Disaster Preparedness and Management

Table of Contents

DISASTER

Disaster is an occurrence disrupting the normal conditions of existence and causing a level of suffering that exceeds the capacity of adjustment of the affected community, WHO

Disaster is also defined as a sudden/unexpected catastrophic event causing serious disruption of the functioning of a community or society that exceed the ability of the affected community or society to cope using its own resources.

Key words used in Disaster

Vulnerability: Is lack of capacity to deal with potential threat. Lack of information, resources and technology. There are many
aspects of vulnerability, arising from various physical, social, economic, and environmental factors. Examples may include: poor design and construction of buildings, inadequate protection of assets, lack of public information and awareness, limited official
recognition of risks and preparedness measures, and disregard for wise environmental management
There are four (4) main types of vulnerability:
(a). Physical Vulnerability may be determined by aspects such as population density levels, remoteness of a settlement, the site, design and materials used for critical infrastructure and for housing. Example: Wooden homes are less likely to collapse in an earthquake, but are more vulnerable to fire.
(b). Social Vulnerability refers to the inability of people, organizations and societies to withstand adverse impacts to hazards due to characteristics inherent in social
interactions, institutions and systems of cultural values. It includes aspects related to levels of literacy and education, the existence of peace and security, access to basic human rights, systems of good governance, social equity, positive traditional values, customs and ideological beliefs and overall collective organizational systems Example: When flooding occurs some citizens, such as children, elderly and differently-able, may be unable to protect themselves or evacuate if necessary.
(c). Economic Vulnerability. The level of vulnerability is highly dependent upon the economic status of individuals, communities and nations i.e. the poor are usually more vulnerable to disasters because they lack the resources to build sturdy structures and put other engineering measures in place to protect themselves
from being negatively impacted by disasters. Example: Poorer families may live in squatter settlements because they cannot afford to live in safer (more expensive) areas.
(d). Environmental Vulnerability. Natural resource depletion and resource degradation are key aspects of environmental vulnerability. Example: Wetlands, such as the Caroni Swamp, are sensitive to increasing salinity from sea water, and pollution from storm water runoff containing agricultural chemicals, eroded soils, etc.
Disaster risk: Is the likelihood of specific hazard occupancy and its probable consequence for people, property and environment.
(a). Acceptable risk: The extent to which a disaster risk is deemed acceptable or tolerable depends on existing social, economic, political, cultural, technical and environmental conditions.
(b). Residual risk: is the disaster risk that remains even when effective disaster risk
reduction measures are in place, and for which emergency response and recovery
capacities must be maintained. T
Intensity: Refers to a disaster agent’s ability to inflict damage and injury.
Scope: Refers to the geographic area and social space dimension impacted by the disaster agent.
Frequency: Refers to the number of times certain disasters occur in certain geographical locations that may give time to the community to take measures in preparation.
Controllability: Refers to some control measures that can reduce the impact of the disaster. It helps the emergency planners.
Triage: Refers to sorting out victims according to the extent of severity.
Time: Refers to the period when certain disasters can last that can allow the affected people to vacate when there is a period of warning the community to vacate for protection.
Capacity: The ability of a community to use all the available resources that can reduce risk level and disaster effects.
Capacity building: It is the efforts to develop human skills within a community to reduce
risk levels.
Emergency: a state in which normal procedures are suspended and extra-ordinary measures are taken in order to avert a disaster, WHO.
Catastrophe: It is a large scope of impact event that affects multiple communities, produces very high levels of damage and social disruption, and sharply and concurrently interrupts community and lifeline services. A broad scope of impact impairs each community’s emergency response system and greatly limits extra community support.”
Hazard: A natural or human-made event that threatens to adversely affects human life, property or activity to the extent of causing a disaster.

Epidemiology of a disaster

Epidemiology is the study of patterns of a disease occurrence in human population and the factors that influence these patterns.

Epidemiology is divided into 3 parts namely i.e. Agent, host
and environment

DISASTER AGENT: The agent is the physical agent that actually causes the injury or destruction.
(a). Primary agents include; falling, building, heat, winds or using water.
(b). Secondary agents include; bacteria and viruses that produce contamination or infection after primary agents.
HOST: These are the characteristics of humans that influence several of the disaster effects e.g. ages, immune status, pre-existing health status, degree of morbidity and emotional stability. The individuals who are mostly affected are the pregnant mothers, the elderly and the children because they are vulnerable.
ENVIRONMENT: Environmental factors that affect outcome of disaster include; physical, chemical, biological and social factors.
(a). Physical factors include; the time when disaster occurs, weather conditions, availability of good water supply and functionality facilities and others for example communication system.
(b). Chemical factors. Influencing disasters include leakage of stored ground water or food supply that may directly affect human life when consumed.
(c). Biological factors are those that occur as a result of contaminated water, waste disposal, and improper food storage.
(d). Social factors are those factors that contribute to the individuals’ social support systems, loss of family members and changes in responsible roles.

Causes of Disasters

1. Geological and Climatic Changes: This causes disasters if they become extreme e.g. lack or insufficiency of rain for an extended period that severely disturbs the hydrologic cycle in an area.
2. Poverty: It generally makes people vulnerable to the impact of hazards because they settle on hills that are prone to landslide, along the riverside invaluably flood their banks
3. Population Growth: More people will be forced to live and work in unsafe areas which cause increasing numbers of people will be competing for limited amount of resources such as employment opportunities, and land which can lead to conflict; this conflict may result in crisis—induced migration thereby resulting in disasters.
4. Rapid Urbanization: It is characterized by rural poor moving to metropolitan areas in search of economic opportunities and security which may cause them not find safe and desirable places to build their houses that can lead to human-made disasters.
5. Transitions in Cultural Practices: This involves cultural Introduction of new construction material to build houses or materials used incorrectly may lead to house that cannot withstand earthquake.
6. Environmental Degradation: Drought conditions exacerbated by poor cropping patterns, overgrazing, the stripping of topsoil, poor conservation techniques, depletion of both surface and subsurface water supply.
7. Lack of Awareness and Information: Lack of knowledge about protective measures, safe locations, safe evacuation routes and procedures that can be accessed during a disaster can lead to community to experience impacts of the disaster since they don’t know how to reduce the effects.
8. War and Civil Strife: Includes competition for scarce resources, religious or ethnic intolerance and ideological differences e.g. the Rwandan massacre.

Phases of Disaster, victim’ response and roles of a Nurse

Disaster Action Phase

These are the steps in which a disaster will occur
There are three phases to any disaster. The actions on emergency personnel and others professional depend on which of the disaster is at hand.

Pre-impact Phase
Impact Phase
Post Impact Phase

PRE-IMPACT PHASE: This is an initial phase of disaster prior to the actual occurrence of warning is given at a sign of the first possible danger to the community. The earliest possible warning is crucial in preventing loss of life and minimizing damage. It is a period when emergency preparedness plan is made, first Aids Centre is opened and communication is very important, time for educating the community. The nurse’s role is to sensitize the community assist in making emergency shelters and prepare medical equipment.

IMPACT PHASE: Occurs when disaster has actually happened; it is time for enduring hardship or injury and trying to survive. It is an emergency period when the individual helps neighbours and families at a “scene”, a time of holding “on” until outside helps arrive. The phase may last longer depending on the type of disaster. This phase provides preliminary assessment of the nature extent and geographical area of the disaster. A period when needs of the victim in the community is assessed. The type and number of needed disaster health services is assessed, reports are given to centre for disease control and action taken. The role of a nurse is to assess health needs, provide physical and psycho-social support to mothers and children, given special shelters, injured persons are treated, coordinate search is made and re-union activities are made

POST IMPACT PHASE: This is a period of recovery from emergency phase and ends with return of normal community order and functioning. The phase may live longer and care must be given. The role of a nurse is to counsel, start rehabilitation, and sensitize the community for empowerment to start income generating activities

Classification of Disasters

Natural Disasters.
Human made Disasters

Natural Disasters

A natural disaster is a major adverse event or disaster resulting from natural processes of the Earth.

SUDDEN OCCURRENCE (MONOCAUSAL)
PROGRESSIVE OCCURRENCE (MULTICAUSAL)

SUDDEN OCCURANCE (MONOCAUSAL)	PROGRESSIVE OCCURRENCE (MULTICAUSAL)
STORM	LANDSLIDE
HEAT WAVE	DROUGHT
FREEZE	FLOODS
EARTHQUAKE	EPIDEMIC
VOLCANIC ERUPTION	PESTS

HUMAN MADE DISASTER

Human-made disasters are Emergency situations which are the results of deliberate human actions. They involve situations in which people suffers casualties, losses of basic services and means of livelihood

SUDDEN OCCURANCE (MONOCAUSAL)	PROGRESSIVE OCCURRENCE (MULTICAUSAL)
FIRE	WAR
EXPLOSION	ECONOMIC CRISIS
COLLISION
SHIPWRECK
STRUCTURAL COLLAPSE
ENVIRONMENTAL POLLUTION

Stages of emotional response

Victims of disaster usually go through 4 stages of emotional response.

Denial stage: Period when victims deny the magnitude of the problem or more likely may understand the problems but seems unaffected emotionally.
Strong Emotional Response: It is a stage when the person is aware but regards it as overwhelming and unbearable. Common reaction during this stage is fighting of feel, weeping, speaking with difficulty, trembling, and sadness. It is a period of counselling and reassurance.
Acceptance stage: It is the time when victims begin to accept either being handicapped with one leg.” I accept disaster, I try to make a decision for what to do next and develop hope.” The role of a Health worker is to help victim develop decision making, and take specific action.
Recovery stage: It is a stage of recovery from crisis reaction. Victims feel that they are back to normal and routines become important again and sense of wellbeing is restored.
Ability to make decision and carry out plans, returns victims, develops realistic memory.
The role of a nurse is to resettle the victims and discuss issues of empowerment if facilities are accessed.