August 2010 inside this issue:
Helping Haiti............................................................................1
Public health preparedness consultant touches lives in Haiti
.............................................................................................1
Director’s Chair .......................................................................2
H1N1 influenza updates...........................................................2
How H1N1 information was communicated to at-risk
populations...........................................................................2
Influenza (Flu) website a valuable tool................................3
MDH/LPHA Emergency Preparedness Policy Summit
brings recommendations ......................................................3
So Many Sites, So Little Time conference a big success.....4
MDH Division Preparedness News .........................................4
Mobile Medical Unit set up at Great Minnesota Air Show..4
MDH Public Health Laboratory gets ready for Challenge
Set ........................................................................................5
Climate change is a public health concern...........................5
Upcoming Events.....................................................................6
Health Care Occupational and Environmental Safety
Workshop.............................................................................6
Emergency Preparedness Resources........................................6
New Workspace coming soon! ............................................6
Free, short training modules for public health professionals7
Editorial Board.........................................................................7
Contributors to this issue .........................................................7
Helping Haiti
R2R: When was the first time you gave a presentation about
your experience? MC: My first presentation was at our church
within a couple days of returning from Haiti. I’ve also given
eight presentations to various groups working with emergency
preparedness and to my granddaughters’ sixth grade class.
R2R: I’ve seen your presentation. It’s powerful and
moving. What is it like for you to present this experience to
multiple audiences? MC: It is an incredibly moving
experience. Sometimes I cannot hold back my emotions and I
choke up. Other times it’s like I am telling someone else’s
story, then I fall apart later. A few weeks ago I gave the
presentation but had not seen my photos for a while. I got
through the presentation fine but was surprised by my
emotions that evening. It really took me back to the
earthquake, my friends and acquaintances in Haiti, and the
tough situation they live in.
R2R: You mentioned life in Haiti before the earthquake was a
challenge, even on a good day. Afterwards, the devastation is
unimaginable for those of us who have not gone there. Tell
me about returning to the United States after being in rubble
for more than a week. MC: I returned with a lot of hurt for the
people of Haiti and a lot of anger and disappointment as I see
Americans spending so much money on “stuff,” our attitude of
“it’s all about me,” the culture to eat, eat and eat, and how we
don’t appreciate what we have.
Public health preparedness consultant touches
lives in Haiti
The 2010 Haiti earthquake occurred on Tuesday, January 12,
2010. By January24, at least 52 aftershocks measuring 4.5 or
greater had been recorded. An estimated three million people
were affected by the quake.
http://en.wikipedia.org/wiki/2010_Haiti_earthquake
Marilyn Cluka is the public health preparedness consultant
(PHPC) for the Minnesota Department of Health Office of
Emergency Preparedness (OEP) in the northeast region. Since
1993, Marilyn has gone on medical mission trips to
Nicaragua. Her first trip to Haiti was in 2004.
R2R: When did you go to Haiti after the earthquake? What
was your mission? MC: We were in Haiti from March 3 to 13,
2010. Our mission had a medical and spiritual focus. We saw
600+ patients, filled over 1900 prescriptions and prayed with
almost everyone we met.
Marilyn Cluka giving medication instructions to Haitian
woman through an interpreter.
August 2010
R2R: What reactions have you received when you share this
story? MC: You could hear a pin drop at every presentation.
People often leave without saying anything. Sometimes, they
sit and process internally without saying a word. Very few
questions are asked. I think the audience really has a hard time
getting their mind around what happened in Haiti.
R2R: Are there lessons you learned from working at OEP that
you took with you to Haiti? MC: The biggest lesson is to ask
if people need help. Don’t just show up…even though
sometimes you just want to GO! Under the National Incident
Management System, you must delegate or you will not be
effective and/or efficient. Psychological First Aid (PFA) was
far more valuable than I considered in the past. We used PFA
with the Haitian people from the time we arrived at the airport
and continued to use it when we arrived home at our church.
Lastly, with all the partnerships and collaborations we invest
in, relationships are the key to success in any disaster or
emergency!
plans and procedures. We’ll continue to provide updates on
implementation of the improvement plan.
In September, we are looking forward to a site visit from the
Centers for Disease Control and Prevention (CDC) for a
review of our ongoing public health emergency preparedness
and response activities. In October, Assistant Secretary for
Preparedness & Response (ASPR) will visit for a review of
the healthcare system preparedness and response activities in
October. This will be an opportunity to showcase our many
accomplishments to our federal grant managers and to better
understand the federal priorities and direction. We may be
reaching out to some of you to participate in those visits as we
develop the agendas for these meetings.
This summer has had its share of severe weather and damage
in many parts of the state and recovery is still happening,
especially for areas hit by tornados. Thanks to everyone who
prepared for and especially those of you who may still be
responding to or recovering from those incidents.
R2R: Are there lessons from Haiti you took to your job at
MDH? MC: Sometimes in our planning we get too elaborate
on how to set up things, such as mass dispensing, shelters, and
alternate care sites. We lose sight of how basic we could set
things up and make them work. It really does all come down
to “relationships.” Because of the relationships we made over
the past several years with the people of Haiti, I believe our
outreach was more successful.
H1N1 influenza updates
R2R: What’s next? MC: I will return to Pignon, Haiti in
October to present at a four-day women’s Christian
conference. The men assist with a construction project (our
sixth year returning to the same place). In January 2011, we
are going to Limbe, Haiti where we will set up a make-shift
medical clinic and serve as many people from the surrounding
areas as we can.
When the threat of H1N1 loomed large, it was clear that
mainstream media could not be the only vehicle for reaching
all Minnesotans. A planning committee with representatives
from MDH Office of Minority and Multicultural Health,
Office of Emergency Preparedness, Refugee Health,
Communications Office and others met to develop strategies
for communicating with at-risk populations.
Director’s Chair
My sincere appreciation to our many partners across the state
who participated in a local, regional, or statewide meeting;
prepared an after action report; responded to a survey;
buttonholed me or other MDH staff; or otherwise provided
positive feedback or ideas for improvement based on our
collective H1N1 response. A related article in this newsletter
describes the Mass Dispensing Conference and the
MDH/LPHA Policy Summit which provided additional
opportunities for discussion and review.
I’ve been struck by the thoughtful and creative responses for
improvements at the local and/or state level. Here’s just one
example for a recommendation for MDH: Have one time per
day (when things change quickly) or one time per week when
MDH sends response updates or changes in guidance. This
would make it easier for local partners to be confident they
have the most recent information without spending time
continually checking their e-mail. And here’s one for a
recommendation for local health departments: Give more
attention to continuity of operations plans to be ready for
situations when staff time is limited. These and other
suggestions will be analyzed and incorporated into ongoing
Ready to Respond Newsletter
Aggie Leitheiser, Director of Emergency Preparedness
How H1N1 information was communicated to
at-risk populations
One effective strategy was to have representatives of our
target audiences participate in planning a half-day conference.
Their input was critical to the success of the conference
Community Update, held in September 2009 for people
serving or working with populations of color, urban American
Indians, refugees, immigrants or people with limited English
proficiency. Topics included what is H1N1, why we are very
concerned about a pandemic, local contact information of
public health preparedness consultants, human services and
other pertinent organizations, and more.
The conference was held in St. Paul and teleconferenced to
eight locations throughout the state. Over 150 representatives
of agencies and media outlets attended the event. Conference
attendees helped distribute critical H1N1 information at
community meetings and other locations.
Examples of MDH activities:
● Translated fact sheets about H1N1 into 18 of the most
common languages spoken in Minnesota (Amharic,
Arabic, Burmese, Chinese -Mandarin, Hindi, Hmong,
Karen, Khmer, Korean, Laotian, Nepali, Oromo, Russian,
Serbo-Croat, Somali, Spanish, Thai, Tagalog and
Vietnamese)
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Produced a series of television and radio programs in
partnership with Latin Experience Television, ECHO,
KFAI, Hmong TV and others
Coordinated staffing and material distribution at cultural
festivals
Sponsored newspaper ads in media outlets serving
cultural communities
Partnered with Metro Transit and other regional transit
systems to place interior bus ads with flu information
Created many handouts, posters, signs and templates in
multiple languages - all distributed through the MDH
website
Through partnership, teamwork, and listening to the needs of
our audience, we communicated and responded effectively
during a time of impending crises.
information at the same time. The next time you have a
question for staff at MDH, first try the MDH website.
MDH/LPHA Emergency Preparedness Policy
Summit brings recommendations
On July 7 and 8, 2010, about 120 state, local, and tribal
representatives met at the Holiday Inn in St. Cloud to
collectively review the H1N1 response as a springboard to
improving preparedness and response to public health threats.
Using a modified World Café model of discussion (see
http://www.theworldcafe.com/), groups of five gathered
around tables festively dressed with café tablecloths loaned by
Olmsted County to share observations, identify opportunities,
and make recommendations.
The discussions focused on four topic areas introduced by a
state and local team.
1. Public information
2. Partner communications
3. H1N1 response issues
4. Structure, roles and responsibilities, and legal strategies
The recommendations are being summarized for use by a State
Community Health Services Advisory Committee Workgroup
who are reviewing past accomplishments and developing the
direction for the future of public health emergency
preparedness.
Posters with flu information in Spanish, Somali, Hmong and
English were placed in buses and libraries across the state.
Influenza (Flu) website a valuable tool
During the H1N1 influenza pandemic, did you wonder where
you could find a flu shot? Or did you need MDH’s flu
guidance for childcare centers, jails or law enforcement?
Perhaps you needed to submit your weekly report of flu clinics
held or antivirals from the asset cache that you used. Instead
of calling MDH, you could get that information on the MDH
influenza website.
http://www.health.state.mn.us/divs/idepc/diseases/flu/index.ht
ml
In October 2009, over 110,000 people visited the MDH flu
website. That’s more than a typical number of visits in a
month to the MDH home page. That suggests the website
really is doing its job – getting information from MDH to
people all over the state.
Having information posted on the Web also saves money
(staff time) and gets the information to readers quickly. After
all, the website is available when you’re up at 2:00 a.m.,
wondering how long you should stay home sick with the flu. It
was a perfect way to give the media the statistics they wanted
without having to talk to them when they called day, after day,
after day. Instead, we updated our flu statistics page once a
week at the same time, and sent an email announcing the
changes. MDH epidemiologists were able to concentrate on
the cases, not the media, and everyone received the same
Ready to Respond Newsletter
The evaluation responses were overwhelmingly positive for
the use of this meeting style for sharing information between
local and state staff as well as sharing from one local area to
another. Diane Thorson (Otter Tail county) and Lois Ahern
(Freeborn county) provided breaking news about the public
health impact of late June tornadoes. Commissioner Sanne
Magnan offered her appreciation for the many efforts to
respond to the H1N1 outbreak and her continued support for
strengthening partnerships and plans. LPHA Chair Lowell
Johnson and MDH Assistant Commissioner John Linc Stine
hosted the meeting and made sure participants had many
opportunities to share and learn.
A full report on the Summit will be posted on the Workspace
by early September.
One wall of participant feedback from the MDH/LPHA
Emergency Preparedness Policy Summit
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So Many Sites, So Little Time conference a big
success
Over 230 people attended the conference So Many Sites, So
Little Time: A Look Back and a Step Forward in Minnesota
Mass Prophylaxis Preparedness on July 20 and 21, 2010 at
the Crowne Plaza Riverfront in St. Paul, Minnesota. Local
public health staff, school nurses and tribal government
members from Minnesota and western Wisconsin attended the
conference, which was sponsored by the Minnesota
Department of Health Office of Emergency Preparedness.
The conference aimed to share statewide accomplishments,
potential barriers, and train and educate on related functions of
mass prophylaxis. The conference’s intended audience was
local staff who provided leadership and/or participated in the
H1N1 vaccination campaign.
General Session offerings on H1N1 included a presentation
CDC Perspectives on Pandemic Influenza Vaccination
Preparedness and H1N1 Response by Pascale Wortley of the
Centers for Disease Control and Prevention. Minnesota
Homeland Security and Emergency Management’s Kevin
Leuer described The State Emergency Operations Center’s
Role in Mass Prophylaxis. Conference participants attended
breakfast roundtable discussions and over 25 breakout
sessions on topics ranging from Partnering with Faith
Communities to Using Social Media during a Pandemic.
MDH Division Preparedness News
Mobile Medical Unit set up at Great Minnesota
Air Show
For the first time, the Great Minnesota Air Show graced the St
Cloud skies on June 26 and 27, 2010. With an eye toward the
needs of an estimated 30,000-40,000 attendees per day, the
MDH-owned Mobile Medical Unit (MMU) was set up at the
St. Cloud airport to accommodate any medical emergencies.
This on-scene care prevented an estimated 23 hospital
transports.
The MMU is a stand-alone mobile medical treatment facility
capable of providing emergency patient stabilization and
ambulatory care. It has eight patient care beds; two beds can
be critical-care stabilization beds. The MMU is equipped with
a lab, pharmacy, mechanical ventilators and portable X-Ray.
Purchased in 2008, the unit was previously deployed at the
Republican National Convention in 2008 and the 2009 Red
River flood.
Speaker Greg Risberg entertained attendees after dinner. In his
warm, funny presentation, Risberg encouraged participants to
Stay Motivated in a Changing World. He had many
participants howling with laughter with his humorous
perspective on life and work.
Participants gave many positive comments, especially
regarding the ability to network with other local public health
officials; garner and develop new ideas and tools; apply
Incident Command training; review mass prophylaxis plans;
and build partnerships with schools. In the words of one
attendee, “The break-out sessions were great! It was good to
be able to move around and see what other counties did for
H1N1 – great way to learn. And the dinner speaker was great!
Funny! He had a great message!”
Attendees settle in for a breakout session at the So
Many Sites, So Little Time conference
Ready to Respond Newsletter
For the Great Minnesota Air Show, the MMU’s Operations
and Oversight Group (OOG) approved a request to support the
Central Region’s Hospital Response Team. The mission was a
collaborative effort between St. Cloud Hospital, Gold Cross
Ambulance, Air Link, and MDH./OOG. The request enabled
the MMU-OOG to establish several MMU operational and
training objectives:
● Complete needed service, equipment and readiness
activities
● Provide an essential training opportunity for new set-up,
strike and operations personnel
● Document training materials and procedures for set up,
operation and striking
● Test operational and medical systems
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Conduct an operational assessment of the set up and
clinical practices to further develop the clinical training
program
● Showcase the MMU at major public event
The MMU arrived at the St. Cloud Airport on Thursday June
24. After the four-hour set up, Dr. Jim Harris, MMU clinical
advisor, provided a tour and orientation for the hospital team.
On Friday, the teams completed additional cleaning and
outfitting, and hospital staff set up a four-bed triage and
treatment tent outside the MMU for minor problems.
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Clinical operations started at 7:00 a.m. on Saturday June 26.
The first patient was treated for a head injury and foot
laceration requiring stitches. Twelve additional patients were
seen, with two requiring hospital transport; one for a possible
heart attack. The estimated patient stay in the MMU was 2030 minutes. On Sunday, fourteen patients were seen in the
MMU for a variety of problems; two required hospital
transport. Many people were also seen in the triage tent for
general cooling or blood pressure checks, or to obtain band
aids, water, and sun screen.
selected for their role in diseases of public health significance,
or as surrogates for potential bioterrorism agents. MLS labs
that choose to participate then identify the organisms and
report their results to MDH-PHL electronically. MDH-PHL
then analyzes the responses and sends customized educational
summary reports on each organism to every participating lab.
Past challenges have simulated food borne outbreaks,
community acquired meningitis, and exposures to anthrax and
other bioterrorism agents.
This year, MDH-PHL plans to exercise a newly established
courier network to distribute challenge set samples to
Minnesota labs. This exercise will measure the ability of the
couriers to rapidly distribute materials from MDH-PHL to
clinical sites across the state. MDH-PHL can then apply this
information to a variety of potential response scenarios that
would require laboratory support, including a chemical release
incident or infectious disease outbreak.
The mission was considered successful by all lead agencies
and the patients, and met the clinical and operational
objectives. This deployment of the MMU was an opportunity
for the OOG to meet the critical mission readiness,
preparedness and training objectives essential to the success of
the project. Working with multiple partners was key to the
successful deployment and use of the MMU.
MDH Public Health Laboratory gets ready for
Challenge Set
The Minnesota Department of Health Public Health
Laboratory (MDH-PHL) is preparing its annual Challenge Set
of organisms to assess the readiness of microbiology labs
across the state as part of the Minnesota Laboratory System
(MLS) program. The MLS is a statewide network of public
and private clinical laboratories serving Minnesota residents
with the goals of facilitating inter-laboratory communication,
collaboration, cooperation, and providing an essential
component of statewide emergency preparedness and
response.
Now in its ninth year, the Challenge Set is a voluntary
educational and self-assessment tool for MLS laboratories that
perform complex microbiology testing as Advanced Sentinels
in the Laboratory Response Network (LRN). MDH-PHL
invites approximately 115 LRN Advanced Sentinel labs to
participate in the Challenge Set program each year in order to
assess current microbiology practices and infrastructure in
laboratories serving Minnesotans, including the ability to
identify and report organisms of public health importance, and
use LRN protocols to rule-out or refer potential agents of
bioterrorism to MDH-PHL. Since its inception, more than
90% of the LRN Advanced Sentinel labs participate in the
annual Challenge Set each year. .
Each year, staff in the MDH-PHL Emergency Preparedness
and Response Unit prepare four “unknown” organisms
Ready to Respond Newsletter
MDH lab staff prepare roughly 600 individual samples for
distribution as part of the annual Challenge Set program.
Climate change is a public health concern
Minnesotans understand living with cold weather, even -33
degree temperatures as displayed in the photo below. Extreme
weather in Minnesota is occurring more frequently and for
longer durations.
Extreme heat and weather, vector-borne diseases, and
migrating species are current climate change issues that can
disrupt the public health of our communities and endanger
vulnerable populations. Here are examples of how MDH seeks
to improve public health’s capacity.
1. A $90,000 climate change grant from the Association of
State and Territorial Health Officials supports interstate
collaboration and MDH activities through August, 2010.
Those activities include:
● Creation of MDH climate change Web pages, Webbased training and communications planning to help
public health officials better understand and respond to
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Upcoming Events
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Extreme heat and extreme weather
Vector-borne diseases (e.g., immigrating
mosquitoes and ticks)
Vulnerable populations
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Assessment of MDH staff climate change knowledge,
work, attitudes and resource needs
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Collaboration on an MDH five-year climate change
strategic plan by representatives from MDH programs
and local public health
2. The MN Environmental Public Health Tracking Program
at MDH is collaborating with federal and state agencies to
develop data and measures for environmental health
hazards, exposures and health outcomes (e.g., including
measures associated with climate change). Data and
measures for allergens (e.g., pollen) and extreme heat, for
example, may be used to define climate change strategic
planning efforts (adaptation strategies) and evaluate the
effectiveness of public health actions.
3. The OEP recognizes the value of emergency preparedness
mapping of populations at risk for flooding and other
extreme weather events. The beginning stages of planning
are underway.
4.
MDH participates on Minnesota’s Interagency Climate
Adaptation Team. It explores the potential effects of
climate change in Minnesota and is developing an
adaptation plan for the state.
MDH is committed to collaborating with many partners to
improve understanding of and adaptation to the public health
consequences of climate change.
For more information, contact Lynne Markus at 651-201-4498
or [email protected]
Health Care Occupational and Environmental
Safety Workshop
September 21-22, 2010
Millennium Hotel, Minneapolis
Do you have occupational or environmental safety and health
responsibilities in your health care organization? Are you
involved with emergency preparedness, infection control,
employee safety, and other Environment of Care topics? If
you are, mark your calendars for Sept 21-22 to participate in
this workshop featuring the latest in health care occupational
and environmental safety. See conference web page for
registration information and workshop agenda:
http://www.childrensmn.org/conferences/
This workshop will provide attendees with practical and up-todate information on health care occupational and
environmental safety. Speaker topics relate to Environment of
Care, emergency management, employee safety, infection
control, and environmental safety.
The workshop is sponsored by Children's Hospitals and
Clinics of Minnesota and co-sponsored by Cincinnati
Children’s and Texas Children’s Hospitals.
Emergency Preparedness Resources
New Workspace coming soon!
The Partner Alerting and Communications Team (PACT) in
the MDH Office of Emergency Preparedness plans to
complete the new Workspace in August. The work is going
well, and although we haven’t set a date yet, it’s looking good
for a rollout of the new portal this September.
What will be different about the new Workspace? You will
recognize it as the Workspace, but it has a slightly different
look. It is cleaner and easier to read, we think. The long
awaited and eagerly anticipated search engine is in place and
working well. Those people who post documents to the
Workspace will be trained about the fine points of naming
documents in a way that will make them easy to find with
‘Search.’
Our communication plan includes messages at Rollover
(moving from old Workspace to new) minus three weeks, two
weeks, and one day. The Education, Exercises and Planning
Unit in OEP is assisting us in using a new Web-based training
tool for new Workspace training.
33 degrees below zero as seen in a state car mirror.
Photo by R. William Bouchard, Jr.
Ready to Respond Newsletter
Workspace user data and documents will be moved to the new
Workspace towards the end of the August. Because we want
to move only accurate and useful information from the old
Workspace to the new portal, we encourage:
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All Workspace users to check their profiles to make sure
they are current.
If you are a document manager, review the documents
you own and remove any that are no longer useful.
For HAN Coordinators, please check your organization’s
role matrix, and update as needed.
Thank you for your patience during this long process. We
think you’ll be happy with the results.
Free, short training modules for public health
professionals
Introduction to Ethical Frameworks for Public Health
Emergencies and Disasters
This 60-minute module (1.0 contact hour and 0.1 CEUs)
examines the general ethical considerations related to public
health disaster response. It describes ethical frameworks as
tools for public health professionals who face ethical
dilemmas during public health threats and disasters.
Applying Ethical Frameworks during Severe Pandemic
Influenza
Public health professionals can apply sample ethical
frameworks in this 45-minute module (0.75 contact hour and
0.075 CEUs). You’ll prepare for difficult ethical dilemmas
and recognize both the efficacy and the challenges inherent in
the process.
Both modules can be found at:
http://www.sph.umn.edu/ce/umncphp/
For more information, please call 612-626-4515 or
800-493-2060. The modules were developed by:
Editorial Board
Editorial Board members include representatives from MDH
divisions that receive preparedness funds.
Aggie Leitheiser, Director of Emergency Preparedness
Marcia Robért, Editor, Office of Emergency Preparedness
Jessica Southwell, Infectious Disease, Epidemiology,
Prevention and Control
Kirsti Taipale, Office of Emergency Preparedness
Lynne Markus, Environmental Health
Nancy Torner, Communications Office
Nathan Kendrick, Public Health Laboratory
Steven Dwine, Office of Emergency Preparedness
Contributors to this issue
Aggie Leitheiser, Office of Emergency Preparedness
Barbara Lundgren, Office of Emergency Preparedness
Edit French, Communications Office
Emily Boog, Children’s hospitals & Clinics of Minnesota
Janice Maine, Office of Emergency Preparedness
John Urbach, Office of Emergency Preparedness
Lynne Markus, Environmental Health
Marcia Robért, Office of Emergency Preparedness
Marilyn Cluka, Office of Emergency Preparedness
Myrlah Olson, Office of Emergency Preparedness
Nancy Torner, Office of Emergency Preparedness
Nathan Kendrick, Public Health Laboratory
Rosemarie Rodriguez-Hager, Office of Minority and
Multicultural Health
Steven Dwine, Office of Emergency Preparedness
Toby McAdams, Office of Emergency Preparedness
MN.
DID YOU KNOW you can request a one-on-one training to
learn the features of MN.TRAIN? MN.TRAIN offers more
than preparedness courses. It has courses on chronic and
infectious diseases, environmental health, health policy issues,
behavioral health, and more. Learn how MN.TRAIN can help
you improve staff development, maintain training records and
more. Contact the Office of Emergency Preparedness at 651201-5700 or send an email to [email protected] to
request a “Basic User” or “Administrator’s” training
Office of Emergency Preparedness
625 North Robert Street
P.O. Box 64975
St. Paul, MN, 55164-0975
Phone: 651- 201-5700
www.health.state.mn.us
Ready to Respond Newsletter
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