 When Typhoon Yolanda hit the Philippines on November 8, 2013, the ground zero was the Cloven City in Leyte. Parts of the Philippines that were hit were the islands of Samar, Leyte, and Panay. In that particular context, we wanted to have an emergency planning for the different LGUs that were affected by Typhoon Hayan. This is to improve their local health systems to withstand other incoming disasters that will hit the Philippines in the future. So based on what happened in Hayan, we wanted to interview the different LGU members as to what lessons can be learned from the experience of Typhoon Hayan. And these are the take home messages that were found based on what we did in the start taking activities in the different LGUs. Most of the LGUs actually did not have a health emergency personnel in charge of disaster management. The local response in each of the LGU were very feeble, very uncoordinated, ineffective, and very inefficient. And most of the human resources capabilities to prepare and respond to the disaster were very insufficient. Therefore, majority of LGUs that were most affected by Hayan did not have a health emergency preparedness response and rehabilitation plan, or if they had one was not very useful. So what is the HEP-RRP plan? It's called the Health Emergency Preparedness Response and Rehabilitation Plan. It is the key to disaster preparedness and it is also the main part of the disaster risk reduction and management plan of the different LGUs. What is the project logic? So we want to reduce the health outcomes, adverse health outcomes during disasters in order to do that, we want to capacitate the different LGUs in preparing their health emergency plans. Who are the partners that we have in this particular project? Number one, we would like to emphasize that three UP campuses are involved, UP College of Public Health under UP Manila, the School for Health Sciences in Palo, and the University of the Philippines, Visayas based in Miagao. We also have several NGO partners, particularly UNICEF, who funded most of the program and Medicos Del Mundo, who was an NGO based in Tacloban that is in charge of disaster planning within the region. We also had one partner, which is an SUC, Bicol University, another international partner, Queensland University, and another NGO, CNET, PSR, which is in charge of psychosocial processing. The Department of Health, the National Office, is a main partner together with one bureau of the DOH, which is the Health Emergency Management System. This is the project profile. There are 50 LGUs that are involved in six provinces and three regions. And there are 10 partner organizations from government, academe, civil society, and even other members of the stakeholders within the LGUs. There are 50 priority LGUs, 19 from Iloilo, 12 from Samar, and 19 from Leyte. UPV is in charge of Iloilo, ZFF or Swillig Family Foundation is in charge of Samar, and UP School of Health Sciences is in charge in Leyte. This is called an evidence-based planning for resilient health systems. We have advisors that act as the technical partner. We have CNET, PSR, Bicol University, the University of Queensland, and UP Manila College of Public Health. And then there are three academic partners, UP Visayas, Swillig Family Foundation, and the School of Health Sciences in Palo. So the technical aspect of the training, it was the University of Queensland who did the technical aspect in cooperation with Bicol University. Swillig Family Foundation, UP Manila, and UP Visayas were the ones who facilitated and coordinated with the different LGUs to use what the schedule and what the format of the module will be. The UP Visayas Rebap Team, as we call it, is also very multidisciplinary. I had the project in UP Visayas, and my line of expertise is in biology and public health. We have Professor Mary Anna Raghdao who is also in biology and public health. We have one social scientist, a social psychologist, we have Dr. Calvin Delisres who is at PhD in international health, and Professor John Revgiliaran who is trained in clinical psychology. We also have three research assistants, Ms. Mikey Canunero, Mr. Darryl Ferrer, and Ms. Dorothy Sarangaya. The model for this particular module is the WHO Six Building Blocks of Resilient Health Systems, namely leadership and governance, human resources, medicines and technology, financing, medical or health informatics, and service delivery. In order to achieve this, we must link this particular Six Building Blocks with the different components of a health emergency plan. The different components of HEP-RRP are mental health and psychosocial services, wash, water, sanitation and hygiene, manchan or maternal and child health and nutrition, infectious diseases and non-communicable diseases. So in this next picture, we see how the six pillars of the WHO links with Kalasugang Pangkalatan or universal health care so that eventually we would have better health outcomes during and after the disaster. The package of intervention for the different partners involves three modules, psychosocial processing for trainers, training of trainers one and training of trainers two. The package of intervention for the planners composts of five modules. We have psychosocial processing for planners, a basic health emergency course run by DOH and the College of Public Health, two planning workshops that try to devise different strategies for health emergencies and lastly coaching and mentoring during the visits of the different faculty members to the different LGUs. What is the roadmap? So we have a social prep part in the module. We go to the different mayors and different planners in order to engage them to participate in the program. We have the PSP the basic health emergency management system, the two planning workshops and the coaching and mentoring. So in order to do and have a stronger buy-in in the different stakeholders we engage the mayors the municipal health officers and the ones in charge of disaster planning within the LGU. We engage them by talking to them and presenting the plan so that they can participate and know the deliverables during the part of the training. We prepared the different LGUs to have assignments so that they are assigned each building block and each municipality should be able to present their different strategies per building block. So there was also two planning workshops for adult learning and the planners were trained in the different parts of the module. We also involved the students of the BS Public Health of UP Visayas so that they were involved in both the planning, the encoding of the different data and facilitating the different workshops. We also did and this is very important a one-on-one coaching with the different LGUs. In this particular example we had coaching with the LGUs in Sibu are the municipalities of Bantayan and the Anbantayan. One thing that we noticed during the coaching and during the workshop itself is that the planners weren't able to write cohesively what their health emergency plan is. So we also engaged them additionally, plus the two working workshops with the two-day live-in write shop for both Ilo Ilo and Capis LGUs to finalize their health emergency plan. We also did and in this case a very special methodology coaching and mentoring. So we went to each of the LGUs and taught them and advised them if the strategies they are trying to come up with are really applicable in their particular municipality in the context of a particular disaster happening in that LGU. I would like to make an example on the municipality of Concepcion which is located on the northern part of the island of Panay in the Visayas which is region 6. It is composed of different island barangays they call it JIDA or Geographically Isolated and Disadvantage areas. Some of the island barangays can only be reached by 2-3 hours of ferry ride and so their local health system is quite challenging. For example, a pregnant woman during a disaster might deliver and there are no birthing facilities within the island and they have to travel several kilometers to the mainland in order to address the health needs of that particular patient. This is the picture of the municipality of Concepcion pre-Hayan and then Hayan happened and this is now what Concepcion looks like after Typhoon Hayan. There was grave destruction within the municipality and the hardest hits were the island barangays away from the population. There were numerous patients that were brought to the rural health unit and the rural health unit was not capacitated in terms of addressing the health needs of those who were affected by the disasters. The part of the municipality of Concepcion that was really affected was the rural health unit. It was deluged by several patients and the RHU itself cannot handle the sheer volume of the number of patients taking consultation after the disaster. Thus, there is really a need for a health emergency plan for the municipality to develop in order to cope with the next disaster that is going to hit the municipality. So for example, we would like to highlight some of the strategies that the municipality of Concepcion came up with in terms of incorporating these particular strategies in their health emergency plan. For example, they strengthened the municipal DRRMC and their baranggay disaster coordinating council and put this into law. So the Sangguniang bayan passed several ordinances strengthening the councils that are responsible for disaster management. They also established and even equipped their municipal disaster risk management office and even passed budget in order to increase the staffing through a municipal ordinance. In order to address the lack of health human resources during disasters, they also increased the number of health staff that are going to man the health disaster council and they also did capacity building for the different human resources involved during disaster times. They also did capacity building not only of the staff in the municipality but also capacity building for the baranggay health workers, the baranggay nutrition scholars who are involved in the nutrition of each baranggay and they also did community-based mental health training for the youth as well as for those volunteer community workers in each of the baranggay of Concepcion. One thing that we would like to highlight is the problem on pregnancy. So one of the strategies that Concepcion tried to follow is that pregnant women from outlying baranggays are taken care of and there is an exact referral system for them to be evacuated pre-disaster so that they will have safe delivery in the mainland or accredited birthing center. And of course the health emergency response team was also conducting drills with increased capacity building. There was also construction of more health centers within the municipality and other satellite birth or health centers within their island baranggays. We would also like to highlight the presence or the mechanism for Concepcion to seek help from a sister city that wasn't hit by the disaster and a sister pharmacy so that medicines can readily be available when the medicines that are stored within the municipality are going to be destroyed by the disaster. For health information networks baranggay at the municipality of Concepcion employed the CHIT system or community health information system. They also have an international health care provider or IHCP portal through PhilHealth, iClinicSys which is the system employed by DOH and an integrated TV information system or ITIS. For financing almost 100% of all the families in Concepcion are already covered by PhilHealth. Therefore when disaster strikes they are not already required to pay for the expenses incurred during the disaster. We would like to highlight also the community resilience strategies employed by Concepcion. They involve the different youth in terms of advocacy and disaster preparedness. They also trained young people as volunteers for psychological first aid to help the children. They also relocated and found housing for those members of the municipality or residents of the municipality who are in the disaster or hazardous prone areas. And they also addressed the different concerns regarding safe water during disaster by establishing bacteriologic examination of all the water sources handwashing facilities and implementation of a zero distribution policy within Concepcion. Aside from that in order to help the relocated communities that were living in the hazardous areas the municipality also help them achieve resilience by giving them livelihood project and farming equipments in order to give more support for their livelihood income. Also the approach here I must emphasize is community resilience and participatory governance so that each of the members of the municipality are trained and have a voice in terms of planning during health emergencies. And coupled with that Concepcion has already done several earthquake drills within their municipality and teamwork and leadership training within the municipality for those who are first responders during a disaster. So now we are proud to say that one of the best examples of a health emergency plan is coming from the local government of Concepcion. But there are still challenges left. Some people insist on staying at hazardous prone areas because of the fact that their livelihood is connected with where they are residing. There's also seeming lack of coordination between the municipal disaster officer and the municipal health officer. So here are the lessons learned from this particular exercise. It is better to be ready than to be sorry during the times of disaster. We must increase community awareness to increase community participation so that we become a more resilient community during disaster. We also need a very strong will in order to come up with concrete and budgeted plans for health emergencies. And lastly nothing without a budget and action within the municipality. So as of the end of 2015 we have already achieved all the health emergency plans of all 50 LGUs. So this has been approved by the local health board and approved by their different and respective Sangguniang bayan. These are the municipalities in capis and next one would be the municipalities in Cebu. So now as an output we have 50 LGUs with 50 health emergency plans and this encompasses three regions and six provinces in the Visayas. What's next for us is we're trying to achieve a national coverage of 1,400 LGUs with 1,400 HEPRR in the 18 regions and 81 provinces of the Philippines. Coupled with the training in developing the plan, we also did take forums on REBAP both in one in Iloilo City and another in Roja City. Also part of this is research and academic endeavor. We presented the paper and the results of this particular module in several conferences and we are getting ready for its publication. As an appreciation for what the different UP units achieve during the past year UNICEF gave a certificate of appreciation and a plaque of appreciation to the different UP system components. So in summary this is a public-private partnership the approach is very multidisciplinary and tri-campus that involves UP, Manila and UP Visayas. It's a community-based approach to disaster planning so that we involve community participation in coming up with the different strategies. We also use adult learning methodology in workshops and coaching and not just a lecture type of trying to train the different planners. Next we have academic presentations and research publication also as an output of this particular project. And lastly, I cannot emphasize the importance of the enhancement of our teaching content and methodology because we involve the students as well as the different faculty members handling courses in health emergency planning and to summarize this public service that is integrated both in the academic and research mandate of the University of the Philippines. So thank you very much.