Disaster Preparedness & Mitigation in Health System

1. Disaster Preparedness & Mitigationin Health System

2. 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

3. 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)

4. 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.

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

6. General model of disaster preparedness plan contd: 5. Assign the responsibility. • 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

7. General model of disaster preparedness plan contd : . • Finalize the plan ---easy to read, not rigid, standard layout • Practice the plan – reg.reviewed , updated, responsible people, identify weakness. • Evaluate the plan ---lesson learned & applied • Compile an information package –demography, epidemiology, Geographic Information System (GIS)

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

9. 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 • Basic sanitation & sanitary Engineering: collaboration with diff.departments ,contingency plan

10. 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 exercises—desktop, field exercise, drills

11. Technical Health Program contd: • 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

12. 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.

13. 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.

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

15. 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

16. Vulnerability reduction:

17. Steps in VCA : • Determine aim, objectives, scope& context of VCA& task. • Formation of planning group . • Hazard identification &description. • A community & environmental description • Determining effects– community vulnerability • Hazard prioritization • Recommendation for action • Documentation of results & decision

18. 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.

19. 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

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

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

22. 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

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

24. 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).

25. Mitigation to reduce to community vulnerability • Reduce risk of communicable diseases. • Improve general health status of population • Water & sanitation projects organized by self help basis e.g. community based organization • Local emergency planning in disaster • Public education • Discussion with water vendors • Intervention by Government & municipal authorities in industrial plant contamination

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

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