PENTINGNYA PERAN MASYARAKAT DALAM MENJALANKAN MODEL BOTTOM-UP

Perubahan internasional yang dibawa oleh globalisasi telah membawa perubahan dalam pengelolaan hubungan antara pemerintah dan negara. Kemajuan teknologi komunikasi tidak hanya mendorong saling ketergantungan antar negara, tetapi juga mendorong saling ketergantungan antar kelompok dalam negeri termasuk pemerintah.Bencana dapat disebabkan oleh alam (natural disaster) atau aktivitas manusia (complex emergency).

The current pandemic, a complex emergency? Mental health impact of the COVID-19 pandemic on highly vulnerable communities in Guatemala

Background: On March 5th, Guatemala declared a ‘State of Calamity’ in response to the COVID-19 pandemic and strict lockdown measures were initiated. The psychological consequences of these measures are yet to be fully understood. There is limited research on the psychological impact of the virus in the general population, and even less focused on Latin America and high-risk communities characterized by poverty, limited mental health resources, and high rates of stigma around mental illness. The goal of this study is to examine the psychological impact of COVID-19 across several highly vulnerable districts in Guatemala. Methods: A semi-structured phone interview was conducted of 295 individuals in multiple districts in Guatemala City to assess self-perceived mental health consequences related to the pandemic. Sociodemographic, medical, and mental health data were collected. Chisquares and t-tests used for categorical and continuous variables, as appropriate, to describe the sample. Binary logistic regressions were estimated to examine associations between sociodemographic characteristics and mental health symptoms (anxiety, stress, depression, burnout, escalation of pre-existing mental health symptoms, and a sense of safety). Results: The results indicate high levels of anxiety and stress in all target communities. Significant differences based on gender, age, and the number of children in the household were identified: women and older adults experience higher rates of stress and anxiety associated with the pandemic; while families with greater number of children experience higher levels of burnout. Conclusion: Contextualizing the current pandemic as a complex emergency can help inform further studies focusing on socioeconomic challenges and higher vulnerabilities as preconditions affecting the impact of the pandemic on mental health. Given the limited available resources for mental health care in Guatemala, informal networks of care may play an important role in meeting the needs of those individuals experiencing increased psychological distress resulting from the pandemic.

Use of a Digital Cognitive Aid Improves Memorization of Military Caregivers After High-Fidelity Simulations of Combat Casualty Care

ABSTRACT Introduction High-fidelity simulation is widely used in the ongoing education of caregivers. However, the complex high-stakes simulated crisis environment affects memorization. This study investigated whether participants would remember more key training messages 3 months after a simulated complex emergency situation if they had used a digital cognitive aid (CA) during the simulations. Materials and Methods This randomized controlled trial was performed during a combat casualty training course for military physicians and nurses. Each pair of care providers completed two scenarios randomized to be undertaken either with or without a digital CA. At the end of each debriefing, instructors gave five scenario-specific key messages aloud. Three months later, learners were asked to recall the messages from their two scenarios and were scored for each scenario. The primary endpoint was the number of key messages recalled. The secondary endpoints were the influence on the results of the profession and the scenario block and age of the leader. Results Thirty-six pairs of participants were included. Due to operational constraints, only 34 completed the study. The use of the digital CA was associated with a positive effect on memorization at 3 months (F = 82.2, P < .001), unrelated to the leader’s profession, age, or the scenario block. The median of the memorization scores was 2/5 [1-3] with the digital CA and 1/5 [1-1] without it, which represents a difference of one memorized element (95% CI, 1-2; η2 = 0.39). Conclusions The digital CA allowed learners to remember twice as many key elements 3 months after simulated training of medical care for military combat casualties. A dedicated digital CA might be an asset for better care in a combat environment and for learning and memorizing critical care procedures following complex emergency situations.

Health emergency management in Aotearoa New Zealand: Making sense of professional development

Objective: To explore how health emergency management (HEM) personnel make sense of professional development, such as education and training, in their everyday roles and responsibilities within an increasingly complex emergency management and disaster field.Design: This in-depth qualitative study comprised of semistructured interviews with 10 Aotearoa New Zealand HEM personnel from a range of healthcare professions, including emergency managers, nurses, clinical support, and paramedics. The thematic, data-driven approach was exploratory. The research identified inductively significant thematic concepts relating to professional development from the health emergency personnel’s talk about their roles and responsibilities.Results: The authors identified four themes relating to professional development in the participants’ talk: test yourself under pressure; selling what we do; under the pump; and real stuff that actually makes a difference. These themes represent shared sense-making about how the participants negotiated their professional development needs and the needs of others while performing their everyday roles and responsibilities. Conclusions: Our findings support the production of local and contextually driven knowledge that highlights how HEM personnel discuss professional development as strengths, tensions, challenges, and knowledge gaps. These insights contribute to a broader understanding of what needs to be taken into account when developing competencies, skill sets, and training programs to promote professional development in an increasingly complex emergency management and disaster field.

Health emergency management in Aotearoa New Zealand: Making sense of professional development

Objective: To explore how health emergency management (HEM) personnel make sense of professional development, such as education and training, in their everyday roles and responsibilities within an increasingly complex emergency management and disaster field.Design: This in-depth qualitative study comprised of semistructured interviews with 10 Aotearoa New Zealand HEM personnel from a range of healthcare professions, including emergency managers, nurses, clinical support, and paramedics. The thematic, data-driven approach was exploratory. The research identified inductively significant thematic concepts relating to professional development from the health emergency personnel’s talk about their roles and responsibilities.Results: The authors identified four themes relating to professional development in the participants’ talk: test yourself under pressure; selling what we do; under the pump; and real stuff that actually makes a difference. These themes represent shared sense-making about how the participants negotiated their professional development needs and the needs of others while performing their everyday roles and responsibilities. Conclusions: Our findings support the production of local and contextually driven knowledge that highlights how HEM personnel discuss professional development as strengths, tensions, challenges, and knowledge gaps. These insights contribute to a broader understanding of what needs to be taken into account when developing competencies, skill sets, and training programs to promote professional development in an increasingly complex emergency management and disaster field.

ACCOUNTABILITY AND TRANSPARENCY IN THE NONPROFITS: EVIDENCES FROM ONLINE CROWDFUNDING DURING COVID-19 PANDEMIC

Through accountability, organizations provide key information for stakeholders enabling the latter to make an informed assessment of organizational performance. To achieve transparency, organizations must make information accessible and timely. During the crisis, as in the COVID-19 pandemic period, accurate accountability and transparency practices are most necessary so stakeholders can make informed decisions in an ongoing complex emergency. This study uses data available in an online crowdfunding platform to investigate to what extent are nonprofits implementing accountability and transparency policies regarding applications for funds published during the COVID-19 pandemic. A case study methodology is applied for providing evidence that nonprofits are not timely implementing transparency policies regarding fundraising campaigns. Nevertheless, results identify, in some cases, innovative accountability practices which impact funds raised must further be analyzed. These findings open up further investigations on the accountability of nonprofits during the crisis and on the online organizational transparency regarding fundraising.

Measles Outbreak in Complex Emergency: Estimating Vaccine Effectiveness and Evaluation of the Vaccination Campaign in Borno State, Nigeria, 2019

Background: From January to May 2019, large measles outbreaks affected Nigeria. Borno state was the most affected, recording 15,237 suspected cases with the state capital of Maiduguri having 1,125 cases investigated and line-listed by March 2019. In Borno state, 22 of the 27 Local Government Areas (LGAs or Districts), including 37 internally displaced persons (IDPs) camps were affected. In response to the situation, an outbreak response immunization (ORI) campaign was conducted in the 13 most affected LGAs. In addition to conventional vaccination teams, special teams were deployed in security compromised areas, areas with migrants, and for nomadic and IDPs. Here we describe the outbreak and the ORI campaign. We also assess the measles-containing vaccine (MCV) coverage and vaccine effectiveness (VE) in order to quantify the population-level impactMethods: We reviewed the ORI activities, and conducted an analysis of the surveillance and the outbreak investigation reports. We assessed VE of MCV by applying the screening-method. Sensitivity analyses were also conducted to assess the effect of final classification of cases on the VE of MCV. The MCV coverage was assessed by a post-campaign coverage survey (PCCS) after completion of the ORI through a quantitative survey in the 12 LGAs that were accessible. . Results: Of the total 15,237 reported measles cases, 2,002 cases were line-listed and investigated, and 737 were confirmed for measles by week 9 of 2019. Of the investigated cases 67.3% (n = 1,348) were between 9 and 59 months of age. Among the 737 confirmed cases, only 9% (n = 64) stated being vaccinated with at least 1 dose of MCV. The overall VE for MCV was 98.4 (95%CI: 97.8 – 98.8). No significant differences were observed in the VE estimates of lab-confirmed and epi-linked cases when compared to the original estimates. The aggregated weighted vaccination coverage was 85.7% (95% CI: 79.6 – 90.1).Conclusion: The experience in Borno demonstrates that adequate VE can be obtained in conflict-affected areas. In complex emergency affected by measles outbreaks, health authorities may consider integration with other health strategies and the engagement of security personnel as part of the ORI activities.