Lt Col (Dr) A K Singh,Department of Anaesthesiology and

Critical CareCommand Hospital Central Command

Lucknow

Disaster Management: Role of Armed Force Medical Services

DISASTER ?

• What is disaster ?

FLOODS 2014

Proneness to disaster

• Is India a disastrous nation ???

• Highly vulnerable to natural hazards• unique geography

– surrounded by sea,– mountains– traversed by rivers.

Landslides 12% Earthquakes - 58 %

National Policy on Disaster Management 2009

Flood- 12% Wind and cyclone -8%

National Policy on Disaster Management 2009

Man made disasters related to

• Industrialisation, • Transportation,

• Environmental degradation

• Terrorist attacks.

About one million houses are damaged annually with irreparable losses

Need of nation...• Need to adopt proactive approach for

– prevention,– mitigation – preparedness

Prior to the origin of NDMA (Before 2005)....

– No clear cut policy for DM

till 2005.

– Indian Army the biggest rescue and succour providing organisation

Govt ‘s Initiative– In December 2005 NDMA –

to tackle multifarious aspects.

– Paradigm Shift response-centric approach, till 2005,

– Holistic, preparedness management and mitigation-centric approach.

Crisis Management – From Despair to Hope”, Third Report, Second Administrative Reforms Commission,Government of India, September 2006

NDMA

PM(NDMA)

State level under the Chief Minister

Chief Secretary

District level, the District Collector

Elected representative of the people (Co-Chairperson) a public-private interface

Multi-Disciplinary Process

– Disaster management is a multi-disciplinary process.

– Ministry of Home Affairs (MHA) - Administrative ministry for disaster management.

– Central ministries and departments• Assist NDMA, in discharging its functions.

– Addresses specific disasters as assigned to them.

Nodal ministries & departmentsMinistries of Home Affairs

(MHA).

Agriculture,

Health,

Environment and Forests,

Civil Aviation

Earth Sciences,

Space,

Atomic Energy,

Mines,

Railways .

Financial Mechanism and Activities

• Disaster Management Organisation financed by the Centre -Disaster Response Fund, (earlier Calamity Relief Fund).

• NDMA raised National Disaster Response Force (NDRF) to execute disaster relief.

NDRF

NDRF• Trained and equipped with

skills to tackle any kind of disaster .

• Eight battalions from Central Police Forces.

• Kosi floods in Bihar, rescued over 1,00,000 people.

• NDRF is the most vibrant face of the NDMA

Armed forces role....

• Coordinating disaster response and relief operation is of the home ministry.

• As per NDMA 2005

• Armed forces under the defence ministry are called out to assist and manage the situation.

. Vij, NC General, ‘Disaster Management at the National and State Levels’, the Journal of the United Services Institutions of India, Vol CXXXVII, No 569, July –September 2007, P 324

First responders

• Location in the entire country,

• Far-flung border areas

• Remote areas-where district administration– is weak or non-existent.

Our strength• Indian armed forces, the most

– Disciplined– Dedicated, – Professional, – Wide exposure – Experience.– Compassionate.– Well equipped

• Technically competent,• Man power and Rescue resources Capable of rescue and relief operations of any disasters.

We are One Stop Shop..

Trace

Reach

Rescue

Reassure

Relieve

Evacuate

Rehabilitate

Solution for all problems

Our records

– Tsunami in December 2004, under Integrated Defence Staff (IDS), AFS efficiently executed, relief, rescue and evacuation (Operation Sea Wave).

– Extended aid to Sri Lanka and Maldives (Operation Rainbow and Operation Castor on request of their respective govts .

List is long....

– Bhuj in 2001– Kashmir earthquake

of 2005,– Cyclone

in Bangladesh on 15 November 2007,

– Fire breakout at Burrabazar in Kolkata on January 12, 2008,

• Serial blasts at Bangalore and Ahmedabad on July 2008,

• 26/11 Mumbai terrorist attack.

• Flash floods in Ladakh’s capital Leh in 2010

• Sikkim earthquake of September 2011,

• Uttrakhand 2013• Floods in J& K 2014

Time and again Managed all types disaster

nation faced.

Mitigated the impact of any disaster.– promptness , – swiftness,– state of preparedness

Defied impact of any disaster

Saved Lives and property

Possible because...

• Continuous training,• Well rehearsed • Organized repeated

drills• Innovations • Improvisations.

.

Role of Medical services

• Well organized infrastructure and medical setup in country to tackle disaster– Resuscitation and first AID– Evacuation of causalities to hospitals.– Management of causalities at hospital.

Tri-services setup - uniform at all service hospitals.

Disaster management programme

• Carried out to assess hospital’s – Promptness,– Readiness, – Efficiency – Status of preparednes.

ARMY

Our set up in hospital

• Well laid out SOPs..

• Any type of disaster,

• Any place

• Any time.

Disaster plan – Pre- hospital,– Reception, – Triage, – Resuscitation,– Life saving surgeries– Treatment, – Rehabilitation

Salient features...

• Member’s role is pre-

assigned and predefined ,

• NEWS- Quick response

teams (QRT) moves

• Activation of Hospital

Disaster response.

Assume active pre-designated role

Everyone reaches respective departments,

Salient features...• Wards are earmarked• Routine patients shifted. • Medical store bricks • Equipments are laid out • Supportive stores -

mobilized • Earmarked places.• Reduces ambiguity,

panicky, confusion and commotion

Salient features...• Mock drills on short notice

• Team members earmarked

• Updated on monthly basis.

• List Displayed at prominent places.

• Replaced Leave, Duty, Sickness, Posting

We are there for you...

• Armed forces respond to disasters as a part of mandate to aid civil authorities.

• Meant ‘last to enter and first to leave’.

• Conversely ‘first to enter and last to leave’.

ConclusionDisasters management

fundamental element

• Prevention,

• Mitigation,

• Preparedness,

• Response,

• Relief and Recovery .. “Governance; Institutional and Policy Frameworks for Risk Reduction”, Thematic Discussion Paper Cluster 1; World Conference on Disaster Reduction, 18-22 January 2005, Kobe, Hyogo, Japan.

Our Armed forces

• State of operational readiness

• Any kind of disaster

• Adverse ground and climatic conditions

• Rescue and response has been exemplary .

• Increase in disasters in the SA region

• Play vital role in the years to come.

JAI HIND !!!!