, the donated drugs should not automatically be distributed free of charge.
V How to implement a policy on drug donations
Management of drug donations by the recipient
Define national guidelines for drug donations
It is difficult for a recipient to refuse a donation that has already arrived. Prevention is therefore better than cure. Recipients should indicate to their prospective donors what kind of assistance they need, and how they would like to receive it. If this information is provided in a professional way, most donors will appreciate it and will comply.
Therefore, recipients should first formulate their own national guidelines for drug donations, on the basis of these international guidelines. They can also be included in the national drug policy. These national guidelines should then be officially presented and explained to the donor community. Only after they have been presented and officially published can they be enforced.
Define administrative procedures for receiving drug donations
It is not enough for the recipient to adopt and publish the general guidelines on the selection, quality, presentation and management of drug donations. Administrative procedures need to be developed by the recipient to maximize the potential benefit of drug donations. As much as possible such arrangements should be linked with existing drug supply systems, but there are several questions which apply to donations only. Examples of such important questions, which have to be addressed in each country, are:
who is responsible for defining the needs, and who will prioritize them?
who coordinates all drug donations?
which documents are needed when a donation is planned; who should receive them?
which procedure is used when donations do not follow the guidelines?
What are the criteria for accepting/rejecting a donation; who makes the final decision?
who coordinates reception, storage and distribution of the donated drugs?
How are donations valued and entered into the budget/expenditure records?
How will inappropriate donations be disposed of?
Specify the needs for donated drugs
The third important action by the recipient is to specify the needs for donated drugs as much as possible. This puts the onus on the recipient to carefully prepare such requests, indicating the required quantities and prioritizing the items. The more information given, the better. Information on donations that are already in the pipeline, or anticipated, is very helpful to other potential donors. Full information from the side of the recipient is greatly appreciated by donors and pays off in the long run.
Manage donated drugs carefully
The value of donated drugs can be considerable, and the gift should be treated with due care. On arrival the drugs should be inspected and their receipt confirmed to the donor agency. They should then be stored and distributed in accordance with normal principles
of good pharmacy practice and under the responsibility of adequately trained professionals. There must be due vigilance to ensure that donated products are not diverted for export, commercial sale, or into illicit channels.
Action required from donor agencies
Donors should always respect the four core principles for drug donations presented above. Donors should also respect the national guidelines for drug donations and respond to the priority needs indicated by the recipient. Unsolicited donations should be prevented as much as possible.
The public at large in the donor country is not always aware of the common problems with drug donations. It is therefore important that governments in donor countries spend some effort to create more public awareness on "good donor practice". The best moment for this is probably at the time of the public appeal through the media.
Within the recipient country it is recommended that the different donors choose a "lead donor" amongst themselves, who coordinates donor activities and who may also act as the central contact point in discussions with the recipient government.
The recipient country should supply as much information as possible on requested and approved donations. On the other hand, the donors themselves should also inform the recipient well in advance and in great detail about which donations are corning, and when. This will greatly assist the coordinating body in the recipient country to plan for the proper reception of the donations, and to identify the need for additional supplies.
Examples of problems with drug donations
After the earthquake, 5,000 tons of drugs and medical supplies worth US$55 million were sent. This quantity far exceeded needs. It took 50 people six months to gain a clear picture of the drugs that had been received. Eight percents of the drugs had expired on arrival, and 4% were destroyed by frost. Of the remaining 88%, only 30% were easy to identify and only 42% were relevant for an emergency situation. The majority of the drugs were only labelled with brand names.5
During the war for independence, despite careful wording of appeals, many inappropriate donations were received. Examples were: seven truck loads of expired aspirin tablets that took six months to burn; a whole container of unsolicited cardiovascular drugs with two months to expiry; and 30,000 half-litre bottles of expired amino-acid infusion that could not be disposed of anywhere near a settlement because of the smell.6
A large consignment of drugs was sent to war-devastated southern Sudan. Each box contained a collection of small packets of drugs, some partly used. All were labelled in French, a language not spoken in Sudan. Most drugs were inappropriate, some could be dangerous. These included: contact lens solution, appetite stimulants, mono-amine oxidase inhibitors (dangerous in Sudan), X-ray solutions, drugs against hypercholesterolaemia, and expired antibiotics. Of 50 boxes, 12 contained drugs of some use.7
Pharmaciens sans Frontieres collected 4 million kg of unused drugs from 4,000 pharmacies in France.
These were sorted out in 88 centres in the country. Only about 20% could be used for international aid
programmes, and 80% were burnt.8
Russian Federation, 1992
Russian pharmaceutical production has fallen far below its 1990 level, and donations of drugs have been welcomed. However, initial enthusiasm soured when the nature of some donations was discovered. Examples of donations include: 189,000 bottles of dextromethorfan cough syrup; pentoxifylline and clonidine as the only antihypertensive items; triamterene and spironolactone as diuretics; pancreatic enzyme and bismuth preparations as the only gastrointestinal drugs.9
Guinea Bissau, 1993
In September 1993 eight tons of donated drugs were sent; all were collected from pharmacies in quantities between I and 100 tablets. The donation contained 22,123 packages of 1,714 different drugs which were very difficult to manage and greatly interfered with government efforts to rationalize drug supply and drug use.10
Eleven women in Lithuania temporarily lost their eyesight after using a donated drug. The drug, closantel, was a veterinary anthelmintic but was mistakenly given to treat endometritis. The drug had been received without product information or package insert, and doctors had tried to identify the product by matching its name with those on leaflets of other products.'1
Former Yugoslavia, 1994,1995
Of all drug donations received by the WHO field office in Zagreb in 1994, 15% were completely
unusable and 30% were not needed.12 By the end of 1995, 340 tons of expired drugs were stored in
Mostar. Most of these were donated by different European nations.13
1 Guidelines for donors and recipients of pharmaceutical donations. Geneva: Christian Medical Commission of the World Council of Churches, 1990 (in English, Spanish, French and German)
2 The New Emergency Health Kit. Geneva: World Health Organization, 1990. WHO/DAP/90.11 p.5
3 The use of essential drugs. Geneva: World Health Organization, 1992. Technical Report Series 825; p.13
4 Medical supplies donor guidelines for WHO humanitarian assistance for former Yugoslavia. Zagreb: World Health Organization, 1994
5 Autier P et al. Drug supply in the aftermath of the 1988 Armenian earthquake. Lancet 1990; i: 1388-90
6 Woldeyesus K, Snell B. Eritrea's policy on donations. Lancet 1994; ii: 879
7 Cohen S. Drug donations to Sudan. Lancet 1990; i: 745
8 Les medicaments non-utilises en Europe: receuil, destruction et reutilisation a des fins humanitaires. Paris: PIMED, 1994
9 Offerhaus L. Russia: emergency drug aid goes awry. Lancet 1992; i: 607
10 Maritoux I. Report submitted to WHO, October 1994
11 Hoen E, Hodgkin C. Harmful use of donated veterinary drug. Lancet 1993; ii: 308-9
12 Forte GB. An ounce of prevention is worth a pound of cure. Presentation at the International Conference of Drug Regulatory Agencies, The Hague, 1994
13 Letter sent by the Mayor of Mostar to the Ambassador of the European Union, 2 October1995.
2.11 WHO GENERAL PRICE LIST
We give here a price list that can be used for quick reference when calculating costs for emergency planning. This list is not complete. In order to spare space, we have abridged the official WHO General Price List. This selection should not be taken as an advice on what is or isnt needed in emergency. For a full selection of the items available and more details, consult the original document tc \l1 "WHO GENERAL PRICE LIST
ITEMStc \l1 "ITEMSsupplierEstimated cost1.00Antimalarials1.01Chloroquine phosphate tabs, 100 MG Base, 1000 pack$8.00 1.02Chloroquine phosphate tabs, 150 MG Base, 100 pack$1.50 1.03Mefloquine Hydrochloride tabs, 250 MG, 100 pack$65.00 2.00Antidiarrhoeals2.01Oral Rehydration salt(ORS) 1/1000ml, 100 pack$65.00 2.02Ringers Lactate, 1000 ml with giving set, set of 12$15.00 2.03Water for injection, 2/5/10ml, 50 amp. Pack2 to 2.53.00Anti tuberculotics & Anti Leprotics3.01Clofazimine caps, 50 MG, 1000 pack$50.00 3.02Isoniazid 300 MG + Thioacetazone 150 MG tabs, 1000 pack$11.00 3.03Rifampicin 150 MG, 100 pack$4.00 4.00Other Tropical diseases Drugs4.01Melarsoprol inj. 30% sol, 5ml amp. X 10$270.00 4.02Pentamidine Isetionate for inj. 200 MG in vials, pack of 10$125.00 4.03Praziquantel tabs, 600 MG 1000 pack$180.00 5.00Anti-Infective Drugs5.01Amoxicillin 250 MG caps/tabs, 1000 pack$31.00 5.02Chloramphenicol caps, 250 MG, 1000 pack$17.50 5.03Chloramphenicol oily susp., 500 MG amp. 2ml, pack of 100$180.00 5.04Chloramphenicol powder for inj. 1g, 100 pack$25.00 5.05Doxycycline 100 MG caps/tabs, 1000 pack$15.00 6.00Miscellaneous Drugs6.01Ascorbic Acid tab. 50 MG tabs, 1000 pack$2.25 6.02Ascorbic Acid tab. 250 MG tabs, 1000 pack$8.00 6.03Salbutamol inj. 0.5 MG (sulfate)ml amp., 100 pack$15.00 6.04Tetracycline Eye Ointment 1%, tube 5 g$0.25 6.05Tetracycline tabs./caps, 250 MG, 1000 pack$10.00 7.00Contraceptives7.01Condoms, gross of 144$6.00 7.02I.U.D., TCU 380 A, Coper T, pack of 50$55.00 7.03Injectables, Medroxymogesterone Acetate Susp., 150mg/ml 100 pack$22.00 7.04Pills, per cycle$0.40 8.00Diagnostics (in vitro and in vivo)8.01Capillus HIV 1/2 Rapid, 100 tests/kit, Cambridge Biotech.$130.00 8.02Detect HIV 1+2 test kit, 96 tests per kit$50.00 8.03Genelavia Mixt 72266 Aids tests, Pasteur, 96 tests$45.00 8.04HIV Spot Screening tests, Genelabs, 100 test per kit$130.00 8.05Immunocomb II Bispot Aids Screening kits 60432002, HIV 1+2, 36 tests/kit, orgenics$45.00 8.06Innotest HIV-1 / HIV-2 Ab, 96 tests per kit$50.00 8.07Recombigen HIV 1&2 EIA kits, 192 tests, Cambridge$90.00 8.08Serodia HIV 1&2, 100 tests/kit, Fujirebio$90.00 8.09Vironostika HIV Uniform-ll Plus O, Organon, 192 tests$90.00 8.10Tuberculin PPD 10TU/0.1 ml, 10 x 1.5 ml pack$116.00 8.11Tuberculin PPD RT 23 FOR Mantouc Tests, 2 Tu / 0.1ml, 10 x1.5 ml pack$43.00
9.00Vaccines9.01BCG vaccine 20 doses amp, infants$1.50 9.03Diphtheria Tetanus Absorbed, Adult, 20 doses$1.00 9.04DPT vaccine, 20 doses, per dose$1.10 9.05Influenza vaccine, single dose$3.40 9.06Measles Vaccine, 10 doses vial$1.25 9.07Meningoccocal vaccine, A+C, 50 doses, per dose$0.20 9.08Polio vaccine live, oral, 20 doses$1.50 9.09Rabies vaccine, Vero, single dose$11.20 9.10Rabies vaccine, ex-diploid cell, single dose$17.00 9.11Tetanus vaccine, 20 doses$0.85 9.12Typhoid Fever vaccine, Polysaccharide, 20 doses vial$27.00 9.13Yellow Fever vaccine, 5 dose vial$290.00 9.14As above, 10 doses vial$4.50 9.15As above, 50 doses vial$8.10 9.16Gammaglobulin Human 16%$3.75 9.17Hepatitis A Immunoglobulin SSVI Globuman Berna Hepatitis A, 2 ml (200 iu)$20.00 9.18Rabies Immunoglobulin, 1 vial 2 ml (300 iu)$66.00 9.19Tetanus Immunoglobulin, 250 iu,1 ml syringe$7.00 9.20Snake antevenom, West Africa$11.00 9.21Snake antevenom, Near East$7.00 11.00SterilizationSterilizer, non electric, complete with syringe rack,prestigeSafety plugs and Instruction manual11.01 Single rack, capacity 4.4 Litres$85.00 11.02 Double rack, non electric, capacity 9 L$100.00 PHC sterilizer kit, non electric, complete with syringe rack,prestigesafety plugs, sterilizer bowl, spare gaskets, carrying bagand instruction manual11.03 Single rack, capacity 4.4 L$100.00 11.04 Double rack, capacity 9 L$120.00 11.07Sterilizer, hot air, convection, 160/180/200 degrees C, 65 Lmeg$550.00 ID. 41x41x41 cm with perforated aluminium trays12.00Injection/samplingSyringe, sterile, disposable12.01 2 ml, box of 100$3.00 12.02 5 ml, box of 100$5.00 12.03 10 ml, box of 100$7.00 Needle, sterile, disposable Luer, box of 100, 12.04size 20G, 21G, 22G, 23G, 24G, 26G, 27G (Specify requirement) $4.00 12.05Vacutainer tube, 10 ml, siliconized, box of 100fleischhacker$15.00 12.06Vacutainer tube, 7 ml, ETDA, box of 100$18.00 12.07Vacutainer tube, 5 ml, Hemogard closure, box of 100$16.00 12.08Microtainer tube, plain, pack of 200$30.00 12.09Vacutainer needles, box of 100, size 20g, 21G, 22G$15.00 Autodestruct syringe with needle, box of 100univec12.10 0 .5 ml with 23G x 25 mm$9.00 12.11 1 ml TB with 27G x 1/2"$9.00 12.12 2 ml with 22G x 1.5"$11.00 12.13 5 ml with 21G x 1.5"$13.00 12.14 10 ml with 21G x 1.5"$15.00 12.15Safety box for used syringes/needles$1.50 12.16Blood lancet, sterile, disposable, box of 200fleischhacker$4.00 12.17Autolet Mini, with 10 x 26G sterile lancets/holders, box of 2 sets$10.00 12.18As above, case of 200 sets$500.00
13.00Diagnosis13.01Glucometer Elite, with sensors, lancets, and casefleischhacker$100.00 13.02Additional blood glucose strips, box of 100$40.00 13.03Diagnostic set contains otoscope, nasal speculummeg$110.00 lampholder, laryngeal mirrors, tongue holderOphthalmoscope, battery handle, spare bulb & case13.04Sphygmomanometers, mercury, 300 mm Hg.,meg$45.00 13.05Sphygmomanometers, aneroid, 300 mm Hg.,$15.00 13.06Stethoscope, dual,meg$5.00 14.00Kits14.01Emergency Health Kit (Basic - for 1 000 people) x 10$2,520.00 14.02Emergency Health Kit (Supplementary for 10 000 people)$3,115.00 14.03Anaesthetic kit$1,300.00 14.04Cholera Diagnostic kit$840.00 14.05Chronic Diseases kit (Balkan Box)$650.00 14.06Clean Intermittent Catheterisation kit (CIC)$1,700.00 14.07Community Health Worker kit$65.00 14.08Diphtheria kit$5,900.0014.09Epidemic Response kit - Part A (for diarrhoea)$90.00 14.10Epidemic Response kit - Part B (for diarrhoea)$150.00 14.11Health Post kit$260.00 14.12Hygiene kit$25.00 14.13Insulin kit "A"$900.00 14.14Insulin kit "B" $1,150.00 14.15Italian Emergency kit "A" (Traumatological profile)$4,200.00 14.16Italian Emergency kit "B" (Supplies for kit "A")$11,000.00 14.17Italian Emergency kit "D" (Diarrhoea profile)$1,800.00 14.18Italian Emergency kit "F" (Supplies for kit "D")$1,100.00 14.19Kato - katz kit for stool examination p&d brazil$150.00
14.20Neonatal resuscitation kit, with mucus extractor, babymeg$655.00 resuscitator and face mask, suction catheters, infantLaryngoscope, endotracheal tubes and suction pump14.21Parental Fluid kit$1,300.00 14.22Perineal / Vaginal / cervical Repair kit$35.00 14.23Pneumonia kit, Box 1 (Part A & Part B)$300.00 14.24Pneumonia kit, Box 2 (Part A & Part B)$250.00 14.25Polio case investigation kit, contains outer and inner bags,meg$600.00 faeces containers, cotton wool pads, labels and lab.report form, case of 200 kits.14.26Polio specimen collection kit, 100 per pack, Code E 11/02meg$300.00 14.27Stitch Pack - Episiotomy set$15.00 14.28Surgical supply kit$10,500.00 14.29Transfusion kit Part "A"$1,000.00 14.30Transfusion kit Part "B"$110.00 14.31Vitamin kit$270.00
15.00General Hospital Consumables15.01Apron, white, reusable plasticfleischhacker$7.00 15.02Apron, white, disposable plastic, box of 100$6.00 15.03Glove heavy duty, flexible neoprene, 31 cm long, pairfleischhacker$4.00 15.04Glove, heavy duty, rubber, small / medium / large, 100 in boxmeg$55.00 15.05Glove, operation, latex sterile, single use, size 6.5 to 9,meg$20.00 box of 50 pairs
15.06Glove, operation, latex non sterile, reusable, size 6.5 to9,meg$10.00 box of 50 pairs15.07Glove, examination, latex disposable, non sterile,meg$5.00 box of 10015.08Scalp vein sets (butterfly needles) size 18G to 27G,meg$12.00 box of 10015.09Infusion giving setmeg$0.25 Blood bag, 450 ml, with cpd - a and taking setmeg15.10 Single$1.00 15.11 Double$2.00 15.12 Triple$3.00 15.13Transfusion set with fixed needle and air inletmeg$0.50 15.14Cadaver bagmeg$17.00 Sutures, catgut, 1.5 m, box of 12ethicon15.15 Plain gauge 2.0 (4 / 0)$27.00 15.16 Chromic gauge 3.0 (3 / 0)$23.00 15.17Mersilk, silk braided, black gauge 3.5 (0), 1.8 m, 12 in box$15.00 15.18Coated Vicryl (Polyglactin 910) braided, violet gauge 3.5$35.00 (0), 1.5 m, box of 1216.00Hospital Equipment16.01Defibrillator, portable, battery operatedmeg$1,800.00 16.02Infant/child resuscitator w/ face mask, oxygen reservoir bagambu$120.00 16.03As above, for adultsambu$140.00 16.04Emergency case, 3 section, complete setambu$2,200.00 16.05WHO oxygen concentrator with standard accessoriesdevilbiss$1,500.00 16.06 Flowsplitter kit for above$400.00 16.07 Sunmist Plus nebulizer$130.00 16.08Stretcher, army type, foldingmeg$80.00 16.09Stretcher, combination wheel / carryingmeg$400.00 16.10Examination table, knock down, folding, 2 sectionmeg$170.00 16.11Wheelchair, basic model, foldingmeg$340.00 16.12Sterilizing drums, ss, 24 cm dia.meg$35.00 16.13Sterilizing drums, ss, 29 cm dia.meg$40.00 16.14Sterilizing drums, ss, 134 cm dia.meg$45.00 16.15Light examining, floor stand type meg$80.00 16.16Light examining, articulated table modelmeg$50.00 16.17Operating light, stand type, knock down, mobile, 220V 50Cmeg$660.00 16.18Scale, bathroom, 120 kg x 1 kgmeg$10.00 16.20Scale, infant, clinic with traymeg$20.00 17.00ChemicalsAcids and Solventsnentech17.01Acetic acid, glacial A.R. 1 liter$9.00 17.02Anisole 99%, 500 ml$14.00 17.03Chloroform A.R., 1 liter$14.00 17.04Glycerol, 500 ml$6.00 17.05Hydrochloric Acid Conc., A.R., 500 ml$12.00 17.06Methanol A.R., 1 liter$10.00 17.07Sulphuric Acid Conc., A.R., 500 ml$12.00 General Chemicals and Reagentsnentech17.08Formaldehyde 37.5% solution, 1 liter$7.00 17.09D-Glucose Monohydrate, 500 g$5.00 17.10Phenol, detached crystals, A.R., 500 g$17.00 17.11Potassium lodide A.R., 500 g$17.00 17.12Silver Nitrate A.R., 25 g$17.00 17.13Sodium Chloride A.R., 500 g$5.00 17.14Tri-Dosium citrate A.R., 500 g$5.00 17.15Sodium Hydrogen Carbonate, 1 kg$5.00 17.16Sodium Hydroxide Pellets, A.R., 500 g$5.00 17.17Sodium Thiosulphate Hydrate A.R., 500 g$5.00 Stains and Reagents for Microscopynentech17.18Buffer tablets, PH 7.2 (for 100 ml), 50$10.00 17.19Cedarwood oil, thickened, for microscopy, 25 ml$5.00 17.20Crystal Violet, 25 g$5.00 17.21Fuchsin, basic, 25 g$5.00 17.22Giemsa's stain powder, 25 g$5.00 17.23Immersion oil, synthetic, 100 ml$8.00 17.24Methylene Blue, 25 g$5.00 17.25Safranin, 25 g$10.00 17.26Wright's stain, 25 g$5.00 18.00Dental Equipment and Materials quayle 18.03Set of 20 (15 adult, 5 child) extraction forceps$600.00 18.04Set of 18 elevators$170.00 18.05Set of 7 excavators$60.00 18.06set of 7 probes$50.00 18.07Set of 15 scalers$160.00 18.08Cartridge syringe$30.00 18.09Mirror handle$3.00 18.10Pack of 12 mirrors$18.00 18.21Local Anaesthetic cartridges, pack of 50$15.00 18.22Disposable dental needles, box of 100$9.00 18.27Cold Sterilizing solution,$20.00 18.28Concentrate, 1 l, disposable saliva, pack of 100$4.00 18.29Gloves, latex, non sterile, box of 100$5.00 18.30Face masks, box of 100$5.00 18.33Mouthwash (Chlorohexidine), 300 ml$4.00 19.00X-Ray Filmscea19.09CEA RP\OGA, blue / Green sensitive, box of 100$70.00 19.10CEATANK, Devolper, Manual processing, 2 x 5 L for$25.00 making 50 L working solution19.11CEAFIX, Fixer, manual processing, 2 x 5 L for making$25.00 50 L working solution20.00Ophthalmology20.01Binocular Loupe, 3 x 420 largeheime$320.00 20.02Beta Ophthalmoscope setheime$150.00 21.00Office Items21.01Computer, Pentium Pro, 180/200 MHz, 256 KB cache, 32 MB RAM,dell, ibm, compaq$2,700.00 2 GB HDD, 1.44 MB FDD, 17" SVGA colour monitor,12 x CD-ROM drive, Keyboard, with WIN 95/NT21.02Portable computer, Pentium 133 MHz, 16 MB RAM, toshiba, ast, dell$2,400.00 144MB FDD, 1.35 MB HDD, Li-Ion battery,10 x CD-ROM swappable, AC adaptor and case21.03HP laserjet 6P, 8ppm, 600x600 dpi, 45 fonts resident,hewlett packard$780.00 2 mb ram, with printer cable21.04HP Deskjet 340 mono printer, portable with cablehewlett packard$240.00 21.05MS Office Professional 97 for Win 95/NT$500.00 21.06Corel Wordperfect for windows, ver. 6.1$400.00 21.07Norton Utilities ver. 8.0$150.00 21.08Norton Antivirus, latest version$230.00 21.09HP Scanjet 4 C, colour flatbed scanner, with$650.00 Calculator21.10Model P-D 4220, printing & display, 12 digitscanon$130.00 21.11Paper rolls for above, box of 50$20.00 21.12Ink ribbons, box of 12$15.00 21.13Solar power and battery pocket calculator$10.00 25.00Filing cabinets25.01Model FC, 4 drawers$400.00 25.02Paper, foolscap, tabbed file, pack of 100$30.00
26.00Library Shelving26.01Model 100 D.4, double door cupboardabbott$370.00 27.00Photocopier27.01Photocopier, 7-8 copies/min., Max. Copy size A4, 220V 50Ccanon, minolta, sharp$1,300.00 27.02Toner, Spare drum, cabinet, Spare parts kit, etc. (if available)$300.00 27.03Photocopier, 12 to 14 copies/min., Max. copy size A4,ricoh, mita$1,500.00 with zoom 70-140% 220V 50Ccanon, milota, sharp$2,000.00 27.04Toner, Spare drum, cabinet, Spare parts kit, etc.$500.00 27.05Photocopier, 15 to 21 copies/min., Max. Copy size A3,canon, mita, minolta$2,500.00 With zoom 50-200%, 220V 50Cricoh, sharp$2,500.00 27.06Sorter, for above$1,300.00 27.07Automatic document feeder for above$1,500.00 27.08Toner, Spare drum, cabinet, Spare parts kit, etc.$1,000.00 29.00ProjectorsOverhead projectors29.01Desktop, standard, f 300 mm lens, 24V 250W lamp,kindermann$340.00 285 x 285 mm image, with spare lamp29.02Dust cover, roll film holderextra29.05Portable, f 300 mm, 24V/250W lamp, 7.2 kgs.,kindermann$477.00 285 x 285 mm at 2 m., w/spare lamp, roll container,29.06Carry bag, laser pointer, projection screen for wallextraSlide Projector29.10Slide projector, 24x36, 2x24V/250W lamp, remote control cable,kindermann$340.00 f 1.2/90 mm zoom, 220V 50CCase with 6 magazines 50 extra30.00Teaching Aids30.02Camera, 35 mm, autofocus, with AF 28-105 f 3.5-4.5 lens, carrying caseandrews$710.00 30.03Film, Ektachrome ASA 100.35 mm, 36 exp.kodak, ch$5.00 30.04Portable radio/cassette recorder, stereo, 2 speakerskindermann$174.00 30.05Audio cassettes, 90 min.boris & rudy, lerch$6.00 30.06VHS video cassettes, 180 min.boris & rudy, lerch$6.00 31.00Laboratory Suppliessts31.01Apron, disposable plastic, bib front, 1200 mm long, box of 100$12.00 Aspirator bottle, polyethylene, w/vented stopcocksts31.02 capacity 5 litres$25.00 31.03 capacity 10 litres$30.00 31.04 capacity 25 litres$65.00 31.05Spare stopcock for above$5.00 Beaker, polyprolyne, low form w/spoutsts31.06 100 ml, pack of 10$12.00 31.07 600 ml, pack of 5$16.00 31.08 1000 ml, pack of 5$18.00 31.09 2000 ml, pack of 5$32.00 31.10Benchcote, 46 cm wide, roll of 50 msts$85.00 31.11Benchcote, 92 cm wide, roll of 50 m$160.00 31.12Biohazard bags, autoclavable, disposable, 610 x 760 mm, pack of 100sts$80.00 31.13Biohazard warning tape, orange on yellow, 25 x 66 mm$5.00
31.14Biohazard warning labels black on yellow, 330 per roll, individually cut on$25.00 backing paperBlood collection bottles, sterlin, non sterile, screw cap w/labelsts31.15 5 ml, pack of 1000$25.00 31.16 10 ml, pack of 500$90.00 31.17Boiling ring, spiral elements, white enamel, 1200W, 220V 50Csts$95.00 31.18Dispenser, Volac digital, adjustable 0.5 to 5 ml, accuracy +/- 1%,sts$175.00 glass syringe, c/w 2 amber glass reservoirs, 80/400 ml31.19Dispenser, as above but 1 ml to 10 ml$175.00 31.20Gloves, LATEX, non sterile, small / medium / largests$10.00 31.21As above, VINYL$11.00 31.22Kahn tubes, glass, rimless, medium wall, 75 x 12 mm, pack of 150sts$18.00 31.23Test tube rack for 36 Kahn tubes$11.00 31.24Kimwipes, lite professional wipes, large, 200 tissuessts$110.00 per carton, case of 36 cartons31.25Scott 130 white 2 ply towels per roll, 24 rolls per case$145.00 31.26Markers, fine point, permanent black colour, pack of 10sts$20.00 31.27Markers, felt tip chisel point, permanent ink in black,$20.00 blue or red, pack of 12Measuring Cylinder, Azlon, clear polypropylenests31.28 100 ml$5.00 31.29 500 ml$8.00 31.30 1000 ml$11.00 Pasteur pipettes w/bulb, disposable plastic, non sterilests31.31 1 ml by 0.25 ml markings, pack of 500$16.00 31.32 3 ml by 0.25 ml markings, pack of 1000$16.00 Pasteur pipettes, glass, non sterile, unpluggedsts31.33 146 mm long, pack of 1000$34.00 31.34 230 mm long, pack of 1000$45.00 31.35Teats for above pipettes, pack of 100$13.00 31.36Pipette fillere, Pi-Pump for up to 2 ml pipettes, bluests$15.00 31.37Pipette fillere, Pi-Pump for up to 10 ml pipettes, green$16.00 31.38Safety pipette filler, universal for all sizes$7.00 31.39Pipette cans, square section, aluminium, 180 mmsts$32.00 31.40As above but 255 mm long$32.00 31.41Pipette stand, universal, ss, holds 8 pipettes horizontallysts$24.00 31.42Safety glasses, with side shields, brow guard andsts$25.00 lenses. Can be worn over prescription spectacles.Sharps containers, polypropylene, stackablests31.43 7.6 litres capacity, pack of 24$130.00 31.44 22.7 litres capacity, pack of 12$130.00 31.45Specimen mailing box, outer cardboard case, preformedsts$250.00 polyethylene foam inner, holds 5 polystyrene containersto contain sealed specimen vials w/instructions & labels31.46Test tube racks, nylon coated wire, for 36 tubes up to 16 mm dia.sts$12.00 31.47Test tube racks, polypropylene, 3 tier, autoclavable, capacity 60 x 16 mmsts$14.00 31.48Timer, digital, 99 min to 1 sec.sts$15.00 31.49Timer, mechanical, hand operated, alarm, 1 to 60 min.$10.00 31.50Universal 30 ml container, plastic, single use, screw cap, sterile, 400 packsts$110.00 31.51As above, re-useable, glass, al. cap and rubber liner, 144 pack$70.00 31.52Wall thermometer, dial type, -30 degrees to +60 degrees C$12.00 31.53Wash bottles, Azlon, slope shoulder, 125 ml, pack of 5sts$9.00 31.54As above, 250 ml, pack of 5$10.00 31.55Wash bottles, Nalgene, polyethylene, wide mouth, 500 mlsts$35.00 31.56Viewer, plate (round)microtec$350.00 31.57Spare mirror for above$80.00 31.58Tissue culture plates, round bottom, 96 wells, sterile, disposable, 50 pack$80.00 31.59As above, for ELISA examination, pack of 50$55.00 31.60Tubes 75 x 13 mm, 5 ml, polystyrene, carton of 2000cml$16.00 31.61Hemolyse tube, glass, SODO, 75 x 13 mm, pack of 100cml$2.00 Cryotubes, screw stoper, self standing,nunc31.62 1.8 ml, case of 1800$290.00 31.63 3.6 ml, case of 1600$300.00 31.64Rack for 40 cryotubes, pack of 25$130.00 31.65Cryobox, 130 x 130 x 50 mm, case of 48$200.00 31.66Microvials 2 ml, w/closure, pack of 1000sarstedt$65.00 31.67Racks, plastic for microvials$25.00 Pipette 8 channel, digital with tip ejectorlabsystems31.68 5 - 50 ul$320.00 31.69 50 - 300 ul$320.00 31.70Tip - bands of 4 for 8 channel pipettes, pack of 100$15.00 31.71Finntip band - 4, 300 ul, bulk, pack of 3200$400.00 31.72Digital finnpipette, 0.5 - 10 ul, colour$120.00 31.73Digital finnpipette, 5 - 40 ul, colour$120.00 31.74Digital finnpipette, 40 - 200 ul$120.00 31.75Digital finnpipette, 200 - 1000 ul$120.00 31.76Finnpipette, continuously adjustable, 1 - 5 ul$120.00 31.77Tips, Finntip 60, 0.5 - 200 ul, box of 500$10.00 31.78Tips, Finntip 60, 0.5 - 200 ul, box of 1000$20.00 31.79Tips, Finntip 60, 0.5 - 200 ul, carton of 22,000$380.00 31.80Tips, Finntip 61, 0.5 - 200 ul, box of 200$5.00 31.81Tips, Finntip, 61, 0.5 - 200 ul, box of 400$10.00 31.82Tips, Finntip, 61, 0.5 - 200 ul, carton of 6,500$130.00 31.83Stand for multi channel pipettes$3.00 31.84Stand for Finnpipettes$20.00 31.85Reagent basins, 60 ul, pack of 5$5.00 31.86Reuseable glass serological pipettes, graduatedsts31.87 1 ml x 0.01 ml, pack of 5$10.00 31.88 5 ml x 0.05 ml, pack of 5$10.00 31.89 10 ml x 0.01 ml, pack of 5$10.00 Disposable glass serological pipettes, non sterile, notstsplugged, bulk wrapped, graduated31.90 1 ml x 0.01 ml, pack of 500$60.00 31.91 5 ml x 0.05 ml, pack of 500$110.00 31.92 10 ml x 0.01 ml, pack of 250$70.00 31.93Plastic boxes with dividers for storing & transporting 96 sts$320.00 tubes, pack of 4831.94Coolboxes, Coleman polylite, 37.8 litres, 57 x 33 x 37 cmsts$50.00 31.95Icepacks for above, 10 per box$2.00 31.96Coolbox, high capacity, 51 litres, 49 x 39 x 41 cms$110.00 31.97Icepacks for above, 10 per box$5.00 31.98Coleman, thermo-electric, 32 litres, 12 volts withsts$340.00 adaptor for 220V 50C32.00Laboratory Equipment32.02Agglutination option Multiscan Plus$260.00 32.03Thermal paper, Multiscan Plus, per roll$8.00 32.04Lamp 8V 50W, Multiscan Plus$20.00 32.05Filter in range 400 - 750 nm$200.00 32.06Reader ELISA, 963 PR, with Epson P40S thermal printer,slt$2,850.00 paper, one filter 405 or 450 or 492 nm, lamp, wiring unit & case32.07Extra filter unit (450, 492 or 612 nm)$250.00 32.12Vacuum pump, Pasteur$500.00 32.13Dry Incubator for microplates$1,500.00 32.14Skatron hand washer, Miniwasher, 8 channel w/standsts$700.00 32.15Skatron hand washer, Miniwasher, 12 channel w/stand$700.00 32.17Multiwash plate viewer, 96 well plate$200.00 32.18Spare mirror for above$100.00 32.19Table top autoclave, non electric, 10 litres$380.00 32.20Table top autoclave, non electric, 12 litres$670.00 32.21Portable autoclave, 13 litres w/safety valve, pressure gauge,certoclav$1,200.00 drain siphon, for one large sterilizing drum 240V 50C32.22Sterilizing drum for above$180.00 32.23Spare parts for aboveextra32.24Centrifuge, benchtop, variable speed, 5000 rpm max., 30 min timerjouan$950.00 10 x 12 ml tubes and adaptors32.30Incubator, 27 litres, convection type, max. Temp. 60 degrees Csts$1,410.00 ss interior 255 x 330 x 320 mm, 2 shelves, 240V 50C32.31Incubator shaker, 1300 rpm, 1.5 mm orbit, variablests$1,700.00 temperature control, accommodates 4 multiwell plates, 220V 50C32.32Orbital shaker, 30 - 250 rpm, orbit dia. 30 mm,sts$1,750.00 w/carrying plate for 4 multiplate plates, suitable for VDRLand serological tests, 230V 50C32.33Oven, Carbolite, 60 litres, 300 degrees C max., 1.5 kw,sts$1,500.00 2 shelves, 220/240V 50C32.34Dry heat indicator tape, 160 degrees C, 19 mm x 55 m$46.00 32.35Suspension mixer, angular rotating action, variable tiltsts$1,400.00 angle 0 to 15 degrees, 220V 50C32.36Vortex mixer, w/cup and 3" platform head, variable$250.00 speed, 220V 50C32.37Vacuum pump, complete system w/2 catch bottles, tubing and sts$900.00 filter, including spare filter housing assembly, 220V 50C32.38 disposable bacterial air filters for above$60.00 32.39 Antifoam, 2 x 500 ml w/dispenser$30.00 32.40Water bath, 3 litres, 295 x 145 x 8 mm, max. 100 degrees C, 220V 50Csts$450.00 32.41 Multiwell plate holder, ss$80.00 32.42Water bath, 16 litres, 325 x 295 x 180 mm max. 100 degrees C, 220V 50C$550.00 32.43 Lid, ss, for above$110.00 32.44 Multiwell plate holder, ss$80.00 32.45Water bath, 20 litres, 500 x 300 x 130 mm, max. 100 degrees C, 220V 50C$590.00 32.46 Lid ss, for above$140.00 32.47Thermometer, -10 degrees to +50 degrees C, for water baths$5.00 32.48Thermometer clip, for above$5.00 32.49Reverse osmosis / de-ioniser water purification system, output 50 L/hrsts$2,100.00 w/25 L storage tank, requires inlet water pressure > 2 bar 32.50 Boost pump for above, 230V 50C$900.00 32.51 Universal plumbing kit w/10 m hose $130.00 32.52 Pre filter, 10", 10 um housing & cartridge$100.00 32.53 Pre filter, 20", 50 um housing & cartridge$150.00 32.54 10 um cartridge for above$70.00 32.55 50 um cartridge for above$140.00 32.56Water still, w/pyrex glass condenser, sheathed heater, 230V 50CIsts$2,000.00 32.57 Reservoir stand$280.00 32.58 Water feed kit$180.00 32.59 Spare parts for aboveextra32.60Microscope, Biological, binocular, anti-fungus, mechanical stageolympus, zeiss$800.00 objectives 10x, 40x, 100x oil, 10x eyepieces and mirror32.63Test tube holder$40.00 32.64Test tube, 0.5" path length, box of 12$40.00 32.65Square cuvettes, 10 mm long, set of 2$150.00 32.66Holder for square cuvettes$30.00 32.67Light shield$35.00 32.68Centrifuge, microhaematocrit w/rotor, 24 place, 220V 50Chettich andreas/$470.00 32.69Evaluation disk w/adjustable zero pointhawksley$100.00 32.70Capillary tubes, 1.4 x 75 mm, heparinised, pack of 1000$70.00 32.71Haemacytometer, complete w/improved Neubauer rhodiumhawksley$55.00 coated counting chamber32.72Cover glasses, pack of 10$15.00 32.73Microscope slides, 75 x 25 mm, 1 mm thick, 1/2 white glassmarienfeld$5.00 ground edges, plain, pre cleaned, tropical packing, box of 14432.74Microscope cover glasses, 18 x 18 mm, box of 1000$1.00 32.77Universal oven, 220 degrees C, 14 litres, natural ventilation, 220V 50Cmemmert$550.00 32.78 perforated shelf, ss, non tipping$25.00 32.79 Timer, 0 to 24 hours, 220V 50C$40.00 32.82Precision Balance, 4100 g range, 0.1 g readabilityohaus$880.00 33.00Refrigerators for Cold Chain / Vaccines33.01Small refrigerator, absorption, RCW 42 EG (Elec / gas)electrolux$1,200.00 10.5 litres storage capacity for vaccines, 220V 50C + 12V + LP gasCode PIS E3 / 21 - M33.02Small refrigerator, absorption, RCW 42 EK (Elec / Kerosene)electrolux$1,400.00 18.2 litres storage capacity for vaccines, 220V +12V + KeroseneCode PIS E3 / 22 - M33.03Icelined refrigerator or freezer, compression, TCW 1151,electrolux$1,900.00 169 litres storage capacity for vaccines, 220V 50CCode PIS E3 / 24 -M33.04Refrigerator & Icepack Freezer, compression, RCW 42 AC,electrolux$1,400.00 12 litres storage capacity for vaccine, 220V 50CCode PIS E3 / 30 - M
33.05Photovoltaic solar refrigerator & icepack freezer, compressionelectrolux$1,700.00 RCW 42 DC, 14 litres storage capacity for vaccine, 12V or 24VCode PIS E3 / 31 - M33.06Photovoltaic solar refrigerator & icepack freezer,bp solar$2,600.00 VR 50, 38 litres storage capacity for vaccine, 12VCode PIS E3 / 37 with CFCAs above with complete solar systembp solar$6,200.00 33.07Photovoltaic solar refrigerator & icepack freezersun frost$1,600.00 RFV - 4, 17.5 litres storage capacity for vaccine, 12VCode PIS E3 / 54 with CFCAs above with complete solar systemsun frost$4,000.00 33.08Icelined refrigerator & icepack freezer, compression, TCW 1990,electrolux$1,400.00 37.5 litres storage capacity for vaccine, 220V 50CCode PIS E3 / 62 - M33.09Photovoltaic solar refrigerator & icepack freezer,naps$2,200.00 CFS 49 IS, 20 litres storage capacity for vaccine, 12VCode PIS E3 / 70 - MAs above with complete solar systemnaps$5,300.00 33.10Voltage regulator for refrigerators, model FF 500/4R ,galatrek$350.00 220V 50C, 500 VA, with delay feature, Code PIS E 7/1134.00Cold Boxes and Vaccine Carriers34.01Large vaccine carrier, 2.6 litres capacity, for 8 x E 5/10quattro elle$35.00 Icepacks, Code PIS E 4/52 - M34.02Small vaccine cold box, short range, Model 55 - CF,blow kings$90.00 8.6 litres, for 24 x E 5/12 icepacks, Code PIS E 4/57 - M34.03Small vaccine cold box, long range, RCW 12 / CF,electrolux$400.00 8.9 litres capacity, for 14 x 5/09 icepacks, Code PIS E 4/62 - M34.04Large vaccine cold box, long range, Model ICB - 7, 25.6 litresinalsa$170.00 capacity, for 50 x E 5/15 icepacks, Code PIS E 4/72 with CFC34.05Vaccine carrier for NID, Model Coolertainer for Kick Polio, 2 litrescip$5.00 capacity for 2 x E 5/12 icepacks or ice bag, Code PIS E 4/84 - MIcepacks34.06E 5 / 09, 0.6 litre, set of 24electrolux$30.00 34.07E 5 / 10, 0.4 litre, eachquattro elle$0.80 34.08E 5 / 12, 0.3 litre, set of 10blow kings$5.00 34.09E 5 / 15, 0.3 litre, eachinalsa$0.50 35.00ThermometersWaterproof liquid crystal thermometer, 0 to +20 degrees C, Code PIS E6/11hallcrest35.01Model 2290, with adhesive backing, pack of 25$30.00 35.02Model 2291, without adhesive backing, pack of 25$30.00 35.03DT & TT shipping Indicator, temp. threshold + 48 degrees Cberlinger$500.00 600 per pack, Code PIS E 6/1535.04Vaccine cold chain Monitor, temp. + 10 to + 34 degrees C,berlinger$800.00 250 per pack, in English or French, Code PIS E 6/1635.05Bimetal vaccine thermometer, - 30 to + 50 degrees Cmoeller therm$400.00 100 per pack, Code PIS E 6/2635.06Freeze watch indicator, 0 degrees C, model recorder no. 9805,berlinger$900.00 400 per pack, Code PIS E 6/4535.07Polio Specimen collection Kit, Code E 11/02meg$3.00 36.00Insecticides (As per WHO specifications)36.01DDT 75% wdp., per kg$3.25 36.02Malathion 50% EC, per litre$2.30 36.03Fenithrothion 50% EC, per litre$12.00 36.04Fenithrothion 40% wdp, per litre$15.00 36.05Fenthion 50% EC, per litre$15.00 36.06Fenthion 40% wdp, per kg$17.00 36.07Deltamethrin 25% EC, per litre$25.00 36.08Icon 10% wp, per kg$70.00 36.09Abate 1% sand granules, per kg$3.50 36.10Abate 50% EC, per kg$18.50 36.11Permethrin for bednets, per litre$36.00 37.00Mosquito NetsImpregnated, knitted 100% polyester, multifilament fibres, Denier 75 or 100,siamdutchmesh 156, colours white, green or blue. (Specify denier and colour)37.01 single size 70 x 180 x 150 cms$3.80 37.02 double size 100 x 180 x 150 cms$4.15 37.03 family size 130 x 180 x 150 cms$4.55 37.04 X-family size 190 x 180 x 150 cms$5.00 38.00Field Project ItemsMegaphone, Loudhailer, handgrip type38.01 Rated 15 w (max. 23 w)$175.00 38.02 Rated 6 w (max. 10 w)$110.00 Megaphone, Loudhailer, shoulder type38.03 Rated 15 w (max. 23 w)$160.00 38.04 Rated 30 w (max. 45 w)$200.00 38.05 Rated 6 w (max. 10 w)$180.00 38.06Car mobile amplifier, 10 w, as TOA CA 200$150.00 38.07Car mobile amplifier, 10 w, with cassette deck, 20 w as TOA CA 207$350.00 38.08Speaker, reflex paging form, 15 w, as TOA TC 154 M$60.00 38.09 As above, but 30 w, as TOA TC 304 M$90.00 38.10Mixer power amplifier, 30 w, as TOA A 503 M, for AC 110 / 220V & DC 12V$350.00 38.11Uni-directional dynamic microphone, 600 ohms, frequency 70 to 12000 Hz$90.00 as TOA DM 1200 with cable and plug for amplifierColumn speaker, splash proof, metal case, for indoor & outdoor use, 10 w$150.00 38.12 As above, but 20 w$170.00 38.13 As above, but 30 w$270.00 38.14Cassette equiped wireless amplifier / public address system, as TOA WA 620 C$600.00 15 w (max. 20 w) on AC 220 - 240V or 6 w on DC 10 - 16V or "D" batteries38.15Microphone, wireless, for above as TOA WM 260$260.00 39.00Generators39.10Portable, Gasoline, 220V 50Hz, AC onlyyamaha39.11ET 650, 0.45 kva$270.00 39.12ET 950, 0.65 kva$300.00 39.13EF 1000, 0.65 kva$410.00 39.14EF 1600, 1.23 kva$480.00 39.15EF 2600, 2.0 kva$540.00 39.16EF 4600, 3.5 kva$790.00 39.17EF 6600, 5.0 kva$1,000.00 39.18EF 6600, 5.0 kva with starter$1,200.00 39.19Portable, Diesel, 220V 50Hz. AC onlyyamaha39.20EDA 3000, 2.7 kva$1,380.00 39.21EDA 5000, 3.9 kva$1,650.00 39.22EDA 5000, E, 3.9 kva$1,800.00 39.23EDA 6500S, 6.0 kvayamaha$3,200.00 39.24 2 - wheel transport kit for above$100.00 39.25 Remote control kit for above$40.00 39.26EDA 10000 TE, 10,0 kva$3,450.00 39.27 2 wheel transport kit for above$180.00 Portable, gasoline, open frame AC / DC (AC 220V 50C / DC 100w / 12Vhonda39.280.55 kva$700.00 39.292.2 kva$1,400.00 39.302.8 kva$1,900.00 39.314.3 kva$2,750.00 As above, but Air cooled, sound proof typehonda39.320.55 kva$1,100.00 39.330.85 kva$1,200.00 39.342.1 kva$2,000.00 39.353.0 kva$3,500.00 39.364.0 kva$4,000.00
40.00Voltage RegulatorsAutomatic input 110 - 250V, Output 110 - 220V 50/60C, single phasestavol40.01SVC 350N, 350 VA$120.00 40.02SVC 500N, 500 VA$150.00 40.03SVC 1000N, 1 kva$205.00 40.04SVC 1500N, 1.5 kva$270.00 40.05SVC 2000N, 2 kva$475.00 40.06SVC 3000N, 3 kva$720.00 40.07SVC 5000N, 5 kva$980.00 41.00Water DisinfectionWater Purification TabletsSodium Dichloroiscyannurate (NaDeC) for disinfection of:41.01 1 litre of water, per 1000 tablets$6.00 41.02 5 litres of water, per 1000 tablets$7.00 41.03 10 litres of water, per 1000 tablets$8.00 41.04 20-25 litres of water, per 1000 tablets$10.00 41.05 1000 litres of water, per 60 tablets$15.00 Calcium Hypochlorite, granular, min. 65% active chlorine, packed in 1 kg jar,(according to IATA Regulations)41.06 5 to 50 kg$24.00 41.07 50 to 100 kg$15.00 41.08 100 to 250 kg$8.00 41.09 250 to 500 kg$7.00 41.10 500 to 1000 kg$6.00 41.11 50 Kg metal drums for seafreight only, per ton$2,500.00 42.00Air ConditionersWindow type, air conditioner, cooling only, 220V 50C42.01 9500 BTU / hr$500.00 42.02 12500 BTU / hr$600.00 42.03 18000 BTU / hr$700.00 Window type air conditioner, Heating & Cooling, 220V 50C42.04 cooling 9000 BTU / hr & heating 9600 BTU / hr$600.00 42.05 cooling 12000 BTU / hr & heating 9600 BTU / hr$650.00 42.06 cooling 15000 BTU / hr & heating 9600 BTU / hr$700.00 42.07 cooling 18000 BTU / hr & heating 9600 BTU / hr$750.00 Split type air conditioners, wall mount, Heating & Cooling, 220V 50C42.08 cooling 9000 BTU / hr & heating 11000 BTU / hr$800.00 42.09 cooling 12000 BTU / hr & heating 13500 BTU / hr$1,000.00 42.10 cooling 18000 BTU / hr & heating 17000 BTU / hr$1,400.00 43.00Motorcycleshonda43.01110 cc, 4 stroke, pillion seat / carrier$2,100.00 43.02125 cc, 4 stroke, pillion seat / carrier$2,200.00 43.03Helmet (small, medium or large)$75.00 43.04100 cc, 2 stroke, leg shield, double seatyamaha$1,400.00 43.05Helmet (small, medium or large)$60.00 43.06125 cc, on / off road$1,600.00 44.00Vehicles (Left or Right hand drive)44.014 TL, tropical, 5 seats, petrol, Express combi RL 1.1renault$9,700.00 44.02CLIO, 5 seats, 5 door saloon, 1400 cc, petrol, hatchback$9,750.00 44.03406 GL, station wagon, 5 seats, 1900 cc, petrolpeugeot$15,200.00 44.04406 GLD, station wagon, 5 seats, 1900 cc, diesel$15,200.00 44.05306 XN, 5 doors, 1360 cc, petrol$9,700.00 44.06306 XR, 5 doors, 1761 cc, petrol$11,200.00 44.09Corolla, 4 door sedan, 5 seats, 2000 cc, petrol$10,600.00 44.10Corolla XL, 5 door wagon, 5 seats, 1300 cc, petrol$9,200.00 44.11Hi Ace, 12 seats, bus, short wheelbase, 2000 cc, petroltoyota$12,000.00 44.12Hi Ace, 12 seats, bus, short wheelbase, 2400 cc, diesel$13,000.00 44.13
Hi Ace, Commuter bus, 15 seats, 2000 cc, petrol$12,500.00
44.14Hi Ace, Commuter bus, 15 seats, 2400 cc, diesel$13,300.00 Samurai, 4x4, metal top DLX, 4 seats, 1300 cc, petrolsuzuki44.15 SJ 413 VT-JX, high roof$8,400.00 44.16 SJ 413 V-JX, without high roof$8,200.00 44.17Vitara (New model in 1998)44.20110" wb, DEFENDER, 4 wd, 9 - 10 seats, station wagon, 3500 cc, petrollandrover$19,400.00 44.21110" wb, 4 wd, 9 - 10 seats, station wagon, 2500 cc, turbo diesel$19,400.00 44.24Pick up, 3 seats, canvas hood, 2500 cc, turbo diesel$17,100.00 Pajero, metal top, short wheelbase, 5 seats, 3 doormitsubishi44.30 2400 cc, petrol$12,100.00 44.31 2500 cc, diesel$13,100.00 Pajero, high roof, station wagon, 9 seats, 5 door44.32 2400 cc, petrol$13,400.00 44.33 2500 cc, diesel$13,700.00 Landcruiser, 4x4, hard top, 3 door, airconditioner, power steering, seat beltstoyota44.42 short wheelbase, PRADO, 2700 cc, petrol$13,400.00 44.43 short wheelbase, PRADO, 2700 cc, diesel$14,100.00 44.50station wagon, 6 seats, swing out back door, 4500 cc, petrol$15,800.00 44.51station wagon, 6 seats, swing out back door, 4200 cc, diesel$18,100.00 44.60 single cab, 3 seats, 2700 cc, petrol$12,100.00 44.61 single cab, 3 seats, 2800 cc, diesel$12,500.00 44.62 double cab, 6 seats, 2700 cc, petrol$13,200.00 44.63 double cab, 6 seats, 2800 cc, diesel$13,600.00 2.12 Sample Health Card
HEALTH CARDtc \l1 "HEALTH CARD
DATE OF REGISTRATION
SECTION HOUSE NO.
DATE OF ARRIVAL AT SITE
DATE OF BIRTH OR AGE
M/FNAME COMMONLY KNOWN BY
DPT POLIO DATE
No. OF PREGNANCIES
No. OF CHILDREN
GENERAL (Family circumstances, living conditions, etc.)
HEALTH (Brief history present condition)
2.13 Sample monthly Activity Reporttc \l1 "Sample monthly Activity Report