USAID/DCHA/OFDA Program for enhancement of emergency response: Asia region

Pursuant to the Foreign Assistance Act of 1961, as amended, the United States Government (USG), as represented by the U.S. Agency for International Development (USAID), Bureau for Democracy, Conflict and Humanitarian Assistance (DCHA), Office of U.S. Foreign Disaster Assistance (OFDA), is seeking applications from US and non-US, non-profit or for-profit, non-governmental organizations (NGOs), international organizations (IOs), and other qualified non-USG organizations to implement activities as described in the following Annual Program Statement (APS).

The purpose of this APS is to disseminate information about this activity to prospective applicants so that they may develop and submit applications for USAID funding of one cooperative agreement. This APS: (1) provides brief background concerning disaster vulnerability and program history in the selected five target countries; (2) describes the program aim, results and types of activities for which applications will be considered; (3) explains the criteria for evaluating applications; (4) describes the level of funding available and the process and requirements for submitting applications; and (5) refers prospective applicants to related documentation available on the Internet.

A. BACKGROUND

OFDA Activities in Asia

USAID/DCHA/OFDA is engaged in a wide variety of disaster mitigation, preparedness and response activities in Asia. Examples of the types of programs that OFDA has supported in Asia include: seismic retrofit demonstration; community-based disaster vulnerability assessment and mitigation planning; the development or refinement of national disaster management plans; and medical first response and search and rescue capacity building. Through ongoing collaboration with a variety of national and regional institutions, USAID/DCHA/OFDA has worked to strengthen the linkages among disaster mitigation, preparedness, response and development, thereby reducing the disaster vulnerability of communities in Asia.

A critical element of the USAID/DCHA/OFDA strategic plan is Intermediate Result 1.2: "Emergency assistance, meeting recognized standards, received by disaster victims in a timely manner." In Asia, OFDA has focussed on enhancing response capacities to ensure that appropriate emergency assistance is delivered quickly to avert further suffering and death. Most casualties from earthquakes, for example, are due to the structural failure of buildings and infrastructure. A quick and effective response can significantly reduce the loss of life and the number of serious injuries. In all mass casualties, on-site stabilization and treatment in a secure and prepared medical environment are equally critical.

Asia is one of the most disaster-prone regions in the world. Every year, Asia suffers from hydro-meteorological disasters such as typhoons and droughts. Less predictably, but more dramatically, Asia also suffers from major earthquakes. Asia's vulnerability to natural and man-made disasters is steadily increasing due to high population growth and rapid urbanization. As a result of uncontrolled population growth, construction standards have dropped and land-use planning guidelines and building codes are either not enforced or not in existence. All of these factors contribute to increased seismic vulnerability. Within the last decade India, Indonesia and the Philippines have been hit with devastating earthquakes. Nepal has a long history of destructive earthquakes and its capital, Kathmandu, is widely viewed as the world's most seismically vulnerable city because of the poor state of its building stock and the likelihood of another major earthquake.

Overview of the PEER Training Program

The Program for Enhanced Emergency Response (PEER) is a training program that was initiated by OFDA in 1998 to enhance disaster response capacities in Asia. Four countries - India, Nepal, Indonesia and the Philippines - were selected to take part in the program based on their seismic vulnerability, need for improved disaster response capacity and keen governmental and civil society interest in the program.

All of the involved countries either have prepared disaster response policies or have access to institutions that would help them to develop disaster response policies, but they do not have adequate disaster emergency response training programs. And while emergency medical response is at a different stage of development in each of the countries, none of them has a fully established emergency medical response service. For these reasons, the PEER program, which gives cursory overview of disaster response and more in-depth training in medical and search and rescue concepts and procedures, was selected as the best intervention to improve the standards of national disaster response and preparedness.

PEER is approaching the end of Stage One. During this first stage, five courses have been developed and administered several times. They are: two principal training courses (Medical First Responder and Collapsed Structure Search and Rescue) and three instructor workshops. The principal training courses are the core courses of PEER. Instructor workshops prepare instructors to teach the principal courses. All of these five courses follow participatory adult education approaches and employ an objectives-based methodology. All of these courses focus on precise life-saving skills.

In addition, one principal training course is in the process of development, the Hospital Preparedness for Emergencies (HOPE) course, and one subsidiary course is in the process of implementation, the Canine Search and Rescue (CSAR) course. This last course is being conducted for Royal Nepal Army and Nepal Police participants in response to a special request made at the beginning of the PEER program. (Follow-up visits should be conducted by a U.S.-based professional Search and Rescue [SAR] organization.)

Principal Courses

• Medical First Responder (MFR)
• Collapsed Structure Search and Rescue (CSSR)
• Hospital Preparedness for Emergencies (HOPE)

Instructor Workshops

• Training for Instructors (TFI)
• MFR Instructor's Workshop
• CSSR Instructor's Workshop

Subsidiary Course

• Canine Search and Rescue (CSAR)

To date, Stage One of PEER has accomplished the following management activities: preparation of the action plan, program administration and program implementation. This work has entailed organizing national and regional planning meetings, conducting regular communication with national agency representatives, and overseeing all coordination for the training courses and workshops, program documentation and website management. (See section F for website reference.)

The MFR and CSSR courses are adaptations of two similar courses that have been taught in the Latin American region for the past decade. In 1992, the courses were developed in response to a request for assistance by Latin American disaster preparedness and response organizations. The courses were designed to help Latin American organizations better mitigate disasters. Beginning in 1998, the MFR and CSSR courses were adapted and introduced to Asia under the PEER program.

The courses are offered in a sequence. The MFR course is offered first, followed by the CSSR course. The MFR course provides the knowledge and skills needed to assess, stabilize and transport disaster victims to a secure medical setting. It is taught at a higher level than first aid and at a lower level than paramedic or emergency medical technician, both of which are professional courses. The CSSR curriculum gives search and rescue personnel the knowledge and skills to safely search for, stabilize and extricate victims trapped in collapsed structures. It teaches how to assess collapsed structures, shore up unstable building elements and operate equipment to tunnel or break through various types of construction. Training managers and instructors can recommend graduates of the MFR course for the CSSR course based on their performance, aptitude, strength, attitude and availability.

The HOPE course is still in the design stage. It is intended to help hospital staff prepare themselves to receive disaster victims, including those victims who have been readied by emergency responders trained in MFR and CSSR. Hospitals are critical elements in the chain of response to mass casualty disasters and emergencies, but hospitals in the target countries are generally lacking in mass casualty preparedness. The HOPE course will teach hospital administrators and key hospital staff how to assess their facilities, operational programs and disaster response needs. The course goal is that hospital management teams will be sufficiently well informed to be able to design their own disaster preparedness plans. (The participants for this course will be hospital personnel, not the emergency response organization personnel who have attended the above two courses.)

TFI is a required course for becoming an instructor. It offers selected graduates of the principal courses an introduction to generic pedagogy and training concepts and exercises. After completing the TFI, selected graduates may proceed to take the MFR and/or CSSR instructor workshops.

The MFR and CSSR course reviews show that participants highly appreciate both courses and find them relevant. Only minor changes have so far been suggested for MFR. Understandably, the reviews have suggested that the CSSR course needs to be adapted to take into account prevailing building construction conditions, availability of technology (i.e., hand tools or power tools), and budgetary constraints. In the next phase, the program will help the key agencies, or the network in each country, to adapt the course to dominant national conditions without compromising the essential precepts of safety and pedagogical quality. Each country will also translate the adapted courses to their national language(s).

Standard western, copyrighted reference material was initially used for MFR and CSSR. Reference materials suitable for Asia were added, and additional Asia specific material prepared, for the MFR course. Suitable reference material for Asia needs to be added and/or prepared for the CSSR and HOPE courses.

A draft overview of the course curriculum has been designed for HOPE by Asian professionals from medical, disaster management and engineering fields with the support of a professional instructional curricula developer. The curriculum materials still need to be reviewed by hospital preparedness experts from medical, administrative and structure fields before being finalized. The HOPE course strongly emphasizes teambuilding and empowerment in the learning process. (See Section G - Annex 1.) Reference materials also need to be prepared for the HOPE course.

Instruction and Participants

A U.S.-based emergency response organization fielded teams of MFR/CSSR training experts to teach the first three MFR and CSSR courses. They also provided six full sets of MFR course equipment, one to each country plus two extras, and two full sets of CSSR equipment which have been dedicated to Nepal and Indonesia. (See Section G, Annexes 2 and 3.)

The participants for the MFR, CSSR and TFI courses were selected by their respective governments and the emergency response organizations to which they belong. The selection was based on their English language skills, potential to become good instructors and relevant skills they already possessed (where feasible, medical skills for the MFR course and engineering skills for the CSSR course). The groups that have been involved in trainings have included governmental agencies or offices, such as police, army, health department personnel, home guards and fire departments or brigades. Non-governmental agencies such as the Red Cross and ambulance and emergency response organizations have also been involved. (See matrix, Program Involvement - To Date and Planned, Section B.) While all participating organizations were selected because of their expected roles of first response in disaster or mass casualty, not all of the graduates are regularly engaged in first response activities.

Two MFR, one CSSR Instructor Workshops and five Training for Instructors Workshops were given by the U.S.-based emergency response experts. These workshops produced 12 local MFR instructors and six local CSSR instructors in each of the four countries. From these instructor batches at least six MFR instructors and several CSSR instructors qualified to become regional or master instructors.

Since late 2001, eight "national" MFR courses have been held, two in each of the four countries, with teams made up of trained national and regional instructors. At each national course, one to four regional instructors joined the national instructors, enriching the quality of course instruction and giving valuable guidance and assistance to the national instructors. Two of the expatriate MFR/SAR experts monitored each of the eight national courses, giving valuable feedback and guidance in instruction as well as being available for reference. Many more national and regional instructors will be required, initially to relieve the load on the first cadre and, further, to expand or cascade the training within the national programs.

Current Status of Training Program

While preparatory work and considerable training have been accomplished in PEER to date, other auxiliary works, plus the conducting of many more training courses remain. The completed works comprise the first stage. Applications are being sought for the second stage.

First Stage: Launching PEER

• Identification of national coordinating agencies
  
  
• Adaptation of existing MFR/CSSR training curriculum to the Asian context
  
  
• Preparation of MFR reference material suitable for Asia
  
  
• Preparation of initial cadres of novice national MFR/CSSR instructors
  
  
• Preparation of draft HOPE course material
  
  
• Appointment of a PEER program coordinator in each country

Second Stage: Establishing PEER in National Programs

• Provision of support to the development of national coordinating networks in each country
  
  
• Implementation of MFR/CSSR national training programs to end users
  
  
• New instructor preparation
  
  
• Further development of existing instructors
  
  
• Adaptation of MFR/CSSR training materials and equipment to each country
  
  
• Translation of MFR/CSSR training materials as appropriate for each country
  
  
• Translation of MFR/CSSR training materials as appropriate for each country Finalization of HOPE course materials
  
  
• Preparation of CSSR and HOPE reference material suitable for Asia
  
  
• Implementation of the HOPE course
  
  
• Expansion of the PEER program and process into northern India (2 states) and northeastern Bangladesh (one area)

B. PROGRAM AIM AND ACTIVITIES

Applications are expected to address the management, implementation, and expansion of PEER activities in the current program countries (Nepal, India, Indonesia and the Philippines). In each of these countries, most of the PEER participants have been drawn from the national capital areas. In Stage II, PEER will also be launched in Bangladesh. In Bangladesh, the program will be implemented at the district level in the seismically vulnerable northeastern region. In India, the program will continue as a national program and it will also start in two states in the seismically vulnerable northern region.

Program duration will be up to five years. (See C.2)

PROGRAM AIM

The program aims to reduce mortality in mass casualty events and increase the survival rates of disaster victims in countries involved in PEER.

The results expected in Stage Two of PEER are:

1. A functioning and sustainable network or professional association in each country that is able to implement and coordinate the courses on its own.

Note: To date, each country (except Bangladesh) has created a national provisional body, consisting of prime and partner agencies, for implementation and coordination of PEER courses. The make-up and decision-making procedures of these bodies differ in each country. Applicants must explain their approach to supporting the establishment of a permanent coordinating mechanism that develops policies and procedures and implements the program in each country. These procedures should take into consideration the level of emergency response capability available, which differs greatly among the five countries. The network or professional association should not only expand the PEER training program, but also integrate it into appropriate existing national plans or activities.

2. Additional MFR, CSSR, TFI and HOPE instructors are well prepared, and training courses are well established and operating in each country.

Note: The degree to which the applicant continues to use outside emergency response training expertise along with national novice PEER instructors may be guided by economy, quality and sustainability, as presented in the program principles, below.

3. A knowledge and skills certification procedure for MFR and CSSR proficiency is initiated in each country.

Note: Upon successful completion of content courses and instructor's workshops, each graduate receives a certificate of completion. For the graduates who go on to become active instructors or who use their new aptitude and skills regularly, their proficiency will grow. For others who use their new skills less frequently, they may require a re-certification procedure before their skills can be confidently relied upon for either instruction or emergency response. The development of national procedures is recommended.

The program will be guided by four principles.

a. A participatory approach will be used to help national networks to develop sustainability through coordination among partner agencies and collaboration with regional and international agencies.

b. Course curriculum and equipment will be adapted to host-country needs in a way that compromises neither the high standards of participatory adult learning methodology nor the quality of content. At the same time, the equipment costs must fall within national financial constraints and encourage program sustainability.

c. The program will be designed and conducted so that it can be replicated in a broad cross-section of government and civil society agencies in each country.

d. The awardee will be accountable directly to OFDA and indirectly to the host country professional organizations through regular and ongoing monitoring. The monitoring will be tied to program benchmarks that will be reviewed and approved by both the awardee and OFDA/USAID.

PROGRAM ACTIVITIES

Program activities should be specifically designed to achieve the results noted above. These activities should include the following (Note: This list is not meant to exclude additional activities that may also support the achievement of program results):

MFR and CSSR Activities:

• Identifying prime and partner agencies in Bangladesh and the two states in northern India;
  
  
• Adapting and translating existing curriculum to the national context as required for all existing and new program countries;
  
  
• Implementing (or supporting the implementation of) the full range of PEER courses in both existing and new countries;
  
  
• Coordinating with the network or professional associations in each country.
  
  
• Providing MFR and CSSR emergency response training expertise as required for either instruction or monitoring.
  
  
• Training national instructors
  
  
• Training national monitors for the development of a sustainable quality control mechanism for training;
  
  
• Providing the following equipment caches to each country. Materials may be adapted to accommodate budgetary constraints and to make use of locally available materials. Note: the full CSSR includes power equipment and the additional CCSR does not include power equipment:

  Nepal: 1 MFR, 2 additional CSSR, 1 full CSSR (already in place);

  Philippines: 6 MFR, 1 full CSSR, 5 additional CSSR;

  Indonesia: 9 MFR, 8 additional CSSR, 1 full CSSR (already in place);

  India: 12 MFR, 2 full CSSR, 10 additional CSSR.

  Bangladesh: 3 MFR, 1 full CSSR, 2 additional CSSR.
  
  

• Completing the preparation of reference materials for MFR and CSSR;

HOPE Activities

• Establishing the HOPE course and preparing instructors;
  
  
• Periodic monitoring of the development of hospital preparedness plans (structural, non-structural and staff preparedness activities).

Administrative Activities:

• Logistical support (travel, administration, etc.) for the aforementioned activities;
  
  
• Reporting, program monitoring and evaluation activities well coordinated with the OFDA Kathmandu office and TraiNet (a USAID training programs database).

Note: A preliminary estimate suggests that professional emergency response involvement may be required for the following:

• instruction provided fully by the awardee's own professional emergency response team for: 2 MFR instructor workshops, 3-4 CSSR courses and 2-3 CSSR instructor workshops;
  
  
• instruction shared by awardee's professional emergency response team and host country national PEER instructors: 14-20 MFR courses, 6-10 CSSR courses, 5-8 MFR instructor workshops and 4-7 CSSR instructor workshops;
  
  
• monitoring by awardee's professional emergency response team (1-2 persons): 16-20 national MFR courses, 10-15 national CSSR courses, 4-6 national MFR instructor workshops, 4-6 national CSSR instructor workshops.

Note: It is assumed that each of the courses either instructed or monitored by the awardee would be financed under the cooperative agreement. During the program period, host countries may also choose to conduct more courses by national instructors accredited by the program without monitoring by the awardee. In this case, and in order to maintain a degree of influence over the quality of the program, the awardee would provide nominal budget support for these additional courses. The awardee must establish a means to review the quality of these additional courses and to track their implementation.

Achievement of program results will also require the applicant to support, facilitate and promote the work of other organizations. Activities may include:

• Supporting the development of a functioning and sustainable network or professional association in each country that is able to implement and coordinate the courses on its own;
  
  
• Tracking the replication of PEER courses and their integration into the national emergency response programs;
  
  
• Collaborating in the development of instructor certification procedures;
  
  
• Supporting the establishment of coordinated information systems for collecting pertinent regional and national data; and
  
  
• Supporting the establishment of national, regional and international communication networks to exchange lessons learned.

Note: OFDA would like applicants to explain how they envision the creation of a national network of first-response agencies. A strong working relationship among these agencies will greatly facilitate their collective ability to plan for and respond to disasters. The applicants should address how they envision this network will create a multiplier or cascade effect to ensure that the courses taught in PEER are widely replicated in the countries' own programs. The applicant's process description should also address administrative and financial issues in the implementation of the above activities.

The following matrix shows where PEER has been focused to date and where the expansion is planned:

C. ADDITIONAL INFORMATION

1. Funding available:

OFDA expects to award a cooperative agreement for up to $7.5 million to support the program. Applications must address all program components and geographical areas detailed above. Awards are contingent upon availability of funds. USAID shall not be liable for any costs incurred by applicants in the preparation and submission of applications.

2. Duration:

The program shall not exceed five (5) years. The bulk of budgeted funds should be used during the first three years to accomplish required program results. As an indicator of growing program sustainability, OFDA