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UNIFIED RESCUE SYSTEM IN REPUBLIC OF BULGARIA -ORGANIZATIONAL STRUCTURE AND MANAGEMENT
Dimitrova Diana Asenova
PhD, MD, Medical University of Sofia, Faculty of Public Health, Department "Preventive medicine", Discipline «Disaster
medicine», Bulgaria, Sofia, "Bialo more"8 St
Slavova Vanya Bancheva
Assistant Professor, MD, Trakya University, Medical Faculty, Department «Neurology, Psychiatry and MDS» Section « Medicine of the disaster situations», Bulgaria, Stara Zagora, «Armeyska» 11 St
Platikanova Magdalena Stefanova
Associate Professor, PhD, MD, Trakya University, Medical Faculty, Department «Hygiene, Infectious diseases and Epidemiology», Section «Hygiene and Ecology», Bulgaria, Stara Zagora, «Armeyska» 11 St
ABSTRACT
Background. The Unified Riscue System (URS) with emergency number 112 in Republic of Bulgaria is a part of the civil protection (CP) system in the country. National system 112 provides continuous assistance to the population in emergency situations, criminal acts, acts of terrorism and disasters. The main and additional components of URS work according to basic principles and organizational structure of CP system in the country. Coordination of activities follows the legislation of protection of the population. Civil Protection legislation is based on the Supreme Law of the country: the Constitution of the Republic of Bulgaria. In Europe and Bulgaria is reported enhancing the danger from man-made disasters. This requires examine in depth the organizational structure and management of URS in Republic of Bulgaria.
Methods. Descriptive analysis of the laws and regulations, in Bulgaria concerning organizational structure and mechanisms for management of the components of URS in Bulgaria for major disasters, accidents and catastrophes.
Results. According to collected data on the organizational structure of the URS it is reported coverage and provided protection for all citizens of the Republic of Bulgaria as well as for temporary foreign residents. According to available information mainly focusing on the population and the forces of URS is in several major cities including the capital. In case of disaster has a real opportunity for redirecting the efforts of URS to the stricken region in the country. There is a need for regularly conducting trainings on protection of the population at all levels of protection.
Conclusion. There is an increasing number of emergency and disasters situation which underlines the importance of efective working of URS. The requirements for the provision of URS in Bulgaria are becoming stricter. The URS in Bulgaria is guaranteed to all those in need of it. The country has a concept for the future development of the system of URS.
Keywords: Unified Rescue System; organizational structure and management, disaster situations, Republic of Bulgaria.
The Unified Riscue System (URS) with emergency number 112 in Republic of Bulgaria is a part of the civil protection (CP) system in the country. National system 112 provides continuous assistance to the population in emergency situations, criminal acts, acts of terrorism and disasters. The main and additional components of URS work according to basic principles and organizational structure of CP system in the country. Coordination of activities follows the legislation of protection of the population. Civil Protection legislation is based on the Supreme Law of the country: the Constitution of the Republic of Bulgaria. In Europe and Bulgaria is reported enhancing the danger from man-made disasters. This requires examine in depth the organizational structure and management of URS in Republic of Bulgaria [14, p. 27; 15, p. 200;16, p. 10; 17, p. 20; 18, p. 32 ].
Aim and tasks
The aim of the study is to examine the current organizational structure and management of URS in significant and serious disasters, accidents and catastrophes in Bulgaria.
To achieve the goal we set the following tasks:
1. To analyze the legal and normative documents, decrees and procedures in Bulgaria on the organizational structure of the URS in Bulgaria.
2. To analyze the legal and normative documents, decrees and procedures in Bulgaria on the management of URS in Bulgaria in case of serious emergency and disaster situations.
Methods. Descriptive analysis of the laws and regulations, in Bulgaria concerning organizational structure and mechanisms for management of the components of URS in Bulgaria for major disasters, accidents and catastrophes.
Results. According to collected data on the organizational structure of the URS it is reported coverage and provided protection for all citizens of the Republic of Bulgaria as well as for temporary foreign residents. According to available information mainly focusing on the population and the forces of URS is in several major cities (Varna, Ruse, Plovdiv, Burgas) including the capital Sofia. In case of disaster has a real opportunity for redirecting the efforts of URS to the stricken region in the country. There is a need for regularly conducting trainings on protection of the population at all levels of protection [7, p. 428; 8, p. 3; 9, p. 5; 10, p. 8; 11, p. 7; 12, p. 6; 13, p. 4 ].
In Bulgaria a common and serious medical situation in the affected regions in the event of different types, sizes and severity Disastrous Situations (DS) are created. The disasters are characterized by the coverage of different sized areas with specific geographical, demographic and economic characteristics. The most typical disasters for the country are
floods and forest fires. In case of collapse of the Healthcare facilities during disasters - completely or partially and there is a shortage of health personnel, medical and sanitary property and etc. Arises threat to the health and life of the population and irretrievable and massive medical losses in the affected areas are occurred. The heavy common and medical setting in the DS require in a short time to organize themselves and implement complex of Emergency, Urgent and Emergency-Recovery Measures (EUERM) across the disaster, so as to prevent or reduce the impact of the Damage Factors (DF). Protection of the population from the DF during the peacetime disasters in Bulgaria is achieved through: Implementation of preventive activities, coordination of the actions of a Unified Rescue System (URS) capabilities; Resource ensuring; Informing the public and etc. [14, p. 33].
A National Emer-gency Plan has been developed, which facilitates the organisation of forecasting, managing and conducting rescue and re-covery activities in emergency situations. The plan also defines the obligations for preparedness and participation of all management bodies and other resources in order to provide and receive interna-tional emergency assistance. Plans for the protection of the population and material assets are developed by other ministries, state agencies, district governments, municipalities and private companies [14, p. 24; 22, p. 10; 23, p.7; 24, p.18].
Civil Protection legislation is based on the Supreme Law of the country: the Constitution of the Republic of Bulgaria. The Civil Protection system is regulated by the following legislation [21, p. 45, 47]:
• Disaster Protection Act.
• Crisis Management Act.
• 112 Act.
• Local Administration Act.
• Waters Act.
• Defence and Armed Forces Act.
• Ministry of Internal Affairs Act.
• Public Health Act.
• State Administration Acts.
• Other special laws and Related secondary legislation.
The main legislative act is the Disaster Protection Act, adopted in 2006, which established the regulations covering the duty to preserve life and health, and protect the environment and property in the event of a disaster [19, p.28;20, p. 11; 25, p. 7; 26, p. 19].
The Disaster Protection Act stipulates the activities related to the coordination and management of the rescue and emergency recovery efforts among the competent authorities - components of the created Integrated Rescue System - which have to work together in the event of disaster and form units of the unified rescue system.
Organizational structure and management of the work of the rescue system. The System for Protection of the Population (SPP) in Bulgaria includes central and local executive authorities and organizations that manage, conduct and coordinate activities to protect the population and the national economy. The National Assembly (NA) in the country carries out legislative building SPP and national economy in DS. The Council of Ministers (CM) formed State Policy for Disasters, Accidents and Emergencies (DAE) and performs the general management in DS and overcome and mitigate the consequences. Interdepartmental Commission for Reconstruction and Assistance (ICRA) is established by CM in Bulgaria in 2007. This commission organizes, coordinates and manages preventive activities at national level. In case of DS the commission implements the general management of EUERM. Its role is to coordinate the interaction of the various ministries and departments and the implementation of maneuver to the forces and resources of the territorial units. The commission includes heads or deputy heads of ministries and agencies related to the DS. The Commission is assisted by the Crisis Center, which is formed by experts to the relevant ministries and departments. The Ministry of Interior in 2009 include specialized directorates «The National System 112» with Single European Emergency Call Number 112 (SEECN) and Directorate General «Civil Protection» which is transformed and renamed in 2011 to the General Directorate «Fire Safety and Protection of the Population «(FSPP) [14, p. 24]. (Fig. 1)
MINISTRY OF INTERIOR
NATIONAL LEVEL
The National Assembly / PARLAMENT
Interdepartmental Commission for ±
experts
ex perts
Reconstruction and Assistance
Council of Ministers
t
DISASTERS
Crisis Center
The National System 112
DISASTERS
experts
experts '
experts
General Directorate "Fire Safety and protection of the population"
MINISTRY OF HEALTH
MINISTRY OF DEFENCE
LOCAL LEVEL
Fig.1. The rescue system in Bulgaria - organizational structure and levels of management.
To realize the protection of the population in the country was built URS. In addition, with regards to search and rescue activities, the ministry has set up 28 rescue teams under the territo-rial Civil Protection Directorates, which comprise of 800 rescuers, organised into 145 general rescue teams, 16 alpine
groups and 8 diving teams. They provide 24-hour duty shifts. Rescue teams and voluntary formations in the country's districts maintain permanent contact with the operational communication and information centres of the ministry [1-6, p. 1-10; 21, p. 48]. This system organizes, coordinates and manages the activities
of its constituent parts in their preparations, in case of DS and during the conduct of EUERM. Fundamental components of the URS in the country are: DG «CP» at the Ministry of Interior (MoI) and the Emergency Medical Care Centers (EMCC) at the Ministry of Health (MoH). They provide continuous adoption of
information, evaluation of the situation and conduct immediate action in case of disasters. Other components of the URS (police and military) provide assistance upon request to conduct EUERM. (Fig. 2). (According to Ministry of Health data)
1-12
Emergency Medical Care Centers
Affiliate of TV jJ^L
Emergency Medical Care Centers
1 1 t
MINISTRY of Health
Fig. 2 Link structure of the 112 in Ministry of Health in Bulgaria (source: Ministry of Health data)
In Bulgaria also is established the National Emergency Call System with the single European emergency call number 112. The system comprises six emergency call centres, one in each planning region. The system is homogeneous, which ena-bles each of the centres to accept calls from any geographical point in Bulgaria, including from geographical areas beyond the respective planning region.
The «National System 112» includes Reception Centers for emergency calls to the URS -112 in Sofia, Varna, Burgas,
Kardzhali, Montana and Ruse, and National Emergency Services - DG «FSPP» and Police at the Mol, and EMCC at the MoH. Calls are related assistance and rapid response to DAE, criminal acts, acts of terrorism and the need for emergency care. The general management of the protection of the population in DS is done by the CM, the direct authority of the protection is done by MI and the fixed and operational - by the DG «FSPP». (Fig. 3 and fig 4.). (According to MoH and MoI data)
Fig. 3. National System 112 in Bulgaria (source: MoH and MoI data)
Emergency call system with a single European number 112
Model of Center emergency advocated by the European Telecommunications Standards Institute (Standard ETSI SR 002 180 V1.1.1 (2003-12) )
Fig. 4. Emergency call system with a single European number 112 (source: MoH and MoI data)
To improve the performance of the URS in the country has established a National Training Center (NTC) and the Centre for Professional Training of Lifeguards (CPTL) with educational and training base in Montana. A Center for Aerospace Monitoring (CASM) supports the process of monitoring, assessing and managing the risk of natural and anthropogenic disasters. Received and processed data from CASM enabling analyzing and making management decisions in the event of crises, natural disasters, earthquakes, floods, industrial accidents, etc. [14, p. 24].
Conclusion. There is an increasing number of emergency and disasters situation which underlines the importance of efective working of URS. The requirements for the provision of URS in Bulgaria are becoming stricter. The URS in Bulgaria is guaranteed to all those in need of it. The country has a concept for the future development of the system of URS.
References
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EMERGENCY MEDICAL CARE SERVICES IN REPUBLIC OF BULGARIA - STRUCTURE, FUNCTIONS AND ACTUAL STATUS OF
MEDICAL STAFF
Dimitrova Diana Asenova
PhD, MD, Medical University of Sofia, Faculty of Public Health, Department "Preventive medicine", Discipline «Disaster
medicine», Bulgaria, Sofia, "Bialo more"8 St
Slavova Vanya Bancheva
Assistant Professor, MD, Trakya University, Medical Faculty, Department «Neurology, Psychiatry and MDS» Section « Medicine of the disaster situations», Bulgaria, Stara Zagora, «Armeyska» 11 St
Ivanov Veselin Asenov
Professor, MD, Trakya University, Medical Faculty, Department «Neurology, Psychiatry and MDS», Section «Medicine of the
disaster situations», Bulgaria, Stara Zagora, «Armeyska» 11 St.
ABSTRACT
Background. The emergency medical care (EMC) in the Republic of Bulgaria is a part of the healthcare system of the country. Bulgaria has a long tradition in organizing medical care in emergency situations and in reacting to natural disaters, accidents and calamities (DAC). Until 1995 the emergency care in Bulgaria was provided by hospitals' emergency departments.The conditions in the country changed a lot during the 1996-2012 period and the EMC system confronts new challenges. A new national system for urgent calls is put in place as well as EMC centres. These measures improved the coordination and harmonized the provision of prehospital care in emergency situations and in DAC. This requires examine in depth the structure functions and actual status of medical staff in EMCC in Republic of Bulgaria.
Methods: Research and descriptive analysis of the laws and regulations, scientific literature data, historical method, documentary method in Bulgaria of concerning structure, functions and actual status of medical staff in EMCC. SWOT analysis.
Results: The analysis of the current state of medical staf of the EMC system in Bulgaria shows the need to update and improve the structure and organization of the EMC centres in response to DAC. It points out the strengths and weaknesses of the system and outlines the concept for sustainable development in the future.
Conclusion: There is an increasing number of disasters worlwide which underlines the importance of EMC. The requirements for the provision of EMC in Bulgaria are becoming stricter. More and more people need EMC - this highlights the pronounced shortage of health personnel in EMC centres in the country.
EMC care in Bulgaria is guaranteed to all those in need of it. The article emphasizes the state's commitment to the medical system in case of DAC. The country has a concept for the future development of the system of EMC centres. This concept provides for the introduction of a new professional category - «the paramedic». Bulgaria lacks a regulatory framework, standards and protocols for the operation of the EMC centres for the provision of pre-hospital care, including in the case of DAC.
Bulgaria is guaranteed to all those in need of it. The country has a concept for the future development of the system of URS.
Keywords: emergency medical care, emergency medical care centres, disaster situations, Republic of Bulgaria, prehospital health care.
