PUBLIC HEALTH PREPAREDNESS FOR DISASTER MANAGEMENT

KATTEY KATTEY A.(mbbs, mph)

OUTLINE• Introduction• Definition of terms• Classification and Impact of disasters• Disaster Management • Public Health Preparedness• Agencies Involved In Disaster Management• Conclusion

KATTEY K.A (MPH, MBBS)

Introduction• Disasters are of global interest because they cause a lot of

suffering and damage to human populations and the environment.

• The 21st century has witnessed several disasters, which have killed and displaced hundreds of thousands of people.

• About 1.2 million people were killed by disasters between 2000-2012; estimated damage worth 1.7 trillion USD.

Introduction•The impact of disasters on public health is tremendous.

•Since disasters cannot be avoided or easily reduced, the best approach is to prepare adequately for them.

•The aim of preparedness programmes is mainly to minimize the adverse effects of a hazard.

DEFINITION OF TERMS• “A disaster can be defined as an occurrence either natural

or manmade that causes human suffering and creates human needs that victims cannot alleviate without assistance”. BY - American Red Cross (ARC)

• A disaster can be defined as : “Any occurrence that causes damage, ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area”. BY - World Health Organisation (WHO)

DEFINITION OF TERMS• HAZARD- A natural or man-made event that threatens to adversely

affect human life, property or activity to the extent of causing a disaster.

• Practically speaking, disasters can be regarded as the effect of the interaction between a hazard and vulnerability.

DEFINITION OF TERMS• VULNERABILITY - The predisposition to suffer damage due to

external factors e.g. rapid population growth, urban squatters, precarious food security, environmental degradation, refugees , displaced persons and personal exposure.

• It is the propensity of things to be damaged by a hazard

DEFINITION OF TERMS• RISK is the probability that a person will experience an event in a

specified period of time.

• It is the product of hazard and vulnerability.

Risk = hazard x vulnerability.

DISASTER RISK REDUCTION

The conceptual framework of elements considered with the possibilities to minimize vulnerabilities and disaster risks throughout a society, to avoid or to limit the adverse impacts of hazards.

DEFINITION OF TERMS

CLASSIFICATION OF DISASTERSThese can be done based on:

Speed of onset (sudden or slow onset)

Origin/Cause (natural or man-made)

Scope (minor, major, catastrophic)

CLASSIFICATIONBASED ON SPEED OF ONSET• SUDDEN ONSET

• Natural (earthquakes, volcanic eruption, hurricane, typhoon, tsunamis, tropical storms, land slides, bushfire)

• Natural & man-made (e.g. fire, landslide)• Man-made (toxic waste, wars, oil spillage, transport accidents,

technological and industrial accidents)

• SLOW ONSET• Natural (drought, desertification, famine and flood)• Man-made (war, civil strife, environmental pollution and

economic crisis)

CLASSIFICATION based on the cause1. NATURAL DISASTERS occur as the result of action of the natural

forces and tend to be accepted as unfortunate, but inevitable.

• They result from forces of climate and geology.

• Examples – hurricanes, typhoons, volcanic eruptions, earthquakes, land slides, mud slides, famine, drought, pests, floods, tsunamis, tropical storms, tornadoes

CLASSIFICATION based on the cause2. MAN-MADE (or technological) disasters are the threats having an element of human intent, negligence, or error; or involving a failure of a human-made system from some human activities.

Examples include explosions, fires, the release of toxic chemicals or radioactive materials, bridge or building collapse, crashes, dam or levee failure, nuclear reactor accidents, breaks in water, gas, deforestation, war etc.

Also includes disease epidemics, CBRN disasters and aviation disasters.

CLASSIFICATION based on the scope1. Minor Disaster: Any disaster that is within the response capabilities

of the Local Government and results in only minimal need for State and Federal assistance.

2. Major Disaster: Any disaster that will likely exceed local capabilities and require a broad range of State and Federal assistance.

3. Catastrophic Disaster: disaster that will require massive State and Federal assistance, including immediate military involvement.

Recent disasters in Nigeria

• Oil spillage (Niger Delta)• Aviation disasters• Inter-community conflicts (border disputes, ?political, ?

religious)• Floods (Lagos, Rivers, Bayelsa etc)• Bomb explosions (Boko Haram)• Building collapse• Immigration employment exercise stampede

EPIDEMIOLOGICAL TRIADCredit: University of Minnesota Center for Public Health Preparedness

FACTORS AFFECTING DISASTER

FACTORS AFFECTING DISASTER

• Age• Immunization status• Degree of mobility• Emotional stability

Host factors

• Physical Factors• Chemical Factors • Biological Factors• Social Factors• Psychological Factors

Environmental factors

Agent factors HAZARD• Predictability • Speed of onset• Length of forewarning• Scope and Intensity of impact• Duration of impact• Time of occurrence

Disaster =

Hazard +Vulnerability

Relationship of vulnerability, hazard and disasterSource: WHO/EHA, 2002

Credit: United Nations Office for Disaster Reduction

Effects of Disasters

Disasters result in losses or deprivation of:

• Life • Health (temporary or permanent) • Social welfare services • Environmental integrity • Socioeconomic or developmental advances• Dislocation & displacement • Injuries e.g. burns, fractures

Effects of Disasters

• Risk of communicable diseases • Mental Health effects

- Post disaster syndrome-Anxiety, depression, hysteria, neurosis etc.

• Lack of shelter resulting in exposure to heat & cold • Poverty• Social frustration

DISASTER MANAGEMENT• Disaster management is the body of policies, administrative decisions

and operational activities which pertain to various stages of a disaster.

• It is essentially an inter-sectoral activity and the contribution of all sectors are crucial for its total success.

AIMS AND OBJECTIVES

• Reduced (or total avoidance of, if possible) potential losses from hazards

• Assurance of prompt and appropriate assistance to victims when necessary

• Achievement of a rapid and durable recovery.

PHASES OF DISASTER

Pre-impact phase

Impact phase

Post-impact phase

Phases of Management :• Disaster Response

• Disaster Rehabilitation

• Disaster Reconstruction

• Disaster Mitigation

• Disaster Preparedness

Recovery phase after disaster

Risk reduction phase before a disaster

DISASTER- MANAGEMENT CYCLE

Emergency(Alertness + Defense) Response/ Relief Preparedness

Mitigation/ Rehabilitation Prevention

ReconstructionPre-disaster: risk reduction Post-disaster recovery

Disaster

Fundamental Aspects of Disaster Mgt.Mitigation relates to those activities directed at eliminating or reducing the degree of long-term risk to human life and property from hazards

Preparedness refers to activities undertaken in advance of an emergency or disaster to develop operational and logistic capabilities and to facilitate an effective response should an emergency management event occur.

Response refers what the government and other organizations do immediately before, during, and after a disaster or terror event occurs.

Policy formulation (government commitment)

Vulnerability assessment (risk or hazard analysis)

Emergency prevention and mitigation

Emergency preparedness

COMPONENTS OF DISASTER MANAGEMENT

1. Policy formulation• Existence of a Policy document (with constitutional backing)

• Existence of an Enforcement agency e.g. NEMA

• Availability of favourable conditions to operate e.g. defined organizational structure, adequate funds, appropriate equipment, etc.

2. Vulnerability assessment (risk or hazard analysis)

• the probability of death;• the probability of injury

(mental and physical);• the probability of disease

(mental and physical);• the probability of secondary

hazards (fire, disease etc.)• the probability of

displacement;

• the probability of loss of property;

• the probability of loss of income;

• the probability of breakdown in security;

• the probability of damage to infrastructure;

• the probability of breakdown in essential services.

3. Emergency prevention and mitigation

• Prevent populations from habiting disaster-prone areas• Cautionary messages mounted in disaster-prone areas• Construction of structures to withstand disaster• Evacuation of populations e.g. for disasters with known

periodicity• Improved intelligence & security

3. Emergency prevention and mitigation cont’d• Improved infrastructure (roads)• Aviation safety (airports’ runways & telecommunication)• Promote peaceful co-existence• Political stability• Address marginalization • Energy provision• Poverty alleviation

4. EMERGENCY PREPAREDNESSEmergency preparedness is a programme of long term

development activities whose goals are to strengthen the overall capacity and capability of a country to manage efficiently all types of emergency.

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

EMERGENCY PREPAREDNESS CONT’D

Emergency plans:(i) to prevent or reduce mass casualty among the population

at risk; (ii) for initial health services (i.e. pre-hospital emergency care)

for rescued victims; and(iii) for disposal of dead bodies (iv) deal with post-emergency problem

i. Preventing or reducing mass casualty

• Training and education of the public:(i) Community awareness of the hazards

(ii) Community awareness of appropriate actions for different types of emergencies; and

(iii) the community is empowered to participate in developing emergency management strategies.

ii. Organisation of initial health services (pre-hospital emergency care)

• Search and rescue

• First aid, triage and field care.

• Tagging

Emergency Plans Cont’d

iii. Recovery and disposal of dead bodies

• Collaboration between public & private morgues• Identify and tag corpses• Issue death certificate• Mass burial for unclaimed corpses

iv. Dealing with post-emergency problems

• Entails taking measures that ensure the organized mobilization of personnel, funds, equipment and supplies with a safe environment for an effective relief.

• These measures are policy, administrative decisions, and operational activities which pertain to various stages of a disaster at all levels

DISASTER PREPAREDNESS

• Plans for these programmes are drawn up, usually

during the non/inter-disaster period.

• A large component of the plans are also implemented during the non- disaster phase either as precautionary activities or in anticipation of a disaster.

DISASTER PREPAREDNESS

Focus for Disaster Preparedness1. Manpower resources:

• community education and training• enhanced with drills or ‘trial runs’ of activities

2. Material resources: • Mobilization of needed supplies• identification of sources of certain supplies for use

during the emergency phase.

3. Mobilization of funds

4. Management of the environment: • Policy guidelines and administrative procedures

Focus for Disaster Preparedness

Framework For Disaster Preparedness Programmes

1. Planning2. Hazard and vulnerability assessment3. Information system4. Resource base5. Early warning system6. Public information, education and training7. Rehearsals and drills8. Response mechanisms

PUBLIC HEALTH INTERVENTIONS• Public health interventions and specific disease control

measures are a priority for reducing morbidity and mortality in disaster affected communities.

• These include provision of:• Water• Housing• Sanitation• Vector control• Vaccination• Treatment services

Issues Limiting Prompt response to Disasters

• Poor telecommunications, poor or surveillance – dallying in reporting

• poor electricity supply.• Limited capacity to detect problems early • Lack of training of health personnel on syndromic

recognition of frequently occurring epidemics such as cholera and CSM.

• Lack of adequate transportation• Denial (of dx outbreak/epidemic) b/c of stigmas • No skilled manpower• Lack of stationery

AGENCIES INVOLVED IN DISASTER MGT.• National Emergency Management Agency (NEMA) has the primary

responsibility of coordinating the National Disaster Response Framework in Nigeria.

• NEMA established in March 1999 to manage disasters in Nigeria.

• Prior to NEMA, National Emergency Relief Agency Committee (NERAC) was established in 1976.

International Organizations

International Organizations:

IDDRIn December, 1989, the UN General Assembly designated the second Wednesday of October as the International Day for Natural Disaster Reduction.

Now celebrated on 13th October annually since after 2009.

Day’s name changed to IDDR.

CONCLUSIONA disaster is any occurrence that causes damage, ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area.

They can be natural or man-made.

The impact of disasters are tremendous ranging from destruction of lives and property and often leads to displacement of victims with its associated effects on public health and social life.

KATTEY K.A (MPH, MBBS)

Conclusion (Cont’d)• Preparedness programs are put in place to enhance a prompt and

effective reaction in the event of an emergency.

• This helps in minimizing the effects of a disaster.

You don’t learn to swim in the storm.Preparedness is key.

KATTEY K.A (MPH, MBBS)

BIBIOGRAPHY• International Federation of Red Cross and Red Crescent Societies,

Geneva• World Health Organization. Community Emergency

Preparedness: a manual for managers and policy makers. WHO, 1999.

• World Health Organization. "Coping with major emergencies." WHO strategies and approaches to humanitarian action, 1995.

• http://www.unisdr.org/we/inform/disaster-statistics (Retrieved April 21, 2015).

• WHO. (2002). Environmental Health in emergencies and disasters: A practical guide

• Ordinioha, B. 2006. Principles and Practice of Environmental Health in Nigeria. Port Harcourt. Health Forum.

• http://www.umncphp.umn.edu/preparedness/site/lesson1/screen4.htm (Retrieved April 18, 2015)

KATTEY K.A (MPH, MBBS)

Bibliography (Cont’d)• Park, K. (2007). Textbook of Preventive and Social

Medicine. Jabalpur: Bhanot • Hogan, E., & Burstein, L. (2002). Disaster Medicine.

Philadelphia: Lippincott Williams and Wilkins.• Schneid T, C. L. (2000). Disaster Management and

Preparedness. CRC Press.• Kevin M, C. M. (2003). Emergency Relief Operations.

USA: The Center for International Health and Cooperation.

• Babatunde L. et al. (2013). The Role of Government and Professionals in Disaster Management in Nigeria. J. of Environmental Sciences and Resource Management, 147-155.

• http://www.gdrc.org/uem/disasters/1-dm_cycle.html (Retrieved April 19, 2015

• http://www.nema.gov.ng/index.htm (Retrieved April 17, 2015)

KATTEY K.A (MPH, MBBS)