DISASTER MANAGEMENT

DR. TAPAS HALDER SR. M.O. Northern Coalfields Ltd.

THE DEFINITION
• W H O : Any occurrence that causes damage, ecological disruption, loss of human life and deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community.

THE DEFINITION
• P A H O : An overwhelming ecological disruption which exceeds the capacity of a community to adjust and consequently requires assistance from outside.

THE DEFINITION
• W. Nick Carter : It is an event, natural or manmade, sudden or progressive, which impacts with such severity that the affected community has to respond by taking exceptional measures.

IN SIMPLE WORDS
• It is a catastrophe, a calamity or a cataclysm which results in loss of life and property.

DISASTER MANAGEMENT
IT IS THE DISIPLINE THAT • DEALS WITH AND AVOID RISKS AND IMPACT OF A DISASTER. • INVOLVES IN PREPARING FOR DISASTER BEFORE IT HAPPENS. • RESPONDS IMMEDIATELY TO THE OUTCOME PRIOR TO AND FOLLOWING A DISASTER . • DEALS WITH THE PROCESS OF SUPPORTING AND REBUILDING SOCEITY AFTER A DISASTER. • IS AN EMERGENCY MANAGEMENT SYSTEM WHICH IS A CONTINUOUS PROCESS INVOLVING INDIVIDUALS, GROUPS AND COMMUNITY TO MANAGE HAZZARDS.

THE EQUATION
DISASTER produces HAZARD makes population VULNERABLE . R h = Hazard Specific Risk V h = Hazard Specific Vulnerability H = Hazard Rh=HXVh

More vulnerability means more risk. Disaster plans are made according to the risk involved.

CLASSIFICATION
A simplified observation

DISASTER

NATURAL

MANMADE

NATURAL DISASTER
Meteorological Disasters : various kind of storms, cold spells,
drought, heat waves

Typological Disaster : avalanches, landslides, floods

Telluric and Teutonic Disasters : earthquakes, tsunamis,
volcanic eruptions

Biological Disaster : insect swarms, epidemics of communicable
diseases

MANMADE DISASTERS
Civil Disturbances : riots, demonstrations etc. Conventional Warfare : bombardment, siege etc. Non Conventional Warfare : nuclear, biological, chemical,
terrorism

Refugees : forced movements of large population usually across
frontiers.

Accidents : transport (land, air or sea), collapse of structures
(building, dam etc.).

Technological Accidents : leak in a chemical plant, mine accident,
nuclear power plant accident etc.

DIFFERENT ASPECTS OF DISASTER GEOGRAPHY Impact area : where maximum damage is done by the
impact agent.

 Filter area : the relatively undamaged zone from which reserves, rescue workers enter, evacuation done.  Community aid area : outside the filter area from which the community, special teams, organizations operate, control and monitor the rescue and rehabilitation works.

DIFFERENT ASPECTS OF DISASTER HUMAN BEHAVIOUR  The Victim : delusion of personal vulnerability.  Disaster Syndrome : due to stress or shock –
acute disorientation and apparent loss of individual purpose or direction.

 Counter Disaster Syndrome :some uninjured
or mildly injured persons vigorously involved in rescue work.

DIFFERENT ASPECTS OF DISASTER CONVERGENCE

• PERSONAL CONVERGENCE : physical
movement of people.

• METERIAL CONVFRVGENCE : physical
movement of supplies and equipments.

• INFORMATION CONVERGENCE : verbal,
telephones, wireless etc.

DIFFERENT ASPECTS OF DISASTER LEADERSHIP
• It must be shared. • It must be clear and well defined. • Higher level of leadership should have recognised authority under existing law. • It must understand the principles of organisations and delegation of authority. • It should have an open ended

SOME MAJOR DISASTERS
FLOOD CYCLONE 3,00,000 EARTHQUAKE 2,90,000 VOLCANO 25,000 TSUNAMI 1,50,000 GAS LEAK 2,500 CHINA 1887 9,00,000 BANGLASESH 1970 CHINA 1976 COLOMBIA 1985 SOUTH - EAST ASIA 2004 BHOPAL 1984

DISASTER PROCESS
FOUR PHASES
• MITIGATION • PRERAREDNESS • RESPONSE • RECOVERY

PHASES ( PROFESSIONAL LEVEL) MITIGATION
Long term preventive measures taken by local authority, govt. NGO, various Disaster Management organizations to eliminate / reduce risk on community

NON-STUCTURAL • FORMULATION AND IMPLEMENTATION OF POLICIES • IDENTIFFING HIGH RISK ZONES • LAYING VARIOUS SAFETY CODE OF CONDUCT e.g. construction rules in high seismic zone STUCTURAL • ESTABLISHMENT OF MONITORING SYSTEM e.g. P.T.W.S. • CONSTRUCTION OF DISASTER SHELTERS

PHASES ( PROFESSIONAL LEVEL) PREPAREDNESS
• MAKING VIABLE DISASTER PLAN TO RESPOND RAPIDLY AND EFFECTIVELY • ASSEMBLING ADEQUATE RESOURCES • COLLECTING STOCKS OF CONSUMABLE ITEMS • TRAINING OF PERSONNEL

PHASES ( PROFESSIONAL LEVEL) RESPONSE
TO SAVE LIFE AND PROTECT PROPERTY

• MEASURES TAKEN IMMEDIATELY PRIOR TO AND FOLLOWING DISASTER • PROPER AND TIMELY WARNING USING MEDIA, ROVING LOUDSPEAKERS etc. • DEPLOYMENT OF SKILLED PERSONS • RESCUE WORK • MEDICAL CARE • DRINKING WATER SUPPLY • RESTORE ALL SORTS OF COMMUNICATION

PHASES ( PROFESSIONAL LEVEL) RECOVERY
• AIM IS TO RETURN TO NORMAL FUNCTIONS • ASSISTED BY COMMUNITIES AND NATIONS • IT IS A LONG PROCESS OFTEN TAKES YEARS

PHASES ( PERSONAL LEVEL)
• MITIGATION – safety measures while building a house PREPAREDNESS – 72 hour kit, fire extinguisher, emergency tel. nos. RESPONSE – home confinement or home evacuation RECOVERY – not only properties but also physical and mental

DISASTER PLANNING
PRINCIPLES
 IT SHOULD BE A CONTINUOUS PROCESS.  IT SHOULD HAVE THE ABILITY TO FORESEE ADVERSE SITUATIONS.  IT MUST EVOKE PROPER RESPONSE.  IT MUST BE BASED ON VALID KNOLEDGE.  IT SHOULD SERVE AS AN EDUCATIONAL ACTIVITY.  IT MUST BE REALISTIC AND ADAPTABLE.  IT MST USE EXISTING STRUCTURE INSTEAD OF CREATING NEW ONE.  IT MUST BE CLEARLY WRITTEN.  IT MUST BE TESTED.  IT SHOULD BE HARMONISED AT EACH LEVEL WITH THE HIGHER LEVEL.

DISASTER PLANNING
FACTORS RESPONSIBLE FOR SEVERITY  DIRECT IMPACT
 POPULATION DENSITY  POPULATION DISPLACEMENT  DELAY IN EVACUATION  DISRUPTION OF PRE-EXSISTING FACILITIES  CLIMATE EXPOSURE  LACK OF FOOD AND NUTRITION  INCREASED VECTOR BREEDING  NON-AVAILABILITY OR INADEQUATE MEDICAL CARE

DI SASTER PLAN NING
MASS CASUALTY MANAGEMENT
• DO THE BEST FOR THE MOST with available resources. • TRIAGE throughout the chain of treatment. • FIRST AID measures carried out at the earliest. Only monitoring and resorting vital functions at the site. • Simple and standard therapeutic measures to be adopted

DI SASTER PLAN NING
MASS CASUALTY MANAGEMENT (PHASES)

• RESCUE • FIRST AID OR PRE- HOSPITAL CARE • TRANSPORTATION • DEFINITIVE TREATMENT OR HOSPITAL CARE

DI SASTER PLAN NING

RESCUE
• it is mostly done by the survivors of the impact area and filter area. Rescue team helps the community with their skill and equipments.

DIS ASTER PL ANNIN G
MEDICAL RELIEF (pre-hospital care)
• FIRST-AID TEAM • MOBILE HOSPITAL • EVALUATION AND CASUALTY CLEARING TEAM • COORDINATION, COMMUNICATION, CONTROL

DI SASTER PLAN NING
MEDICAL RELIEF (pre-hospital care)

PREMILINARY PHASE
• On site analysis of the situation • On site first aid treatment – limited to primary life support measures e.g. maintain airway, control bleeding if any. • Stabilization • Transport for selective care.

DI SASTER PLAN NING
MEDICAL RELIEF (transportation)
• Triage or sorting out : evaluation based on chance of survival and priority of treatment Category 1(immediate treatment) :severely injured, immediate transport. Category 2(delayed treatment) : urgent but less serious requires surgery in 8 to 12 hrs. Category 3(minimal treatment) : walking wounded, can be transported in a group in any vehicle. Category 4(injuries) : simple injuries, can be sent to home after primary treatment. • Handling with utmost care • • Preventive measures to avoid spinal injury Adequate space in the transport vehicle

DI SASTER PLAN NING
MEDICAL RELIEF (hospital care)

DEFINITIVE CARE PHASE
• Continuation of treatment • 2nd stage diagnosis • Need based treatment at emergency room, intensive care etc. • Definite diagnosis and treatment

DI SASTER PLAN NING
MEDICAL RELIEF

• RECUPERATION AND REHABILITATION PHASE : continues for a long period of time even for years e.g. in nuclear or chemical disaster.

HOSPITAL DISASTER PLANNING

 Main role of a hospital in disaster management is in preparedness and response .  The purpose of a hospital is to serve maximum number of people require medical care promptly and effectively to minimize the number of death and disability.

HOSPITAL DISASTER PLANNING (OBJECTIVES)
• TO PREPARE STAFFS AND RESOURCES OF THE HOSPITAL TO PERFORM OPTIMALLY. • TO MAKE THE COMMUNITY AWARE OF THE IMPORTANCE, BENEFITS AND WAYS OF EXECUTION. • TO TRAIN THE STAFFS AS PART OF EDUCATIONAL ACTIVITIES. • TO CONDUCT PERIODIC DRILLS. • EVALUATION REGULARLY FOR UPGRATION.

DISASTER COMMITTEE
• CHIEF OF THE HOSPITAL may act as DISASTER CO-ORDINATOR • HOSPITAL ADMINISTRATOR • IN-CHARGE OF CASUALTY / EMERGENCY DEPT. • H. O. D. s • NURSING SUPERINTENDENT • STAFF REPRESENTATIVE

ORGANISSATIONAL STRUCTURE OF DISASTER COMMITTEE
DISASTER COORDINATOR

ADMINISTRATOR

H. O. D. s

NURSING SUPER.

MEDICAL STAFF

NURSING STAFF

SOME IMPORTANT DEPARTMENTS IN DISASTER MANAGEMENT
• CASUALTY / EMERGENCY • RADIOLOGY AND IMAGING • CRITICAL CARE UNIT • O. T. COMPLEX • LABORATORY

DISASTER FACILITIES IN A HOSPITAL (PREPAREDNESS)
• TRIAGE or SORTING AREA : - attached with Emergency Services - triage team consist of physician, surgeon, nursing staff who first handle the incoming casualties - rapid assessment of the severity - sending to appropriate treatment area

DISASTER FACILITIES IN A HOSPITAL (PREPAREDNESS)
• PRIMARY TREATMENT AREA : - immediate care area with resuscitation facility to restore airway, control bleeding, support fractures, treat shock > CATEGORY 1 cases. - urgent care area : primary management of less severe cases > CATEGORY 2 cases. - non-urgent care area for CATEGORY 3 cases. - special care area for nuclear or chemical

DISASTER FACILITIES IN A HOSPITAL (PREPAREDNESS)
• SECONDARY TREATMENT AREA : C. C. U. I. C. U. O. T. diagnostic dept. e. g. radiology.

DISASTER FACILITIES IN A HOSPITAL (PREPAREDNESS)
• IN-PATIENT EVACUATION HOLDING AREA - pre-evacuated special ward for disaster victims - deployment of manpower easier - deployment of equipments easier - additional beds should be made available

DISASTER FACILITIES IN A HOSPITAL (PREPAREDNESS)
• DISASTER MANUAL Hospital Policies and Procedures Disaster Notification Casualty / Emergency department Dept. Duties and Responsibilities Special Duties and Responsibilities Nursing services

DISASTER FACILITIES IN A HOSPITAL (RESPONSE)
• GRADED ALERT SYSTEM : according to increasing severity – Green Alert Amber Alert Red alert

DISASTER FACILITIES IN A HOSPITAL (RESPONSE)
• ALERT AND RECALL : - first and most important part of response - the designated person who first receives the disaster alert is responsible to recall the staffs - systems used – public address system coded light system personal paging system

DISASTER FACILITIES IN A HOSPITAL (RESPONSE)
• DEPLOYMENT : - rule out confusion - action cards are very useful tool - simple and clear instructions - separate plan for holidays / Sundays and for night

DISASTER FACILITIES IN A HOSPITAL (RESPONSE)

• ADDITIONAL FACILITIES : control room staff report board information centre volunteer reception relatives’ waiting room media room

DISASTER FACILITIES IN A HOSPITAL
• DISASTER DRILL : - to test preparedness and response - should be well organized - an opportunity to deal with the community and local / state authorities - proper evaluation

DISASTER MANAGEMENT IN INDIA
NATIONAL LEVEL

• BASIC ROLE of CENTRAL GOVT.: mainly supportive
through information, finance, material, technical . • CONTINGENCY ACTION PLAN FOR NATURAL CALAMITIES issued by Ministry of Agriculture, GOI is the basic guideline . It is a relief oriented programme. • ORGANISATIONAL COMPONENT consists of : - Cabinet Committee headed by P. M. - National Crisis Management Committee chaired by Cabinet Secretary. - Crisis Management Group chaired by Cabinet Relief Commissioner. - Calamity Relief fund, Prime Minister Relief Fund for financial support.

STA TE L EV EL

• Each State Govt. has different policies, plans and ways of

functioning • Responsible for preparedness, relief works and rehabilitation • State Crisis Management Group headed by Chief Secretary • District Relief Committee is responsible for plans, response, coordination, supervision and monitoring • District Control Room for day to day information and monitoring

SOME DISAATER MANAGEMENT ORGANISATIONS • Emergency Management and Research Institute ( India ) • International Association of Emergency Managers ( education & training ) • National Red Cross / Red Crescent Societies • World Bank • United Nations • Indian Army – largest disaster management organisation and rescue operator in India

DISASTER WILL HAPPEN BUT THE POINT IS HOW PREPARE WE ARE AND HOW RAPID AND EFFECTIVE OUR RESPONSE WILL BE

‘IF YOU KNOW YOUR ENEMY AND KNOW YOURSELF, YOU NEED NOT FEAR THE RESULT OF A HUNDRED BATTLE’ SUN YZU (500 B.C.)

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