Disaster: Perspectives

Source: EK Noji, The Public Health Consequences of Disaster

 Emergency and Disaster
Incidence 2004-2008
Number of Disaster Incidence from 2004 to 2008
Emergenc
y& Number of Number of
Disaster Provinces Districts
No Year Incidence Affected Affected Death Injured IDP Missing

1 2004 37 18 81 129,103 173,452 570,185

2 2005 45 21 40 96,985 12,591 80,611 407

2,485,95
3 2006 162 27 101 7,679 291,110 3 712

4 2007 205 28 156 642 355,336 870,708 507

5 2008 359 30 162 299 75,457 288,323 82

3,725,59
Total 771 124 540 105,605 734,494 5 1,708
 Emergency & Disaster Incidence During 2008
CASUALTIES
NO TYPE OF DISASTER FREQUENCY MAJOR INJURY / MINOR INJURY/
DEATH MISSING IDP
INPATIENT OUTPATIENT

1 Flood 190 60 130 42,633 9 302,932

2 Tornado 65 13 21 173 0 570
3 Strong Wind 14 3 9 13 0 0
4 Landslide 83 104 27 405 3 4,864
5 Disease Outbreak 36 58 1,892 2,225 0 0
6 Flash Flood 18 40 406 25,992 8 22,875
7 Flash Flood and Landslide 3 6 2 2 1 500
8 Tide Wave 10 5 1 5 0 274
9 Earthquake 11 14 51 779 0 10,747
10 Industrial Accident 5 6 10 207 0 0
11 Flood with Landslide 10 12 11 809 0 2,390
12 Failure of Technology 1 3 9 44 0 0
13 Bomb Blast 1 2 1 0 0 0
14 Volcano Eruption 4 0 0 0 0 0
15 Social Conflict 4 1 12 3 0 3,000
16 Thunder 2 7 1 4 0 0
Total 457 334 2,583 73,294 21 348,152
 Hazards

Earthquake & Tsunami

Floods
Earthquake Volcanoes Eruption

Flash floods & Landslides

Bomb Blast

Conflict – Social unrest

Transportation Accident Cyclone

Infectious Diseases

Black Outs
Industrial Accident
 Disaster: Perspectives
“A disaster is a result of a vast ecological
breakdown in the relation between humans
and their environment, a serious or sudden
event on such a scale that the stricken
community needs extraordinary efforts to
cope with it, often with outside help or
international aid”

Source: EK Noji, The Public Health Consequences of Disaster

 Disaster: Perspectives

Public Health View

“Disasters are defined
by what they do to people...”

Source: EK Noji, The Public Health Consequences of Disaster

 Disaster: Perspectives

Major Categories of Disasters

-Natural Disasters
-Human-generated Disasters

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

 Disaster: Perspectives

Natural Disasters
-Arise from forces of nature
-Two subcategories:
 Sudden impact or acute onset
 Slow or chronic onset
Sources: CDC & EK Noji, The Public Health Consequences of
Disaster
 Disaster: Perspectives
Sudden Impact or Acute Onset Disasters
Geological or climatic hazards
Hurricanes/typhoons Tornadoes
Earthquakes Volcanoes
Floods Tsunamis
Temperature extremes Wildfires
Landslides Avalanches
Epidemics
Food, water, vector-borne diseases
Person-to-person transmission diseases
Sources: CDC & EK Noji, The Public Health Consequences of Disaster
 Disaster: Perspectives

Slow or Chronic Onset Disasters

Drought
Famine
Environmental degradation
Chronic exposure to toxic substances
Desertification
Deforestation
Pest infestation
Sources: CDC & EK Noji, The Public Health Consequences of Disaster
Disaster: Perspectives
Disaster: Perspectives
Disaster: Perspectives
Disaster: Perspectives
 Disaster: Perspectives

2002 DEEP Center Classification

-Natural disasters
-Non-intentional human-generated disasters
-Terrorist-perpetrated disasters
-Complex disasters
-Natural-technological disasters (NA-TECHS)
 Disaster: Perspectives

Human-Generated Disasters
Industrial/technological
Transportation (vehicular)
Deforestation
Material shortages
Complex emergencies

Source: EK Noji, The Public Health Consequences of Disaster

 Disaster: Perspectives

Complex Emergencies
-Wars and civil strife
-Armed aggression
-Insurgency
-Other actions resulting in displaced
persons and refugees

Source: EK Noji, The Public Health Consequences of Disaster

 Disaster: Perspectives

Terrorist-perpetrated Disasters
-Biological
-Nuclear
-Incendiary
-Chemical
-Explosive
The Disaster Cycle
Disaster Cycle
Sudden impact natural disasters
can be considered as a continuous time sequence
of five phases:
Inter-disaster
Pre-disaster
Impact
Emergency
Reconstruction
Source: EK Noji, Sivertson KT. Injury prevention in natural
disasters: a theoretical framework. Disasters
1987;11:290-296.
 Disaster Cycle
Interdisaster Phase
Planning disaster
prevention/preparedness/mitigation
Identifying risks
Identifying vulnerabilities
Creating a resource inventory
Conducting professional training
Conducting community education

Synonym: Non-disaster Phase

 Disaster Cycle
Pre-disaster Phase
Issuing timely warnings
Implementing protective actions
Undertaking emergency management
activities
Evacuating population as necessary

Synonym: Warning Phase

 Disaster Cycle

Impact Phase
Destruction
Injuries
Deaths
may occur during impact
Disaster Cycle
Emergency Phase
Implementing life-saving actions
-search and rescue
-first aid
-emergency medical assistance
Restoring emergency communications
Restoring emergency transportation
Implementing public health surveillance
Evacuating vulnerable areas

Synonyms: Relief Phase, Isolation Phase

Disaster Cycle

Emergency Phase
Note: The immediate post-impact period is
the isolation phase where most urgent
rescue tasks are accomplished by the
survivors using local resources

Synonyms: Relief Phase, Isolation Phase

 Disaster Cycle

Reconstruction Phase
Restoring pre-disaster conditions
Reestablishing health services
Reconstructing & repairing damaged facilities
Reflecting and debriefing on lessons learned

Synonym: Rehabilitation Phase

Disaster Severity
Disaster Severity

A Decade of Natural Disasters

1 million thunderstorms
100,000 floods
Tens of thousands of landslides,
earthquakes, wildfires & tornadoes
Several thousand hurricanes, tropical
cyclones, tsunamis & volcanoes
Sources: CDC & EK Noji, The Public Health Consequences
of Disaster
 Disaster Severity

A Decade of Natural Disasters (1980s)

Floods 39,000 deaths
Tropical cyclones 14,000 deaths
Hurricanes 1,000 deaths
Earthquakes 54,000 deaths
Other disasters 1,012,000 deaths
TOTAL 1,120,000 deaths

Sources: CDC & EK Noji, The Public Health Consequences

of Disaster
 Disaster Severity

Factors Contributing to Disaster Severity

-Human vulnerability due to poverty &
social inequality
-Environmental degradation
-Rapid population growth especially among
the poor

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

 Disaster Severity

Influence of Poverty
Persons in poverty:
-Live in poor housing unable to withstand seismic activity
-Live in poor housing susceptible to landslides
-Inhabit coastal areas and flood plains vulnerable to
hurricanes, storm surges, flooding, and tidal waves
-Live near hazardous industrial sites
-Do not receive education on life-saving actions during
disasters
-Do not receive warning of impending disasters
Sources: CDC & EK Noji, The Public Health Consequences of Disaster
 Disaster Severity

Influence of Poverty
-Low-income countries:
3,000 deaths per disaster
-High-income countries:
500 deaths per disaster

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

 Disaster Severity

Influence of Population Growth

- Urban dwellers:
1920: 100 million
1980: 1 billion
2000: 2 billion

- 2000: 20 cities with >10 million people

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

 Disaster Severity

Capabilities of Developed Nations

That Mitigate Disaster Effects
-Ability to forecast severe storms
-Ability to enforce strict building codes
-Ability to use communication networks to
broadcast alerts and warnings
-Ability to provide emergency medical
services
-Ability to engage in contingency planning
Sources: CDC & EK Noji, The Public Health Consequences of Disaster
 Disasters:
The Public Health Impact
Disasters: The Public Health Impact

Mortality & Morbidity

Disasters cause deaths, injuries, and
illnesses
Disasters may overwhelm medical
resources and health services

Sources: CDC & EK Noji, The Public Health Consequences of

Disaster
Disasters: The Public Health Impact

Health Care Infrastructure

Disasters may destroy hospitals
Disasters may disrupt routine health services
Disasters may disrupt preventive activities
Consequence: long-term increases in morbidity
and mortality
Sources: CDC & EK Noji, The Public Health Consequences of
Disaster
 Disasters: The Public Health Impact

Environment & Population

Disasters may increase potential for
communicable diseases
Disasters may exacerbate environmental
hazards
Consequences: increases in morbidity and
premature death, decreased quality of life
Sources: CDC & EK Noji, The Public Health Consequences of
Disaster
 Disasters: The Public Health Impact
Psychological and Social Behavior
Disasters may cause generalized panic or
paralyzing trauma
Disasters may provoke increases in anxiety,
depression and neuroses
Disasters may lead to post-traumatic stress
disorder (PTSD) at epidemic levels

Sources: CDC & EK Noji, The Public Health Consequences of

Disaster
 Disasters: The Public Health Impact

Food Supply
Disasters may disrupt the food supply
Disasters leading to food shortages may
cause specific micronutrient deficiencies
Disasters may provoke severe nutritional
consequences including famine and
starvation
Sources: CDC & EK Noji, The Public Health Consequences
of Disaster
 Disasters: The Public Health Impact
Population Displacement
Disasters may cause large spontaneous or organized
population movements
Population movement may increase morbidity and
mortality
Population movement may precipitate epidemics of
communicable diseases in both displaced and host
communities
Crowding of populations and overlay of refugee and
host populations may lead to injuries and violence

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

Kondisi Indonesia

 Geografis Indonesia rawan bencana

– Bencana alam (Natural Disaster)
– Karena ulah manusia (Man-Made Disaster)
– Kedaruratan Kompleks (Complex Disaster)
 Selalu akibatkan masalah kesehatan 
ujung tombak
Peta Lempeng Bumi di Indonesia
Kerawanan Gempa
Peta Tingkat Kerawanan Bencana
Tsunami di Indonesia
Peta Rawan Gempa Bumi
di Indonesia
Peta Daerah Gunung Api
di Indonesia
Gunung Berapi
129 gunung berapi aktif:
 Jawa ( 21 gunung )
 Sumatra ( 21 gunung api )
 Bali ( 2 gunung api )
 Nusa Tenggara ( 20 gunung api )
 Laut banda ( 9 gunung api )
 Sulawesi Utara ( 6 gunung api )
 Kepulauan Sangihe ( 5 gunung api )
 Halmahera ( 5 gunung api )
Peta Rawan Tanah Longsor
di Indonesia
Peta Rawan Banjir di Indonesia
Peta Rawan Konflik di Indonesia

NAD Kalbar, Kalteng Maluku, Malut, Poso

(Separatisme) (Suku) (Agama)

Papua
(Separatisme)

Jawa, Sulsel, NTB

(kepentingan politik, antar daerah)
Bencana & Korban Massal di Indonesia
1980 – 2004 :
1. Gunung Galunggung, 1980
2. Food Poisening Jakarta Barat, 1981
3. Kebakaran Tanjung Priok, 1981
4. Gas Tanjung Priok, 1982
5. Gempa Jawa Barat, 1983
6. Fire Hotel Jakarta, 1985
7. Bouraq Krawang, 1985
8. KLL Jalan Tol, 1985
9. Banjir RS Atmajaya, 1986
10. Evac RS Fatmawati Ledakan Mesiu), 1987
11. Kecelakaan Kereta Api Bintaro, 1987
12. Isolasi RS Koja (Huru-hara Tg Priok), 1987
13. Food Poisening Pabrik Jakarta, 1988
Bencana & Korban Massal di Indonesia
1980 – 2004 :
14. Gempa Flores, 1991
15. Riot Jakarta, 1992
16. Banjir Jakarta, 1991&1992
17. Tsunami Lombok, 1993
18. Gempa Liwa, 1993
19. Gn Merapi Jogya, 1995
20. Gempa Kerinci, 1995
21. Riot PDI-P Jakarta, 1996
22. Gempa& Tsunami Biak
23. Gempa Sulawesi Selatan, 1997
24. Riot Etnik Pontianak, 1997
25. Gempa Bengkulu, 1997
26. Riot Etnik Sampit, 2001
Bencana & Korban Massal di Indonesia
1980 – 2004 :
27. Pengungsi di Madura, Poso, NTB, NTT, Papua,
Jawa Barat, Jawa Tengah, Maluku, Maluku Utara,
Sulawesi Utara, 2001
28. Kekeringan di Sampang, 2001
29. Gunung Papandayan, 2002
30. Kecelakaan Kereta Api Brebes, 2002
31. Tnh Longsor Jawa Timur, 2002
32. Banjir Sumatera Utara, 2002
33. Banjir Sumatera Utara, 2002
34. Banjir Pekalongan & Semarang, 2002
35. Riot Agama Ambon, 1999 - 2002
36. Riot Agama Palu, 1999 - 2002
37. Riot Papua, 1999 - 2002
38. Bom Teroris (32x) & Riot Jakarta, 1998 - 2002
Bencana & Korban Massal di Indonesia
1980 – 2004 :
39. Banjir 3 Minggu Jakarta 2002
40. Nunukan Displaced Migrant Worker 2002
41. Bom Teroris Bali 2002
42. Bom Teroris Htl Marriott Jkt 2003
43. Ledakan Pabrik Kimia Gresik 2004
44. Gempa Karang Asem Bali 2004
45. Gempa Nabire 2x 2004
46. Gempa Aceh 2004
47. Gempa Palu 2005
48. Kelaparan NTT 2005
49. Sampah Longsor Bandung 2005
50. Gempa Nias 2005
Bencana Alam & Manusia
Bencana & Korban Massal di Indonesia
1980 – 2004 :
Masyarakat panik
Terganggunya pelayanan umum bagi warga
Kerusakan sarana dan prasarana
Kegiatan sosial terganggu
Kegiatan sehari-hari lumpuh
Kerusakan kehidupan
Kegiatan ekonomi Lumpuh
Pengungsian penduduk.
Cedera tubuh
Angka kesakitan >
Kematian >
Efek Psikologis  Post Trauma Stress
“Bencana Bisa Terjadi Kapan
Saja, di mana Saja, dan Bisa
Menimpa Siapa Saja.”