Disaster Preparedness & Mitigation in Health System

Disaster Preparedness
Definition: Activities designed to minimize loss of life and damage, to organize the temporary removal of people and property from a threatened location &facilitate ,timely &effective rescue, relief & rehabilitation

Disaster Preparedness contd:

National & International agencies conduct activities like planning, organization ,training &communicating ,educating the people to provide prompt and appropriate responses to prevent &reduce adverse effects. Ongoing ,multisectoral activity Integral part of national system & responsibility Difference in developed and developing countries (infrastructure, resources, management capacity, communication &logistic problem)

Objectives :
To prevent excess mortality by impact, rescue, relief , appropriate health care & disruption . To provide appropriate &timely health care for casualities,malnutrition & comm. Diseases. To prevent exposure to adverse climatic & environmental conditions. To prevent long term & short term disaster related morbidities. Reestablishment of health services to or above the pre- disaster level.

General model of disaster preparedness plan

1. Identify the hazards and estimate their effects.
2. Assess the likely needs preliminary list, local capacity, quantify the needs, consider basic needs. 3. Discuss the needs teams involved in planning process 4. Determine operational procedure & review existing priorities. --- provide frame work, hazard prioritization, fundamental policy set out, goals approve by higher authority, delegation of responsibility.

General model of disaster preparedness plan contd:

5. Assign the responsibility. 6. Make an inventory of local capacity & available resources. 7 Review steps 2 & 5 8. Identify critical areas-----strengthening & monitoring plan 9. Confirm priorities ---needs & resources, time

General model of disaster preparedness plan contd :

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10. Finalize the plan ---easy to read, not rigid, standard layout 11. Practice the plan reg.reviewed , updated, responsible people, identify weakness. 12. Evaluate the plan ---lesson learned & applied 13. Compile an information package demography, epidemiology, Geographic Information System (GIS)

Technical Health Program

1. Treatment of casualties
a) Pre hospital plan : - search & rescue of victims, first aid at disaster site (triage) b) Hospital plan : emergency plan, training & information safety of pts &health personnel. c) Back up system: water, power, communication, transportation.

Technical Health Program contd:

2. Identification of bodies :coordination
with FM, protocol for identification & transport. 3. Epidemiological surveillance & disease control ---simple data collection ,warning mechanism with list of potential illnesses ,special programmes for diseases 4. Basic sanitation & sanitary Engineering: collaboration with diff.departments ,contingency plan

Technical Health Program contd:

5. Health management in shelters or temporary settlements---control of infectious diseases, vaccination of children, nutrition surveillance 6. Training Health personnel & public health management ---in service training ,professional staff, professional curriculum, research, officers ongoing information 7. Logistic resources---budget, networking 8. Simulation exercisesdesktop, field

exercise, drills

Technical Health Program contd:

9. Evacuation :temporary transfer of population from areas at risk to safer location. Organized e.g.. (tropical storm air attack,military action, industrial accidents) Spontaneous e.g.. (floods,drought,chemical &nuclear accidents) Environmental health services : --short travel time ,clean potable water,excreta solid waste rest stop & knowledge Disaster warning :simple language ,clear exact nature of message. Restore of radio & broad casting

Health policy & legislation

Legislation to develop preparedness &response plan, routine, simulation assign financial resources. Coordination mechanism :health disaster coordinator -Incharge of preparedness activities , - coordinating plans with
Government ,International agencies, NGOs &other dept.. water, housing power ,communication

-communication &co ordination with PAHO, WHO& civil protection agencies, emergency preparedness program.

Mitigation and prevention

Definition :
These are actions aimed at reducing or eliminating the impact of future hazard events by avoiding hazard or strengthening resistance to it.

Objectives:
Reduce vulnerability of the system e.g. improving & enforcing building codes Reduce magnitude of
hazard. e.g. diverting flow of river

Vulnerability and capacity assessment

Definition: It is the degree to which population, individual, or organization is unable to anticipate, cope with resist & recover from the impact of disaster .(Blaikie 1994) Risk ,threat assessment
To identify hazard &their possible effects, capacity to prevent & respond Develop strategies Emergency prevention mitigation preparedness measures Rapid, relevant emergency response Gaps in resources

Vulnerability reduction:
Develop policy

Assess vulnerability

Prevent/mitigation

Prepare for emergency

Vulnerability reduction

Steps in VCA :
1. Determine aim, objectives, scope& context of VCA& task. 2. Formation of planning group . 3. Hazard identification &description. 4. A community & environmental description 5. Determining effects community vulnerability 6. Hazard prioritization 7. Recommendation for action 8. Documentation of results & decision

Mitigation Programme:
Identify areas exposed to natural hazards with help of specialists. Coordinate the work of multidisplinary teams in developing design & building codes. Include disaster mitigation in health sector

Identify the priority hospitals & critical health

facilities -----current building standards & codes.

Mitigation Programme:
Ensure disaster mitigation measures in maintains plan, structural modification& functional aspects. Inform & sensitize & train those personnel involved in planning, administration, operation, maintenance . Include disaster mitigation in the curricula of professional training institution related to construction, maintenance, administration, financing & planning health facility

Disaster Mitigation
1. Health facilities loss of life, hospital functions Structural Non- structural Administrative /organizational 2.Drinking water supply ,sewage system. 3. Mitigation to reduce community vulnerability.

Disaster mitigation in health system

1. Structural vulnerability : part of building required for support (foundation, columns, beams, diaphragm &supporting walls ) 2. Non-structural vulnerability : Joined to building structure: e.g. window, door, roof Building functionality: e. g. plumbing, airconditioning, power, water, communication. Items located with in building: e.g. medical, furniture, mechanical equipments

Disaster mitigation in health system contd:

3.Administrative & organizational vulnerability:
Physical design : external site, internal , distribution of space, access route. Physical & functional relationship with diff. sectors e.g. hiring, maintenance, supply. Administrative & operational facility: disaster management, simulation exercises

Mitigation measures
1. Start with low cost measures e.g. Non structural 2. Implement mitigation at National, local level discussion with all parties (client, owner, finance officer& technical personnel) 3. Measures 4-8 % of total hospital costfailure of systems

Disaster mitigation in water supply & sewage system:

Water supply & sewage system vulnerable Outbreak of communicable disease & sanitation deteriorates. e.g. Mexico city in1985 Strategies to quickly & effectively restore system Hazard analysis by team focus on operation maintenance, administration &impact on service. Mitigation measures in master plan. Measures retrofitting ,replacement, repair, Back up equipments relocation of components (rigid joints, flexible pipes).

Mitigation to reduce to community vulnerability

1. Reduce risk of communicable diseases. 2. Improve general health status of population 3. Water & sanitation projects organized by self help basis e.g. community based organization 4. Local emergency planning in disaster 5. Public education 6. Discussion with water vendors 7. Intervention by Government & municipal authorities in industrial plant contamination

References
1. Natural disasters protecting public health WHO publication. 2. Principals of disaster mitigation in health facility PAHO publication. 3. Environmental health in emergencies & disaster. 4. Text book of PARK 5. Indian journal of public health Jan-march 1992