Introduction:Indonesia’s road traffic fatality rate stands at 15.3 per 100,000 people, compared to 17 in the Southeast Asia region. Traffic fatalities are predicted to increase by 50%, becoming the third leading contributor to the global burden of disease by 2020. Indonesian police reported that 575 people died and 2,742 road accidents occurred during Eid-al-Fitr 2015. The problem is increasing rapidly in Indonesia, particularly during Ramadan. Policy makers need to recognize this growing problem as a public health crisis to prevent mass casualty incidents.Aim:To assess the health system preparedness with regard to road traffic accidents during 2017 Eid-al-Fitr homecoming in West Java, Central Java, East Java, and Lampung.Methods:The project started with an interview and observation followed by stakeholder analysis to assess the level of preparedness. This qualitative and quantitative research was conducted one month prior to Eid-al-Fitr homecoming 2017. The instruments were evaluated for policy, organization, communication, procedure, contingency plan, logistics, facility and human resources, financing, monitoring, evaluation, coordination, and socialization.Results:The levels of preparedness were moderate (B) for West Java, East Java, and Lampung, but high (A) for Central Java. Levels of preparedness based on district health office indicators were high for coordination, but low for a contingency plan. Levels of preparedness based on hospitals and primary health care were high for logistics and human resources, but low for a contingency plan and financing.Discussion:The findings indicated a moderate level (B) of health sector preparedness. Benchmark information from this research will provide information for further training in contingency planning, particularly for the district health office.

Introduction:Disaster and emergency management planning has an essential role to ensure that hospitals can continue to function in disaster response situations. However, there are several gaps for safe hospital policies and implementations between national and provincial/district level. The Special Region of Yogyakarta, as one of the provinces with high disaster risk in Indonesia, initiated a study to identify local policies needed for safe hospitals.Method:Focus Group Discussion (FGD) series were conducted with several hospitals representing private, public, academic, and military hospitals located in the first ring of Mount Merapi, an active volcano located on the border between Yogyakarta and Central Java Province. The FGD participants consisted of the Hospital Disaster Plan team, hospital task force of COVID-19, emergency department and hospital management team. Three FGD were carried out with different topics of discussion in each session. The topics were hospital experiences in implementing Hospital Disaster Plans during COVID-19, hospital incident command, coordination and networking. In addition, they also conducted advocacy and public consultationResults:The study that involved 12 hospitals and 40 persons, resulting in 11 specific additional policies for Yogyakarta safe hospital which include; six additional Standard Operating Procedure (SOP) in terms of donation management, volunteers’ recruitment and cost claim; one initiated Memorandum of Understanding (MoU) for surge capacity; conducting functional exercise rather than full scale ritual simulation with management scenario, as well as develop two plans for cyber-attack and business continuity plan.Conclusion:The pocketbook of Yogyakarta’s safe hospital will be useful for more than 70 hospitals in implementing and developing their hospital disaster plan, improving coordination among hospitals in the disaster phase, as well as a lesson-learned process for other regions to develop their local-based safe hospital policies.

Introduction:Deployment of EMT from one institution is a common thing to do in Indonesia. However, it is still rare to deploy a composite team that is combining two or more different institutions and area of origin. CHPM UGM had coordinated composite EMT deployment during West Sulawesi Earthquake in 2021. They sent a management team from Yogyakarta and a medical teams from Central Sulawesi. This paper aimed to report the experience of sending composite EMT to earthquake disasters amid the COVID-19 pandemic.Method:Documentation studies were carried out during the process of coordination, planning, and deployment of EMTs. Initial coordination was carried out with the Central Sulawesi Health Office which was the nearest neighboring province to affected West Sulawesi. The Central Sulawesi’s medical team arrived in Mamuju in less than 24 hours. Followed by the health cluster management team on the second day.Results:Three composite EMTs came from different institutions and diverse competencies (midwives from PHC, nurses and medical doctor from hospital, health promotion and management from university) were deployed during the emergency response. Coordination activities were carried out through WHATSAPP chat, Zoom, and telephone. The handover process was carried out via online streaming. In addition, prevention of infected COVID-19 was conducted by preparing PPE for personal and team, limiting service time only during the day, ensuring sufficient rest and nutrition, as well as screening and isolation before and after duty. However, there were two people who were infected with COVID-19 at the exit screening.Conclusion:Intense coordination is required during the preparation and deployment process, including an extra personal approach when the team first meets on the field. In addition, the Covid-19 pandemic situation has made the composite team's task even more challenging.

Introduction:Hospitals have had Hospital Disaster Plans (HDP), however, when the COVID-19 pandemic attacked, several hospitals neglected the HDP. They seem to find it difficult to operationalize HDP. The hospital’s problems were also increasingly complex because they must also think about how to break the internal transmission chain and how to deal with the surge in COVID-19 patients besides building a clear incident command system (ICS). This study aimed to carry out documentation and analyze hospital preparedness in dealing with COVID-19 based on the ICS.Method:This study was documentation research using a qualitative approach. All hospital preparations in "high case" areas in Jakarta and Yogyakarta from April to June 2020 were documented, followed by interviews and document observations. Furthermore, data were analyzed according to the ICS management functions; commander, secretary, operational, logistics, planning, and financial administration.Results:Since the COVID-19 pandemic, hospitals had developed a separate COVID-19 handling system from the existing HDP documents. The analysis showed the division of tasks and functions of each field in the COVID-19 Task Force already existed, but it had not been described in detail. The communication and procedure flow within the internal and external COVID-19 task force were generally only verbal. In conclusion, related to the readiness to face the surge in COVID-19 patients, the hospitals have not made any plans or supervision for handling COVID-19.Conclusion:Hospital preparedness in the face of the COVID-19 pandemic based on the Command System has not been maximized. The existing HDP only includes planning for natural disaster management. Furthermore, every health facility established the COVID-19 Task Force. However, the principle of division of tasks, communication, and planning flow in the Task Force still needs to be improved.

Introduction:Located in a disaster-prone country, more than 3000 hospitals in Indonesia must have a Hospital Disaster Plan (HDP). Instead of pursuing only the hospital accreditation requirements, HDP should be beyond that. Since 2008, CHPM UGM has been providing various HDP training. However, during the COVID-19 pandemic, there was a change in offline assistance that shifts to online. This study reports the learning activities, output, and challenges.Method:There were three batches of HDP-paid online courses in 2021. Each batch consists of three series courses. The first series was a basic HDP seminar. The second series was for intensive HDP mentoring for two months. In the second series, the participants focused on analyzing risk and hospital safety index (HSI), detailing job action sheets, and detailing disaster standard operating procedures. Moreover, the third series in the fourth month was an online tabletop exercise (TTX).Results:25 hospitals and 112 people participated. However, only five hospitals that committed finalized the HDP document. The learning process challenges were the participant’s unstable network and their focus on who was on duty while attending the courses. Although the TTX online was a new trial, it worked to asses hospital preparedness for disaster management through well preparation, detailed scenario and proper evaluation instrument. However, it was still difficult to assist participants in completing the HDP documents online, because observation of the hospital environment cannot be carried out while the evidence provided by participants were limited, for example supporting evidence for the HSI indicators.Conclusion:The online series of HDP is feasible because it saves accommodation and transportation costs. However, the intensive online mentoring should be carried out longer to allow participants to do assignments and collect evidence of indicators that must be shown to the facilitators.