[MUSIC] Hello, I am an engineer at the ICRC and I'm here to talk about the risk that facility might face in a conflict context. I will first introduce some basic definition of risk analysis. I will show you an exercise, a specific tool that is called risk scenario to try to identify what might lead to a risk event. And then finally describe a bit what might be the effect of preventive measures, some of them, and how they should be considered. And finally, I would really touch a couple of words about contingency planning and how is important in this context. So let's start. The first concept that I wanted to tell you about is the definition of source of risk and risk event. The sources of risk is something that might trigger a risk, an event that might affect a facility and the consequences on the facility usually might be negative. And in this context, what we really fear is that the facility cannot operate anymore. So the event causing a disruption of the service in the facilities, so what we want to do is to prevent this to be happening. So what is important is to understand where in facilities, to understand the context, to understand that what event might lead to this risk. So in this table you can see what is called a risk scenario. Which is a description of all the events, the chain of cause and effects that may lead to specific risk to our health facility. As an example you may have a riot in a city that might cause road blockages and this might cause an impossibility for the staff of the facility to reach the hospital and therefore to operate. The same riot may create fear into the population and therefore the health facility might be seen as a safe haven, and therefore, there would be overcrowding in the facility causing difficulties in the operation. All these events should be analyzed, should be known ahead, and try to be ready to handle them. If this analysis is done, you can see that at the end of the table there are what are called events. This risk event, this results can be regrouped in to, let's say three main groups. The first one is related to heavy weapons, bombing that may have target the facility for the surroundings. We talk, then, about intrusion that might target this staff, the patient, or simply, you might have intrusion because criminals want to steal or target the equipment or the drugs on the facility. Then the third group of events related to massive influx may be of wounded, may be of people. In any case, the require specific countermeasure to be implemented. One last concept is concerning the infrastructure that surround the facility. The hospital requires basic services like water, like power from the city, the surrounding city, it's important that these are evaluated as well because it may create an extra vulnerability and worsen the impacts of the risk event. So if this analysis is clear and should be continuously updated, what can be done to be ready, to be prepared to face a risk. It's important that those risks are clearly identified. What are the main one affecting my facility? Because I need to apply the right countermeasures. For example, if your risk is related to heavy weapon, bombing, and you put a grate on the window, there is really not such an impact. You put a grate, if you know, that intrusion is your worst enemy. Another example, if you increase the capacity of storage of your pharmacy, you might be doing a very good thing in terms of prevention of a mass influx of wounded, but you are at the same time increasing the likelihood of intrusion, so all this should be understood well in advance. Another more tricky example might be related to the layout of your facility. If, for example, you have a campus like, a very spread facility composed by different buildings. This might create a situation where you are actually in a good position, in case of bombing because one bomb might hit one building and leave the others to operate. But it's very difficult to control in terms of intrusion, in terms of monitoring, because if it's very spread, you might have difficulties to control all the accesses. The opposite situation, where you have one facility, multi-story building, it's very vulnerable in terms of bombing, one hits all, but at the same time, it's also easier to control. So there should be an analysis that starts from the understanding of what is the situation around the facility. So the measures that you might take are specific to the threats. In certain cases, you may have one measure that is valid for more than one group of threats, of risks. But in general, what you want to avoid is that a health facility is becoming like a barrack. You don't want to militarize an hospital. You need to guarantee access. You need to guarantee a perception that the hospital can be reached by anyone. Finally, what is important is to have an holistic approach, to make sure that in terms of prevention, in terms of readiness to face the type of risk that you might encounter, and it's important that both software and hardware are considered. You need to be ready in terms of infrastructure, in terms of all the different equipment that you need but also in terms of management, in terms of procedures that are in place to tackle risks, events. The most important tool to do that is the contingency planning. Contingency planning is a list of action with response person identified as responsible that helps to deal with this type of situation. The contingency plan should be well-known by all the key person. There should be even a redundancy in the diffusion of the contingency planning because you don't want to be in a situation that you don't know what to do. It should be specific focus that you should be able to perform this in a critical situation, and it should be focused on the analysis of the risk that you have conducted beforehand. [MUSIC]
