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INTRODUCTION
Disaster caused by nature’s fury is not uncommon in this planet, earth. In fact, scientists
believe that the birth of this planet Earth was the result of explosion that occurred in the
solar system. From time immemorial, this planet had witnessed numerous natural disasters.
In the past, man used to view these natural disasters as the ‘acts of God’. Gradually, science
opened the doors of knowledge and enabled man to understand the mysterious occurrence
of natural disasters. Disasters are cause of trouble to human society since ancient times.
Human beings has to face and cope up with such disasters. Although scientific invention,
information resolution, latest technology skills etc, are successful in reducing the dreadful
effects of disasters and their intensity but still many old and new forms of natural
calamities/disasters takes place here and there and we had to suffer major threats of life
and property.

MEANING
The word ‘Disaster’ is derived from the French word “Desater”. This is formed by two words
“Des” and “aster”. The meaning of Des is “bad” or “calamity” and Astre is “planet”.

DEFINITION
Disaster is any human made or natural event that caused destruction and deviation that
cannot be revealed without assistance. The event need not cause injury or death to be
considered a disaster-stanhope.

Disaster is “any occurrence that causes damage, economic disruption, loss of human life
and deterioration of health and health service on a scale sufficient to warrant an
extraordinary response from outside the affected community or area”- WHO

Disaster is sudden and catastrophic

Disaster is sudden calamity which causes damage to life and property at a big extend.

Disaster alphabetically means:

D : Destructions

I : Incidents

S : Sufferings

A : Administrative failures
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S : Sentiments

T : Tradegies

E : Eruption of communicable diseases

R : Research program and its implementation

PRINCIPLES OF DISASTER MANAGEMENT

 Prevent disaster
 Minimize the casualities
 Prevent further casualities
 Rescue the victims
 First aid
 Evacuate
 Medical care
 Reconstruction

FACTORS AFFECTING DISASTER

Poverty: Rich people are less affected by disaster as they get themselves immediately
secured. Normally poor people get much affected because they are insecure and don’t have
shelter or enough resources for protection.

Environmental Deterioration: Many disasters happen due to deterioration in environment

and become more serious. Deforestation, over grazing, removal of upper soil, bad
conservative techniques, low level of the water, increasing population, all these factors
make the disaster eg; famine more serious.

Change in cultural patterns: the growing inevitable changes in entire social fabric makes
society vulnerable to disasters.

Population Explosion: there would be more harm in more population, through disaster. The
place where large number of people resides in number of buildings, then effect of disaster is
more. Such incidences occurs more in the developing countries, where the effect of disaster
is more due to large population.

Rapid Urbanization: Population increases through rapid urbanization and people use to
move towards cities. Poor people from villages or deprived places comes to cities in search
of financial opportunities and security. Due to intense and unorganized urbanization,
disasters like landslide and floods use to happen. Because of intense and uncontrolled
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urbanization, families of low income group are obliged to live in slopes of hills and banks of
rivers which are not safe.

Lack of Vigilance and Information: Lack of vigilance and information turn hazards into
disaster. Some people don’t know rescue measures to save themselves.

Unsecured Shelter: Wrong selection of land for houses or ignoring the possibility of
earthquake at the time of construction or ignoring the quality of soil, all these invites
disasters.

CLASSIFICATION OF DISASTERS
Disasters can be classified as follows;

(A) On the basis of origin

(B) On the basis of its nature or form
(C) On the basis of intensity
A. On the basis of Origin
1. Man-made disasters:
 Accidents: Road, rail, air, sea and collapse of buildings
 Industrial accidents: Gas leakage, explosion, lapidation and security failure.
 Fire: Fire in the houses, in coal and oil storage, in forests(Sometimes occur
naturally but mostly by human beings.)
 Poisoning: Food, water, illicit liquor, epidemics etc.
 Ecological: Pollution (Air, water and sound), loss of quality of soil, loss of
biological diversitites
 Warfare: Conventional, chemical atomic.
2. Natural Disaster:
 Related to Earth: Earthquake, Tsunami(seawaves), landslide, melting of ice,
bursting of volcano.
 Related to water: Floods, cloud burst, sudden floods, heavy rainfall, thunderclap,
drought.
 Related to Air: Storm, cyclonic storm, storm waves, crest of the waves etc.
B. On the Basis Of Nature
1. Geographical Disaster
 Earthquake: The upper part of the Earth or the lower part of the earth through
the sudden crack causes vibration of the upper surface resulting the collapse of
buildings causing damage of life and property. Earthquake is natural destructive
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activity which takes places suddenly, without warning. No exact predictions of

earthquake could be made till now.
 Volcanic explosion: Volcano is an exit or chimney on the layer of earth for the
lava melting beneath the earth. 10% of the world population lives on the upper
surface or around the volcanic region. Though, through volcano monitoring
technique, its warning could be given hours or days before the explosion.
 Landslide: Normally it is the result of heavy rains, storms, earthquake or volcanic
explosion. It occurs due to water flow on rocks, or shape of trees on slopes of
rocks or due to sudden artificial changes in existing infrastructure.
 Tsunami: Tsunami is a Japanese word which means “coastal waves”. These
waves emanate from the base of sea, due to volcanic effect, earthquake or
landslide. The sea water advances with an intense speed in excessive quantum
and causes massive destruction around coastal area and habitation.
2. Climatic disaster:
 Cyclone: It happens due to gust and hot storms in which the speed of the air is
120km per hour. The storm form a circle from all the four sides of centre in the
area of low pressure.
 Drought: The common meaning of drought is low rainfall or low dampness for
sometime. Drought spreads slowly and due to intense scarcity of water, poses
serious threat.
 Flood: Flood occurs due to heavy rainfall, collapsing dams, intense melting of cie,
obstruction in the flow of rivers, and disturbances in other sources of water.
3. Environmental Disaster
 Environmental pollution: It is of two main types (a) air pollution (b) water
pollution. It may cause thinning of ozone layer in air, rise in geophysical
temperature, rise in water level of ocean or can cuase fire in forest.
Environmental pollution is gradually becoming major causes of disasters.
 Deforestation: It can be explained as relentless cutting of plants, trees or
vegetation. Sudden flood, landslide or drought can occur due to deforestation.it
also raises the level of carbon dioxide in the air. Barren is a phenomenon which
occurs due to low vegetation or low rainfall for a longer period.
4. Industrial and Technological Accidents
 Blasts in industrial and chemical plants, accidents in transportation of chemicals,
wrong garbage disposal, security lapses in the industry, technological flaws, fire,
earthquake, landslide all these gives rise to chemical and industrial accidents
which create emergency conditions.
5. Epidemics
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 This is a result of a particular disease which spread fast with intensity leaving
dangerous and destructive consequences. Many stressful and serious situations
can emerge from epidemics.
C. On the Basis of Intensity
1. Disaster with intensity: Such disaster occurs very fast and can cause adverse effect. It is
difficult to predict or control them e.g. earthquake, flood, tsunami etc.
2. Slow disaster: These continue for prolonged period, eg. Drought. Pre-estimation is easy
and we get time for remedial measures.

PHASES OF DISASTER MANAGEMENT

 Prevention phase
 Preparedness phase
 Response phase
 Recovery phase

PREVENTION PHASE

The task during this phase is to identify community risk factors and to develop and
implement programs to prevent disasters from occurring. Programs developed during this
phase may also focus on strategies to mitigate the disaster that cannot be prevented such as
earth quakes, cyclones etc. task force includes are local and national government, social
service providers, police and fire department, major industries, local medias etc.

PREPAREDNESS PHASE

Personal preparedness: Health care professionals with client responsibilities can also
become disaster victims. Conflicts arise between client related and work related
responsibilities. Personal and family preparation can help to ease of some of the conflicts.

Professional preparedness: Professional preparedness requires that health care

professionals become aware of and understand the disaster plans at their work place and
community. Adequately prepared professionals can function as leaders in the disaster
management areas. Personal items that are recommended for a professional to keep for the
disaster management are- copy of professional license, personal equipments such as
stethoscope, flash light and extra batteries, cellular phone, warm clothing or heavy jackets,
protective shoes, pocket sized reference books, watch etc.
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Community preparedness: The level of community preparedness for a disaster is only as

high as the people and organization in the community make it. Some communities stay
prepared for disaster with written plans and by participating in disaster drills. Community
must have adequate warning system and a back up evaluation plan to remove people from
the area of danger.

RESPONSE PHASE

The level of disaster varies and the management plans mainly based on the severity or
extent of the disaster.

 Level III disaster- considered a minor disaster. The disaster is classified as one that involves a
minimal level of damage.
 Level II disaster- considered a moderate disaster that is likely to result in major disaster.
Mobilizations of support system are necessary at this level.
 Level I disaster- considered a massive disaster. This disaster involves a massive damage to
lives and property.

RECOVERY PHASE

During this phase, the community take actions to repair, rebuild or reallocate damaged
homes and businesses and restore health and economic vitality to the community.
Psychological recovery must be addressed. The emotional scars of witnessing a disaster may
persist for long duration. Both victims and relief workers should be offered mental health
activities and services.

DISASTER MANAGEMENT CYCLE

1. DISASTER EVENT: This refers to the “REAL TIME” event of the hazard occurring and affecting
elements of risk.
2. RESPONSE AND RELIEF: This refers to the first stage response to any calamity, which include
setting up control rooms, putting the contingency plan in action, issue warnings, evacuating
people to safe areas, rendering medical aid to the needy etc.
3. RECOVERY: It has three overlapping phases of emergency relief rehabilitation and
reconstructing
4. DEVELOPMENT: Evolving economy and long-term prevention/disaster reduction measures
like construction of houses capable of withstanding the onslaught of heavy rains, wind
speeds and shocks of earthquakes.
5. REDUCTION AND MITIGATION: Protective or preventive actions that lessons the scale of
impact. Minimizing the effects of disaster , eg. Building codes for zoning, vulnerability
analysis, public education.
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6. PREPAREDNESS: Includes the formulation and development of viable emergency plans, of

the warning system, the maintenance of inventories and the training of personnel.

DISASTER MANAGEMENT PLANS

Although no disaster management plans can be made to fit every emergency but protocols
and choronological action plans to prove to deal emergency situation efficiently it executed
in coordinated manner.

Aims of disaster plans

 To provide prompt and effective medical care to the maximum possible in order to minimize
morbidity and mortality.

OBJECTIVES

 To optimally prepare the staff and institutional resources for effective performance in
disaster situation.
 To make the community aware of the sequential steps that could be taken at individual and
organizational levels.

CONSTITUTION OF DISASTER MANAGEMENT COMMITTEE

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The following members would comprise the disaster management committee under the
chairmanship of medical superintendent/director

 Medical superintendent/director
 Additional medical superintendent
 Nursing superintendent/chief nursing officer
 Chief medical officer(casualty)
 Head of departments- surgery, medicine, orthopedics, radiology, anesthesiology,
neurosurgery.
 Blood bank in charge
 Security officers
 Dietician
 Transport officer
 Sanitary personnel

The disaster management committee is overall responsible for managing the disaster
situation, take administrative decisions review the disaster plans and inform authorities.

ORGANIZATION OF DISASTER MANAGEMENT AT THE HOSPITAL

Mobilization of hospital services for a mass emergency is only a quantitative extension of
normal hospital operation and emergencies. Therefore, every hospital must be prepared to
give emergency care to mass casualties and have a disaster plan.

Hospitals have to be prepared for three kinds of disasters. The first is internal hospital
disaster, such as explosion or a major fire. The second is an external disaster, such as a
hurricane, flood, earthquake or a transportation accident. The third is a forewarned disaster,
such as the receipt of a large number of patients from some other hospitals.

As far as possible, planning should include consultation and liaison with local civil authorities
such as Fire brigade, Police, Civil Defense Warden and similar agencies. Such planning should
result in disaster-site triage and distribution of patients that assures effective coordination
and the most efficient use of available facilities and resources.

Forming a Disaster Management Committee

To execute the disaster plan, the hospital should have a Disaster Committee consisting of key
functionaries of the hospital, vis. The Director, or the Medical Superintendent,
Administrative Officer, Heads of Clinical Units including operation theatres, and casualty,
Matron. And Officers in Charge of Transport, Supply, Security and Communications.
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Preparing a Disaster Plan

The primary task of the Disaster Committee is to assess the situation of the hospital, its
capabilities, strengths and weaknesses, available resources, and prepare a disaster plan for
managing sudden influx of casualties on a mass scale.

PRINCIPLES OF HOSPITAL ADMINISTRATION AND PLANNING

The essentials of a disaster plan are;

1. An efficient system of notifying and assigning personnel to specified tasks.

2. A unified medical command
3. A probable self-sustaining ability in the area of basic utilities and supplies for a minimum one
week
4. Establishment of the source and methods of supply of drugs, dressing and other stores and
consumables
5. Method of identifying patients who are immediately dischargeable
6. Conversion of all usable space to provide triage, observation and treatment areas
7. Introduction/ use of a special disaster medical record or medical tag that accompanies the
patient at all times.
8. Establishment of a centralized public information centre with a designed spokesman
9. Security system, to minimize the presence of unauthorized individuals and vehicles in or near
the reception, triage, observation and immediate care areas.

ACTIVATION OF DISASTER MANAGEMENT PLANS

A standard operating procedure should be developed that defines how each task would be
accomplished. As soon as the information regarding disaster is received emergency control
room officer on duty in consultation with ms/director would activate the disaster plan.

Reception Area- the disaster control room will act as the reception area to receive the
casualties and to screen them.

Triage: A predetermined triage should be undertaken to classify the casualties. For large
number of casualties the triage team should incorporate a surgeon, an orthopedic surgeon,
physician and an anesthesiologist.

 Priority One- Needing immediate resuscitation, after emergency treatment shifted to

intensive care unit.
 Priority Two- Immediate surgery, transferred immediately to operation theatre.
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 Priority Three- Needing only first aid and possible surgery- give first aid and admit if bed is
available or shift to hospital
 Priority Four- Needing only first aid- discharge after first aid.

DOCUMENTATION
A comprehensive documentation is essential. Documentation will be done at the casualty by
CMO and attending health care professionals. All MLC’s will be recorded as per the
institutional policy. However the treatment of patients will get priority over the paper work.

Public relations: The identified officer would liaison with relatives of the victims to inform
them on their clinical status. The list of casualties along with their status displayed at
prominent place outside casualty in both English and local language and should be updated
regularly. The MS or the authorized person should brief the media(Press, Radio, TV)

Essential services: Adequate provision should be made to meet additional requirement of

water & power supply and other services prominent to patient care.

Crowd management/ security arrangement: Immediate mobilization of security staff

available within the hospital campus to ensure security of admitted patients, their
belongings, hospital staff equipments and crowd management. The local police station
should be informed to provide assistance in managing the crowd.

DISASTER DRILL

Definition
A disaster drill is an exercise in which people simulate the circumstances of a disaster so that
they have an opportunity to practice their responses.

Features

 On a basic level, drills can include responses by individuals to protect themselves, such as
learning how to shelter in place, understanding what to do in an evacuation, and organizing
meet up points so that people can find each other after disaster.
 Disaster drills handle topics like what to do when communications are cut off, how to deal
with lack of access to equipments, tools and even basic services like water and power, and
how to handle evacuations.
 It also provides a chance to practice for events such as mass casualties which can occur
during a disaster.
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 Regular disaster drills are often required for public buildings like government offices and
schools where people are expected to practice things like evacuating the building and
assisting each other so that they will know what to do when a real alarm sounds.
 Community based disaster drills such as whole-city drills provide a chance to practice the full
spectrum of disaster response. These drills can include actors and civilian volunteers who
play roles of victims, looters and other people who may be encountered during a disaster,
and extensive planning may go into such drills. A disaster drill on this scale may be done once
a year or once every few years.

BENEFITS

 Used to identify weak points in a disaster response plan

 To get people familiar with the steps they need to take so that their response in a disaster
will be automatic.

DISASTER MANAGEMENT- NURSE’S ROLE IN COMMUNITY

Assess the community

Assess the local climate conducive for disaster occurrence, past history of disasters in the
community, available community disaster plans and resources, personnel available in the
community for the disaster plans and management, local agencies and organizations
involved in the disaster management activities, availability of health care facilities in the
community etc.

Diagnose community threats

Determine the actual and potential disaster threats(eg: explosions, mass accidents, tornados,
floods, earthquakes etc.)

Community Disaster Planning

 Develop a disaster plan to prevent or deal with identified disaster threats.

 Identify local community communication system, identify disaster personnel, including
private and professional volunteers, local emergency personnel, agencies and resources.
 Identify regional back up agencies and personnel
 Identify specific responsibilities for various personnel involved in the disaster plans
 Set up an emergency medical system and chain for activation
 Identify location and accessibility of equipment and supplies
 Check proper functioning of emergency equipments
 Identify outdated supplies and replenish for appropriate use.
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Implement disaster plans

 Focus on primary prevention activities to prevent occurrence of manmade disasters

 Practice community disaster plans with all personnel carrying out their previously identified
responsibilities (eg. Emergency triage, providing supplies such as food, water, medicine,
crises and grief counseling)
 Practice using equipment, obtaining and distributing supplies

Shelter Management Plans

 Nurses can act as shelter managers

 Listen to the victims and retell their feelings related to disasters
 Encourage victims to share their feelings
 Help victims to overcome the crisis
 Delegate tasks to team members and coordinate activities
 Provide basic necessities(food, water, shelter etc)
 Provide compassion and dignity to the victim

Evaluate effectiveness of Disaster Plan

 Critically evaluate all aspects of disaster plans and practice drills for speed, effectiveness,
gaps and revisions.
 Evaluate the disaster impact on community and surrounding regions.
 Evaluate the response of personnel involved in disaster relief efforts.

HEALTH SECTOR INVOLVMENT IN DISASTER MANAGEMENT

1. National organization: It is an important responsibility of all the sate governments to protect
the people from all kinds of disaster. There is a team of members such as cabinet secretary,
who have the team of nodal ministers who implement the rescue system to save people
from disaster. The rescue team conducts assessment of the disaster and release the funds
and makes plans to provide relief to the people affected by the disaster.
2. Sate level organization: There is usually the in charge staff from the state cabinet to provide
relief activities for the people affected from the disaster. Money is realized from the funds of
the state governments. Many voluntary organizations also give hand by providing clothes,
drugs and other daily need materials for the people affected by the disaster.
3. District level organization: A District level coordination and review committee is
constituted; it is headed by the collector as chairman with participation of all other related
agencies and departments.
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4. Community level helpers (CLHs): Any community when faced with a disaster displays a
response to the situation by the local people who immediately come forward to help. They
are called community level helpers(CLHs). They are vital link between the affected
population and the helping agencies(individuals, nongovernmental organizations and
governmental organizations). Community level helpers can provide psychological
intervention through daily visits. During such visits they talk to the survivors about their
feelings and experiences, impart health education, discuss health problems, motivate
individuals to hold group meetings and organize educational activities. Community level
helpers therefore have to educate the survivors about common stress reactions following a
disaster and ways to cope with stress and the available resources.

National
Organization

Distric level Health Sector State level

organization Disaster organization
Management

Community level
helpers

ROLE OF NURSE DURING DISASTERS

Nurses play an important role in providing relief to the people affected by the disaster by
initiating the preventive measures, being well prepared and trained to possess the skill of
readiness to help people any time and implementing the relief measures.

1. Immediate care providers: The reflections from the ICN, or International Nursing Council,
initiates and motivates the nursing community to provide the care immediately by training
the team of disaster nurses in every health center to act immediately in the scenario to
rescue the victims.
2. Government and voluntary organizations: The concerned state government and the
voluntary organization constitute a core team, which manages the team of disaster nurses,
health team members, paramedical workers, and provide drugs, suppliers, food and
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diagnostic lab equipments to the disaster areas. They establish camps and treat the affected
victims.
3. Human rights: The rights of the affected victims should not be violated any time during and
after the disaster.
4. Alternative care: Alternative refers to using a nonmainstream approach in place of
conventional medicine. The health of the people should be maintained by folding the
complementary medicine system. It generally refers to using a nonmainstream approach
together with the conventional medicine system. This kind of treatment usually follows the
allopathic medicine to treat disability as a result of the disaster where alternative therapies
are used, eg: acupuncture, massage therapy, meditation, progressive relaxation techniques,
spinal manipulation therapy, etc.
5. Maintain the social justice and equality: All the victims should receive equal care impartially
in terms of social class, caster or race or religion.
6. Accountability; Every member in the health team should be responsible in the administration
of the disaster care and should keep the care recorded. The members are accountable for
the health of the victims during the disaster.
7. Relief Development and planning: Plan effectively to manage the disaster by releasing the
resources in time for providing relief to the victims who experienced the disaster.
Therefore, nurses play a vital role as immediate caregiver, they are held accountable for
their work as they are relief providers. They should also respect the rights of the patients,
maintain social justice and equality and encourage and perform the alternative health care.

Govt and Huma

Immediate relief
organizatio n
services
ns rights

Accounta
Alternati bility
ve care System

Relief
Social
Developme
Justice and
nt Planning
equity

Nurse’s role(ICN)
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CONCLUSION
Disaster Nursing is an important part of community health nursing and poses a challenging
role to nursing profession. Providing immediate help to sufferings and affected human
beings and to minimize the loss are the main objectives of disaster nursing.

BIBLIOGRAPHY
1. Deepak. K, A Comprehensive Textbook on Nursing Management, Emmess Publication, 1 st
Edition, 2013, Page no.163
2. Alamelu Venkataraman, Newer Trends in Management of Nursing Services and Education,
Jaypee Publications, 1st Edition, 2017, Page no.328
3. D. Elakkuvana Bhaskara Raj, Management of Nursing Services and Education, Emmess
Publications, 3rd Edition, 2015, Page no.111
4. B.M. Sakhaekar, Principles of Hospital Administration and Planning, Jaypee Publication, 2 nd
Edition, 2009, Page no.341
5. I. Clement, Management of Nursing Services and Education, 2nd Edition, Elsievier Publication,
1st Edition, 2015, Page no.161
6. Keshav Swarnkar, Community Health Nursing, NR Brothers Publication, 3 rd Edition, 2011,
Page no.848
7. www.google.com