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INTRODUCTION
Calamitous, distressing, or ruinous effects of a disastrous event (such as drought, flood, fire, hurricane,
war) of such scale that they disrupt (or threaten to disrupt) critical functions of an organization, society
or system, for a period long enough to significantly harm it or cause its failure. It is the consequences
of a disastrous event and the inability of its victims to cope with them that constitute a disaster, not
the event itself. Although there is no universally accepted definition of a disaster, the following
observation by the US disaster relief specialist Frederick C. Cuny (1944-1995) comes close, "A
situation resulting from an environmental phenomenon or armed conflict that produced stress,
personal injury, physical damage, and economic disruption of great magnitude." The definition
adopted by the World Health Organization (WHO) terms a disaster as "The result of a vast
ecological breakdown in the relations between man and his environment, a serious and sudden (or
slow, as in drought) disruption on such a scale that the stricken community needs extraordinary efforts
to cope with it, often with outside help or international aid." The US Federal Emergency Management
Agency (FEMA) describes it as "An occurrence of a natural catastrophe, technological accident, or
human caused event that has resulted in severe property damage, deaths, and/or multiple injuries."
Dr. Kathleen J. Tierney (Director, Disaster Research Center, University of Delaware) puts the matter
in a different perspective: "Many people trying to do quickly what they do not ordinarily do, in an
environment with which they are not familiar."
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The magnitude of the effects of the event will be viewed differently.
Although experts may differ in their definitions of disaster, many public health
practitioners would characterize a disaster as a "sudden, extraordinary
calamity or catastrophe, which affects or threatens health".
DISASTERS INCLUDE
FIRES
EARTHQUAKES
SEVERE AIR POLLUTION (SMOG)
HEAT WAVES
EPIDEMICS
BUILDING COLLAPSE
TOXICOLOGICAL ACCIDENTS, (E.G. RELEASE OF HAZARDOUS SUBSTANCES)
NUCLEAR ACCIDENTS
EXPLOSIONS
CIVIL DISTURBANCES
WATER CONTAMINATION
FOOD SHORTAGES
TORNADOES/HURRICANES/FLOODS/SEA SURGES/TSUNAMIS
SNOW STORMS/LANDSLIDES
Deaths
Severe injuries, requiring extensive treatments
Increased risk of communicable diseases
Damage to the health facilities
Damage to the water systems; Food shortage
Population displacements
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Social reactions
Communicable diseases
Climatic exposure
Mental health
Damage to health infrastructure
DISASTER RESPONSE
OBJECTIVES
1. Injuries,
2. Emotional stress,
3. Epidemics of diseases,
Each of these stages may vary in extent and duration depending on other
factors.
EPIDEMICS are included in the definition of disaster; however, they can also
be the result of other disaster situations.
Diseases spread by the respiratory route (e.g., measles & influenza, Swine
flu H1N1).
Ideally, attempts to mitigate the results of a disaster would not add to the
negative consequences;
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However, there have been many instances in which inappropriate and/or
incomplete management actions taken after a disaster contributed to unnecessary
morbidity, mortality, and a waste of resources.
Many of the Causalities and much more of the Destruction occurring to natural
disaster are due to ignorance and neglect on the part of the individuals and
public authorities.
Physicians and nurses have been sent into disaster areas in numbers far in excess
of actual need.
Medical and paramedical personnel have often been hampered by the lack of the
specific supplies they need to apply their skills to the disaster situation.
In some disasters, available supplies have not been inventoried until well after the
disaster, resulting in the importation of material which is used or needed.
DISASTER RELIEF
An effective plan for public health and other personnel during a disaster would
outline activities designed to minimize the effects of the catastrophe.
The Petroleum Depot Fire has not been identified by any of the Districts in Rajasthan in their
Disaster Management Plan.
The lack of Fire Fighting Resources with Indian Oil, Hindustan Petroleum, Bharat Petroleum,
Airport Authority, Nagar Nigam and JDA were noticeable. As per Mr. Gopal Prasad Gupta,
President, Rajasthan Builders & Promoters Association, they have contributed over Rs. 15 Crore
to the kitty of Nagar Nigam towards fire safety of Multi Storied Buildings; however, the funds
are misappropriated towards salary and allowances of the staffs.
Indian Oil Corporation Limited failed to use the fire fighting resources.
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Although many relief workers may be needed to obtain surveillance
information, analyze the data, provide relief services, evaluate results, and
provide information to the public , it is essential that a single person
with managerial experience be placed in absolute charge of the entire
disaster relief operation.
Following a disaster, the desire to provide immediate relief may lead to hasty
decisions which are not based on the actual needs of the affected population.
The disaster relief managers can determine the actual needs of the population
and make responsible relief decisions. Reliable information must be obtained
on problems occurring in the disaster stricken area, relief resources available
and relief activities already in progress. For this, a surveillance system must
be set up immediately.
The specific information required would vary from disaster to disaster, but a
basic, three -step processes includes:
1) Collect data,
2) Analyze data,
3) Respond to data.
Who is affected?
There was no regular bulletin disseminating information on disaster on any of the local TV
channels.
As all kinds of disasters require immediate rescue and Medical Relief, thus Vice-Chancellor
Rajasthan University of Health Sciences, Jaipur should be in-charge of Disaster Relief
Management. All major Hospitals should be nodal centre for Disaster Relief Management.
The CGM BSNL and MOBILE SERVICE PROVIDERS must be part of Disaster Relief
Management team to establish communication facilities or help lines, if required.
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What problems will subside on their own?
After answering such questions one can carry out the third part, i.e., planning
an appropriate Response to the situation described in the
surveillance data. In developing this plan one will decide what types of relief
responses are appropriate and what the relative priorities are among the relief
activities.
1. Immediate Assessment
3. Ongoing Surveillance
IMMEDIATE ASSESSMENT
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survey may be useful in defining the geographical extent of the disaster-
stricken area and in observing major damage and destruction. Census
data can be examined to determine how many people previously lived in the
disaster-stricken area and thus were at risk.
SHORT-TERM ASSESSMENT
One of the most atrocious ‘Disaster Management Decision’ taken by the district
administration was to close down all Petrol Pumps in five kilometer area without making
alternative arrangement for supply of Diesel to the Hospitals which were running on DG sets in
the absence of electricity supply.
The Public Health Engineering Department must have a ‘Disaster Management Plan’. One
of the actions could be to have under ground/above ground storage tanks in addition to
overhead tanks. There must be parallel arrangement for supplying water directly from tube well
into the domestic water supply line.
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KOTA, RAWAT BHATA must have disaster management plan to deal with such situations.
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The number of persons known to be dead. The estimated number of
persons severely injured requiring medical care, possibly according to age
group, sex, and type of injury or medical problem. Location and condition
of health facilities, estimates of medical personnel, equipment's and
supplies available.
Condition of schools, churches, temples and other public buildings etc. and
also condition of roads, bridges, communication facilities and public
utilities.
ONGOING SURVEILLANCE
Rescue of victims
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Either we should do away with naming the streets with names of persons living or dead, or
alternatively should have a parallel system of streets and avenues so that even a first timer to
the city in a rescue team can find his way.
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The assessment should be immediately put in public domain to (a) avoid panic and (b)
sourcing help like rare blood group donors and services of specialists.
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MASS CASUALTY MANAGEMENT
First Aid
Field Care
Triage13
Tagging
DISASTER PREPAREDNESS14
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Triage (pronounced /’triɑʒ/) is a process of prioritizing patients based on the severity of their
condition. This rations patient treatment efficiently when resources are insufficient for all to be
treated immediately. The term comes from the French verb trier, meaning to separate, sort, sift
or select. There are two types of triage: simple and advanced. The outcome may result in
determining the order and priority of emergency treatment, the order and priority of
emergency transport, or the transport destination for the patient, based upon the special needs
of the patient or the balancing of patient distribution in a mass-casualty setting.
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The Disaster Management Act, 2005 envisages that every State Government, in turn, is
to establish a District Disaster Management Authority for every district in the State with the
District Collector as the Chairperson and such number of other members, not exceeding seven.
The District Authority is to act as the district planning, coordinating and implementing body for
disaster management and take all measures for the purposes of disaster management in the
district in accordance with the guidelines laid down by the National Authority and the State
Authority. However, the information on JAIPUR District Disaster Management Authority is
missing from the state website. http://www.rajrelief.nic.in/ddmplan/ddmp.htm
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Disaster preparedness is an ongoing, multi-sectoral activity to carry
out the following activities;
Adopt measures to ensure that financial and other resources are available for
increased readiness and can be mobilized in disaster situations.
Govt. Agencies
EMERGENCY PREPAREDNESS
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SHOCKINGLY FIRE FROM AN OIL DEPOT WAS NOT IDENTIFIED AS POTENTIAL DISASTER.
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3. Chemical Emergencies: Ricin16, Phosgene17, Bromine18, Sarin19;
4. Radioactive Emergencies:
6. Recent Outbreaks and Incidents: Bird flu, SARS, West Nile Virus, Mad Cow
Disease, H1N1 Virus;
DISASTER MITIGATION
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Ricin (pronounced /’raɪ sɨn/) is a protein that is extracted from the castor bean (Ricinus
communis). It can be either a white powder or a liquid in crystalline form. Ricin may cause
allergic reactions, and is toxic, though the severity depends on the route of exposure. The U.S.
Centers for Disease Control (CDC) gives a possible minimum figure of 500 micrograms
(about half a grain of sand) for the lethal dose of Ricin in humans if exposure is from
injection or inhalation.
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Phosgene is the chemical compound with the formula COCl2. This colorless gas gained infamy
as a chemical weapon during World War I, and is also a valued industrial reagent and building
block inorganic synthesis. In low concentrations, its odor resembles freshly cut hay or grass.
Some soldiers during the First World War stated that it smelled faintly of May Blossom. In
addition to its industrial production, small amounts occur naturally from the breakdown of
chlorinated compounds and the combustion of chlorine-containing organic compounds.
from Greek: βρῶμος, brómos, meaning "stench (of he-goats)"), is a chemical element with the
symbol Brand atomic number 35. A halogen element, bromine is a reddish-brown volatile liquid
at standard room temperature that is intermediate in reactivity between chlorine and iodine.
Bromine vapors are corrosive and toxic. Approximately 556,000 metric tonnes were produced in
2007. The main applications for bromine are in fire retardants and fine chemicals.
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Sarin, also known by its NATO designation of GB, is an extremely toxic substance whose sole
application is as a nerve agent. As a chemical weapon, it is classified as a weapon of mass
destruction by the United Nations in UN Resolution 687. Production and stockpiling of Sarin was
outlawed by the Chemical Weapons Convention of 1993.
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A SPECIALISED UNIT WITHIN THE NATIONAL HEALTH DISASTER
MANAGEMENT PROGRAM SHOULD COORDINATE THE WORKS OF
EXPERTS IN THE FIELD OF:
Public Policy
Water Systems
Civil Defense
Armed Forces
Fire Fighting
5. Inform, sensitize and train21 those personnel’s who are involved in planning,
administration, operation, maintenance and use of facilities about disaster
mitigation. Promote the inclusion of Disaster Mitigation in the curricula of
Professional training institutes, such as MNIT, SMS Medical College, and Nursing
Colleges.
Treatment of injured
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All hospitals must necessarily b equipped with Diesel Generating sets and keep stock of diesel
for minimum seven days.
21
HCM (RIPA) should not only train Government Servants but also citizens about disaster
mitigation
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Epidemiological surveillance and disease control
Population density
Population displacement
Implement as soon as possible all public health measures to reduce the risk of
disease transmission.
Investigate all reports of disease outbreaks rapidly. Early clarification of the situation
may prevent unnecessary dispersion of scarce resources and disruption of normal
progress.
Post disaster environmental health measures can be divided into two priorities
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Looking at important role of health services in post disaster management, all Government
Hospitals and Dispensaries should be the nodal point for Disaster Management Activities.
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1. Ensuring that there are adequate amounts of safe drinking water, basic sanitation
facilities, disposal of excreta, waste water and solid wastes and adequate shelter.
Water Supply
Food Safety
Vector Control
EVALUATION
A critical step in the management of any disaster relief is the setting of objectives,
which specify the intended outcome of the relief.
The comparison of the "actual" with "desired" is the first critical step of
evaluation. If the objectives were met, those who have participated in the
relief have demonstrated that they have accomplished what they set out to
do.
On the other hand, if the objectives were not met, it is desirable for those
conducting the evaluation to continue with the evaluation process, identify the
reasons for the discrepancy and suggest corrective action.
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EVALUATION OF THE HEALTH DISASTER MANAGEMENT PROGRAM
PREVENTION OF DISASTERS
Early warning systems and Disaster preparedness which will help to minimize morbidity,
mortality and economic loss.
CONCLUSION
IMMEDIATE ASSESSMENT,
SHORT-TERM ASSESSMENT
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Despite experiencing Disaster in 1981 floods and periodic noises by people, media, courts;
the civil administration controlled by land mafia has allowed construction of houses and Multi
Storied flats in Amani Shah Nala.
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ONGOING ASSESSMENT,
Through study of the past disasters, their effects and their relief efforts [what
has been effective and what have been mismanaged] better plans are now
available for effective disaster management as well as for the reduction of
preventable losses.
The country will have to pay more attention towards creating public awareness
and preparedness in respect of people living in known disaster prone areas.
Any Disaster is an emergency situation and the health sector alone cannot
tackle it in isolation.
It must have Coordination with the local community, civil defense, army, police,
FIRE BRIGADE and with various governmental and non-governmental bodies
including voluntary organizations like Red Cross.
RECOMMENDATIONS: to be added.
References:
2. Wikipedia
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