Hospital pharmacies’ surge capacity for disasters and Public health emergencies

Abstract

Background : Lessons learnt from worldwide disaster and public health emergencies such as the earthquake in Haiti 2011 and the 2011 flooding in Pakistani have shown that poor surge capacity increases unnecessary morbidity and mortality. Tanzania has of recent experienced a number of disasters and public health emergencies. These include the capsizing of the MV Bukoba in 1996 that killed over 1000 people, the bombing of the United States Embassy in Dar es Salaam in 1998 that killed 11, the influenza outbreak in 2009 and the recent capsizing of MV spice Islander and MV Skagit in 2012 that killed 203 and 144 people respectively. The mortality and morbidity associated with these disasters could have been minimized if the hospital emergency departments where the victims were sent were better prepared to cater for this additional workload in terms of pharmaceutical supplies, medical equipment, and personnel. The surge capacity of Hospitals emergency departments in particular the pharmacy is unknown. Study Objective: To assess hospital pharmacies’ surge capacity for disasters and public health emergencies. Methodology: A cross sectional survey of tertiary hospitals with emergency departments was conducted. Both qualitative and quantitative data collection methods were applied. Guided in-depth interviews were conducted and data was analyzed using content relation analysis. Review of important documents was also done. Results: Thirteen out of fifteen of health personnel working in tertiary health facilities could not define the term surge capacity. Only two out of the seven hospitals reported to have adequate pharmaceutical personnel and the average number of pharmacists per pharmaceutical dispensing unit was less than one. Only one of these had a special pharmaceutical dispensing unit within the emergency department. None of the health facilities had a written disaster management plan. The overall perceived role of pharmaceutical personne l in managing disasters is simply as a drug dispenser. Lack of special pharmaceutical dispensing units for emergency departments, lack of training and out of stocks are the main perceived challenges by pharmaceutical personnel when dispensing during disasters. viii Conclusion: Currently hospital pharmacies in Dar es salaam have limited surge capacity to cater for natural and manmade disasters. This is due to lack of knowledge, available pharmaceutical personnel, training, and appropriate emergency plans and protocols. In addition to this, there is negative perception of the pharmacists’ role in disaster preparedness by pharmaceutical personnel and medical officers, inactive hospital disaster management committees, lack of specialized emergency pharmaceuticals’ dispensing units as well as poor management of the scarcely available emergency pharmaceuticals. Recommendations: Ministry of Health and Social Welfare should formulate a clear plan of action to ensure skilled staff availability by facilitating schools of Pharmacy in the country to enroll more students. They should also revise their curricula accordingly to incorporate basic life saving skills. The Ministry of Health and Social Welfare (MoHSW) should conduct continuous education programs in disaster preparedness for all in service pharmaceutical personnel. The Prime Minister’s Office and Ministry of Health and Social Welfare, in collaboration with other stakeholders should prepare a set of regulations to govern the tertiary health facilities, both public and private health facilities in disaster and public health emergencies management.