Second draft: as of 20 Sep. THAILAND S COUNTRY REPORT For the 10 th ASEAN & Japan High Level Official Meeting on Caring Societies

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Second draft: as of 20 Sep. THAILAND S COUNTRY REPORT For the 10 th ASEAN & Japan High Level Official Meeting on Caring Societies Country profile The kingdom of Thailand is situated in the continental Southeast Asia, just north of the equator, and is part of the Indochina Peninsula. It covers an area of about 514,000 square kilometers. Thailand is the third largest country among the South Asian nations, compared to Indonesia and Myanmar. It is bordered by the Lao Peoples Democratic Republic on the North, Kingdom of Cambodia on the East, Malaysia and gulf of Thailand on the South, Myanmar and the Gulf of Thailand on the West. Geographically, Thailand is divided into four regions: Central, North, Northeast, and South, and is administratively divided into provinces. Each province is divided into district and each district is also divided into sub-district. Currently there are 77 provinces; one of which Bangkok Metropolis, the capital of Thailand, 877 district and 7,255 sub-districts. Thailand has three types of climate; 1) Tropical rain climate in the coastal areas in the East and the South, with heavy rainfalls all year round and tropical rain forest. 2) Tropical monsoon climate in the south-western and the southeastern coasts with monsoons and a very high average annual rainfall 3) Seasonal tropical grassland or savannah climate with a lot of heavy rains in the south-west monsoon season and droughts in the cold season covering most regions of the country, particularly the Central Region, the North and the North-east. Prevailing winds include the south-westerly monsoon from about mid- May through October and the north-easterly monsoon from November through February.

According to the Institute of Population and Social Research, Mahidol University, as of 1 July 2012 the population of Thailand is 64.413 million, 31.683 men and 32.780 women, an almost 10 millions of whom work and reside in Bangkok. When considering the age group, it is found that the young population (aged 0-14) accounted for 12.832 million or 19.92 % of the total population. The working-age group (aged 15-59) accounted for 43.410 million, or 67.39 %, and the elderly group (aged 60 or more) accounted for 8.111 million or 12.59%. The Thai population is aging over time due to the decreasing fertility rate and increasing life expectancy. The proportion of the population above 60 years is expected to 16% in 2020. Thai demographic structure is changing to aging society in the near future of 20 years Table 1: Population characteristics (in thousand) Characteristics 2006 2007 2008 2009 2010 2011 2012 Total Male Female 62,163 30,710 31,453 62,520 30,868 31,652 63,121 31,125 31,996 63,336 31,241 22,889 63,776 31,408 32,368 63,891 31,445 32,446 64,413 31,683 32.730 Age 0-14 13,912 14,094 13,635 13,412 13,229 13,010 12,832 Age 15-59 41,450 41,809 42,444 42,710 43,010 43,091 43,410 Age 60 and over 6,801 6,000 7,042 7,274 7,537 5,212 8,111 Source: Mahidol population gazette Midyear 2012 (1st July) Current situation and trend in the elderly, the disabilities and the vulnerable people The elderly: In accordance with Elderly Act B.E. 2003, Elderly is a person who is 60 years and above and a Thai citizen. According to the National Statistics Office, in 2010, there were 7.2 million elderly (44.5 % male and 45.4 % female). Employed elderly workforce was 2.51 million (35.745 % of the total elderly population). In total employed elderly 1.44 million (57.56%) were in agricultural sector and 1.06 million (42.44) were in

non-agricultural sector. The reason that these elderly were still in the workforce are mainly from the needs to provide for themselves and their family and also that they were healthy and still could work. Right now, Thailand is facing an ageing society, resulting in the working-age population bearing a higher burden in taking care of the elderly. The disabilities: Based on the 2007 figures of the National Statistics Office, the persons with disabilities account for 1.9 million (or 2.9%) out of the total population in Thailand. Out of 1.8 million of the disabled aged over 15, only 0.6 is employed. As of 10 March 2011, the number of disabled registered for disability cards reached 1,183,801, of which, 545,152 amongst them were disabled aged between 15-60 years old. In addition, WHO Country Cooperation Strategy Thailand, 2012-2016 mentioned the other two vulnerable groups as follows;- The south: Continuous violence in the three Southern-most provinces (Pattani, Yala, and Narathiwat) since 2004 has killed and injured many innocent people. Health services are affected. Increasing malaria incidences, comparative low immunization coverage, a diphtheria outbreak in 2010 and available data on infant mortality and maternal mortality suggest the need for tailored approaches to ensure demand and access to high-quality of all health services; prevention, promotion and curative. Non-Thai mobile and migrant populations: According to the latest data from the Ministry of Labour, an estimated 2.4 million non-thai migrants are living in Thailand, mostly from the Mekhong countries, but only 1.3 million are registered. Studies have confirmed that migrants are needed for the long-term economic development of Thailand, and they account for 5% of the labor force within Thailand. Currently, access to health services of migrants is linked to a process of registration and obtaining a work permit, and the purchase of an insurance package for non-thai migrants. A large

number of migrants working in Thailand do not acquire health insurance, yet migrants and other mobile populations bear a disproportionate share of the health burden in Thailand. Health status, health care seeking behavior, and access to health services among non-thai migrants are poor quality, particularly for unregistered migrants. Follow up of the 9 th ASEAN-Japan High Level Official Meeting Human Resource Development in the sectors of Welfare and Health Recommendation No.1 To identify challenges and needs of vulnerable people in each Member State in strengthening HRD programs for government officials, services providers, health and social workers, community volunteers to provide accessible, affordable and quality of health and welfare services. In addition, these human resources need to be properly allocated and distributed to alleviate urban and rural disparities. Present - Providing evidence-based information of vulnerable people as input for the development of the 10 th Five-Year National Health Plan - Providing evidence-based information of migrants as input for the development of Border Health Development Master Plan 2012-2016 Next Step - Provided evidenced based of vulnerable people as input for the development of ASEAN Migrant Health Plan Recommendation No.5 To adopt the People-Centered Approach to ensure that individuals, families and communities are served by and able to participate in trusted systems which respond to their needs in humane and

holistic ways in all settings across the health, social welfare and labour sectors, at all times. Present - District Health Promotion Hospital Next to door and close to heart Next Step - Family Doctor Policy Recommendation No. 9 To have a cross sectoral policy dialogue and develop common language at the ASEAN level among sectoral bodies on health, social welfare, and labour, including ASEAN Conference on Civil Service Matters. Present - Providing evidence- based information of vulnerable people at Senior Official Meeting on Health Development (SOMHD) and ASEAN Health Minister Meeting Next Step - Providing evidenced based of vulnerable people as input for the development of Roadmap for the Implementation of MRA of Medicine, Nurse and dentist. Disaster Management Framework in General Natural Disaster The global climate change has direct impact on fluctuations in weather. During the last 30 years global temperature has risen about 0.2 degrees Celsius on average per decade. The rising temperature has caused variability in weather and natural disasters which tend to happen more frequently and with greater intensity. These disasters are made manifest by earthquakes, volcanic eruptions, flooding, storms, droughts, and forest fires. Ecosystems in

many areas are weakened. These include the loss of flora and fauna biodiversity, physical change in earth surface and deprivation in coastal communities, industrial areas, and places of tourism. Bad ecosystems may cause an epidemic which jeopardizes plants and living creatures, affects people migration and poverty and ultimately results in a fight over resources. Thailand is considered fortunate so far as natural disaster is concerned. We have not had to endure a disaster of gigantic proportions which has resulted in a financial drain on the country; however, there have been 5-10 disasters which have been harmful nonetheless. Most disasters in Thailand are associated with water. The most common disasters are floods, droughts and landslides due to geographic and climatic characteristic of the country. With a vast mountainous areas in the north from where the main rivers (i.e. Ping, Wang, Yom, Nan and the Chao Phraya) are originated, large volume of water flows down to the mouth of the ocean in Bangkok passing through many provinces. This phenomenon takes places every year during the rainy season, influenced by the southwest monsoon weather which arrives annually between mid-june and October. In recent years, the amount of water has exceeded the capacities of either rivers or reservoirs and subsequently causes flooding. The first is flooding in Bangkok in 1942 caused by heavy rain which resulted in the overflow of Chaophraya River. Thailand is also vulnerable to typhoon and windstorm disasters, twenty years later, a typhoon and tropical storm Harriet surge at Laem Talumpuk, Nakorn Sri Thammarat Province in the South On 25-26 October 1962 causing the death of 911 people. In November 1989 Typhoon Gay made landfall and destructed the southern part of Thailand, especially Chumporn Province in the South. As many as 458 people were killed by either drowning or being crushed by a series of blowing debris. The most destructive natural

disaster in Thailand was the Indian Ocean 2004. On December 26, a tsunami hit the Southern part of Thailand which killed 5,395 Thais and 220,000 people in Asia and part of Africa lost their lives. It is ranked as the world s third costliest disaster in terms of the number of victims. And finally in late July 2011 to mid January 2012, a severe flood hit the country during the rainy season which wrecked havoc on Chaophraya and the Greater Mekong basin. The extreme damage caused by the flood affected 12.8 million people and cost the country over 1.44 billion Baht. The disaster has been described as the worst flooding yet in terms of the amount of water and people affected. It ranks as the world's fourth costliest disaster as of 2011. Flooding resulted in a total of 4,086,138 affected households, 13,595,192 affected people and 813 deaths (with 3 missing). Sixty-five of Thailand's 77 provinces were declared flood disaster zones and over 20,000 square kilometers (7,700 sq mi) of farmland was damaged together with 13,961 roads, 777 drainpipes, 982 dams, 142 barrages, 724 bridges, 231,919 fish ponds and 13.41 million livestock. A natural disaster of any magnitude generally results in the loss of property and people s lives. It affects the economic status of not only individuals but the country as a whole. Therefore, it is deemed necessary to provide social services such as food, drinks, shelter, physical and mental care as well as the creation of rebuilding efforts to ensure that people will recover from disaster as soon as possible. National Policies related to disaster management and relevant legislation Thailand had the Civil Defense Act 1979 for disaster management. After the most destructive natural disaster of tsunami took place in Thailand in 2004, this act was terminated after about 30 years of use. On 19 November 2007, the Disaster Prevention and Mitigation Act 2007 or DPM Act 2007

entered into force, cancelling the old Civil Defense Act 1979. Thailand s disaster management system has been based on the 2007 Act ever since. The DPM Act 2007 has the provisions regarding the institutional arrangement as follows: (1) The National Committee on Disaster Prevention and Mitigation (NCDPM) serves as a policy making body. It is chaired by the Prime Minister. The Committee comprises 34 members, designated from ministries, agencies and organizations related to disaster management. (2) The Minister of Interior is by law the Commander in-chief when it comes to disaster emergency response particularly in large-scale disaster. (3) The Director-General of the Department of Disaster Prevention and Mitigation (DDPM) is by the law the Secretary General of the NCDPM. (4) The Director under the 2007 DPM Act is the Incident Commander when a disaster takes place. National Master Plan for Disaster Prevention and Mitigation National Master Plan for Disaster Prevention and Mitigation for the year 2010 2014 is the master plan for all agencies concerned, and provides guidelines for the formulation of operational plan of agencies responsible for management of disaster. The first part of this master plan related to disaster prevention and mitigation principle. The second part focuses on standard operating procedures (SOPs) in dealing with 14 different types of disasters. And the third part is touches upon national security issues.

Scope of disaster Encompasses disaster and security threat Disaster comprises: 1) Flood and landslide 2) Tropical cyclone 3) Fire 4) Chemical and hazardous materials 5) Transport Hazard 6) Drought 7) Cold spell 8) Forest fire and haze 9) Earthquake and building collapse 10) Tsunami 11) Human epidemic 12) Plant disease and pest 13) Animal and aquatic animal epidemic 14) Information technology threat Security threat comprises : 1) Sabotage Action 2) Mine and landmines threat 3) Air threat 4) Protest and riot Disaster Severity Scales and Person in Charge of Commanding Level 1 Small Scale Disaster: Persons in charge are Local Director, District Director, and/or Bangkok Metropolitan Director Assistant. Level 2 Medium Scale Disaster: Persons in charge are Provincial Director and/or Bangkok Metropolitan Director. Level 3 Large-Scale Disaster: Disaster with severe and widespread impact or required specialist or special equipment. Persons in charge are Central Director and/or National Commander.

Level 4 Very Large-Scale Disaster: Disaster with widespread catastrophic impact, person in charge is prime Minister or the Deputy Prime Minister whom assigned by the Prime Minister. Disaster Strategy First Strategy : Disaster Prevention and Impact Reduction Second Strategy : Preparedness Third Strategy : Disaster Emergency Management Fourth Strategy : Post disaster management Disaster Operating Procedure and Countermeasure Operating procedure and countermeasures required to be taken by agencies concerned to deal with all phases of disaster both in Bangkok and other provincial jurisdictions have been identified. In addition, these concerned agencies are clearly identified and classified into key operating agency, supporting agency, and disaster relief and rehabilitation agency. At Provincial Level: Local Administration Organization of Specified Locality (tambon administration organization, municipality, and Pattaya City) is responsible for conducting disaster management activities within its jurisdiction. In case where the scale of disaster is beyond its capacity to deal with, the affected local entity is required to request for assistance from District Director and Provincial Director respectively. Still, if it is beyond the capacity of provincial government, the aforesaid Provincial Director is required to further request assistance from Central Director or national Commander. And in case of large-scale disaster with catastrophic and widespread impact, the

Prime Minister or the Deputy Prime Minister who is assigned by the Prime Minister has been empowered to command. In Bangkok Metropolitan Area: Bangkok Metropolitan Governor, as Bangkok Metropolitan Director is responsible for dealing with disaster situation in his jurisdiction. Permanent Secretary for Bangkok Metropolitan Administration and the director of Bangkok Metropolitan District, as Deputy Bangkok Metropolitan Director and Bangkok Metropolitan Director Assistant respectively, are obliged to provide assistance. Incase where the scale of disaster is beyond its capacity to cope with, Bangkok Metropolitan Director is entitled to request for assistance from Central Director of National Commander. The Prime Minister or the Deputy Prime Minister whom assigned by the Prime Minister will assume commanding power in case of large- scale disaster with catastrophic and widespread impact.

Organization structure of natural disaster management at national level Prime minister Command Report National Committee on Disaster Prevention and Mitigation (NCDPM) Cooperate Committee on Cooperate International Organizations Dept. of Disaster prevention and mitigation command request aid request aid Commander of National Committee on Disaster Prevention and Mitigation command supervision Director at Central Level request aid request aid Ministries, Departments Support, Request Cooperate aid Director of Regional Disaster Prevention and Mitigation 1-18 aid command request aid Director of adjacent province request aid Director of adjacent district area Director at Provincial Level/ Bangkok Metropolis request command Director at district level/ Assistant Director of Bangkok Metropolis/ Director at local level join command Civil Protection Volunteers join request aid Private sectors, Foundations command Armies command Confronting Unit Confronting unit Mitigating Unit Confronting Unit Confronting Unit Confronting Unit Encounter danger areas

Organization structure of Emergency medical service and health services MoPH: Minister Center for Operation at National Level Emergency Public Health Bureau Commander of Emergency Medicine and Emergency Public Health: Permanent Secretary of MoPH/Deputy Permanent National Institute For Emergency Medicine(Thailand) Dept. of Thai Traditional and Alternative Medicine Dept. of Disease control Dept. of Health Dept. of Medical Services Office of the Permanent Secretary Dept. of Mental Health Dept. of Medical Sciences Dept. of Health Services Support FDA National Disaster Warning Center Dept. of Disaster Prevention and Mitigation Emergency Medicine and Public Heath War Room EMT Command Center, 1669 Radio Communication System: VHF, SSB Thai Red Cross Royal Thai Army Royal Thai Navy Royal Thai Air Force

Project on disaster reduction 1. The One Tambon-One-Search and Rescue Team (OTOS) In this regard, DDPM has launched OTOS program which contains; at the provincial level, the training of provincial search and rescue team were completed and have been assigned to be search and rescue instructors; at district level, district search and rescue team have been trained to become instructors as well; at Tambon level (Thailand s administrative unit between district and village), it is expected there will be Tambon search and rescue team in every Tambon nation-wide. 2. Community-Based Disaster Risk Management (CBDRM) Program Thailand by DDPM has adopted and applied this appropriate people participatory approach to generate the awareness among the general public and mobilize their participation in every phase of disaster management so as to build sage and resilient community. In the past year, DDPM, in collaboration with various government agencies, local authorities, NGOs and international organization, has launched CBDRM program in hundreds of communities at risk. This program will be jointly organized on continuous to cover all vulnerable communities nation-wide. 3. Mr. Warning Training Program In conjunction with various government agencies and NGOs, DDPM has implement a community-based volunteer training program which aims at creating a disaster warning network in the flashflood and mud slide prone villages. The trained villagers are designated as Mr. Warning and assigned to be the vigilant, forewarned and coordinator in emergency and nonemergency situation respectively. This program has been in concerted with its preceded program, Simple Rain Gauge Installation program.

4. Emergency Response Team Development project (ERT) Emergency Response Team or ERT has been developing to DDPM to response for each type of large-scale hazards of incidents. Basically, ERT was set up 20 teams, 2 teams embedded in DDPM, Bangkok Office, and the other 18 team in each Regional Center of DDPM. Each ERT will consist 10 members, including one (1) team leader, three (3) for planning, and six (6) for operation. Team leader will be the chief officer to coordinate with Provincial Director and officers of the Ad-Hoc Directing Center in case of disaster occurring. The Department of Disaster Prevention and Mitigation (DDPM) established in the year 2002, under the Ministry of Interior, is the principal agency for disaster management coordination among all agencies concerned at all levels. Budget for Disaster Management Since its establishment in late 2002, the annual budget of DDPM has been increasing, jumping by 174 percent- from 31 Millions USD in 2003 to 86 Millions USD in the year 2010 Fiscal year (see the table below). Budget of DDPM Fiscal Year 2003-2010 Year Amount (THB) Amount (USD) 2003 1,066,412,900 31,365,085 2004 1,312,578,500 38,605,250 2005 1,685,362,700 49,569,491 2006 2,437,850,700 71,701,491 2007 1,948,805,800 57,317,818 2008 2,184,972,800 64,263,906 2009 2,315,783,900 68,111,291 2010 2,934,135,400 86,298,100

Roles of the Ministries in preparedness, response, and recovery/reconstruction Ministry of Public Health As below Ministry of Social Development and Human Security 1.preparedness: - The Ministry of Social Development and Human Security (MSDHS) contribute to disaster preparation by encouraging capacity building of community level trough the support of Community Organizations Development Institute (Public Organization) under MSDHS. - MSDHS offers training program for volunteer of the Provincial office of Social Development and Human Security to acknowledge measure to tackle and get themselves and other people ready for disaster. - Publicize news and information about Centre and network for disaster management. 2.response : - The staff of the Provincial office of Social Development and Human Security follow the news of disaster and work in collaboration with Department of Disaster Prevention and Mitigation (Ministry of Interior) to tackle with disaster. disaster. - survey, collect the data, and make a report of up to date news about - Working in cooperation with provincial level staff and other nongovernment organizations to tackle with emergency situation. - Hot Line Centre called 1300 Prachabordi for people across the country to make a report of flood situation or request for help in flooded areas.

- Department of Social welfare (MSDHS) works cooperatively with its provincial centre in 75 provinces to help people immediately after request for help. 3. recovery/reconstruction: - MSDHS provides social workers team and psychiatrist for home visiting to help effected people from disaster. - Grants for vulnerable groups such as for family with low income, MSDHS paid 3,000 baht thrice a year, for Family which lost its members, MSDHS gives educational funds for children for no more than 3,000 baht, etc. - Occupational training program plus additional aid for target group under Advance Payment Acts for effected people in emergency situation 2003 for a total budget of 10 million baht. - Other additional aids such as necessary item for living, capitals, etc. in correspondence to MSDHS Acts for emergency situation 2004. - Community recovery based on variation of each communities led by Community Organizations Development Institute (Public Organization). Actual Practices A natural disaster of any magnitude generally results in the loss of property and people s lives. It affects the economic status of not only individuals but the country as a whole. Therefore, it is deemed necessary to provide social services such as food, drinks, shelter, physical and mental care as well as the creation of rebuilding efforts to ensure that people will recover from disaster as soon as possible. From Our Experience in Thailand Floods 2011

The situation of major flood in 2011 started during monsoon season when tropical storm Nock-Ten hit Northern part of Vietnam and caused heavy rain throughout the North and North-east part and caused flash flood in many provinces in Thailand. The flood was starting from 25 May 2011 till 16 January 2012. The affected areas were particular in Chao Phraya river basin including Mekong river basin. Many areas were declared a disaster emergency (Flooding), there were 65 provinces in total. The flood affected 3,014,532 families with 9,926,471 people. There were 615 cases dead and 3 loosed. Damage assessment was estimated 156,700 million Baths and impacted the overall economy around 231,000 million Baths. This major flood also damaged land for 150 million Rais (6 million hectares) which cover agricultural and industrial areas in 63 provinces from the north to the central plain and Mekong basin area. The first thing to note about the national response in Thailand is that the bulk of assistance was provided by government and non-government actors (private companies, civil society organizations, volunteers and communities) as well as by the Red Cross Societies in their role as auxiliaries to the national governments. The Thai Red Cross, with the assistance of nearly 40,000 volunteers across 43 provinces, distributed more than 300,000 relief kits, prepared 500,000 meals and provided medical assistance to more than 10,000 people assistance in total was more than $US10m. Contributions made by politicians were a significant component of the response. The Thai Democrat Party set up a Southern Kitchen in inner- Bangkok, which served almost five million meals. In Thailand, the staff and volunteers of various institutions that hosted evacuation centres were also an integral part of the response. Throughout the country, evacuation centres were set up on an ad hoc basis by

a range of actors in a range of venues, including schools, universities, temples and sports stadiums. Coordination by the central Government was vary with some; imitations, while many centres run by individuals (university professors, teachers, monks, and others) with no experience in disaster management. The Response of the Royal Thai Government The Thai Disaster Prevention and Mitigation Act 2007 defines the Department for Disaster Preparedness and Mitigation (DDPM) as the central government unit to operate any related activities on national disaster prevention and mitigation. The DDPM is the State nodal agency to carry out disaster management activities, with responsibility to take action, conduct disaster operations coordination, and provide the support and assistance to government agencies, local administration organizations, and private sector to deal with disaster. The Disaster Prevention and Mitigation Act establishes the Minister of Interior as the Minister with the power to control and oversee disaster prevention and mitigation. In mid-august, the DDPM began emergency operations for a level three disaster that is, a large-scale disaster with severe and widespread impact. Emergency Operations Centres were established at national, provincial and district levels; and under the leadership of the Ministry of Interior, daily meetings were held for the purpose of coordinating the floodrelated activities of all concerned government agencies. The Floods Relief Operation Centre (FROC) was established in early October to oversee the management of the flood response. At the national level, the DDPM was left with a supporting role collecting and consolidating data, distributing situation reports, supporting flood-prevention initiatives, and processing compensation payments.

However there are limitations to the working of government those are lack of financial, technical and human resource capacity at the sub-national level. The DDPM s Summary of Lessons Learned from the 2010-2011 Floods notes that DDPM does not have adequate staff for its operation at district, sub-district and village levels, and that therefore, it took time to get government personnel who belonged to other agencies to perform disasterrelated activities at field level. The DDPM s Lessons Learned report notes that it seemed that all public agencies did not follow or did not have detailed guidelines to follow. Hence, they reacted as fragmented efforts according to the orders of their superiors instead. In some worse cases, some superiors who were appointed as Chief of Command for emergency responses did not have background in disaster management. (Lack of preparation and no clarification of organizational structure to deal with disaster management). Best Practices during the 2011 floods According to The Floods Relief Operation Centre (FROC), MoPH, MSDHS, M.of Interior along with other ministries were in charge with the national contingency plan to help affected people irrespective of gender, groups, or status. The Ministries worked under Flood Recovery and Restoration Committee on Quality of Life to implement projects and procedures for recover and lift up the standard of living for affected people. The recovery processes are categorizes into 4 phrases: emergency solution, aids for low-moderate level flooded areas, recovery after floods, and infrastructure change management. The MSDHS was immediately responded to the committee by searching and making a record of vulnerable groups in the flooded areas. Furthermore, we provided training for making employment, grant, and shelter for affected people, by spending budget of 2,105,040,000 million baht for recovery processes.

The example set by helping vulnerable groups on the occasion of disaster was somehow ensuring the achievement of social security for targeted groups. The ministry gives a subsistence allowance for aging people and people with disabilities. Monthly allowances will be guaranteed to these target groups irrespective of circumstances to ensure better quality of life. Operation of MoPH during floods The Ministry of Public Health has provided assistant to recover and heal regarding public health to the people who have been affected by flood as follow: 1. Set up operating center for flood relief regarding medical services and public health 2. Set up center for flood relief at Ministry of Public Health. They were 1,600 victims received assistant. 3. Develop action plan under policy of MOPH s Minister by every health units in MOPH 4. Develop plan at Central level for mobilizing human resources 5. Perform food surveillance such as expire date of food from the donation 6. Set up MOPH s measures of preparedness of flood response 6.1 Prevention of work place/hospital 6.2 Resources reservation and necessary medical supplies 6.3 Preparing services in necessary area in case to move from 1 st floor 6.4 Preparing services for being out of health facility unit including coordination for further assistant 6.5 Preparing system for referral patient, crisis patient and semi crisis patient 6.7 Preparing plan for travel rout: main roads and reserve roads

6.7 Preparing transportation: vehicles, high vehicles, boats, including place for helicopter landing 6.8 Preparing temporary shelter and assistance center for flood victim 6.9 Setting up field hospital 7. Provide treatment and care by conducting 102 mobile teams. There were 38,321 cases were treated and 24 patients were referred to the hospitals. 8. Provide mental health care, there were 122,036 cases received mental assessment. With this number, there are 7,047 cases with high stress, 8,818 cases with depress, 1,558 cases were risk to suicide, 2,513 cases need special follow up, and 7,693 were on psychiatric medication. 9. Perform promotion, prevention and disease control, including disease surveillance in flood area and temporally shelters, control vector born diseases, develop material for health education. Up to now there were reported cases of 22 diarrhea/food poisoning, 5 respiratory tract infections, and 53 Cold/Flu like symptom. However, there is no report of cluster illness regarding flood. 10. Perform environmental and sanitation management, food and safe drinking water, waste product, control quality of water and enhance proper health behavior. Operation of MSDHS during floods: 1. Aged people, people with disabilities, and children Problems Resist to evacuate due to many reasons such as worry about properties and belonging, lots of people believe that they can survive and misunderstood water level, hence they rather stay home to move to temporary shelter, etc. Solving

Resist to evacuate MSDHS has to make sure that help is on the Way to community. In case people can t help themselves/ need to evacuate due to emergency situation Shelter ill/injured hospital/workhouse Activities provided in shelter by MSDHS In case Children have to stay with parents in shelter, MSDHS provided entertaining activity, classroom for children to know about disaster and how to look after themselves while await for parents. Vulnerable persons take care of children, people with disabilities, homeless, poor people, unemployed Network of Organizations: UNICEF, Save the Children UK., Mercy Relief, Universities, Temple, National Foundation and International Foundation, Volunteer, etc. Shelter The temporary shelters under care of MSDHS were for affected people from floods. The centres are varies from capital city to rural areas which ministry ensured the access to water, food, and necessary item for living of all people with the campaign of Creating happiness Creating employment- and Creating better quality of life. To be concluded there are

approximately 1,059 shelters across the country with 107,682 inhabitants (as of December 2011) under care of MSDHS itself and some are under care of communities. Necessary item for living MSDHS provided goods and services in more than 1,293 temporary shelters/communities or even in flooded area with total number of 6,085,828 boxes of food worth 110,070,050 million baht (as of December 2011), 1 million bottles of water, 2,600 waterproof raincoats, and other necessary items for 44,117 people worth 44,117,000million baht which covered the need of 1,354,389 million people. Whereas in Bangkok itself MSDHS works in cooperation with Royal Thai Police in shelter-non shelter areas and another gathering zone to heighten production capacity. Hot Line Normally MSDHS used its Hot Line Centre called 1300 Prachabordi for victims of human trafficking and vulnerable persons to access MSDHS when they need help. For emergency floods situation, 1300 Prachabordi works in cooperation with 1111 ext. 5 for people across the country to make a report of flood situation or request for help in flooded areas. The centre works collaboratively with both government and non-governmental organizations as a link of network for donation and volunteer team. Activities for vulnerable group suffering from floods 1. Survey and Record MSDHS was taken care of surveying the needs of vulnerable group to make sure that their needs will be fulfill. To achieve this MSDHS was recorded the personal data of target group such as aged people and people with disabilities. We further give funds/ capital to affected family with the amount of 5,000 baht. The necessary items such as wheelchair, glasses, walking stick, etc. also provided.

2. Consultation and entertainment program were provided for 3,095 persons. 3. Family MSDHS offers various kinds of family activities to strengthen relationship of family s members such as activities under slogan Communicating with heart + Sharing the time together For Family which lost its members, MSDHS gives educational funds for children for no more than 3,000 baht and travel expenditures for student with 500 baht per disaster. For family with low income, MSDHS paid 3,000 baht thrice a year where occupational training program is also provided. For children in low income family, MSDHS gives 1,000 baht and 2,000 baht for families with 2 or more children. MSDHS provided necessary items for living to aged people and people with disabilities.

Occupational training program for 20 days (short term) which MSDHS gives 120 baht/per day/ per person. And 88 days in communities and temporary shelters. Plus 44 days of occupational training after disaster (with the budget of 137,200,000 million baht). Home for homeless and poor people under care of National Housing Authority (NHA). NHA also offers debt alleviation for a period of 6 months with 0% interest Supporting services for mental care with Ministry of Health in strengthening family and quality of life of vulnerable group (1,445,464 million people). Enhancing voluntarily program to ensure that people empowerment is achieved and that people are able to help themselves in emergency situation. (making a capacity building) (with the budget of 124,850,000 million baht). - - People with Disabilities The National Office for Empowerment of Persons with Disability (NEP) under MSDHS,in respond to floods, held the project called Making Employment and Encouragement to People with Disabilities (PWD) since September 7 th, 2011 at Rajabhat Sunantha University. The project was implemented to entertain people and guarantee employment after disaster. It aims for skilled PWD to independently help each other in mental care, and job training. The job training provided by Thailand

Association of the Blind, Association of the physically handicapped of Thailand, Association for persons with intellectual disability of Thailand (APIDTH) are for example foot massage, weaving, crochet, handbag paintings, bead knitting, astrology, embroidery, etc. Pak Kret s Centre for Development of the blind offers relaxing massage, Rajabhat Sunantha University along with Department of Social Development and Welfare (MSDHS), and other profit organizations such as L Oreal Thailand Co. offer daily Dhamma for mental treatment and entertainment activities especially for families and children. From an assessment of service users, they are satisfied with the services provided by MSDHS which succeed in decreasing tensions and stress due to disaster. MSDHS also succeed in making employment for vulnerable group such as weaving centre in communities. In Conclusion the Making Employment and Encouragement to People with Disabilities (PWD) held 5 types of activities those are: 1. Job training for 897 people 2. Relaxing Massage for 421 people 3. Entertainment activities for 560 people 4. Consultation for 85 people 5. Other related activities 480 people Even though the project s objectives had already been completed, MSDHS still highlights the precedence of better quality of life by means of implementing policies and programs toward social protection for all. Another prominent organization worth mentioning here is organization

dealing with vulnerable groups such as the Redemptorist Foundation concerned to people with disabilities, who affected by floodwaters. Since the floods spread down to Ayutthaya province, it had decided to set up the camp as a temporary shelter to accepted people with disabilities and their families from the flood areas, as the camp is fully accessible. When the floods situation was recovered, The organization in cooperation with MSDHS made an effort to find needs and some ways to help vulnerable group recover to their normal lives. Priority on disaster risk management Thailand urgently needs to reform disaster management systems and mechanisms as follows: 1. Pushing more public awareness and education and improving public safety of every sector particularly those who are living with risk by enhancing people s understanding of the threats posed by various types of disasters. 2. Materializing Early Warning Systems: Following the catastrophic tsunami disaster in 2004, Thailand took immediate action to establish National Disaster Warning Center, which covers the warning of both natural and man-made disasters. 3. Establishing More International Disaster Management Networks: Thailand needs to enhance the country s disaster management capacity and efficiency through the mobilization of technical assistance from foreign countries, particularly from developed and advanced countries. 4. Introducing remote survey technology to effectively assess the damages caused by large scale disaster. The staff of the agencies concerned needs to be trained to enhance their capacity in applying satellite images to assess the damage.

5. Enhancing the potential of local authority and community, who are in the frontline in the event of disaster occurrence and consequently are the most vulnerable and effected, in responding to disasters, and to equip them with awareness and preparedness. 6. Highlighting on preventive approach. The new approach of disaster management has shifted its focus from assistance or relief to prevention. In this regard, risk reduction must be vigorously taken into account. So as to reduce the risk, both structural and non-structural measures should be materialized, thus, this new approach focusing on risk reduction will soon efficiently diminish the cost of disaster damage comparing to the traditional one. 7. Focusing on human resource development as a key factor for disaster management. 8. Placing an importance on livelihood rehabilitation with activities such as community development and vocational training. The improving of the standards of living should be immediately materialized to normalize disaster victims means of living. Challenges There are 6 challenging issues: 1. A need to develop simulation model for disaster event with gigantic proportions and severity happening in various areas. 2. A vulnerable group record is a must. This record helps government to easily identify people who need special aid when disaster occurs. 3. Bringing in technical support such as communication systems in order to evaluate deprivation and identify and measure the required aid. 4. Budget planning related to national and international aid funds, national loans, etc. in order to help affected people recovering from disaster.

5. Community based services for affected people such as reporting when disasters take place and cooperating with the government in providing first aid and shelter centers. 6. International cooperation such as technical support, supporting funds, etc. Social Service Network A protection and mitigation cooperation plan between government and non-government sectors is required to cope up with disaster. This cooperation should also come from both the central and community level to ensure that government works at its best. As a result of the severe flooding in 2011 the government is collaborating with the non-governmental sector in setting up centers for help, providing funds for affected people, providing food and subsistence and sharing information via mass media and internet. Site visit by MSDHS s staff to the flooded area where aged people resist to stay home rather than evacuate to temporary shelter. (This is one of the problem persisted in Thailand at the time of floods where aged people denied to move to safe place, on the other hand, government is to make sure that enough services are accessible by all.

Job training for aged people (postdisaster). Job training for aged people (post-disaster).

Job training for aged people in community END