Towards Broadening the Scope of Disaster Risk Reduction: An Exploration of How Epidemic and Pandemic Preparedness is Currently Embedded Within Existing Disaster Risk Reduction Planning in Sri Lanka

Abstract

COVID-19 has illustrated the systemic nature of risk by not only dismantling the health, social and economic aspects of a system but by also giving rise to compound vulnerabilities, particularly in the event of other hazards that occur in parallel with the pandemic situation. Therefore, the United Nations Office for Disaster Risk Reduction [UNDRR] in its Engagement Strategy for COVID-19 Interim Report has stressed on the need for integrating biological hazards into Disaster Risk Reduction [DRR] planning and institutional mechanisms while fostering stronger collaboration between health and DRR authorities. This paper examines the extent to which epidemic and pandemic preparedness has been embedded within existing DRR Planning in Sri Lanka, particularly highlighting the current status and gaps. For the purpose of this study, a thorough review of existing literature on preparedness planning for biological hazards and DRR efforts in the country was carried out referring to policy and legal documents, national and international reports, scholarly articles and internet sources. Further, semi-structured, in-depth interviews were conducted with nineteen purposively selected key informants from the disaster management and health sectors of the country. Results show although ‘epidemics’ have been included in the interpretation of the term ‘disaster’ in Sri Lanka Disaster Management Act No. 13 of 2005, preparedness planning for biological hazards is a predominantly health-sector process the primary responsibility of which is vested with the Director General of Health Services of the Ministry of Health and Indigenous Medical Services. Biological hazards been taken into account in national level DRR policing and planning in the country. Further, even though sub-national level DRR plans have largely overlooked biological hazards, attention has been paid to the epidemic of Dengue in certain districts. Nevertheless, the following gaps remain unaddressed: (1) lack of attention paid to biological hazards in executing DRR programs; (2) lack of technical knowledge regarding biological hazards among disaster management authorities; (3) minimal collaboration between disaster management and health authorities at a planning/decision making level and (4) limited indication of preparedness planning for biological hazards being mainstreamed into sub-national level DRR activities. The study depicts that while there’s ample room for integrating preparedness planning for biological hazards into DRR planning in the country, such integration requires a legal framework that advocates a multi-hazard and multi-sectoral approach to DRR.

Annexures

Interview Guide

A Representative from the Disaster Management Centre [DMC]

• 1. Was the DMC involved in planning and/or responding to COVID19? What was that involvement? Was that involvement adequate?

• 2. To what extent is epidemic and pandemic preparedness currently embedded within existing disaster risk reduction planning?

• 3. Who is responsible for this aspect of national disaster risk reduction and planning? What actions and measures [in relation to both disaster response and Disaster Mitigation] have been taken in this regard? [Eg: Have response teams been assigned? Have risk and vulnerability assessments been conducted? Have actions been taken to include epidemics and pandemics in future risk profiling activities?]

• 4. What are the governance structures associated with the epidemic and pandemic preparedness planning including response measures at the national and local levels?

• 5. The Sri Lanka Disaster Management Act No. 13 of 2005 sets out provisions for the formulation of Provincial, District, Divisional and Grama Niladhari level disaster management plans. Have these sub-national level disaster management plans been formulated? To what extent has any form of pandemic and epidemic preparedness (including Dengue Outbreaks) been included in these plans?

• 6. The Sri Lanka Disaster Management Act No. 13 of 2005 sets out provisions for the establishment of Provincial, District, Divisional and Grama Niladhari level disaster management committees. Have these sub-national level committees been established? If so, what actions have these committees taken with the guidance of the DMC in relation to pandemic and epidemic preparedness?

• 7. What national level exercises does the country participate in with regard to epidemics and pandemics? Is there a epidemic and pandemic related drill like in the case of Tsunami? Is the debriefing adequate and lessons learned?

• 8. The National Disaster Management plan sets out the requirement for Disaster Mitigation Action plans to be developed at sub-national levels [including provincial, district, divisional and Grama Niladhari levels?]. Have these plans been formulated? If so, to what extent has preparedness for biological hazards like epidemics and pandemics been included in these plans?

• 9. A project proposal for an ‘Integrated Epidemic Risk Assessment’ was put forward in the Ministry of Disaster Management’s publication: ‘Towards a Safer Sri Lanka: Road Map for Disaster Risk Management’. Has this project been implemented?

• 10. In the COVID-19 pandemic situation in the country, did the DMC collaborate with the newly established Presidential Task force in providing the grant of Rs. 5000 to economically vulnerable groups?

• 11. Why wasn’t the NDRSC involved in providing relief services during the COVID-19 pandemic situation in the country? Can the current services provided and allocations of the NDRSC be used to address the cascading impacts of epidemics and pandemics? Have actions been taken to formulate an OP for the NDRSC to follow in the event of an epidemic or pandemic?

• 12. Are there any other authorities assigned to deal with the social and economic impacts (the cascading impacts) of the COVID-19 situation in Sri Lanka. If so, what are they and what actions have been taken or what plans have been formulated in this regard?

• 13. Are there any other authorities assigned to deal with the social and economic impacts of biological hazards like pandemics and epidemics [including Dengue and Malaria] in Sri Lanka? If so, what are they ad what actions have been taken and what plans have been formulated in this regard?

• 14. At the national level, what criteria/parameter used in issuing the epidemic and pandemic warning including pandemic response measures?

• 15. What criteria/parameter is used in deciding the issuance of epidemic and pandemic warning including pandemic response measures?

• 16. Is there a set of rules/regulations/laws/standard operating procedures (SOPs) guiding the national and local actors in:

  • (a) decision for issuing the warning

  • (b) disseminating/conveying the warning

  • (c) decision for issuing the order for pandemic response measures

  • (d) Disseminating/conveying the order for pandemic warning including pandemic response measures

    Please specify these rules/regulations/laws, SOPs.

• 17. Is the above mentioned set of rules/regulations/laws/SOPs the same across all the national institutions involved in the process? If not, please specify the different rules/regulations/laws that apply to specific institutions.

• 18. Do current early warning systems address epidemics and pandemics? Who are the authorities and stakeholders involved in issuing and disseminating early warning regarding epidemics and pandemics at the national and sub-national levels?

• 19. What is the process followed in issuing and disseminating early warning regarding pandemics and epidemics from the national to sub-national levels? What formal and informal communication channels are employed to disseminate warnings and response? How effective are these formal and informal communication channels? How is noise in communication filtered?

• 20. What are the spatial and socio-cultural aspects involved in the decision making structure within the pandemic early warning system?

  • (a) National Level

  • (b) Local Level

  • (c) Please specify whether they act as strengths, weaknesses or challenges within the interface.

• 21. What sort of gaps (if any) do you see within the epidemics and pandemics early warning systems?

• 22. What existing early warning infrastructure could be used to strengthen preparedness planning for epidemics and pandemics?

• 23. Are the needs to vulnerable groups identified in your preparedness planning? How do you identify vulnerable groups? Have vulnerable populations undergone preparedness training?

• 24. Is epidemics and pandemics preparedness mainstreamed in the school curriculum? Elementary? Secondary? Higher?

Interview Guide

District Secretaries from Selected Districts

• 1. Has a disaster management plan been formulated for your district? To what extent has this plan taken epidemic and pandemic preparedness into consideration?

• 2. Has a disaster management committee been appointed for your district? Who is involved in this committee? What actions have been taken by this committee with regard to any form of pandemic or epidemic preparedness [including Dengue outbreaks]?

• 3. Have you formulated any disaster mitigation action plans under the guidance of the DMC? If so, to what extent has preparedness for biological hazards like epidemics and pandemics been included in these plans?

• 4. What role did you play during the COVID-19 pandemic situation in Sri Lanka? Under whose purview did you act in this situation [who gave the orders?]? With what organizations did you collaborate in this situation?

• 5. Who were the main stakeholders [in the health sector and other sectors] involved in dealing with the COVID-19 pandemic situation in your district? What role did they play and under whose purview did they act?

• 6. What were the issues/challenges you faced in dealing with the COVID-19 pandemic situation in your district? How did you overcome these issues/challenges?

• 7. Have risk and vulnerability assessments been conducted for any kind of epidemic or pandemic [including Dengue and Malaria] in your area? If so, with what national level organizations did you collaborate with in this process?

• 8. Do you maintain a close link with the District General Hospital and other district level health authorities [Eg: Regional Director of Health Services]? What actions have you performed with regard to preventing and planning for epidemics [including and Dengue and Malaria] and pandemics in collaboration with these authorities?

• 9. Did you collaborate with the District General Hospital and other district level health authorities [Eg: Regional Director of Health Services] during the COVID-19 pandemic situation? If so, what actions did you perform?

• 10. From whom do you receive early warning messages regarding the onset of an epidemic or pandemic [including Dengue and Malaria outbreaks]?

• 11. Who is involved in disseminating Early Warning regarding pandemics and epidemics [including Dengue and Malaria outbreaks] at the district level? How do you coordinate and collaborate with these institutions and parties in the Early Warning dissemination process? How do early warning messages in this context flow to divisional and GN levels? What are the formal and informal communication methods/tools used in this process?

• 12. Who was involved in disseminating early warning and other communications during the COVID-19 pandemic situation in your district? How did you coordinate and collaborate with these institutions and parties in the early warning dissemination process? How did early warning and other communications flow to divisional and GN levels? What were the formal and informal communication methods/tools used in this process?

• 13. Were you involved in granting Rs. 5000 to economically vulnerable groups during the COVID-19 pandemic situation? If so, what role did you play? With what national level organizations did you collaborate with in this process? With what divisional and GN level organizations did you collaborate in this process? Under whose purview did you act?

• 14. What role do you play in providing post-disaster relief services? Under whose purview do you act? With what national level organizations do you collaborate in this process? With what divisional and GN organizations do you collaborate with in this process?

Interview Guide

Divisional Secretaries of Selected Divisional Secretariat Divisions

• 1. Has a disaster management plan been formulated for your Divisional Secretariat Division [DSD]? To what extent has this plan taken epidemic and pandemic preparedness into consideration?

• 2. Has a disaster management committee been appointed for your [DSD]? Who is involved in this committee? What actions have been taken by this committee with regard to any form of pandemic or epidemic preparedness [including Dengue outbreaks]?

• 3. Have you formulated any disaster mitigation action plans under the guidance of the DMC? If so, to what extent has preparedness for biological hazards like epidemics and pandemics been included in these plans?

• 4. What role did you play during the COVID-19 pandemic situation in Sri Lanka? Under whose purview did you act in this situation [who gave the orders?]? With what organizations did you collaborate in this situation?

• 5. Who were the main stakeholders [in the health sector and other sectors] involved in dealing with the COVID-19 pandemic situation in your DSD? What role did they play and under whose purview did they act?

• 6. What were the issues/challenges you faced in dealing with the COVID-19 pandemic situation in your DSD? How did you overcome these issues/challenges?

• 7. Have risk and vulnerability assessments been conducted for any kind of epidemic or pandemic [including Dengue and Malaria] in your area? If so, with what organizations did you collaborate with in this process?

• 8. Do you maintain a close link with the Divisional General Hospital and other divisional level health authorities [Eg: MOHs]? What actions have you performed with regard to preventing and planning for epidemics [including and Dengue and Malaria] and pandemics in collaboration with these authorities?

• 9. Did you collaborate with the Divisional General Hospital and other divisional level health authorities [Eg: MOHS] during the COVID-19 pandemic situation? If so, what actions did you perform?

• 10. From whom do you receive early warning messages regarding the onset of an epidemic or pandemic [including Dengue and Malaria outbreaks]?

• 11. Who is involved in disseminating Early Warning regarding pandemics and epidemics [including Dengue and Malaria outbreaks] at the DSD level? How do you coordinate and collaborate with these institutions and parties in the Early Warning dissemination process? How do early warning messages in this context flow to GN levels? What are the formal and informal communication methods and tools used in this process?

• 12. Who was involved in disseminating early warning and other communications during the COVID-19 pandemic situation in your DSD? How did you coordinate and collaborate with these institutions and parties in the early warning dissemination process? How did early warning and other communications flow to GN levels? What were the formal and informal communication methods and tools used in this process?

• 13. Were you involved in granting Rs. 5000 to economically vulnerable groups during the COVID-19 pandemic situation? If so, what role did you play? With what district level organizations did you collaborate with in this process? With what divisional and GN level organizations did you collaborate in this process? Under whose purview did you act?

• 14. What role do you play in providing post-disaster relief services? Under whose purview do you act? With what organizations do you collaborate with in this process?

Interview Guide

Grama Niladhari Officers from Selected GN Divisions

• 1. Has a disaster management plan been formulated for your Grama Niladhari Division [GN Division]? To what extent has this plan taken epidemic and pandemic preparedness into consideration?

• 2. Has a disaster management committee been appointed for your GN Division? Who is involved in this committee? What actions have been taken by this committee with regard to any form of pandemic or epidemic preparedness [including Dengue outbreaks]?

• 3. Have you formulated any disaster mitigation action plans under the guidance of the DMC? If so, to what extent has preparedness for biological hazards like epidemics and pandemics [including Dengue and Malaria outbreaks] been included in these plans?

• 4. What role did you play during the COVID-19 pandemic situation in Sri Lanka? Under whose purview did you act in this situation [who gave the orders?]? With what organizations did you collaborate in this situation?

• 5. Who were the main stakeholders [in the health sector and other sectors] involved in dealing with the COVID-19 pandemic situation in your GN Division? What role did they play and under whose purview did they act?

• 6. What were the issues/challenges you faced in dealing with the COVID-19 pandemic situation in your GN Division? How did you overcome these issues/challenges?

• 7. Have risk and vulnerability assessments been conducted for any kind of epidemic or pandemic [including Dengue and Malaria] in your area? If so, with what organizations did you collaborate with in this process?

• 8. Do you maintain a close link with the local level health authorities [Eg: PHIS]? What actions have you performed with regard to preventing and planning for epidemics [including and Dengue and Malaria] and pandemics in collaboration with these authorities?

• 9. Did you collaborate with the local level health authorities [Eg: PHIs] during the COVID-19 pandemic situation? If so, what actions did you perform?

• 10. From whom do you receive early warning messages regarding the onset of an epidemic or pandemic [including Dengue and Malaria outbreaks]?

• 11. Who is involved in disseminating Early Warning regarding pandemics and epidemics [including Dengue and Malaria outbreaks] at the GN level? How do you coordinate and collaborate with these institutions and parties in the Early Warning dissemination process? What informal and formal communication tools/methods do you use to disseminate early warning messages to the community?

• 12. Who was involved in disseminating early warning and other communications during the COVID-19 pandemic situation in your GN division? How did you coordinate and collaborate with these institutions and parties in the early warning dissemination process? What informal and formal communication methods were used to disseminate early warning and other messages to the community?

• 13. Were you involved in granting Rs. 5000 to economically vulnerable groups during the COVID-19 pandemic situation? If so, what role did you play? With what divisional level organizations did you collaborate with in this process? Under whose purview did you act?

• 14. What role do you play in providing post-disaster relief services? Under whose purview do you act? With what organizations do you collaborate with in this process?

Interview Guide

Representatives from NGOs, INGOs and International Organizations

• 1. Have you been involved in responding to the COVID-19 pandemic situation in Sri Lanka? If so, please explain the role you played.

• 2. With what government sector organizations [both national and sub- national level] did you collaborate in responding to the COVID-19 pandemic situation in Sri Lanka?

• 3. What challenges/issues did you face in responding to the COVID-19 pandemic situation in the country? How did you overcome these issues/challenges?

• 4. How were the vulnerable groups identified in targeting your interventions? What criteria did you use to identify these vulnerable groups?

• 5. How did you adjust your global response measures to COVID-19 to suit the local context of Sri lanka? What were the factors you were most sensitive to in this regard?

• 6. Have you executed programs or interventions to facilitate preparedness for, prevention and/or mitigation of other biological hazards (Eg: Dengue and Malaria) in Sri lanka? If so, with what government authorities/organizations (both national and sub national level) did you collaborate in executing these programs?

Interview Guide

Assistant Directors—District Disaster Management Coordinating Units of Selected Districts

• 1. Has a disaster management plan been formulated for your district? To what extent has this plan taken epidemic and pandemic preparedness into consideration?

• 2. Has a disaster management committee been appointed for your district? Who is involved in this committee? What actions have been taken by this committee with regard to any form of pandemic or epidemic preparedness [including Dengue outbreaks]? How have you coordinated with divisional and GN level Disaster Management Committees in carrying out these activities?

• 3. Have you formulated any disaster mitigation action plans under the guidance of the DMC? If so, to what extent has preparedness for biological hazards like epidemics and pandemics been included in these plans?

• 4. What role did you play during the COVID-19 pandemic situation in Sri Lanka? Under whose purview did you act in this situation [who gave the orders?]? With what organizations did you collaborate in this situation?

• 5. Who were the main stakeholders [in the health sector and other sectors] involved in dealing with the COVID-19 pandemic situation in your district? What role did they play and under whose purview did they act?

• 6. What were the issues/challenges you faced in dealing with the COVID-19 pandemic situation in your district? How did you overcome these issues/challenges?

• 7. Have risk and vulnerability assessments been conducted for any kind of epidemic or pandemic [including Dengue and Malaria] in your area? If so, with what national level organizations did you collaborate with in this process?

• 8. Do you maintain a close link with the District General Hospital and other district level health authorities [Eg: Regional Director of Health Services]? What actions have you performed with regard to preventing and planning for epidemics [including and Dengue and Malaria] and pandemics in collaboration with these authorities?

• 9. Did you collaborate with the District General Hospital and other district level health authorities [Eg: Regional Director of Health Services] during the COVID-19 pandemic situation? If so, what actions did you perform?

• 10. From whom do you receive early warning messages regarding the onset of an epidemic or pandemic [including Dengue and Malaria outbreaks]?

• 11. Who is involved in disseminating Early Warning regarding pandemics and epidemics [including Dengue and Malaria outbreaks] at the district level? How do you coordinate and collaborate with these institutions and parties in the Early Warning dissemination process? How do early warning messages in this context flow to divisional and GN levels? What are the formal and informal communication methods/tools used in this process?

• 12. Who was involved in disseminating early warning and other communications during the COVID-19 pandemic situation in your district? How did you coordinate and collaborate with these institutions and parties in the early warning dissemination process? How did early warning and other communications flow to divisional and GN levels? What were the formal and informal communication methods/tools used in this process?

• 13. How prepared are you to face a landslide that occurs during the COVID-19 pandemic situation in the country? What actions have you taken in this regard?

• 14. Have you taken into consideration the COVID-19 pandemic situation and its effects in your preparations for the South West monsoon?

Interview Guide

Representatives from the Disaster Preparedness and Response Division [DPRD]; Quarantine Unit; Health Promotion Bureau; College of Community Physicians and the Dengue Prevention Unit

• 1. Is epidemic/pandemic preparedness currently embedded within existing disaster risk reduction planning?

• 2. What is the role of your organization towards epidemic and pandemic preparedness planning in Sri Lanka?

• 3. What are the legal provisions which define your role in epidemic and pandemic preparedness planning?

• 4. In what level of administration (National, provincial, local), your organization involved in epidemic and pandemic preparedness planning?

• 5. Who are the stakeholders in epidemic/pandemic preparedness connects with your organization (National governing bodies, Ministries engaged in the process, Disaster Management Center, Public Health Authorities, Tri-forces, NGO/INGOs)?

• 6. How does your organization connect with the other stakeholders of epidemic and pandemic preparedness planning?

• 7. How the potential cascading impacts are addressed in your process of epidemic and pandemic preparedness planning?

• 8. Are there already developed SOPs/ guidelines/ circulars etc. to be followed by your organization? If yes what are they? If no, what are the underlying reasons?

• 9. Are the above mentioned SOPs/ guidelines/ circulars etc. in effect same across all the administration levels?

• 10. What is the level of involvement of the Public Health Authorities in the process of epidemic/pandemic preparedness?

• 11. What are the public health authorities involved in epidemic/pandemic preparedness planning?

• 12. How effective is the coordination between the Public Health Authorities?

• 13. Are the needs of vulnerable groups identified in your preparedness planning? How do you identify vulnerable groups? Have vulnerable populations undergone preparedness training?

• 14. How is your preparedness towards the sudden outbreaks of diseases with unknown sources?

• 15. Have you/your organization been involved in planning and/or developing strategies to respond in COVID19? What was that involvement? Was that involvement adequate?

• 16. Is the role of your organization in epidemic and pandemic response, pre-defined? If yes where it is defined and what is the role?

• 17. Who are the stakeholders coordinating with your organization in the phase of epidemic/pandemic response?

• 18. How do you coordinate with the other stakeholders in the phase of the epidemic/pandemic response?

• 19. Does your organization have the authority to generate early warning messages? If no, who is the responsible authority?

• 20. Does your organization have the authority to disseminate early warning messages? If no, who is the responsible authority?

• 21. How does your organization connect with the existing national early warning system?

• 22. What sorts of gaps (if any) do you see within the epidemics and pandemics early warning systems?

• 23. How the existing early warning systems for epidemic and pandemic can be strengthened?

• 24. What are the other information have to add more than what you have mentioned earlier?