Disaster means a catastrophe, a calamity or mishap, a grave

occurrence, which causes a serious disruption of the functioning of a society, causing widespread human, material or environmental losses exceeding the ability of the affected society to cope using only its resources.
WHO: Any occurrence that causes damage, ecological

disruption, loss of human life and detoriation of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community.
It lead to ecological disruption which exceeds the capacity

of a community to adjust and require assistance from the outside.

W. Nick Carter defined as an event natural or man-made, sudden or progressive which impact with such severity that the affected community has to respond by taking exceptional measures.

Disaster Classification

Natural

Man made

Natural DisasterMeteorological: storm, cold spells heat waves & droughts, cyclones, hurricanes, tornadoes. Typological: Avalanches, Landslides & Floods Telluric & Teutonic: Earthquakes, Tsunamis, and Volcanic Eruptions. Biological: Epidemic of communicable diseases

Manmade DisasterCivil Disturbances: Riots & Demonstrations Warfare: Conventional Warfare (bombardment, blockage) Non Conventional Warfare: Nuclear, Biological & Chemical Warfare, Guerrilla Warfare, Terrorism Refugees: Forced Movement of large number of people usually across frontiers. Accidents: Transportation calamities (Land, air, water), Collapse of buildings, dams etc. mine disaster. Technological failures: mishap at nuclear power station, leak at a chemical plant, Breakdown of a public sanitation system etc.

Disaster Process
Preparedness Warning Threat Impact

Immediate Action

Rescue

Assessment

Initial Recovery

Long Term Rehabilitation

Prevention

Disaster Impact
Preparedness

Mitigation

Response

Disaster Cycle
Prevention Recovery

Development

Principles of Emergency Management

In 2007 Dr. Wayne Blanchand and Dr. Cortez Lawrence of Federal Emergency Management Agency (FEMA) formulate eight principles of emergency management. 1. Comprehensive consider and take into account all hazards, all phases, all stakeholders and all impact relevant to disaster. 2. Progressive anticipate future disaster and take preventive and preparatory measures to build disaster resistant and disaster resilient communities. 3. Risk driven use sound risk management principles (hazard identification, risk analysis and impact analysis).

Contd
4. Integrated ensure unity of effort among all levels of government and all elements of a community. 5. Collaborative create and sustain sincere relationship among individuals and organization and facilitate communication. 6. Co-ordinated synchronize the activities of all relevant stakeholders to achieve a common purpose. 7. Flexible use creative and innovative approaches in solving disaster challengers. 8. Professional Knowledge based approach; based on education, training, experience, ethical practice, public stewardship and continuous improvement.

Morbidities classified into 4 groups

Injuries
Emotional Stress

Epidemic of diseases
Increase of indigenous diseases.

Health Problems are mainly due to:

Impact of drowning during flood, injuries during earthquake. Delay in evacuation. Non-availability / inadequate immediate medical care. No / damaged advance medical care. Delay in transportation to medical centres.

These consequences or hazards again depends on a large no. of factors Population density
Population displacement Disruption of pre-existing facilities

Disruption of normal health programme

Increase vector breeding

Climatic exposure
Inadequate of food and nutrition.

Organization for medical relief

Pre-hospital care Hospital care
Mass Casualty management

Triage
Cat I Cat II Cat III-

Cat IV-

Immediate treatment:- Severely injuries and critical patient need immediate treatment to save their life. Delayed treatment:- Also urgent but can be wait for 8 10 hrs. for surgery. Minimal treatment:- Walking wounded can be attended. Can transfer to hospital without ambulance. Injury not serious or moribund cases under irreversible shock and no hope.

Disaster in India
Vulnerable due to unique geo-climatic condition. Flood, drought, cyclone, earthquake and landslide are important. About 60% of landmass is prone to earthquake over 40 million is prone to flood. 8% of total areas is prone to cyclone. 68% of area is susceptible to drought. In decade 1990-2000 an average 4344 people lost their live & 30 million people were affected by Disaster every year.

Flood scene

Flood Scene

Recent Map indicating Earthquakes Zones in India

Zone Zone V Magnitude Very High Risk Quakes of magnitude 8 and greater High Risk Quakes upto Magnitude 7.9 Moderate Risk Quakes upto Magnitude 6.9 Seismic Disturbances upto Magnitude 4.9

Zone IV

Zone III

Zone II

Disaster Management in India

At the National level the Ministry of Home Affairs is the Nodal Ministry of Disaster Management. Central Relief Commissioners (CRC) in the Ministry of Home Affairs is the Nodal Officer to coordinate relief operations for natural disasters.

Organizational Component- Cabinet committee headed by P.M. - Empowered grout of ministers headed by Deputy P.M. - National Crisis Management Committee headed by Cabinet Secretary

give direction to any specific action needed for meeting the crisis. - National Crisis management group under the Chairmanship of Central Relief Commissioner to co-ordinate the activities of the Central Ministers and State Govt.

Contd.
Control room- (Emergency operation Room) exists in the

Nodal Ministry of Home Affairs to transmit the information concerning natural calamities keep in touch with Govt. of the affected state. Contingency Action Plan- is to dealing with the contingencies situation. It facilitate the launching of relief operation without delay. National Calamity Contingency Fund (NCCF)- is created at the Central Govt. level. Natural Disaster Management Programme has been implemented since 1993-94 by the Deptt. Of Agriculture with the objective to focus preparedness and mitigation to reduce adverse impact of disaster. Within the scheme National Centre for Disaster Management has set up for research and consultancy and training.

State Level
State Crisis Management Committee headed by Chief

Secretary. The Senior Officers of various deptt. form the part. This committee reviewed the action taken for response and relief and give the direction as necessary. Response, relief and rehabilitation are handled by deptt. of Relief and Rehabilitation. A Control Room is established under Relief Commissioner and is constant touch with the climate monitoring and monitor the action being taken by various agencies in performing their responsibilities.

District Level
District Co-ordination and Relief Committee headed by DC A close liaison with dist. & state Govt. and nearest unit of Armed forces / central police organization and other agencies like water resource, drinking water surface transport. District have their contingency plan which is updated from time to time.

Hospital Disaster Plan

1. Internal Disaster Plan
2. External Disaster Plan

Principle of Hospital Disaster Plan

To provide maximum treatment & to reduces the No. of death and disabilities.

Objective of the Plan

To prepare the staff and institutional

resources for optimal performance in an emergency situation. To make community aware of the importance of disaster plan. Train the staff for evaluation and update

Development of Disaster Plan should

Analyze the geographic location and risk & hazard.

Carry out vulnerability analysis of the community

exposed to the risk and hazards. Probable demand and nature of work expected during Disaster. Assess the resource available. Determine response capabilities. Determine organizational structure for Disaster. Periodic revision of both the plan and organization.

Hospital Disaster Plan Provisions should include

Efficient system of alert and staff assignment. Conversion of a usable space into clearly defined area

for triage, patient observation and medical care. Special medical service for Disaster Cases. Procedure for prompt transfer patients within the hospital. Security arrangements. Establishment of a public information centre. Evaluation of hospital service. Special Disaster Medical record & medical tag. Planning use of OT, X-ray, Blood bank & laboratory.

Hospital Disaster Committee

The Director of Hospital.
In-charge of accident and emergency service. Departmental Heads.

The Nursing Supdt.

The hospital administration.

The staff representative.

Functions of Hospital Committee

Develop Hospital Disaster Plan.
Develop Departmental Plan in support of Hospital plan. Allocate duties of hospital staff. Established standards of emergency care. Conduct and supervise training programme .

Renew and revise the Disaster Plan at regular intervals.

Facilities at Hospital
1. 2.

Triage or sorting area Primary treatment area

Immediate care area

Urgent Care area

Non-urgent Care area (special care area)

3.

Secondary treatment area

Critical Care unit 4.

Operating Unit

Diagnostic Deptt.

Inpatient evacuation holding area

Additional facilities
Control & information centre Volunteer reception Relatives waiting area Media Room

5.

Support facilities Pharmacy, dietary service, security service &

transport.

Some existing and newer initiatives

A National Policy on Disaster Management

has been drafted. Constitute a National Emergency Management Authority at National Level. Deptt. of Relief and Rehabilitation to convert as deptt. of Disaster Management with enhancing responsibilities of mitigation and preparedness.

Contd. State Level Disaster management authority under CM.

Each state govt. has relief manual and code to identify the role of each deptt.

For NE state North Eastern Council has been made the Nodal Agency.

Our Vision
Our vision 2020 is to build a safer and secure India through sustained collective effort, synergy of national capabilities and peoples participation. What looks a dream today will be transformer into reality in the next two decades. The path ahead which looks difficult to day will become a lot easier as we move along together.