Disaster Preparedness & Mitigation in Health System

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Disaster Preparedness Mitigationin Health
System
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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

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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)

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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.

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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.

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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

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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)

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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.

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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

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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

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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

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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.

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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.

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Objectives

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

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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

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Vulnerability reduction
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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

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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.

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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

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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.

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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

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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

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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 costfailure of
  systems

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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).

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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

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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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Thank you