Environmental Engineering Reference
In-Depth Information
information proved to be a challenge in certain parts of the country, given the
existing communications infrastructure. Graphing total cases per day instead of new
cases provided an alarming picture on the Health canada website. the experience
was a chilling wake-up call, and canada is now better prepared. However, there is
still much more work to do.
SarS has taught the lesson that the luxury of a central command-and-control
approach is not a possibility in canada. Unlike the experience of Singapore, where
all SarS cases could be seen at a single facility, even the containment of SarS
within the Greater toronto area did not necessarily lend itself to the Singapore
model given the unique conditions there, such as culture and health systems. when
new information is emerging continually from the trenches, authorities must be able
to interpret it. the question remains, however, how to take new information and
allow the front-line responders in each area to do what they know to be best in
their community or for their population base. they know whom to call. they know
the infrastructure. they know who their potential partners are. How can authorities
ensure, in terms of crisis governance, that local workers are not impeded from doing
what they really know how to do? In essence, these issues force the realisation that
the largest obstacle to managing a public health crisis successfully is a lack of a
collaborative framework and ethos among different levels of government, health
authorities, citizens, and practitioners.
canada has taken the lessons learned from SarS into a broader context: pandemic
preparedness both at home and in the global village. David naylor's thoughtful
report was, in fact, a blueprint of what needed to be done in this country (national
advisory committee 2003). as the minister of state for public health my department
established the PHAC and appointed the first chief public health officer, David
butler-Jones. He was then able to nurture and develop cooperation and collaboration
among medical officers of health for all 13 provincial and territorial jurisdictions
in the country into PHac, so that public health could be conceived as an inclusive
collective. The creation of PHAC and the position of chief public health officer
of Canada allowed the deputy head of an agency—for the first time in Canadian
history—to speak directly to canadians to deliver science-based advice, rather than
go through political channels. there were immediate changes within the ontario's
Ministry of Health as well. For example, as part of an internal reorganisation, an
office was established to coordinate the development of an emergency preparedness
programme, integrate it into planning, identify the infrastructure requirements for its
maintenance, and develop a quality improvement programme. Since its inception,
this office has created a number of programmes addressing issues in emergency
planning and preparedness for citizens and healthcare providers, with specific
concern for influenza pandemic planning and avian influenza. Ultimately, the SARS
experience reinforced the case for a collaborative and coordinated approach to public
health, making it evident that systems-based thinking and coordination within a well-
designed infrastructure are as essential in a crisis as they are in the core functions of
public health (212).
