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The Haitian Health Cluster Experience: A Comparative Evaluation of the Professional Communication )] TJ ET BT 26.250 614.490 Td /F1 9.8 Tf [(Response to the 2010 Earthquake and the Subsequent Cholera Outbreak. PLOS Currents Disasters. 2012 Sep 5 . Edition 1. )] TJ ET BT 26.250 602.585 Td /F1 9.8 Tf [(doi: 10.1371/5014b1b407653.)] TJ ET q 15.000 33.144 577.500 567.060 re W n 0.271 0.267 0.267 rg BT 26.250 573.482 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 553.528 Td /F1 9.8 Tf [(The 2010 Haitian earthquake and consequent Cholera epidemic taxed the already fragile health system. A large number of )] TJ ET BT 26.250 541.623 Td /F1 9.8 Tf [(humanitarian organizations participated in the disaster response and the health communication response was analysed. Health )] TJ ET BT 26.250 529.719 Td /F1 9.8 Tf [(Cluster updates from both periods were analysed for contents with a World Health Organization draft check list for monitoring )] TJ ET BT 26.250 517.814 Td /F1 9.8 Tf [(and evaluating the quality of epidemiological data contained in WHO and Health Cluster emergency reports. The Pan-American )] TJ ET BT 26.250 505.909 Td /F1 9.8 Tf [(Health Organization Emergency Operations Centre reports from the Earthquake had the lowest score with an average score of )] TJ ET BT 26.250 494.004 Td /F1 9.8 Tf [(2.54/17 and the Health Cluster Cholera reports had the highest average score of 11/17. There is a wide variety and quality of )] TJ ET BT 26.250 482.100 Td /F1 9.8 Tf [(information published in terms of epidemiological information in emergency reports with a distinct difference found between the )] TJ ET BT 26.250 470.195 Td /F1 9.8 Tf [(earthquake reporting and the cholera event. A comprehensive and modifiable template for emergency reporting could alleviate )] TJ ET BT 26.250 458.290 Td /F1 9.8 Tf [(these differences and allow for improved reporting.)] TJ ET BT 26.250 438.885 Td /F1 9.8 Tf [(Citation: Dhillon P, Annunziata G. The Haitian Health Cluster Experience: A comparative evaluation of the professional )] TJ ET BT 26.250 426.981 Td /F1 9.8 Tf [(communication response to the 2010 earthquake and the subsequent cholera outbreak. PLOS Currents Disasters. 2012 Sep 5. )] TJ ET BT 26.250 415.076 Td /F1 9.8 Tf [(doi: 10.1371/5014b1b407653.)] TJ ET BT 26.250 378.473 Td /F4 12.0 Tf [(Funding Statement)] TJ ET BT 26.250 358.519 Td /F1 9.8 Tf [(No funding received.)] TJ ET BT 26.250 329.417 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 309.462 Td /F1 9.8 Tf [(Two disasters in 2010, the Haitian earthquake and the cholera epidemic, caused severe distress on an already fragile health )] TJ ET BT 26.250 297.558 Td /F1 9.8 Tf [(system and impoverished nation to create a unique environment in which comparisons of the public communication response )] TJ ET BT 26.250 285.653 Td /F1 9.8 Tf [(can be analysed.)] TJ ET BT 26.250 266.248 Td /F1 9.8 Tf [(A complete analysis of the health response and information dissemination through all methods available is beyond the scope of )] TJ ET BT 26.250 254.343 Td /F1 9.8 Tf [(this paper. However a more focused and in depth analysis of specific aspects of the health response can be done. In particular )] TJ ET BT 26.250 242.439 Td /F1 9.8 Tf [(this paper attempts to analyse how the two emergency events were communicated to other professional humanitarian response )] TJ ET BT 26.250 230.534 Td /F1 9.8 Tf [(agents involved in the Health Cluster. In principle, professional communications implies production and dissemination of )] TJ ET BT 26.250 218.629 Td /F1 9.8 Tf [(documents that are usually posted to the internet as the primary means of communication with all stakeholders. The study )] TJ ET BT 26.250 206.724 Td /F1 9.8 Tf [(reviews and compares key papers produced by the Pan-American Health Organization)] TJ ET 0.267 0.267 0.267 rg BT 400.153 208.232 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 404.971 206.724 Td /F1 9.8 Tf [( and the Health Cluster in collaboration )] TJ ET BT 26.250 194.820 Td /F1 9.8 Tf [(with the Ministry of Public Health of Haiti.)] TJ ET BT 26.250 175.415 Td /F1 9.8 Tf [(This study focuses solely on documents produced by PAHO/WHO and the UN Health Cluster and applies a draft checklist for )] TJ ET BT 26.250 163.510 Td /F1 9.8 Tf [(epidemiological completeness to these documents. This assumes that the writers and organizations that prepared the )] TJ ET BT 26.250 151.605 Td /F1 9.8 Tf [(documents were aware of the importance of epidemiological reporting and were versed in its use and application, it follows that )] TJ ET BT 26.250 139.701 Td /F1 9.8 Tf [(the information was available and could have been present in the reports.)] TJ ET BT 26.250 103.098 Td /F4 12.0 Tf [(Background)] TJ ET BT 26.250 83.144 Td /F1 9.8 Tf [(In 2010, the Repiblik Ayiti \(Rpublique dHati\) was the poorest nation in the Western Hemisphere according to the United )] TJ ET BT 26.250 71.239 Td /F1 9.8 Tf [(Nations Human Development Index.)] TJ ET 0.267 0.267 0.267 rg BT 182.855 72.746 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 187.673 71.239 Td /F1 9.8 Tf [( A population of nine million people, with 67% living on less than $2USD a day were living )] TJ ET BT 26.250 59.334 Td /F1 9.8 Tf [(in cramped conditions.)] TJ ET 0.267 0.267 0.267 rg BT 123.789 60.842 Td /F4 8.7 Tf [(2)] TJ ET BT 128.608 60.842 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 133.426 59.334 Td /F1 9.8 Tf [( Compounding this fragile baseline was a 7.0 magnitude earthquake, the strongest in recorded history )] TJ ET BT 26.250 47.430 Td /F1 9.8 Tf [(on the fault line, occurring on January 12, 2010. The earthquake shattered infrastructure and estimates of the total loss of life )] TJ ET Q q 15.000 659.406 577.500 78.594 re W n 0.267 0.267 0.267 rg BT 15.000 718.042 Td /F2 21.0 Tf [(The Haitian Health Cluster Experience: A Comparative )] TJ ET BT 15.000 693.094 Td /F2 21.0 Tf [(Evaluation of the Professional Communication Response to the )] TJ ET BT 15.000 668.146 Td /F2 21.0 Tf [(2010 Earthquake and the Subsequent Cholera Outbreak)] TJ ET Q 0.271 0.267 0.267 rg BT 15.000 650.140 Td /F3 9.8 Tf [(September 5, 2012)] TJ ET BT 92.717 650.140 Td /F3 9.8 Tf [()] TJ ET 0.267 0.267 0.267 rg BT 97.592 650.140 Td /F3 9.8 Tf [(Disasters)] TJ ET BT 26.250 638.299 Td /F1 9.8 Tf [(Paul Dhillon)] TJ ET 0.271 0.267 0.267 rg BT 78.266 638.299 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 83.687 638.299 Td /F1 9.8 Tf [(Giuseppe Annunziata)] TJ ET 0.271 0.267 0.267 rg BT 26.250 626.394 Td /F1 9.8 Tf [(Dhillon P, Annunziata G. The Haitian Health Cluster Experience: A Comparative Evaluation of the Professional Communication )] TJ ET BT 26.250 614.490 Td /F1 9.8 Tf [(Response to the 2010 Earthquake and the Subsequent Cholera Outbreak. PLOS Currents Disasters. 2012 Sep 5 . Edition 1. )] TJ ET BT 26.250 602.585 Td /F1 9.8 Tf [(doi: 10.1371/5014b1b407653.)] TJ ET q 15.000 33.144 577.500 567.060 re W n 0.271 0.267 0.267 rg BT 26.250 573.482 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 553.528 Td /F1 9.8 Tf [(The 2010 Haitian earthquake and consequent Cholera epidemic taxed the already fragile health system. A large number of )] TJ ET BT 26.250 541.623 Td /F1 9.8 Tf [(humanitarian organizations participated in the disaster response and the health communication response was analysed. Health )] TJ ET BT 26.250 529.719 Td /F1 9.8 Tf [(Cluster updates from both periods were analysed for contents with a World Health Organization draft check list for monitoring )] TJ ET BT 26.250 517.814 Td /F1 9.8 Tf [(and evaluating the quality of epidemiological data contained in WHO and Health Cluster emergency reports. The Pan-American )] TJ ET BT 26.250 505.909 Td /F1 9.8 Tf [(Health Organization Emergency Operations Centre reports from the Earthquake had the lowest score with an average score of )] TJ ET BT 26.250 494.004 Td /F1 9.8 Tf [(2.54/17 and the Health Cluster Cholera reports had the highest average score of 11/17. There is a wide variety and quality of )] TJ ET BT 26.250 482.100 Td /F1 9.8 Tf [(information published in terms of epidemiological information in emergency reports with a distinct difference found between the )] TJ ET BT 26.250 470.195 Td /F1 9.8 Tf [(earthquake reporting and the cholera event. A comprehensive and modifiable template for emergency reporting could alleviate )] TJ ET BT 26.250 458.290 Td /F1 9.8 Tf [(these differences and allow for improved reporting.)] TJ ET BT 26.250 438.885 Td /F1 9.8 Tf [(Citation: Dhillon P, Annunziata G. The Haitian Health Cluster Experience: A comparative evaluation of the professional )] TJ ET BT 26.250 426.981 Td /F1 9.8 Tf [(communication response to the 2010 earthquake and the subsequent cholera outbreak. PLOS Currents Disasters. 2012 Sep 5. )] TJ ET BT 26.250 415.076 Td /F1 9.8 Tf [(doi: 10.1371/5014b1b407653.)] TJ ET BT 26.250 378.473 Td /F4 12.0 Tf [(Funding Statement)] TJ ET BT 26.250 358.519 Td /F1 9.8 Tf [(No funding received.)] TJ ET BT 26.250 329.417 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 309.462 Td /F1 9.8 Tf [(Two disasters in 2010, the Haitian earthquake and the cholera epidemic, caused severe distress on an already fragile health )] TJ ET BT 26.250 297.558 Td /F1 9.8 Tf [(system and impoverished nation to create a unique environment in which comparisons of the public communication response )] TJ ET BT 26.250 285.653 Td /F1 9.8 Tf [(can be analysed.)] TJ ET BT 26.250 266.248 Td /F1 9.8 Tf [(A complete analysis of the health response and information dissemination through all methods available is beyond the scope of )] TJ ET BT 26.250 254.343 Td /F1 9.8 Tf [(this paper. However a more focused and in depth analysis of specific aspects of the health response can be done. In particular )] TJ ET BT 26.250 242.439 Td /F1 9.8 Tf [(this paper attempts to analyse how the two emergency events were communicated to other professional humanitarian response )] TJ ET BT 26.250 230.534 Td /F1 9.8 Tf [(agents involved in the Health Cluster. In principle, professional communications implies production and dissemination of )] TJ ET BT 26.250 218.629 Td /F1 9.8 Tf [(documents that are usually posted to the internet as the primary means of communication with all stakeholders. The study )] TJ ET BT 26.250 206.724 Td /F1 9.8 Tf [(reviews and compares key papers produced by the Pan-American Health Organization)] TJ ET 0.267 0.267 0.267 rg BT 400.153 208.232 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 404.971 206.724 Td /F1 9.8 Tf [( and the Health Cluster in collaboration )] TJ ET BT 26.250 194.820 Td /F1 9.8 Tf [(with the Ministry of Public Health of Haiti.)] TJ ET BT 26.250 175.415 Td /F1 9.8 Tf [(This study focuses solely on documents produced by PAHO/WHO and the UN Health Cluster and applies a draft checklist for )] TJ ET BT 26.250 163.510 Td /F1 9.8 Tf [(epidemiological completeness to these documents. This assumes that the writers and organizations that prepared the )] TJ ET BT 26.250 151.605 Td /F1 9.8 Tf [(documents were aware of the importance of epidemiological reporting and were versed in its use and application, it follows that )] TJ ET BT 26.250 139.701 Td /F1 9.8 Tf [(the information was available and could have been present in the reports.)] TJ ET BT 26.250 103.098 Td /F4 12.0 Tf [(Background)] TJ ET BT 26.250 83.144 Td /F1 9.8 Tf [(In 2010, the Repiblik Ayiti \(Rpublique dHati\) was the poorest nation in the Western Hemisphere according to the United )] TJ ET BT 26.250 71.239 Td /F1 9.8 Tf [(Nations Human Development Index.)] TJ ET 0.267 0.267 0.267 rg BT 182.855 72.746 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 187.673 71.239 Td /F1 9.8 Tf [( A population of nine million people, with 67% living on less than $2USD a day were living )] TJ ET BT 26.250 59.334 Td /F1 9.8 Tf [(in cramped conditions.)] TJ ET 0.267 0.267 0.267 rg BT 123.789 60.842 Td /F4 8.7 Tf [(2)] TJ ET BT 128.608 60.842 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 133.426 59.334 Td /F1 9.8 Tf [( Compounding this fragile baseline was a 7.0 magnitude earthquake, the strongest in recorded history )] TJ ET BT 26.250 47.430 Td /F1 9.8 Tf [(on the fault line, occurring on January 12, 2010. The earthquake shattered infrastructure and estimates of the total loss of life )] TJ ET Q q 15.000 659.406 577.500 78.594 re W n 0.267 0.267 0.267 rg BT 15.000 718.042 Td /F2 21.0 Tf [(The Haitian Health Cluster Experience: A Comparative )] TJ ET BT 15.000 693.094 Td /F2 21.0 Tf [(Evaluation of the Professional Communication Response to the )] TJ ET BT 15.000 668.146 Td /F2 21.0 Tf [(2010 Earthquake and the Subsequent Cholera Outbreak)] TJ ET Q 0.271 0.267 0.267 rg BT 15.000 650.140 Td /F3 9.8 Tf [(September 5, 2012)] TJ ET BT 92.717 650.140 Td /F3 9.8 Tf [()] TJ ET 0.267 0.267 0.267 rg BT 97.592 650.140 Td /F3 9.8 Tf [(Disasters)] TJ ET BT 26.250 638.299 Td /F1 9.8 Tf [(Paul Dhillon)] TJ ET 0.271 0.267 0.267 rg BT 78.266 638.299 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 83.687 638.299 Td /F1 9.8 Tf [(Giuseppe Annunziata)] TJ ET 0.271 0.267 0.267 rg BT 26.250 626.394 Td /F1 9.8 Tf [(Dhillon P, Annunziata G. The Haitian Health Cluster Experience: A Comparative Evaluation of the Professional Communication )] TJ ET BT 26.250 614.490 Td /F1 9.8 Tf [(Response to the 2010 Earthquake and the Subsequent Cholera Outbreak. PLOS Currents Disasters. 2012 Sep 5 . Edition 1. )] TJ ET BT 26.250 602.585 Td /F1 9.8 Tf [(doi: 10.1371/5014b1b407653.)] TJ ET q 15.000 33.144 577.500 567.060 re W n 0.271 0.267 0.267 rg BT 26.250 573.482 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 553.528 Td /F1 9.8 Tf [(The 2010 Haitian earthquake and consequent Cholera epidemic taxed the already fragile health system. A large number of )] TJ ET BT 26.250 541.623 Td /F1 9.8 Tf [(humanitarian organizations participated in the disaster response and the health communication response was analysed. Health )] TJ ET BT 26.250 529.719 Td /F1 9.8 Tf [(Cluster updates from both periods were analysed for contents with a World Health Organization draft check list for monitoring )] TJ ET BT 26.250 517.814 Td /F1 9.8 Tf [(and evaluating the quality of epidemiological data contained in WHO and Health Cluster emergency reports. The Pan-American )] TJ ET BT 26.250 505.909 Td /F1 9.8 Tf [(Health Organization Emergency Operations Centre reports from the Earthquake had the lowest score with an average score of )] TJ ET BT 26.250 494.004 Td /F1 9.8 Tf [(2.54/17 and the Health Cluster Cholera reports had the highest average score of 11/17. There is a wide variety and quality of )] TJ ET BT 26.250 482.100 Td /F1 9.8 Tf [(information published in terms of epidemiological information in emergency reports with a distinct difference found between the )] TJ ET BT 26.250 470.195 Td /F1 9.8 Tf [(earthquake reporting and the cholera event. A comprehensive and modifiable template for emergency reporting could alleviate )] TJ ET BT 26.250 458.290 Td /F1 9.8 Tf [(these differences and allow for improved reporting.)] TJ ET BT 26.250 438.885 Td /F1 9.8 Tf [(Citation: Dhillon P, Annunziata G. The Haitian Health Cluster Experience: A comparative evaluation of the professional )] TJ ET BT 26.250 426.981 Td /F1 9.8 Tf [(communication response to the 2010 earthquake and the subsequent cholera outbreak. PLOS Currents Disasters. 2012 Sep 5. )] TJ ET BT 26.250 415.076 Td /F1 9.8 Tf [(doi: 10.1371/5014b1b407653.)] TJ ET BT 26.250 378.473 Td /F4 12.0 Tf [(Funding Statement)] TJ ET BT 26.250 358.519 Td /F1 9.8 Tf [(No funding received.)] TJ ET BT 26.250 329.417 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 309.462 Td /F1 9.8 Tf [(Two disasters in 2010, the Haitian earthquake and the cholera epidemic, caused severe distress on an already fragile health )] TJ ET BT 26.250 297.558 Td /F1 9.8 Tf [(system and impoverished nation to create a unique environment in which comparisons of the public communication response )] TJ ET BT 26.250 285.653 Td /F1 9.8 Tf [(can be analysed.)] TJ ET BT 26.250 266.248 Td /F1 9.8 Tf [(A complete analysis of the health response and information dissemination through all methods available is beyond the scope of )] TJ ET BT 26.250 254.343 Td /F1 9.8 Tf [(this paper. However a more focused and in depth analysis of specific aspects of the health response can be done. In particular )] TJ ET BT 26.250 242.439 Td /F1 9.8 Tf [(this paper attempts to analyse how the two emergency events were communicated to other professional humanitarian response )] TJ ET BT 26.250 230.534 Td /F1 9.8 Tf [(agents involved in the Health Cluster. In principle, professional communications implies production and dissemination of )] TJ ET BT 26.250 218.629 Td /F1 9.8 Tf [(documents that are usually posted to the internet as the primary means of communication with all stakeholders. The study )] TJ ET BT 26.250 206.724 Td /F1 9.8 Tf [(reviews and compares key papers produced by the Pan-American Health Organization)] TJ ET 0.267 0.267 0.267 rg BT 400.153 208.232 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 404.971 206.724 Td /F1 9.8 Tf [( and the Health Cluster in collaboration )] TJ ET BT 26.250 194.820 Td /F1 9.8 Tf [(with the Ministry of Public Health of Haiti.)] TJ ET BT 26.250 175.415 Td /F1 9.8 Tf [(This study focuses solely on documents produced by PAHO/WHO and the UN Health Cluster and applies a draft checklist for )] TJ ET BT 26.250 163.510 Td /F1 9.8 Tf [(epidemiological completeness to these documents. This assumes that the writers and organizations that prepared the )] TJ ET BT 26.250 151.605 Td /F1 9.8 Tf [(documents were aware of the importance of epidemiological reporting and were versed in its use and application, it follows that )] TJ ET BT 26.250 139.701 Td /F1 9.8 Tf [(the information was available and could have been present in the reports.)] TJ ET BT 26.250 103.098 Td /F4 12.0 Tf [(Background)] TJ ET BT 26.250 83.144 Td /F1 9.8 Tf [(In 2010, the Repiblik Ayiti \(Rpublique dHati\) was the poorest nation in the Western Hemisphere according to the United )] TJ ET BT 26.250 71.239 Td /F1 9.8 Tf [(Nations Human Development Index.)] TJ ET 0.267 0.267 0.267 rg BT 182.855 72.746 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 187.673 71.239 Td /F1 9.8 Tf [( A population of nine million people, with 67% living on less than $2USD a day were living )] TJ ET BT 26.250 59.334 Td /F1 9.8 Tf [(in cramped conditions.)] TJ ET 0.267 0.267 0.267 rg BT 123.789 60.842 Td /F4 8.7 Tf [(2)] TJ ET BT 128.608 60.842 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 133.426 59.334 Td /F1 9.8 Tf [( Compounding this fragile baseline was a 7.0 magnitude earthquake, the strongest in recorded history )] TJ ET BT 26.250 47.430 Td /F1 9.8 Tf [(on the fault line, occurring on January 12, 2010. 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On October 19, 2010 the first cases of cholera )] TJ ET BT 26.250 657.238 Td /F1 9.8 Tf [(were confirmed on the island nation.)] TJ ET 0.267 0.267 0.267 rg BT 182.864 658.745 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 26.250 637.833 Td /F1 9.8 Tf [(The Health Cluster is a manifestation of a process initiated in 2004 after Jan Egeland began a Humanitarian Response Review )] TJ ET BT 26.250 625.929 Td /F1 9.8 Tf [(to look at ways to better coordinate the humanitarian response at a global level. It is essentially the bringing together of )] TJ ET BT 26.250 614.024 Td /F1 9.8 Tf [(disparate organizations under the umbrella of health in order to better coordinate action in that realm. 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One of the products of the Health Cluster )] TJ ET BT 26.250 114.742 Td /F1 9.8 Tf [(is the Health Cluster Bulletin which is a regular publication drafted in the field and presenting the main health needs and the )] TJ ET BT 26.250 102.837 Td /F1 9.8 Tf [(activities that are ongoing and planned to address those needs.)] TJ ET Q q 15.000 37.837 577.500 739.163 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(are over 200,000 with more than 300,000 injured.)] TJ ET 0.267 0.267 0.267 rg BT 239.239 768.983 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 244.057 767.476 Td /F1 9.8 Tf [( The lack of enforcement of building codes led to 1.5 million people being )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(made homeless, and one year after this devastation more than 1 million people were still living in camps.)] TJ ET 0.267 0.267 0.267 rg BT 477.100 757.079 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 26.250 736.167 Td /F1 9.8 Tf [(Relief aid flooded into the country from around the world to help rebuild the shattered country. In particular the already sub-)] TJ ET BT 26.250 724.262 Td /F1 9.8 Tf [(standard health care system was greatly affected. Eight hospitals were totally destroyed and 22 were seriously damaged in the )] TJ ET BT 26.250 712.357 Td /F1 9.8 Tf [(three regions most affected.)] TJ ET 0.267 0.267 0.267 rg BT 147.101 713.864 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 151.920 712.357 Td /F1 9.8 Tf [( Prior to the earthquake there were 594 primary health care centres; 30 referral communal )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(hospitals with 30-60 beds each; and 10 department hospitals.)] TJ ET 0.267 0.267 0.267 rg BT 291.265 701.960 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 26.250 681.048 Td /F1 9.8 Tf [(As the country was beginning to rebuild, with the Health Cluster attempting to coordinate the health response to the earthquake, )] TJ ET BT 26.250 669.143 Td /F1 9.8 Tf [(a new threat was emerging which threw the recovery process into further chaos. On October 19, 2010 the first cases of cholera )] TJ ET BT 26.250 657.238 Td /F1 9.8 Tf [(were confirmed on the island nation.)] TJ ET 0.267 0.267 0.267 rg BT 182.864 658.745 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 26.250 637.833 Td /F1 9.8 Tf [(The Health Cluster is a manifestation of a process initiated in 2004 after Jan Egeland began a Humanitarian Response Review )] TJ ET BT 26.250 625.929 Td /F1 9.8 Tf [(to look at ways to better coordinate the humanitarian response at a global level. It is essentially the bringing together of )] TJ ET BT 26.250 614.024 Td /F1 9.8 Tf [(disparate organizations under the umbrella of health in order to better coordinate action in that realm. This strategy has also )] TJ ET BT 26.250 602.119 Td /F1 9.8 Tf [(been employed for other areas as well such as water/sanitation, logistics, and nutrition.)] TJ ET BT 26.250 582.714 Td /F1 9.8 Tf [(The cholera epidemic added new difficulties just as the health sector was beginning to recover and rebuild. Ten weeks after the )] TJ ET BT 26.250 570.810 Td /F1 9.8 Tf [(start of the epidemic, all departments were affected. This was a surprising event to many as cholera had not been documented )] TJ ET BT 26.250 558.905 Td /F1 9.8 Tf [(in Haiti for decades. On July 25, the Ministry of Health of Haiti \(Ministre de la Sante Publique et de la Population, MSPP\) )] TJ ET BT 26.250 547.000 Td /F1 9.8 Tf [(reported a total of 388,958 cumulative cholera cases and 5,899 deaths due to cholera. 206,882 patients \(53.2%\) have been )] TJ ET BT 26.250 535.095 Td /F1 9.8 Tf [(hospitalized out of the total cholera cases.)] TJ ET 0.267 0.267 0.267 rg BT 207.805 536.603 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 212.623 535.095 Td /F1 9.8 Tf [( The two crises in the same nation provide an interesting retrospective comparison )] TJ ET BT 26.250 523.191 Td /F1 9.8 Tf [(between an earthquake and a cholera epidemic, both unexpected and rapidly escalating events that had vastly different levels )] TJ ET BT 26.250 511.286 Td /F1 9.8 Tf [(of staffing on the ground at the onset of each.)] TJ ET 0.965 0.965 0.965 rg 26.250 301.528 555.000 199.877 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 501.405 m 581.250 501.405 l 581.250 500.655 l 26.250 500.655 l f 26.250 301.528 m 581.250 301.528 l 581.250 302.278 l 26.250 302.278 l f q 112.500 0 0 112.500 35.250 379.155 cm /I3 Do Q q 35.250 312.778 537.000 60.377 re W n 0.271 0.267 0.267 rg BT 35.250 363.631 Td /F4 9.8 Tf [(Fig. 1: Epidemiological Information Image of Cholera from OCHA)] TJ ET BT 35.250 344.261 Td /F1 9.8 Tf [(The Health Cluster)] TJ ET BT 35.250 323.025 Td /F1 9.8 Tf [(https://reliefweb.int/sites/reliefweb.int/files/resources/map_1289.pdf)] TJ ET Q BT 26.250 284.504 Td /F1 9.8 Tf [(Lessons learned from previous disaster responses have illustrated that humanitarian aid is in some cases wasted or not )] TJ ET BT 26.250 272.599 Td /F1 9.8 Tf [(matched to on the ground needs.)] TJ ET 0.267 0.267 0.267 rg BT 169.341 274.106 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 174.160 272.599 Td /F1 9.8 Tf [( A Humanitarian Response Review \(HRR\) was commissioned by the Emergency Relief )] TJ ET BT 26.250 260.694 Td /F1 9.8 Tf [(Coordinator \(ERC\), Jan Egeland, towards the end of 2004. His feelings about the slow and inadequate response in Darfur, )] TJ ET BT 26.250 248.790 Td /F1 9.8 Tf [(Sudan by the humanitarian community signalled weaknesses that needed to be addressed. Four consultants were hired to map )] TJ ET BT 26.250 236.885 Td /F1 9.8 Tf [(the capacity of the humanitarian community at the global level and to suggest changes that would help to ensure a more )] TJ ET BT 26.250 224.980 Td /F1 9.8 Tf [(predictable response to humanitarian crises.)] TJ ET BT 26.250 205.575 Td /F1 9.8 Tf [(The HRR final report came with a number of recommendations that covered a wide range of issues including human resources, )] TJ ET BT 26.250 193.671 Td /F1 9.8 Tf [(common humanitarian services, coordination, and the idea of creating clusters in order to provide greater accountability and )] TJ ET BT 26.250 181.766 Td /F1 9.8 Tf [(predictability in the humanitarian response.)] TJ ET BT 26.250 162.361 Td /F1 9.8 Tf [(The Health Cluster serves as a mechanism for coordinated assessments, joint analyses, development of agreed overall )] TJ ET BT 26.250 150.456 Td /F1 9.8 Tf [(priorities and objectives, health crises response strategy, and the monitoring, evaluation, implementation, and impact of that )] TJ ET BT 26.250 138.552 Td /F1 9.8 Tf [(strategy. Agencies delivering aid are grouped together in similar areas of expertise and service delivery. The Health Cluster is )] TJ ET BT 26.250 126.647 Td /F1 9.8 Tf [(usually led by the World Health Organization but can be led by multiple organizations. One of the products of the Health Cluster )] TJ ET BT 26.250 114.742 Td /F1 9.8 Tf [(is the Health Cluster Bulletin which is a regular publication drafted in the field and presenting the main health needs and the )] TJ ET BT 26.250 102.837 Td /F1 9.8 Tf [(activities that are ongoing and planned to address those needs.)] TJ ET Q q 15.000 37.837 577.500 739.163 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(are over 200,000 with more than 300,000 injured.)] TJ ET 0.267 0.267 0.267 rg BT 239.239 768.983 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 244.057 767.476 Td /F1 9.8 Tf [( The lack of enforcement of building codes led to 1.5 million people being )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(made homeless, and one year after this devastation more than 1 million people were still living in camps.)] TJ ET 0.267 0.267 0.267 rg BT 477.100 757.079 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 26.250 736.167 Td /F1 9.8 Tf [(Relief aid flooded into the country from around the world to help rebuild the shattered country. In particular the already sub-)] TJ ET BT 26.250 724.262 Td /F1 9.8 Tf [(standard health care system was greatly affected. Eight hospitals were totally destroyed and 22 were seriously damaged in the )] TJ ET BT 26.250 712.357 Td /F1 9.8 Tf [(three regions most affected.)] TJ ET 0.267 0.267 0.267 rg BT 147.101 713.864 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 151.920 712.357 Td /F1 9.8 Tf [( Prior to the earthquake there were 594 primary health care centres; 30 referral communal )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(hospitals with 30-60 beds each; and 10 department hospitals.)] TJ ET 0.267 0.267 0.267 rg BT 291.265 701.960 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 26.250 681.048 Td /F1 9.8 Tf [(As the country was beginning to rebuild, with the Health Cluster attempting to coordinate the health response to the earthquake, )] TJ ET BT 26.250 669.143 Td /F1 9.8 Tf [(a new threat was emerging which threw the recovery process into further chaos. On October 19, 2010 the first cases of cholera )] TJ ET BT 26.250 657.238 Td /F1 9.8 Tf [(were confirmed on the island nation.)] TJ ET 0.267 0.267 0.267 rg BT 182.864 658.745 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 26.250 637.833 Td /F1 9.8 Tf [(The Health Cluster is a manifestation of a process initiated in 2004 after Jan Egeland began a Humanitarian Response Review )] TJ ET BT 26.250 625.929 Td /F1 9.8 Tf [(to look at ways to better coordinate the humanitarian response at a global level. It is essentially the bringing together of )] TJ ET BT 26.250 614.024 Td /F1 9.8 Tf [(disparate organizations under the umbrella of health in order to better coordinate action in that realm. This strategy has also )] TJ ET BT 26.250 602.119 Td /F1 9.8 Tf [(been employed for other areas as well such as water/sanitation, logistics, and nutrition.)] TJ ET BT 26.250 582.714 Td /F1 9.8 Tf [(The cholera epidemic added new difficulties just as the health sector was beginning to recover and rebuild. Ten weeks after the )] TJ ET BT 26.250 570.810 Td /F1 9.8 Tf [(start of the epidemic, all departments were affected. This was a surprising event to many as cholera had not been documented )] TJ ET BT 26.250 558.905 Td /F1 9.8 Tf [(in Haiti for decades. On July 25, the Ministry of Health of Haiti \(Ministre de la Sante Publique et de la Population, MSPP\) )] TJ ET BT 26.250 547.000 Td /F1 9.8 Tf [(reported a total of 388,958 cumulative cholera cases and 5,899 deaths due to cholera. 206,882 patients \(53.2%\) have been )] TJ ET BT 26.250 535.095 Td /F1 9.8 Tf [(hospitalized out of the total cholera cases.)] TJ ET 0.267 0.267 0.267 rg BT 207.805 536.603 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 212.623 535.095 Td /F1 9.8 Tf [( The two crises in the same nation provide an interesting retrospective comparison )] TJ ET BT 26.250 523.191 Td /F1 9.8 Tf [(between an earthquake and a cholera epidemic, both unexpected and rapidly escalating events that had vastly different levels )] TJ ET BT 26.250 511.286 Td /F1 9.8 Tf [(of staffing on the ground at the onset of each.)] TJ ET 0.965 0.965 0.965 rg 26.250 301.528 555.000 199.877 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 501.405 m 581.250 501.405 l 581.250 500.655 l 26.250 500.655 l f 26.250 301.528 m 581.250 301.528 l 581.250 302.278 l 26.250 302.278 l f q 112.500 0 0 112.500 35.250 379.155 cm /I3 Do Q q 35.250 312.778 537.000 60.377 re W n 0.271 0.267 0.267 rg BT 35.250 363.631 Td /F4 9.8 Tf [(Fig. 1: Epidemiological Information Image of Cholera from OCHA)] TJ ET BT 35.250 344.261 Td /F1 9.8 Tf [(The Health Cluster)] TJ ET BT 35.250 323.025 Td /F1 9.8 Tf [(https://reliefweb.int/sites/reliefweb.int/files/resources/map_1289.pdf)] TJ ET Q BT 26.250 284.504 Td /F1 9.8 Tf [(Lessons learned from previous disaster responses have illustrated that humanitarian aid is in some cases wasted or not )] TJ ET BT 26.250 272.599 Td /F1 9.8 Tf [(matched to on the ground needs.)] TJ ET 0.267 0.267 0.267 rg BT 169.341 274.106 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 174.160 272.599 Td /F1 9.8 Tf [( A Humanitarian Response Review \(HRR\) was commissioned by the Emergency Relief )] TJ ET BT 26.250 260.694 Td /F1 9.8 Tf [(Coordinator \(ERC\), Jan Egeland, towards the end of 2004. His feelings about the slow and inadequate response in Darfur, )] TJ ET BT 26.250 248.790 Td /F1 9.8 Tf [(Sudan by the humanitarian community signalled weaknesses that needed to be addressed. Four consultants were hired to map )] TJ ET BT 26.250 236.885 Td /F1 9.8 Tf [(the capacity of the humanitarian community at the global level and to suggest changes that would help to ensure a more )] TJ ET BT 26.250 224.980 Td /F1 9.8 Tf [(predictable response to humanitarian crises.)] TJ ET BT 26.250 205.575 Td /F1 9.8 Tf [(The HRR final report came with a number of recommendations that covered a wide range of issues including human resources, )] TJ ET BT 26.250 193.671 Td /F1 9.8 Tf [(common humanitarian services, coordination, and the idea of creating clusters in order to provide greater accountability and )] TJ ET BT 26.250 181.766 Td /F1 9.8 Tf [(predictability in the humanitarian response.)] TJ ET BT 26.250 162.361 Td /F1 9.8 Tf [(The Health Cluster serves as a mechanism for coordinated assessments, joint analyses, development of agreed overall )] TJ ET BT 26.250 150.456 Td /F1 9.8 Tf [(priorities and objectives, health crises response strategy, and the monitoring, evaluation, implementation, and impact of that )] TJ ET BT 26.250 138.552 Td /F1 9.8 Tf [(strategy. Agencies delivering aid are grouped together in similar areas of expertise and service delivery. The Health Cluster is )] TJ ET BT 26.250 126.647 Td /F1 9.8 Tf [(usually led by the World Health Organization but can be led by multiple organizations. 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Prior to the earthquake the PAHO/WHO staff numbered )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(52 and more than 60 additional expert staff were added immediately after the earthquake.)] TJ ET 0.267 0.267 0.267 rg BT 412.662 745.174 Td /F4 8.7 Tf [(8)] TJ ET BT 417.481 745.174 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 422.299 743.667 Td /F1 9.8 Tf [( Operational only four days after the )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(earthquake, more than 400 agencies and organizations had registered with the Health Cluster.)] TJ ET 0.267 0.267 0.267 rg BT 433.244 733.269 Td /F4 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 26.250 712.357 Td /F1 9.8 Tf [(The aim of the cluster approach is to improve the coordination and cooperation between the many different response actors )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(while adhering to accepted humanitarian principles.)] TJ ET 0.267 0.267 0.267 rg BT 247.887 701.960 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 252.706 700.452 Td /F1 9.8 Tf [( The health cluster lead was PAHO/WHO, in the initial stages after the )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(earthquake, who worked closely with the Haitian Ministry of Health. They then subsequently became partners in leading the )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(cluster in some quarters this was deemed one of the largest successes of the coordination aspect of the mission in that the )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(international response organizations goals were appropriately aligned with national structures and long term goals.)] TJ ET 0.267 0.267 0.267 rg BT 519.385 666.245 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 26.250 645.333 Td /F1 9.8 Tf [(An examination of key parts of the Health Cluster Guide provides the theoretical framework for this paper; one function of the )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(Cluster Lead Agency is Monitoring and Reporting and roles are outlined in Table 1 below.)] TJ ET q 26.250 609.811 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 612.559 Td /F1 9.8 Tf [(Table 1. Cluster Function 8)] TJ ET Q 1.000 1.000 1.000 rg 26.250 507.380 555.000 94.931 re f 0.267 0.267 0.267 rg 26.625 601.186 138.152 0.750 re f 164.777 601.186 242.346 0.750 re f 26.625 585.305 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 591.331 Td /F5 9.8 Tf [(Cluster Lead Agency)] TJ ET 0.267 0.267 0.267 rg 406.373 601.186 174.502 0.750 re f 406.373 585.305 0.750 16.631 re f 580.125 585.305 0.750 16.631 re f 0.271 0.267 0.267 rg BT 411.623 591.331 Td /F5 9.8 Tf [(Cluster Partners)] TJ ET 0.267 0.267 0.267 rg 26.625 585.305 138.527 0.750 re f 26.625 561.793 0.750 24.262 re f 0.271 0.267 0.267 rg BT 31.875 575.450 Td /F4 9.8 Tf [(Cluster Lead Agency )] TJ ET BT 31.875 567.819 Td /F4 9.8 Tf [(Representative)] TJ ET 0.267 0.267 0.267 rg 164.402 585.305 242.721 0.750 re f 164.402 561.793 0.750 24.262 re f 0.271 0.267 0.267 rg BT 169.652 575.450 Td /F4 9.8 Tf [(Health Cluster Coordinator \(HCC\))] TJ ET 0.267 0.267 0.267 rg 26.625 561.793 138.527 0.750 re f 26.625 507.755 138.527 0.750 re f 26.625 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 31.875 551.938 Td /F1 9.8 Tf [(Produce and disseminate )] TJ ET BT 31.875 544.306 Td /F1 9.8 Tf [(Cluster sit-reps and regular )] TJ ET BT 31.875 536.675 Td /F1 9.8 Tf [(Health Bulletins using HCC )] TJ ET BT 31.875 529.044 Td /F1 9.8 Tf [(input.)] TJ ET 0.267 0.267 0.267 rg 164.402 561.793 242.721 0.750 re f 164.402 507.755 242.721 0.750 re f 164.402 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 169.652 551.938 Td /F1 9.8 Tf [(Ensure partners active contribution to and )] TJ ET BT 169.652 544.306 Td /F1 9.8 Tf [(involvement in joint monitoring of individual and )] TJ ET BT 169.652 536.675 Td /F1 9.8 Tf [(common plans of action for health interventions; )] TJ ET BT 169.652 529.044 Td /F1 9.8 Tf [(collate and disseminate this and other information )] TJ ET BT 169.652 521.413 Td /F1 9.8 Tf [(related to the health sector in Cluster sit-reps and/or )] TJ ET BT 169.652 513.781 Td /F1 9.8 Tf [(regular Health Bulletins.)] TJ ET 0.267 0.267 0.267 rg 406.373 561.793 174.502 0.750 re f 406.373 507.755 174.502 0.750 re f 406.373 507.755 0.750 54.788 re f 580.125 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 411.623 551.938 Td /F1 9.8 Tf [(Participate in defining and agreeing )] TJ ET BT 411.623 544.306 Td /F1 9.8 Tf [(on any information and reports that )] TJ ET BT 411.623 536.675 Td /F1 9.8 Tf [(Cluster partners should provide to )] TJ ET BT 411.623 529.044 Td /F1 9.8 Tf [(the HCC, and provide such )] TJ ET BT 411.623 521.413 Td /F1 9.8 Tf [(information and reports in a timely )] TJ ET BT 411.623 513.781 Td /F1 9.8 Tf [(manner)] TJ ET BT 26.250 452.856 Td /F1 9.8 Tf [(*\(Modified from Health Cluster Guide, Page 38\))] TJ ET BT 26.250 433.452 Td /F1 9.8 Tf [(Furthermore the Health Cluster Guide states that the CLA/HCC should bring together all significant health actors and facilitate a )] TJ ET BT 26.250 421.547 Td /F1 9.8 Tf [(process of analyzing available assessment information and agreeing on an initial response strategy for which it is essential to )] TJ ET BT 26.250 409.642 Td /F1 9.8 Tf [(have accurate information disseminated to the different actors involved. This distribution of information is done through the )] TJ ET BT 26.250 397.737 Td /F1 9.8 Tf [(health bulletins and documents posted to the internet.)] TJ ET BT 26.250 378.333 Td /F1 9.8 Tf [(Drawing from this, the main question this paper addresses is whether or not there were reporting differences in key )] TJ ET BT 26.250 366.428 Td /F1 9.8 Tf [(professional, and publically available, documents distributed during the implementation of the health responses to the Haitian )] TJ ET BT 26.250 354.523 Td /F1 9.8 Tf [(earthquake and Cholera epidemic.)] TJ ET BT 26.250 317.921 Td /F4 12.0 Tf [(Methodology)] TJ ET BT 26.250 297.966 Td /F1 9.8 Tf [(This paper analyses the content of the following document groups which were posted to the internet during the crises;)] TJ ET BT 26.250 278.562 Td /F1 9.8 Tf [(1. The Pan American Health Organization \(PAHO\), Health Cluster in Haiti Bulletin, Earthquake;)] TJ ET BT 26.250 259.157 Td /F1 9.8 Tf [(2. The PAHO/World Health Organization \(WHO\), Emergency Operations Center Situation Report, Earthquake;)] TJ ET BT 26.250 239.752 Td /F1 9.8 Tf [(3. PAHO/WHO, Emergency Operations Center Situation Report, Cholera; and)] TJ ET BT 26.250 220.347 Td /F1 9.8 Tf [(4. PAHO/WHO/Ministere de la Sante Publique et de la Population \(MSPP\), Health Cluster Bulletin, Cholera and Post-)] TJ ET BT 26.250 208.443 Td /F1 9.8 Tf [(Earthquake Response in Haiti.)] TJ ET BT 26.250 189.038 Td /F1 9.8 Tf [(Particular attention was be paid to timing of the production of the bulletins and to their content. A set of draft standard )] TJ ET BT 26.250 177.133 Td /F1 9.8 Tf [(references has been generated by the World Health Organization for the function of monitoring and evaluating the quality of )] TJ ET BT 26.250 165.228 Td /F1 9.8 Tf [(epidemiological data published by various WHO and Health Cluster emergency reports and a modified version of these is used )] TJ ET BT 26.250 153.324 Td /F1 9.8 Tf [(to analyse the content of the reports. \(Appendix A\))] TJ ET BT 26.250 133.919 Td /F1 9.8 Tf [(The checklist points were assigned a value of one point for each aspect leading to a maximum value of 17 for any particular )] TJ ET BT 26.250 122.014 Td /F1 9.8 Tf [(bulletin and a minimum value of zero. In addition to scored content the frequency of publication and average page length of )] TJ ET BT 26.250 110.109 Td /F1 9.8 Tf [(each bulletin was ascertained.)] TJ ET BT 26.250 90.705 Td /F1 9.8 Tf [(This paper is retrospectively examining and comparing the contents and frequency of a segment of the online updates from the )] TJ ET BT 26.250 78.800 Td /F1 9.8 Tf [(Health Cluster during the Haitian cholera and earthquake in 2010. This task included sourcing the documents online and then )] TJ ET BT 26.250 66.895 Td /F1 9.8 Tf [(applying a WHO rubric for evaluating the quality of the epidemiological data that they contained.)] TJ ET BT 26.250 47.490 Td /F1 9.8 Tf [(All Health Cluster Bulletins and PAHO/WHO Emergency Operations Centre Bulletins were obtained from the Relief Web )] TJ ET Q q 15.000 33.205 577.500 743.795 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(In the Haitian situation there were 12 clusters in total and the Health Cluster was led by the World Health Organization and the )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(Pan-American Health Organization in close cooperation with the MSPP. Prior to the earthquake the PAHO/WHO staff numbered )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(52 and more than 60 additional expert staff were added immediately after the earthquake.)] TJ ET 0.267 0.267 0.267 rg BT 412.662 745.174 Td /F4 8.7 Tf [(8)] TJ ET BT 417.481 745.174 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 422.299 743.667 Td /F1 9.8 Tf [( Operational only four days after the )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(earthquake, more than 400 agencies and organizations had registered with the Health Cluster.)] TJ ET 0.267 0.267 0.267 rg BT 433.244 733.269 Td /F4 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 26.250 712.357 Td /F1 9.8 Tf [(The aim of the cluster approach is to improve the coordination and cooperation between the many different response actors )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(while adhering to accepted humanitarian principles.)] TJ ET 0.267 0.267 0.267 rg BT 247.887 701.960 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 252.706 700.452 Td /F1 9.8 Tf [( The health cluster lead was PAHO/WHO, in the initial stages after the )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(earthquake, who worked closely with the Haitian Ministry of Health. They then subsequently became partners in leading the )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(cluster in some quarters this was deemed one of the largest successes of the coordination aspect of the mission in that the )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(international response organizations goals were appropriately aligned with national structures and long term goals.)] TJ ET 0.267 0.267 0.267 rg BT 519.385 666.245 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 26.250 645.333 Td /F1 9.8 Tf [(An examination of key parts of the Health Cluster Guide provides the theoretical framework for this paper; one function of the )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(Cluster Lead Agency is Monitoring and Reporting and roles are outlined in Table 1 below.)] TJ ET q 26.250 609.811 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 612.559 Td /F1 9.8 Tf [(Table 1. Cluster Function 8)] TJ ET Q 1.000 1.000 1.000 rg 26.250 507.380 555.000 94.931 re f 0.267 0.267 0.267 rg 26.625 601.186 138.152 0.750 re f 164.777 601.186 242.346 0.750 re f 26.625 585.305 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 591.331 Td /F5 9.8 Tf [(Cluster Lead Agency)] TJ ET 0.267 0.267 0.267 rg 406.373 601.186 174.502 0.750 re f 406.373 585.305 0.750 16.631 re f 580.125 585.305 0.750 16.631 re f 0.271 0.267 0.267 rg BT 411.623 591.331 Td /F5 9.8 Tf [(Cluster Partners)] TJ ET 0.267 0.267 0.267 rg 26.625 585.305 138.527 0.750 re f 26.625 561.793 0.750 24.262 re f 0.271 0.267 0.267 rg BT 31.875 575.450 Td /F4 9.8 Tf [(Cluster Lead Agency )] TJ ET BT 31.875 567.819 Td /F4 9.8 Tf [(Representative)] TJ ET 0.267 0.267 0.267 rg 164.402 585.305 242.721 0.750 re f 164.402 561.793 0.750 24.262 re f 0.271 0.267 0.267 rg BT 169.652 575.450 Td /F4 9.8 Tf [(Health Cluster Coordinator \(HCC\))] TJ ET 0.267 0.267 0.267 rg 26.625 561.793 138.527 0.750 re f 26.625 507.755 138.527 0.750 re f 26.625 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 31.875 551.938 Td /F1 9.8 Tf [(Produce and disseminate )] TJ ET BT 31.875 544.306 Td /F1 9.8 Tf [(Cluster sit-reps and regular )] TJ ET BT 31.875 536.675 Td /F1 9.8 Tf [(Health Bulletins using HCC )] TJ ET BT 31.875 529.044 Td /F1 9.8 Tf [(input.)] TJ ET 0.267 0.267 0.267 rg 164.402 561.793 242.721 0.750 re f 164.402 507.755 242.721 0.750 re f 164.402 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 169.652 551.938 Td /F1 9.8 Tf [(Ensure partners active contribution to and )] TJ ET BT 169.652 544.306 Td /F1 9.8 Tf [(involvement in joint monitoring of individual and )] TJ ET BT 169.652 536.675 Td /F1 9.8 Tf [(common plans of action for health interventions; )] TJ ET BT 169.652 529.044 Td /F1 9.8 Tf [(collate and disseminate this and other information )] TJ ET BT 169.652 521.413 Td /F1 9.8 Tf [(related to the health sector in Cluster sit-reps and/or )] TJ ET BT 169.652 513.781 Td /F1 9.8 Tf [(regular Health Bulletins.)] TJ ET 0.267 0.267 0.267 rg 406.373 561.793 174.502 0.750 re f 406.373 507.755 174.502 0.750 re f 406.373 507.755 0.750 54.788 re f 580.125 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 411.623 551.938 Td /F1 9.8 Tf [(Participate in defining and agreeing )] TJ ET BT 411.623 544.306 Td /F1 9.8 Tf [(on any information and reports that )] TJ ET BT 411.623 536.675 Td /F1 9.8 Tf [(Cluster partners should provide to )] TJ ET BT 411.623 529.044 Td /F1 9.8 Tf [(the HCC, and provide such )] TJ ET BT 411.623 521.413 Td /F1 9.8 Tf [(information and reports in a timely )] TJ ET BT 411.623 513.781 Td /F1 9.8 Tf [(manner)] TJ ET BT 26.250 452.856 Td /F1 9.8 Tf [(*\(Modified from Health Cluster Guide, Page 38\))] TJ ET BT 26.250 433.452 Td /F1 9.8 Tf [(Furthermore the Health Cluster Guide states that the CLA/HCC should bring together all significant health actors and facilitate a )] TJ ET BT 26.250 421.547 Td /F1 9.8 Tf [(process of analyzing available assessment information and agreeing on an initial response strategy for which it is essential to )] TJ ET BT 26.250 409.642 Td /F1 9.8 Tf [(have accurate information disseminated to the different actors involved. This distribution of information is done through the )] TJ ET BT 26.250 397.737 Td /F1 9.8 Tf [(health bulletins and documents posted to the internet.)] TJ ET BT 26.250 378.333 Td /F1 9.8 Tf [(Drawing from this, the main question this paper addresses is whether or not there were reporting differences in key )] TJ ET BT 26.250 366.428 Td /F1 9.8 Tf [(professional, and publically available, documents distributed during the implementation of the health responses to the Haitian )] TJ ET BT 26.250 354.523 Td /F1 9.8 Tf [(earthquake and Cholera epidemic.)] TJ ET BT 26.250 317.921 Td /F4 12.0 Tf [(Methodology)] TJ ET BT 26.250 297.966 Td /F1 9.8 Tf [(This paper analyses the content of the following document groups which were posted to the internet during the crises;)] TJ ET BT 26.250 278.562 Td /F1 9.8 Tf [(1. The Pan American Health Organization \(PAHO\), Health Cluster in Haiti Bulletin, Earthquake;)] TJ ET BT 26.250 259.157 Td /F1 9.8 Tf [(2. The PAHO/World Health Organization \(WHO\), Emergency Operations Center Situation Report, Earthquake;)] TJ ET BT 26.250 239.752 Td /F1 9.8 Tf [(3. PAHO/WHO, Emergency Operations Center Situation Report, Cholera; and)] TJ ET BT 26.250 220.347 Td /F1 9.8 Tf [(4. PAHO/WHO/Ministere de la Sante Publique et de la Population \(MSPP\), Health Cluster Bulletin, Cholera and Post-)] TJ ET BT 26.250 208.443 Td /F1 9.8 Tf [(Earthquake Response in Haiti.)] TJ ET BT 26.250 189.038 Td /F1 9.8 Tf [(Particular attention was be paid to timing of the production of the bulletins and to their content. A set of draft standard )] TJ ET BT 26.250 177.133 Td /F1 9.8 Tf [(references has been generated by the World Health Organization for the function of monitoring and evaluating the quality of )] TJ ET BT 26.250 165.228 Td /F1 9.8 Tf [(epidemiological data published by various WHO and Health Cluster emergency reports and a modified version of these is used )] TJ ET BT 26.250 153.324 Td /F1 9.8 Tf [(to analyse the content of the reports. \(Appendix A\))] TJ ET BT 26.250 133.919 Td /F1 9.8 Tf [(The checklist points were assigned a value of one point for each aspect leading to a maximum value of 17 for any particular )] TJ ET BT 26.250 122.014 Td /F1 9.8 Tf [(bulletin and a minimum value of zero. In addition to scored content the frequency of publication and average page length of )] TJ ET BT 26.250 110.109 Td /F1 9.8 Tf [(each bulletin was ascertained.)] TJ ET BT 26.250 90.705 Td /F1 9.8 Tf [(This paper is retrospectively examining and comparing the contents and frequency of a segment of the online updates from the )] TJ ET BT 26.250 78.800 Td /F1 9.8 Tf [(Health Cluster during the Haitian cholera and earthquake in 2010. This task included sourcing the documents online and then )] TJ ET BT 26.250 66.895 Td /F1 9.8 Tf [(applying a WHO rubric for evaluating the quality of the epidemiological data that they contained.)] TJ ET BT 26.250 47.490 Td /F1 9.8 Tf [(All Health Cluster Bulletins and PAHO/WHO Emergency Operations Centre Bulletins were obtained from the Relief Web )] TJ ET Q q 15.000 33.205 577.500 743.795 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(In the Haitian situation there were 12 clusters in total and the Health Cluster was led by the World Health Organization and the )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(Pan-American Health Organization in close cooperation with the MSPP. Prior to the earthquake the PAHO/WHO staff numbered )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(52 and more than 60 additional expert staff were added immediately after the earthquake.)] TJ ET 0.267 0.267 0.267 rg BT 412.662 745.174 Td /F4 8.7 Tf [(8)] TJ ET BT 417.481 745.174 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 422.299 743.667 Td /F1 9.8 Tf [( Operational only four days after the )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(earthquake, more than 400 agencies and organizations had registered with the Health Cluster.)] TJ ET 0.267 0.267 0.267 rg BT 433.244 733.269 Td /F4 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 26.250 712.357 Td /F1 9.8 Tf [(The aim of the cluster approach is to improve the coordination and cooperation between the many different response actors )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(while adhering to accepted humanitarian principles.)] TJ ET 0.267 0.267 0.267 rg BT 247.887 701.960 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 252.706 700.452 Td /F1 9.8 Tf [( The health cluster lead was PAHO/WHO, in the initial stages after the )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(earthquake, who worked closely with the Haitian Ministry of Health. They then subsequently became partners in leading the )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(cluster in some quarters this was deemed one of the largest successes of the coordination aspect of the mission in that the )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(international response organizations goals were appropriately aligned with national structures and long term goals.)] TJ ET 0.267 0.267 0.267 rg BT 519.385 666.245 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 26.250 645.333 Td /F1 9.8 Tf [(An examination of key parts of the Health Cluster Guide provides the theoretical framework for this paper; one function of the )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(Cluster Lead Agency is Monitoring and Reporting and roles are outlined in Table 1 below.)] TJ ET q 26.250 609.811 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 612.559 Td /F1 9.8 Tf [(Table 1. Cluster Function 8)] TJ ET Q 1.000 1.000 1.000 rg 26.250 507.380 555.000 94.931 re f 0.267 0.267 0.267 rg 26.625 601.186 138.152 0.750 re f 164.777 601.186 242.346 0.750 re f 26.625 585.305 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 591.331 Td /F5 9.8 Tf [(Cluster Lead Agency)] TJ ET 0.267 0.267 0.267 rg 406.373 601.186 174.502 0.750 re f 406.373 585.305 0.750 16.631 re f 580.125 585.305 0.750 16.631 re f 0.271 0.267 0.267 rg BT 411.623 591.331 Td /F5 9.8 Tf [(Cluster Partners)] TJ ET 0.267 0.267 0.267 rg 26.625 585.305 138.527 0.750 re f 26.625 561.793 0.750 24.262 re f 0.271 0.267 0.267 rg BT 31.875 575.450 Td /F4 9.8 Tf [(Cluster Lead Agency )] TJ ET BT 31.875 567.819 Td /F4 9.8 Tf [(Representative)] TJ ET 0.267 0.267 0.267 rg 164.402 585.305 242.721 0.750 re f 164.402 561.793 0.750 24.262 re f 0.271 0.267 0.267 rg BT 169.652 575.450 Td /F4 9.8 Tf [(Health Cluster Coordinator \(HCC\))] TJ ET 0.267 0.267 0.267 rg 26.625 561.793 138.527 0.750 re f 26.625 507.755 138.527 0.750 re f 26.625 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 31.875 551.938 Td /F1 9.8 Tf [(Produce and disseminate )] TJ ET BT 31.875 544.306 Td /F1 9.8 Tf [(Cluster sit-reps and regular )] TJ ET BT 31.875 536.675 Td /F1 9.8 Tf [(Health Bulletins using HCC )] TJ ET BT 31.875 529.044 Td /F1 9.8 Tf [(input.)] TJ ET 0.267 0.267 0.267 rg 164.402 561.793 242.721 0.750 re f 164.402 507.755 242.721 0.750 re f 164.402 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 169.652 551.938 Td /F1 9.8 Tf [(Ensure partners active contribution to and )] TJ ET BT 169.652 544.306 Td /F1 9.8 Tf [(involvement in joint monitoring of individual and )] TJ ET BT 169.652 536.675 Td /F1 9.8 Tf [(common plans of action for health interventions; )] TJ ET BT 169.652 529.044 Td /F1 9.8 Tf [(collate and disseminate this and other information )] TJ ET BT 169.652 521.413 Td /F1 9.8 Tf [(related to the health sector in Cluster sit-reps and/or )] TJ ET BT 169.652 513.781 Td /F1 9.8 Tf [(regular Health Bulletins.)] TJ ET 0.267 0.267 0.267 rg 406.373 561.793 174.502 0.750 re f 406.373 507.755 174.502 0.750 re f 406.373 507.755 0.750 54.788 re f 580.125 507.755 0.750 54.788 re f 0.271 0.267 0.267 rg BT 411.623 551.938 Td /F1 9.8 Tf [(Participate in defining and agreeing )] TJ ET BT 411.623 544.306 Td /F1 9.8 Tf [(on any information and reports that )] TJ ET BT 411.623 536.675 Td /F1 9.8 Tf [(Cluster partners should provide to )] TJ ET BT 411.623 529.044 Td /F1 9.8 Tf [(the HCC, and provide such )] TJ ET BT 411.623 521.413 Td /F1 9.8 Tf [(information and reports in a timely )] TJ ET BT 411.623 513.781 Td /F1 9.8 Tf [(manner)] TJ ET BT 26.250 452.856 Td /F1 9.8 Tf [(*\(Modified from Health Cluster Guide, Page 38\))] TJ ET BT 26.250 433.452 Td /F1 9.8 Tf [(Furthermore the Health Cluster Guide states that the CLA/HCC should bring together all significant health actors and facilitate a )] TJ ET BT 26.250 421.547 Td /F1 9.8 Tf [(process of analyzing available assessment information and agreeing on an initial response strategy for which it is essential to )] TJ ET BT 26.250 409.642 Td /F1 9.8 Tf [(have accurate information disseminated to the different actors involved. This distribution of information is done through the )] TJ ET BT 26.250 397.737 Td /F1 9.8 Tf [(health bulletins and documents posted to the internet.)] TJ ET BT 26.250 378.333 Td /F1 9.8 Tf [(Drawing from this, the main question this paper addresses is whether or not there were reporting differences in key )] TJ ET BT 26.250 366.428 Td /F1 9.8 Tf [(professional, and publically available, documents distributed during the implementation of the health responses to the Haitian )] TJ ET BT 26.250 354.523 Td /F1 9.8 Tf [(earthquake and Cholera epidemic.)] TJ ET BT 26.250 317.921 Td /F4 12.0 Tf [(Methodology)] TJ ET BT 26.250 297.966 Td /F1 9.8 Tf [(This paper analyses the content of the following document groups which were posted to the internet during the crises;)] TJ ET BT 26.250 278.562 Td /F1 9.8 Tf [(1. The Pan American Health Organization \(PAHO\), Health Cluster in Haiti Bulletin, Earthquake;)] TJ ET BT 26.250 259.157 Td /F1 9.8 Tf [(2. The PAHO/World Health Organization \(WHO\), Emergency Operations Center Situation Report, Earthquake;)] TJ ET BT 26.250 239.752 Td /F1 9.8 Tf [(3. PAHO/WHO, Emergency Operations Center Situation Report, Cholera; and)] TJ ET BT 26.250 220.347 Td /F1 9.8 Tf [(4. PAHO/WHO/Ministere de la Sante Publique et de la Population \(MSPP\), Health Cluster Bulletin, Cholera and Post-)] TJ ET BT 26.250 208.443 Td /F1 9.8 Tf [(Earthquake Response in Haiti.)] TJ ET BT 26.250 189.038 Td /F1 9.8 Tf [(Particular attention was be paid to timing of the production of the bulletins and to their content. A set of draft standard )] TJ ET BT 26.250 177.133 Td /F1 9.8 Tf [(references has been generated by the World Health Organization for the function of monitoring and evaluating the quality of )] TJ ET BT 26.250 165.228 Td /F1 9.8 Tf [(epidemiological data published by various WHO and Health Cluster emergency reports and a modified version of these is used )] TJ ET BT 26.250 153.324 Td /F1 9.8 Tf [(to analyse the content of the reports. \(Appendix A\))] TJ ET BT 26.250 133.919 Td /F1 9.8 Tf [(The checklist points were assigned a value of one point for each aspect leading to a maximum value of 17 for any particular )] TJ ET BT 26.250 122.014 Td /F1 9.8 Tf [(bulletin and a minimum value of zero. In addition to scored content the frequency of publication and average page length of )] TJ ET BT 26.250 110.109 Td /F1 9.8 Tf [(each bulletin was ascertained.)] TJ ET BT 26.250 90.705 Td /F1 9.8 Tf [(This paper is retrospectively examining and comparing the contents and frequency of a segment of the online updates from the )] TJ ET BT 26.250 78.800 Td /F1 9.8 Tf [(Health Cluster during the Haitian cholera and earthquake in 2010. This task included sourcing the documents online and then )] TJ ET BT 26.250 66.895 Td /F1 9.8 Tf [(applying a WHO rubric for evaluating the quality of the epidemiological data that they contained.)] TJ ET BT 26.250 47.490 Td /F1 9.8 Tf [(All Health Cluster Bulletins and PAHO/WHO Emergency Operations Centre Bulletins were obtained from the Relief Web )] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(3)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 127 0 obj << /Type /Font /Subtype /Type1 /Name /F5 /BaseFont /Helvetica-Oblique /Encoding /WinAnsiEncoding >> endobj 128 0 obj << /Type /Annot /Subtype /Link /A 129 0 R /Border [0 0 0] /H /I /Rect [ 412.6620 744.3722 417.4807 753.1905 ] >> endobj 129 0 obj << /Type /Action >> endobj 130 0 obj << /Type /Annot /Subtype /Link /A 131 0 R /Border [0 0 0] /H /I /Rect [ 417.4807 744.3722 422.2993 753.1905 ] >> endobj 131 0 obj << /Type /Action >> endobj 132 0 obj << /Type /Annot /Subtype /Link /A 133 0 R /Border [0 0 0] /H /I /Rect [ 433.2443 732.4674 442.8816 741.2858 ] >> endobj 133 0 obj << /Type /Action >> endobj 134 0 obj << /Type /Annot /Subtype /Link /A 135 0 R /Border [0 0 0] /H /I /Rect [ 247.8870 701.1579 252.7057 709.9762 ] >> endobj 135 0 obj << /Type /Action >> endobj 136 0 obj << /Type /Annot /Subtype /Link /A 137 0 R /Border [0 0 0] /H /I /Rect [ 519.3855 665.4437 524.2042 674.2620 ] >> endobj 137 0 obj << /Type /Action >> endobj 138 0 obj << /Type /Annot /Subtype /Link /A 139 0 R /Border [0 0 0] /H /I /Rect [ 412.6620 744.3722 417.4807 753.1905 ] >> endobj 139 0 obj << /Type /Action >> endobj 140 0 obj << /Type /Annot /Subtype /Link /A 141 0 R /Border [0 0 0] /H /I /Rect [ 417.4807 744.3722 422.2993 753.1905 ] >> endobj 141 0 obj << /Type /Action >> endobj 142 0 obj << /Type /Annot /Subtype /Link /A 143 0 R /Border [0 0 0] /H /I /Rect [ 433.2443 732.4674 442.8816 741.2858 ] >> endobj 143 0 obj << /Type /Action >> endobj 144 0 obj << /Type /Annot /Subtype /Link /A 145 0 R /Border [0 0 0] /H /I /Rect [ 247.8870 701.1579 252.7057 709.9762 ] >> endobj 145 0 obj << /Type /Action >> endobj 146 0 obj << /Type /Annot /Subtype /Link /A 147 0 R /Border [0 0 0] /H /I /Rect [ 519.3855 665.4437 524.2042 674.2620 ] >> endobj 147 0 obj << /Type /Action >> endobj 148 0 obj << /Type /Annot /Subtype /Link /A 149 0 R /Border [0 0 0] /H /I /Rect [ 412.6620 744.3722 417.4807 753.1905 ] >> endobj 149 0 obj << /Type /Action >> endobj 150 0 obj << /Type /Annot /Subtype /Link /A 151 0 R /Border [0 0 0] /H /I /Rect [ 417.4807 744.3722 422.2993 753.1905 ] >> endobj 151 0 obj << /Type /Action >> endobj 152 0 obj << /Type /Annot /Subtype /Link /A 153 0 R /Border [0 0 0] /H /I /Rect [ 433.2443 732.4674 442.8816 741.2858 ] >> endobj 153 0 obj << /Type /Action >> endobj 154 0 obj << /Type /Annot /Subtype /Link /A 155 0 R /Border [0 0 0] /H /I /Rect [ 247.8870 701.1579 252.7057 709.9762 ] >> endobj 155 0 obj << /Type /Action >> endobj 156 0 obj << /Type /Annot /Subtype /Link /A 157 0 R /Border [0 0 0] /H /I /Rect [ 519.3855 665.4437 524.2042 674.2620 ] >> endobj 157 0 obj << /Type /Action >> endobj 158 0 obj << /Type /Page /Parent 3 0 R /Annots [ 160 0 R 162 0 R 164 0 R 166 0 R 170 0 R 172 0 R 174 0 R 176 0 R 180 0 R 182 0 R 184 0 R 186 0 R ] /Contents 159 0 R >> endobj 159 0 obj << /Length 21563 >> stream 0.271 0.267 0.267 rg q 15.000 38.409 577.500 738.591 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(website and PAHO/WHO web domains.)] TJ ET 0.267 0.267 0.267 rg BT 198.016 768.983 Td /F4 8.7 Tf [(11)] TJ ET BT 207.653 768.983 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 217.290 767.476 Td /F1 9.8 Tf [( One of a total of 91 documents was not available online and was therefore )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(excluded.)] TJ ET q 26.250 731.954 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 734.701 Td /F1 9.8 Tf [(Table 2. Source Documents)] TJ ET Q 1.000 1.000 1.000 rg 26.250 624.716 555.000 99.738 re f 0.267 0.267 0.267 rg 26.625 723.329 343.334 0.750 re f 26.625 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 713.474 Td /F1 9.8 Tf [(Organization/Description)] TJ ET 0.267 0.267 0.267 rg 369.209 723.329 168.716 0.750 re f 369.209 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 713.474 Td /F1 9.8 Tf [(Dates)] TJ ET 0.267 0.267 0.267 rg 537.176 723.329 43.699 0.750 re f 537.176 707.448 0.750 16.631 re f 580.125 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 713.474 Td /F1 9.8 Tf [(#)] TJ ET 0.267 0.267 0.267 rg 26.625 707.448 343.334 0.750 re f 26.625 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 31.875 697.593 Td /F1 9.8 Tf [(PAHO/WHO Health Cluster Bulletin \(Earthquake\))] TJ ET 0.267 0.267 0.267 rg 369.209 707.448 168.716 0.750 re f 369.209 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 374.459 697.593 Td /F1 9.8 Tf [(January 20 March 1, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 707.448 43.699 0.750 re f 537.176 688.616 0.750 19.582 re f 580.125 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 542.426 695.232 Td /F1 9.8 Tf [(1-23)] TJ ET BT 561.936 697.798 Td /F1 8.7 Tf [(*)] TJ ET 0.267 0.267 0.267 rg 26.625 688.616 343.334 0.750 re f 26.625 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 678.761 Td /F1 9.8 Tf [(PAHO/WHO Emergency Operations Center Situation Report \(Earthquake\))] TJ ET 0.267 0.267 0.267 rg 369.209 688.616 168.716 0.750 re f 369.209 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 678.761 Td /F1 9.8 Tf [(January 13 April 15, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 688.616 43.699 0.750 re f 537.176 672.735 0.750 16.631 re f 580.125 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 678.761 Td /F1 9.8 Tf [(1-26)] TJ ET 0.267 0.267 0.267 rg 26.625 672.735 343.334 0.750 re f 26.625 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 662.880 Td /F1 9.8 Tf [(PAHO/WHO Health Cluster Bulletin \(Cholera\))] TJ ET 0.267 0.267 0.267 rg 369.209 672.735 168.716 0.750 re f 369.209 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 662.880 Td /F1 9.8 Tf [(November 11, 2010 May 27, 2011)] TJ ET 0.267 0.267 0.267 rg 537.176 672.735 43.699 0.750 re f 537.176 656.853 0.750 16.631 re f 580.125 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 662.880 Td /F1 9.8 Tf [(1-25)] TJ ET 0.267 0.267 0.267 rg 26.625 656.853 343.334 0.750 re f 26.625 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 646.998 Td /F1 9.8 Tf [(PAHO/WHO Emergency Operations Center Situation Report \(Cholera\))] TJ ET 0.267 0.267 0.267 rg 369.209 656.853 168.716 0.750 re f 369.209 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 646.998 Td /F1 9.8 Tf [(October 22 December 15, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 656.853 43.699 0.750 re f 537.176 640.972 0.750 16.631 re f 580.125 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 646.998 Td /F1 9.8 Tf [(1-17)] TJ ET 0.267 0.267 0.267 rg 26.625 640.972 343.334 0.750 re f 26.625 625.091 343.334 0.750 re f 26.625 625.091 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 631.117 Td /F1 9.8 Tf [(*Missing #22)] TJ ET 0.267 0.267 0.267 rg 369.209 640.972 168.716 0.750 re f 369.209 625.091 168.716 0.750 re f 369.209 625.091 0.750 16.631 re f 537.176 640.972 43.699 0.750 re f 537.176 625.091 43.699 0.750 re f 537.176 625.091 0.750 16.631 re f 580.125 625.091 0.750 16.631 re f 0.271 0.267 0.267 rg BT 26.250 570.192 Td /F1 9.8 Tf [(The evaluation framework used was the Health Cluster activities of the WHO. Specifically Function 8, Monitoring and Reporting )] TJ ET BT 26.250 558.287 Td /F1 9.8 Tf [(and Function 9, Advocacy and resource mobilization.)] TJ ET 0.267 0.267 0.267 rg BT 254.936 559.795 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 26.250 538.883 Td /F1 9.8 Tf [(A draft check list for monitoring and evaluating the quality of epidemiological data published by various WHO and Health Cluster )] TJ ET BT 26.250 526.978 Td /F1 9.8 Tf [(emergency reports was provided by Dr. Giuseppe Annunziata, Chief Information and Knowledge Management, WHO )] TJ ET BT 26.250 515.073 Td /F1 9.8 Tf [(Mediterranean Centre for Health Risk Reduction and was used as a comparative tool \(Appendix 1\) through an Excel )] TJ ET BT 26.250 503.168 Td /F1 9.8 Tf [(comparison template.)] TJ ET BT 26.250 483.764 Td /F4 9.8 Tf [(Document Selection and Description)] TJ ET BT 26.250 464.359 Td /F1 9.8 Tf [(A total of 90 documents were located and downloaded electronically and subsequently printed. They ranged in size from 2 )] TJ ET BT 26.250 452.454 Td /F1 9.8 Tf [(pages to 16 pages \(single sided\) and were in Adobe Portable Document Format. A sample cover image of a bulletin is included )] TJ ET BT 26.250 440.549 Td /F1 9.8 Tf [(as Appendix B.)] TJ ET BT 26.250 421.145 Td /F4 9.8 Tf [(Data Collection Procedures)] TJ ET BT 26.250 401.740 Td /F1 9.8 Tf [(Data was collected by the main investigator and input into Excel. Each document was reviewed twice for accuracy in data )] TJ ET BT 26.250 389.835 Td /F1 9.8 Tf [(collection and a second trained reviewer was used to ensure validity through randomly selected checks of data entry.)] TJ ET BT 26.250 370.430 Td /F4 9.8 Tf [(Data Analysis)] TJ ET BT 26.250 351.026 Td /F1 9.8 Tf [(The data spread-sheet was then analysed along a number of metrics. The main issue examined was the checklist score of )] TJ ET BT 26.250 339.121 Td /F1 9.8 Tf [(which a maximum value of 17 was possible. Data was plotted on graphs and means were found for the following variables:)] TJ ET BT 26.250 319.716 Td /F1 9.8 Tf [(a. Average score per bulletin)] TJ ET BT 26.250 300.311 Td /F1 9.8 Tf [(b. Average days between bulletin production)] TJ ET BT 26.250 280.907 Td /F1 9.8 Tf [(c. Average length of bulletin)] TJ ET BT 26.250 244.304 Td /F4 12.0 Tf [(Results)] TJ ET BT 26.250 224.350 Td /F1 9.8 Tf [(The average score of the bulletins was calculated and is shown below with the PAHO/WHO Emergency Operating Centre )] TJ ET BT 26.250 212.445 Td /F1 9.8 Tf [(receiving an average score of 2.54/17 and the Health Cluster Cholera Bulletins receiving the highest value of 11 out of a )] TJ ET BT 26.250 200.540 Td /F1 9.8 Tf [(possible maximum of 17.)] TJ ET 0.965 0.965 0.965 rg 26.250 38.409 555.000 152.250 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 190.659 m 581.250 190.659 l 581.250 189.909 l 26.250 189.909 l f q 225.000 0 0 136.500 35.250 44.409 cm /I5 Do Q q 35.250 38.409 537.000 0.000 re W n Q Q q 15.000 38.409 577.500 738.591 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(website and PAHO/WHO web domains.)] TJ ET 0.267 0.267 0.267 rg BT 198.016 768.983 Td /F4 8.7 Tf [(11)] TJ ET BT 207.653 768.983 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 217.290 767.476 Td /F1 9.8 Tf [( One of a total of 91 documents was not available online and was therefore )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(excluded.)] TJ ET q 26.250 731.954 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 734.701 Td /F1 9.8 Tf [(Table 2. Source Documents)] TJ ET Q 1.000 1.000 1.000 rg 26.250 624.716 555.000 99.738 re f 0.267 0.267 0.267 rg 26.625 723.329 343.334 0.750 re f 26.625 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 713.474 Td /F1 9.8 Tf [(Organization/Description)] TJ ET 0.267 0.267 0.267 rg 369.209 723.329 168.716 0.750 re f 369.209 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 713.474 Td /F1 9.8 Tf [(Dates)] TJ ET 0.267 0.267 0.267 rg 537.176 723.329 43.699 0.750 re f 537.176 707.448 0.750 16.631 re f 580.125 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 713.474 Td /F1 9.8 Tf [(#)] TJ ET 0.267 0.267 0.267 rg 26.625 707.448 343.334 0.750 re f 26.625 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 31.875 697.593 Td /F1 9.8 Tf [(PAHO/WHO Health Cluster Bulletin \(Earthquake\))] TJ ET 0.267 0.267 0.267 rg 369.209 707.448 168.716 0.750 re f 369.209 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 374.459 697.593 Td /F1 9.8 Tf [(January 20 March 1, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 707.448 43.699 0.750 re f 537.176 688.616 0.750 19.582 re f 580.125 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 542.426 695.232 Td /F1 9.8 Tf [(1-23)] TJ ET BT 561.936 697.798 Td /F1 8.7 Tf [(*)] TJ ET 0.267 0.267 0.267 rg 26.625 688.616 343.334 0.750 re f 26.625 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 678.761 Td /F1 9.8 Tf [(PAHO/WHO Emergency Operations Center Situation Report \(Earthquake\))] TJ ET 0.267 0.267 0.267 rg 369.209 688.616 168.716 0.750 re f 369.209 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 678.761 Td /F1 9.8 Tf [(January 13 April 15, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 688.616 43.699 0.750 re f 537.176 672.735 0.750 16.631 re f 580.125 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 678.761 Td /F1 9.8 Tf [(1-26)] TJ ET 0.267 0.267 0.267 rg 26.625 672.735 343.334 0.750 re f 26.625 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 662.880 Td /F1 9.8 Tf [(PAHO/WHO Health Cluster Bulletin \(Cholera\))] TJ ET 0.267 0.267 0.267 rg 369.209 672.735 168.716 0.750 re f 369.209 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 662.880 Td /F1 9.8 Tf [(November 11, 2010 May 27, 2011)] TJ ET 0.267 0.267 0.267 rg 537.176 672.735 43.699 0.750 re f 537.176 656.853 0.750 16.631 re f 580.125 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 662.880 Td /F1 9.8 Tf [(1-25)] TJ ET 0.267 0.267 0.267 rg 26.625 656.853 343.334 0.750 re f 26.625 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 646.998 Td /F1 9.8 Tf [(PAHO/WHO Emergency Operations Center Situation Report \(Cholera\))] TJ ET 0.267 0.267 0.267 rg 369.209 656.853 168.716 0.750 re f 369.209 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 646.998 Td /F1 9.8 Tf [(October 22 December 15, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 656.853 43.699 0.750 re f 537.176 640.972 0.750 16.631 re f 580.125 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 646.998 Td /F1 9.8 Tf [(1-17)] TJ ET 0.267 0.267 0.267 rg 26.625 640.972 343.334 0.750 re f 26.625 625.091 343.334 0.750 re f 26.625 625.091 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 631.117 Td /F1 9.8 Tf [(*Missing #22)] TJ ET 0.267 0.267 0.267 rg 369.209 640.972 168.716 0.750 re f 369.209 625.091 168.716 0.750 re f 369.209 625.091 0.750 16.631 re f 537.176 640.972 43.699 0.750 re f 537.176 625.091 43.699 0.750 re f 537.176 625.091 0.750 16.631 re f 580.125 625.091 0.750 16.631 re f 0.271 0.267 0.267 rg BT 26.250 570.192 Td /F1 9.8 Tf [(The evaluation framework used was the Health Cluster activities of the WHO. Specifically Function 8, Monitoring and Reporting )] TJ ET BT 26.250 558.287 Td /F1 9.8 Tf [(and Function 9, Advocacy and resource mobilization.)] TJ ET 0.267 0.267 0.267 rg BT 254.936 559.795 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 26.250 538.883 Td /F1 9.8 Tf [(A draft check list for monitoring and evaluating the quality of epidemiological data published by various WHO and Health Cluster )] TJ ET BT 26.250 526.978 Td /F1 9.8 Tf [(emergency reports was provided by Dr. Giuseppe Annunziata, Chief Information and Knowledge Management, WHO )] TJ ET BT 26.250 515.073 Td /F1 9.8 Tf [(Mediterranean Centre for Health Risk Reduction and was used as a comparative tool \(Appendix 1\) through an Excel )] TJ ET BT 26.250 503.168 Td /F1 9.8 Tf [(comparison template.)] TJ ET BT 26.250 483.764 Td /F4 9.8 Tf [(Document Selection and Description)] TJ ET BT 26.250 464.359 Td /F1 9.8 Tf [(A total of 90 documents were located and downloaded electronically and subsequently printed. They ranged in size from 2 )] TJ ET BT 26.250 452.454 Td /F1 9.8 Tf [(pages to 16 pages \(single sided\) and were in Adobe Portable Document Format. A sample cover image of a bulletin is included )] TJ ET BT 26.250 440.549 Td /F1 9.8 Tf [(as Appendix B.)] TJ ET BT 26.250 421.145 Td /F4 9.8 Tf [(Data Collection Procedures)] TJ ET BT 26.250 401.740 Td /F1 9.8 Tf [(Data was collected by the main investigator and input into Excel. Each document was reviewed twice for accuracy in data )] TJ ET BT 26.250 389.835 Td /F1 9.8 Tf [(collection and a second trained reviewer was used to ensure validity through randomly selected checks of data entry.)] TJ ET BT 26.250 370.430 Td /F4 9.8 Tf [(Data Analysis)] TJ ET BT 26.250 351.026 Td /F1 9.8 Tf [(The data spread-sheet was then analysed along a number of metrics. The main issue examined was the checklist score of )] TJ ET BT 26.250 339.121 Td /F1 9.8 Tf [(which a maximum value of 17 was possible. Data was plotted on graphs and means were found for the following variables:)] TJ ET BT 26.250 319.716 Td /F1 9.8 Tf [(a. Average score per bulletin)] TJ ET BT 26.250 300.311 Td /F1 9.8 Tf [(b. Average days between bulletin production)] TJ ET BT 26.250 280.907 Td /F1 9.8 Tf [(c. Average length of bulletin)] TJ ET BT 26.250 244.304 Td /F4 12.0 Tf [(Results)] TJ ET BT 26.250 224.350 Td /F1 9.8 Tf [(The average score of the bulletins was calculated and is shown below with the PAHO/WHO Emergency Operating Centre )] TJ ET BT 26.250 212.445 Td /F1 9.8 Tf [(receiving an average score of 2.54/17 and the Health Cluster Cholera Bulletins receiving the highest value of 11 out of a )] TJ ET BT 26.250 200.540 Td /F1 9.8 Tf [(possible maximum of 17.)] TJ ET 0.965 0.965 0.965 rg 26.250 38.409 555.000 152.250 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 190.659 m 581.250 190.659 l 581.250 189.909 l 26.250 189.909 l f q 225.000 0 0 136.500 35.250 44.409 cm /I7 Do Q q 35.250 38.409 537.000 0.000 re W n Q Q q 15.000 38.409 577.500 738.591 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(website and PAHO/WHO web domains.)] TJ ET 0.267 0.267 0.267 rg BT 198.016 768.983 Td /F4 8.7 Tf [(11)] TJ ET BT 207.653 768.983 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 217.290 767.476 Td /F1 9.8 Tf [( One of a total of 91 documents was not available online and was therefore )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(excluded.)] TJ ET q 26.250 731.954 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 734.701 Td /F1 9.8 Tf [(Table 2. Source Documents)] TJ ET Q 1.000 1.000 1.000 rg 26.250 624.716 555.000 99.738 re f 0.267 0.267 0.267 rg 26.625 723.329 343.334 0.750 re f 26.625 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 713.474 Td /F1 9.8 Tf [(Organization/Description)] TJ ET 0.267 0.267 0.267 rg 369.209 723.329 168.716 0.750 re f 369.209 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 713.474 Td /F1 9.8 Tf [(Dates)] TJ ET 0.267 0.267 0.267 rg 537.176 723.329 43.699 0.750 re f 537.176 707.448 0.750 16.631 re f 580.125 707.448 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 713.474 Td /F1 9.8 Tf [(#)] TJ ET 0.267 0.267 0.267 rg 26.625 707.448 343.334 0.750 re f 26.625 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 31.875 697.593 Td /F1 9.8 Tf [(PAHO/WHO Health Cluster Bulletin \(Earthquake\))] TJ ET 0.267 0.267 0.267 rg 369.209 707.448 168.716 0.750 re f 369.209 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 374.459 697.593 Td /F1 9.8 Tf [(January 20 March 1, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 707.448 43.699 0.750 re f 537.176 688.616 0.750 19.582 re f 580.125 688.616 0.750 19.582 re f 0.271 0.267 0.267 rg BT 542.426 695.232 Td /F1 9.8 Tf [(1-23)] TJ ET BT 561.936 697.798 Td /F1 8.7 Tf [(*)] TJ ET 0.267 0.267 0.267 rg 26.625 688.616 343.334 0.750 re f 26.625 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 678.761 Td /F1 9.8 Tf [(PAHO/WHO Emergency Operations Center Situation Report \(Earthquake\))] TJ ET 0.267 0.267 0.267 rg 369.209 688.616 168.716 0.750 re f 369.209 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 678.761 Td /F1 9.8 Tf [(January 13 April 15, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 688.616 43.699 0.750 re f 537.176 672.735 0.750 16.631 re f 580.125 672.735 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 678.761 Td /F1 9.8 Tf [(1-26)] TJ ET 0.267 0.267 0.267 rg 26.625 672.735 343.334 0.750 re f 26.625 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 662.880 Td /F1 9.8 Tf [(PAHO/WHO Health Cluster Bulletin \(Cholera\))] TJ ET 0.267 0.267 0.267 rg 369.209 672.735 168.716 0.750 re f 369.209 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 662.880 Td /F1 9.8 Tf [(November 11, 2010 May 27, 2011)] TJ ET 0.267 0.267 0.267 rg 537.176 672.735 43.699 0.750 re f 537.176 656.853 0.750 16.631 re f 580.125 656.853 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 662.880 Td /F1 9.8 Tf [(1-25)] TJ ET 0.267 0.267 0.267 rg 26.625 656.853 343.334 0.750 re f 26.625 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 646.998 Td /F1 9.8 Tf [(PAHO/WHO Emergency Operations Center Situation Report \(Cholera\))] TJ ET 0.267 0.267 0.267 rg 369.209 656.853 168.716 0.750 re f 369.209 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 374.459 646.998 Td /F1 9.8 Tf [(October 22 December 15, 2010)] TJ ET 0.267 0.267 0.267 rg 537.176 656.853 43.699 0.750 re f 537.176 640.972 0.750 16.631 re f 580.125 640.972 0.750 16.631 re f 0.271 0.267 0.267 rg BT 542.426 646.998 Td /F1 9.8 Tf [(1-17)] TJ ET 0.267 0.267 0.267 rg 26.625 640.972 343.334 0.750 re f 26.625 625.091 343.334 0.750 re f 26.625 625.091 0.750 16.631 re f 0.271 0.267 0.267 rg BT 31.875 631.117 Td /F1 9.8 Tf [(*Missing #22)] TJ ET 0.267 0.267 0.267 rg 369.209 640.972 168.716 0.750 re f 369.209 625.091 168.716 0.750 re f 369.209 625.091 0.750 16.631 re f 537.176 640.972 43.699 0.750 re f 537.176 625.091 43.699 0.750 re f 537.176 625.091 0.750 16.631 re f 580.125 625.091 0.750 16.631 re f 0.271 0.267 0.267 rg BT 26.250 570.192 Td /F1 9.8 Tf [(The evaluation framework used was the Health Cluster activities of the WHO. Specifically Function 8, Monitoring and Reporting )] TJ ET BT 26.250 558.287 Td /F1 9.8 Tf [(and Function 9, Advocacy and resource mobilization.)] TJ ET 0.267 0.267 0.267 rg BT 254.936 559.795 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 26.250 538.883 Td /F1 9.8 Tf [(A draft check list for monitoring and evaluating the quality of epidemiological data published by various WHO and Health Cluster )] TJ ET BT 26.250 526.978 Td /F1 9.8 Tf [(emergency reports was provided by Dr. Giuseppe Annunziata, Chief Information and Knowledge Management, WHO )] TJ ET BT 26.250 515.073 Td /F1 9.8 Tf [(Mediterranean Centre for Health Risk Reduction and was used as a comparative tool \(Appendix 1\) through an Excel )] TJ ET BT 26.250 503.168 Td /F1 9.8 Tf [(comparison template.)] TJ ET BT 26.250 483.764 Td /F4 9.8 Tf [(Document Selection and Description)] TJ ET BT 26.250 464.359 Td /F1 9.8 Tf [(A total of 90 documents were located and downloaded electronically and subsequently printed. They ranged in size from 2 )] TJ ET BT 26.250 452.454 Td /F1 9.8 Tf [(pages to 16 pages \(single sided\) and were in Adobe Portable Document Format. A sample cover image of a bulletin is included )] TJ ET BT 26.250 440.549 Td /F1 9.8 Tf [(as Appendix B.)] TJ ET BT 26.250 421.145 Td /F4 9.8 Tf [(Data Collection Procedures)] TJ ET BT 26.250 401.740 Td /F1 9.8 Tf [(Data was collected by the main investigator and input into Excel. Each document was reviewed twice for accuracy in data )] TJ ET BT 26.250 389.835 Td /F1 9.8 Tf [(collection and a second trained reviewer was used to ensure validity through randomly selected checks of data entry.)] TJ ET BT 26.250 370.430 Td /F4 9.8 Tf [(Data Analysis)] TJ ET BT 26.250 351.026 Td /F1 9.8 Tf [(The data spread-sheet was then analysed along a number of metrics. The main issue examined was the checklist score of )] TJ ET BT 26.250 339.121 Td /F1 9.8 Tf [(which a maximum value of 17 was possible. Data was plotted on graphs and means were found for the following variables:)] TJ ET BT 26.250 319.716 Td /F1 9.8 Tf [(a. Average score per bulletin)] TJ ET BT 26.250 300.311 Td /F1 9.8 Tf [(b. Average days between bulletin production)] TJ ET BT 26.250 280.907 Td /F1 9.8 Tf [(c. Average length of bulletin)] TJ ET BT 26.250 244.304 Td /F4 12.0 Tf [(Results)] TJ ET BT 26.250 224.350 Td /F1 9.8 Tf [(The average score of the bulletins was calculated and is shown below with the PAHO/WHO Emergency Operating Centre )] TJ ET BT 26.250 212.445 Td /F1 9.8 Tf [(receiving an average score of 2.54/17 and the Health Cluster Cholera Bulletins receiving the highest value of 11 out of a )] TJ ET BT 26.250 200.540 Td /F1 9.8 Tf [(possible maximum of 17.)] TJ ET 0.965 0.965 0.965 rg 26.250 38.409 555.000 152.250 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 190.659 m 581.250 190.659 l 581.250 189.909 l 26.250 189.909 l f q 225.000 0 0 136.500 35.250 44.409 cm /I9 Do Q q 35.250 38.409 537.000 0.000 re W n Q Q q 225.000 0 0 136.500 35.250 44.409 cm /I11 Do Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(4)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 160 0 obj << /Type /Annot /Subtype /Link /A 161 0 R /Border [0 0 0] /H /I /Rect [ 198.0157 768.1817 207.6531 777.0000 ] >> endobj 161 0 obj << /Type /Action >> endobj 162 0 obj << /Type /Annot /Subtype /Link /A 163 0 R /Border [0 0 0] /H /I /Rect [ 207.6531 768.1817 217.2904 777.0000 ] >> endobj 163 0 obj << /Type /Action >> endobj 164 0 obj << /Type /Annot /Subtype /Link /A 165 0 R /Border [0 0 0] /H /I /Rect [ 254.9363 558.9929 264.5736 567.8112 ] >> endobj 165 0 obj << /Type /Action >> endobj 166 0 obj << /Type /Annot /Subtype /Link /A 167 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 44.4095 260.2500 180.9095 ] >> endobj 167 0 obj << /Type /Action /S /URI /URI (https://currents.plos.org/disasters/files/2012/07/Figure-2-Average-Bulletin-Score.png) >> endobj 168 0 obj << /Type /XObject /Subtype /Image /Width 300 /Height 182 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 1 /Columns 300 /BitsPerComponent 8>> /ColorSpace /DeviceGray /BitsPerComponent 8 /Length 393>> stream xA 0 =fy9뀟\ endstream endobj 169 0 obj << /Type /XObject /Subtype /Image /Width 300 /Height 182 /SMask 168 0 R /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 300 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 29706>> stream x}y]U>SUJ*Je `HH[ĥDRq] " m [m@ȜTeJJU^8*b/Gw>ӹZCZ)]R|R~·-K ǧ ",\QUva=.lT#>*1}X iR!z4ffc$L$gl vaY񴂇G2" *щ9Vbv!2LG4qjۄ V޳gO6'ډv-/X`޽{+**&MD;h3fJl6;yiӦçQBeR@+ p5]|"T|5)$(qO4UEcǵ&ŠOz@[ݦ0 &D^xXhVEra1G1*gn/s(V/!hbbf9j!m#2]Y7̙㢤f8S#" gJ/DD#L/‚ \*"bs +< QcE !'!n6\ZE@@AK\ ,/Z8u$Cj^"CF c2Ɣ-FHʎaDH WFx.;"'J9@]sq Q'yG̲"Vx*J#:Xpa%n%!*p.}pVXn1"4q2qn.q8 bGfIKwqdj^"JEzɵ681kgjPpl!+2/F V"fGc54V1Wj*v, 9b{hSK'O"bԸ0[KFAE0l/kS< =Ʊ(aJ!UX#(qnLj@ؖ.\l 1oO4D%?8%OID*3%Hla i:::<ddddhhЋZb,_^$*[ohXG VX/pMH\4 I80kJ"& q9V?WpHRh!+K9D4ù hA\wzT2;a„_|O)Pn?Oo֛7okJJJ&N+b 9k__;;;>J0-ׯ[nXxq6}뭷v2|"1W[ ~_\q<#s#z8<07 EX NOb؅@|1&. 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#X`E4 "VM+ ŊE4GV*  J+ -cǎ:u*{M݇fJ00s|8~CCC;vd28{_|oʕ~bTUUyp}XXX \.W0|tΝ;tzttH$m5@q}L&s-kjj"H,d2w^r… @OOOaa@jWu83@p8\[[dFGGx4OP4HVB؈pvڰaqT9ϗ~&|VL&JKK@aa!8UR 4rX҃rt SO4=55n޼i4ϟ/͛7sŋC"WMM xCtii7JJJ<>pKcqDVn?5̔$XPP022FϜ9z@ i&YN89r+a2FGGY֭㏷o>00DND"ǏXMeQ) hoÇN7͛g4VkccG}m۶ឞ˗/I{n.\p8:;;_{5hfCFd4}UHt>Flrƍ p٥K,uu5q7xcpp0Hݻw۶m ,@f+b7'~YGGmjjeݻHΝ;W\y\lWWWMM ?Soo/˲(^z^b|i΃qE^lp; R`S#Gf;$EQhtpppzznL& Ax}Q۽x⢢kz<@ O_( DQٴiӵkׂ HSV _V3_g(Dtfxm[ZZyzl6WTTZlxx8 ](RFfۇb6m|2I& <\#pFԪ&2, 8v}Ŋ===J0/^La5kחM0e,sasE L4MKp8^o(uVss/xڵL&q܏?(@fպu\.hrS YAQ~z}`ppb$N,\={t|>EE%M4S`633<8b###Xjp6|ggd|7o8Nb5$M(`1%Ijll|'dY@7€pCEQK QAH$Hdzz~%I-[绺fs]]ƍ)ة\M/aϛ7رclRF NL&Smmm[[N;}4˲$ڵ^A8n4q!ttt$IaRll dY.,,xظqc>ǥ%΍]Ͼ4M~*."p4d_~ cd2ԘL&YZZʲlggd2K,*//ꫯ{7---?s$lK.󥥥uuulv˖-Ν[~}___OOEQJpAK.D"QRR2<<A{׳gVWW3ׯ_GQ0h3mGZt>X̙3CCC6l0$^|_`2nw,}bihh?xX'* 7E7Y+**&''ϟ?]QQf@"DSSɓ'{{{n*(֭pBbafPd2[V"V\5U&;,˧O3H@EZE)&,KJDQy  ble9J I'A=x[o@8KӀeYQu:]&t O6g*@SWT*^R;RPJ.]tΝW_}, P: F̀<!-g5b80&)͂4XM~,  4AO tRj1 \ie$MF;8d2\$|>ִYJJC@بa}KK EQh .]4DJ]$~/50Gk1m GxCPp2"9_5gE@I"jHWDJ5c Vjkc 7 Θ!|cIsDDdy]|" '4G Mk't\CMt{mж\(X^XỚK↤-D(&OcM^-y6w s܋V@0 (QJpم!,b=8k!(<+,Ĥ)nA#*]!!o ;-CxL"΀p `5}BjJ9V#6G iD /OpVZ ܧZ"8l4pJbjAΈʂ)A 5) +8<: Jpp7 yi"CF \/|O@P4rU-ՉrX p.MͶc|\\tJ}ť=.h/шR GOMpd J>-у<(cWF"*cʃRYyiO%CҹTeu_Jd1j39)X,vh_f*s\[YmGQ{RmePX"7"#PġPBRԈ3N44Xsz.e.g.m7XJ endstream endobj 192 0 obj << /Type /Page /Parent 3 0 R /Annots [ 194 0 R 198 0 R 202 0 R 206 0 R 210 0 R 214 0 R 218 0 R 222 0 R 226 0 R ] /Contents 193 0 R >> endobj 193 0 obj << /Length 13034 >> stream q 15.000 25.598 577.500 751.402 re W n 0.965 0.965 0.965 rg 26.250 747.845 555.000 29.155 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 747.845 m 581.250 747.845 l 581.250 748.595 l 26.250 748.595 l f q 35.250 759.095 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 2: Average Bulletin Score)] TJ ET Q BT 26.250 730.821 Td /F1 9.8 Tf [(In terms of how many days passed between bulletin production the Cholera Health Cluster bulletins were produced every 7.21 )] TJ ET BT 26.250 718.917 Td /F1 9.8 Tf [(days and the Earthquake Health Cluster Bulletins were produced every 2.17 days.)] TJ ET 0.965 0.965 0.965 rg 26.250 527.631 555.000 181.405 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 709.036 m 581.250 709.036 l 581.250 708.286 l 26.250 708.286 l f 26.250 527.631 m 581.250 527.631 l 581.250 528.381 l 26.250 528.381 l f q 225.000 0 0 136.500 35.250 562.786 cm /I13 Do Q q 35.250 538.881 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 547.262 Td /F4 9.8 Tf [(Fig. 3: Bulletin production per day.)] TJ ET Q BT 26.250 510.607 Td /F1 9.8 Tf [(The scores obtained by the Cholera Emergency Operations Centre and the Cholera Health Cluster over time are illustrated )] TJ ET BT 26.250 498.702 Td /F1 9.8 Tf [(below with the Cholera Health Cluster scoring higher than the EOC throughout their production cycle.)] TJ ET 0.965 0.965 0.965 rg 26.250 374.167 555.000 114.655 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 488.821 m 581.250 488.821 l 581.250 488.071 l 26.250 488.071 l f 26.250 374.167 m 581.250 374.167 l 581.250 374.917 l 26.250 374.917 l f q 225.000 0 0 69.750 35.250 409.321 cm /I15 Do Q q 35.250 385.417 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 393.798 Td /F4 9.8 Tf [(Fig. 4: Cholera EOC and Health Cluster Average Score Over Time)] TJ ET Q BT 26.250 357.143 Td /F1 9.8 Tf [(The Earthquake Health Cluster and the Earthquake EOC illustrated similar results with the epidemiological score for the Health )] TJ ET BT 26.250 345.238 Td /F1 9.8 Tf [(Cluster higher than the EOC throughout their production.)] TJ ET 0.965 0.965 0.965 rg 26.250 208.702 555.000 126.655 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 335.357 m 581.250 335.357 l 581.250 334.607 l 26.250 334.607 l f 26.250 208.702 m 581.250 208.702 l 581.250 209.452 l 26.250 209.452 l f q 225.000 0 0 81.750 35.250 243.857 cm /I17 Do Q q 35.250 219.952 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 228.333 Td /F4 9.8 Tf [(Fig. 5: Earthquake EOC and Health Cluster Average Score Over Time)] TJ ET Q BT 26.250 174.481 Td /F4 12.0 Tf [(Limitations)] TJ ET BT 26.250 154.527 Td /F1 9.8 Tf [(As this is the first time the draft checklist for monitoring and evaluating the quality of epidemiological data in publications by )] TJ ET BT 26.250 142.622 Td /F1 9.8 Tf [(various WHO and Health Cluster emergency reports was completed there is currently no way to validate the results or compare )] TJ ET BT 26.250 130.717 Td /F1 9.8 Tf [(them against previous studies. An online review does not illustrate that there are previous standardized templates for reporting )] TJ ET BT 26.250 118.812 Td /F1 9.8 Tf [(across the different bodies that produced the reports and the aims of the emergency bulletins are not inherently clear. As was )] TJ ET BT 26.250 106.908 Td /F1 9.8 Tf [(noted on the front page of one of the bulletins late in its production cycle, there were questions about the contents and )] TJ ET BT 26.250 95.003 Td /F1 9.8 Tf [(relevance of the reports.)] TJ ET BT 26.250 75.598 Td /F1 9.8 Tf [(The major limit to this data is that for all intents and purposes it is the first to be analysed using the WHO Checklist for quality of )] TJ ET BT 26.250 63.693 Td /F1 9.8 Tf [(epidemiological data in the comparison of two events in the same country. However, future studies that utilize the same )] TJ ET BT 26.250 51.789 Td /F1 9.8 Tf [(checklist can ascertain the validity of this study. Another major limitation is the lack of standardization of the different health )] TJ ET BT 26.250 39.884 Td /F1 9.8 Tf [(bulletins; there are multiple opportunities where interpretation of the presence or absence of quantitative variables could have )] TJ ET Q q 15.000 25.598 577.500 751.402 re W n 0.965 0.965 0.965 rg 26.250 747.845 555.000 29.155 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 747.845 m 581.250 747.845 l 581.250 748.595 l 26.250 748.595 l f q 35.250 759.095 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 2: Average Bulletin Score)] TJ ET Q BT 26.250 730.821 Td /F1 9.8 Tf [(In terms of how many days passed between bulletin production the Cholera Health Cluster bulletins were produced every 7.21 )] TJ ET BT 26.250 718.917 Td /F1 9.8 Tf [(days and the Earthquake Health Cluster Bulletins were produced every 2.17 days.)] TJ ET 0.965 0.965 0.965 rg 26.250 527.631 555.000 181.405 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 709.036 m 581.250 709.036 l 581.250 708.286 l 26.250 708.286 l f 26.250 527.631 m 581.250 527.631 l 581.250 528.381 l 26.250 528.381 l f q 225.000 0 0 136.500 35.250 562.786 cm /I19 Do Q q 35.250 538.881 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 547.262 Td /F4 9.8 Tf [(Fig. 3: Bulletin production per day.)] TJ ET Q BT 26.250 510.607 Td /F1 9.8 Tf [(The scores obtained by the Cholera Emergency Operations Centre and the Cholera Health Cluster over time are illustrated )] TJ ET BT 26.250 498.702 Td /F1 9.8 Tf [(below with the Cholera Health Cluster scoring higher than the EOC throughout their production cycle.)] TJ ET 0.965 0.965 0.965 rg 26.250 374.167 555.000 114.655 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 488.821 m 581.250 488.821 l 581.250 488.071 l 26.250 488.071 l f 26.250 374.167 m 581.250 374.167 l 581.250 374.917 l 26.250 374.917 l f q 225.000 0 0 69.750 35.250 409.321 cm /I21 Do Q q 35.250 385.417 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 393.798 Td /F4 9.8 Tf [(Fig. 4: Cholera EOC and Health Cluster Average Score Over Time)] TJ ET Q BT 26.250 357.143 Td /F1 9.8 Tf [(The Earthquake Health Cluster and the Earthquake EOC illustrated similar results with the epidemiological score for the Health )] TJ ET BT 26.250 345.238 Td /F1 9.8 Tf [(Cluster higher than the EOC throughout their production.)] TJ ET 0.965 0.965 0.965 rg 26.250 208.702 555.000 126.655 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 335.357 m 581.250 335.357 l 581.250 334.607 l 26.250 334.607 l f 26.250 208.702 m 581.250 208.702 l 581.250 209.452 l 26.250 209.452 l f q 225.000 0 0 81.750 35.250 243.857 cm /I23 Do Q q 35.250 219.952 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 228.333 Td /F4 9.8 Tf [(Fig. 5: Earthquake EOC and Health Cluster Average Score Over Time)] TJ ET Q BT 26.250 174.481 Td /F4 12.0 Tf [(Limitations)] TJ ET BT 26.250 154.527 Td /F1 9.8 Tf [(As this is the first time the draft checklist for monitoring and evaluating the quality of epidemiological data in publications by )] TJ ET BT 26.250 142.622 Td /F1 9.8 Tf [(various WHO and Health Cluster emergency reports was completed there is currently no way to validate the results or compare )] TJ ET BT 26.250 130.717 Td /F1 9.8 Tf [(them against previous studies. An online review does not illustrate that there are previous standardized templates for reporting )] TJ ET BT 26.250 118.812 Td /F1 9.8 Tf [(across the different bodies that produced the reports and the aims of the emergency bulletins are not inherently clear. As was )] TJ ET BT 26.250 106.908 Td /F1 9.8 Tf [(noted on the front page of one of the bulletins late in its production cycle, there were questions about the contents and )] TJ ET BT 26.250 95.003 Td /F1 9.8 Tf [(relevance of the reports.)] TJ ET BT 26.250 75.598 Td /F1 9.8 Tf [(The major limit to this data is that for all intents and purposes it is the first to be analysed using the WHO Checklist for quality of )] TJ ET BT 26.250 63.693 Td /F1 9.8 Tf [(epidemiological data in the comparison of two events in the same country. However, future studies that utilize the same )] TJ ET BT 26.250 51.789 Td /F1 9.8 Tf [(checklist can ascertain the validity of this study. Another major limitation is the lack of standardization of the different health )] TJ ET BT 26.250 39.884 Td /F1 9.8 Tf [(bulletins; there are multiple opportunities where interpretation of the presence or absence of quantitative variables could have )] TJ ET Q q 15.000 25.598 577.500 751.402 re W n 0.965 0.965 0.965 rg 26.250 747.845 555.000 29.155 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 747.845 m 581.250 747.845 l 581.250 748.595 l 26.250 748.595 l f q 35.250 759.095 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 2: Average Bulletin Score)] TJ ET Q BT 26.250 730.821 Td /F1 9.8 Tf [(In terms of how many days passed between bulletin production the Cholera Health Cluster bulletins were produced every 7.21 )] TJ ET BT 26.250 718.917 Td /F1 9.8 Tf [(days and the Earthquake Health Cluster Bulletins were produced every 2.17 days.)] TJ ET 0.965 0.965 0.965 rg 26.250 527.631 555.000 181.405 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 709.036 m 581.250 709.036 l 581.250 708.286 l 26.250 708.286 l f 26.250 527.631 m 581.250 527.631 l 581.250 528.381 l 26.250 528.381 l f q 225.000 0 0 136.500 35.250 562.786 cm /I25 Do Q q 35.250 538.881 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 547.262 Td /F4 9.8 Tf [(Fig. 3: Bulletin production per day.)] TJ ET Q BT 26.250 510.607 Td /F1 9.8 Tf [(The scores obtained by the Cholera Emergency Operations Centre and the Cholera Health Cluster over time are illustrated )] TJ ET BT 26.250 498.702 Td /F1 9.8 Tf [(below with the Cholera Health Cluster scoring higher than the EOC throughout their production cycle.)] TJ ET 0.965 0.965 0.965 rg 26.250 374.167 555.000 114.655 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 488.821 m 581.250 488.821 l 581.250 488.071 l 26.250 488.071 l f 26.250 374.167 m 581.250 374.167 l 581.250 374.917 l 26.250 374.917 l f q 225.000 0 0 69.750 35.250 409.321 cm /I27 Do Q q 35.250 385.417 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 393.798 Td /F4 9.8 Tf [(Fig. 4: Cholera EOC and Health Cluster Average Score Over Time)] TJ ET Q BT 26.250 357.143 Td /F1 9.8 Tf [(The Earthquake Health Cluster and the Earthquake EOC illustrated similar results with the epidemiological score for the Health )] TJ ET BT 26.250 345.238 Td /F1 9.8 Tf [(Cluster higher than the EOC throughout their production.)] TJ ET 0.965 0.965 0.965 rg 26.250 208.702 555.000 126.655 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 335.357 m 581.250 335.357 l 581.250 334.607 l 26.250 334.607 l f 26.250 208.702 m 581.250 208.702 l 581.250 209.452 l 26.250 209.452 l f q 225.000 0 0 81.750 35.250 243.857 cm /I29 Do Q q 35.250 219.952 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 228.333 Td /F4 9.8 Tf [(Fig. 5: Earthquake EOC and Health Cluster Average Score Over Time)] TJ ET Q BT 26.250 174.481 Td /F4 12.0 Tf [(Limitations)] TJ ET BT 26.250 154.527 Td /F1 9.8 Tf [(As this is the first time the draft checklist for monitoring and evaluating the quality of epidemiological data in publications by )] TJ ET BT 26.250 142.622 Td /F1 9.8 Tf [(various WHO and Health Cluster emergency reports was completed there is currently no way to validate the results or compare )] TJ ET BT 26.250 130.717 Td /F1 9.8 Tf [(them against previous studies. An online review does not illustrate that there are previous standardized templates for reporting )] TJ ET BT 26.250 118.812 Td /F1 9.8 Tf [(across the different bodies that produced the reports and the aims of the emergency bulletins are not inherently clear. As was )] TJ ET BT 26.250 106.908 Td /F1 9.8 Tf [(noted on the front page of one of the bulletins late in its production cycle, there were questions about the contents and )] TJ ET BT 26.250 95.003 Td /F1 9.8 Tf [(relevance of the reports.)] TJ ET BT 26.250 75.598 Td /F1 9.8 Tf [(The major limit to this data is that for all intents and purposes it is the first to be analysed using the WHO Checklist for quality of )] TJ ET BT 26.250 63.693 Td /F1 9.8 Tf [(epidemiological data in the comparison of two events in the same country. However, future studies that utilize the same )] TJ ET BT 26.250 51.789 Td /F1 9.8 Tf [(checklist can ascertain the validity of this study. Another major limitation is the lack of standardization of the different health )] TJ ET BT 26.250 39.884 Td /F1 9.8 Tf [(bulletins; there are multiple opportunities where interpretation of the presence or absence of quantitative variables could have )] TJ ET Q q 225.000 0 0 136.500 35.250 562.786 cm /I31 Do Q q 225.000 0 0 69.750 35.250 409.321 cm /I33 Do Q q 225.000 0 0 81.750 35.250 243.857 cm /I35 Do Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(5)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 194 0 obj << /Type /Annot /Subtype /Link /A 195 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 562.7858 260.2500 699.2858 ] >> endobj 195 0 obj << /Type /Action /S /URI /URI (https://currents.plos.org/disasters/files/2012/07/Figure-3-Bulletin-Production-per-day.png) >> endobj 196 0 obj << /Type /XObject /Subtype /Image /Width 300 /Height 182 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 1 /Columns 300 /BitsPerComponent 8>> /ColorSpace /DeviceGray /BitsPerComponent 8 /Length 393>> stream xA 0 =fy9뀟\ endstream endobj 197 0 obj << /Type /XObject /Subtype /Image /Width 300 /Height 182 /SMask 196 0 R /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 300 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 25304>> stream x}yTŹWҳ/#" n<7ĈIk5&IQuIL1ɍA%AvWgYzfgzQTΙf0suz۪FbBRx9R0&\X+$C*a4ls.[⺼ Zxef#<w& ȑHW^yws=j涶66I a$-=ő3D^(8\AtdH4G#fh)w}^;/8w`0חF)x<.+''leUrssGOOʕ+wqw\ڧ~pdeeAߟ0X,ӓ<OZZZ~~ B999p)Loo@NNNNNdټˑH7---++ ^o$˳X|?7UYYORJ =LJSѾ@ vyvx]w@0zH$eH$(nJKKz6m̘1iii([yYna4(XR777cXϏb > ,,%epe/˵dJƍছnbK,2eʲebX[[ی3_vv{y>ӧO///1cƒ%K"-ܒp8&O|w˿7<88t;kjjկ=z3ljj1cC=twTUU{M&N_b ,я~0vؙ3g7 Xl˖-_|qMMͼyΝ[PP޽{Μ9<@0 Bzy?x9sTVVN>޺뮻rssvĉo|7tW_}uΜ9zcbO<1w_׳fͪ{t뭷 6PJ~;qI&}_x>w܊oذaӦM|O:VXg]z555O=T$&I)0$(WxM\UEygǣ&fT]ձuR9/ޚ}{Ǐ%b0}?88._ߵk׼y󊊊mƐ?~ &"ǎ 6m{niӦ۷o̙. /袋"ȁسl|]w500h鯿O~P(յiӦ?&L{ט@KK˺u9 . o~hѢO?"Ȗ-[_}_~O>9nܸe˖tww/_Ginn~y䑢""N yKFrr}Yp2((8[WqBaٕ̺FW^'|>˵u֋/Ryx7333.\8v/|۷o[׬Y~_TWW777Sc?߲e׾5B?;W^ٽ{wff&̞=/KYYYssʕ+'L_;\vmEE/tx;v;rʎ_Cw\|pIV%-_<?馛:n:Ǧ{[oy`}ٰa;5k\.#f.wDgb3+2&?ȸBDPYYcϗ6E"HGG'eJKKs݅/R}}=,((`k$ Bʊ|?Pz{{}>#33wJ'Nظq3&Nvkpԩzgx7n@ p >s_~Ӈ)e˖-<ĉWZ{y=z/))ihhذaó>{-yTVV]}ڵk ;;;;;{O=ԁ[QQA)=N3<p}{޿/ ,9s&kp\veK.o >}]uUxX.\ˆ /d_W~cǛ6m*** ?mjj몪z{{_z3fL2%??B"*Y? 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Җ-[n}YId7^l>n.$\K897~ټ8p %tEOߗ [C UbkL_:od {OlJ|4V+p`sLZ"]`,_ofia'HTf %͢+K`qE_&yXPZuy4B {~FVАX4DcB"R?ޝ}V9sŋF)=vO"-˪jɉ 5D3V6q3xzzksy~ytjj{ ^ !$x^T1̐R1f  Zhv;۶/njw=3a.SHݵkןٟY5::zo|l6{zfO> \o_K/T._0.Jngc-!dxxȑ#=~׮]ǎW~q۶~ÇJ3c*JϾ;<̿뿞oۿ53CMX1v~###Baddyp|+BX,;syo,_w]˲>|^m,!0FRX$;Ϡ۷\1v-[³d?y睧zʛb؇?aS~xG({M&͛7_ޜ}ϯ뺊}7x~np#c>JSN53f.(~B2=!rСo=K/3Ϝ>}]Q~OLLض|dzzڲ.= zl0<"Rs^BO?|{166699999(ʖ-[4M;qݻ1Ǿ!bWk.NaUU3w%˽ <Ȟ={<!LR‘L&sw_R)7BH$ ,@Jmwuuz|MJ]w, TӧOamۦ??<<ގzP( ~ p* ^[lVw>s̑#G4M;::6ols=g뺔R]QW1</{BpbX,NО={na02뚦%m۶cǎcǎ{>s>(5X,1>tP.zUUf{ Vۺu+8Ʉ^xaʕwuвÇ_xkzG[f 3z-7߄fm۶if{zzΝ;eowW.#7|C|u]q? 1)uŋ;xWxt:o !4M3#> endobj 237 0 obj << /Length 18328 >> stream 0.271 0.267 0.267 rg q 15.000 35.865 577.500 741.135 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(an impact on the final results.)] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(The study was limited by the number of bulletins that were published online and this was required in order to be able to )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(complete the study in a location remote from Haiti and in a retrospective fashion that is reproducible in future studies.)] TJ ET BT 26.250 699.564 Td /F4 12.0 Tf [(Discussion)] TJ ET BT 26.250 679.610 Td /F1 9.8 Tf [(One of the goals of this paper was to compare the response to two distinct disasters within the same country. In particular, by )] TJ ET BT 26.250 667.705 Td /F1 9.8 Tf [(focusing on the epidemiological data published in key documents for professional communication it became readily apparent )] TJ ET BT 26.250 655.800 Td /F1 9.8 Tf [(that emphasis in the bulletins was placed more on epidemiological information during the cholera outbreak in comparison to the )] TJ ET BT 26.250 643.896 Td /F1 9.8 Tf [(earthquake. This was illustrated in Figure 2 with the starkly higher average scores during the cholera outbreak in comparison to )] TJ ET BT 26.250 631.991 Td /F1 9.8 Tf [(the earthquake. However, this could be heavily influenced by the fact the infrastructure on the ground was severely limited in the )] TJ ET BT 26.250 620.086 Td /F1 9.8 Tf [(aftermath of the earthquake and there was much more plentiful staff on the ground during the cholera epidemic.)] TJ ET BT 26.250 600.681 Td /F1 9.8 Tf [(Throughout the reporting, when looking longitudinally across the time of the report generation, it was seen that the Health )] TJ ET BT 26.250 588.777 Td /F1 9.8 Tf [(Cluster scores for each bulletin in terms of epidemiological data was higher than in the Emergency Operations Centre bulletins; )] TJ ET BT 26.250 576.872 Td /F1 9.8 Tf [(this could be due to a number of different factors. One plausible factor could be the intended market audience for the reporting; )] TJ ET BT 26.250 564.967 Td /F1 9.8 Tf [(at no stage was there a direct indication of who the reports were addressed to. Assuming they were for the organizations )] TJ ET BT 26.250 553.062 Td /F1 9.8 Tf [(working in each of the disasters as well as for greater public dissemination, including the media, there was perhaps too broad of )] TJ ET BT 26.250 541.158 Td /F1 9.8 Tf [(a market for the information creating a dilutional effect of what was included and what was not. In fact, in one of the later )] TJ ET BT 26.250 529.253 Td /F1 9.8 Tf [(bulletins, it was specifically mentioned that the goals of the bulletin were being re-evaluated in order to more closely address the )] TJ ET BT 26.250 517.348 Td /F1 9.8 Tf [(needs of the readership. There was likely a strong amount of overlap between the EOC reports and the Health Cluster Bulletins )] TJ ET BT 26.250 505.443 Td /F1 9.8 Tf [(and this is an area in which duplication of work could be reduced with a closer integration of the two bodies.)] TJ ET BT 26.250 468.841 Td /F4 12.0 Tf [(Conclusions and Recommendations)] TJ ET BT 26.250 448.887 Td /F1 9.8 Tf [(What this review of professional organizations published emergency bulletins found was that there is a wide variety and quality )] TJ ET BT 26.250 436.982 Td /F1 9.8 Tf [(of information published in terms of epidemiological data in emergency reports. In the earthquake reporting, a sudden onset )] TJ ET BT 26.250 425.077 Td /F1 9.8 Tf [(non-medical emergency, there is an apparent lack of epidemiological data present throughout the reports. In comparison, there )] TJ ET BT 26.250 413.172 Td /F1 9.8 Tf [(is more epidemiological notation, but varied information in the more medical cholera epidemic reporting.)] TJ ET BT 26.250 393.768 Td /F1 9.8 Tf [(Closer collaboration between professional organizations should be strived for within disaster medicine when deciding which )] TJ ET BT 26.250 381.863 Td /F1 9.8 Tf [(metrics are required for complete epidemiological reporting. A comprehensive template, modifiable for different situations with )] TJ ET BT 26.250 369.958 Td /F1 9.8 Tf [(key metrics always including could be used in order to standardize reporting globally. This would allow for more research into )] TJ ET BT 26.250 358.053 Td /F1 9.8 Tf [(professional communication outcomes and comparison across nations and disasters in addition to allowing for more accurate )] TJ ET BT 26.250 346.149 Td /F1 9.8 Tf [(communication to donors and the greater public through the media.)] TJ ET BT 26.250 309.546 Td /F4 12.0 Tf [(Competing Interests)] TJ ET BT 26.250 289.592 Td /F1 9.8 Tf [(Dr. Paul Dhillon has no competing interests in the production of this paper. Dr Giuseppe Annunziata was employed at the Chief )] TJ ET BT 26.250 277.687 Td /F1 9.8 Tf [(Information and Knowledge Management Office, WHO Mediterranean Centre for Health Risk Reduction during the production of )] TJ ET BT 26.250 265.782 Td /F1 9.8 Tf [(this paper.)] TJ ET BT 26.250 229.180 Td /F4 12.0 Tf [(Acknowledgements)] TJ ET BT 26.250 209.226 Td /F1 9.8 Tf [(I would like to thank Dr. Fergal Cummins, for his help and support through the Retrieval, Emergency, and Disaster Medicine )] TJ ET BT 26.250 197.321 Td /F1 9.8 Tf [(Research Unit along with the many new friends made around the world through the XI European Masters in Disaster Medicine )] TJ ET BT 26.250 185.416 Td /F1 9.8 Tf [(2011-2012.)] TJ ET BT 26.250 156.314 Td /F4 12.0 Tf [(APPENDIX 1)] TJ ET BT 26.250 119.162 Td /F4 12.0 Tf [(Check list for monitoring and evaluating the quality of epidemiological data published by )] TJ ET BT 26.250 104.510 Td /F4 12.0 Tf [(various WHO and Health Cluster emergency reports DRAFT)] TJ ET BT 26.250 84.555 Td /F1 9.8 Tf [(Epidemiological data published onHealth Cluster Bulletins and/or WHO Emergency Situation Reports should include:)] TJ ET BT 26.250 65.151 Td /F1 9.8 Tf [(1. Location of collected data: country, state, province, district, city or village)] TJ ET Q q 15.000 35.865 577.500 741.135 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(an impact on the final results.)] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(The study was limited by the number of bulletins that were published online and this was required in order to be able to )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(complete the study in a location remote from Haiti and in a retrospective fashion that is reproducible in future studies.)] TJ ET BT 26.250 699.564 Td /F4 12.0 Tf [(Discussion)] TJ ET BT 26.250 679.610 Td /F1 9.8 Tf [(One of the goals of this paper was to compare the response to two distinct disasters within the same country. In particular, by )] TJ ET BT 26.250 667.705 Td /F1 9.8 Tf [(focusing on the epidemiological data published in key documents for professional communication it became readily apparent )] TJ ET BT 26.250 655.800 Td /F1 9.8 Tf [(that emphasis in the bulletins was placed more on epidemiological information during the cholera outbreak in comparison to the )] TJ ET BT 26.250 643.896 Td /F1 9.8 Tf [(earthquake. This was illustrated in Figure 2 with the starkly higher average scores during the cholera outbreak in comparison to )] TJ ET BT 26.250 631.991 Td /F1 9.8 Tf [(the earthquake. However, this could be heavily influenced by the fact the infrastructure on the ground was severely limited in the )] TJ ET BT 26.250 620.086 Td /F1 9.8 Tf [(aftermath of the earthquake and there was much more plentiful staff on the ground during the cholera epidemic.)] TJ ET BT 26.250 600.681 Td /F1 9.8 Tf [(Throughout the reporting, when looking longitudinally across the time of the report generation, it was seen that the Health )] TJ ET BT 26.250 588.777 Td /F1 9.8 Tf [(Cluster scores for each bulletin in terms of epidemiological data was higher than in the Emergency Operations Centre bulletins; )] TJ ET BT 26.250 576.872 Td /F1 9.8 Tf [(this could be due to a number of different factors. One plausible factor could be the intended market audience for the reporting; )] TJ ET BT 26.250 564.967 Td /F1 9.8 Tf [(at no stage was there a direct indication of who the reports were addressed to. Assuming they were for the organizations )] TJ ET BT 26.250 553.062 Td /F1 9.8 Tf [(working in each of the disasters as well as for greater public dissemination, including the media, there was perhaps too broad of )] TJ ET BT 26.250 541.158 Td /F1 9.8 Tf [(a market for the information creating a dilutional effect of what was included and what was not. In fact, in one of the later )] TJ ET BT 26.250 529.253 Td /F1 9.8 Tf [(bulletins, it was specifically mentioned that the goals of the bulletin were being re-evaluated in order to more closely address the )] TJ ET BT 26.250 517.348 Td /F1 9.8 Tf [(needs of the readership. There was likely a strong amount of overlap between the EOC reports and the Health Cluster Bulletins )] TJ ET BT 26.250 505.443 Td /F1 9.8 Tf [(and this is an area in which duplication of work could be reduced with a closer integration of the two bodies.)] TJ ET BT 26.250 468.841 Td /F4 12.0 Tf [(Conclusions and Recommendations)] TJ ET BT 26.250 448.887 Td /F1 9.8 Tf [(What this review of professional organizations published emergency bulletins found was that there is a wide variety and quality )] TJ ET BT 26.250 436.982 Td /F1 9.8 Tf [(of information published in terms of epidemiological data in emergency reports. In the earthquake reporting, a sudden onset )] TJ ET BT 26.250 425.077 Td /F1 9.8 Tf [(non-medical emergency, there is an apparent lack of epidemiological data present throughout the reports. In comparison, there )] TJ ET BT 26.250 413.172 Td /F1 9.8 Tf [(is more epidemiological notation, but varied information in the more medical cholera epidemic reporting.)] TJ ET BT 26.250 393.768 Td /F1 9.8 Tf [(Closer collaboration between professional organizations should be strived for within disaster medicine when deciding which )] TJ ET BT 26.250 381.863 Td /F1 9.8 Tf [(metrics are required for complete epidemiological reporting. A comprehensive template, modifiable for different situations with )] TJ ET BT 26.250 369.958 Td /F1 9.8 Tf [(key metrics always including could be used in order to standardize reporting globally. This would allow for more research into )] TJ ET BT 26.250 358.053 Td /F1 9.8 Tf [(professional communication outcomes and comparison across nations and disasters in addition to allowing for more accurate )] TJ ET BT 26.250 346.149 Td /F1 9.8 Tf [(communication to donors and the greater public through the media.)] TJ ET BT 26.250 309.546 Td /F4 12.0 Tf [(Competing Interests)] TJ ET BT 26.250 289.592 Td /F1 9.8 Tf [(Dr. Paul Dhillon has no competing interests in the production of this paper. Dr Giuseppe Annunziata was employed at the Chief )] TJ ET BT 26.250 277.687 Td /F1 9.8 Tf [(Information and Knowledge Management Office, WHO Mediterranean Centre for Health Risk Reduction during the production of )] TJ ET BT 26.250 265.782 Td /F1 9.8 Tf [(this paper.)] TJ ET BT 26.250 229.180 Td /F4 12.0 Tf [(Acknowledgements)] TJ ET BT 26.250 209.226 Td /F1 9.8 Tf [(I would like to thank Dr. Fergal Cummins, for his help and support through the Retrieval, Emergency, and Disaster Medicine )] TJ ET BT 26.250 197.321 Td /F1 9.8 Tf [(Research Unit along with the many new friends made around the world through the XI European Masters in Disaster Medicine )] TJ ET BT 26.250 185.416 Td /F1 9.8 Tf [(2011-2012.)] TJ ET BT 26.250 156.314 Td /F4 12.0 Tf [(APPENDIX 1)] TJ ET BT 26.250 119.162 Td /F4 12.0 Tf [(Check list for monitoring and evaluating the quality of epidemiological data published by )] TJ ET BT 26.250 104.510 Td /F4 12.0 Tf [(various WHO and Health Cluster emergency reports DRAFT)] TJ ET BT 26.250 84.555 Td /F1 9.8 Tf [(Epidemiological data published onHealth Cluster Bulletins and/or WHO Emergency Situation Reports should include:)] TJ ET BT 26.250 65.151 Td /F1 9.8 Tf [(1. Location of collected data: country, state, province, district, city or village)] TJ ET Q q 15.000 35.865 577.500 741.135 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(an impact on the final results.)] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(The study was limited by the number of bulletins that were published online and this was required in order to be able to )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(complete the study in a location remote from Haiti and in a retrospective fashion that is reproducible in future studies.)] TJ ET BT 26.250 699.564 Td /F4 12.0 Tf [(Discussion)] TJ ET BT 26.250 679.610 Td /F1 9.8 Tf [(One of the goals of this paper was to compare the response to two distinct disasters within the same country. In particular, by )] TJ ET BT 26.250 667.705 Td /F1 9.8 Tf [(focusing on the epidemiological data published in key documents for professional communication it became readily apparent )] TJ ET BT 26.250 655.800 Td /F1 9.8 Tf [(that emphasis in the bulletins was placed more on epidemiological information during the cholera outbreak in comparison to the )] TJ ET BT 26.250 643.896 Td /F1 9.8 Tf [(earthquake. This was illustrated in Figure 2 with the starkly higher average scores during the cholera outbreak in comparison to )] TJ ET BT 26.250 631.991 Td /F1 9.8 Tf [(the earthquake. However, this could be heavily influenced by the fact the infrastructure on the ground was severely limited in the )] TJ ET BT 26.250 620.086 Td /F1 9.8 Tf [(aftermath of the earthquake and there was much more plentiful staff on the ground during the cholera epidemic.)] TJ ET BT 26.250 600.681 Td /F1 9.8 Tf [(Throughout the reporting, when looking longitudinally across the time of the report generation, it was seen that the Health )] TJ ET BT 26.250 588.777 Td /F1 9.8 Tf [(Cluster scores for each bulletin in terms of epidemiological data was higher than in the Emergency Operations Centre bulletins; )] TJ ET BT 26.250 576.872 Td /F1 9.8 Tf [(this could be due to a number of different factors. One plausible factor could be the intended market audience for the reporting; )] TJ ET BT 26.250 564.967 Td /F1 9.8 Tf [(at no stage was there a direct indication of who the reports were addressed to. Assuming they were for the organizations )] TJ ET BT 26.250 553.062 Td /F1 9.8 Tf [(working in each of the disasters as well as for greater public dissemination, including the media, there was perhaps too broad of )] TJ ET BT 26.250 541.158 Td /F1 9.8 Tf [(a market for the information creating a dilutional effect of what was included and what was not. In fact, in one of the later )] TJ ET BT 26.250 529.253 Td /F1 9.8 Tf [(bulletins, it was specifically mentioned that the goals of the bulletin were being re-evaluated in order to more closely address the )] TJ ET BT 26.250 517.348 Td /F1 9.8 Tf [(needs of the readership. There was likely a strong amount of overlap between the EOC reports and the Health Cluster Bulletins )] TJ ET BT 26.250 505.443 Td /F1 9.8 Tf [(and this is an area in which duplication of work could be reduced with a closer integration of the two bodies.)] TJ ET BT 26.250 468.841 Td /F4 12.0 Tf [(Conclusions and Recommendations)] TJ ET BT 26.250 448.887 Td /F1 9.8 Tf [(What this review of professional organizations published emergency bulletins found was that there is a wide variety and quality )] TJ ET BT 26.250 436.982 Td /F1 9.8 Tf [(of information published in terms of epidemiological data in emergency reports. In the earthquake reporting, a sudden onset )] TJ ET BT 26.250 425.077 Td /F1 9.8 Tf [(non-medical emergency, there is an apparent lack of epidemiological data present throughout the reports. In comparison, there )] TJ ET BT 26.250 413.172 Td /F1 9.8 Tf [(is more epidemiological notation, but varied information in the more medical cholera epidemic reporting.)] TJ ET BT 26.250 393.768 Td /F1 9.8 Tf [(Closer collaboration between professional organizations should be strived for within disaster medicine when deciding which )] TJ ET BT 26.250 381.863 Td /F1 9.8 Tf [(metrics are required for complete epidemiological reporting. A comprehensive template, modifiable for different situations with )] TJ ET BT 26.250 369.958 Td /F1 9.8 Tf [(key metrics always including could be used in order to standardize reporting globally. This would allow for more research into )] TJ ET BT 26.250 358.053 Td /F1 9.8 Tf [(professional communication outcomes and comparison across nations and disasters in addition to allowing for more accurate )] TJ ET BT 26.250 346.149 Td /F1 9.8 Tf [(communication to donors and the greater public through the media.)] TJ ET BT 26.250 309.546 Td /F4 12.0 Tf [(Competing Interests)] TJ ET BT 26.250 289.592 Td /F1 9.8 Tf [(Dr. Paul Dhillon has no competing interests in the production of this paper. Dr Giuseppe Annunziata was employed at the Chief )] TJ ET BT 26.250 277.687 Td /F1 9.8 Tf [(Information and Knowledge Management Office, WHO Mediterranean Centre for Health Risk Reduction during the production of )] TJ ET BT 26.250 265.782 Td /F1 9.8 Tf [(this paper.)] TJ ET BT 26.250 229.180 Td /F4 12.0 Tf [(Acknowledgements)] TJ ET BT 26.250 209.226 Td /F1 9.8 Tf [(I would like to thank Dr. Fergal Cummins, for his help and support through the Retrieval, Emergency, and Disaster Medicine )] TJ ET BT 26.250 197.321 Td /F1 9.8 Tf [(Research Unit along with the many new friends made around the world through the XI European Masters in Disaster Medicine )] TJ ET BT 26.250 185.416 Td /F1 9.8 Tf [(2011-2012.)] TJ ET BT 26.250 156.314 Td /F4 12.0 Tf [(APPENDIX 1)] TJ ET BT 26.250 119.162 Td /F4 12.0 Tf [(Check list for monitoring and evaluating the quality of epidemiological data published by )] TJ ET BT 26.250 104.510 Td /F4 12.0 Tf [(various WHO and Health Cluster emergency reports DRAFT)] TJ ET BT 26.250 84.555 Td /F1 9.8 Tf [(Epidemiological data published onHealth Cluster Bulletins and/or WHO Emergency Situation Reports should include:)] TJ ET BT 26.250 65.151 Td /F1 9.8 Tf [(1. Location of collected data: country, state, province, district, city or village)] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(6)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 238 0 obj << /Type /Page /Parent 3 0 R /Annots [ 240 0 R 244 0 R 246 0 R 250 0 R 252 0 R 256 0 R ] /Contents 239 0 R >> endobj 239 0 obj << /Length 12546 >> stream 0.271 0.267 0.267 rg q 15.000 39.485 577.500 737.515 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(2. Timing: date of reporting ; period of reporting \(from/to\))] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(3. Organization reporting: WHO, Health Cluster, etc.)] TJ ET BT 26.250 728.667 Td /F1 9.8 Tf [(4. Source of information: MoH, WHO, EWAR, NGOs, rumours, media.)] TJ ET BT 26.250 709.262 Td /F1 9.8 Tf [(5. Identification of the event reported: name according to ICD-10; case definition adopted in the context \(annex\))] TJ ET BT 26.250 689.857 Td /F1 9.8 Tf [(6. 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Surveillance system: sentinel/exhaustive; type of facilities)] TJ ET BT 26.250 530.214 Td /F1 9.8 Tf [(12. Completeness: % of facilities reporting by time period and location)] TJ ET BT 26.250 510.810 Td /F1 9.8 Tf [(13. Timeliness: % of facilities reporting on time by time frame and location)] TJ ET BT 26.250 491.405 Td /F1 9.8 Tf [(14. Events: list of the events under surveillance; priority to epidemic prone diseases with potential high health impact and whose )] TJ ET BT 26.250 479.500 Td /F1 9.8 Tf [(prevention and control is possible; include other category to calculate proportional morbidity.)] TJ ET BT 26.250 460.095 Td /F1 9.8 Tf [(15. Alerts: number per week by location; number investigated by whom)] TJ ET BT 26.250 440.691 Td /F1 9.8 Tf [(16. Laboratory: number of samples taken and location; number of positive samples)] TJ ET BT 26.250 421.286 Td /F1 9.8 Tf [(17. 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Number of new cases: suspected vs confirmed with lab test; age class/gender; by time period \(by day, week, month )] TJ ET BT 26.250 677.952 Td /F1 9.8 Tf [(according to the seriousness of the event\))] TJ ET BT 26.250 658.548 Td /F1 9.8 Tf [(7. Incidence or proportional morbidity by time period)] TJ ET BT 26.250 639.143 Td /F1 9.8 Tf [(8. Attack rate \(cumulative incidence\))] TJ ET BT 26.250 619.738 Td /F1 9.8 Tf [(9. Number of deaths: by age class/gender; by time period; case fatality ratio by time period)] TJ ET BT 26.250 600.333 Td /F1 9.8 Tf [(10. Graphs: incidence or proportional morbidity by line graphs, absolute number of cases by histograms)] TJ ET BT 26.250 580.929 Td /F1 9.8 Tf [(In addition to the below points, epidemiological data published on Emergency Weekly Epidemiological Bulletins produced by )] TJ ET BT 26.250 569.024 Td /F1 9.8 Tf [(MoH, WHO and/or Health Cluster partners should include:)] TJ ET BT 26.250 549.619 Td /F1 9.8 Tf [(11. Surveillance system: sentinel/exhaustive; type of facilities)] TJ ET BT 26.250 530.214 Td /F1 9.8 Tf [(12. Completeness: % of facilities reporting by time period and location)] TJ ET BT 26.250 510.810 Td /F1 9.8 Tf [(13. Timeliness: % of facilities reporting on time by time frame and location)] TJ ET BT 26.250 491.405 Td /F1 9.8 Tf [(14. Events: list of the events under surveillance; priority to epidemic prone diseases with potential high health impact and whose )] TJ ET BT 26.250 479.500 Td /F1 9.8 Tf [(prevention and control is possible; include other category to calculate proportional morbidity.)] TJ ET BT 26.250 460.095 Td /F1 9.8 Tf [(15. Alerts: number per week by location; number investigated by whom)] TJ ET BT 26.250 440.691 Td /F1 9.8 Tf [(16. Laboratory: number of samples taken and location; number of positive samples)] TJ ET BT 26.250 421.286 Td /F1 9.8 Tf [(17. Graphs: completeness of reporting by line graphs)] TJ ET BT 26.250 401.881 Td /F1 9.8 Tf [([1] The Pan American Health Organization \(PAHO\) is an international public health agency with over 100 years of experience )] TJ ET BT 26.250 389.976 Td /F1 9.8 Tf [(working to improve health and living standards of the people of the Americas. It enjoys international recognition as part of the )] TJ ET BT 26.250 378.072 Td /F1 9.8 Tf [(United Nations system, serving as the Regional Office for the Americas of the World Health Organization, and as the health )] TJ ET BT 26.250 366.167 Td /F1 9.8 Tf [(organization of the Inter-American System.)] TJ ET BT 26.250 329.564 Td /F4 12.0 Tf [(APPENDIX 2)] TJ ET BT 26.250 292.412 Td /F4 12.0 Tf [(Health Bulletin Cover)] TJ ET 0.965 0.965 0.965 rg 26.250 149.982 555.000 132.000 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 281.982 m 581.250 281.982 l 581.250 281.232 l 26.250 281.232 l f 26.250 149.982 m 581.250 149.982 l 581.250 150.732 l 26.250 150.732 l f q 112.500 0 0 112.500 35.250 159.732 cm /I39 Do Q 0.271 0.267 0.267 rg BT 26.250 115.760 Td /F4 12.0 Tf [(References)] TJ ET BT 26.250 88.306 Td /F1 9.8 Tf [(1.)] TJ ET BT 38.132 88.306 Td /F1 9.8 Tf [(International Human Development Indicators. 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Surveillance system: sentinel/exhaustive; type of facilities)] TJ ET BT 26.250 530.214 Td /F1 9.8 Tf [(12. Completeness: % of facilities reporting by time period and location)] TJ ET BT 26.250 510.810 Td /F1 9.8 Tf [(13. Timeliness: % of facilities reporting on time by time frame and location)] TJ ET BT 26.250 491.405 Td /F1 9.8 Tf [(14. Events: list of the events under surveillance; priority to epidemic prone diseases with potential high health impact and whose )] TJ ET BT 26.250 479.500 Td /F1 9.8 Tf [(prevention and control is possible; include other category to calculate proportional morbidity.)] TJ ET BT 26.250 460.095 Td /F1 9.8 Tf [(15. Alerts: number per week by location; number investigated by whom)] TJ ET BT 26.250 440.691 Td /F1 9.8 Tf [(16. Laboratory: number of samples taken and location; number of positive samples)] TJ ET BT 26.250 421.286 Td /F1 9.8 Tf [(17. Graphs: completeness of reporting by line graphs)] TJ ET BT 26.250 401.881 Td /F1 9.8 Tf [([1] The Pan American Health Organization \(PAHO\) is an international public health agency with over 100 years of experience )] TJ ET BT 26.250 389.976 Td /F1 9.8 Tf [(working to improve health and living standards of the people of the Americas. 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Accessed August 1, 2011.)] TJ ET 0.267 0.267 0.267 rg BT 26.250 79.820 Td /F1 7.5 Tf [(REFERENCE LINK)] TJ ET 0.271 0.267 0.267 rg BT 26.250 61.270 Td /F1 9.8 Tf [(2.)] TJ ET BT 38.132 61.270 Td /F1 9.8 Tf [(Pan American Health Organization/World Health Organization. January 2011. Earthquake in Haiti One Year Later. 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