DISASTER

MANAGEMENT



30 July 2012 - One of the
coaches of the Chennai-
bound Tamil Nadu Express
(New Delhi - Chennai)
caught fire early on 30 July
morning, near Nellore in
Andhra Pradesh.
47 people have died and
25 others have been
injured

OBJECTIVE
DISASTER
Any incident in which number, severity
and types of injuries
Requires extraordinary response
From outside of that community or
region

SOME RECENT DISASTERS..
Earthquake in Pakistan
2005
Earthquake and
tsunami in the Indian
coast - 2004
Gujarat Earthquake -
2001
Floods in Mumbai,
West Bengal
Cyclone: Rita, Wilma
etc..
Fire: Kumbakonam,
Dabwali
Terrorist attack:
Chechnya

And the list goes on and on

Disasters occur in varied forms

Some are predictable in advance
Some are annual or seasonal
Some are sudden and unpredictable


Floods Days and weeks
Earthquakes Seconds/minutes
Cyclones Days
Droughts Months
WHY IS DISASTER MANAGEMENT
IMPORTANT TO US?
57% of the land area is prone to Earthquakes
12% to Floods
8% to Cyclones
70% of the cultivable land is prone to drought
85% of the land area is vulnerable to number of
natural hazards
22 states are prone to multi hazards.
WHY? And WHAT about Man made Disasters?

TYPES OF DISASTERS
Natural Disasters

Earthquakes
Cyclones
Floods
Tidal waves
Land-slides
Volcanic eruptions
Tornadoes
Fires
Hurricanes
Snow Storms
Heat Waves
Famines



Man-made Disasters

Toxicological accidents
Severe Air pollution
Epidemics
Building collapse
Nuclear accidents
Warfare

WHAT IS DISASTER MANAGEMENT
Disasters not only affect health &
well being of people but also large
number of people are displaced,
killed or injured or subjected to
greater risk of epidemics.
Economic loss
Not confined to particular part of
world.
Unpredictable

Seismic
Disturbances upto
Magnitude 4.9
Zone II
Moderate Risk
Quakes upto
Magnitude 6.9
Zone III
High Risk
Quakes upto
Magnitude 7.9
Zone IV
Very High Risk
Quakes of
Magnitude 8and
greater
Zone V
Magnitude Zone
Source: IS 1893 (Part 1) : 2002 (BIS)

POTENTIAL HAZARDS OF DISASTER
Number of injuries & deaths differ depending upon
type of disaster, the density & distribution of
population, condition of environment, degree of
preparedness & opportunity of warning.
Injuries exceeds death in explosions, earthquakes,
typhoons, hurricanes, fires, tornadoes
Death frequently exceeds injuries in landslides,
avalanches, volcanic eruptions, tidal waves, floods
etc.
In earthquake there is high number of mortality(Even
deadlier @ night).

POTENTIAL HAZARDS OF DISASTER
CONTD.
In volcanic eruptions mortality is high in case of
mudslides( 23000 deaths in Columbia in 1985 ) &
glowing clouds.(30000 deaths at Saint-pierre in
Martinique)
In floods high mortality only in sudden
floodinge.g. Flash floods, collapse of dams or
tidal waves.
Otherwise fractures, injuries & bruises may occur
In cyclones & hurricanes mortality is not so much
high.

POTENTIAL HAZARDS OF DISASTER
CONTD.
In draught mortality may increase where there is famines
in which case there is protein-calorie malnutrition &
vitamin deficiencies.
Vit A def. leading to xerophthalmia & blindness
Also measles, respiratory infections, diarrhea with
dehydration leads to increase in infant mortality.
When people migrate & settle down on outskirts of
famine hit areas, there is spread of endemic
communicable diseases.
Post disaster morbidity & mortality
Injuries
Epidemics
Emotional disorders

Injuries- nature & severity varies in different types
of disasters

Epidemics-
Common belief associated with disaster is that
epidemics of communicable disease is inevitable.
This happens only if insanitation conditions are
allowed to prevail.
Emotional Stress Disorders

Disaster syndrome-
Shock stage- Victims are stunned, dazed and
apathy
Suggestible stage- Individual are passive &
open to suggestions.
Recovery stage- Individuals have accepted the
event and willing to start all over again.
Methods to relieve stress are :
Meditation
Supportive psychological therapy
Rest

DISASTER MANAGEMENT CYCLE

DISASTER IMPACT & RESPONSE
Search, rescue & first-aid
Field care
Triage-
Highest priority should be given
to victims whose immediate or
long term prognosis can be
dramatically affected by simple
intensive care

Flow of Patients one triaged. Please note how both walking wounded (green) and non-
salvageable (black) stay out side the treatment area. Also note that as patients status can
change, triage should be dynamic in an effort to asses changes categories.



3


Walking
Yes
Injured
Survival
reception
center
Not Injured
Delayed priority-3 green
No
Breathing
Yes
No
Dead-Black
Open airway
Breathing
Yes
Immediate priority-
p1
Red
No
Breathing
present
10 or less
30 or more
Count RR
11 to 29 RR
Count Pulse
< 120
>120
Priority-
p2
Yellow
Immediate Priority-
P1
Red
TAGGING
Complements
Triage
Rapid
Identification of
patient
Color Coded / Bar
Coded system
Plastic bands
can substitute tags
IDENTIFICATION OF DEAD
Proper respect and care of the dead is
en essential part of disaster
management
Care of the dead includes:
1. Removal of dead from the disaster
scene
2. Shifting to mortuary
3. Identification
4. Reception of bereaved relatives
Hazards associated with cadavers:
Relief Phase

Immediately following disaster the most critical
health supplies are those needed for treating
casualties, and preventing spread of communicable
diseases.
Food, blankets, clothings, shelter, sanitary
engineering equipment & construction material
Four principles in managing humanitarian supplies.
a) Acquisition of supplies
b) Transportation
c) Storage
d) Distribution

EPIDEMIOLOGICAL SURVEILLANCE &
DISEASE CONTROL
1. Overcrowding & poor sanitation
2. Population displacement
3. Disruption & contamination of water supply,
damage to sewerage system & power systems
4. Disruptions of routine control programmes
5. Ecological changes
6. Displacement of domestic & wild animals
7. Provision of food, water & shelter from different or
new source may itself a source of infectious
diseases
Vaccination
The best protection is maintenance of high level of
routine immunization in general population before
disaster occurs
Nutrition
Infants, children, pregnant women, nursing
mothers & sick persons are more prone to
nutritional problems.
REHABILITATION
Starts from the very first moment of the disaster.
Aim is to restore the pre-disaster conditions.
Water supply
Food safety
Basic sanitation & personal hygiene
Vector control
Emergency prevention & mitigation involves
measures designed either to prevent hazards from
causing emergency or to lessen likely effect of
emergencies.
flood mitigation works,
appropriate land use planning,
improved building codes
reduction or protection of vulnerable population &
structure.
DISASTER MITIGATION
Aim of mitigation is to reduce the
vulnerability of the system.
Medical casualties can be drastically
reduced by improving the structural
quality of house, schools & other public
& private buildings.
long-term measures for reducing or
eliminating risk.


DISASTER PREPAREDNESS
Definition:
A programme of long term development
activities whose goals are to strengthen the overall
capacity & capability of a country to manage efficiently
all types of emergency. It should bring about an orderly
transition from relief through recovery, and back to
sustained development
Objective:
To ensure that appropriate systems, procedures
& resources are in place to provide prompt effective
assistance to disaster victims, thus facilitating relief
measures & rehabilitation of services.
Disaster preparedness is ongoing multisectoral activity.

1. Evaluate the risk (Hazard mapping!)
2. Adopt standards & regulations
3. Organize communication, information & warning
system
4. Ensure coordination and response mechanisms
5. Ensure that financial & other resources are available
& can be mobilized in disaster situation
6. Develop public education programmes
7. Coordinate information sessions with media
8. Organize disaster simulation exercises (mock drill)
Community preparedness-
Individuals are responsible for their well-being.
Community members, resources, organizations and
administration should be cornerstone of an emergency
preparedness programme.
The reasons for community preparedness are
1. Members of the community have the most to lose from
being vulnerable to disaster.
2. Those who first respond to an emergency
3. Resources are most easily pooled at the community
level.
4. Sustained development is best achieved by allowing
emergency affected communities to design, manage,
and implement internal & external assistance
programme.
NATIONAL ORGANIZATIONS IN INDIA
In India, the role of emergency management falls to
National Disaster Management Authority of India, a
government agency subordinate to the Ministry of
Home Affairs.
In recent years there has been a shift in emphasis,
from response and recovery to strategic risk
management and reduction, and from a government-
centred approach to decentralized community
participation.

Survey of India, an agency within the Ministry of
Science and Technology, is also playing a role in this
field, through bringing the academic knowledge and
research expertise of earth scientists to the
emergency management process.

INTERNATIONAL ORGANIZATIONS

International Association of Emergency
Managers
Red Cross/Red Crescent
United Nations
World Bank
European Union
International Recovery Platform


Recently the Government has formed the
Emergency Management and Research
Institute (EMRI).
Some of the groups' early efforts involve the
provision of emergency management
training for first responders (a first in India),
the creation of a single emergency
telephone number, and the establishment of
standards for EMS staff, equipment and
training.
TABLE 2 - Some major natural disasters and related outbreaks in India
Year Type Place Death
Injurie
s
Outbreak (if any)
2004 Tsunami
Andhra
Pradesh,
Kerala,
Tamil
Nadu,
A&N
Islands,
Pondiche
rry,
10,749
(5,640
missing)
N.A.
focal outbreak of measles in
coastal Tamilnadu.
increase incidence of
malaria cases in known
endemic areas of southern
group of A&N islands.
2004 Flood
Assam ,
Bihar,
Gujarat
N.A. N.A.
Sporadic incidence of
diarrhoeal diseases
2001 Earthquake
Bhuj,
Gujarat
19,800
1.66
lakhs
Sporadic incidence of water
borne diseases
1999
Super
Cyclone
Orissa N.A. N.A. Leptospirosis
Cyclone
Andhra
Pradesh
N.A. N.A.
POST-DISASTER PUBLIC HEALTH
INTERVENTIONS
Public health interventions to prevent disease
outbreaks after disaster should essentially focus on:
a) Post disaster sanitation measures for:
Safe water supply
Food hygiene
Proper sewage systems/disposal of excreta
Vector/rodent control.
Public health education.



In post-disaster phase,
important epidemic-prone diseases can be
grouped as under:

Water-borne diseases (eg. acute diarrhoeal
diseases including cholera, enteric fever, viral
hepatitis A & E)
Vector-borne diseases (eg. malaria, dengue,
acute encephalitis)
Vaccine-preventable diseases (eg. measles)
Others (eg. meningitis, leptospirosis,plague)




























































































GUIDELINES FOR CONTROL OF EPIDEMIC-
PRONE DISEASES IN DISASTER SETTINGS

a) Guidelines for prevention and control of
water borne diseases
1. Setting up of control rooms
Control rooms to be set up at district and state level
Nodal officers should be identified at the state and district levels for
collecting data and analyzing relevant surveillance reports and
ensuring appropriate follow up action.
For technical assistance and help in investigation of outbreaks,
control room of National Institute of Communicable Diseases (NICD)
and Directorate General of Health Services may be contacted.

2. Surveillance of Acute Diarrhoeal Diseases (ADD)
Information on occurrence of ADD is to be collected from all the health
facilities including temporary/mobile health units.

3. Identify source of contamination of water and remedial
measures
Identify source(s) of contamination of drinking water and ensure
repairing of water pipes (if indicated), make it safe for use or make
alternative arrangements for safe drinking water by supplying through
'Tankers'.
Check water for chlorination, and if possible for bacteriological
contamination.
If surface water/hand pump water is found contaminated, it should not
be used for drinking purposes.
Boiling will kill or inactivate V.cholerae and other common organisms
that cause diarrhoea. Boiling is, however, expensive and may not be
practical in areas having fuel shortages.

6. Safety of food
Avoid raw and uncooked food.
Cook food thoroughly and eat it while still hot.
Cooked food should not be stored for a long time. Keep
the food covered and reheat it thoroughly before
consuming.

7. Information Education & Communication
(IEC)
Increase awareness in the community about personal
hygiene and sanitation including the importance of hand
washing with soap after defecation and before preparing
or eating food.

8. Case management
Treatment facilities should be readily available and accessible.
Manage dehydration and electrolyte imbalance due to acute watery
diarrhoea by using ORS (Oral Rehydration Salt) solution.
Monitor the clinical condition of the patients during and after
rehydration until diarrhoea stops.
IV fluids (Ringer lactate solution) should be used only for the initial
rehydration of patients with severe dehydration. Plain glucose
solutions are ineffective and should not be used.
Antimicrobials are unnecessary for the treatment of ordinary
diarrhoeas; the anti-diarrhoeal preparations are contraindicated. In
case of suspected cholera cases, tetracycline and norfloxacin may
be given.
9. Community participation
Community must be encouraged to participate in activities for the
prevention and control of outbreaks including taking appropriate
action for storage of water at household level and personal hygiene.
They must be aware of danger signals of dehydration and when to
seek immediate medical care

PREVENTION AND CONTROL OF
VECTOR-BORNE DISEASES
1. Active surveillance of Acute Fever
cases
2. Vector Surveillance
3. Vector Control
4. Community participation
Thank You