The Disaster Medicine departmentThe Disaster Medicine department

Arsen Gudyma, MD, prof.Arsen Gudyma, MD, prof.Vasyl Demianenko, MCVasyl Demianenko, MC, , as. profas. prof..

““Extraordinary situations of Extraordinary situations of natural disaster: calamitiesnatural disaster: calamities:: medicine and sanitarian medicine and sanitarian consequencesconsequences””

““Extraordinary situations of Extraordinary situations of natural disaster: calamitiesnatural disaster: calamities:: medicine and sanitarian medicine and sanitarian consequencesconsequences””

Lecture 2 - p.Lecture 2 - p.22

Types of calamitiesTypes of calamitiesGeological Volcanic eruption, earthquakes,

tsunami (tidal waves)

Topological

Meteorological

Land slides (heave, dislocation), collapses (falling in) earth surface, mountain torrents, snow avalanches, icing, inundation, flooding, mud flows, dry.

Downpour, storm, tempest, whirlwind, tornado, sand-storm, water spout, lightning.

Bacteriological Epidemic

Zoological Flows of locusts, termites etc.

Types of calamities Types of calamities Geological Eruption of volcanic, earthquakes,

tidal waves (tsunami)Annually over 100 thousands of shoves are registered in the world, from what 2 – by force 8 marks, 70 – 7 marks, 6 marks – 100, 5 marks – 1500, 4 marks – 3000.Earthquakes are 15 % від all natural catastrophes, however take first seat after the scales of human and financial losses (to 100.000 thousand of victims and $400.000.000)

Considerable territory of Ukraine (120 thousands apt. km, 20 % від general territory with a population there are 11 million persons) – are seismic with force earthquakes – 6-8 marks. In Crimea earthquakes are possible to 9 marks, in the South-west region - to 7 marks, in Kyiv - 4-6 marks (after the Rikhter scale).

4-6 grades – light damaging of the stone constructions

7 grades ( very strong) – cracks in the wall of stone constructions

9 grades ( devastating) – heavy damages and ruins stone buildings

8 grades (ruining) the intensive destruction of the building

Medo-sanitarian consequences of earthquakes

Medo-sanitarian consequences of earthquakes

10 % cases of traumas is a direct action of collapses, destructions of walls and roofs of houses, 35 % cases of traumas is an action of falling constructions and wreckages of buildings, 55 % cases of traumas is improper behavior of victims, unrealized of own actions which were conditioned neuro-psychic stress (jumping out from windows, hammered in places during a haste and others like that).Volume of sanitary losses - 10-12 % of amount those, who got to the area of earthquake.

perished very heavy injured

=31

Types of traumas: Breaks of various localizations; traumatic amputations; damage of soft fabrics; traumas of chairman; syndrome of long duration роз-чавлення; infectious diseases; neuro-psychic disorders.

It’s inevitable appearance among the population of psychical reactions (to 75 % suffering population), weight of which depends both on destroying forces of earthquake and personality of injures. Emotional reactions which arise up in connection with fears on it to age and life of the near are result of influencing of a stress situation. They appear in people as a sense of fear, general retardation, by internal tension, violation of sleep, various hysterical reactions. 10 % of the people require the psycho-neurological aid. In addition, for persons which appeared in the area of earthquake, frequency of attack of sharp cardiac insufficiency, heart attack of myocardium is multiplied, hypertensive complications, sharp violations of cerebral circulation of blood, and also the amount of premature births grows.

Seismic danger regions of Ukraine

Earthquake in Armenia 7 of December 1988. Spitak. Died 25 000, injured 32 500

Earthquake in Armenia 7 of December 1988. Spitak. Died 25 000, injured 32 500

Medico-sanitarian consequences: breaks of bones of extremities and pelvis – 49,7 %; damage of skull and spine – 27,1 %; syndrome of long-term squashing – 23,8 %; isolated damages of soft fabrics – 12,5 % traumas of thorax and stomach – 10,7 %.

Southeast of Iran, on December, 26, 2003, Bam/ Earthquake by force a 6,9 grade. Perished over 4 000. 30 000 people

were injured

Southeast of Iran, on December, 26, 2003, Bam/ Earthquake by force a 6,9 grade. Perished over 4 000. 30 000 people

were injured

5 % injured were hospitalized in the first 3 days after an earthquake. Patients which need the first aid were acted during 15 days. First casualties were delivered at hospital with easy defeats, on 2-3 days – with heavy defeats. In 6-7 days – with pus-septic complications of wounds of soft tissues and opened breaks.

mortality due to earthquake

mmonotrauma of stomach – 5,4 %; monotrauma of thorax – 0,2 %; monotrauma of chairman and necks – 0,1 %; monotrauma of extremities – 3,8 % politrauma – 53,2 %.

Consequences of earthquake in Ternopil region

January of 2002, Intensity of 4 grades

Consequences of earthquake in Ternopil region

January of 2002, Intensity of 4 grades

EFFECTIVENESS OF RESCUERS: in the first 3 h. rescuers can save to 90 % people which remained living; in the first 6 h - 50 %;during the next 10 days rescue works were halted

May 2003. Earthquake in Japan. 6-8 gradesMay 2003. Earthquake in Japan. 6-8 grades

The common problems due to earthquake

Absence or insufficiency of medical personnel for giving urgent medicalaid for the injures.Destruction of hospitals.Absence or insufficiency of medical equipment and medications.Absence or insufficiency of drinking-water and meal.Insufficiency of facilities is for transporting of heavy casualties.Problem of storage, authentication and burial place of lost.Destruction of communal services is in the district of disaster.Absence of means of connection.Risk of spreading infectious diseases people which lost the habitation related to the considerable concentration, absence of the proper sanitary epidemic terms in the places of their location.

Types of calamitiesTypes of calamities

Topological Land slides (heave, dislocation), collaps (falling in) earth surface, mountain torrents, snow avelanches, icing, inundation, flooding, dry, forest inflagrations

For the last 30 years on territory of Ukraine over 5 000 failures of collapsed of earthly surface are marked and 20 000 changes, collapses, happened with total area of 1880 sq. km.Comparatively with 80 years their amount grew almost on 45 %, area of spreading - on 28,8 %.That processes of changes spread on territory almost 200 cities and settlements of city type 18 areas of Ukraine.

Areas of earth collaps

The ground falling in Monastyrysk The ground falling in Monastyrysk districtdistrict

The ground falling in witn the The ground falling in witn the total total destruction of multistoreyed building in destruction of multistoreyed building in

Dnipropetrovsk

Area of falling in Western Donbass is equaled 8 000 sq. km, in Dnipropetrovsk – 500 sq. km.

The total collapsing can achieve 5-7 meters. This action develop to catastrophic floodings

Landslide.Landslide. Sarno in Italy.Sarno in Italy. May of 1May of 1998998

The most danger is made by changes, which take place on built-up territories which can arise up instantly and heavily added prognostication.Changes predetermine mechanical traumas and as a result of worsening of terms of residence are psycho-emotional disorders, sharpening of somatic pathology, worsening of epidemiology situation.

Фільм

Land slides is movement of masses of overburdeningprecipitations soil on hard rocks slopes from the high to the foot.

Areas of Ukraine witg possible flooding of

mud flows

Areas of Ukraine witg possible flooding of

mud flows

Mud flow – stormy rocky-flooding flow, that was formed suddenly, as a result of the sharp Mud flow – stormy rocky-flooding flow, that was formed suddenly, as a result of the sharp getting up of water level in the mountain rivers. A mud flow contains in the composition getting up of water level in the mountain rivers. A mud flow contains in the composition hard materials (10-75 % to his volume) and moves with speed of over 10km/h. Volumes hard materials (10-75 % to his volume) and moves with speed of over 10km/h. Volumes can achieve the hundreds of thousands of millions of m3 a mud flow, and sizes of can achieve the hundreds of thousands of millions of m3 a mud flow, and sizes of mountain breeds - to 3-4 m and by mass to 100-200 t. Having large mass and speed of mountain breeds - to 3-4 m and by mass to 100-200 t. Having large mass and speed of movement, mud flows destroy houses, buildings, roads and all other on the way of the movement, mud flows destroy houses, buildings, roads and all other on the way of the following. following.

Flooding of mud flows

Mud flows predetermine mechanical traumas and worsening of the life conditions, psycho-emotional disorders, sharpening of somatic pathology, worsening of epidemiology situation.

The snow avalanches meltingSnowdrifts, icing, avalanche influence on Snowdrifts, icing, avalanche influence on work of transport, communally power work of transport, communally power economy, establishments of communication, economy, establishments of communication, economic objects and others. Especially economic objects and others. Especially dangerous are melting of snows in dangerous are melting of snows in mountains which have large destructive mountains which have large destructive force and cause large financial loss and force and cause large financial loss and cause human losses. Snows avalanche cause human losses. Snows avalanche predetermine mechanical traumas, predetermine mechanical traumas, overcooling, and as a result of worsening of overcooling, and as a result of worsening of terms of residence are psycho-emotional terms of residence are psycho-emotional disorders, sharpening of somatic pathology.disorders, sharpening of somatic pathology.

Regions of Ukraine with avalanche danger

Regions of Ukraine with avalanche danger

Icing in central regions of UkraineIcing in central regions of Ukraine

Hoar-frost in village of Hoar-frost in village of Ozerna in Zboriv Ozerna in Zboriv

district/ March 2002district/ March 2002

Hoar-frost in village of Hoar-frost in village of Ozerna in Zboriv Ozerna in Zboriv

district/ March 2002district/ March 2002

The map of inundation and flood The map of inundation and flood in Ukraine in Ukraine

The map of inundation and flood The map of inundation and flood in Ukraine in Ukraine FloodsFloods is the most is the most

frequent calamity in frequent calamity in UkraineUkraine

повеней

підтоплень

Flood is a temporal submergence of considerable part of dry.Flood is a temporal submergence of considerable part of dry.They consist 40 % all calamities in the world.They consist 40 % all calamities in the world.Inundation is a temporal submergence of considerable Inundation is a temporal submergence of considerable part of dry land by water due to increase of level of the ground part of dry land by water due to increase of level of the ground waters as a result of abundant precipitations waters as a result of abundant precipitations and violation of the natural ground drainage system. and violation of the natural ground drainage system.

For 20 years the amount of cities, settlements and rural settlements with the For 20 years the amount of cities, settlements and rural settlements with the permanent displays of inundation grew twice and makes 995 settlements, area permanent displays of inundation grew twice and makes 995 settlements, area of inundation – 196,2 ha. of inundation – 196,2 ha.

Inundation is constantly acting Inundation is constantly acting calamity in Ukrainecalamity in Ukraine

Ice-congestion is piling up of ice in the river-bed of the river during floods and ice-drifting.Ice-devouring is freezing of ice under water, which forms an icy cork in a freeze up period or in the river which isn’t frost.

Ice-congestion on the Dnister-river.Village of Gvanets Khmelnitsky region

January 2002

Ice-congestion on the Dnister-river.Village of Gvanets Khmelnitsky region

January 2002

Measurement of water level

Floods on the large rivers (Dnipro, Danube and Siversky Donets are “quiet”. They cause the protracted submergence of considerable territories and necessity of partial evacuation of population.

Floods on the large rivers (Dnipro, Danube and Siversky Donets are “quiet”. They cause the protracted submergence of considerable territories and necessity of partial evacuation of population.

Felling of the forests, melioration, transport, industrial and housing building Felling of the forests, melioration, transport, industrial and housing building destroy the redistribution of river flow and blocking the natural ways of under-destroy the redistribution of river flow and blocking the natural ways of under-ground water drenage. ground water drenage.

Floods on the mountain rivers (Dnistro, Tissa, Prut, rivers of Crimea) are stormy. They are formed in a few hours to 2-3 days and can cause heavy and tragic consequences.

1998. During 12 h more than 260 settlements and almost 400 1998. During 12 h more than 260 settlements and almost 400 thousands of population found oneself in the area of the flood. thousands of population found oneself in the area of the flood. 17 people perished, 1 disappeared in obscurity. The useless 17 people perished, 1 disappeared in obscurity. The useless was become by 2695 dwelling-houses.was become by 2695 dwelling-houses.

2001 year. 33580 houses were flooded in 255 settlements, 1920 it is blasted. In an area a submergence found oneself 218044 habitants, from what 50310 – children. 9 people perished. It was flooded 47 buildings of hospitals.

Medico-sanitarian consequences of inundation Medico-sanitarian consequences of inundation

1. Specific (caused the consequences of (caused the consequences of water element): sinking, overcooling, water element): sinking, overcooling, mechanical traumas.mechanical traumas.

2. Common Common (arise up under act of stress (arise up under act of stress situations, changes in an environment, situations, changes in an environment, worsening of domestic terms and others like worsening of domestic terms and others like that):that):

a) psychic disorders;a) psychic disorders;b) intensifying of chronic diseases, b) intensifying of chronic diseases,

first of all with cardio-vessel pathology;first of all with cardio-vessel pathology;c) growth of amount of bronchial-c) growth of amount of bronchial-

pulmonary pathology, including tuberculosis;pulmonary pathology, including tuberculosis;d) flashes of mass infectious d) flashes of mass infectious

diseases (sharp intestinal infections, diseases (sharp intestinal infections, salmonellosis, hepatitis A);salmonellosis, hepatitis A);

e) in endemic areas flashes of e) in endemic areas flashes of anthropo-zoonotic diseases (rabbit-fever, anthropo-zoonotic diseases (rabbit-fever, leptospirosis).leptospirosis).

Medico-sanitarian consequences of inundation in Zakarpattia. 1998

Medico-sanitarian consequences of inundation in Zakarpattia. 1998

Surgical and traumatic pathology – 5,7 %;Therapeutic pathology:

Disease of the respiratory system – 31,6 %;Disease of the cardio-vessel system – 16,1

%;Disease of gastro-intestinal highway – 12,0

%;Neurological disorders - 12,5 %.

Quantity of found out patients - 8,1 %.From them were hospitalized 8,3 %: overcooling - 17,2 %; on social reasons – 13,5 %; with somatic diseases – 61,3 %; with infectious pathology - 8,0 %.

Among all patients infectious pathology was discovered in 25,8 % (gastro-enterocolitis, angina, cases of dysentery, entero-viral infections, chicken pox, German measles, epidemic parotitis).

Medico-sanitarian consequences of inundation in Zakarpattia

Medico-sanitarian consequences of inundation in Zakarpattia

Regularly it is marked:Regularly it is marked: in middle at floods number of patients - to 10 % of all injures from them are hospitalized – to 8 %.It allows to make the previous calculations of amount of beds in case of this extraordinary situation.

That is why at floods a necessity That is why at floods a necessity is the permanent monitoring for is the permanent monitoring for the health of injures and other the health of injures and other populationpopulation

Types of calamities Types of calamities

Meteorological Downpour, storm, tempest, Downpour, storm, tempest, whirlwind, tornado, sand-whirlwind, tornado, sand-storm, water spout, storm, water spout, lightning.lightning.

Meteorological calamities

in Ukraine

For the last period the promoted For the last period the promoted repetition of the elemental repetition of the elemental meteorological phenomena is the meteorological phenomena is the most characterizedmost characterized

The strong wind is observed mainly in a The strong wind is observed mainly in a cold period of year and more frequent in the cold period of year and more frequent in the mountain areas of Ukrainian Carpathians, mountain areas of Ukrainian Carpathians, Crimea, on the Donetsk ridge, Wolyn and Crimea, on the Donetsk ridge, Wolyn and Podillia submities.Podillia submities.

8 12,5-15,2

9 15,3-18,2

10 18,3-21,5

Strong storm

11 21,6-25,1

12 25,2-29,0

Hurricane

8 12,5-15,2

Strong wind Breaking of branches of trees. It is Breaking of branches of trees. It is heavy to go against wind.heavy to go against wind.

9 15,3-18,2

Storm Small destructions of buildings. Chimneys and tile break away.

10 18,3-21,5

11 21,6-25,1

Hard storm

12 25,2-29,0

Devastating actions.

Grades m/s Characteristic Action of wind

Ruinous action of storm

FILMFlorida, USA, 1992.

Tornado of IV category

Considerable destructions. Trees are rooted out.

Large destructions.

On the period of hurricane ( tornado) about 50 % traumas caused due to action of objects which fly and fall. In the structure of damages a cranial-cerebral trauma can make 50-70 %, (thus 18-20 % makes heavy clinic forms ), breaks of bones of extremities, pelvis, spine - near 15 %. The combined trauma can make 60-65 %. Wounds usually are torn, muddy sand, earth, fragments of glass on a large depth

Medico-sanitarian consequences of storm

Result of strong wind actionIn the village of Vovkivtsi in

Borshtchiv district. 2002

Result of strong wind actionin Ivano-Frankivsk region. 2004

Hurricanes very often are accompanied considerable precipitations, that can worsen the medico-sanitarian consequences of calamity

On August, 4-5 in 2004, as a result of strong thundershower and hurricane the bank with holiday-makers was cut out and brought away in open Azov sea in the Mycolayv region. The rescuers for 2 days evacuated from a coast over 150 persons of different age and during a few days took out their personal transport. For evacuated the conditions for sojourn were created.

In July,2004, the hurricane swept on the Western areas of In July,2004, the hurricane swept on the Western areas of Ukraine. The Ivano-frankivsk region suffered the most.Ukraine. The Ivano-frankivsk region suffered the most.

Strong wind action was joined with hail and rain

The great threaten problems are connected with making of mass measures

The EndThe End