Italian
Proposal for GDIN2002 in Rome, June, 2002
Concept paper for discussion.
1.
GENERAL INFORMATION
‡
When: three days during the first half of June 2002, ‡ Where:
at Istituto Superiore di Sanitö (National Institute of Health
of Italy), viale Regina Elena, 299 š 00161 Roma (ten minute
walk from the main railway station š stazione Termini, close
to the Policlinico tube station; in front of the main University
campus, Rome 1 š La Sapienza) ‡ Expected participation:
300 š 500 staff from different countries and organisations.
‡ Event format: conferences, parallel seminars, workshops,
demonstrations, poster sessions, teaching-learning sessions
(pre and/or post conference satellite events) ‡ Videoconferencing
and TV coverage ensured ‡ Wide media coverage, reports published
and distributed via internet ‡ Social programme for accompanying
persons and participants either in Rome and Lazio region
area or to Florence (northbound: 1,5 hrs by train, 2,5 hrs
drive), Naples (southbound: same as Florence), Assisi and
Perugia (1,5 to 2 hrs by car).
2.
Theme of the conference
Information
systems and telecommunications in support of health, survival,
rehabilitation: from need analysis to technological development
and use. Human beings first.
The
Conference organizers will assume that technology has be
used for an essential ethical scope: wellbeing, good health,
survival, with strategies adapted to local contexts and
technological/economic absorption capacities. It may have
just little scope outside human benefit. In the case of
disasters, IT becomes critical for preparedness, planning,
management, restoration and rehabilitation. Under extreme
circumstances, good management practices are even more important
than clinical skills and may have a higher impact on survival
and early rehabilitation of communities.
Therefore
the conference will be developed with the aim at putting
individuals and communities as the main subject (victim
of a disaster and beneficiary of IT deployed) in the conference.
Technology will be presented that makes a significant contribution
to human survival and victims‰ benefit by and large.
3.
The conference organization and strategy
The
Conference will will deal with three major sections (one
topic per day):
‡
human made disasters (war, attacks on civilians, displacements)
‡ natural disasters (earthquakes, hurricanes, etc.) ‡ chronic
disasters (droughts, famine)
Three
major areas will be described in each section (format: one
key speech, two invited papers, one workshop per area, in
parallel): ‡ preparedness ‡ early interventions ‡ rehabilitation
And
five critical sectors analysed (working groups, poster sessions,
practical experience, invited papers): ‡ health and social
services ‡ shelters ‡ communications (road, air, railway)
‡ industrial plants (focus on energy production and transport)
‡ agriculture and water management
Two
key issues will be elaborated in each above session/area,
namely: ‡ information q technology options (focus on international
benchmarking and cost-effectiveness) q best practice in
information generation, storage, distribution q use of timely
information to support decision ‡ communication q technology
options (focus on international benchmarking and cost-effectiveness)
q best practice in communication standard and management
q use of proper means to disseminate useful and understandable
information
These
two issues can be used to frame invited papers and poster/presentations.
They may also be used in a possible Delphi exercise (to
be prepared and announced in Canberra) to derive standards,
and to start a best practice portal.
4.
Justification and rationale
In
the past fifty years since the last world war, many countries
have been affected by epidemics of droughts (‹chronic emergenciesŠ),
and other natural disasters, such as earthquakes, hurricanes
and similar ‹acuteŠ events.
In
addition to this, other epidemics of armed conflicts and
violations of human rights at national and international
level have devastated the health and well-being of increasing
proportions of people with no differences in sex, age and
ethnical group.
Armed
conflicts alone have claimed more than 100 million people
in the past few years.
The
mounting complexity of societal organizations, interdependence
and globalization, connectivity, satellites and the internet,
the end of the cold war and the still fragile international
solidarity are all factors that make disasters, either human
made or not, one of the main source of human suffering,
avoidable death, social organization disruption from one
side, and potentially predictable events from the other
hand.
From
one side, tthere is an increasing need to develop evidence
based strategies and approaches that can promote actions
that work and the adoption of effective measures within
the public health domain in its broadest definition, especially
in the area of complex emergencies. On the other, tools
and resources that technology makes available are not used
at their best to prepare communities and individuals, to
alert societies and governments, to establish mechanisms
by which early interventions are planned and implemented
when the need becomes obvious.
IT
tools can be seen as the major sectoral contribution that
technology can offer to save lives, to prevent deaths and
diseases, to focus and deploy resources to areas and populations
at risk or hit by catastrophic events.
Preparing
for the health problems of large populations as well as
of small communities that experience natural or human-made
disasters is probably the greatest challenge currently facing
public health officials.
Almost
always disasters have resulted in extremely high rates of
mortality, morbidity, and malnutrition, either for decreased
caloric intake or due to micronutrient deficits. This generally
occurs during the acute emergency phase, when relief efforts
are in the early stage and populations affected can suffer
from death rates 60 times higher than in normal situations.
Many
relief agencies agree that: ‹since the early 1960s, most
emergencies involving refugees and displaced persons have
taken place in less developed countries where local resources
have been insufficient for providing prompt and adequate
assistance. The international community's response to the
health needs of these populations has been at times inappropriate,
relying on teams of foreign medical personnel with little
or no training. Hospitals, clinics, and feeding centers
have been set up without assessment of preliminary needs,
and essential prevention programs have been neglectedŠ.
One
major issue has been the inadequate preparation to foreseen
and preventable conditions, at least from the public health
perspective. Aid has been often inappropriate, has focused
on ineffective protocols, to the point that most needed
resources have been wasted and almost always not properly
managed. Local staff, public and private organizations have
rarely been decision owners and have rarely been supported
in the decisional process by proper information and the
evidence of need, supplied by evidence based protocols and
guidelines.
The
elements of inappropriate emergency response programs will
be enhanced if the affected communities and countries have
prepared for the emergency. Preparedness for sudden population
displacement is critical and should be targeted at the most
important public health problems identified in both in previous
emergencies and on the basis of a proper understanding of
the country and population social, epidemiological, economic,
infrastructure and organizational profile.
Quick,
reliable, affordable communication systems are perhaps the
single most critical factor in decision making during emergencies
and disasters. Although technology offers a wide selection
of communication means, it is interesting to note that very
little attention has been dedicated to benchmarking and
developing proper guidelines in this field.
Preparedness,
supported by information, which is properly collected, analyzed,
stored and retrieved and then communicated, requires that
planning for emergencies be included as an integral part
of routine health development programs. A few developed
countries have done so, and their experience can be usefully
transferred to other emerging or less developed countries,
in order to support the design of their own context specific
program.
It
is also essential to recognize that additional concerns
must be acted on to effectively restore and promote health
in the aftermath of disasters. For example, fundamental
community structures, including families, schools, places
of worship, and employment opportunities, must be established
so that those affected by the event can be reintegrated
into a sound, functioning community.
Italy
is one of the major bilateral and multilateral donors. It
is also a country that has experienced a long series of
different disasters in its recent history. They range from
volcano eruptions, to earthquakes, from floods, to environmental
contamination. It has been involved in all the most recent
peace keeping and peace restoration operations around the
world, and especially in the Mediterranean area (Middle
East, the Balkans, to quote a few).
The
Italian policy has been to focus on emergency preparedness
and management with three main objectives: to rescue human
lives, to re-establish the essential conditions for the
civil society and productive system rehabilitation, to foster
local communities‰ ownership in the reconstruction process.
This guideline has been applied to both in-country and external
emergencies. Technology has been extensively used to support
these strategies and to identify and implement cost-effective
actions. Satellite-based communications have connected field
hospitals to major clinical centres, standards have been
developed and field tested under different conditions.
The
development of GDIN as well as of other regional and/or
local networks is a promising tool if and when properly
addressed to meet policy, technical, human needs. The Italian
organization is willing to foster an international concerted
action that links public and private resources and is based
on systematic research and development, with pilot areas
developed to test and model technology applications as well
as standards an model developments.
