Moa Maria Ulrika Herrgård


Moa Maria Ulrika Herrgård

External Coordinator of the International Federation for Medical Student Association UN Task Force and Deputy Organising Partner of the UN MGCY Disaster Risk Reduction (DRR) Working Group. Moa is facilitating youth in design and implementation of Sendai Framework for DRR 2015‐2030; doing research in disaster medicine; and are facilitating disaster medicine trainings worldwide.

Resilient Urban Health Workforce

The frequency and intensity of disasters and other emergencies are increasing. [1] In 2015, there were 346 disasters reported. These disasters have extensive impact on the urban resilience and sustainable development, with potential short and long term political, economic and social consequences. Disasters in 2015 resulted in 22,773 deaths, 98.6 million injuries and economic damage worth 66.5 billion USD. [2] In order to mitigate the negative consequences of disasters, urban health workers need to reduce vulnerability to risks and enhance the capacity to appropriately respond. Urban resilience is therefore a crucial component to fulfill and strengthen
the goals outlined in the Agenda 2030 on Sustainable Development 2015‐2030, the Sendai Framework on Disaster Risk Reduction 2015‐2030 and the New Urban Agenda.[3] [4] 

Urban resilience is the capacity of individuals, communities, institutions, businesses, and systems within a city to survive, respond, adapt, and grow regardless of the nature of the hazard. No one is immune to hazards and the need for proactive measures through preparedness and reduced vulnerability is the only solution to adequately reduced the adverse effects imposed by hazards. There is currently a gap in the resilience of urban health care systems.[5] The lack of sufficient disaster preparedness in healthcare has devastating consequences for the affected individuals as well as the urban community. 

Health‐care professionals belong to the emergency first responders. They provide emergency care while juggling the challenges of reducing the risk of long‐term health consequences and maintaining basic services during unstable times. The knowledge and skills of these health care responders are a matter of life and death, and have an indirect effect on the resilience and sustainability of the cities they serve. Post‐disaster response evaluations have proven that healthcare emergency responders lack knowledge and skills.[6] There is usually weak clinical competence, inadequate management and lack of standardised protocols.[7] 

Medicine is a worldwide profession following unified methods. The health care delivered within disaster and emergency settings are often not delivered based upon internationalised common and evidence‐based standards.[5] There is currently a lack of international standards and practice of disaster medicine, and there is a lack of competency‐based training. Disaster medicine needs to be professionalised, further institutionalised in the local health system and live up to the high quality standard of medicine. Without a formalised field of disaster medicine, we will not reach a resilient urban health care system and individuals, as well as the collective society, will continue to be vulnerable to hazards.

Healthcare personnel are provided few opportunities for formal training in disaster medicine. In Italy there is an awareness of disaster medicine among medical students, but there lacks inclusion of this specialty in the medical curriculum.[8] The majority of current available training opportunities are only provided to a cost without external funding available for the students, and most of them aretargeting emergency responders. A larger number of these disaster medicine curricula lack substance and are narrowly focused on topics such as pandemic influenza, and community and hospital hazards planning.[9] [10]

There is a clear need to professionalise disaster medicine as its own discipline, including a globally unified curriculum, clinical guidance and management. It is though important to contextualizing it with local sociocultural and environmental settings.

The increasing access to internet, dissemination of knowledge (i.e. Massive Open Online Courses ‐ MOOCs), and technologic innovations are providing a solution. MOOCs and innovative tools such as computer‐based disaster simulations are providing a unique opportunity for easily accessible, affordable, quality, and expert disaster medicine trainings for health care personnel worldwide. Online training has the potential to reach a greater number of health workers in vulnerable urban communities, providing a new face for disaster medicine education. The courses provide students with flexibility, making it available for undergraduate students in training as well as medical doctors in practice. These online disaster medicine curricula are comprehensive and based upon research on best practices. Computerized disaster simulations further enhance the outcome of online learning.[11] It revolutionises the experience and efficacy of the learning process, exposing students
to far greater range of scenarios and adaptive systems in which to practice and enhance their skills as first responders. The simulation’s backend are based on real time data extracted from national disaster reports of urban disasters, legitimizing the user‐experience and reflecting practice real‐world situations responders could one day encounter.

Training of health care personnel enhances the capacity to manage urban disasters, it reduces society’s vulnerability to risks, and contributes developing resilient health care system in cities.

[Twitter: @moaherrgad / Linked In: Moa Herrgard / Facebook: Moa Herrgard]


[1]“Guha‐Sapir D, Hoyois Ph. , Below. R. Annual Disaster Statistical Review 2014: The Numbers and Trends. Brussels: CRED; 2015.

[2] EM‐DAT (25th January 2016) : The OFDA/CRED ‐ International Disaster Database Université catholique de Louvain Brussels – Belgium.

[3] UN Office for Disaster Risk Reduction. Sendai Framework for Disaster Risk Reduction 2015‐2030. United Nations. URL: [A... 21 February 2016].

[4] UN Department for Social and Economic Affairs. Transforming our world: the 2030 Agenda for Sustainable Development. United Nations. URL: [Accessed 14 March 2016]

[5] Burkle FM Jr. Future Humanitarian Crises: 21stt Century Challenges to Surgical Practice and Policy. Davos, Switzerland.11 Dec 2011. Available at:‐future‐crises‐davos‐talk‐burkle. Accessed 3 March 2016.

[6] Djalali A, Ingrassia PL, Della Corte F, Foletti M, Ripoll Gallardo A, Ragazzoni L, Kaptan K, Lupescu O, Arculeo C,

[7] Burkle FM Jr., Clarke G, VanRooyen MJ: Challenges to the humanitarian community: The role of academia in advancing best practices and policy promotion. Prehosp Disaster Med 2009;24(l):s247‐s25.

[8] Ragazzoni L, Ingrassia PL, Gugliotta G, Tengattini M, Franc JM, Corte FD. Italian medical students and disaster medicine: awareness and formative needs. Am J Disaster Med. 2013 Spring;8(2):127‐36. doi: 10.5055/ajdm.2013.0119.

[9] Ingrassia PL, Foletti M, Djalali A, Scarone P, Ragazzoni L, Della Corte F, Kaptan K, Lupescu O, Arculeo C, von Arnim G, Friedl T, Ashkenazi M, Heselmann D, Hreckovski B, Khorrram‐Manesh A, Komadina R, Lechner K, Patru C, Burkle FM Jr., Fisher P. Education and training initiatives for crisis management in the European Union: a web‐based analysis of available programs. Prehosp Disaster Med. 2014;29(2):1‐12.

[10] Smith J, Levy MJ, Hsu EB, Levy JL. Disaster curricula in medical education: pilot survey. Prehosp Disaster Med. 2012;27(5):492‐494.

[11] Nationwide Program of Education for Undergraduates in the Field of Disaster Medicine:Development of a Core Curriculum Centered on Blended Learning and Simulation Tools. Prehosp Disaster Med. 2014 August;29(05):1‐8.