Developing countries face various challenges in implementing bio-risk management systems in the laboratory. In addition, educational settings are considered as workplaces with biohazard risks. Every activity in a laboratory facility carries many potential hazards that can impact human health and the environment and may cause laboratory incidents, including Laboratory Acquired Infections (LAIs). In an effort to minimize the impact and occurrence of these incidents, it is necessary to evaluate the implementation of a bio-risk management system in every activity that involves handling biological agents. This study was conducted in an Indonesian higher-education institution, herein coded as University Y. This is a descriptive, semi-quantitative study aimed at analysing and evaluating the implementation of the bio-risk management systems used in laboratories by analysing the achievements obtained by each laboratory. The study used primary data that were collected using a checklist which referred to ISO 35001: 2019 on Laboratory Bio-risk Management. The checklist consisted of 202 items forming seven main elements. In addition, secondary data obtained from literature and document review were also used. The results show that out of 11 laboratories examined, only 2 laboratories met 50% of the requirements, which were Laboratory A and B, achieving good performance. Regarding the clauses of standards, a gap analysis identified leadership, performance evaluation, and support as elements with the lowest achievement. Therefore, corrective action should be developed by enhancing the commitment from management as well as improving documentation, policy, education and training.

The increasing threats from biological agents have become a concern in laboratories, and emerging infectious diseases have demanded increased awareness and preparedness of laboratory facilities. Bio-risk assessment is needed to provide a framework for organisations to establish a comprehensive bio-risk management system. The assessment criteria should include both biosafety and biosecurity measures. Laboratories in Indonesia play a significant role in public health interventions in term of disease screening, diagnosis and medical decision making. The National Clinical and Medical Referral Centre Laboratories have the potential of daily exposures to dangerous biological materials. This study aims to identify the gap between bio-risk management system implementation and International Standard Organisation (ISO) 35001:2019 requirements. The 202 items in ISO 35001:2019 are categorized into seven main elements. The findings show that more than half of the elements on ISO 35001:2019 have been implemented in these centres. Good performance was identified at lab 4 and 5 which obtained the highest scores, particularly in the context of organisation, planning, operation and improvement elements. However, the widest gap was found in leadership, support and performance evaluation. One way to address this would be to create written rules and regulations at the laboratory top management level to require all laboratory facilities to comply to the bio-risk policies, rules, and regulations.

The World Health Organization (WHO) defines the primary healthcare center (PHC) as a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation, and palliative care, and as close as feasibly possible to people’s everyday environment. PHCs are expected to remain operational when disasters occur. This study aimed to assess the PHC disaster preparedness level in Indonesia using The Hospital Safety Index (HSI) from WHO/PAHO. Eleven PHCs located in four provinces in Indonesia, i.e., Jakarta, Yogyakarta, North Sumatera, and West Java, were selected. Data were collected through interviews, focus-group discussions (FGDs), observations, and document reviews. The parameters assessed were all types of hazards, structural or construction safety, nonstructural safety, and functional attributes. The results show that the overall score of HSI for PHCs in Jakarta (0.674) and North Sumatera (0.752) fell into the “A” category, meaning that these PHCs would likely remain operational in the case of disasters. Meanwhile, the overall HSI scores for PHCs in West Java (0.601) and Yogyakarta (0.602) were between 0.36 and 0.65, or in “B” category, meaning that these PHCs would be able to recover during disasters but several services would be exposed to danger. The results suggested that there are several gaps that need urgent interventions to be applied for the structural safety of buildings, water supply systems, fuel storage, disaster committee organization, furniture and fittings, offices and storage equipment, as well as increasing the capacity of workers through a structured and systematic training framework for disaster readiness. The results from this study can be used for prioritizing budgets and resource allocation, cost planning, providing specific solutions for local and national government, and efforts to achieve disaster risk reduction.

Indonesia is country with abundant high-risk areas for various disasters that can affect both the structural and non-structural safety of various vital establishments, particularly hospitals. This present study aims to examine the level of the hospital safety index in nine hospitals in four provinces based on the guidelines from the WHO/PAHO (World Health Organization/Pan American Health Organization). The Hospital Safety Index (HSI) guidelines consist of four parameters that include the types of hazards, structural safety, non-structural safety, disasters and emergency managements. This study was a cross-sectional study on data obtained through interviews, focus group discussions (FGDs), observations, and document reviews to assess the parameters of the HSI. Data were calculated for the HSI score, and descriptive statistics and multiple correspondence analysis (MCA) were carried out. The SPSS software version 25.0 was used for the statistical analysis. Results show that the overall safety index was 0.673 (Level A), meaning that it is likely the hospital will maintain functionality in emergencies and disasters. By province, the level A index was identified in DKI Jakarta (0.76), Yogyakarta (0.709), and West Java (0.673), showing that hospitals in these provinces will maintain functionality in emergency and disaster situations; however, in North Sumatera, the index was categorized in B category (0.507), demonstrating that the hospital’s ability to function during and after emergencies and disasters is potentially at risk. The multiple correspondence analysis shows that the hospitals in the provinces of Yogyakarta and West Java tend to achieve similar categories in almost all assessment modules; therefore, control measures of preparedness should be considered, such as improvements in equipment and facilities; hospital emergency and disaster response and recovery planning; communication and information management; training; and relevant stakeholders awareness.

The city of Cilegon in Banten Province, Indonesia is selected as a site of this study. The city locates in the western edge of Java Islands and is known as one of the most famous and significant heavy industrial zones in Indonesia. Cilegon is potentially exposed both to natural and industrial hazards so that we can consider it as a suitable place for studying NATECH (NAtural-Hazard triggered TECHnological disasters) disaster situations. The Indonesian government indicates the presence of seismic gap in the Sunda Strait and the associated tsunami risk. Large-scale facilities of chemical, petrochemical, oil and gas industries stand in coastal areas in Cilegon. The industry and its surrounding communities can be affected by combination of the natural and industrial disasters. In Cilegon, we aim at strengthening capacity of the education section in the Cilegon city government and the school principals and teachers. Our preliminary implementation and survey reveal that knowledge and understanding of teachers are very limited. We will combine existing research findings from both of industrial accidents and tsunami, and develop educational materials.