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EUROPEAN COMMISSION
HUMANITARIAN AID OFFICE (ECHO)
Contribution Agreement - International Organisations
ANNEX I
Development of a Health Training Program on Preparedness for
Volcanic Eruptions in Colombia and Ecuador
Pan American Health Organization
Final Report
SINGLE FORM FOR HUMANITARIAN AID ACTIONS
Summary
As reflected in the schedule established in the Action Plan, there are four major
phases of this Project:
Development of training materials is the most extensive part of the
Project (lasting from 7 to 9 months). Development of the training guides
(Result No. 1) is nearly concluded, and development of the simulation
materials (Result No. 3) is 50% completed, thereby complying with over
90% of the activities scheduled for the first six months.
2. The evaluation workshops are scheduled to follow month 7 of the
project. Evaluation workshops for the training guides are scheduled for
October. The simulation materials will be evaluated in January 2005.
3. Reproduction of the training materials (including design and printing)
will take place between November 2004 and January 2005.
4. Training will begin in early 2005.
1.
This work plan involves special allocation of budgeted funds. Expenditures are
not made on a regular basis and will be higher in the second and third stages
of the Project when the majority of funds will be spent for the validation and
production of training materials.
This report describes the activities and methods followed to develop the
training guides (Result No. 1) and the multimedia simulation tool (Result No. 3).
Annexes are attached with meeting agendas and lists of participants.
Conclusion
The activities developed and contacts maintained with a large number of
organizations and experts demonstrate and reconfirm the need for these
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special training materials, particularly at the local and provincial levels.
Colombia, with the recent eruption of the Galeras Volcano, has again felt the
need to have updated preparedness and response plans. Ecuador continues to
live in a latent emergency situation because of the activity of its volcanoes.
This demonstrates the relevance and timeliness of the programmed activities.
Regarding the current process, we would like to highlight:

The open and participative approach to the development of the training
materials, with a large number of organizations from a variety of sectors
from national, departmental, provincial, and local levels.
 The interaction and collaboration with other DIPECHO Projects;
 Existing interest in simulation as a training tool, which introduces an
innovative method for working with Emergency Operations Committees.
The challenge is to achieve the correct balance between the
technologically complex, the practical, and the pedagogical aspects of
this device.
The original time-frame is being maintained, but it may be necessary to extend
the period by one or two months owing to the complexity of developing the
simulation software. The precise time-frame for completion of the software will
be known at the beginning of December, when a formal request for extension
will be made to ECHO, if necessary.
Executive Summary - Final Project Report

The work plan was implemented within the Project’s time schedule,
including the additional two months extension granted by ECHO. The last
two workshops were slightly delayed until the first week in June due to the
unstable political situation in Ecuador and the local health professionals
(physicians) strike which lasted for more than two months and brought
most health services almost to a standstill. Nonetheless, there was no
administrative impact for the Project in the use of available funds during the
approved period.

All training materials were produced and distributed as planned: the Health
Preparedness Guide for Volcanic Eruptions, made up by five practical
modules, a CD-ROM with related training material, a CD-ROM with technical
information on Health and Volcanoes (produced jointly with CRID), and the
multimedia sumulation simulator. The PAHO-produced video on Volcanoes
and Health (2000) was widely used and disseminated.

Ten training workshops were organized and were attended by more than
320 professionals, technical experts and authorities from the health and
other related sectors from both countries.

In general, all activities were welcomed with significant openness and
interest by participants and beneficiaries alike. A contributing factor to be
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noted was the real volcanic eruption threat due to an increased activity of
several volcanoes in the area during the Project’s implementation
(particularly volcanoes Reventador in Ecuador and Galeras in Colombia).
This reconfirmed the relevance and need of training activities and actions to
create and rise awareness regarding the importance of plans of action and
preparedness measures.

The future sustainability of the Project’s activities is assured in different
fronts. Activities were always been implemented, in both countries, in close
cooperation with health organizations and stakeholders that have the
leading responsibility in disaster preparedness and response. Furthermore,
one of PAHO’s priorities in the Region is to support and provide follow-up to
disaster preparedness initiatives; its Country Offices and the Regional
Programme maintain permanent working relations with MOHs and other
stakeholders in the health sector. The training material produced during the
Project –and which can be considered as one of its most important resultswill be still promoted and disseminated throughout the region. There will be
a second edition of the sumulation software which will continue to be used
in training and conscience awareness activities in countries exposed to
high risks of volcanic eruptions in Latin America. A workshop for Central
America will take place in Nicaragua in late September 2005.

Finally, a number of conclusions and lessons learnt have been included
herewith; they reflect the views and analysis of local stakeholders involved
in the implementation of the Project’s activities:
 The Project’s single-threat approach enabled an intense and extremely
focussed work within and between sectors and multiple disciplines (thus
avoiding dispersion), with extremely high responsiveness and participation
of institutions and experts from both countries.
 This effort resulted in significant interaction and exchange of experiences,
analysis, and visions on scientific, academic and operational matters
between the two countries.
 On the basis of the training contents and issues examined, participant
sectors and organizations have been able to standardise concepts,
approaches and working tools for disaster preparedness in volcanic
eruptions.
 In both countries, the health sector has been able to consolidate its position
and strengthen its role in disaster preparedness planning and organization.
 General agreement has emerged on the convenience of comparative studies
and analysis between different countries that face similar threats and risk
levels.
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 There is the need to foster the development of training activities with a
multiplying effect (training of trainers) to ensure appropriation of the
process by local experts and professionals.
 Cooperation with universities contributes to the incorporation of
preparedness issues in local frameworks and to the sustainability of
training activities.
 Simulation exercises have contributed to further consolidate the concept of
health EOCs and their working dynamics, highlighting the need for such
committees at different geopolitical level (particularly at national and
provincial level). Notwithstanding this, there is the need to continue working
on and promoting the creation and strengthening of such bodies.
 There is the need to promote the development of an increased number of
tools to improve information systems and the use of new technologies.
DIPECHO projects provide an excellent platform for further work in the
Region on the analysis, production and dissemination of technical
information on risk management.
1.
General Information
1.1.
Name of the International Organisation Pan American Health Organization
1.2.
FPA number (if applicable)
1.3.
Purpose of the submission
1.3.1 Proposal
New proposal
Revised proposal
ECHO reference

X
date: dd-mm-yy
date: 9-02-04
date: dd-mm-yy

date
A/…
1.3.2 Final report
5-08-05
1.4.
Contribution agreement number ECHO/…
1.5.
Implementing rules applicable to this agreement
Grant, 100% financing

Grant, co-financing

Multi-donor Action

1.6.
Framework of this submission
Primary emergency decision
Emergency decision
Ad hoc decision
Global plan decision
DIPECHO
Other, please specify




X

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1.7.
Executive summary of the Action
(4.1.)
(4.2.)
Title of the Action
Developing a Health Training Program to Prepare for
Volcanic Eruptions in Colombia and Ecuador
Country/ies and region(s)of implementation of the Action
Ecuador and Colombia. In Ecuador, the provinces of
Pichincha, Chimborazo, Tungurahua, Sucumbios, and Napo.
In Colombia, the departments of Nariño, Caldas, Risaralda
and Quindío.
(4.3.)
(4.4.)
(4.5.1.)
Start date of the Action 30 March 2004
Duration in months 12 Months
Total number of direct beneficiaries:


Training for health trainers: 50 trainers (25 in each
country). (At least 10 of these trainers in each country
will participate as a trainer in additional training
sessions at the municipal and local level).
Other people trained: 120 health staff (participants
from ministries of health, Red Cross, NGOs, water
systems companies) at the municipal and local level
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
(4.5.2.)
(these persons will be trained by the above mentioned
trainers)
50 Emergency Operations Committees (EOC) (average
of 6 persons per EOC) Total: 300 persons
Every participant will be a direct recipient of the
training materials produced by this project.
Identify the status and give details of the beneficiaries
Direct beneficiaries: health services staff in both countries.
-
Particularly, but not limited to, the staff of the Ministries of
Health and of health services networks (e.g., hospitals and
health centres, Red Cross staff, humanitarian NGOs, water
systems companies, at national, sub-national and municipal
level located in high-risk areas.
-
Health staff of a minimum of 25 Emergency Operations
Committees in the principle high-risk areas of each country.
-
Technical staff responsible for water supply and sanitation
services.
-
The target population of both the training materials and
training module will be those health staff who would
participate in prevention, preparedness or response actions
in case of a volcanic emergency. The overarching focus will
be on accumulated perspective and experience in the
region. The material will be focussed on the main health
risks of volcanic eruptions and the basic planning actions
that must be taken by the health sector to reduce potential
damages.
Indirect beneficiaries:
-
Universities, NGOs, and other disaster-related organizations
that have or are interested in developing training programs
in these areas, will be able to access and make use of
training material relevant to the reality of these two
countries.
-
Communities in areas at risk of volcanic eruption (the
material will be able to be used in the design and evaluation
of health prevention and preparedness activities relevant to
volcanic eruptions).
-
Other organizations in countries with volcanic activity will
be able to use the material for training, since it will be freely
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available on the Internet with clear instructions and no
restrictions as to access.
-
4.6.
Civil society at large, as it is hoped that the materials and
training will help stimulate disaster preparedness and
prevention awareness programs.
Principal objective
To reduce risk by better preparing the vulnerable populations in the
areas most affected by volcanic eruptions in Ecuador and Colombia. In
this case, preparedness means the reinforcement of the coping capacity
of the health sector at the national, sub-national and municipal level in
both selected countries. These improvements are critical to the
establishment of a better preparedness program, and to the exchange of
technical experiences between Ecuador and Colombia.
4.7.
Action’s specific objective
4.7.1. Specific objective
Strengthening the technical capacity of the health sector in both
selected countries to respond to volcanic eruptions, through the
development and dissemination of training materials on health
preparedness, a “train the trainers” program for health
professionals at the national, sub-national and municipal levels,
and training of members of existing disaster response teams
(EOCs).
4.7.2. Indicators and sources of verification
Availability of training materials, records of training sessions,
records of participants, and participant evaluations of the training
program.
(4.8.1.)
Expected Result #1
Availability and distribution of a technical guide and multimedia
training material for health preparedness for volcanic eruptions,
designed for health professionals in damage assessment,
epidemiological
surveillance,
environmental
health,
communication, mental health and mitigation.
Indicator: 1.1 Availability of the technical guide and multimedia
training material.
1.2 Within 10 months of the start of the project, availability and
dissemination of 1000 copies of the technical guide and
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multimedia training material in the identified high-risk volcanic
areas of Ecuador and Colombia, as well as unrestricted access
through the Internet. At least 50 institutions in every country will
receive the training material during this project.
Source of Verification: 1.1. The technical guide and multimedia
material. 1.2 Distribution report detailing the institutions that have
been sent the training material, dates of distribution, and details
regarding internet access.
(4.8.2)
Expected Result #2
Existence of a select group of 25 health staff members (in each
country) trained in health preparedness for volcanic eruptions in
the areas of assessment of damages and need, epidemiological
surveillance; environmental health; communications; mental
health and mitigation. Staff will be selected based on their
experience and above all their ability to carry out training activity
in areas of high-risk for volcanic activities in Ecuador and
Colombia. They will be given the technical and methodological
tools to provide training to the staff of health institutions in these
areas.
Existence of two additional groups of trained people -60 people in
every country, at the municipal and local levels - (health staff
trained by the trainers).
Indicators: 2.1 At the end of the project year, at least 25 staff
members in each country trained in health preparedness for
volcanic eruptions in these same areas and capable of transferring
this knowledge to other local health professionals, and 120
additional people trained by the trainers.
Source of Verification: 2.1 Final report of the training sessions,
including summary of contents and session locations. Report
detailing the names and institutions of recipients of the training in
each country, including a personal commentary from each to
evaluate the training they have received.
(4.8.3.)
Expected Result #3
Availability of a special module for decision-making: a multimedia
sumulation tool with an emergency volcanic eruption scenario that
will make it possible to exercise decision-making through a series
of tests and practical exercises. The module will be supported with
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a selected collection of electronic documents based on the direct
experience accumulated in the region in the last 25 years.1
Indicator: 3.1. Availability of the decision-making module, as well
as the collection of electronic documents, in CD format as well as
freely accessible on the Internet. Dissemination of 1000 copies of
the multimedia simulation and collection of associated reference
documents. At least 50 institutions in every country will receive
this training material during this project.
Source of Verification: 3.1 The module will be available in CD
format as well as freely accessible on the Internet.
(4.8.4.)
Expected Result #4
Training of health professionals in a minimum of 25 EOCs in each
country, at the sub-national and municipal levels, making use of
simulation.
Indicators: 4.1 At the end of the project year, health units of 25
EOCs in each country with strengthened decision-making
capability and access to the multi-media simulation and materials.
Sources of Verification: 4.1. Final report of the training sessions,
including summary of contents and session locations. Report
detailing the EOCs trained and names of members who received
the training in each country, including a personal commentary
from each to evaluate the training they have received.
(4.8.5.)
Expected Result #5
Health preparedness for volcanic eruptions and the related
training material developed, disseminated, promoted, and visible
in the health sectors of the Project countries through
communication and information actions at different levels.
Participation of at least two people by country (national staff from
the participating organizations in the project) in the DIPECHO
seminars, both national and regional level.
Indicator: 5.1 At least 10 web sites and 3 newsletters or journals
will publish information and material of this project.
1
Simulations are excellent tools for studying scenarios related to health and disasters because they allow realistic
creation (or simulation) of complex situations involving numerous variables and several types of participants,
allowing the practical exercise of decision-making by each, factors which are absolutely critical in preparing for
disasters. In simulations, the “student” is submerged in a space in which he/she faces various situations, in such a
way that each action brings an immediate consequence. Furthermore, the exercise includes factors that evolve
over time. The design and development of multimedia simulations requires considerable investment, but brings
with it versatile and functional tools that facilitate the desired results.
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5.2 At the end of this Project, the conclusions are presented in the
DIPECHO seminars in Ecuador and Colombia, with the
participation of technical staff from the organizations participating
in this Project.
Sources of Verification: 5.1 Report detailing the web sites,
bulletins, and journals that have announced the availability of the
technical training material.
5.2 Technical reports from the DIPECHO seminars.
(11.1.)
(11.2.)
(11.5.)
Total budget of the Action: EUR 252.476
Contribution requested from EC: EUR 206,000
Eligibility date of expenditure 30 March 2004
2.
NEEDS ASSESSMENT
2.1.
Date(s) of assessment ongoing activities though PAHO technical
cooperation in Latin America and Caribbean countries.
Methodology and sources of information used
2.2.

Evaluation of lessons learned in several disasters and emergencies.
Analysis of recent emergencies such as the Tungurahua and Reventador
volcanoes eruptions in Ecuador that revealed the need for specific
training in the health sector.

Conclusions from several meetings of international experts held in
Ecuador and Bogotá in 2003, which identified weaknesses in current
training programs as well as the need for updated training materials
appropriate for local and national realities.

A technical analysis of existing training materials and technical
information regarding volcanic eruptions in the Region (CRID and other
information centres) indicates absence of practical training materials
aimed at the training of trainers.

Contacts and interviews with technical disaster personnel in the offices
of the Health Ministries in Ecuador and Colombia, with the Ecuadorian
and Colombian Red Crosses, demonstrate the relevance and timeliness
of Project activities.
2.3.
Organisation/person(s) responsible for the assessment
PAHO/WHO, through the Disaster Preparedness regional office for South
America located in Ecuador, and its regional publications unit, in
collaboration with the PAHO/WHO office in Bogotá.
On-going
collaboration and communication between PAHO and key actors in the
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health sector (including, but not limited to health ministries) of both
countries.
2.4.
Problem statement and stakeholder analysis
Volcanoes are a part of daily life in Andean countries. Although many
volcanoes have remained dormant for decades, others remain active and
pose significant risks to the health and wellbeing of scores of
communities in the region. Almost half of the most devastating volcanic
eruptions registered in the last century have occurred in Latin America
and the Caribbean.
Together, Ecuador and Colombia have the highest number of active
volcanoes in Latin America. History in those countries is plagued with
examples of volcanic eruptions that have caused dramatic human and
economic losses with a significant impact on the development of the
affected populations, such as the Nevado del Ruiz eruption in 1985 in
Colombia, and the eruptions of the Guagua Pichincha, Tungurahua and
Reventador volcanoes in recent years in Ecuador.
Both Ecuador and Colombia have established health emergency plans
for disasters and are developing health preparedness plans for volcanic
eruptions, given their high risk of volcanic eruptions. Nonetheless, postdisaster evaluations of lessons learned following volcanic eruptions 2 have
revealed gaps and weaknesses that call for special attention:

Epidemiological surveillance systems should be strengthened with
better trained staff and updated technical guidelines on information
systems and mechanisms that can be used in such circumstances.

The health sector in Ecuador does not have a disaster information
system to monitor risk factors, to collect and analyze information in
crisis or timely and adequately assess the impact of actions undertaken.
There are no adequate tools to support decision-making.

Mental or psychological health actions in high-risk areas have been
inconsistent and haphazard. Local health services have no permanent
programmes to provide adequate care to the population.

Drinking water systems, particularly in rural areas, are still very
vulnerable. The quality of water supply systems has deteriorated in the
aftermath of volcanic eruptions and in some cases, the service has not
been resumed; in the geographical areas exposed to highest volcanic
risks, water supply systems do not have built-in mitigation components
to minimize the risks of drinking water pollution and general collapse.
2
Ministry of Public Health of Ecuador, PAHO/WHO, Erupciones volcánicas en el Ecuador: impacto, respuesta
y lecciones aprendidas: la perspectiva del sector salud. (Volcanic eruptions in Ecuador: impact, response and
lessons. A Health Sector’s Perspective.) Preliminary Document.
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
Agencies involved in disaster management and health contingency plans
still suffer from significant weaknesses in communications and media
relations; Internet benefits have not been fully tapped.

In few cases have health facilities developed plans or taken
preparedness measures to mitigate damages and to ensure functioning
in case of disaster.
There is an obvious need for health staff to work with updated technical
instruments and tools that respond to national and local realities.
Plentiful experiences and expertise exist in this area, but remain to be
synthesized and analyzed in a way that can be applied effectively in
practice. Nor have lessons learned through several recent emergencies
been integrated into the existing health system. Furthermore, the
frequent mobility among technical health staff is a reality that calls for
continuing training and education programmes.
New information and communication technologies nowadays enable
greater innovation and creativity in the design and development of
training material to strengthen national capacities. Some of this material
will be produced using multimedia formats and techniques, with didactic
and pedagogical criteria geared toward the training of trainers and
decision-making enhancement.
3.
INTERNATIONAL ORGANISATION'S STRATEGY
3.1.
Organisation's strategy in the country and/or region(s) of implementation
PAHO’s Emergency Preparedness Program has 27 years of experience in
all health aspects of disaster preparedness mitigation and response in
the countries of the Western Hemisphere. PAHO’s Emergency
Preparedness Sub-Regional Office has been located in Ecuador since
1988. Developing and implementing these disaster preparedness
activities will be an important part of PAHO’s work plan.
3.2.
Link between the proposed action, the findings of the assessment and the
problem statement.
The accumulated experiences and the existing information on measures
and health actions that must be taken when facing volcanic eruptions,
and the lack of technical materials for training for the Andean countries,
create the need to develop, disseminate and use the proposed materials.
The training will improve the preparedness level of the health personnel
in the vulnerable communities and of the EOCs.
The project aims to eliminate part of these weaknesses and encourage
an exchange of experiences and knowledge between both countries, and
between communities that share the same volcano eruption vulnerability.
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3.3.
Are there similar action(s) in the country/region? There is no similar project
in the Region.
If yes, explain the measures foreseen to avoid overlap/duplication.
3.4. Previous humanitarian actions with EC financial support in the country/region
 Strengthening Building Codes for Health Facilities in the Caribbean
(DIPECHO 2002)
 Enhancing Health Sector Disaster for Floods in The Caribbean (DIPECHO
2002)
 Assistance to the population affected by Hurricane Keith (ECHO 2000)
 Training in the Management of Humanitarian Supplies in the Caribbean
(DIPECHO 2000)
 Reduction of Vulnerability to Disasters in the Health Sector of the Andean
Region (DIPECHO 1999)
 Reduction of the Impact of Hurricanes on the Main Hospitals in the Small
Caribbean States (DIPECHO 1999)
 Development of the Regional Disaster Information Centre – Improving
Access to Disaster Information in Central America and the Dominican
Republic (DIPECHO Central America, 1998)
(Project reports available on request)
3.5.
Have you discussed this proposal with ECHO's technical assistance office in
the country/region?
Yes X No 
Comments:
4.
OPERATIONAL FRAMEWORK
4.1. Title of the Action
Developing a Health Training Program to Prepare for Volcanic Eruptions in
Colombia and Ecuador
4.2. Country/ies and region(s)of implementation of the Action:
Ecuador and Colombia. In Ecuador, the provinces of Pichincha, Chimborazo,
Tungurahua, Sucumbios, and Napo with more than 2 million people in high-risk
areas. In Colombia, the departments of Nariño, Caldas, Risaralda and Quindío
with a population of more than 2.5 million in high-risk areas.
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4.3.
4.4.
Start date of the Action 30 March 2004
Duration in months 12 Months (extended to 14 months)
4.5.
Beneficiaries
4.5.1. Total number of direct beneficiaries:



Training for health trainers: 50 trainers (25 in each
country). (At least 10 of these trainers in each country
will participate as a trainer in additional training
sessions at the municipal and local level).
Other people trained: 120 health staff (participants
from ministries of health, Red Cross, NGOs, water
systems companies) at the municipal and local level
(these persons will be trained by the above mentioned
trainers).
50 Emergency Operations Committees (EOC) (average
of 6 persons per EOC) Total: 300 persons
Every participant will be a direct recipient of the
training materials produced by this project.
4.5.2. Identify the status and give details of the beneficiaries:
Direct beneficiaries: health services staff in both countries.
-
Particularly, but not limited to, the staff of the Ministries of
Health and of health services networks (e.g., hospitals and
health centres), ), Red Cross staff, humanitarian NGOs,
water systems companies at national, sub-national and
municipal level located in high-risk areas.
-
Health staff of a minimum of 25 Emergency Operations
Committees in the principle high-risk areas of each country.
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-
Technical staff responsible for water supply and sanitation
services.
-
The target population of both the training materials and
training module will be those health staff who would
participate in prevention, preparedness or response actions
in case of a volcanic emergency. The overarching focus will
be on accumulated perspective and experience in the
region. The material will be focussed on the main health
risks of volcanic eruptions and the basic planning actions
that must be taken by the health sector to reduce potential
damages.
Indirect beneficiaries:
- Universities, NGOs, and other disaster-related organizations
that have or are interested in developing training programs
in these areas, will be able to access and make use of
training material relevant to the reality of these two
countries.
-
Communities in areas at risk of volcanic eruption (the
material will be able to be used in the design and evaluation
of health prevention and preparedness activities relevant to
volcanic eruptions).
-
Other organizations in countries with volcanic activity will
be able to use the material for training, since it will be freely
available on the Internet with clear instructions and no
restrictions as to access.
-
Civil society at large, as it is hoped that the materials and
training will help stimulate disaster preparedness and
prevention awareness programs.
4.5.3. Catchment population
Populations and communities situated in areas at high risk for
volcanic eruptions in Colombia and Ecuador will benefit from this
Project investments in preparedness. In Ecuador, the provinces of
Pichincha, Chimborazo, Tungurahua, Sucumbios, and Napo with
more than 2 million people living in high-risk areas. In Colombia,
the departments of Nariño, Caldas, Risaralda and Quindío with a
population of more than 2.5 million living in high-risk areas.
Specifically, the project will target health services managers and
professionals.
All the participants in the training sessions will be direct recipients
of the new material developed by this project. In addition, we
expect to distribute more than 500 copies in every country.
4.5.4. What are the identification mechanisms and criteria?
For more than 25 years, PAHO has worked and coordinated with
Ministries of Health in both Project countries in numerous disaster
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preparedness, mitigation, and response activities. The high-risk
areas for volcanic eruptions are well-defined. In order to identify
the direct beneficiaries of this project, a joint evaluation will be
carried out with local and national health officials in each country.
4.5.5. To what extent and how were the beneficiaries involved in the design of
the Action?
This project is the result of a series of meetings, workshops, and
previous initiatives with health professionals of institutions from
the health sectors of both Project countries, and more generally,
the Andean region. For example, in a March 2003, workshop
coordinated by PAHO, Lessons Learned from the Volcanic
Eruptions of the Past Five Years in Ecuador, a main conclusion
was the need for manuals and materials to aid health
professionals in preparation for disaster response for volcanoes.
Similarly, in a meeting of disaster response officials from health
ministries of countries throughout the Andean region, held in
September 2003, in Bogotá, Colombia, and coordinated by PAHO
and the Red Cross, one of the most unanimous conclusions was
the need to synthesize and apply the experience acquired by the
health sectors of all countries of the region in recent disasters.
These same health professionals will be the direct beneficiaries of
this project.
4.5.6. Sectors of intervention/activity
Training materials (education)
The target population of both the training materials and training module
will be those health staff who would participate in prevention,
preparedness or response actions in case of a volcanic emergency. The
most direct beneficiaries will be the participants in the training sessions
(see 4.5.1), but we expect a dissemination-multiplication effect.
Research and dissemination
Research: To develop the training materials we will collect reports,
publications, and experiences from the most important actors working in
prevention, preparedness or response to volcanic emergencies in
Ecuador and Colombia (ministries of health, civil defense, NGOs, UN
agencies, etc.).
Dissemination: The target population is the same mentioned for the
training materials. For the DIPECHO seminars we will invite and
coordinate with the organizations involved in project activities.
Institutional strengthening (in this Project, Training)
The staff of the Ministries of Health and of health services networks (e.g.,
hospitals and health centres), Red Cross staff, humanitarian NGOs,
water systems companies, at the national, sub-national and municipal
level, located in high-risk areas.
Health staff of a minimum of 25 Emergency Operations Committees in
the principle high-risk areas of each country.
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4.5.7. Give the following information for each sector
 Total number of direct beneficiaries: health services of the
principle cities and communities in areas at high risk of
volcanic eruptions. Types of beneficiaries and number of
beneficiaries per type: please, see 4.5
 Location: In Ecuador, the provinces of Pichincha, Chimborazo,
Tungurahua, Sucumbios, and Napo with a population of more
than 2 million in high-risk areas. In Colombia, the departments
of Nariño, Caldas, Risaralda and Quindío with a population of
more than 2.5 million in high-risk areas.
4.6.
Principal objective
To reduce risk by better preparing the vulnerable populations in the
areas most affected by volcanic eruptions in Ecuador and Colombia. In
this case, preparedness means the reinforcement of the coping capacity
of the health sector at national, sub-national and municipal level in both
selected countries. These improvements are critical to the establishment
of a better preparedness program, and to the exchange of technical
experiences between Ecuador and Colombia.
4.7.
Action’s specific objective
4.7.1. Specific objective
Strengthening the technical capacity of the health sector in both
selected countries to respond to volcanic eruptions, through the
development and dissemination of training materials on health
preparedness, a “train the trainers” program for health
professionals at the national, sub-national and municipal levels,
and training of members of existing disaster response teams
(EOCs).
As described under the Results and Activities section, the Project
attained its goal of strengthening the health sectors in Colombia
and Ecuador through the implementation of all planned activities
with significantly high levels of participation, motivation and
commitment from participating national stakeholders.
4.7.2. Indicators and sources of verification
Availability of training materials, records of training sessions,
records of participants, and participant evaluations of the training
program.
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Sources of verification can be found in the following attachments:
- List of materials developed, distributed quantities and main
beneficiaries.
- List of training workshops and participants
- Participants’ assessments.
4.8.
4.8.1.
Expected Results
Expected Result #1
Availability and distribution of a technical guide and multimedia
training material for health preparedness for volcanic eruptions,
designed for health professionals in damage assessment,
epidemiological
surveillance,
environmental
health,
communication, mental health and mitigation.
The final draft of the technical guides has been completed and is presently
being reviewed by technical personnel from PAHO. As can be seen in Annex
1, the first evaluation workshop for the guides is scheduled for 13 and 14
October 2004, in Ambato, Ecuador, with participation of more than 35
experts from Colombia and Ecuador. The second workshop will take place
on 26 and 27 October 2004 in Pereira, Colombia.
Indicator: 1.1 Availability of the technical guide and multimedia training
material.
Eighty percent of the work required to produce these technical guides has been
completed. Technical evaluation, design, printing, and distribution of the
guides still have to be completed.
The five guides were produced, printed and distributed with the relevant CDs
that include multimedia presentations and support material for training
activities. The technical guides address the following issues:





Health Sector and Volcanic Risks
Protection of health services during volcanic eruptions.
Damages and health needs assessment in volcanic eruptions.
Environmental health and volcanic risks
Communications planning in volcanic eruptions.
1.2 Within 10 months of the start of the project, availability and dissemination
of 1000 copies of the technical guide and multimedia training material in the
identified high-risk volcanic areas of Ecuador and Colombia, as well as
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unrestricted access through the Internet. At least 50 institutions in every
country will receive the training material during this project.
Source of Verification: 1.1. The technical guide and multimedia material.
Annex 2 presents the expanded Table of Contents of the six guides.
Information on the technical guides and their contents is included in Annex 2
1.2 Distribution report detailing the institutions that have been sent the training
material, dates of distribution, and details regarding internet access.
Annex 3 includes a report on the dissemination of materials developed.
4.8.2
Expected Result #2
Existence of a select group of 25 health staff members (in each country) trained
in health preparedness for volcanic eruptions in the areas of assessment of
damages and needs, epidemiological surveillance; environmental health;
communications; mental health and mitigation. Staff will be selected based on
their experience and above all their ability to carry out training activity in areas
of high risk for volcanic activities in Ecuador y Colombia. They will be given the
technical and methodological tools to provide training to the staff of health
institutions in these areas.
Existence of two additional groups of trained people -60 people in every
country, at the municipal and local levels - (health staff trained by the trainers).
Indicators: 2.1 At the end of the project year, at least 25 staff members in each
country trained in health preparedness for volcanic eruptions in these same
areas and capable of transferring this knowledge to other local health
professionals, and 120 additional people trained by the trainers.
Information on the training of trainers workshops and the national workshops
organized in both countries is included under the Activities section.
Source of Verification: 2.1 Final report of the training sessions, including
summary of contents and session locations. Report detailing the names and
institutions of recipients of the training in each country, including a personal
commentary from each to evaluate the training they have received.
Annex 4 includes the Agendas and lists of the two bi-national workshops.
Annex 5 includes the Agendas of the four national workshops.
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Annex 6 includes the list of participants in all training activities and information
related to participants’ evaluations.
Annex 14 Master with the list of agencies that have collaborated in the Project
and table with resource distribution.
4.8.3.
Expected Result #3
Availability of a special module for decision-making: a multimedia sumulation
tool with an emergency volcanic eruption scenario that will make it possible to
exercise decision-making through a series of tests and practical exercises. The
module will be supported with a selected collection of electronic documents
based on the direct experience accumulated in the region in the last 25 years. 3
The script (theory and practice) of the simulation has been completed. The
simulation software is being developed in collaboration with a technical team
from the Ecuadorian headquarters of the Instituto Tecnológico de Monterrey
(Technological Institute of Monterrey) and will be finalized in January 2005. The
software is complex and requires intensive programming and technical
evaluation. We estimate that we can complete it in time to comply with other
Project activities, but a one or two month extension might be required.
A two month extension was required from ECHO. The sumulation software
programme was finalized and training activities for its validation and use were
carried out in both countries (see under Activities).
Indicator: 3.1. Availability of the decision-making module, as well as the
collection of electronic documents, in CD format as well as freely accessible on
the Internet. Dissemination of 1000 copies of the multimedia simulation and
collection of associated reference documents. At least 50 institutions in every
country will receive this training material during this project.
Source of Verification: 3.1 The module will be available in CD format as well as
freely accessible on the Internet.
Fifty percent of development of the simulation materials has been completed.
Annex 7 includes a detailed operational description of the simulation software
programme and pictures from the training exercises.
3
Simulations are excellent tools for studying scenarios related to health and disasters because they allow realistic
creation (or simulation) of complex situations involving numerous variables and several types of participants,
allowing the practical exercise of decision-making by each, factors which are absolutely critical in preparing for
disasters. In simulations, the “student” is submerged in a space in which he/she faces various situations, in such a
way that each action brings an immediate consequence. Furthermore, the exercise includes factors that evolve
over time. The design and development of multimedia simulations requires considerable investment, but brings
with it versatile and functional tools that facilitate the desired results.
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Annex 8 presents the contents and an image of the CD-ROM collection of full
text documents, produced with the Regional Disasters Information Centre
(CRID).
4.8.4.
Expected Result #4
Training of health professionals in a minimum of 25 EOCs in each country, at
the sub-national and municipal levels, making use of simulation.
As per the information included under the Activities section, two training
workshops for EOC staff were organized in Colombia and Ecuador.
Indicators: 4.1 At the end of the project year, health units of 25 EOCs in each
country with strengthened decision-making capability and access to the multimedia simulation and materials.
Sources of Verification: 4.1. Final report of the training sessions, including
summary of contents and session locations. Report detailing the EOCs trained
and names of members who received the training in each country, including a
personal commentary from each to evaluate the training they have received.
The Agendas of the simulation workshops are included in Annex 9.
Annex 10 includes the lists of participants and their evaluations.
4.8.5
Expected Result #5
Health preparedness for volcanic eruptions and the related training material
developed, disseminated, promoted, and visible in the health sectors of the
Project countries through communication and information actions at different
levels.
Participation of at least two people per country (national staff from the
participating organizations in the project) in the DIPECHO seminars, both
national and regional level.
Read about visibility and promotion actions under Activities. (4.9)
Indicator: 5.1 At least 10 web sites and 3 newsletters or journals will publish
information and material of this project.
Annex 11 presents examples of magazines, information bulletins and web
pages featuring news on the Project and the training material produced.
5.2 At the end of this Project, the conclusions are presented in the DIPECHO
seminars in Ecuador and Colombia, with the participation of technical staff
from the organizations participating in this Project.
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PAHO (in cooperation with the Spanish Red Cross and the Colombian Red
Cross) organized the national workshop in Colombia and funded the
participation of 8 representatives of the health sector and the Project’s
implementing organizations.
PAHO was involved in the organization of the national workshop in Ecuador
and contributed funds towards the participation of 8 representatives of the
health sector.
Several PAHO delegates attended also the Regional DIPECHO meeting in
Manta.
Annex 14 Master with the list of agencies that have collaborated in the Project
and table with resource distribution.
Sources of Verification: 5.1 Report detailing the web sites, bulletins, and
journals that have announced the availability of the technical training material.
Annex 11 presents examples of magazines, information bulletins and web
pages featuring news on the Project and the training material produced.
5.2 Technical reports from the DIPECHO seminars.
Annex 12 includes the Agendas and a brief summary of the final reports of the
DIPECHO workshops organized in Colombia and Ecuador
4.9.
Activities
As reflected in the schedule established in the Action Plan, there are four major
phases of this Project:
1. Development of training materials is the most extensive part of the
Project (lasting from 7 to 9 months). Development of the Technical
Guides (Result No. 1) is nearly concluded, and development of the
simulation materials (Result No. 3) is 50% completed, thereby complying
with over 90% of the activities scheduled for the first six months.
2. The evaluation workshops are scheduled to follow month 7 of the
project. Workshops for the Technical Guides are scheduled for October.
The simulation materials will be evaluated in January 2005.
3. Reproduction of the training materials (including design and printing)
will take place between November 2004 and January 2005.
4. Training will begin in early 2005.
This work plan involves special timing for the allocation of budgeted funds.
Expenditures are not made on a regular basis and will be higher in the second
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and third stages of the Project when the majority of funds will be spent for the
evaluation and production of training materials.
As per the detailed information provided under each result, all four phases
were implemented, with a slight delay in the production of the sumulation
software programme, which motivated an extension request submitted to and
granted by ECHO. From the managerial point of view, all financial resources
were used according to the time frame provisions of the contract (May 31st,
2005).
Result 1



Development of a Technical Guide and complementary multimedia
support material (based on the guide) related to health
preparedness for volcanic eruptions, with the following thematic
components: damage assessment, epidemiological surveillance,
environmental health, communication, mental health and
mitigation.
Conduct two technical workshops (one in each country) bringing
together experts from both countries to discuss, analyze and
validate the material produced. Experts will be selected from highrisk areas, so that the validation is based on a realistic
understanding of these areas´ needs.
Reproduction, via the internet, and printing, of 1500 copies of the
Technical Guide and complementary multimedia material.
Activities Completed as of 30 September 2004
A. During April 2004, visits were made to a wide variety of organizations in
Colombia and Ecuador with the objective of promoting the activities of
the Project and inviting participation from these organizations in the
development of the project activities.
As a result of more than 25 working meetings (see the complete list in
Annex 3), important commitments for participation and collaboration
were made. As a result, many of these organizations have been
represented during meetings for the design and review of the training
materials, and will be present in the evaluation and training workshops.
Coordination has been strong with other organizations that are working
in other DIPECHO Projects in the Andean Region. There has been
particularly close collaboration with the Spanish Red Cross,
Cooperazione Internazionale (COOPI), Catholic Relief Services (CRS),
Comitato Internazionale per lo Sviluppo dei Popoli (International
Committee for the Development of Peoples--CISP), and the United
Nations Development Programme (UNDP). One practical result of this
coordination is that two of the NGOs have printed PAHO training
materials for distribution in areas where their Projects are being
implemented (particularly technical materials about volcanoes).
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B. A consultant responsible for developing the guides was contracted.
C. During a multidisciplinary workshop that took place in May 2004 in Quito
(see the list of participants in Annex 4), planning for the guides was
reviewed and valuable technical recommendations were made. Among
other recommendations, it was decided to group the guides into the
following six modules (rather than five):
-
General health sector preparedness measures for volcanic
eruptions;
Protection of the health services;
Environmental health;
Mental health;
Damage and needs assessment;
Communications.
Recommendations were made on pedagogic aspects of the guides. Each
module will be accompanied by a “power point” presentation.
D. During the development of the Guides, the consultant has carried out an
intensive process of collecting information, technical review of
documents, and synthesizing experiences and interviews made in
Colombia and Ecuador.
Collection of information: The consultant has reviewed different reports
from the Ministries of Health and the national disaster prevention and
response agencies of Ecuador and Colombia, as well as from Mexico,
Costa Rica, Chile, and Argentina. These reports cover scientific studies
and experiences relating to active volcanoes, with an emphasis on health
effects (caused by ash, volcanic gases, and lahars) and environmental
effects.
Review of publications: The consultant has reviewed the majority of
PAHO/WHO
publications
on
relevant
topics
(epidemiological
surveillance, mental health, public health, communications, disaster
damage and needs assessment, health facility vulnerability, and natural
disasters), including reports and technical documentation from various
workshops sponsored by PAHO in Latin America.
In addition, the consultant reviewed documents by other authors on the
above topics that were available from the Luís Ángel Arango Library in
Bogotá, various Web sites, Colombian and Ecuadorian Red Cross
Societies, and the Ministry of Health of Colombia, as well as documents
recommended by advisors in specific disciplines.
Interviews in provinces affected by volcanic hazards: Interviews have
been carried out with personnel from the health sector and relief
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agencies. In Ecuador, interviews took place with: the Metropolitan Health
Directorate, Provincial Health Directorate of Pichincha, Disaster Office of
the Ministry of Health, Ecuadorian Red Cross (relief and mental health
divisions), Provincial Civil Defense Directorate of Cotopaxi, Provincial
Health Directorate of Cotopaxi (disaster preparedness branch), Municipal
Environmental Health Directorate of Ambato, Epidemiology Division of
the Provincial Directorate of Tungurahua, Training and Research
Directorate of the Ambato Teaching Hospital, and the local hospital and
district Red Cross of Pelileo.
In Colombia, interviews took place with: the National Directorate for
Disaster Prevention and Response, Ministry of Social Protection (Health
Directorate for Disaster Prevention and Response), Colombian Red
Cross (National Relief Directorate and the Caldas Section) , Spanish Red
Cross, Territorial Health Directorate of Caldas, Manizales Municipal
Office for Disaster Prevention and Response, Centro Regulador de
Urgencias y Emergencias de Caldas (Emergency Center of Caldas),
Caldas Branch of the Instituto de Investigaciones en Geociencias,
Minería Y Química (INGEOMINAS--Research Institute for Geosciences,
Mining and Chemistry), Autonomous University of Manizales (branch for
pre-hospital treatment technology) , the University of Caldas, and
Catholic University.
The advisory group had participation from the fields of geology, health
(medicine, psychiatry, psychology, pre-hospital care, occupational
health, and respiratory therapy), social communication, and engineering
(civil and sanitary).
E. Evaluation workshops for the guides have been scheduled. In Ecuador,
they will take place on 13 and 14 October 2004 in Ambato. Forty experts
representing more than 15 organizations from Ecuador and Colombia will
participate (the provisional agenda and list of participants is attached in
Annex 1).
In Colombia, the evaluation workshop will be carried out in collaboration
with the “Alma Mater” University Network of the Eje Cafetero (coffeegrowing region) in the city of Pereira on 25 and 26 October. Owing to
their capacity for organization and the national recognition that exists for
the work carried out in the provinces of Caldas, Tolima, Quindío and
Risaralda, PAHO has decided to execute a Letter of Agreement with the
“Alma Mater” University Network to collaborate in a variety of the
DIPECHO Project activities. We believe that this collaboration will give
better and greater visibility to the Project, improved coordination, and
greater success in the activities. Indirectly this collaboration will support
the growth of an important local institution.
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F. Proposals and budgets have been completed for the design and
production of the materials, and we expect that they will be printed by 15
December 2004.
In summary, in accordance with the scheduled activities of the Project, the
production of the guides complies with the projected time-frame. Ninety
percent of the production (as outlined in Activity 1) and planning for the
evaluation workshops for the guides has been fulfilled.
Activities completed as of May 30, 2005
A. Development of a Technical Guide and complementary multimedia support
material (based on the guide) related to health preparedness for volcanic
eruptions.
The guide on “Health Preparedness in Volcanic Eruptions”, composed of five
practical modules was produced, printed and distributed. The technical
modules address the following issues:





Health Sector and Volcanic Risks
Protection of health services during volcanic eruptions.
Damages and health needs assessment in volcanic eruptions.
Environmental health and volcanic risks
Communications planning in volcanic eruptions.
The design and edition was entrusted to “Desarrollo XXI”, an NGO based in
Cuenca, Ecuador, with extensive experience in the production of educational
and training material.
The Guide includes a CD-ROM with training material that includes:





Five Power Point presentations with the exact content of the different
technical modules.
Presentations on volcanic threats in Ecuador and Colombia, prepared by
specialized scientific agencies (INGEOMINAS of Colombia and the
Ecuadorian National Geophysical Institute)
The five guide modules in PDF electronic format that can be consulted
and printed directly from the CD.
Trainers support material (i.a. training methodology, practical
recommendations for workshops)
Other publications on health and disasters.
The Power Pont presentations were used and validated in six training
workshops. Participants suggestions and recommendations were taken into
account in the development of the final CD version distributed with the
Guides.
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B. Conduct two technical workshops (one in each country) bringing together
experts from both countries to discuss, analyze and validate the material
produced. Experts will be selected from high-risk areas, so that the
validation is based on a realistic understanding of these areas´ needs.
Two validation workshops took place in October 2004 (first in Ambato, Ecuador
and later on in Pereira, Colombia). The following conclusions, amongst others,
emerged from those meetings:
1. Participation. In both cases, participation exceeded expectations, with more
than a 100 participants altogether. There was excellent institutional response in
both countries and intense commitment from participants in reviewing and
analyzing the workshop contents. A successful effort was made to strike the
right balance between institutions and disciplines represented as well as
between operational, academic and scientific staff. Participants from the other
country were invited in both occasions to ensure interaction and information
exchange on experiences.
In both countries, the main participating institutions were: the MOH, the Red
Cross, the Civil Defence, specialized scientific agencies (Ingeominas in
Colombia, Instituto Geofísico in Ecuador), with representatives at national and
particularly, at provincial or departmental level. In Pereira, PAHO financed the
attendance of an expert from Guatemala in order to enrich the discussion on
experiences to be shared and contribute to the future use of such material in
Central America.
In Ecuador, the workshop was organized in close cooperation with the MOH
Disasters Office. This facilitated the involvement and participation of the health
sector, particularly of the technical staff working in provincial offices. The Red
Cross and the Civil Defence were represented at central and provincial level.
Forty-seven participants attended the Ambato workshop.
In Pereira, the workshop was planned and developed in cooperation with the
ALMA MATER Universities Network of the Coffee Growing Region, based in
Pereira. The extraordinary convening power and high technical prestige of
ALMA MATER in the area facilitated and contributed to the success in
convening more than 40 participants from the departments of Quindío, Caldas,
Risaralda, Tolima and Nariño.
Both workshops were attended by representatives of different organizations
that are implementing other DIPECHO projects in Colombia and Ecuador,
ensuring adequate coordination and positive information exchange.
2. Results. The Guides were thoroughly and extensively reviewed and
examined in working groups (established always with a multidisciplinary
approach). This resulted in both editorial and substantial technical suggestions
and recommendations that contributed to the practical improvement of the
guides, more in tune with the field needs in the health sector. The five Guides
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mentioned under A were produced taking due account of the proposed
recommendations.
The main health and disasters-related organizations in Ecuador and Colombia
were successfully involved in the development of the training material, to the
extent they could feel identified with it because it reflects their needs and
technical priorities. This process facilitated the use and dissemination of such
material.
Furthermore, the workshops provided an opportunity for dialogue and
technical discussions on volcanic emergencies precisely at a time when both
countries face volcanic alerts. New cooperation opportunities emerged from
this exchanges (for instance, one of the national workshops was organized in
May, in the city of Ibagué, within the framework of the activities planned by the
Colombian Government to mark the 20th anniversary of the Armero tragedy.
Annex 1 includes the Agendas and the lists of participants of each one of these
validation workshops.
C. Reproduction, via the internet, and printing, of 1500 copies of the Technical
Guide and complementary multimedia material.
Taking into account the expectation generated in both countries, an initial
edition of 2000 copies of the Guides and the CD-ROMs with the training
material was produced.
The Guides are also available through the Internet in PDF format at PAHO and
CRID web pages:
www.paho.org/spanish/dd/ped/guias_volcanes.htm
www.crid.or.cr/crid/esp/index.html
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More than 1500 copies of the Guides have been distributed in training
workshops and through special requests. Due to such an excellent response, it
was decided to reprint 700 additional copies.
Annex 3 presents a distribution report of the material produced.
Result 2
A. Conduct two bi-national workshops for trainers on health preparedness for
volcanic eruptions, with 25 participants in each country at national, subnational and municipal levels.
In Colombia, the workshop was organized on March 31st and April 1st, in close
cooperation with the ALMA MATER Universities Network of the Coffee Growing
Region, based in Pereira. In Ecuador, the workshop took place in Ambato on
April 19 and 20, 2005 and was jointly convened by PAHO and the MOH
Disasters Office (DIPLASEDE). Annexe 4 includes the workshops Agendas and
lists of participants.
In both countries, the goals, agendas and methodologies were identical or
quite similar.
The general purpose was to train a selected group of trainers providing them
with adequate knowledge on health preparedness in volcanic emergencies and
practical tools regarding teaching techniques and methods, that could enable
them to organize and replicate similar workshops in the Departments or
municipalities exposed to highest volcanic risks in their own countries.
Three specific goals were identified:
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


Share and exchange technical experiences on volcanic eruptions and health
preparedness in Colombia and Ecuador.
Share, present and promote the use of the Guide on Health Preparedness in
Volcanic Eruptions.
Train multiplying agents of the Preparedness Guide for local or national
workshops on health preparedness in volcanic emergencies.
Working guides were developed in order to provide practical information to
participants, trainers and working groups. All trainers were Colombian and/or
Ecuadorian experts. Besides the formal introduction to the Guides, there were
also presentations on the latest developments in the volcanic situation in each
one of the countries and on the results of the working groups discussions.
Each participant provided a personal assessment of the relevant workshop and
its contents, identifying strengths, weaknesses or general shortcomings
(regarding contents, methodologies and logistics).
Participation. In Colombia, participants included 30 representatives of different
Departmental and Municipal Health Secretariats, Municipal Emergency
Response Bureaux (CLOPAD), Departmental Chapters of the Red Cross, the
Ministry of Social Protection, Universities, the Directorate of Disasters
Prevention and Response and the Ecuadorian Ministry of Health.
In Ecuador, participants included representatives from the health sector of all
provinces exposed to volcanic risks and the central administration, the Civil
Defence, the Red Cross, different municipalities, the National Geophysical
Institute, and the Ministry of Housing (MIDUVI).
The following are some of the conclusions that emerged from the two
workshops:

The Guide on Health Preparedness in Volcanic Eruptions and the related
training material were considered extremely useful both for individual
and collective training. The easy use and simple adaptation to different
local realities were mentioned as an added value.

A successful convening effort was made and an adequate balance was
achieved between the different institutions and sectors, as well as
between operational, academic and scientific staff. Participants from the
other country attended its neighbour’s local workshop in order to ensure
interaction and information exchange on experiences.

These exercises contribute to improve coordination and joint
cooperation amongst different sectors and institutions; furthermore, they
create awareness regarding the need to develop operational response
plans.
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
There was a particularly intense technical contribution of the scientific
institutions that monitor volcanic activity in Colombia and Ecuador.
Scientists themselves consider that “these activities have helped
improve the health sector’s awareness regarding volcanic threats and
has forced us to leave our labs to develop joint plans and preventive
measures. This is the way we should work”.

Notwithstanding the fact that time was short to address all technical
matters during the workshop, a group of knowledgeable trainers was
created with adequate tools and skills to act as multipliers. In Ecuador
alone, 5 additional workshops have been organized (3 of them not
included in the Project’s programme) with trainers that originally
attended the Ambato workshop.

In Ecuador, the difficult and volatile political situation that culminated in
the former President’s departure on April 20th, precisely when the
workshop was taking place in Ambato, had an impact on organizational
aspects (need to postpone the workshop for a week) and attendance
(several participants cancelled). Likewise, the health professionals strike
which lasted for more than two months affected the health sector,
resulted in delays and difficulties to confirm attendance of staff from
different health centres.
B. Organize and support two additional national “training sessions” where
health staff trained will provide training at municipal and local levels. This
activity will help assess the success of the training materials and the ability of
the trainers.
As planned, two national workshops were organized in each country, with
significant local initiative. PAHO provided financial support to cover some
trainers travel expenses and per diems, training materials and meals. Local
institutions contributed with facilities and convened participants.
In Colombia, the workshops took place in May, in Pasto (Nariño) and Ibagué. In
Pasto, response and motivation were particularly high (the Galeras volcano had
shown increased activity in previous weeks). The workshop was organized by
the Nariño Departmental Health Institute, with limited support from PAHO.
Amongst participants, there were representatives of the hospital network of the
Galeras neighbouring areas, Cumbal and Ipiales (Nariño), relief organizations
(such as the Red Cross and the Fire Department) the Nariño CREPAD and the
CLOPAD of 6 municipalities.
In Ibagué, local commitment was not as intense and the convening effort was
less successful as far as health sector representatives and relief organizations
operating in the Department were concerned. The workshop was organized by
the Tolima Departmental Health Secretariat, with PAHO support.
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A hundred copies of the guides, CDs and CD-ROMs on “Information resources
on Health and Volcanoes” and PAHO’s DVD “Volcanoes and health protection”
were distributed at institutional level.
In Ecuador, both workshops were organized in May, first in Ambato (May 1820) and then in Quito (May 25-26), with participants from hospitals, health
centres and health authorities of the Provinces of Tungurahua, Chimborazo,
Cotopaxi, Pichincha, Imbabura and Sucumbios, together with delegates from
the Red Cross, the Civil Defence, the Fire Department and several
municipalities and Prefectures. The MOH DIPLASEDE convened the meeting
and was the leading coordinating party, with PAHO support.
Annex 5 includes the Agendas of the national workshops and Annex 6 includes
the lists of participants.
These are some of the conclusions reached regarding these national
workshops:

All trainers had been previously trained during the training for trainers
workshops organized in Pereira and Ambato. The success of the strategy of
using trainers as multiplying agents was obvious; the relevance and
soundness of the training material developed was equally appreciated.
Training was extended to a third day. The four workshops included a brief
introduction to DIPECHO and its activities as well as a presentation on the
volcanoes situation in each country. Formal presentations were always
supplemented with working groups discussions.

The workshops were based on the contents of the Guide on Health
Preparedness in Volcanic Eruptions, which were enlarged and enriched with
the experience of the local health staff and information regarding specific
threats (e.g. in Pasto, the influence zone of the Galeras volcano; In Ambato,
the activity of volcanoes Tungurahua or Reventador).

The workshop provided input that helped the health sector in developing,
updating, or readjusting contingency plans for volcanic eruptions, by
promoting participation and information exchange on experiences. Different
risk scenario situations were examined on the basis of a case study at
municipal level.

The multiplying effect was achieved regarding training, the technical guides
and, particularly preparedness work and contingency plans. Requests
received in June and July might help illustrate such impact:
-
-
The Sucumbios Provincial Health Directorate has requested support in
the organization of a workshop with the health team of the Reventador
Operational Unit.
The Chimborazo Health Directorate has submitted a similar request to
organize two workshops: in Penipe-Guano and in Riobamba.
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-
-
The Ecuadorian Red Cross has requested 25 Guides for its provincial
and cantonal chapters.
The Rumiñahui municipality has requested Guides to organize
community workshops.
The Latacunga Hospital is organizing an internal training workshop
based on the contents of the technical guides.
The Quito Metropolitan District has organized a two day workshop based
on the Guides content, on July 14-15.
The National Civil Defence Board has requested copies of the Guide for
distribution in the Sucumbios and Napo Provinces.
In Pasto, the Departmental Health Institute continues providing training
with the technical guides and will carry out a sumulation exercise in
October, using the Project’s software.
The Geophysical Institute of the Polytechnic School of Ecuador is using
the Guide in its training activities.
UN officials who visited in June high-risk areas exposed to an eruption of
the Reventador volcano, found that the Guide on Health Preparedness in
Volcanic Eruptions was used at the Baeza Hospital to review and update
the emergency plan.
Annex 13 contains several letters submitted to PAHO requesting copies
of Guide and support to hold workshops.
R3





Design and development of a multimedia simulation based on an
emergency scenario of a volcanic eruption, and focused on the
decision-making responsibilities of the EOC. The simulation will
involve a scenario in which health aspects are the priority,
however with interaction and collaboration with other sectors.
Conduct a workshop with a total of 10 experts from both countries
to analyze and validate the technical training material.
Final production and reproduction in CD format of 2000 copies of
the multimedia simulation.
Development of a collection of reference documents for health
aspects of volcanic eruptions in electronic format: selection of
relevant material, digitalization, design and production of a CD
with 100-125 documents in total).
Production, reproduction and dissemination of 2000 copies of the
CD of reference documents.
The development of the simulation materials is being carried out in the
following five stages:
1.
2.
3.
4.
5.
Design and development of the technical script;
Validation of the script;
Development of the simulation software;
Evaluation of the software program;
Final production and distribution of the software.
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At this time, the first two stages have been completed and the third is being
initiated. The following explains in greater detail the accomplishments thus far.
A. A consultant from Colombia was contracted to prepare the simulation
manual.
B. A workshop was convened in Ecuador to share the work plan with different
organizations (see Annex 5) and to receive comments and suggestions.
C. The guide was developed with three complementary components: creation
of scenarios (simulation of volcanic events in the context of a defined
territory), technical component (geologic and volcanic aspects of the
exercise); operational component (management of an emergency by an
Emergency Operations Centre, team work, and decision-making).
The consultant has made a detailed analysis of technical and operational
information on the performance of emergency response systems in Ecuador
and Colombia, with an emphasis on the health sector.
Analysis of the technical component: Bibliographic review of the scientific
basis for volcanic eruptions; analysis of events in Ecuador and Colombia;
interviews and ongoing consultation with personnel specializing in the
volcanic hazards in both countries.
The following institutions have participated in analysis of the technical
component of the simulation:
 Instituto Geofísico (Geophysical Institute) of Ecuador;
 INGEOMINAS of Colombia (Caldas and Bogotá branches);
 Regional Autonomous Corporation of Quindío.
Analysis of the operational component: Review of the disaster prevention
and response systems of Ecuador and Colombia; analysis of response to
volcanic events; interviews with personnel from the disaster prevention and
response systems in both countries; collection of information regarding the
health sector’s response to volcanic emergencies; review of PAHO/WHO
publications related to response to volcanic emergencies and the
development of simulation exercises.
The following institutions have participated in the analysis of the
operational component of the simulation exercises:
 National Civil Defence System of Ecuador (Quito headquarters);
 Ecuadorian Red Cross;
 Colombian Red Cross;
 Health Secretariat of Armenia (Colombia);
 Health Network of Armenia (Colombia);
 Ministry of Health of Ecuador;
 Local Disaster Prevention and Response Committee of Armenia
(Colombia).
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Creation of scenarios: The following institutions participated in and
evaluated the creation of theoretical volcanic events in a defined territorial
context:







National Civil Defence System of Ecuador (Quito headquarters);
Ecuadorian Red Cross;
Colombian Red Cross;
Health Secretariat of Armenia (Colombia);
Health Network of Armenia (Colombia);
Ministry of Health of Ecuador;
Local Disaster Prevention and Response Committee of Armenia
(Colombia);
 Pan American Health Organization.
D. An evaluation workshop for the script was held in Quito on 30 and 31
August (see Annex 5) to present and analyze the three components. The
documents were modified in accordance with recommendations made at the
workshop.
E. Development of the software was initiated as a result of the Letter of
Agreement signed with the Ecuadorian Headquarters of the Technological
Institute of Mexico. Evaluation of the Ecuadorian and Colombian
educational software market showed that the Technological Institute of
Monterrey is an excellent partner due to its extensive experience in
developing software and educational programs using current technology. A
four-month development period was planned, but because of the complexity
of the product, the work of the Technological Institute may be delayed. In
this case, we would have to request ECHO to approve an extension of one
or two months for this phase of activities. We expect to know the actual time
for completion of the software at the beginning of December.
F. Evaluation of the software will take place during the second week of
January 2005 in Colombia and Ecuador. Training will take place in February
and March.
G. Reference documents and publications on public health and volcanoes have
been selected for inclusion on a CD. Production will be completed at the
beginning of December 2004.
It is estimated that some 50% of the development of the simulation has been
completed, complying with 90% of the schedule activities in the first six
months (see Action Plan table). There is a small delay (less than one month)
in the development of the software which we hope to correct in the next
three months in order to make it available by 15 January 2005.
Activities completed as of May 30, 2005
A. The simulation module development:
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The script, considered as the main element in this kind of software
development, was prepared by experts in disasters and volcanoes, and duly
takes into account all technical variables and elements required for optimum
dynamics in order to ensure participation, motivation and even entertainment
of the users group.
PAHO had to suspend and was forced to rescind on February 28 th, 2005 the
contract signed with the Monterrey Technological Institute for non-compliance
with the deadlines and product specifications as required. In was a frustrating
and unexpected outcome in dealing with a private institution renowned for
technical excellence and client service. Under the contract (entered into and
signed by TEC’s local headquarters in Quito), the TEC’s Multimedia
Development Department in Toluca (México) was to develop the product. PAHO
and TEC representatives met in person on several occasions, conducted
scores of virtual meetings and exchanged hundred of e-mails.
TECs non-compliance in delivering the product was the main cause for the
delay in this software development which was finally produced by two
Ecuadorian companies that under a strategic alliance decided to combine their
expertise in programming and multimedia design. The final product complies
with the technical specifications required, was produced within budget, and
was successfully used in the training provided as planned.
The director of the Ecuadorian Geophysical Institute helped in the final finetuning of the script.
Compared with traditional simulation models, this multimedia software offers
several advantages that increase its potential for training purposes. The
computers, the interface and its multimedia elements (with video images, radio
files, pictures, written reports and support documents) are combined to provide
the user with a full immersion experience and facilitate motivation with its
participatory and interactive format.
The software design allows exercises with groups of 20-25 people who act as
EOC (EOC-Health) representatives and work on line in a network of 8 or 9
computers making decisions and solving problems generated by a volcanic
crisis.
With no exposure to real life risks, participants have to manage and interpret a
significant amount of (quantitative and qualitative) information, assess the
consequences of their own decisions, negotiate, argue, face multiple
uncertainties derived from the far from complete understanding of the
situation, their colleagues actions and decisions taken by other institutions
participating in the exercise.
The programme uses free software and allows changes and adaptations. For
the time being, technical requirements are quite stringent: installation requires
a computer network with dedicated server, which means it is not a product
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designed for individual or self-training purposes. It also requires control and
follow-up by somebody well acquainted with the software’s characteristics.
These reasons have so far inhibited massive reproduction of the software. On
July 2005 PAHO entered into a second contract (unrelated to the DIPECHO
Project) to incorporate most of the recommendations and readjustments
requested in different training activities. The second version will be used in
September during a workshop to be organized in Nicaragua for Central America
and in other national workshops in Colombia and Ecuador. A demo simulation
will also be featured at the International Congress on Cities and Volcanoes,
which will take place in Quito, on January 2006.
Multimedia simulation interface screens
B . Conduct two workshops (one in each country) with participants selected
from 25 EOCs (in each country) at the sub-national and municipal levels,
applying the simulation methodology.
The two training workshops for EOCs-Health took place on the first week of
June 2005. In Ecuador (Quito, 2-3 June) participants included provincial health
directors and other MOH staff members, Red Cross relief coordinators, Civil
Defence officials, MIDUVI representatives and participants from other local
institutions. There was general surprise and interest from participants who had
no previous experience in computer sumulation exercises. Several participants
considered this a “valuable, innovative and high quality activity to address
EOC issues” that “could be implemented throughout the country and should
be enlarged to include not only an EOC-Health perspective but rather have a
comprehensive approach useful to all EOC member institutions”
In Colombia, the workshop was organized in Pereira, in cooperation with the
Alma Mater Universities Network. It followed the same Agenda and
methodology used in Ecuador with slight changes introduced to speed up the
hands on experience with the tool. Though technical specifications for the
computer systems to be used were submitted in due time to the University,
problems appeared because there was no such compliance.
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As far as preparedness is concerned, thanks to the sumulation tool and the
training exercise participants gain a better understanding about volcanic
activity, the characteristics of this threat and its health impact as well as an
insight into the complexity of decision–making processes at EOC-Health level,
they learn about the importance of coordination and early communication
within and between sectors. The creation of EOCs-Health is promoted as a key
instrument in disaster preparedness and management. Players realize in “real
life” the importance of setting up and keeping up to date a situation room that
provides information and analytical support to EOC members in their decisionmaking process. Through the script and the different exercise activities,
participants learn to address response priorities: i.a. health services,
sanitation, environmental health, victims care, logistics, external/foreign aid,
communication.
At the end of the exercise, participants collectively asses those in charge of
carrying out assessments, observers and other players. Most of the 50
participants who attended the two workshops organized in Colombia and
Ecuador, mentioned that it was an intense and fruitful learning experience and
that the sumulation exercise was useful in putting to a test their technical
expertise, their decision-making skills, and their teamwork potential in rather
uncertain and stressful situations. The also assessed the script, the software
and the methodology. The results of these assessments are been examined
and systematized in order to modify and readjust a second version of the tool
that will be used in Central America during the third quarter of the current year.
The following are some of the most significant comments or recommendations
included in the simulation workshops:
-
-
-
-
Both the tool and the exercise succeed in forging an important link
between Vulcanology and Health in order to strengthen disaster
preparedness.
It enables adequate levels of communication between the different
groups and improves coordination and organization within and between
institutions.
Both the scrip and the programme need to be readjusted in order to
avoid participants dispersion or lack if interest at different moments.
The instructions need to be improved in order to ensure fast and
adequate understanding of the user’s interface.
The programme is an excellent pedagogical tool to train people with no
previous knowledge about disasters. The exercise prompts self-criticism
and reflection.
It was recommended that national agencies (MOH, Civil Defence) should
implement a training programme with the sumulation software and,
furthermore, that they should have permanent fully equipped facilities to
develop the sumulation exercise.
D. Development of a collection of reference documents for health aspects of
volcanic eruptions in electronic format.
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Information was selected by a disasters expert. CRID digitally loaded all the
documents and produced the CD with its own resources. PAHO reproduced
(2,000 copies) and distributed the CD with the Project’s resources.
The CD features 130 full text documents organized by thematic categories
related to health: i.e. health services, damages assessment, mental health,
environmental health, communication and epidemiological surveillance. It
contains a good selection of internet links to enable navigation. The
information
is
also
available
at
CRID’s
web
page:
www.crid.or.cr/crid/MiniKitVolcanicEruptions/kit_erupcionesvolcanicas.html
CD with information on health
and volcanoes
R5



Production of a promotional pamphlet and distribution of 2000
copies of the same.
Co-organize and participate in the DIPECHO national seminar in
Ecuador; participate in the regional DIPECHO seminar.
Organize the national DIPECHO seminar in Colombia in
collaboration with the ECHO office in Quito and other DIPECHO
implementing partners in Colombia.
Visibility of the Project has been taken into account since its inception. A
summary of the Project was written in Spanish and has been distributed to all
of the participating individuals and/or organizations (more than 120 persons
have already received a copy).
Two large banners have been prepared and are being displayed at all of the
meetings and workshops associated with the Project (a colour image is
included in Annex 6).
A promotional brochure is being prepared, and it will begin to be distributed at
the evaluation workshop in Colombia on 26 and 27 October 2004.
PAHO has participated in the two workshops organized by the ECHO Office in
Quito that were convened in Colombia and Ecuador to present DIPECHO
projects.
Activities completed as of May 30, 2005
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A. The following visibility and promotion actions have been undertaken within
the Project:

All training activities were identified with “banners” that clearly stated
the name of activity and mentioned ECHO support. Annexes 15 and 16

A standardized design was applied to all training materials and activities.

Two posters with legends in English were presented during the World
Conference on Disasters Reduction, in Kobe, Japan. An additional poster
in Spanish was produced for the Regional DIPECHO workshop in Manta,
Ecuador, organized in June 2005.

A dissemination brochure was prepared with information on activities
and products developed. Annex 16 includes a digital image of the
brochure and visibility materials.

Information regarding the Project was published in news and leading
articles of disasters-related magazines, bulletins, and web pages. Three
examples of such publications are included in Annex 11.
B. DIPECHO Workshops

PAHO organized the Colombian Workshop in cooperation with the Spanish
Red Cross, together with the Colombian Red Cross and the National
Directorate for Disaster Prevention and Response. The meeting took place
at the Colombian Red Cross headquarters with excellent attendance of
national sectors and agencies. PAHO supported the participation of 8
members of the health sector, some of them from Caldas, Risaralda and
Quindio.
A document reflecting national priorities, recommendations and proposals for
the IV DIPECHO Plan for the Andean countries emerged from that meeting.

PAHO actively cooperated with NGOs that were implementing projects in
Ecuador in the planning and organizational phases of the DIPECHO Workshop.
This resulted in a country document (prepared by a risk management expert)
that portrays an excellent summary of Ecuador’s situation regarding disasters
and risks management. This document was of paramount importance in
guiding discussions and generating conclusions during the workshop. PAHO
supported the participation of 8 representatives of the health sector, Quito’s
municipality, MIDUVI and PAHO/WHO.
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Project’s brochure and poster
Conclusion
The activities developed and contacts maintained with a large number of
organizations and experts demonstrate and reconfirm the need for these
special training materials, particularly at the local and provincial levels.
Colombia, with the recent eruption of the Galeras Volcano, has again felt the
need to have updated preparedness and response plans. Ecuador continues to
live in a latent emergency situation because of the activity of its volcanoes.
This demonstrates the relevance and timeliness of the programmed activities.
Regarding the current process, we would like to highlight:

The open and participative approach to the development of the training
materials, with a large number of organizations from a variety of sectors
from national, departmental, provincial, and local levels.
 The interaction and collaboration with other DIPECHO Projects;
 Existing interest in simulation as a training tool, which introduces an
innovative method for working with Emergency Operations Committees.
The challenge is to achieve the correct balance between the
technologically complex, the practical, and the pedagogical aspects of
this device.
The original time-frame is being maintained, but it may be necessary to extend
the period by one or two months owing to the complexity of developing the
simulation software. The precise time-frame for completion of the software will
be known at the beginning of December, when a formal request for extension
will be made to ECHO, if necessary.
Conclusions

The work plan was implemented within the Project’s time schedule,
including the additional two months extension granted by ECHO. The last
two workshops were slightly delayed until the first weeks in June due to the
unstable domestic political situation and the local health professionals
(physicians) strike which lasted for more than two months and brought
most health services almost to a standstill. Nonetheless, there was no
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administrative impact for the Project in the use of available funds during the
approved period

In general, all activities were welcomed with significant openness and
interest by participant organizations and beneficiaries alike. A contributing
factor to be noted was the real volcanic eruption threat due to an increased
activity of several volcanoes in the area during the Project’s implementation
(particularly volcanoes Reventador in Ecuador and Galeras in Colombia).
This reconfirmed the relevance and need of training activities and actions to
create and rise awareness regarding the importance of plans of action and
preparedness measures.

The future sustainability of the Project’s activities is assured in different
fronts. Activities have always been implemented, in both countries, in close
cooperation with health organizations and stakeholders that have the
leading responsibility in disaster preparedness and response. Furthermore,
one of PAHO’s priorities in the Region is to support and provide follow-up to
disaster preparedness initiatives; its Country Offices and the Regional
Programme maintain permanent working relations with the MOHs and other
stakeholders in the health sector. The training material produced during the
Project –and which can be considered as one of its most important resultswill be still promoted and disseminated throughout the region. There will be
a second edition of the simulator which will continue to be used in training
and conscience awareness activities in countries exposed to high risks of
volcanic eruptions in Latin America.

Finally, we include herewith a number of conclusions and lessons learnt
that reflect the views and analysis of local stakeholders involved in the
implementation of the Project’s activities:
 The Project’s single-threat approach enabled an intense and extremely
focussed work within and between sectors and multiple disciplines (thus
avoiding dispersion), with extremely high responsiveness and participation
of institutions and experts from both countries.
 This effort resulted in significant interaction and exchange of experiences,
analysis, and visions on scientific, academic and operational matters
between the two countries.
 On the basis of the training contents and issues examined, participant
sectors and organizations have been able to standardize concepts,
approaches and working tools for disaster preparedness in volcanic
eruptions.
 In both countries, the health sector has been able to consolidate its position
and strengthen its role in disaster preparedness planning and organization.
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 General agreement has emerged on the convenience of comparative studies
and analysis between different countries that face similar threats and risk
levels.
 There is the need to further the development of training activities with a
multiplying effect (training of trainers) to ensure appropriation of the
process by local experts and professionals.
 Cooperation with universities contributes to the incorporation of
preparedness issues in local frameworks and to the sustainability of
training activities.
 Sumulation exercises have contributed to further consolidate the concept of
health EOCs and their working dynamics, highlighting the need for such
committees at different geopolitical level (particularly at national and
provincial level). Notwithstanding this, there is the need to continue working
on and promoting the creation and strengthening of such bodies.
 There is the need to promote the development of an increased number of
tools to improve information systems and the use of new technologies.
DIPECHO projects provide an excellent platform for further work in the
Andean Region on the analysis, production and dissemination of technical
information on risk management.
4.10. Work plan

The materials for the training module on health preparedness in
volcanic eruptions will be produced, with different supplementary
thematic components, in several formats and with various teaching
aids to enable different training strategies. Among the different topics,
particular emphasis will be given to damages and needs assessment,
epidemiological surveillance, environmental health and drinking water
systems, communications, mental health and basic mitigation actions
in health services. As far as teaching tools are concerned,
complementary materials will be developed to be used with different
training strategies and audiences (basic guide, audiovisual support
material, multimedia sumulation, and technical reference and
consultation material). The Project foresees a material validation
process by the technical staff of the affected countries who will be
both actors and users.

The second component involves a training strategy with two
objectives: “training for trainers” in health preparedness for volcanic
eruptions; and training to strengthen the technical capacity of
existing Emergency Operation Committees (EOC) with respect to
health. Both components will make use of the training material
developed and will be geared towards individuals selected for
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previous experience and training sufficient to fulfil the necessary
functions.
The advantages and large possibilities offered by modern technology will be
fully exploited to develop user-friendly multimedia tools adapted to local
conditions. One of the main instruments will be the development of a
multimedia sumulation tool which will be available in CD ROM and the
Internet for training exercises that will stimulate decision-making practices.
4.11. Monitoring and evaluation
4.11.1. Monitoring
Monitoring will be done by a PAHO project coordinator based on the
activities schedule. Every technical material will be evaluated during
training activities. Every training session will be evaluated by the
participants.
4.11.2.Evaluation
 Is an evaluation foreseen during the action?
Yes X
No 
(Trainees’ evaluation of the “train the trainers” program)
 Is an evaluation foreseen after the action?
Yes X
No 
5.
RISKS AND ASSUMPTIONS
5.1.
Pre-conditions
The Project will work with two countries in which the socio-political
situation is very unstable, and unforeseen aggravation of the situation in
either country may, by necessity, lead to a change in national priorities
as well as the priorities of the national health ministries and the direct
beneficiaries of the Project. Such changes could potentially affect
planned training activities, the validation of materials developed, and/or
their production.
Similarly, a major disaster would result in a change of focus of activities
on the part of partner agencies/centers.
Finally, the turnover of technical personnel in disaster-related
institutions could cause a delay in the production or validation of
materials, or the planned training strategy.
If the total budget is not approved, completion of all planned activities
may be affected
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There are neither internal nor external factors that have changed the
development of the activities at this time. The team is working in
accordance with the original plan.
In Ecuador, the internal political upheaval during the months of March
and April, compounded by the local health professionals (physicians)
strike which lasted for more than two months and brought most health
services almost to a standstill, slightly altered the original dates foreseen
for some of the training workshops and had an impact on the attendance
of health sector participants to one of them (Ambato, April 19 and 20).
This caused a slight delay in the following workshops dates. The last two
workshops took place on the first week of June 2005.
5.2.
5.3.
Assumptions and risk assessment profile
For the development of project activities, standard United Nations norms
and guidelines will be followed, particularly in high-risk areas with
respect to travel, meetings, and the organization of training activities.
Security
5.3.1. Situation in the field
Special security precautions are necessary, given the conflict situation in
Colombia. There are also a number of Ecuadorian provinces in which
the United Nations has activated security restrictions to guarantee the
highest possible degree of security. In both countries, PAHO has offices
and national security advisers. Following the UN procedures, PAHO will
adopt all the necessary security precautions to avoid risk in both
countries, particularly in Colombia.
5.3.2. Have you established a specific security protocol for this action?
Yes X
No

Standard procedures
X
If yes please elaborate: U.N. procedures
5.3.3. Have you a specific plan for security-related and medical evacuations
for this action?
Yes X
No

Standard procedures
X
If yes please elaborate: U.N. procedures
5.3.4. Are your field staff and expatriates informed of and trained in these
procedures?
Yes
X
No

6.
RESOURCES REQUIRED
6.1.
6.2.
Total budget (point 11.1.) EURO 252,476
Human resources
6.2.1. Staff included in Title 01 of the budget: Goods and services delivered to
the beneficiaries
 Number of staff: 2 persons
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
Status
1 Expatriate Staff: Project Manager
1 Local Staff: Training Materials and Communications Assistant
 Functions
Project Manager: coordinate the organization, execution and
evaluation of all activities; supervise the management of the
project; prepare the narrative reports and guarantee follow up with
ECHO on management issues.
Training materials and communications assistant: Collaborate in
the development of all training materials, coordinating with all
parties (writers, editors, designers, publishers), ensuring quality,
and timeliness of these materials. Developing a plan for a
promotional campaign to disseminate the material and increase
awareness of Project activities.
6.2.2. Staff included in Title 02: Support costs
 Number of staff: 1 person
 Status: Local Staff: Administrative assistant
 Function: Carry out all administrative and financial duties
required by the project. Prepare the financial report for ECHO,
in coordination with the Project Manager.
6.3. Material resources
6.3.1. Equipment: 2 laptops and one printer
6.3.2. Goods
6.3.3. If the action requires the purchase of medicines and/or medical
equipment: Who certifies and validates the supplier and how is it
done?
7.
PERSPECTIVES OF THE INTERNATIONAL ORGANISATION IN TERMS OF
LINKING RELIEF, REHABILITATION AND DEVELOPMENT
7.1.
7.2.
This (or similar) action is under way since N/A
Describe the expected level of sustainability
The most important product of this proposal is the creation of updated
training material, which will maintain its relevance for several years and
continue to be utilized by health personnel in the two Project countries,
as well as others. Moreover, PAHO´s commitment to training and the
strengthening of institutions has been renewed in its Strategic Plan for
2003-2007, which emphasizes technical cooperation as one of its 11 chief
priorities.
National authorities responsible for disaster management exist in both
countries and their local representatives’ capacity at municipal (parish)
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level will be strengthened. The selected areas are so vulnerable to
natural hazards that the interest of authorities can be almost guaranteed.
In addition to that, PAHO has a long-standing working relationship with
Ministries of Health, Red Cross, Civil Defence and other response
agencies who are all involved in the health sector response to disasters.
The future sustainability of the Project’s activities is assured in different
fronts. Activities have always been implemented, in both countries, in
close cooperation with health organizations and stakeholders that have
the leading responsibility in disaster preparedness and response.
Furthermore, one of PAHO’s priorities in the Region is to support and
provide follow-up to disaster preparedness initiatives; its Country Offices
and the Regional Programme maintain permanent working relations with
the MOHs and other stakeholders in the health sector. The training
material produced during the Project –and which can be considered as
one of its most important results- will be still promoted and disseminated
throughout the region. There will be a second edition of the simulator
which will continue to be used in training and conscience awareness
activities in countries exposed to high risks of volcanic eruptions in
Latin America.
7.3.
Continuum strategy
This training module should be viewed as a best practice and replicated
in other countries for other hazards. The material created will continue to
be promoted and utilized independently of the designated project period.
All field work will be done with local counterparts and local authorities
will be trained and involved to ensure follow-up and transfer of
experiences to other areas.
8.
MAINSTREAMING
The proposed project activities are very much in accordance with the
strategies and activities that PAHO develops in the region to improve the
state of preparedness and reduce the vulnerability of the poorest and
most vulnerable populations in case of a disasters. This in turn
contributes to the reduction of the number of victims and material
damage which could have a long-term impact on the development of
these populations.
This project is extremely relevant in that it strengthens the health sector
of particularly vulnerable areas in Ecuador and Colombia. Project
activities are consistent with improving the state of community
preparedness by strengthening the capacity of the health sector to
prepare for and respond to disasters.
Additionally, this experience may be replicated in similar areas in other
countries, with an expanded number of communities and beneficiaries.
Finally, the long-term results achieved through this project will be a
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reduction of the number of victims and material damages caused by
volcanic eruptions in Latin American and Caribbean countries.
9.
VISIBILITY PLAN AND COMMUNICATION STRATEGY
The production of the proposed materials will be accompanied by a
dissemination and promotion plan:
four web pages hosted by
PAHO/WHO, the web page of the CRID (Regional Center for Disaster
Information), the Disaster Bulletin: Preparedness and Mitigation in the
Americas (with more than 27,000 subscribers), the PAHO/WHO training
materials catalogue, and a special pamphlet dedicated to the promotion
of the use of these materials in high-risk areas.
Additionally, the dissemination and promotion plan will include a uniform
design, recognizing the participation of ECHO, for all of the materials
produced by the Project.
PAHO staff will participate in national DIPECHO seminars in Ecuador and
Colombia as well as at regional seminars to present the conclusions of
the project. PAHO is also willing to collaborate in the organization of the
national seminar in Colombia.
As described under section 4.9 (Activities) communications and visibility
actions were a constant element during the Project’s implementation in
order to disseminate information on the Project’s activities and material
developed as well as ECHO support.
10.
FIELD
COORDINATION,
CONTRACTORS
IMPLEMENTING
PARTNERS
AND
10.1. National and local authorities
All of the materials will be developed in cooperation with technical
personnel of the relevant health ministries, offices of the Civil Defense,
NGOs involved in disaster preparedness, and universities of the two
countries selected. Specifically, the ministries of health in Ecuador and
Colombia will be involved in the selection of the areas to use the training
materials, through their local representatives.
10.2. Field co-ordination fora
10.3. Implementing partner(s)
10.3.1. Name and address of implementing partner(s)
Ministries of Health in Ecuador and Colombia will be involved in the
selection of the areas to use the training materials, through their local
representatives.
National Societies of the Red Cross in Colombia and Ecuador will
participate in the validation of the training materials and in the retraining
activities.
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Public or private universities will collaborate in the design, production
and validation of the materials.
NGOs (like COOPI Ecuador, OXFAN Colombia, etc.) and other national
and international organizations will be involved in the validation and
testing of the materials.
PAHO will establish contracts with universities and NGOs for the
development of the training materials such as the Instituto de Estudios
de Salud in Medellín and the NGO “Pájara Pinta” in Ecuador. Before the
starting of the project, a final evaluation to select the partners will take
place in Ecuador and Colombia. PAHO will share this evaluation with
ECHO before April 30 2004.
10.3.2.
10.3.3.
Role of implementing partner(s) in this action
Type of relationship with implementing partner(s)
Ecuador and Colombia are Member Governments of the Pan American
Health Organization. The Minister of Health of both countries is the
nations’ official representative to all PAHO meetings. Therefore, all
project activities will be carried out in consultation with the Ministries of
Health and others health sector actors.
10.3.4.
10.3.5.
History of previous collaboration with implementing partner(s)
Name and title of the person(s) authorised to represent the
implementing partner(s) with regard to this agreement.
10.4. Contractor(s) and procedure envisaged for the award of contracts
10.4.1. Name and address of contractor(s)
10.4.2. Role of contractor(s) in implementing this action
10.4.3 Describe the selection procedure (tender) of the contractor(s).
11.
FINANCIAL INFORMATION
11.1. Total budget of the action:
11.2. Contribution requested from European Community:
Percentage of the total amount:
11.3. Co-financing:
11.3.1. Indicate your own contribution:
11.4.1. Contributions by other donors:
Name:
11.4. Pre-financing requested from European Community:
Percentage of the total EC contribution:
11.5. Eligibility of expenditures, date
(4.3.)
Start date of the action 30 March 2004
… EUR 252,476
… EUR 206 ,000
… %81,60
… EUR
… EUR 46,476
… EUR
….EUR 164,800
… %80
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11.5.1.
If the action has already started explain the reason that justifies that
situation:
 Primary emergency operation

 Emergency operation

 Other

Please elaborate:
11.5.2. If the eligibility date of expenditure precedes the start date of the
action please justify this request.
12.
ADMINISTRATIVE INFORMATION
12.1. Humanitarian organisation’s official name, address, phone/fax n°
Pan American Health Organization, 525 Twenty-third
Washington, D.C. 20037 ph: 202-974-3434; fax: 202-775-4578
St.
N.W.,
12.2. ECHO FPA number, (if applicable)
12.3. Name and title of legal representative Dr. Mirta Roses, Director
12.4. Name, telephone, fax and e-mail of desk officer at HQ Dr. Jean Luc
Poncelet, poncelej@paho.org; ph: 202-974-3434; fax: 202-775-4578
12.5. Name, telephone, fax and e-mail of the representative in the country of
implementation Ricardo Perez, rperez@ecu.ops-oms.org; fax: (59-32) 2256174; ph: (59-32) 246-0277
12.6. Bank account
Riggs National Bank
Washington, D.C. (ABA) 054000030
Pan American Sanitary Bureau
A/C 04-07-080-437
Swift: RIGGS US 33
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13. CONCLUSIONS AND INTERNATIONAL ORGANISATION’S COMMENTS
This Project was conceived of to synthesize and make use of a large
body of accumulated experience in the region with respect to volcanic
eruptions through the creation of up-to-date training material that brings
together diverse areas in which the greatest weaknesses of the health
sector have been identified. Moreover, the material will be produced
taking advantage of new information and communication technologies
for their production and dissemination - above all for use in training
activities.
The development of training materials is an activity that requires
continuity, innovation and creativity in order to guarantee that nations
and localities produce new disaster preparedness plans and to continue
strengthening technical capacity and policies aimed at reducing the
negative impacts of disasters on the most vulnerable populations
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