health implications of disasters in the philippines
TRANSCRIPT
HEALTH IMPLICATIONS OF
DISASTERSIN THE PHILIPPINES
JOFRED M. MARTINEZ, MAN, RN
2ND ANTIQUE HEALTH CONGRESSST. ANTHONY’S COLLEGE, SAN JOSE, ANTIQUE
FEBRUARY 26, 2015
Faculty, Nursing Department
PHILIPPINE DISASTER RISK PROFILE
20 earthquakes per day
22 active volcanoes
36,289 kms. of coastline
20 to 30 typhoons a year
Assessment of Disaster and Risk Reduction Management at the Local Level, 2014
PHILIPPINE DISASTER RISK PROFILE
"EM-DAT: The OFDA/CRED International Disaster Database www.em-dat.net – Université Catholique de Louvain - Brussels - Belgium"
8
28
18
136
314
25
0 50 100 150 200 250 300 350
Drought
Earthquake
Epidemic
Flood
Storm
Volcano
Natural Disaster Occurrence in the Philippines from 1900 to 2014
EFFECTS OF DISASTERS
• Death, injury, illness and disability
• Damage/loss of essential life support services
• Damage/loss of facilities, services, infrastructure
• Displacement of populations
• Psychosocial stress
• Environmental pollution
• Economic and social impact
EFFECTS OF DISASTERS
• Risk of infection or contamination for response and relief personnel
• Breakdown in communication networks and information flows
• Breakdown in security
• Delay or lack of access to routine services
HEALTH EFFECTS OF DISASTERS• Increased number of deaths and injuries
• Population displacement, including missing persons
• New cases of disease and disability
• Increased number of cases of psychological and social behavioural disorders
• Possible food shortages and nutritional deficiencies
HEALTH EFFECTS OF DISASTERS• Contamination or injury of relief personnel
• Environmental health hazards
• Damage to healthcare facilities and other health infrastructures
• Diversion of development resources to emergency relief
• Disruption of routine disease surveillance
• Disruption of routine health services
HEALTH SERVICES IN EMERGENCIES• Mass casualty management
• Management of the dead and missing
• Health information and communication
• Communicable disease control measures
• Environmental health
• Psychosocial services
• Reproductive health
• Feeding and nutrition
VulnerabilitiesCapacities
EMERGENCY INDIRECT IMPACTS
DIRECT IMPACTS
HEALTH RESPONSE
search and rescuefirst aidtriage
medical evacuationprimary care
disease surveillance and controlcurative careblood bankslaboratories
referral systemspecial units (burns, spinal)
evacuation centresshelterwater
food and nutritionenergysecurity
environmental healthprimary health care
care of the deadpsychosocial care
disability care
recoveryreconstruction
ASSOCIATED FACTORS
Climate/weather/time of dayLocation
Security situationPolitical environment
Economic environmentSocio-cultural environment
Morale, solidarity, spiritCompetence, corruption
COMMUNITY
Damageand
Needs
EMERGENCIES & HEALTH
ROLES OF NURSES IN EMERGENCIES
PLANNING• meeting with national/local coordination bodies
• planning/implementing command systems
• planning for logistics and administrative arrangements
• planning for safety and security arrangements
ROLES OF NURSES IN EMERGENCIES
COORDINATION• with military
• with private sectors
• with professional associations
• with international assistance
• with forensics and mortuaries
• with social and welfare services
ROLES OF NURSES IN EMERGENCIES
ASSESSMENT• conducting inter-sectoral damage analysis and
needs assessment
• conducting community risk assessment
• conducting patient assessment
ROLES OF NURSES IN EMERGENCIES
PROVIDING IMMEDIATE CARE• search and rescue
• victim identification and reporting
• evacuation
• first aid
• triage
• transport of victims
• trauma/primary care
ROLES OF NURSES IN EMERGENCIES
PROVIDING ACUTE CARE• treatment of disease or injury
• laboratory services and blood bank products
• medical supplies
• essential drugs
ROLES OF NURSES IN EMERGENCIES
PROVIDING REHABILITATION CARE• orthotics and prosthetic
• dental care
• disability care
ROLES OF NURSES IN EMERGENCIES
PRIMARY HEALTH CARE• emergency shelter
• water safety and quality
• food safety and nutrition
• food supply and food security
• energy, protection and security
• recovery of PHC activities (EPI, MCH, CDD, ARI)
ROLES OF NURSES IN EMERGENCIES
COMMUNICATION AND REPORTING• emergency reporting system
• disability and infectious/outbreak surveillance
ROLES OF NURSES IN EMERGENCIES
RECOVERY AND REHABILITATION• compensation of victims
• recovery, reconstruction and rehabilitation of community
• post-event evaluation
• research and documentation
• community risk reduction programmed
ROLES OF NURSES IN EMERGENCIES
PROVIDING TRAINING IN EPR• emergency drills
• risk communication
• mass casualty management
NURSE COMPETENCIES INDISASTER MANAGEMENT
PRE-INCIDENT PHASEA. Assist in the assessment of communities to
determine pre-existing health issues and health care resources in a given community
B. Contribute to the planning of health care needs of individuals and communities in an emergency/disaster
C. Mobilize community for health and intersectoral plan on health emergency management
NURSE COMPETENCIES INDISASTER MANAGEMENT
PRE-INCIDENT PHASED. Collaborate with other health care professionals
to develop measures to reduce vulnerability of populations
E. Support health policy and organizational preparation for emergencies
F. Develop health education and advocacy materials and provide training on health emergency management
NURSE COMPETENCIES INDISASTER MANAGEMENT
PRE-INCIDENT PHASEG. Demonstrate application of professional, ethical,
legal, cultural and gender considerations
H. Demonstrate leadership and management skills in health emergency management
NURSE COMPETENCIES INDISASTER MANAGEMENT
INCIDENT PHASEA. Perform situation and needs assessment and
prioritize care and management in the field and health facility during emergencies
B. Provide initial relief and care during emergencies
C. Provide nursing care of individuals, especially the vulnerable groups
NURSE COMPETENCIES INDISASTER MANAGEMENT
INCIDENT PHASED. Support and implement public health
interventions
E. Provide safety and security of patients and personnel
F. Provide psychosocial support to patients and staff
NURSE COMPETENCIES INDISASTER MANAGEMENT
INCIDENT PHASEG. Facilitate coordination and communication
H. Supervise/support management of logistics and supplies
NURSE COMPETENCIES INDISASTER MANAGEMENT
POST-INCIDENT PHASEA. Provide long-term care to individuals and
families B. Support recovery - reconstruction efforts in the
hospital and communityC. Evaluate the impacts of nursing intervention and
utilize these results to develop evidence-based decisions
HOW SOMEONE RESPONDS DEPENDS ON THESE FACTORS
• the nature and severity of the event(s) they experience;
• their experience with previous distressing events;
• the support they have in their life from others;
• their physical health;
WHAT IS PFA?PSYCHOLOGICAL FIRST AIDA humane, supportive response to a fellow human being who is suffering and who may
need support.According to Sphere (2011) and IASC (2007)
WHAT IS PFA?• providing practical care and support, which does
not intrude;
• assessing needs and concerns;
• helping people to address basic needs (for example, food and water, information);
• listening to people, but not pressuring them to talk;
WHAT IS PFA?• comforting people and helping them to feel
calm;
• helping people connect to information, services and social supports;
• protecting people from further harm.
WHAT IS PFA IS NOT• It is not something that only professionals do.
• It is not professional counselling.
• It is not “psychological debriefing”.
• It is not asking someone to analyse what happened to them or to put time and events in order.
WHAT IS PFA IS NOT• Although PFA involves being available to listen
to people’s stories, it is not about pressuring people to tell you their feelings and reactions to an event.
WHO NEEDS IT?PFA is for distressed people who have been recently exposed to a serious crisis event.
Who needs more immediate advanced support:• people with serious, life-threatening injuries who need
emergency medical care• people who are so upset that they cannot care for
themselves or their children• people who may hurt themselves• people who may hurt others
PFA TARGET OUTCOMESPhysical health:
RESTORE SAFETY
Psychological health:
FACILITATE FUNCTION
Behavioral health:
EMPOWER ACTION
PFA DO’S Be honest and trustworthy.
Respect people’s right to make their own decisions.
Be aware of and set aside your own biases and prejudices.
Make it clear to people that even if they refuse help now, they can still access help in the future.
PFA DO’S Respect privacy and keep the person’s story
confidential, if this is appropriate.
Behave appropriately by considering the person’s
culture, age and gender.
PFA DONT’Sx Don’t exploit your relationship as a helper.
x Don’t ask the person for any money or favor for helping them.
x Don’t make false promises or give false information.
x Don’t exaggerate your skills.
PFA DONT’Sx Don’t force help on people, and don’t be
intrusive or pushy.
x Don’t pressure people to tell you their story.
x Don’t share the person’s story with others.
x Don’t judge the person for their actions or feelings.
PREPARING FOR PFA• Learn about the crisis event.
• Learn about available services and supports.
• Learn about safety and security concerns.
LOOK• Check for safety.
• Check for people with obvious urgent basic needs.
• Check for people with serious distress reactions.
PEOPLE WHO ARE LIKELY TO NEED SPECIAL ATTENTION
• Children – including adolescents – especially those separated from their caregivers
• People with health conditions or physical and mental disabilities
• People at risk of discrimination or violence
LISTEN• Approach people who may need support.
• Ask about people’s needs and concerns.
• Listen to people, and help them to feel calm.
LEARN TO LISTEN WITH:• Eyes ›› giving the person your undivided attention
• Ears ›› truly hearing their concerns
• Heart ›› with caring and showing respect
KEEPING PEOPLE CALM• Keep your tone of voice calm and soft.• If culturally appropriate, try to maintain some
eye contact with the person as you talk with them.
• Remind the person that you are there to help them. Remind them that they are safe, if it is true.
KEEPING PEOPLE CALMIf someone feels unreal or disconnected from their surroundings, it may help them to make contact with their current environment and themselves. • Place and feel their feet on the floor.• Tap their fingers or hands on their lap.• Notice some non-distressing things in their environment,
such as things they can see, hear or feel. • Encourage the person to focus on their breathing, and to
breathe slowly.
LINK• Help people address basic needs and access
services.• Help people cope with problems.• Give information.• Connect people with loved ones and social
support.
FREQUENT NEEDS• Basic needs, such as shelter, food, and water and
sanitation.
• Health services for injuries or help with chronic (long-term) medical conditions.
• Understandable and correct information about the event, loved ones and available services.
• Being able to contact loved ones, friends and other social supports.
FREQUENT NEEDS• Access to specific support related to one’s culture
or religion.
• Being consulted and involved in important decisions.
POSITIVE COPING• Get enough rest.• Eat as regularly as possible and drink water.• Talk and spend time with family and friends.• Discuss problems with someone you trust.• Do activities that help you relax (walk, sing, pray,
play with children).• Do physical exercise.• Find safe ways to help others in the crisis and get
involved in community activities.
NEGATIVE COPING• Don’t take drugs, smoke or drink alcohol.• Don’t sleep all day.• Don’t work all the time without any rest or
relaxation.• Don’t isolate yourself from friends and loved
ones.• Don’t neglect basic personal hygiene.• Don’t be violent.
CRISIS AND SPIRITUALITY• Be aware of and respect the person’s religious
background.• Ask the person what generally helps them to feel
better.• Listen respectfully, and without judgment, to
spiritual beliefs or questions the person may have.
CRISIS AND SPIRITUALITY• Don’t impose your beliefs, or spiritual or religious
interpretations of the crisis, on the person.• Don’t agree with or reject a spiritual belief or
interpretation of the crisis, even if the person asks you to do so.
ENDING YOUR HELP• Use your best judgment of the situation, the
person’s needs and your own needs.
• Explain to the person that you are leaving, and if someone else will be helping them from that point on, try and introduce them to that person.
• If you have linked the person with other services, let them know what to expect and be sure they have the details to follow up.