p ISSN
2723-6927-e ISSN 2723-4339
Ayu Laili Rahmiyati1*, Elda
Permatasari2, Suhat3, Asep Dian Abdilah4
1,2,3,4Jenderal
Achmad Yani University, West Java, Indonesia
Email: ayunasihin2@gmail.com*
ABSTRACT
Disaster logistics management is
an effort to arrange logistics raw materials in the implementation of disaster
management, which consists of planning, procurement, storage, distribution,
transportation, and receiving. Cianjur Hospital is one of the health facilities
affected by the Cianjur earthquake; due to the earthquake, almost all parts of
the hospital were damaged, so some health services were carried out in
emergency tents. The purpose of this study was to obtain an analysis of the
disaster logistics management system at RSUD Cianjur. The design used is
qualitative with a descriptive approach. The informants in this study were 5
employees of Cianjur Hospital. Data collection is carried out through in-depth
interviews, document studies, and observations. Analysis data processing uses
data reduction analysis, data presentation, and conclusions. The results showed
that the disaster logistics management system at Cianjur Hospital had
appropriate planning, but there was little difficulty meeting needs. At the
time of procurement and/or receipt, there is a discrepancy in needs and an unclear
identity of the sender. There are two logistics warehouses, namely inside the
building and in the emergency tent, but the warehouse security in the emergency
tent is less safe and the place is inadequate. In distribution, there is speed,
accuracy, and the amount of distribution that is sometimes not right. It is recommended that hospitals
optimize the performance of each human resource as well as write SOPs regarding
disaster logistics management systems.
Keywords: disaster, hospital, logistics management
INTRODUCTION
Disasters are events or series of events that cause human suffering such as damage to property, environmental damage, facilities and infrastructure, and have the potential to disrupt human life and livelihood. Due to its geographical location, Indonesia is prone to natural disasters such as earthquakes, volcanic eruptions, tsunamis, floods, droughts, and landslides (Safri, 2016).
On
November 21, 2022, at noon at 13:21:10 WIB, there was an earthquake with a
magnitude of 5.6 in the Cianjur area, West Java. Based on BMKG data, until
November 22, 2022, 140 aftershocks with a strength of 1.2 4.2 Magnitude have
been recorded with an average depth of about 10 Km, of which 5 earthquakes were
felt by the surrounding community (Sormin, Tampubolon,
& Sinaga, 2023).
The main earthquake with a magnitude of 5.6 impacted and was felt in the city
of Cianjur with an intensity scale of V-VI MMI (Modified Mercalli Insensity); Garut and Sukabumi IV-V MMI; Cimahi,
Lembang, Bandung City, Cikalong Wetan, Rangkasbitung, Bogor, and Bayah with MMI
III intensity scale; South Tanggerang, Jakarta, Depok with intensity scale
II-III MMI. According to information from BNPB, the earthquake caused 334
casualties, more than 50,000 houses were damaged, and refugees currently
reached 114,683 people from 41,166 households (Susila, Dewi, &
Alamsyah, n.d.).
The
earthquake that occurred in the Cianjur area was a shallow-motion tectonic
earthquake caused by the shift of the Cimandiri Fault. Cianjur is one of the
districts crossed by the Cimandiri fault. This Cimandiri fault is an active
fault or shear fault along 100 Km (Prayogo, 2023).
The Cimandiri Fault area stretches from the mouth of the Cimandiri River in
Pelabuhan Ratu, Sukabumi Regency, heading northeast through Cianjur Regency,
West Bandung Regency, and
The
earthquake disaster in Cianjur caused massive damage. In addition to
casualties, the damaged property was not small. The National Disaster
Management Agency (BNPB) recorded 56 damaged infrastructures, namely 363
damaged school buildings, 144 places of worship, 16 office buildings, and 3
health facilities ((Wibowo, Meilano, &
Virtriana, 2024);(Hendriati &
Achmat, 2024)).
Cianjur
Hospital is one of the health facilities affected by the Cianjur earthquake on
Monday, November 21, 2022, with a magnitude of 5.6. As a result of the
earthquake, almost all parts of the hospital were affected by damage to many
walls inside the hospital, which were cracked, ceilings dislodged, and broken
tiles. No exception in the emergency room, which is also used as an evacuation
place for earthquake victims; victims in the emergency room are forced to lie
down with views of damaged buildings. In addition to the emergency room, the
inside of the hospital was also vacated for security reasons. As a result, the
victims were forced to lie in evacuation tents. Until now, several health
services have been carried out in the emergency tent of Cianjur Hospital,
including inpatient services, childbirth services, hemodialysis services, and
emergency services for surgery. Due to the damaged hospital building, patients
with high risk were referred to various hospitals in Bogor, Sukabumi, and
Bandung.
After the
earthquake occurred, many volunteers brought logistical assistance to Cianjur
Hospital because of the many limited logistical supplies such as velbed, oxygen
concentrator, HEOC operational kit, medicines, masks, PPE, antigen kits,
emergency kits, handscoons, body bags, diapers for children and adults, Kesling
packages, family kits, tents, blankets, mats, women's and men's clothing
packages, ready meals, to toiletries. The logistics distribution process is
also supported by the regional apparatus of Cianjur Regency including the Human
Resources Personnel and Development Agency (BKPSDM), the Licensing Office, the
Social Service, the Regional Disaster Management Agency (BPBD), the Fisheries
and Livestock Office, the Agriculture Office, the Industry and Trade Office,
the Library and Archives Office, Tagana and Satpol PP (Supendi et al., 2023).
Logistics has
an important role in disaster management efforts, especially during
pre-disaster, preparedness, and disaster response, to be able to ensure the
right assistance goods, right quantity, right quality, right target, on time,
right reporting, and on cost (MACK, n.d.). Effective,
efficient, and reliable logistics management will be an important factor in
disaster management (Iskaputri, Razak, & Arifin, 2020). Logistics
management system and disaster management equipment is the management of
logistics and equipment including planning, procurement, warehousing, distribution, and elimination in order
to achieve goals and objectives effectively and efficiently (Negi & Negi, 2021). In
addition, logistics management and disaster management equipment is a system
that explains the logistics and equipment needed to overcome disasters in the
pre-disaster period, during disasters and in the post-disaster.
Previous studies have highlighted the critical role of logistics in disaster
management, emphasizing the need for effective and efficient logistics
management systems to ensure timely and appropriate assistance during
pre-disaster, preparedness, and response phases ((MACK, n.d.); (Iskaputri et al., 2020)). These studies have underscored the importance of logistics planning,
procurement, warehousing, distribution, and disposal in achieving disaster
management goals and objectives (Negi & Negi, 2021).
The novelty of this study resides in its emphasis on amalgamating
logistics management with disaster management equipment. While prior studies
have dissected logistics and disaster management as distinct entities, this
research endeavors to investigate the seamless integration of these two facets
into a unified system. By scrutinizing the logistics requirements and necessary
equipment throughout every stage of disaster management, ranging from
pre-disaster strategizing to post-disaster rehabilitation, this study aims to
furnish a holistic comprehension of streamlining logistics and equipment
provisions for disaster readiness and response.
Moreover, the objective of this study is to pinpoint optimal methods and
tactics for overseeing logistics and disaster management equipment in a unified
fashion, leveraging insights from both domains. Through amalgamating existing
literature and scrutinizing case studies or real-world instances, this research
intends to enrich the repertoire of more productive and streamlined approaches
to disaster logistics management. Furthermore, by underscoring the significance
of harmonized coordination and cooperation among stakeholders engaged in
logistics and disaster management, this study will proffer actionable
suggestions for bolstering disaster preparedness and response endeavors.
Based on the
above, the researcher conducted research on the application of logistics management
in disaster management at the Cianjur Regional General Hospital. This study
aims to determine disaster logistics management at Cianjur Regional General
Hospital which consists of planning, procurement and/or receiving, storage, and
distribution processes.
RESEARCH METHODS
This research design uses a
Qualitative Descriptive approach to understand human or social phenomena
related to logistics control in disaster management at Cianjur Regional General
Hospital. The object of this study is logistics control policies and procedures
in disaster management at the hospital. The source of the research data came
from five informants selected based on certain criteria, namely understanding
of disaster logistics policies, mastery of work processes and tasks, and
involvement in the activities studied. Informants consist of the Director or
Deputy Director of the Hospital, the Head of Finance, the K3RS Committee,
Disaster Logistics Staff, and Asset Coordination.
The data collection method is
carried out through triangulation, namely in-depth interviews, observations,
and document reviews. In-depth interviews were conducted to obtain detailed
views from informants on logistics control policies and procedures in disaster
management. Observations are made to gain a direct understanding of the work
processes carried out related to logistics control. In addition, document
reviews are conducted to collect recorded data regarding existing policies and
procedures in writing.
The population in this study was
all individuals involved in disaster logistics control at Cianjur Regional
General Hospital. The sample consists of five informants selected based on
predetermined criteria.
Data analysis is carried out
qualitatively by summarizing and analyzing information obtained from
interviews, observations, and document reviews. The results of the analysis
will be presented in the form of a comprehensive and complex description of
logistics control policies and procedures in disaster management at Cianjur
Regional General Hospital.
RESULTS
AND DISCUSSION
A. Man
Based on the results of research and interviews at the Cianjur Regional General Hospital, it was found that the human resources involved in this disaster logistics management system were the Deputy Director of Services, down to the Head of Supporting Affairs, then the logistics coordinator of facilities and infrastructure, the coordinator of hospital assets, as well as the person in charge of medicines and medical devices by the Head of Nursing. In addition, there is also a Disaster Preparedness Team at Cianjur Regional General Hospital.
Based on the results of research and interviews at the Cianjur Regional General Hospital, it was found that there was no special budget for disaster logistics management, but there was a budget for training before the disaster. The hospital only accepts donations, so it only receives, accommodates, and distributes them.
Based on the results of research and interviews at the Cianjur Regional General Hospital, it was found that the materials needed by the Cianjur Regional General Hospital after the earthquake were consumables such as food, drinks, medicines, medical equipment such as intravenous fluids, IV tubes, infusion needles, syringes as well as medical devices for wound services because of the large number of victims affected and buried in the rubble of buildings.
Tents are also needed; tents are the most
needed material because almost all paralyzed buildings cannot be used,
especially buildings for inpatient services. Therefore, all patients are served
in emergency care. In addition, Cianjur Regional General Hospital needs health workers. Based on the
Regulation of the Minister of Defense of the Republic of Indonesia Number 39 of
2014 concerning Disaster Management in Hospitals of the Ministry of Defense and
the Indonesian National Army Article 9 Hospitals must provide command
posts, information/public relations centers, evacuation tents, rapid evacuation
routes, gathering places, patient assessment places (triage), emergency
operating rooms, open additional wards, morgues, soup kitchens, backup
logistics warehouses, Emergency exits, Rump, and Line link with those adjacent
to the Hospital.
The planning process is an activity through identifying needs or initial steps to determine who needs it, what I need, where, when, and how to deliver it to produce minimum standards of needs in disaster management (Mimin, Paripurno, & Lestari, 2020). This planning requires accuracy, skills, and the ability to know exactly the conditions that disaster victims face in order to overcome them.
The purpose of this planning is to find out how many victims
affected by disasters need logistical assistance and equipment, know how much
logistical assistance and equipment are needed, know the types of needs
(clothing, food, shelter), know how to deliver aid, know the person in charge
of the recipient group, and know when aid must be delivered. This planning
consists of preparing minimum needs standards, identifying needs, and preparing
short, medium, and long-term needs (Agyekum, Amjad, Mohsin, & Ansah, 2021). Based on
the results of research and interviews at the Cianjur Regional General
Hospital, it was found that planning was carried out by calculating and looking
at the capacity of the hospital to accommodate patients, so the needs were adjusted
to the capacity of the hospital. In addition, coordination meetings or
evaluations of any needs and previous needs have been met or not. The process
of selecting the logistics type at the Cianjur Regional General Hospital is
adjusted to the needs. In hospital planning, plan the needs that have led in
the event of a disaster.
The time for disaster logistics management planning was carried
out before the disaster, in addition to holding disaster management training in
areas such as earthquake management and fire management. However, at the time
of the disaster, it was not in accordance with the planned planning. The way to
ensure effective and efficient logistics planning at Cianjur Regional General
Hospital is to look at patient safety and comfort. In addition, reports are made,
and periodic evaluations of the availability of logistics for disaster
management are monitored.
The challenge of planning disaster logistics management of the
Cianjur General Hospital is the difficulty of meeting needs due to the large
demand. However, the stock in the market, especially in Cianjur itself, is very
limited. In addition, things that are not taken into account occur such as the
accuracy of using tents with the influence of weather. If the disaster recurs,
Cianjur Regional General Hospital will prepare starting from the information
system, reception flow, distribution flow, and recording to preparing
logistical reserves for the disaster.
This logistics receipt and/or procurement process starts from recording or inventory including the category of logistics or equipment, from where the aid was received, when it was received, what type of assistance, how much amount, how to use or operate it, whether there is a demand for whom this assistance is addressed. This process is carried out by disaster management organizers and must be inventoried or recorded (Agyekum et al., 2021).
The purpose of this procurement and/or receipt is to determine the
types of logistics and equipment received from various sources, to match the
needs with existing logistics and equipment, to inform logistics and equipment
according to the priority scale of needs, as an effort to control and supervise
logistics and equipment countermeasures, and to adjust in terms of storage. The
logistics procurement process is carried out in a planned manner by taking into
account the type and number of needs, which can be done through auctions,
elections and direct appointments according to needs. Logistical receipt
through grants is carried out based on applicable laws and regulations by
taking into account the conditions in emergencies (Kristian, 2022).
Based on the results of research and interviews at the Cianjur
Regional General Hospital, it was found that the hospital has an RBA (Business
Plan and Budget) from each of the smallest units that purses to the DPA (Budget
Implementation Document) for one year but an evaluation is carried out every 6
months to determine any deficiencies or advantages. In addition, to see effectiveness
and efficiency by looking at stocks that are not too much or can be interpreted
as enough.
The time of procurement and/or receipt of disaster logistics
management is in the post-disaster period but hospitals always have logistical
reserves that can be sufficient for 2-3 months. So, at the time of this
disaster, the hospital used the existing stock. How to determine these
logistical needs by evaluating field needs and then this evaluation is added
with possibilities for future improvements.
According to the information obtained, the absence of special
logistics quality provisions other than the logistics received should not
expire. The standards taken are patient safety standards and are viewed in numbers.
In addition to the absence of logistics quality provisions, hospitals also do
not consider logistics vendors or providers because emergencies and logistics
stocks in the market are not many and very difficult.
To control expenses during disasters, namely daily, monthly, and
semester reports. In addition, by comparing needs in the field with
procurement. The challenges of procurement and/or receipt of disaster logistics
management of the Cianjur General Hospital are not easy to fulfill due to
limited stock and providers, goods received are not as needed, and the identity
of senders who do not want to be known, which causes recording is lacking.
Warehousing is managing the receiving, storage, maintenance, and expenditure of logistics and equipment in the warehouse. The procedure for determining warehouses is divided into the location of ease of access, type of warehouse, storage capacity and facilities, and security and safety systems (Regulation of the National Disaster Management Agency of the Republic of Indonesia No. 4 of 2018 concerning Logistics and Equipment Management System, 2018).
The warehousing process starts with receiving logistics submitted
to warehousing and storage units accompanied by minutes of receipt and proof of
receipt of logistics at that time. According to the Standard Operating Procedure (SOP) for Disaster Logistics and Equipment
Management, the purpose of this meeting is to record the type, quantity,
quality, condition of logistics and equipment, time, and identity of officers,
maintain logistics conditions from damage and loss or reduction in quality
standards, facilitate logistics distribution using first-in-first-out and first-expired first-out methods, and
guarantee the availability of logistics at all times (Mahardika & Setianingsih, 2018).
Based on the results of research and interviews at the Cianjur
Regional General Hospital, it was found that the logistics storage room
provided could meet the needs and ensure logistics availability, namely by
preparing a logistics warehouse that was not only one and with a large room
according to the number of logistics. In addition, monitoring evaluation is
also carried out by presenting those in charge of logistics. Meanwhile, the way
to ensure the feasibility of this logistics is by storing it in accordance with
the temperature provisions of each logistics and, of course, storing it neatly.
In addition, there are also periodic visits to check availability and security,
both for theft and damage.
To determine logistics storage, namely by means of real needs plus future needs. This
logistics is divided into three categories, namely consumables, medicines, and
assets. The three categories in storage have their respective persons in
charge. Inventory is organized and managed by administrating receipts, storage,
and expenses.
If logistical damage is found, all are separated, then reported to
the provider that there is damage and will be destroyed or eliminated
logistics. If the logistics come from donations, a minutes are made for their
destruction, as well as if the logistics are provided by the hospital.
To ensure the security of this warehouse, namely by arranging
warehouse storage that is separate from other buildings, there are also guards
for security. Safety and security during logistics picking and storage are
achieved by first ensuring that the room is safe and then wearing PPE or
personal protective equipment such as head protection, foot protection, and
hand protection.
The challenge of warehousing disaster logistics management of the
Cianjur General Hospital is due to the damaged building, so logistics storage
is required to be stored in emergency tents whose security is very lacking. In
addition, the place is inadequate, so if there is an excess of goods, it is
difficult to place it.
Distribution is a distribution system for delivering logistics from the warehouse to the intended target. Based on the needs inventory data, a logistics distribution plan is prepared accompanied by supporting data, which is based on requests and obtaining approval from officials authorized in disaster management (Ye, Jiao, & Yan, 2020).
Distribution planning consists of who will receive assistance, the
priority of logistical assistance needed when it will be delivered, location,
mode of delivery, means of transportation used, and who is responsible for the
delivery. This distribution aims to know the target recipients precisely, know
the type and amount of assistance that must be delivered, plan how to deliver
or transport, hand over logistical assistance to recipients, and ensure the
security, safety, and integrity of logistical assistance during the
transportation process from the warehouse to the recipient's destination (Arif, Wang, Chen, & Chen, 2019).
Based on the results of research and interviews at the Cianjur
Regional General Hospital, it was found that the way to manage distribution is
effective and efficient, namely by holding direct ball pick-ups or sending
directly to tents in need, the handover was not handed over to individuals but
handed over to each installation. However, in the nature of medical devices and
assets, the person in charge of logistics waits in the warehouse and each
installation that requires it must make a delivery or request for a request
according to their needs.
To ensure that this logistics distribution is carried out in
accordance with its priorities and needs, namely with proof of receipt from
each installation, in addition to picking tests or directly going to the field
to ensure the suitability of needs with the logistics that have been distributed.
Meanwhile, how to ensure the achievement of this need is by checking logistics
requests and then with documentation when handing over logistics. The
documentation can be in the form of photos or proof of receipt. In addition,
there are also health workers who are responsible for several patients and are
tasked with ensuring the needs of patients, be it food, clothing, to
toiletries.
Distribution transportation at this hospital is by using trolleys,
and if the reach is far, the hospital has a car unit for logistics
distribution. If there are accessibility problems or road conditions that might
affect distribution, they are addressed by creating and appointing officers in
three directions. One left way, one right way, and one middle direction to
prevent possible delays in arriving time. In addition, if access cannot be
passed by a trolley, the officer transports manually. This distribution time is
open 24 hours, so when there is a request for anything, it is immediately
fulfilled, but informant 5 said that those who came to ask for logistics were open
from 08.00 WIB to 20.00 WIB.
The challenges of this distribution are the speed of distribution,
the accuracy of distribution, as well as the amount of distribution. In
addition, due to the fairly spread area and many logistical needs, there is a
queue for logistics distribution.
B.
Output
A.
Strength
Based on the results of research and interviews at the Cianjur Regional General Hospital, it was found that the strength of the logistics management system at the Cianjur Regional General Hospital was to have reliable and very compact human resources, all of whom played an important role in handling the disaster.
B.
Debilitation
Based on the results of research and interviews at the Cianjur Regional General Hospital, it was found that the weakness of the logistics management system at the Cianjur Regional General Hospital was the limited goods on the market, especially when procuring tents, besides when receiving goods, the logistics team often found expired or expired logistics.
C. Challenge
Based on the results of research and interviews at the Cianjur Regional General Hospital, it was found that the challenge of the logistics management system at the Cianjur Regional General Hospital was that the hospital must contain standardization of disaster management starting from before the disaster, during the disaster, and after the disaster. In addition, the challenge is when, at the time, the goods needed are not on the market or are very difficult to obtain.
D. Threat
Based on the results of research and
interviews at the Cianjur Regional General Hospital, it was found that the
threat to the logistics management system at the Cianjur Regional General
Hospital was the reaction of the disaster victims who were quite pressed
because they wanted to meet all their needs, and the hoax news spread about the non-distribution of aid and
the non-compliance with regulations.
The disaster
logistics management system implemented at Cianjur Regional General Hospital
demonstrated effectiveness in orchestrating disaster response operations,
particularly in the realms of planning, procurement, warehousing, and material
distribution. The hospital's planning phase encompassed the identification of
needs, capacity assessment, and collaboration with various stakeholders to
ensure readiness in accommodating patients and delivering essential services.
Similarly, the procurement procedures proved efficient, leveraging donations
and inventory management to guarantee timely availability of necessary materials
(Kholis, Syah, & Lubis, 2021). Furthermore,
the warehousing and distribution processes operated smoothly, employing
emergency tents for storage and efficient dissemination of materials to
affected areas.
The research also
brought attention to the obstacles encountered by the hospital in overseeing
the disaster response, such as the limited availability of goods in the market
and the struggle to address the needs of all patients. These hurdles align with
the observations of previous studies examining disaster management in
Indonesia. In essence, the study furnishes significant perspectives on the
disaster logistics management system adopted by Cianjur Regional General
Hospital, emphasizing the significance of proficient planning, procurement,
warehousing, and distribution in disaster mitigation. Moreover, it sheds light
on the complexities hospitals face in handling disaster responses and
underscores the ongoing necessity for research and enhancements in this domain.
CONCLUSION
Based on the results of research at
the Cianjur Regional General Hospital, it can be concluded that the disaster
logistics management system has involved staff in accordance with their fields,
including the Deputy Director of Services, Head of Supporting Affairs,
logistics coordinator, and disaster preparedness team. However, there are
limitations related to financial aspects, where hospitals only rely on external
donations without a special budget for disaster logistics management.
Post-earthquake material needs are mainly focused on consumables and medical
equipment, with emergency tents being one of the main needs due to building
damage. The process of planning, procurement, warehousing, and logistics
distribution has been carried out, although there are still obstacles such as
difficulties in meeting needs due to limited stock on the market, goods that
are not in accordance with what is needed, and incomplete records.
Nevertheless, the cohesiveness and ability of the staff became a strength in
the disaster logistics management system. However, there are weaknesses such as
limited goods on the market and expired logistics findings. The main challenge
for hospitals is to standardize disaster management before, during, and after a
disaster. Another challenge is the availability of goods that are difficult to
market. The main threat comes from the reaction of disaster victims who ask for
their needs to be met and the spread of hoax news. Therefore, efforts are
needed to overcome challenges and manage threats to improve the effectiveness
of the disaster logistics management system at Cianjur Regional General
Hospital.
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Copyright Holder: Ayu Laili Rahmiyati1*, Elda
Permatasari2, Suhat3, Asep Dian Abdilah4 (2024) |
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First Publication Right: Journal of Health Science |
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This article is licensed under: |