HEALTH RESERVE WORKFORCE AND EMERGENCY MEDICAL TEAMS (EMTs)
ATTACHMENT 23 Standard Operating Procedure for Physical and Mental Health Monitoring of
C. Medical (Emergency Box)
1. Procedure for Receiving Medical Aid Logistics
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• Acceptance of logistics and equipment through grants is carried out based on applicable regulations of the law, taking into account the conditions in an emergency situation.
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Table 4.1 Steps for administrative and quality checks of medical logistics
Focal Point Activity
Beneficiary/ administrative
staff • Check and verify whether the medical logistics to be received administratively can be received
• Check the distribution permit, EUA, and ensure that the donated medical equipment has been functionally tested
Beneficiary/ pharmaceutical
staff Check and verify whether the medical logistics to be received technically are suitable and usable Beneficiary/ warehouse
manager • Check and verify whether the medical logistics to be received technically can be stored and received during delivery
• Ensure that the physical condition of the goods is safe and in good condition/ still sealed
• Ensure warehouse access, security, and safety
• Coordinate transportation personnel
In sudden-onset health crisis emergency situations, when management is in a state of chaos in the early days of the event and there is no definitive person responsible for receiving health logistics and pharmaceutical personnel, the recipient party needs to have standard procedures in receiving health logistics assistance.
Several requirements that need to be considered in the management of drug and health supplies reception are as follows:
a. Physical Condition
The condition of the drugs and health supplies provided is in good and complete condition, and there is no damaged logistic packaging.
b. Expiration Date
The fulfillment of drug and health supply needs must pay attention to the expiration date on the packaging when received by the recipient of the aid.
The expiration date of drugs and health supplies should be at least two years at the time of receipt by the aid recipient. This is intended so that drugs and health supplies can be utilized according to the needs of the sub-cluster in the operational field and routine programs after the emergency response/ crisis period has ended. The aid provider should have confirmed and included the expiration date on the packing list as well as on the aid packaging provided.
142 c. Source of Donated Goods
The drugs and health supplies received must come from official sources, or in this case, the aid received must be registered/ have distribution permits from the Indonesian Ministry of Health Affairs and the Indonesian National Agency of Drug and Food Control (BPOM) or, if from abroad, from the official institution of the country of origin of the drugs and health supplies or the WHO. This is necessary to ensure the safety of the drugs and health supplies received by the health authorities affected by the disaster.
d. In accordance with the National Essential Medicines List (NEML)
This is necessary to avoid disrupting the Essential Medicines Use program for healthcare facilities affected by disasters. It has been observed that healthcare workers sometimes use interventions and drugs outside the essential service standards, which is acceptable only during the Emergency Medical Team (EMT) deployment and not when leaving drug and medical supplies at healthcare facilities.
e. The dosage and medication should be the same as those commonly used by healthcare workers
This is necessary to prevent confusion among healthcare workers regarding the strength of the donated drugs, as frontline workers often receive insufficient training in this regard.
f. Should have labels in Indonesian and/or English
The purpose of providing these labels is to enable healthcare workers to easily understand the instructions for use, storage conditions, and the label should include the generic name and batch number, dosage form, strength, manufacturer's name, quantity in the smallest container, storage conditions, and expiry date.
g. Meet international shipping standards
Each drug and medical supply shipment should be accompanied by a waybill/
airway bill (if shipped by air) and a detailed packing list specifying the specific dosage form, quantity, batch number, expiration date, volume, weight, and specific storage conditions. The carton weight should not exceed 50 kg. This is necessary to facilitate the storage and distribution of drugs to healthcare facilities, especially during disaster situations when healthcare facilities do not have equipment to lift cartons weighing more than 50 kg. It would also be beneficial to provide wooden or rubber pallets during shipment.
143 h. Demurrage and customs
Donated drugs and medical supplies may receive exemption from tax if recommended by the State Secretariat (categorized as technical assistance). The process involves coordination with the Ministry of Finance, Directorate General of Customs and Excise. For provincial areas, a recommendation from the Head of the Provincial Health Office is required, and for district/ city areas, a recommendation from the Head of the District/ City Health Office and Customs Office is needed.
Shipping costs from the donor country, local transportation, proper warehousing, and customs clearance should be covered by the donor, including any demurrage fees. The term demurrage refers to the fee (fine) that must be paid for returning the provider's container late and when the container is still in the port, whether by sea or air. Container providers typically allow 7-10 days to use the container. By the end of this period, the user must return the container empty. If it exceeds the specified time limit, the shipping company will charge a demurrage fee. This fee varies, and can be waived, but requires lengthy administrative procedures.
Therefore, it is advisable to provide training and appoint a responsible person to handle this matter.
This information should be communicated to the donor from the outset so that the disaster-affected area, as the recipient of the aid, does not encounter problems if unwanted drug and medical supply items are included in the shipment documents from the donor, particularly if the aid comes from abroad. By doing so, the recipients of donated drugs and medical supplies can assess the technical aspects of the donated drugs and medical supplies, manage their storage, and prepare the necessary administrative requirements from the beginning.