Common disasters and disaster management

GUIDED BY:

DR. RAJEEV YADAV,

ASSISTANT PROFESSOR,

P.S.M. DEPARTMENT.

BY:

DR. PRIYANKA KAPOOR,

RESIDENT,DEPT. OF PSM,

SMS MEDICAL COLLEGE.

INTRODUCTION

DISASTER:  It is defined as any occurrence that

causes damage, ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area. (WHO)

Hazard Any phenomenon that has the potential to

cause disruption or damage to people and their environment.

When hazard involves elements of risks, vulnerabilities and capacities, they can turn into disasters.

Hazards may be inevitable but disasters can be prevented. 

“A hazard is natural event while the disaster is its consequence. A hazard is perceived natural event which threatens both life and property…… A disaster is a realization of this hazard.” -John Whitlow

CLASSIFICATION OF DISASTERS

DISASTERS

NATURAL DISASTERS

MAN-MADE DISASTERS

DISASTERS

Natural Disasters

BENEATH EARTHS SURFACE(TECTO

NIC)

• a) earthquake• b) tsunamis• c) volcanic

eruptions

AT EARTHS SURFACE

(TOPOLOGICAL)

• a) landslides• b) avalanches

ABOVE EARTHS SURFACE

• a) meteorological (hydrological)

• b) biological

ABOVE EARTH’S SURFACE:

METEOROLOGICAL BIOLOGICAL

WINDSTORMS :

> cyclone

>Typhoon

> Hurricane TORNADOES HAILSTORMS

(SNOWSTORMS) SEA-SURGES FLOODS DROUGHTS

EPIDEMICS OF DISEASES

LOCUST SWARMS ( group of insects or bees)

Man made Disasters

BY WARFARE

•CONVENTIONAL•NUCLEAR•BIOLOGICAL•CHEMICAL

BY ACCIDENTS•Vehicular•drowning•Collapse of building•Explosions•Fires•Biological•Chemical including poisons

NATURAL DISASTERS

TYPES OF NATURAL DISASTERS

Avalanches:

It is a mass of snow which is set in motion by its own weight through a violent disturbance in equilibrium.

Earthquakes

An earthquake is the result of a sudden release of energy in the Earth's crust (7 major plates) that creates seismic waves. It manifests by vibration, shaking and sometimes displacement of the ground.

The underground point of origin of the earthquake is called the focus. The point directly above the focus on the surface is called the epicenter. Earthquakes by themselves rarely kill people or wildlife. It is usually the secondary events that they trigger, such as building collapse, fires, tsunamis (seismic sea waves) and volcanoes, that are actually the human disaster.

UNDP has selected ALWER and BIKANER ( seismic zone) for DRR( disaster risk reduction) project. http://www.ndma.gov.in/en/hazard-risk-response.html

Volcanic eruptions

Volcanic eruption itself may cause harm following the explosion of the volcano or the fall of rock.

Second, lava may be produced which destroys many buildings and plants it encounters.

Third, volcanic ash generally meaning the cooled ash - may form a cloud, and settle thickly in nearby locations. When mixed with water this forms a concrete-like material. In sufficient quantity ash may cause roofs to collapse under its weight but even small quantities will harm humans if inhaled.

Floods

o A flood is an overflow of an expanse of water that submerges land. 

o It may result from the volume of water within a body of water, such as a river or lake, which overflows or breaks levels, with the result that some of the water escapes its usual boundaries.

o Reasons includes a steep increase in population, rapid urbanization growing developmental and economic activities in flood plains coupled with global warming, inadequate carrying capacity of rivers, drainage congestion and erosion of river-banks. Cyclones, cyclonic circulations and cloud bursts also

cause flash floods 

Droughts

If a particular area has no rainfall or less rain than normal for a long period of time is called drought.

it is not only lack of rainfall that causes drought, hot dry winds, very high temperature and evaporation of moisture from the ground can result in conditions of drought.

Tsunamis

Tsunamis are caused by undersea earthquakes. Tsunamis generally consist of a series of waves with periods ranging from minutes to hours, arriving in a so-called "wave train".

Wave heights of tens of metres can be generated by large events.

The 2004 Indian Ocean tsunami was among the deadliest natural disasters in human history with over 2,79,000 people affected in 14 countries bordering the Indian Ocean, 10,749 deaths , 5,640 persons missing , 11,827 hectares of crops damaged , 300,000 fisher folk lost their livelihood. http://www.ndma.gov.in/en/hazard-risk-response.html

Tornadoes

A tornado is a violent, dangerous, rotating column of air that is in contact with both the surface of the earth and a cumulonimbus cloud or, in rare cases, the base of a cumulus cloud.

They are often referred to as a twister or a cyclone, although the word cyclone is used to name any closed low pressure circulation.

Tornadoes come in the form of a visible condensation funnel, whose narrow end touches the earth and is often encircled by a cloud of debris and dust.

cyclones

Cyclones are caused by atmospheric disturbances around a low-pressure area distinguished by swift and often destructive air circulation. Cyclones are usually accompanied by violent storms and bad weather.

Cyclones are given many names in different regions of the world – They are known as

Typhoons in the China Sea and Pacific Ocean; Hurricanes in the West Indian islands in the Caribbean

Sea and Atlantic Ocean; Tornadoes in the Guinea lands of West Africa and

southern USA.; Willy -willies in north-western Australia and tropical

cyclones in the Indian Ocean. 

MAN-MADE DISASTERS"anthropogenic/ man made disasters" means threats having an element of human intent, negligence, or error; or involving a failure of a man-made system. Airplane crashes and terrorist attacks are examples of man-made disasters: they cause pollution, kill people, and damage property.

Mumbai, Floods July 2005

Mumbai Terrorist Attacks

(26/2011)

Flood, Assam & Bihar 2004

MAJOR DISASTERS IN INDIA (1982-2013)

June 2013,  Uttrakhand  Heavy Rainfall & Floods

Earthquake, Bhuj Jan 2001

Earthquake, Latur Sept 1993

Tsunami Dec 2004

Bhopal Gas Disaster, Dec 1984

Earthquake, Oct 2005, cloud burst 2010, flood 2014

Kosi Floods, Aug, 2008

Cyclone Aila, West Bengal, 2009

Avalanche Feb 2005

Odisha super cyclone, 1999,PHAILIN Cyclone 2013

SIKKIM EARTHQUAKE,2011

VULNERABILITY PROFILE OF INDIA (2013)

More than 58.6 per cent of the landmass is prone to earthquakes .

over 40 million hectares (12%) of its land is prone to floods and river erosion.

close to 5,700 kms, out of the 7,516 kms long coastline is prone to cyclones and tsunamis.

 68% of its cultivable area is vulnerable to droughts.

Hilly areas are at risk from landslides and avalanches.  http://www.ndma.gov.in/en/vulnerability-profile.html

Last Updated on Thursday, 26 September 2013 16:55

DISASTER MANAGEMENT

“AN APPLIED SCIENCE WHICH SEEKS, BY THE SYSTEMATIC OBSERVATION AND

ANALYSIS OF DISASTERS, TO IMPROVE MEASURES RELATING TO

PREVENTION, PREPAREDNESS , RESPONSE AND RECOVERY.”

PHASES OF DISASTER MANAGEMENT

Disaster Preparedness

Disaster Impact

Disaster Response

Disaster Recovery

Disaster Mitigation

Integrated

Disaster

Management

Prepared-ness

Response

Recovery

Mitigation

Activities prior to a disaster.• Preparedness plans• Emergency exercises• Training,• Warning systems

Activities that reduce effects of disasters• Building codes & zoning• Vulnerability analyses• Public education

Activities following a disaster.• Temporary housing• Claims processing• Grants• Medical care

Activities during a disaster.• Public warning systems• Emergency operations• Search & rescue

Disaster preparedness

Preparedness should be in the form of

money, manpower and materials

Evaluation from past experiences about risk

Location of disaster prone areas

Organization of communication, information

and warning system

Ensuring co-ordination and response

mechanisms

Contd...

Development of public education

programme

Co-ordination with media

National & international relations

Keeping stock of foods, drug and

other essential commodities.

E.g.: Indian Meteorological department (IMD) plays a key role in forewarning the disaster of cyclone-storms by detection tracing. It has 5 centres in Kolkata, Bhubaneswar, Vishakhapatnam, Chennai & Mumbai. In addition there are 31 special observation posts setup along the east coast of India.

The International Agencies which provides humanitarian assistance to the disaster strike areas are United Nation agencies.

Office for the co-ordination of Humanitarian Affair (OCHA)

World Health Organization (WHO)

UNICEF

World Food Programme (WFP)

Food & Agricultural Organisation (FAD)

E.g.: Non Governmental Organizations

Co-Operative for assistance and Relief Every where (CARE)

International committee of Red cross

Disaster impact

Search, rescue and first aid

Field care

Triage

Tagging Identification

of dead

RESPONSE Taken immediately prior to and following

disaster impact.

Typical measures include : Implementation of plans Mass evacuation Search and Rescue Provision of emergency food, shelter, medical

assistance etc. Maintenance of law and order Survey and assessment

Policies related to emergency/disaster management

1. “First come, first treated” principle will not be followed during emergencies.

2. Triage protocol3. ABCDE care is provided

Airway Breathing Circulation Disability limitation Exposure / environmental control

Aim of Triage

To achieve the greatest good for the greatest number of casualties

Basis of Triage ( in Mass Casualty Incident)

Severity of injury Number of injured Available resources and Survival chances of the

victims

Procedures of Triage

TRIAGE FIRST BEFORE TREATMENT!

Do not take more than 60 seconds per patients

Determine best facility for definitive care in the emergency department and the field

The triage categories include a) Emergent b) Urgentc) Non-urgent

Emergent Category

Major trauma Acute myocardial

infarction Airway obstruction Tension pneumothorax Flail Chest Hypovolemic shock

(Class III and IV) Burns with inhalation

injurymanagement should begin upon

arrival

Urgent

Vertebral and Spine Injury Femoral shaft fracture Closed head injury Burns Acute Appendicitis

They all are at risk if not treated in a few hours

Non-urgent

Skin lacerations Contusions Abrasions Upper extremity fractures Fever Associated medical conditions

Triage Protocol/System

Red: High priority for treatment & transfer

Yellow: Medium Priority

Green: Ambulatory patients

Black: Dead or Moribund patients

THE GOLDEN HOUR

Amount of time from injury to the definitive care.

Care given within the first hour, mortality and morbidity is favorably reduced

Aims to correct the main threats to life:

Blocked airways

Severe bleeding

START

Procedures of START (time <60 seconds / patient)

Respiratory assess for RR and adequacy not breathing – check for foreign body

obstruction; remove loose dentures; reposition head with C-spine precautions

Does not initiate respiratory effort – BLACK RR > 30/min – RED RR< 30/min – do not tag; assess perfusion: pulse or capillary refill

Procedures of START

Perfusion assess capillary refill (> or < 2 secs) >2 secs – RED <2 secs – do not tag yet; assess mental

status If capillary refill cannot be assessed

radial pulse not palpable SBP < 80mmHg Control hemorrhage – using walking

patients or self

Procedures of START

Mental Status simple commands:

“open and close your eyes” “squeeze my hands”

cannot follow – RED can follow -- YELLOW

Hospital Roles in a Disaster Duty chart well displayed on notice board. Unit head should take round in casualty to

evaluate casualty ward, Information to all resident doctors and senior

docs of concerned deptt timely whenever a information of mass casualty.

Keeping all medicines & equipments ready to deal the mass casualty before it reaches.

Evacuation of crowd that can be hindrance in proper treatment.

Follow triage and apply tag on patients according to seriousness.

Disaster Management Team Medical Superintendent Additional Medical Superintendent Nursing superintendent Chief medical officer (Casualty) HOD’d of all the dept.s Blood bank incharge Security officers Dietician Transport officer Sanitary personnel

EQUIPMENTS:

Resuscitation equipment IV sets and IV fluids Disposable needles, syringes & gloves Dressing & suturing materials and splints Oxygen delivery devices Suction catheter and machine ECG monitors, defibrillators and ventilators Cut down sets, tracheostomy sets and

lumbar puncture sets Linens and blankets

Overcrowding

The less equipped hospitals are especially vulnerable because of the high risk of overcrowding even before a disaster occurs.

During the influx of pts to a hospital, or situation, temporary pt care areas may have to be established. Lobby areas and corridors, Chapels and other prayer areas have been used.

RECOVERY Communities and the nation are assisted in

returning to their proper/normal level of functioning following a disaster.

It includes: Water supply Food safety Basic sanitation and personal hygiene Vector control Animal control Communicable disease control

MITIGATION It is the effort to reduce loss of life and property by lessening

the impact of disasters. Mitigation is taking action now —before the next disaster. To reduce human and financial consequences later (analyzing

risk, reducing risk, ensuring against risk).

Eg. improving structural qualities of schools, houses and such

other buildings so that medical causalities can be minimized.

Similarly ensuring the safety of health facilities and public

health services including water supply and sewerage system

to reduce the cost of rehabilitation and reconstruction.

DISASTER-EFFECTS

Deaths

Disability

Increase in communicable

disease

Psychological problems

Food shortage

Socioeconomic losses

Shortage of drugs and medical

supplies.

Environmental disruption

Institutional Framework

Disaster Management Structure According to disaster management act 2005, NDMA is Apex body with Prime Minister as Chairperson.

National Executive Committee - Secretaries of 14 Ministries and Chief of Integrated Defence Staff.

Centre LevelCentral Ministries; National Disaster Management

Authority,National Institute of Disaster Management National Disaster Response Force (NDRF).

State LevelSDMA headed by Chief Minister.State Executive Committee (SEC).

District LevelDDMA headed by District Magistrate.Interface between Govt. and Public.

Nodal agencies for disaster management

Floods: ministry of water resources , (central water commission) Cyclones, earthquakes : Indian meteorological department Epidemics: ministry of health and family welfare Tsunami: Indian National Centre for Oceanic Information Services Landslides: Geological Survey of India Avalanche: DRDO ( Defence research and development

organisation) Chemical disasters: ministry of environment and forests Industrial disaster: ministry of labor Rail accidents: ministry of railway Air accidents: ministry of civil aviation Fire: ministry of home affairs Nuclear incidents: department of atomic energy Mine disasters: department of mines

Disaster Reduction Day

NIDM observes "Disaster Reduction Day" on the

Second Wednesday of October.

UN General Assembly in 2009, designated

October 13 as International Day for Disaster

Reduction.

2013 Theme -“Living with Disability and

Disasters”.

Rallies and lectures for awareness for disaster

reduction amongst youth, children and general

people.

FOR INFORMATION ON DISASTERS DIAL TOLL FREE No. 1070

Log on to http://www.ndmindia.nic.in

Thank You!