BACKGROUND

The Philippines faces a challenge in addressing the mental health needs of internally displaced persons (IDPs) following disasters. The lack of an integrated mental health triage system within evacuation centers and the shortage of specialists trained in post-traumatic stress triaging have hindered effective emergency response. Existing interventions primarily focus on traditional trauma and psychiatric symptoms, often lacking standardized mental health triage classifications and leading to data gaps, complicating resource allocation decisions.

To develop a culturally relevant mental health triage system, this study proposes the "Unahon Tool" to meet the needs of Filipino IDPs. Integrating with existing medical triage protocols equips frontline responders to identify stress-related concerns, enables informed decision-making for mental health and psychosocial support (MHPSS) allocation, and optimizes resource utilization.

The study involved key informants, including disaster responders, mental health specialists, and government officials, who participated in interviews and focus group discussions. Thematic analysis was used to identify behavioral aspects affecting IDP communities. The Unahon Tool development incorporated disaster response frameworks, mental health interventions, and other existing triage tools. A red-yellow-green categorization system was employed based on the severity and urgency of observed behaviors. Stakeholder consultations and expert reviews guided tool refinement.

The final Unahon Tool includes 17 behaviors categorized into red (urgent), yellow (moderate), and green (low) severity levels. It provides corresponding recommended interventions to aid responders. During direct observations, yellow-category behaviors like shouting and cursing were prevalent. Responders focused on reminders for peace and order in response to these behaviors. The tool's "Notes" section was identified as a potential area for contextual information inclusion.

The Unahon Tool fills a crucial gap in the Philippine disaster response infrastructure by offering a behavior-based mental health triage system. It enables responders to prioritize mental health resources effectively, reducing the burden on specialists and enhancing overall disaster response effectiveness. Future directions   include expanding tool adoption beyond Metro Manila, translating it into regional languages, and developing a version for children and teenagers. Collaboration with other regions and age groups will ensure broader applicability and effectiveness in addressing mental health needs among diverse IDP populations.

On July 4, 2021, a Philippine C-130 military plane carrying 104 personnel crashed in Patikul, Sulu after attempting to land at Jolo Airport, killing 53 individuals and injuring 50 others, both on board and on the ground. Some of the injured sustained multiple injuries, including fractures and burns. This incident triggered a swift response from various agencies. Mass casualty incidents, including those with multiple burn-injured patients, pose significant challenges to health care systems and can lead to high morbidity and mortality rates.1 2 3 Burn injuries, which account for at least 200,000 deaths annually, are a major global public health issue, particularly in low-resource settings, and can easily overwhelm the limited burn resources available.4 5 6 Efficient management of mass casualty incidents, proper triage decisions, and sound health care planning are crucial for optimizing patient outcomes and matching potential needs with available resources.7 Burn mass casualty incidents (BMCI) are incidents that involve at least three burn victims. These incidents, whether due to natural or human-caused accidents, can occur anywhere and anytime. The injuries are unpredictable and involve a large number of victims, requiring a significant consumption of logistics and medical attention. Medical response tasks in massive burn injuries are much more challenging than those required in separate burn incidents due to the unexpected nature of the events and the simultaneous involvement of a large number of patients. Such situations require the immediate mobilization of a significant number of personnel, resources, and facilities to address upcoming issues. In this article, we describe the management of BMCIs based on our experiences in responding to the Patikul incident. We elucidate the strategies that are put into action and offer insights aimed at improving protocols for handling BMCIs in the future. Our goal is to contribute to the body of knowledge in this field and aid in the development of more effective responses to such critical situations.
Mass Casualty Incidents ; Burns

A burn mass casualty incident (BMCI), an incident that involves at least three burn victims with severe injuries,1 presents several unique challenges. In a mass casualty event, between 25 and 30 percent of those injured can sustain moderate-to-severe burn injuries.2 Management of burn patients necessitates a significant amount of health resources and logistical support, along with prompt and high-quality care to optimize the functional and cosmetic outcomes of severely injured patients. While some developed countries have sound disaster management plans, many countries where most BMCIs occur lack such well-established plans.3 The effective management of BMCIs is crucial for positive patient outcomes. Given resource scarcity, especially in geographically isolated and disadvantaged areas, comprehensive mitigation and preparedness strategies are essential. These strategies must address worst-case scenarios that may challenge the existing internal protocols, especially at the local level.4 The surge in health care facility capacity during BMCIs can quickly overwhelm local and regional resources, from prehospital care to specialized burn centers. In the Philippines, disaster response levels and adequacy may vary widely among different regions and local government units (LGU). While the Department of Health has issued guidelines for health emergency and disaster response management,5 there are currently no policies or guides on specifically addressing preincident planning for BMCIs. The aim of this article is to recommend policies that will potentially improve the current health care approach to BMCIs.
Mass Casualty Incidents ; Burns

A crucial lesson gained through the pandemic preparedness and response to COVID-19 is that all measures for epidemic control must be law-based. The legal system is related not only to public health emergency management per se but also to all aspects of the institutional supporting system throughout the lifecycle. Based on the lifecycle emergency management model, this article analyses the problems of the current legal system and the potential solutions. It is suggested that the lifecycle emergency management model shall be followed to establish a more comprehensive public health legal system and to gather the intelligence and consensus of experts with different expertise, including epidemiologists, sociologists, economists, jurist and others, which will collaboratively promote the science-based legislation in the field of epidemic preparedness and response for the establishment of a comprehensive legal system for public health emergency management and with Chinese characteristics.
Humans ; China ; Pandemics/prevention & control* ; Public Health ; Emergencies ; Disaster Planning

Medical supply is a key resource for responding to public health emergencies and maintaining people's lives and health. As the medical equipment management department, the medical devices department is mainly responsible for the procurement, supply, technical support, management and coordination of medical equipment and medical consumables, playing an important role in epidemic prevention and control. Through the analysis of the expansion cases of designated hospitals, the experience of emergency management of medical equipment has been accumulated, which has strong practicability and replicability.
Humans ; Public Health ; Emergencies ; Hospitals ; Epidemics

Major natural disasters seriously threaten human life and health. After earthquakes and other catastrophes, survivors are often trapped in the confined spaces caused by the collapse of ground and buildings, with relative separation from the outside world, restricted access, complex environment, and oncoming or ongoing unsafety, leading to the rescue extremely difficult. In order to save lives and improve the outcome more efficiently in the confined spaces after natural disasters, it is very important to standardize and reasonably apply the trauma assessment and first aid workflow. This study focuses on trauma assessment and first aid. From the aspects of trauma assessment, vital signs stabilization, hemostasis and bandaging, post-trauma anti-infection, and the transportation of patients, a trauma first aid work process suitable for a small space of a major natural disaster is formed, It is helpful to realize the immediate and efficient treatment of trauma in the confined spaces after natural catastrophes, to reduce the rate of death and disability and improve the outcome of patients.
Humans ; Disasters ; First Aid ; Confined Spaces ; Earthquakes

The medical emergencies during oral diagnosis and treatment needs urgent treatment. If the emergent situations are not managed immediately and correctly, the consequences may be lethal to the patients. Due to the actuality that most of the dental clinicians are insufficient in medical first aid theoretically and practically, the Society of Stomatological Emergency, Chinese Stomatological Association organized some domestic famous dental and medical experts to write the present clinical diagnosis and treatment expert consensus on the basis of repeated discussion.The consensus aims to guide the dental clinician to take correct steps in the process of chair-side first aid in case of medical emergency, so as to reduce the risks, to prevent medical emergencies and to ensure the life safety and health of patients.
Consensus ; Dental Care ; Emergencies ; First Aid ; Humans ; Oral Medicine

The development of burn units in our country is now undergoing a trend of geographic centralization and regionalization. To solve the problems like severe burn patients are too far away from burn units, overloaded operation in regional burn centers when mass burn accidents happen, and growing requirement for aeromedical transportation, etc., it is now the top priority to improve national aeromedical transportation system for burn patients. Expert teams from Chinese Burn Association, National Aeromedical Rescue Base, and China Association for Disaster & Emergency Rescue Medicine discussed and reached a consensus on the key points of aeromedical transportation of burn patients, including organizational structure, staff and materials, and three links before, during, and after aeromedical transportation. The consensus aims to provide guidance for a safe, efficient, and standardized operation of aeromedical transportation for burn patients in China.
Accidents ; Air Ambulances ; Burn Units ; Consensus ; Disasters ; Humans

In the context of public health emergencies, a Hospital used the existing SPD supply chain model as a basis, research and practice proceeded simultaneously and formed a set of "three-group three-port" emergency plan by itself. The program played a positive role and effectiveness in this emergency incident, assisting the hospital to obtain a valuable experience in closed-loop management of emergency supplies. This article elaborated on how the hospital can supply materials in case of emergency medical supplies shortage after emergencies by focusing on the three groups of closed-loop working group, inventory management group, and material procurement group, and the three ports of material storage port, logistics receiving and dispatching port, and closed-loop releasing port. In the case of emergency medical supplies being in short supply after emergencies, how can hospitals ensure adequate and balanced supply of supplies; barrier-free demand information; command and dispatch without chaos and reasonable deployment; materials receiving and dispatching are efficient and distributed in an orderly manner.
Emergencies ; Equipment and Supplies, Hospital ; Hospitals ; Humans ; Public Health

With the progress of globalization, the public health emergencies represented by major infectious diseases have become a major challenge for the public health management in China. The article briefly describes the emergency response capability assessment tools in China, and introduces two emergency response assessment tools with complete content structure and wide application in the world. Then the advantages and disadvantages of the tools are compared and discussed in order to provide reference for improvement of the assessment tools for public health emergency response capability in China.
China ; Disaster Planning ; Humans ; Public Health ; Public Health Administration