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Hospital Preparedness for Emergencies (HOPE)

Prof. Pradeep Vaidya

Nepal is one of the 20 most disaster-prone countries in the world. Based on the historical earthquake records and geological evidence of active faults that have produced earthquakes in the past. Recently, in 2015, 25th April, 11:56 am, an earthquake occurred with the magnitude of 7.8  causing nearly 9000 death and 22000 injured, followed by major aftershock on 12 May, 2015. Scientist after studying the post earthquake status, has mentioned the possibility of much larger earthquakes which can occur anytime in near future.

They estimate that the death could be as high as 300000. Such numbers pose a critical challenge to the health services of the country, equally in rural and urban context. Various seismic  assessment conducted by Ministry of Health and Population (MoHP), WHO and DFID highlighted that 80% of the health facilities demonstrated weakness in their physical infrastructure which will lead to the interruption of critical and lifesaving medical intervention during and immediately after emergency. This was proven in large number of medical facilities which got damaged in 2015 earthquake.

There was no regular complete training program to prepare hospitals to manage emergency and disaster risk management till Hospital Preparedness for Emergencies (HOPE) under the PEER program of US AID. The first HOPE Course in Nepal was conducted in Godavari in the
year 2004, where some Nepali doctors and nurses were trained.

After this, HOPE has been conducted regularly and have included all Central, Zonal, District hospitals in Nepal. Most private hospitals staff has also undergone HOPE courses in Kathmandu. Nearly 40 HOPE courses have been conducted with approximately 28 participants in each
and 7 HOPE TFI in Nepal. Approximately, 1000 participants have taken HOPE and we have the largest contingency of qualified instructors (nearly 150). Thus, in all the 2015 post earthquake reviews, HOPE has been recognized as one factor due to which all hospitals/ministries (also
trained) did so well in medical management of victims.

HOPE course
The Hospital Preparedness for Emergencies (HOPE) four days Course addresses the structural, non-structural, organizational and medical concerns of health facilities in order to develop and implement well-designed plans that increase their capacity to respond effectively to emergencies.

The HOPE Course is intended for medical experts, with expertise in the field of emergency medicine and disaster preparedness along with members of hospital disaster-planning committees, including head of institutes, hospital administrators, hospital engineers,
emergency room physicians, nursing directors and hospital planning staff.

This course is part of the Program for Enhancement of Emergency Response (PEER) and is the training program initiated by the U.S. Agency for International Development/Office of U.S. Foreign Disaster Assistance (USAID/OFDA) in 1998. Previously, it was earthquake centric course but in 2008, it was redeveloped by regional experts into a multi-hazard course. Now, this program is conducted in twelve different Asian countries namely Bangladesh, India, Indonesia, Nepal, Pakistan, Philippines, Laos, Vietnam, Cambodia, Sri Lanka, Afganistan and Thailand.
For HOPE graduates, Hospital Preparedness for Emergencies Training for Instructors (HTFI) is conducted to make them instructors. After HTFI, one can become an Assistant Instructors, then Instructors, Course Coordinators and Monitors.
Due to increase demand for community medical facilities needing a disaster course, a two days Mass Casualty Management Course (modified from the HOPE course) have been developed, piloted and conduct for the District level and Primary Health Center medical personnel. We have conducted this course successfully for the INGO/NGO and district level medical personnel.

Overview of Disasters

Disaster Risk Management
Disaster Epidemiology and Patterns of Injury
Structural Components
Non Structural Components
Functional Collapse of Hospitals
Pre- Hospital Care
Emergency Department
Principles of Disaster Medicine
Hospital Emergency Incident Command System (HEICS)
Hospital Preparedness Planning
Techno-Industrial Disasters
Complex Emergencies
Mass Casualty Incident
Mass Gathering Event
On-Site Medical Care
Psychosocial Consequences of Disaster
Inter-agency Coordination
Hospital Internal Disaster
Mass Fatality Management
Disaster Risk Communications
Resource Management
Epidemics and Emerging Infections
Return to Normal Health Operations