Disaster: Perspectives

Source: EK Noji, The Public Health Consequences of Disaster

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: 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 (NATECHS)

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.

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

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

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

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

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 )

Peta Rawan Tanah Longsor di Indonesia

Peta Rawan Banjir di Indonesia

Peta Rawan Konflik di Indonesia

NAD (Separatisme) Kalbar, Kalteng (Suku) Maluku, Malut, Poso (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

Bencana & Korban Massal di Indonesia 1980 2004 : 14. Gempa Flores,
15. Riot Jakarta, 16. Banjir Jakarta, 1991&1992 17. Tsunami Lombok, 18. Gempa Liwa, 19. Gn Merapi Jogya, 20. Gempa Kerinci, 21. Riot PDI-P Jakarta, 22. Gempa& Tsunami Biak 23. Gempa Sulawesi Selatan, 24. Riot Etnik Pontianak, 25. Gempa Bengkulu, 1992

1991

1993 1993 1995 1995 1996 1997 1997

1997

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

Indonesia 1980 2004 :

39. Banjir 3 Minggu Jakarta 40. Nunukan Displaced Migrant Worker 41. Bom Teroris Bali 42. Bom Teroris Htl Marriott Jkt 43. Ledakan Pabrik Kimia Gresik 44. Gempa Karang Asem Bali 45. Gempa Nabire 2x 46. Gempa Aceh 47. Gempa Palu 48. Kelaparan NTT 49. Sampah Longsor Bandung 2005 50. Gempa Nias 2002 2002 2002 2003 2004 2004 2004 2004 2005 2005 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 >

Emergency and Disaster Incidence 2004-2008

Number of Disaster Incidence from 2004 to 2008
Emergency & Disaster Incidence 37 45 162 205 359 771 Number of Provinces Affected 18 21 27 28 30 124 Number of Districts Affected 81 40 101 156 162 540 No 1 2 3 4 5 Year 2004 2005 2006 2007 2008 Total Death 129,103 96,985 7,679 642 299 105,605 Injured 173,452 12,591 291,110 355,336 75,457 734,494 IDP 570,185 80,611 2,485,953 870,708 288,323 3,725,595 407 712 507 82 1,708 Missing

Emergency & Disaster Incidence During 2008

CASUALTIES NO TYPE OF DISASTER Flood Tornado Strong Wind Landslide Disease Outbreak Flash Flood Flash Flood and Landslide Tide Wave FREQUENCY DEATH MAJOR INJURY / INPATIENT MINOR INJURY/ OUTPATIENT MISSING IDP

1 2 3 4 5 6 7 8

190 65 14 83 36 18 3 10

60 13 3 104 58 40 6 5

130 21 9 27 1,892 406 2 1

42,633 173 13 405 2,225 25,992 2 5

9 0 0 3 0 8 1 0

302,932 570 0 4,864 0 22,875 500 274

9
10 11 12 13 14 15 16

Earthquake
Industrial Accident Flood with Landslide Failure of Technology Bomb Blast Volcano Eruption Social Conflict Thunder

11
5 10 1 1 4 4 2 457

14
6 12 3 2 0 1 7 334

51
10 11 9 1 0 12 1 2,583

779
207 809 44 0 0 3 4 73,294

0
0 0 0 0 0 0 0 21

10,747
0 2,390 0 0 0 3,000 0 348,152

Total

Hazards

Earthquake & Tsunami Floods Earthquake Volcanoes Eruption

Flash floods & Landslides

Conflict Social unrest

Bomb Blast

Transportation Accident

Cyclone Infectious Diseases

Black Outs
Industrial Accident

Bencana Bisa Terjadi Kapan Saja, di mana Saja, dan Bisa Menimpa Siapa Saja.