International Medical Corps

International Medical Corps is a global humanitarian nonprofit organization dedicated to saving lives and relieving suffering through healthcare training, disaster relief, and long-term development programs.
Dec 4, 2013

Valuable Lessons Learned at a Japanese Public School Emergency Shelter

International Medical Corps and The Association for Aid and Relief (AAR) Japan are working together to build the capacity of communities to respond to future disasters in a way that is more representative of the entire population by putting more emphasis on assisting people with disabilities (PWDs). Taking into account PWDs during the planning of disaster response protocols is critical, because during the March 2011 earthquake and tsunami, the mortality rate for PWDs was more than double that of the average population. 

As part of our initiative, International Medical Corps and AAR Japan are continuing to partner with Iwaki Jiritsu Seikatsu Center (IJSC), a local non-profit organization supporting PWDs in Iwaki City, Fukushima Prefecture. The goal of this partnership is to help develop self-reliance among PWDs by taking their needs into account during the planning process, and including them in a way that will allow them to express their needs and take ownership of their role in the management of emergency shelters.

For such an initiative to be successful, International Medical Corps and AAR believe it is crucial to work with key people in the community who can share the lessons they learned through experiencing emergency shelter management in order to help raise the community’s awareness of the various needs and abilities of PWDs.  In this regard, we are privileged to work with Shiro Sawai, school principal of Yumoto Secondary School #2 in Iwaki City. Shiro was in charge of an emergency shelter located in his school for a total of 74 days, from March 13 until May 22nd.

Important Lessons Learned from Running an Emergency Shelter:

When the earthquake struck on March 11, 2011, Shiro was standing outside of his school. Fortunately, graduation was also that day so all of his students had gone home at noon.

In Japan, public schools are often designated as emergency shelter sites. While there were schools closer to the affected areas that were designated as shelters, Shiro knew there was still a possibility that people evacuating from the coastal areas would start coming to his school to seek refuge. Shiro and his vice-principal immediately decided that they would stay at the school for as long as needed and keep the emergency shelter open.

Later that day, a total of 10 people showed up to seek shelter at the school. Since the school didn’t have any emergency supplies, aside from some floor sheets, the people brought their own futons and blankets. On March 13th, when the nuclear power plant accident forced thousands from their homes, 280 people arrived at Shiro’s school.  Two-thirds of them arrived by a city-chartered bus and one-third used their own cars to reach the school. Many of the evacuees that came by bus had evacuated from homes for the elderly. The influx of these elderly and disabled people presented an unanticipated challenge for the undersupplied shelter.

“The first thing you need to know about emergency shelters,” says Shiro, “is that some of your expectations will come true, especially in the beginning… Emergency shelters are cold (in mid-winter), noisy, dirty, and inconvenient. And yes, it is terribly difficult to get any sleep there. There will inevitably not be enough food, drinking water, or blankets. There will be lots of garbage to deal with. Medical care will also take some time to arrive.”

Emergency shelters are the last resort when people have nowhere else to go, and it is generally the most vulnerable who end up spending the longest amount of time there. Young, single people tend to stay only for a short time, those with small children stay a little longer, and the elderly and people with disabilities tend to stay the longest. These trends are why Shiro believes it is imperative that emergency shelters adapt to the needs of the most vulnerable given that they are the population that demonstrates the greatest need from emergency response services.

Shiro said that one of the most difficult aspects of running an emergency shelter was creating and maintaining a roster of all the people staying there. Particularly in the beginning, the school was flooded with calls from people wanting to know whether their family or loved ones were there and safe, etc. Since people come and go every day, it was difficult to keep track of everyone’s movements.  Shiro says that the importance of a consistently updated roster cannot be underestimated, and that its proper stewardship was one of the first lessons he learned through experience during this disaster.

When creating a roster of residents, Shiro emphasized that it is very important to ask people what they can do (e.g., cook, use a PC, carry things, etc.) Everyone has a role to play, and it’s important that they know this and are counted on to help. Shiro created multiple teams consisting of both volunteer staff and evacuees soon after people began arriving at the shelter, including a cooking team, a water distribution team and a health team (in charge of running morning exercise classes, checking in with the evacuees to see who needs assistance, etc.). He continued to create more teams to meet new needs as they arose over time.

Shiro felt that it was also important to make sure evacuee-children played a role in the shelter’s management. They were put in charge of tea time; bringing candy to the other residents and talking with them; and distributing newspapers. In the evening, the teachers and other adults helped the children with their homework.

Through this experience, Shiro found that the average Japanese public school is an ideal place to have an emergency shelter. Even if the building may be old and not up to universal design, it still held many advantages in times of an emergency, including:

  • A pool - which allowed the shelter to have water to flush toilets when the main water tank ran out after 3 days
  • A good supply of chlorine - that Shiro used to disinfect where necessary
  • A large kitchen equipped to cook for many people - where the evacuees cooked for themselves as teams
  • Classrooms - which are warmer and more accommodating than the gymnasium. After the people had been at the school for an extended period of time, Shiro started to move people out of the gym and into classrooms, particularly people who needed special assistance like those in wheelchairs.

Shiro strongly believes through his experiences that emergency shelters are not a place to come and wait to be helped; they are places to regain the strength and know-how to become self-reliant again. The most important lesson Shiro says he learned during his emergency shelter management is the need to be flexible and to maintain a sense of humor, even in times of crisis. Shiro is working closely with International Medical Corps on this project by offering his lessons to other schools and shelters in the community in the hopes that they will adopt some of the more helpful points in emergency shelter management during future disasters.

Dec 4, 2013

How BCP Training is Helping Prepare Japanese NGOs for the Next Disaster

Hiroyuki Kakuho (center)  from Japan Platform
Hiroyuki Kakuho (center) from Japan Platform

After Japanese Scientists at Tokyo University and Global Seismologists predicted a 70% chance of a 7+ Richter-scale earthquake hitting Japan by 2016, the majority of Japanese non-government organizations realized that ensuring their organizations integrity when they are hit by a disaster is critical to being able to deliver relief to local populations. In response to this realization, International Medical Corps began working with seasoned business continuity planning (BCP) experts from two premier Japanese risk management corporations (Tokio Marine & Nichido Risk Consulting Co., Ltd., and Mitsubishi Corporation Insurance Co., Ltd.), and have successfully completed a three-part workshop series that taught local humanitarian aid organizations the fundamentals of business continuity planning.

Through a combination of lectures and hands-on practical exercises that took participating non-government organizations (NGOs) through a simulated disaster; potential risks were identified (e.g., closed roads, power outages, etc.); the specific tasks staff members must complete to ensure that they are functional and able to fulfill their mandate after the disaster were established; people were assigned responsible for each task; and special strategies that must be used as part of the planning process were decided upon.

Participants then developed a list of action items, including timeframes, to ensure the implementation of their plan was realistic and carried out in a timely manner. At the end of the series, each NGO was able to create a simple, practical BCP plan that fits its organizational needs. A total of 25 individuals from 17 organizations completed this course. For those organizations requesting additional assistance, BCP experts also provided feedback to the organization’s BCP draft and offered suggestions/advice for improvement.

The response from the participants was overwhelmingly positive. Here are a few examples of the feedback we received:

Hiroyuki Kakuho, Administrative Manager for Japan Platform (JPF):

“JPF is known as an emergency response organization. It is vital that we are able to function during an emergency. Clearly identifying what we need to do to be ready in a time of crisis and making appropriate preparations has always been a core issue, but we had been unable to really work on any concrete plans with everyone being busy with their own day-to-day work. We also didn’t know where to begin to better prepare ourselves. This BCP workshop was very important in teaching our staff specific techniques on how to think through and create a BCP plan that fits our organization’s needs. Since we were getting trained with other NGOs, we also benefited from sharing our concerns, ideas and experiences with each other, which allowed us to gain hints as to how to create a more realistic plan of action.”

“We found the BCP creation process outlined by the experts very thorough and with a logical flow. We were surprised at how the workshops spent a lot of time on practical exercises. It was also great that the assignments we received between workshops helped focus our discussions and prepared us for the next lessons. We also appreciated how there was ample time between the three workshops so that we had some time to go back to our organization and think through various issues. We were able to share the BCP learning process with our other colleagues and discuss what should go into our BCP plan.”

“We are currently updating our simple BCP based on what we learned at this workshop series. We are looking forward to more of the same kind of practical workshops from International Medical Corps that will build our capacity and help us to more effectively do our work.”

Japan Platform (JPF) is an international emergency humanitarian aid organization made up of 44 member NGOs, the majority of which do emergency humanitarian aid throughout the world. JPF conducts aid through a tripartite cooperation system, where NGOs, business community, and government of Japan work in close cooperation, based on equal partnership. 

 

Masayuki Okada, Administrative Manager for Association for Aid and Relief (AAR) Japan:

“AAR Japan has been concerned about how we would respond if a natural disaster should strike our own headquarters in the greater Tokyo area, a likelihood we know all too well could happen in the future.  When we heard about this opportunity to learn about BCP directly from BCP experts, we thought this would be a great chance to brush up on our organization’s BCP approach.”

“Two staff members from AAR Japan including myself participated in these workshops. We learned many specific techniques such as how to calculate the number of staff that would likely be able to come to the office if transportation routes were closed and how to identify priority tasks for our operations during an emergency as opposed to normal times. We also realized that we faced serious issues if the building in which our office is located becomes inaccessible, such as losing the ability to access any of the data we have stored on our server or any workspace our staff would need to carry out their tasks even if they could make it to the office. Thanks to these lessons, we are now creating a backup plan for saving our data and are considering moving our office to a newer building with more advanced earthquake resistance.”

“This workshop even included a review of AAR Japan’s BCP plan by the experts, something we would have had great difficulty getting on our own. Japanese NGOs in general have a great budget limitation, and so getting expert advice is extremely difficult.”

“Based on what we learned, AAR Japan has already started to improve upon a number of measures we already had in place, such as our procedures to check on the safety of our staff and measures to better utilize our satellite phones to ensure communication in case both landlines and mobile phone lines crash during an emergency. We plan on reviewing our BC plan on a regular basis within our organization and make sure that our staff are aware of what is in the BC plan. We hope to run simulations with staff to test how the BCP plan would work. We ask for International Medical Corps and the BCP experts to continue to support our efforts to prepare ourselves for emergencies.”

Association for Aid and Relief, Japan (AAR Japan) is a NGO focusing on emergency assistance, assistance to persons with disabilities, and Mine/UXO action. AAR Japan initiated Tohoku aid and relief activities one day after the Great East Japan Earthquake and they have been engaged in emergency and recovery assistance in the affected areas ever since.


Kazutaka Ueda, Senior Program Manager for SEEDS Asia:

“SEEDS Asia was only created in 2006 and so is still a young NGO. Until 3 years ago, we only had 5 staff members. During these last years we’ve expanded our projects and now have 3 branch offices. It was perfect timing for us when we learned about International Medical Corps’ BCP training, because within our organization we were recently discussing the need to have a continuity plan in the case of an emergency like a natural disaster. We jumped at the chance to participate and traveled the over 500km from Kobe to Tokyo for the workshops.”

“What drew us to this workshop was the fact that it wasn’t just a lecture but a workshop that would actually result in creating a BCP. Like most small NGOs in Japan, we are extremely limited in human and financial resources, and we hadn’t had the time to spend making a BC plan on our own. If we hadn’t participated in a workshop like this that let us put words on paper (i.e., a written BCP), we would probably have never been able to create our own BCP.  In addition, it was important that we shared the BCP process with our staff so we are all on the same page about how we should respond in case of an emergency.”

“It was wonderful to be able to ask questions and receive advice from BCP experts specific to our organization’s needs. Being able to have this one-on-one advice increased the practicality of our BC plan and helped us think more deeply about what we can do to be operationally functioning when disaster strikes at our own doorstep.”

SEEDS Asia has been conducting activities in Asia Pacific region related to development, environmental management and community-based Disaster Risk Reduction (DRR). In Kesennuma City, SEEDS Asia has been assisting community building at temporary housing sites, organizing meetings for leaders of temporary housing sites, conducting DRR education/Education for Sustainable Development (ESD). 



Hiroyuki Okada (far right) from AAR
Hiroyuki Okada (far right) from AAR
Dec 4, 2013

Delivering Relief to the Philippines by Any Means Possible

Preparing to Deliver Relief to Guiuan
Preparing to Deliver Relief to Guiuan

Typhoon Haiyan, equivalent to a category 5 hurricane, has affected an estimated 9.9 million people in the Philippines. The storm, which made landfall on November 8, caused widespread devastation, displacing 3.4 million people and destroying over 1 million houses, according to the United Nations. This rare and very powerful storm has severely disrupted the delivery of critical health services, and access to safe water continues to be a serious problem for the affected regions.

Since access to affected areas has improved with the clearing of roads and the re-opening of most airports, relief efforts from humanitarian organizations and the Government of the Philippines have scaled up substantially. While humanitarian assistance is getting through to the hard hit areas urban areas with high populations, efforts must continue to extend to the rural and remote villages, many of which have not received any assistance to-date.

Damaged Health Care Infrastructure: Super Typhoon Haiyan caused widespread destruction and damage to permanent health facilities which has slowed the recovery efforts and has caused shortages of essential medicines and medical supplies. The Government of the Philippines has announced plans for rebuilding or rehabilitating destroyed or damaged health facilities and appealed to the private sector and NGOs to offer resources and expertise to address gaps in infrastructure, equipment, and staffing. However, in the immediate term, services are being provided through a mixture of mobile medical clinics and temporary health facilities. As such, there is a tremendous need for medicines and medical supplies to be delivered to the affected areas in order to provide adequate medical care to the population. The need for these daily supplies will only continue to grow as facilities are brought back online or made functional, because supplies lost in the storm will need to be replaced in order to regain the ability to operate as they did before the storm.

International Medical Corps response: International Medical Corps is on the ground in the Philippines providing medical services through ten mobile medical units in some of the hardest-hit areas following Typhoon Haiyan. International Medical Corps is also conducting water, sanitation and hygiene; medical; and mental health assessments in affected communities, and has begun nutrition screening and treatment referral for children.

By working through mobile medical units, International Medical Corps has been able to provide critical health services on remote islands where families struggle to access medical care and basic resources.

With the support of its partners, International Medical Corps has sent hundreds of hygiene kits, scrubs, antibiotics, primary health medicines and 5 Interagency Emergency Health Kits that can each support 10,000 people for approximately three months. These supplies are being distributed through its mobile medical units to vulnerable communities in isolated and heavily impacted areas.  The top conditions being treated are open wounds and bruises (from reconstruction efforts), acute respiratory infection, hypertension, fever and skin diseases. Left untreated, these conditions can quickly become life-threatening among vulnerable populations such as infants and the elderly.

The demand for critical medicines paired with the difficult logistical situation has made it difficult and costly to supply medical items to where they are desperately needed, which is making the situation more urgent. International Medical Corps’ efforts to obtain and distribute medicines and supplies will help to maintain health of the most vulnerable while the health care infrastructure is restored in the hardest hit areas of the Philippines. As little as $15,000 can send an emergency health kit that will provide medicine and supplies for a community of 10,000 people for three months. Kits like these are vital for our Emergency Response Unit - they often depend on shipments like these to provide care for communities affected by disaster.

Unloading Relief Items in Guiuan
Unloading Relief Items in Guiuan
Delivering Relief in Hernani by Helicopter
Delivering Relief in Hernani by Helicopter
Unpacking Medical Supplies
Unpacking Medical Supplies
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