Simulated bus accident tests crisis preparedness in the former Yugoslav Republic of Macedonia


A simulation exercise to test the preparedness of the City Hospital 8th September in Skopje as well as of the Emergency Medical Services (EMS) in the Skopje region was held on 22 May 2014. Health and emergency workers responded to a simulated traffic accident involving a bus with school children and an ensuing fire. This was the sixth such test organized by WHO in close cooperation with health authorities in the former Yugoslav Republic of Macedonia to strengthen the health system's capacity to plan for and respond to crisis situations. 

The City Hospital 8th September is a major hospital located in the capital city of Skopje, which includes a well-planned urgent care centre. As the only general hospital in the city, it covers all specialties and has a high daily circulation of patients.

It was important to test the functioning of the hospital´s preparedness plan as well as its communication and coordination with other institutions responsible for health preparedness in crisis, especially the Emergency Medical Services, the Crisis Management Centre (CMC) and the Red Cross. The exercise helped refresh the knowledge of the Emergency Medical Services teams and improve their skills in coping with situations involving a high number of injured patients.

The exercise was organized in cooperation with the National Security Council on Road Safety in parallel with its International Conference on the Role of Local Government and Municipalities in Improving Traffic Safety on Local and Regional Roads (21–22 May 2014); all of the conference participants were invited to follow the exercise. Other participating institutions were the Crisis Management Centre (CMC), fire-rescue units, National Public Health Institute, Health House Skopje and the Ministry of the Interior.


A series of preparatory meetings gave the participants an overview of the simulation exercise and highlighted relevant information on expected casualties, trigger indicators for activating the emergency response plan, triage and patient traffic flow, and the responsibilities of hospital and Emergency Medical Services staff.


The exercise called for strong and coordinated multisectoral cooperation in the public health response to emergencies, in accordance with the principles of the WHO European Policy Framework Health 2020. It revealed the presence of strong command leadership, committed and qualified staff, and effective management of incoming patients.

WHO and Ministry of Health officials in the former Yugoslav Republic of Macedonia will continue to work with the national counterparts to further test and upgrade hospital crisis preparedness plans, to ensure that emergency medical services and hospitals will be ready to meet increased service demands during crisis situations.