DISASTER

INDEX

 

INTRODUCTION

                           WHO defines Disaster as "any occurrence, that causes damage, ecological disruption, loss of human life, deterioration of health and health services, on a scale sufficient to warrant an extraordinary response from outside the affected community or area"

.Disasters can be defined in different ways.

¨     A disaster is an overwhelming ecological disruption occurring on a scale sufficient to require outside assistance

 

¨     A disaster is an event located in time and space which produces conditions whereby the continuity of structure and process of social units becomes problematic

 

¨     It is an event or series of events which seriously disrupts normal activities

 

The magnitude of the effects of the event will be viewed differently.

 

Disasters are classified in various ways.

¨     Natural disasters and Man made disasters

¨     Sudden disasters and Slow onset disasters

 

The dividing line between these types of disasters is imprecise

Activities related to man may exacerbate natural disasters.

 

Disaster means Sudden or Great Misfortune

 

Although experts may differ in their definitions of disaster, many public health practitioners would characterize a disaster as a "sudden, extraordinary calamity or catastrophe, which affects or threatens health".

 

Disasters include

¨     Tornadoes,

¨     Fires

¨     Hurricanes,

¨     Floods / Sea Surges / Tsunamis

¨     Snow storms,

¨     Earthquakes,

¨     Landslides,

¨     Severe air pollution (smog)

¨     Heat waves,

¨     Epidemics,

¨     Building collapse,

¨     Toxicological accidents

(e.g. release of hazardous substances),

¨     Nuclear accidents,

¨     Explosions

¨     Civil disturbances,

¨     Water contamination and

¨     Existing or anticipated food shortages.

 

 

EFFECTS OF MAJOR DISASTERS

 

Disasters throughout  history have had significant impact on the numbers, health status and life style of populations.

 

¨     Deaths

¨     Severe injuries, requiring extensive treatments

¨     Increased risk of communicable diseases

¨     Damage to the health facilities

¨     Damage to the water systems

¨     Food shortage

¨     Population movements

 

Health problems common to all Disasters

 

¨     Social reactions

¨     Communicable diseases

¨     Population displacements

¨     Climatic exposure

¨     Food and nutrition

¨     Water supply and sanitation

¨     Mental health

¨     Damage to health infrastructure

 

India's Natural Disasters Proneness

 

On the basis of geographic and climatic considerations, India can be divided into 5 Zones according to its disaster proneness to natural disasters;

1.    Northern mountain region including foot hills; this region is prone to strong Snow Storms leading to Land slides and strong Cold waves and also is Earthquake prone belt with violent subterranean Volcanic activity.

2.    Indo-gangetic plains; heavy rains during monsoon make these plains vulnerable to Floods.

3.    Deccan plateau; a Drought prone area.

4.    The western desert; a Drought prone area.

5.    Coastal areas; they are prone to Sea erosion, Cyclones and Tidal waves

 

India’s Disaster Ridden  History

·       About 60% of India’s land mass is prone to Earth Quakes

·       Over 40 million Hectares are prone to Floods

·       Nearly 3 lakh  sq. km are at risk of Cyclones

·       The Earth quake in Bhuj killed 14,000 people

·       Cyclone in Orissa took away 10,000 lives.

·       Between 1990 and 2000 an average of about 3400 people lost their lives annually.

·       About 3 crore people were affected by Disasters every year.

·       About 17,000 people perished by the Tsunami on 26 Dec.04

 

This is reason enough for Governments to give more priority to Disaster Management

 

But it has not been the case so far.

 

 

 

POPULATION GROWTH AND DISASTERS

 

Hardly a day passes without news about a major or complex emergency happening in some part of the World.

Disasters continue to strike and cause destruction in developing and developed countries alike, raising peoples concern about their vulnerability to occurrences that can gravely affect their day to day life and their future.

 

Major disasters have had a big impact on the migration of populations and related health problems, and many millions are struggling for minimum vital health and sanitation needs and suffer from malnutrition.

 

Vulnerable Populations

Emergencies, especially those that occur in Nature, only become catastrophic events when they combine with vulnerability factors such as human settlements and population density.

An earthquake occurring in a deserted area would be considered a natural hazard; but if it occurred in a mega city it would be recognized as a major disaster.

 

Man made emergencies and another type of emergency that has to do with population vulnerability concerns technological disasters such as those of a Chemical or Radiological or Nuclear in nature. E.g. Bhopal Gas Tragedy and Chernobyl nuclear disaster.

 

These examples demonstrate that major and complex emergencies are closely linked to anarchic population growth, leading to unplanned population settlement, environmental degradation and poverty.

 

The lack of minimum health services and basic health education are aggravating factors which could make a disaster out of an emergency and a complex emergency out of social tension.

 

 

TYPES

EARTHQUAKES

Definition and Measurement

 

"An earthquake is a sudden motion or trembling of the ground produced by the abrupt displacement of rock masses".

Most earthquakes result from the movement of one rock mass past another in response to tectonic forces.

 

The focus is the point where the earthquake's motion starts,

 

The epicenter is the point on the earth's surface that is directly above the focus.

 

Earthquake Magnitude is a measure of the strength of an earthquake as calculated from records of the event made on a calibrated seismograph.

 

In 1935, Charles Richter first defined local magnitude, and the Richter scale is commonly used today to describe an

earthquake's magnitude.

 

Earthquake Intensity.

In contrast, earthquake intensity is a measure of the effects of an earthquake at a particular place. It is determined from observations of the earthquake's effects on people, structures and the earth's surface.

 

Among the many existing scales, the Modified Mercalli Intensity Scale of 12 degrees, symbolized as MM, is frequently used 

 

Earthquake Hazards

Earthquake hazards can be categorized as either direct hazards or indirect hazards.

Direct Hazards

¨     · Ground shaking;

¨     · Differential ground settlement;

¨     · Soil liquefaction;

¨     · Immediate landslides or mud slides, ground lurching

       and avalanches;

¨     · Permanent ground displacement along faults;

¨     · Floods from tidal waves, Sea Surges & Tsunamis

 

Indirect Hazards

¨     · Dam failures;

¨     · Pollution from damage to industrial plants;

¨     · Delayed landslides.

Most of the damage due to earthquakes is the result of strong ground shaking. For large magnitude events, trembling has been

felt over more than 5 million sq. km. 

 

Site Risks

Some common site risks are:

(I) Slope Risks - Slope instability, triggered by strong shaking may cause landslides. Rocks or boulders can roll considerable distances.

(ii) Natural Dams - Landslides in irregular topographic areas may create natural dams which may collapse when they are filled.

This can lead to potentially catastrophic avalanches after strong seismic shaking.

(iii) Volcanic Activity - Earthquakes may be associated with potential volcanic activity and may occasionally be considered as precursory phenomena.

Explosive eruptions are normally followed by ash falls and/or pyroclastic flows, volcanic lava or mud flows, and volcanic gases.

 

CYCLONE.

 

The term "cyclone" refers to all classes of storms with low atmospheric pressure at the centre, are formed when an organized system of revolving winds, clockwise in the Southern Hemisphere, anti-clockwise in the Northern Hemisphere, develops over tropical waters.

Cyclones are classified on the basis of the average speed of the wind near the centre of the system as follows:

 Wind Speed                            Classification

¨     Up to 61 km/hr                    Tropical Depression

¨     61 km/hr - 115 km/hr          Tropical Storm

¨     Greater than 115 km/hr       Hurricane

 

Hurricane.

A hurricane is a low pressure, large scale weather system which derives its energy from the latent heat of condensation of water vapor over warm tropical seas. A mature hurricane may have a diameter ranging from 150 to 1000 km with sustained wind speeds often exceeding 180 km/hr near the centre with still higher gusts.

 

A unique feature of a hurricane is the Eye. The eye provides a convenient frame of reference for the system, and can be tracked with radar, aircraft or satellite.

 

Classification

The Saffir/Simpson scale is often used to categorize hurricanes based on their wind speed and damage potential. Five categories of hurricanes are recognized:

¨     Minimal, Moderate, Extensive, Extreme & Catastrophic

 

The destructive potential of a hurricane is significant due to the high wind speeds, accompanying torrential rains which produce

flooding, and storm surges along the coastline

TSUNAMIS

 

Tsunamis are Ocean Waves produced by Earth Quakes or Underwater land slides.

 

The word is Japanese and means “Harbor Waves

 

Tsunami is actually a series of waves that can travel at speeds from 400-600 mph in the open ocean. As the waves approach the coast, their speed decreases, but their amplitude increases.

 

Unusual wave heights of 10-20 ft high can be very destructive and cause many deaths and injuries.

 

Most deaths caused by Tsunamis are because of Drowning.

 

Associated risks include

·       Flooding

·       Contamination of Drinking Water

·       Fires from ruptured gas lines and tanks

·       Loss of vital Community Infrastructure [police, fire, medical]

·       Areas of greatest risks are

-Less than 25 feet above sea level

-Within 1 mile of the shore line.

Environmental Conditions left by the Tsunamis may contribute to the transmission of the following diseases

From Food or Water

·       Diarrhea illnesses;  Cholera, Acute Diarrhea, Dysentery

·       Hepatitis-A, Hepatitis-E

·       Typhoid Fever

·       Food borne illnesses;Bacterial;Viral;Parasitic;Non-infections;

From Animals or Mosquitoes

        Leptospirosis, Plague, Malaria, J.E, Dengue, Rabies

Respiratory Diseases;    Avian flu, Influenza, Measles

EFFECTS OF NUCLEAR HOLOCAUST

 

The effects of nuclear holocaust will result into blasts,

heat storms, secondary fires, fire, ionizing radiation and fall outs.

 

These effects fall into 3 categories;

 

1). Immediate, 2). Short term and 3). Long term effects.

 

¨     The immediate effects include blast effects, heat effects, electromagnetic pulse (EMP) effects and radiation effects.

 

¨     The short term effects include problems connected with water supply, sanitation, food, dispersal of excreta, wastes and dead bodies, break down of vector control measures and outbreak of infections. Radioactive contamination of water and food are major concerns. The affected area creates a lot of other problems for the survivors and the rescue teams.

 

Major problem among survivors is of bone marrow depression resulting in leucopenia, which increases their susceptibility to infections.

 

¨     Long term effects; the knowledge about the long-term effects is still incomplete. Some well known effects include radiation injuries due to radiation fallout, suppression of body immunity, chronic infection and other associated illnesses.

 

Persistent radiation hazards will lead to prolonged contamination of water supply, increased ultraviolet radiation, climatic and ecological disturbances, psychological disturbances and genetic abnormalities.

 

Current World Concern

 

In the light of the above facts the current world concern about the use of nuclear weapons is justified.

 

The world already possess an estimated total of 30,000 megatons of nuclear weapons with a total explosive power 50-100 times greater than that of all the explosives used during the Second World War.

 

Even if 1% of the nuclear weapons now possessed are used on urban populations, they can cause more deaths in a few hours than during the entire period of the Second World War.

 

The fundamental aspects of Disaster Management Program

 

¨     Disaster Prevention

¨     Disaster preparedness

¨     Disaster response

¨     Disaster mitigation

¨     Rehabilitation

¨     Reconstruction

 

 3 Fundamental Aspects of Disaster Management

 

1.    Disaster response

 

2.    Disaster Preparedness

 

3.    Disaster Mitigation   

 

 

These 3 aspects of Disaster Management corresponds to the

2 phases in the Disaster Cycle, ie,

 

1, Risk Reduction Phase, before a Disaster

 

2. Recovery Phase, after a Disaster   

 

 DISASTER RESPONSE

 OBJECTIVES

 

¨     Appropriate application of current technology can prevent much of the death, injury, and economic disruption resulting from disasters

¨     Morbidity and mortality resulting from disasters differ according to the type and location of the event.

¨     In any disaster, prevention should be directed towards reducing

 

(1) Losses due to the disaster event itself

(2) Losses resulting from the Mismanagement of disaster relief.

 

Therefore, the public health objectives of disaster management can be stated as follows:

 

1.    Prevent unnecessary morbidity, mortality, and economic loss resulting directly from the disaster.

 

2.    Eliminate morbidity, mortality, and economic loss directly attributable to Mismanagement of disaster relief efforts.

 

Nature and Extent of the Problem

 

Morbidity and mortality, which result from a disaster situation, can be classified into four types:

1.    Injuries, 

2.    Emotional stress,

3.    Epidemics of diseases,

4.    Increase in indigenous diseases.

 

The relative numbers of deaths and injuries differ on the type of disaster.

 

Injuries usually exceed deaths in explosions, typhoons, hurricanes, fires, famines, tornadoes, and epidemics.

 

Deaths frequently exceed injuries in landslides, avalanches, volcanic eruptions, tidal waves, floods, and earthquakes.

 

Disaster victims often exhibit emotional stress or the "disaster shock" syndrome. The syndrome consists of successive stages of shock, suggestibility, euphoria and frustration.

 

Each of these stages may vary in extent and duration depending on other factors. 

 

Epidemics are included in the definition of disaster; however, they can also be the result of other disaster situations.

 

Diseases, which may be associated with disasters, include

¨     specific food and/or water bone illnesses

     (e.g., typhoid, gastroenteritis and cholera),

¨     vector bone illnesses

    (e.g., plague and malaria),

¨     diseases spread by person-to-person contact

     (e.g., hepatitis A and shigellosis)

¨     Diseases spread by the respiratory route

     (e.g., measles and influenza).

 

 

·       The current status of environmental sanitation, disease surveillance, and preventive medicine has led to a significant reduction in the threat of epidemics following disaster.

 

·       Immunization programs are rarely indicated as a specific post disaster measure. 

 

·       A disaster is often followed by an increase in the prevalence of diseases indigenous to the area due to the disruption of medical and other health facilities and programs.

 

 

Morbidity and Mortality from Mismanagement of Relief

 

Ideally, attempts to mitigate the results of a disaster would not add to the negative consequences;

 

However, there have been many instances in which inappropriate and/or incomplete management actions taken after a disaster contributed to unnecessary morbidity, mortality, and a waste of resources.

 

Many of the Causalities and much more of the Destruction occurring to natural disaster are due to ignorance and neglect on the part of the individuals and public authorities.

 

There is a plethora of literature describing the inappropriate actions taken to manage past disasters. Many of the same mismanagement problems tend to recur.

¨     Physicians and nurses have been sent into disaster areas in numbers far in excess of actual need.

¨     Medical and paramedical personnel have often been hampered by the lack of the specific supplies they need to apply their skills to the disaster situation.

¨     In some disasters, available supplies have not been inventoried until well after the disaster, resulting in the importation of material which is used or needed.

 

In a study of past disaster mismanagement problems and their causes, these problems were categorized as follows:

 

1.    Inadequate appraisal of damages

2.    Inadequate problem ranking

3.    Inadequate identification of resources

4.    Inadequate location of resources

5.    Inadequate transportation of resources

6.    Inadequate utilization of resources

 

 

DISASTER RELIEF

 

An effective plan for public health and other personnel during a disaster would outline activities designed to minimize the effects of the catastrophe.

These efforts can be summarized as closely situation analysis and response; the two types of activities are interrelated.

 

Although many relief workers may be needed to obtain surveillance information, analyze the data, provide relief services, evaluate results, and provide information to the public, it is essential that a single person with managerial experience be placed in absolute charge of the entire disaster relief operation.

 

Following a disaster, the desire to provide immediate relief may lead to hasty decisions which are not based on the actual needs of the affected population.

 

The disaster relief managers can determine the actual needs of the population and make responsible relief decisions.

Reliable information must be obtained on problems occurring in the disaster stricken area, relief resources available and relief activities already in progress.For This, a Surveillance systems must be set up immediately.

   

The objective of Surveillance in a disaster situation is to obtain information required for making relief decisions.

 

The specific information required would vary from disaster to disaster, but a basic, three -step processes includes:

(1)            Collect data,

(2)            Analyze data,

(3)            Respond to data.

 

The analysis involves collating and interpreting the data and can include asking questions as the following:

 

·       What problems are occurring? Why are they occurring?

·       Where are problems occurring?

·       Who is affected?

·       What problems are causing the greatest morbidity and mortality?

·       What problems are increasing or decreasing?

·       What problems will subside on their own?

·       What problems will increase if unattended?

·       What relief resources are available?

·       Where are relief resources available?

·       How can relief resources be used most efficiently?

·       What relief activities are in progress?

·       Are relief activities meeting relief needs?

·       What additional information is needed for decision making?

 

 

   After answering such questions one can carry out the third part, i.e., planning an appropriate Response to the situation described in the surveillance data.

 

In developing this plan one will decide what types of relief responses are appropriate and what the relative priorities are among the relief activities.

            

This 3-step process of Data Collection, Analysis and Response can be described as a closed feedback system involving re-evaluation of relief needs and their effects.

 

Surveillance following a disaster evolves in phases:

1. Immediate Assessment

2. Short term assessment

3. Ongoing Surveillance

 

 

Immediate Assessment

 

The object of this phase of surveillance is to obtain as much general information as possible and as quickly as possible.

 

The most basic information needed at this point is the following:

(1)            The geographical extent of the disaster-stricken area,

(2)            The major problems occurring in the area,

(3)            The number of people effected.

 

This information can be obtained by whatever means seems most efficient. Listening carefully and asking questions is the best way to begin. 

An Arial survey may be useful in defining the geographical extent of the disaster-stricken area and in observing major damage and destruction.

 Census data can be examined to determine how many people previously lived in the disaster-stricken area and thus were at risk.

 

 Hospitals, clinics, and morgues, which were in operation, may be able to obtain numbers of known deaths and injuries.

 

It is useful to determine the most frequent causes of deaths and types of injuries in order to predict whether demands for medical care will be increasing or decreasing.

 

Some problems likely to occur after a disaster can be predicted according to past experience with that particular type of disaster.

For example, experience has shown that disruption of water supplies has often been a problem following earthquakes.

 

New types of disasters, such as chemical emergencies and nuclear accidents, still present many unknown problems.

 

Short-term Assessment

The short-term assessment involves more systematic methods of collecting data and is likely to result in more detailed reliable information on problems, relief resources, and relief information on problems, relief resources and relief activities in progress.

 

One way to organize data collection during this phase of assessment is to divide the disaster-stricken area into smaller areas or "blocks" to be surveyed simultaneously by different workers or teams of workers.

 

Simple reporting forms can be developed and workers sent out to survey the different areas and report at a specified time. 

  

The following is a list of Information, which may be needed in order to make relief decisions

 

·       The geographical extent of the affected area as defined by streets and other clear boundaries.

·       The number of persons known to be dead, possibly according to age groups and sex.

·       The estimated number of persons severely injured and / requiring medical care, possibly according to age group, sex, and type of injury or medical problem.

·       Estimated number of homes destroyed, homes uninhabitable, and homes, which are still habitable.

·       Condition of schools, churches, temples and other public buildings etc.

·       Condition and extent of water supply.

·       Condition and extent of food supply.

·       Condition of roads, bridges, communication facilities and public utilities.

·       Location and condition of health facilities

·       Estimates of medical personnel, equipment's and supplies available

·       Description of relief activities already in progress

(E.g. search and rescue, first aid, food relief etc).

 

 

Ongoing Surveillance

 

Depending on the factors above, short-term assessment may take as little as 5-6 hours or up to 3-4 days. As early as possible, relief priorities should be determined, resources ordered and full scale relief activities initiated.

 

Once the short-term assessment is complete and appropriate relief is in progress, surveillance becomes an ongoing system.

 

When information obtained by the ongoing surveillance is analyzed, new problems may become apparent, requiring investigation.

The surveillance report is one way of coordinating different agencies and preventing duplication of relief efforts.

 

A relief plan developed during any of the surveillance cycle may include some or all of the following activities:

·       Rescue of victims

·       Provision of emergency medical care

·       Elimination of physical dangers (fire, gas leak etc)

·       Evacuation of the population ( nuclear and chemical emergencies)

·       Provision of preventive and routine medical care

·       Provision of water

·       Provision of food

·       Provision of clothing

·       Provision of shelter

·       Disposal of human waste

·       Control of vector born diseases

·       Disposal of human bodies

·       Disposal of solid waste

 

 

MASS CASUALTY MANAGEMENT

 

Management of mass casualties is divided into three main areas

 

1.    Pre-Hospital Emergency Care

 

¨     Search and Rescue

¨     First Aid

¨     Field Care

¨     Stabilization of the victims

¨     Triage

¨     Tagging

 

2.    Hospital Reception and Treatment

 

¨     Organizational structure in the hospital with a disaster management team consists of senior officers in the medical, nursing and administrative fields

¨     Standardized simple therapeutic procedures followed

 

3.  Re-distribution of Patients between Hospitals

 

 

 

DISASTER PREPAREDNESS

 

The objectives of the disaster preparedness is to ensure that appropriate systems, procedures and resources are in place to provide prompt, effective assistance to disaster victims, thus facilitating relief measures and rehabilitation services.

 

Disaster preparedness is an ongoing, multi-sectoral activity to carry out the following activities;

¨     Evaluate the risk of the country or particular region to disasters.

¨     Adopt standards and regulations

¨     Organize communication, information and warning systems

¨     Ensure coordination and response mechanisms

¨     Adopt measures to ensure that financial and other resources are available for increased readiness and can be mobilized in disaster situations.

¨     Develop public education programs

¨     Coordinate information sessions with news media

¨     Organize disaster simulation exercises that test response mechanisms

 

For the Health Sectors Disaster Preparedness plan to be successful, clear mechanisms for coordinating with other sectors and internationally must be in place.

 

The Health Disaster Coordinator is in charge of preparedness activities and coordinating plans with

·       Govt. Agencies

·       Foreign Relations- UN,UNICEF.WHO & other international agencies

·       NGO’s- Red Cross etc

·       Those responsible for power, communication, Housing, water services etc

·       Civil Protection agencies-Police, armed forces

 

 

EMERGENCY PREPAREDNESS

 

Agents, Diseases and Other Threats

 

1. Natural Disasters

    Earthquakes, Floods, Cyclones, Typhoons, Tsunamis, Winter

 

2. Bio-Terrorism Agents

    Anthrax, Plague, Smallpox

 

3. Chemical Emergencies

    Ricin, Phosgene, Bromine, Sarin

 

4. Radioactive Emergencies

 

5. Mass Trauma

    Explosions, Blasts, Burns, Injuries

 

6. Recent Outbreaks and Incidents

    Bird flu, SARS, West Nile Virus, Mad Cow Disease

 

 DISASTER MITIGATION

 

It is virtually impossible to prevent occurrence of most Natural Disasters, but it is possible to minimize or mitigate their damage effects.

 

Mitigation measures aim to reduce the Vulnerability of the System [ eg. By improving & enforcing building codes etc]

 

Disaster prevention implies complete elimination of damages from a hazard, but it is not realistic in most hazards. [eg. Relocating a population from a flood plain or from beach front]

 

Medical Casualty could be drastically reduced by improving the Structural Quality of Houses, Schools, Public or Private buildings.

 

Also ensuring the Safety of Health facilities, Public Health Services, Water Supply, Sewerage System etc.

 

Mitigation complements the Disaster Preparedness and Disaster Response activities.

 

A Specialised Unit within the National Health Disaster Management Program should coordinate the works of experts in the field of

·       Health, Public Policy & Public Health

·       Hospital Administration

·       Water Systems

·       Engineering & Architecture

·       Planning, Education etc

 

 

The Mitigation Program will direct the following activities

 

1. Identify areas exposed to Natural Hazards and determine  

    the vulnerability of key health facilities and water systems

2. Coordinate the work of Multi Disciplinary teams in designing

    and developing building codes and  protect the water

    distribution from damages

3. Hospitals must remain operational  to attend to disaster victims

4. Include Disaster Mitigation Measures in the planning and

    development of New facilities

5. Identify priority hospitals and critical health facilities that

    complies with current building codes and standards

6. Ensure that mitigation measures are taken into account in a

    facility’s maintenance plans

7. Inform, sensitize and train those personnel’s who are involved in

    planning, administration, operation, maintenance and use of

    facilities about disaster mitigation

8. Promote the inclusion of Disaster Mitigation in the curricula of

    Professional training institutes

 

TECHNICAL HEALTH PROGRAMS

 

¨     Treatment of casualties

¨     Identification and disposal of bodies

¨     Epidemiological surveillance and disease control

¨     Basic sanitation and sanitary engineering

¨     Health management in shelters or temporary settlements

¨     Training health personnel and the public

¨     Logistical resources and support

¨     Simulation exercises / Mock Exercises

            1.Desktop simulation exercises[ war games ]

            2.Field exercises

            3.Drills designed to impart skills

 

 

 EPIDEMIOLOGIC SURVEILLANCE AND DISEASE CONTROL

 

Natural disasters may increase the risk of preventable diseases

due to adverse changes in the following areas

¨     Population density

¨     Population displacement

¨     Disruption and contamination of water supply and sanitation services

¨     Disruption of public health programs

¨     Ecological changes that favor breeding of vectors

¨     Displacement of domestic and wild animals

¨     Provision of emergency food, water and shelter in disaster situation

 

 

The principles of preventing and controlling communicable diseases after a disaster are to;

 

¨     Implement as soon as possible all public health measures to reduce the risk of disease transmission

¨     Organize a reliable disease reporting system to identify outbreaks and to promptly initiate control measures

¨     Investigate all reports of disease outbreaks rapidly. Early clarification of the situation may prevent unnecessary dispersion of scarce resources and disruption of normal progress

 

 

ENVIRONMENTAL HEALTH MANAGEMENT

 

Post disaster environmental health measures can be divided into two priorities

 

1.    Ensuring that there are adequate amounts of safe drinking water, basic sanitation facilities, disposal of excreta, waste water and solid wastes and adequate shelter

 

2.    Providing food protection measures, establishing or continuing vector control measures, and promoting personal hygiene

 

·       Water Supply

Alternate water sources

Mass distribution of Disinfectants

·       Food Safety

·       Basic Sanitation and Personal Hygiene

·       Solid Waste Management

·       Vector Control

·       Burial of the Dead

·       Public information and the Media

 

 

EVALUATION

 

In the case of disaster management, the Evaluator will be looking at the " actual" verses the "desired" on two levels, i.e. the overall outcome of disaster management efforts and the impact of each discrete category of relief efforts

(Provision of food, shelter, management of communications etc)

 

A critical step in the management of any disaster relief is the setting of objectives, which specify the intended outcome of the relief.

 

The general objectives of the disaster management will be the elimination of unnecessary morbidity, mortality and economic loss directly and indirectly attributable to mismanagement of disaster relief.

 

The comparison of the "actual" with "desired" is the first critical step of evaluation. If the objectives were met, those who have participated in the relief have demonstrated that they have accomplished what they set out to do.

On the other hand, if the objectives were not met, it is desirable for those conducting the evaluation to continue with the evaluation process, identify the reasons for the discrepancy and suggest corrective action.

 

Simulated Disaster Preparedness Operations should be undertaken to test the various components before actual need arise.

 

Evaluation of the health disaster management program

¨     Evaluation of the preparedness program

¨     Evaluation of the mitigation measures

¨     Evaluation of the training

 

 

PREVENTION OF DISASTERS

 

Existing knowledge that might reduce the undesirable effects of disasters is often not applied.

¨     Hurricane/Tornado/ Cyclone warning systems

 

¨     Legislation preventing building in the flood prone areas

 

¨     Requirement of protective cellars/shelters in disaster prone areas

 

¨     A Seismic housing code for earthquake-prone area

 

¨     Strict procedural code followed to prevent Nuclear, Toxicological and Chemical disasters

 

¨     Early warning systems, and Disaster preparedness which will help to minimize morbidity, mortality and economic loss

 

SUMMARY

 

Disasters have resulted in significant morbidity, mortality and economic loss. Public health is concerned with two objectives in disaster management;

¨     the elimination of the preventable consequences of the disaster 

¨     The prevention of losses due to disaster mismanagement.

Appropriate disaster relief follows a specific pattern;

¨     Gathering information on the situation

¨     Analysis of this information

¨     Developing and implementing an appropriate response

This pattern occurs at various levels;

¨     immediate assessment,

¨     short-term assessment

¨     ongoing assessment,

 

Through study of the past disasters, their effects and their relief efforts [what has been effective and what have been mismanaged] better plans are now available for effective disaster management as well as for the reduction of preventable losses.

 

·       The disaster proneness varies widely from State to State.

 

·       The country will have to pay more attention towards creating public awareness and preparedness in respect of people living in known disaster prone areas.

 

·       Special training is required to the medical, paramedical, voluntary workers in the relief and rescue work.

 

·       Any Disaster is an emergency situation and the health sector alone cannot tackle it in isolation.

 

·       It must have Coordination with the local community, civil defense, army, police, fire brigade and with various governmental and non-governmental bodies including voluntary organizations like Red Cross.

 

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DR.S.GOPALAKRISHNAN

Professor, Dept. of Community Medicine

Stanley Medical College, Chennai.

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