Preparedness of healthcare facilities for a public health emergency in a Caribbean country

OBJECTIVE: To review basic, critical elements of emergency preparedness and response capacity in the healthcare system of Trinidad and Tobago. DESIGN AND METHODS: A descriptive study involving one major hospital and one randomly selected health centre in each Regional Health Authority (RHA). Responders were chosen by purposive sampling and structured face-to-face interviews were carried out. Data collection was undertaken using modified versions of two previously validated data collection tools. RESULTS: All 5 hospitals in each RHA and 4 of 5 health centres participated. Emergency response plans existed in all healthcare facilities reviewed; however plans were not regularly tested. An investigation team can be assembled in 24 hours and a patient referral system was in place in all hospitals. There appeared to be access to stockpiles in all facilities. There was a gap in ongoing infection control measures including the absence of regular personal protective equipment (PPE) training for staff. CONCLUSIONS: There was an urgent need for systematic rather than ad hoc measures for testing existing plans and staff training in their roles and responsibilities during an acute public health event should one occur. For infectious diseases with high case fatality rates such as avian influenza and Ebola, it is critical for front line staff to be aware of infection control measures including how to properly use PPE. Governments should take the opportunity of the Ebola outbreak in West Africa to utilize public health capacity to catalyse the systematic strengthening of core capacities for alert and response to meet their International Health Regulations (IHR) 2005 obligations.