EVALUATION OF PMI

MEDICAL ERU OPS IN

CENTRAL SULAWESI
2018-2019
BY: DEWI SITOMPUL
INDEPENDENT EVALUATION CONSULTANT
BACKGROUND

• Earthquake 7.7 Richter scale struck Central Sulawesi

• Tsunami
• Liquefaction
• 4300 fatalities
• 172. 000 people displaced
• 185 health facilities damaged
• 100.000 houses destroyed
HEALTH CONTEXT:

• Most common diseases before disasters: Palu: respiratory tract infection, gastritis, skin
allergies, high blood pressure, diarrhea, etc
• Donggala: TB, pneumonia among children, DM, leprosy, malaria
• Sigi: TB, pneumonia, leprosy, DHF, hypertension, diarrhea, malaria
• After disasters: skin diseases, diarrhea, acute respiratory diseases, hypertension, injury
• Five potential outbreaks: malaria, dengue, acute respiratory diseases and measles.
• EWARS was established under MoH to monitor 20 diseases
PMI MEDICAL ERU OPERATION:

• A total of 42 teams were deployed

• Well targeted: 1 fixed clinic in Tompe & 3 mobile clinics (1 each at Palu, Sigi and Donggala)
• 23,039 patients were treated (Oct 18-May 19)
• PMI Medical ERU is highly relevant to the needs of population
• PMI Medical ERU teams are highly praised by local health officials (Head of PHC/ District
and Provincial Health Office)
• PMI Medical ERU provided services to people who have challenges to access UHC/BPJS
post emergency period
SOME CHALLENGES:

• Disruption of services (some gaps between team arrival and departure), funding gaps
post emergency period, not all team have been trained on new M-ERU modul
• Reporting: multiple formats and lines, reporting (end of deployment, quarterly report, end
of operation report)
• Coordination: internal province based ERU & coordinator, between PMI Medical ERU and
larger PMI Operation, between PMI health & health cluster system. Between PMI Palu
and PMI NO
CHALLENGES:

• Coordination between PMI & IFRC: strong during emergency period and became less in
the recovery period, minimum contact between delegates and PMI NO technical staff
• Logistic: equipment, medicine stocks
• Technical skills: data analysis, infection & prevention control
• Exit strategy: unknown to involves parties, kept changing due to temporary PHC
completion, negotiation with local stakeholders
• Needs a comprehensive plan/ strategies: for example to cover 3 months period of
emergency
RECOMMENDATIONS:
PMI HEALTH DEPT
• Develop PMI M-ERU strategic plan : goals, strategies, success indicators, team training,
M&E plan, utilize LFA, SWOT analysis in the process
• Develop short-medium and long term plan and its benchmark to upgrade between the
current emergency clinic to field hospital. Develop SOP from the registration, to
treatments, pharmacy and exit the facilities
• Review the operational and technical guidelines: update the jobdesc i.e. team leader will
prepare end of mission report incl data analysis, guidelines is available for each
deployment, read and signed by team member
HEALTH DEPT…

• Review current training module: focus on assessment, coordination, reporting, data

analysis, infection and prevention control, minimum standard of PGI in emergencies,
EWARS mechanism, exit strategy, waste management
• Consider to remove PSP from Medical ERU team and include mental health module in
the training
• For future deployment develop 3 months POA (incl budget) and design exit strategy
from the beginning
HEALTH DEPT…

• Improve reporting: end of deployment report, quarterly report and end of operation
report-> use these as resources for future training
• Develop clear coordination and reporting lines including for financial needs (stock
replenishment: equipment and medicines)
• Form a working group to develop PMI M-ERU future plan and strategy
• Consider to develop province based M-ERU training
• Appoint PMI Bogor Hospital team as PMI M-ERU coordinator/ logistician
HEALTH DEPT…

• Participate in sister national societies M-ERU training and continue participation on EMT
network in Indonesia
• Conduct evaluation at the end of M-ERU Operation and discuss the feedback in the
working group for future improvement of the system.