Health Preparedness for Volcanic Eruptions in Ecuador and Colombia DIPECHO/PAHO Project

By Ricardo Pérez, PAHO/WHO, Quito, Ecuador, December 2004
rperez@ecu.ops-oms.org

“Up to1985, all Colombians knew that there were active volcanoes in our territory, but almost no one was aware that these volcanoes could represent a real threat to the population.”
(Source: Historia y desastres en América Latina, vol. II, 1997, Red de Estudios Sociales en Prevención de Desastres en América Latina)

In the context of the third DIPECHO Plan for the Andean countries –funded by the Humanitarian Aid Department of the European Commission (ECHO)- the Pan-American Health Organization (PAHO/WHO) is currently carrying out a project that aims at strengthening health services in Ecuador and Colombia in order to cope with any emergency situation caused by volcanic eruptions.

A project for local capacity strengthening

Volcanoes destroy and create, scare and attract. This dual characteristic makes volcanoes a complex hazard which, on many occasions, is difficult to perceive or recognize by those populations who live near them, and therefore, are prone to greater risks. There is still much to do to gain a better understanding of volcanoes, and especially to be prepared for a volcanic crisis and mitigate any potential impact.

In Latin America, Colombia and Ecuador are among the countries with largest number of active volcanoes.

Their history is full of examples of volcanic eruptions that have caused dramatic death tolls and economic losses, with a major impact on the development of all communities affected. The most well-known case is the Nevado del Ruiz Volcano, whose eruption in 1985 killed more than 20,000 people in the city of Armero. Similarly but with less significant effects, Ecuador has experienced for many years an ongoing warning situation due to its active volcanoes (in particular the Reventador, Guagua Pichincha and Tungurahua volcanoes), which pose threats to thousands of people.

Both countries have already established disaster programs for their health sectors. They have also developed specific preparedness plans for volcanic eruptions in high-risk areas. However, some gaps are still found in these plans and major technical weaknesses have been identified, particularly when carrying out actions to respond to some of the most recent volcanic eruptions :

• Epidemiological surveillance services must be strengthened and have better trained staff members, as well as updated technical manuals and guidelines regarding information systems and mechanisms for this type of hazards.
• The health sector (at large) in Ecuador does not have an appropriate information system for monitoring risk factors, gathering and analyzing data related to crises, or carrying out timely damage assessments needed for decision- making.
• Actions related to mental health in high-risk areas have been inconsistent and weak. Local health services do not have permanent programs for providing efficient assistance to potentially affected populations.
• Drinking water systems, especially in rural areas, still remain vulnerable. The quality of many of these systems has deteriorated in the aftermath of volcanic eruptions, and
their damage has not being repaired. Many of these systems, located in high-risk areas, do not have mitigation measures to protect their different components and minimize damage.
• Communication management and relationships with the media are still weak, especially due to the lack of trained staff and stable plans and programs. The potential of Internet and new technologies is still underutilized.
• Coordination within and among sectors is still weak and must be strengthened at political and technical levels, in particular through more permanent and stable work plans.

In sum, there exists a clear need for the health sector to work with more updated technical tools and instruments that can respond more efficiently to local realities. Many of the lessons learned in recent emergency situations have not become practical measures within health systems. In addition, the frequent turnover of health technical staff must be addressed by establishing ongoing training programs and plans.

New materials and training programs

In accordance with the priorities set by DIPECHO plans, project activities intend to contribute to eliminating some of these weaknesses and promoting the exchange of experience and knowledge among countries and communities that share a similar level of vulnerability to volcanic eruptions.

Based on this background, work is being done through two complementary phases:

• The first one focuses on the production of a set of training materials on health preparedness for volcanic eruptions. These materials include complementary thematic compo- nents.
• The second one is a training strategy based on the use of these materials, with two clear goals: training for trainers within the health sector, focusing on the main areas of
volcanic risk in Ecuador and Colombia, as well as on technical strengthening of all existing Emergency Operations Committees (COE) in the same geographic areas.

Training materials include two modules with different features. The first one is composed of five thematic and practical guidelines on health preparedness, addressing the following issues: (I) public health and volcanic eruptions, (II) health service protection, (III) damage and needs assessment, (IV) environmental health, and (V) communication strategies. Each guide includes a presentation in PowerPoint that may facilitate the work to be done by trainers.

In order to design and develop these guides, an intensive process was carried out for data gathering and analysis, technical review of all documents, systematization of relevant experience and individual interviews in Colombia and Ecuador. Subsequently, two bi-national workshops were held (Ecuador-Colombia) to review and validate the contents of these guides.

These workshops gathered more than 100 experts from both countries.

The review process (carried out in October 2004) enabled major Ecuadorian and Colombian organizations (at both national and provincial levels) working on health and disaster-related issues to learn more in detail about the project, participate in the production of these training materials and, endorse them as they reflect their technical needs and priorities.

These guides will be used as the basis for the planning of training workshops in Ecuador and Colombia, and they will become a strategy for the training of trainers who, subsequently, will share this knowledge in other workshops intended for local health services in both countries. Furthermore, these guides will be available for all interested parties and may be used in all countries of this region facing volcanic threats.

Training based on new technologies

The second training module is an innovative tool as it includes a multimedia simulation software that will allow for the
development of training actions aimed at fostering multistakeholder decisions and coordination, in the framework of all Emergency Operations Committees established in volcanic areas at risk in Ecuador and Colombia.

The simulation software was developed based on a technical script that defines the possible scenario in which volcanic eruptions would occur, and the stakeholders involved in the COEs, including the special health COE, as well as their tasks, duties, work procedures and interrelations.

The software will be used in training workshops and will allow for the realistic creation (or simulation) of volcanic crises, with multiple variables and different stakeholders who must make decisions and “play” to solve the problems identified, taking into consideration that, in this context, each action will produce an immediate consequence. The exercise includes factors that evolve in time. The conception and development of this multimedia simulation requires a significant investment. It, however, generates adaptable and functional training tools. These exercises will require the use of computers and Internet access, in order to search and analyze technical information from a practical standpoint adapted to reality and the possibilities of using technology in developing countries.

There are no magical solutions without political will

We already know that, contrary to earthquakes, volcanic eruptions show some previous indications. Today, due to the creation of more observation stations and the improvement of measuring instruments, an awakening volcano may be detected and its eruption anticipated hours and even days before it occurs. In addition, the health sector is able to develop training programs and plans, and have better training tools and materials. However, even the best preventive measures in the world are not very useful if government officials are not convinced that actual risk reduction starts with efficient coordination, preparedness in advance, and mitigation measures aimed at reducing or eliminating vulnerability in communities exposed to volcanic risk.

This and other projects with limited duration cannot neglect the importance of raising awareness. In this manner, the population at large will be enabled to demand that lasting risk reduction measures and actions be implemented in order to coexist “peacefully” with volcanoes.