Written by Abigail Trewin AM, Director Strategy, Reform and Transition
In November 2022, a collaboration between the Republic of Indonesia and the World Health Organization (WHO) led to the establishment of a multi-country training hub in Indonesia. The hub focuses on operational readiness for health emergencies and the deployment of Emergency Medical Teams (EMTs). It aims to enhance preparedness capacity for Indonesia and other participating nations, ensuring a swift and effective response to emergencies.
The training hub, spanning multiple countries, facilitates access to supplementary training modules including simulation exercises. The curriculum covers critical areas such as public health emergency management, medical and logistical operations, and the impact of emergencies on medical, social and economic aspects.
In October 2023, the NCCTRC Director Strategy, Reform and Transition, Mrs Abi Trewin, and Director Intergovernmental Relations, Ms Meredith Neilson, attended the WHO EMT Coordination Cell (CC) Training in Indonesia. The EMTCC training was for experienced emergency medical staff in the WHO South East Asia Region.
Attendees came from many countries in the region including Indonesia, Sri Lanka, the Maldives, India and Nepal. The training was hosted by the Republic of Indonesia Defence University’s (RIDU) Multi-Country Training Hub for Health Emergency Operational Readiness (MULTHEOR) in Bogor, West Java, Indonesia with faculty from the WHO EMT sector.
Professor Prof. Dr. apt. Yahdiana Harahap, M.S., Rector of RIDU and Chair of the WHO-MULTHEOR, invited NCCTRC representatives to attend the training.
What is an EMTCC?
The EMTCC is activated to support the Ministry of Health (MoH) after a disaster. It fits within the incident command structure of the MoH or national authority, coordinating national and international EMTs. Its purpose is to facilitate the integration of these teams into both disaster response and established health systems. While the EMTCC collaborates with various stakeholders to address the population's needs, it is crucial to note that the MoH or national authority retains the primary responsibility for coordination, and the EMTCC follows their directives to bridge the gap.
An EMTCC utilises a specific incident management structure and system. Training provides students with understanding of this system and the key responsibilities of the EMTCC once activated. The size of the EMTCC varies depending on the size and breadth of the response. One of the key issues is ensuring the availability of trained personnel ready to deploy in support of establishing an EMTCC. This can be challenging, particularly when the EMTCC is likely to operate in high-risk environments as seen during responses to conflict situations.
The NCCTRC has delivered two EMTCC training courses previously, and has a number of AUSMAT members trained for response.
The Australian Government provided support to the WHO for an EMTCC in response to the Ukraine crisis in 2022 with the deployment of AUSMAT Logistics Lead Mr Terry Trewin. Prior to this, AUSMAT Clinical Lead Ms Angie Jackson contributed for a number of months to the management of the EMTCC in Cox’s Bazar in response to the Bangladesh diphtheria outbreak.
There were also excellent examples of an EMTCC in the field during the Indonesian Sulawesi earthquake and tsunami response. Ministry officials, the Indonesian Military and WHO colleagues created a comprehensive incident management team within Palu city that tracked health assets, personnel and responding agencies. This supported an early decision to decline extensive offers of assistance from EMT’s globally as they could identify the need and the allocated assets of response to the impacted population.
An EMTCC that is deployed needs to be aware of the critical functions that happen at each stage of the EMTCC life cycle. While the operational phase may seem like the priority, preparing for transition to the host authorities and deactivating the EMTCC is as big a role as activating. Ensuring that all teams that deploy have met the obligations of the response by submitting reports, copies of patient records to the health authorities and exit summaries is critical. Coordination is needed to ensure that there is a plan to manage patients and rehabilitation long after the EMT’s have deactivated.
AUSMAT played a critical role in developing a medium to long term follow up plan during the 2019 Samoan Measles outbreak. The AUSMAT Public Health team worked collaboratively with the Samoan Public Health team to identify children with likely long-term challenges from their infection to ensure that the MoH could activate additional support and seek assistance for the increased health requirements of this population. This information gathering supported the coordination planning at both the Ministry and the EMTCC activated during this response.
The RIDU's MULTHEOR, established in collaboration with the WHO, is a significant step in enhancing global preparedness for health emergencies. This initiative aims to strengthen the capacity of participating nations, particularly Indonesia, to respond swiftly and effectively to emergencies.
The role of the EMTCC is pivotal in supporting the MoH post-disaster. It operates within the incident command structure of the MoH, coordinating national and international EMTs. While the EMTCC collaborates with various stakeholders, the MoH retains primary coordination responsibility.
In navigating the complexities of health emergencies, ongoing collaboration, training, and preparedness remain essential. These efforts not only contribute to effective immediate responses but also establish frameworks for sustained support and rehabilitation, ensuring a comprehensive approach to global health challenges.
Abigail Trewin AM
Director Strategy, Reform and Transition
Abigail Trewin's career spans various domains within Paramedicine, disaster management and emergency response. As a registered Intensive Care Paramedic for 15 years. She has since assumed key roles in Government Health Departments for over a decade. Her responsibilities encompass interpreting and operationalising global health standards for the Australian government's disaster response capabilities. She has led collaboration with Ministries of Health in multiple countries, including Indonesia, Fiji, Thailand, and South Korea, to apply WHO global emergency health standards. She is a WHO mentor, trainer and EMT verification member Working for the WHO in Geneva 2018 as the senior technical officer of the Emergency Medical Team program. Abigail was instrumental in developing the Australian training program for a multidisciplinary healthcare workforce responding to Disasters . In her operational roles, Abigail has responded to numerous large-scale Australian Government disaster healthcare responses, Pakistan floods in 2010, Philippines Typhoon Haiyan, AUSMAT Mission Lead for multidisciplinary healthcare teams in Fiji Cyclone Winston, Samoa Measles outbreak, Aged Care Crisis and Artania vessel crisis. Her experience included managing infectious disease responses and establishing and running Australia's first Quarantine facility, The Centre for National Resilience in 2020 through to June 2021, supporting 6000 returning Australians. She was also an Executive Director and State Health Command for the quarantine program run by the Victorian Government, overseeing and effectively managing the care and well-being of over 10,000 quarantined individuals distributed across 15 sites and a workforce of 3,000 dedicated staff.