19th November 2017

International Health Organization

All the Point of Entries Health (POEs) Organizations are the part of International Health Division of Directorate General of Health Services under Director General of Health Services, Min. of Health &Family Welfare. The Nodal In-charge for all the point of entries is Deputy Director General International Health (DDG-IH). The main purpose of the Point of Entries Health (POEs) Organizations is to prevent spread of disease (Public Health Emergencies of International Concern) from foreign countries to India and similarly the any disease outbreak of international importance should not be transmitted from India to other foreign countries. Other main purpose of the Point of Entries Health (POEs) Organizations is to ensure provision of safe healthy environment at point of entries for travelers & the staff working at the POEs. The safe healthy environment includes provision of safe food, safe drinking water, sanitation & Vector control at POEs.

ROUTINE ACTIVITIES APHOs

1. Surveillance of International Passengers and Crew for yellow fever disease-
All the incoming international passengers of all International flights are screened by the immigration officials for history of travel to yellow fever endemic countries within last 6 days of arriving in India. Thereafter all the passengers who have embarked from or have transited through the yellow fever endemic countries are screened for having proper protection against yellow fever

2. Quarantine of Passengers-
All those passengers, who have embarked from or have transited through the yellow fever endemic countries during six days prior to arriving in India and they are not having proper vaccination against yellow fever, are quarantined as per the Indian Aircraft (Public Health) Rules, 1955. During the period of quarantine the passengers are medically observed for various signs and symptoms of yellow fever disease.

3. Yellow Fever & Polio Vaccination:
International vaccination center for Yellow fever, APHO, Delhi provides vaccinations to all the international passengers on request who are travelling through the yellow fever endemic countries. The APHOs are also providing vaccinations for Polio Drops for the passengers visiting Poilo Endemic/Affected countries.

4. Public health clearance of dead body/human remains-
In accordance with “THE AIRCRAFT (PUBLIC HEALTH) RULES, 1954 PART 4” officials of airport health organization after checking the necessary documents in order to check the spread of any communicable disease of International concern in this country.

5. VVIP Food Safety & Surveillance Duties:
WIP food safety & surveillance duties are undertaken for both national and International Heads of States. Various activities are as follows:

a. Sampling of the raw materials from the designated flight kitchen Stores.
b. Sampling of Water from various areas of designated flight kitchen.
Samples of raw materials are examined at the Delhi Public Health laboratory and bacteriological testing of water samples is done by NICD, Delhi.
c. Examination of the Perishable food items.
d. Sampling and oral tasting of prepared food items for instant poison.
e. Results of raw material and water samples collected are communicated to the respective flight kitchen before cooking process starts for the VIP flight.

6. Food and Water Safety Duties:
As per the FSS Act 2006 APHO Palam, Local Health Authority undertakes inspection of food outlets operating in the airport premises regularly e.g. Lounges, snack counters and restaurants that have contracts for serving food and drinks to the passengers and staff at international airport.

7. Vector surveillance –
As per rule the Airport up to the radius of 400m has to be mosquito free (container/ house Index has to be zero) therefore vector control/ surveillance activities primarily for Aedes aegypt mosquito, which is vector for many diseases including yellow fever disease, are performed by APHO along with coordination from team of NVBDCP (National Vector Borne Disease Control Program).The Feedback & necessary corrective action are suggested to the airport managers for implementation through different stakeholders at Airport & identified pest and vector control agency by the Airport managers.

8. Flight Dis-insection:
Aircraft disinsection details are to be verified for all the incoming international aircraft by examination of the General Declaration of Health and passenger manifest submitted by the Crew at the time of arrival to the Airport Health Organization. The Aircraft Disinsection / Disinfection spray/fumigation are performed on the request of airlines in case of need, invalid Disinsection certificate, on board death and during any PHEICs (Public Health Emergency of International Concerns).

9. Sanitary Inspection:
International Health Organization undertakes periodic sanitary inspection rounds at airports. The feedback & details of survey rounds are communicated to airport officials for appropriate corrective measures.

10 Training Activities:
» Immigration Officials:
Periodic training to the Immigration officials is imparted to orient them about various steps for screening the passengers with regard to yellow fever/PHEICs.
» Officials of intelligence bureau:
The training pertaining to health surveillance at International ports and airports is conducted for IB officials coming from different parts of the country.
» Training for Medical and para-medical staff:
Training activities are being arranged for medical and para-medical staff i.e. field workers training, vector surveillance training, Haj Training, PHEICs etc.
» Training for Medical PG students:
The relevant training is also provided to the students visiting APHO Delhi from different organizations as PG students from NIHFW, Nursing Colleges and other organizations.

11 .Other Activities:
IH related health activities for non Scheduled charted Flights: APHO, Delhi also assists the surveillance of international passengers and flight dis-insection activities during the arrival of the non-scheduled flights at Agra, Jaipur and other nearby international airports.
Disaster Management MockDrill- APHO, Delhi provides its expert opinion whenever Mock Drill is conducted by DIAL for Disaster Management.


EMERGENCY DUTIES

1. Medical & Flight Emergencies- The APHOs are Public Health Organization and perform the public health related activities at the Airport. Every International Airport has health unit to take care any clinical emergency occurring onboard to the passengers or to the staff working at the Airport. In case the emergency is having large number of affected persons then the APHO works along with other control room officers and coordinate with other Government Health facilities for transportation and management of the health services needy persons.
2. Public Health Emergency of International Importance- Activities during the Public Health Emergencies Out Break e.g. Ebloa Virus Disease, Yellow Fever Disease, MERS- CoV & Zika Virus Disease
• Activation of PHECP
• Coordination with other stakeholders.
• Functions as per guidelines for PHEIC.
• Training of stakeholders.
• Procurement and Deployment of additional manpower.
• Procurement of material required.
• Screening/ Quarantine/ Isolation/ Lab testing/ Transportation/ Contact tracing
• Coordination with National /state/ local agencies.
• Reporting.

Major functions of Port Health Organization :

In routine times:
1. Port quarantine Work and clearance of healthy and suspected vessels arriving / departing from Mumbai seaport.
2. Issue of Free and Radio Pratique certificates to arriving vessels.
3. Health clearance of ships.
4. Supervision and monitoring of Disinfection, disinsection, deratting and other sanitary measures advised to the vessels.
5. Inspection of vessels and Issue of Ship Sanitation Certificate.
6. Inspection of hospital of the vessels and Issue of Medicine Chest certificate to Indian registered vessels which is valid for One year.
7. Inspection of Provision and Issue of Provision certificate to foreign going Indian registered vessels.
8. Supervision & monitoring of sanitation, water supply and anti-mosquito & other vector and anti- rodent work in docks, surrounding areas and container & cargo handling areas of the port.
9. Clearance of Dead body:
• Issue of NOC if death on board a vessel.
• Clearance if body / human remains arrived as cargo.
10. Inspection, fumigation and clearance of imported used clothing.
11. Administration of yellow fever vaccine and issue of yellow fever vaccination certificate to travelers.
12. Medical Examination of Seamen if referred by D.G.Shipping for issue of CDC.
13. Licensing of catering establishments under FSSAI Act & Rules.

During Emergency / PHEIC :
• Activation of PHECP
• Coordination with other stakeholders.
• Functions as per guidelines for PHEIC.
• Training of stakeholders.
• Procurement and Deployment of additional manpower.
• Procurement of material required.
• Coordination with National /state/ local agencies.
• Reporting.