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.

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.

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.

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.

The ambiguity of the command system is still the main challenge during the activation of health cluster coordination. It begins with the unclear division of tasks, communication channels that are not yet optimal, and do not have an alternative plan. This study reported the management of health cluster coordination posts during the disaster of Mount Semeru Eruption, in December 2021.

This study was a case study of qualitative research methods, data collection was carried out by observing the health cluster operation of Lumajang District Health Office (DHO) and supported by an analysis of health cluster activation policy reviews.

Resources to manage health clusters were limited due to a lack of staff knowledge in health cluster management. Therefore, the head of the Lumajang DHO appointed the Office Secretary as the health cluster coordinator. The Head of Referrals Health Services is the emergency medical team focal person and the Head of Health Promotion is the spokesperson. East Java Provincial Health Office, Ministry of Health, and Disaster Task Force of Faculty of Medicine UGM assisted in the management of health cluster post operations. Then, assisting was concerned with the most fundamental thing in facilitating health clusters such as establishing an organizational structure based on the incident command system approach as well as mapping the capacity of existing health resources on the field to visualize the geographical situation of health service capacity and emergency medical teams distribution.

Although located in prone and high-risk or periodically eruption areas, the staff still have a low capacity in disaster health management. Thus, capacity building in the pre-disaster phase is highly required in the management of health clusters and emergency medical team coordination by the mandate of the Ministry of Health Regulation.

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.

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 consultation

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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

The Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) developed Regional Collaboration Drills (RCDs) and is proposing an ASEAN Academic Network to strengthen capacity in disaster health management (DHM) in ASEAN Member States (AMS), as well as developing a standard training curriculum in DHM. This study aims to clarify the impacts and sustainability of the ARCH Project.

The four previous RCDs and the enhancement of academic activities were reviewed.

The ARCH Project developed the RCDs with simulation exercises based on possible disaster scenarios in each host country to test and validate the capacity of AMS International Emergency Medical Teams (I-EMTs), the Standard Operating Procedure (SOP) for I-EMT coordination, and regional tools, as well as the relevant domestic SOPs of the host countries for receiving international assistance. Following the RCD in Thailand, three AMS: Viet Nam, Philippines, and Indonesia, all of which are considered disaster-prone, successfully hosted RCDs with significant improvements. The project also established a sub-working group (SWG) to develop a standard curriculum in DHM. Two curricula developments, the Basic Course on DHM and In-Country Course for Coordination on EMTs, are on-going as part of the project activity. The establishment of the ASEAN Academic Network and the ASEAN Institute for DHM (AIDHM) are currently in the endorsement process of the ASEAN health sector.

The RCDs are very effective to test and to validate the SOP and regional tools developed, providing opportunities for AMS I-EMT to familiarize the tools, as well as for host countries to assess their coordination capacity for receiving international assistance and identifying the country’s specific challenges, and verifying ASEAN regional coordination mechanism. The development of the standard curriculum can enhance regional capacity both in supporting disaster-affected countries and in receiving international assistance. A sustainable capacity development mechanism in DHM is envisaged through the establishment of the ASEAN Academic Network and AIDHM toward the goal of One ASEAN One Response.

Emergencies and disasters need inter-discipline and inter-professional approaches because many problems in a disaster are due to poor coordination and collaboration. The disaster events during a decade in Indonesia highlighted the limitations of the healthcare system in responding to large-scale public health problems. Disaster health preparedness is the key to an effective response to any problems in community and family. Thus, education for health students has become a priority.

Preparing fourth-year health students to be aware of disaster health problems in family and community with an inter-professional approach.

Faculty of Medicine, Public Health, and Nursing UGM were prepared for the fourth year undergraduate health students through a semester “Emergency and Disaster Course” under Community Family and Healthcare with the Inter-professional Education Program, first given in 2016 for four hundred students. Mix method between class lecture, training skill, and simulation. The course goals are to (1) educate students on disaster health management, (2) understand the health preparedness and disaster family kit, and (3) define the principle of health worker’s role and collaboration in disaster.

The course was well received and at the 2017-2018 session was improved based on students and faculty feedback. Disaster knowledge of students changed. However, they still had a problem in communication between professions. And addition, they became aware of the function and each role of health profession competency during a disaster.

A course for fourth-year health students about emergency and disaster health management is extremely relevant because they will be health workers soon. They must have good awareness, knowledge, and attitude to cope with disaster health problems in the future.

Located in the Pacific Ring of Fire, Indonesia is prone to natural hazards, such as earthquakes, tsunamis, floods, and volcanic activity. Management in the health sector is a necessary foundation for dealing with a disaster. Management lessons and essential experiences identified from disasters are often forgotten. The faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada has been developing disaster health management since 2009 after Padang Earthquake, followed by Merapi Volcano Eruption (2009), Pidie Jaya Earthquake (2016), and Lombok Earthquake (2018). The latest series of earthquakes that struck Central Sulawesi has revealed management problems with respect to the communication process, the development of coordination, and information and data synchronization.

To show the importance of effective management in a health cluster, including what went well, what went poorly, and what will happen from the acute phase until the transition phase.

Disaster health management implementation was compared from Padang to the Central Sulawesi’ earthquake. Then health cluster management was compared in Lombok and Central Sulawesi. Indicators were coordination, communication, data information, and organization.

There has been good progress for disaster health management in Indonesia. The health cluster approach makes coordination, data collected, and communication much easier. However, it also needs to focus on disaster planning, training, or simulation for the district health office while enhancing district response capacity. Although the challenges have changed in the last few decades, additional research is planned to limit management difficulties in the health cluster.

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.

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.

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.

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.

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.

The effort of medical and health services distribution requires data. However, the data and information were ignored in an emergency situation. For improving the distribution of data and information, the Center of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada (UGM) developed forms based on Health Crisis Response Guideline by Ministry of Health 2016 and the World Health Organization (WHO).

Describing the implementation and development of forms based on Lombok and Central Sulawesi earthquake in 2018 for health cluster.

The form contains (1) a volunteer registration form; (2) a monitoring potential outbreak disease form; (3) health problem in health cluster daily report form; (4) a chronological situation form. This will be implemented in health policymaking by the Sulawesi district health office (DHO) and will be regularly analyzed in every week.

North Lombok DHO, Central Sulawesi health office, and volunteers accepted these forms well. Periodically volunteers had reported their activity to DHO. All these reports contain many health indicators including environmental health. Reproductive health and health promotion. Implementation of this form in the other type of disaster in Indonesia is suggested.

First, these forms are important to attach to the guideline of health crisis response in order to be accessed by all DHO. Second, all forms are printed documents. It needs to develop into data input and analysis applications.