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Regaining Access to Public Health after an Emergency: Training Health Workers to Address the Shift from Relief to Development

Author(s): L. E. Pacifici*1, F. Riccardo2, M. Linetti3, E. Scaroni1, L. Nardi1, A. G. De Rosa1, G. Russo2, F. Rocca1, V. Vullo2
Affiliation(s): 1International Health Cooperation and Development, Italian Red Cross, 2Infectious and Tropical Diseases, Faculty of Medicine University “La Sapienza” of Rome, 3Training Programme (ECM), Italian Ministry of Health, Rome, Italy
Keywords: Public health, emergency, training

Past experience in relief operations has taught international relief workers that the late and post emergency phases are critical moments of change in the kind of assistance and support to provide to an affected country. The needs of beneficiaries as well as of the health system shift and more articulate programmes and activities have to be put in place in order to allow access to public health and help restore damaged health systems. Although this is not a priority for many International Organizations and NGOs the Italian Red Cross works both in relief and in development and has tackled the problem of transition specifically in a 14 day course in collaboration with the Faculty of Medicine Department of Infectious and Tropical Diseases of the University “La Sapienza” of Rome and with the Training Programme of the Italian Ministry of Health (ECM). Public Health and Tropical medicine specialists from national research institutions and universities, engineers, logistic staff, psychologists as well as communication and Water and Sanitation experts were invited. Senior Staff from major international organizations and NGOs were requested to hold interactive lessons on real field situations and challenges.


To provide relief workers not only coming from medical or nursing schools but also from economy, engineering and law school backgrounds with a comprehensive training package to help them acquire knowledge on the different aspects of relief during post and late emergency phases. The topics of the course ranged from psychology and psychological support to the relevant international laws and regulations that could apply to this context such as IHL and IHR 2005, from environmental health to epidemiology and infectious disease surveillance from ethical issues to quality assurance in public health delivery. The aim was not to produce experts as each participant had his or her own area of expertise, but to offer a global picture of the multi-sector approach to humanitarian aid and of the situation they would face on the field. The training was divided in theoretical and practical modules involving role playing and a final examination.


The course was organized in Rome between the 17th of May and the 22nd of June 2007 and lasted two weeks. Of the 30 participants 17 were women (57%). 44% were medical doctors, 17% were students or “stagiaires” and 17% were members of the Italian Red Cross. Pharmacists and lawyers each accounted for 7% of participants. Upon examination of the final qualitative tests 93% considered the topics were either relevant or very relevant to their training needs and the same proportion evaluated positively the quality of teaching. All participants evaluated the course as effective for their ongoing education on the subject. 17 of the 30 participants required the certification of the Ministry of Health for the training and undertook an evaluation test. 88% of those answered correctly to at least 80% of the questions.

Lessons learned:

The idea of a specific multidisciplinary course and the down to earth and practical approach that characterised the course were enthusiastically accepted by participants. The challenge of handling classes with people from very different backgrounds and experiences was counterbalanced by the added value of sharing different viewpoints and approaches.

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