DISASTER MENTAL HEALTH AND HIGH VULNERABILITY

7 POPULATIONS
NCM 120: Disaster Nursing
Ms. Ma. Concepcion B. Sekito • April 28, 2022

MAN MADE DISASTERS ● Often, these accidents are a byproduct of a

natural disaster, such as foggy conditions or icy
Man-made disasters can be divided into 3 categories: roads.
1. Technological disasters Another example is Dona Paz, where thousands died as a
a. Industrial accidents like chemical spills result of the water disaster.
b. transportation accidents 5. MINING ACCIDENTS
c. mining accidents ● Even if conditions are being improved by mining
2. Social disasters: companies, accidents still occur.
a. Warfare ● Miners face the possibility of getting trapped in
b. Genocide collapsed mining tunnels, poisonous gas leaks,
c. Civil unrest dust explosions, and many other dangers.
d. Hyperinflation 6. EXPLOSIONS AND FIRES
e. Terrorism ● The largest non-nuclear explosion disaster
3. Environmental disasters: occured recently.
a. Deforestation ● In 2020, improperly stored nitrate exploded at the
b. Climate change Port of Beirut.
● More than 200 people died, and 6000 people
TYPES OF MAN-MADE DISASTERS were injured.
7. NUCLEAR AND RADIATION ACCIDENTS
1. CHEMICAL SPILL ● The Chernobyl accident is considered the worst
● The Bhopal disaster in 1984 was considered the nuclear disaster in history.
worst chemical spill in history. ● An explosion and fire occured due to poorly-
● 45 tons of chemical methyl isocyanate leaked trained staff using unsafe practices.
from an insecticide plant owned by Union ● Massive amounts of radioactive material were
Carbide. released into the air.
● Thousands of people were killed immediately ● Approximately 350,000 people had to be
from exposure to the gas, and panic ensued as resettled, and the entire area contained.
people attempted to flee. 8. GRID FAILURE
● An estimated 15,000 to 20,000 people died and ● When the grid fails, people can be left without
many more suffered long-term health power for heating, cooling, or life-saving medical
complications. devices.
With this chemical spill, ano an nahihinabo han mga ● Road accidents are also more likely on dark
infants? Ano an nahinabo ha mga burod? Ano an streets without working traffic signals.
nahinabo han mga children? What happens to the school ● The 2021 Texas grid outage is one of the largest
population if classes are ongoing during the chemical and most notorious grid failures in recent times.
spill? 9. OIL SPILLS
2. STRUCTURAL COLLAPSE ● Oil spills don’t usually cause direct human death
● Outside of the developing world, structural but can have a massive environmental toll.
collapse disasters are rare. ● The largest accidental oil spill in history is the
● However, they still do happen. 2010 BP Deepwater Horizon oil spill.
● The recent collapse of the Surfside Condominium Approximately 134 million gallons of oil were
in Florida shows that these disasters can and do released and coated the Gulf coast.
occur: 98 people died when the 12-story tower ● However, the largest oil spill was not an accident.
collapsed. ● In 1990, during their retreat from Kuwait,
In the developing countries, this can be possible Saddam Hussein ordered Iraqi troops to release
especially if there is substandard construction being oil into Kuwait's Sea Island Terminal.
made. ● It is estimated that 380 to 520 million gallons of
3. DRINKING WATER CONTAMINATION oil were intentionally spilled.
● The most significant case of drinking water One example of this is the Dona Paz. There was a collision
contamination occurred in Bangladesh. that took place between Dona Paz and another vessel
● The water sources were contaminated with which was a tanker and oil spilled into the sea. Oil is
arsenic, poisoning upwards of 100 million people lighter than water that's why ada hiya bawbaw han dagat.
in the region. What happened? Mayda kalayo then na light an oil then
● The Flint water Crisis exposed 100,000 people to nag lalaga an dagat. So, there is less chance for people
lead in the USA. nga mabubuhi because of this unless individuals who are
● Many children experience brain damage as a divers are able to survive.
result. 10. WARFARE
So what are the implications in terms of infants, children, ● In the entire history of the United states, there
and pregnant women? have been only 15 years during which the country
4. TRANSPORT DISASTERS was not at war.
● Transport disasters include air, rail, road, and ● Since the end of WW2 (the war to “end all wars”),
water vehicle accidents. there have been at least 285 armed conflicts.
● These accidents are often too small to be 11. GENOCIDE
considered disasters. ● The UN defines genocide as “acts committed with
● However, there have been many situations where intent to destroy, in whole or in part, a national,
transport accidents led to mass fatalities. ethnical, racial, or religious group.”

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 DISASTER MENTAL HEALTH AND HIGH VULNERABILITY
7 POPULATIONS
NCM 120: Disaster Nursing
Ms. Ma. Concepcion B. Sekito • April 28, 2022
Some of the most recent genocides include:
1. Rohingya genocide
2. Yazidis genocide by ISIS
3. Darfur genocide
4. Effacer le tableau in the Democratic Republic of
the Congo
12. CIVIL UNREST
● Civil unrest disasters can include riot, strikes, and
acts of mass disobedience.
● Through US history, there have been many
incidents of civil unrest, including many which
resulted in massive property damage or death.
● The 1991 LA riots were one of the worst in US
history: 53 people killed, and thousands were
injured.
13. HYPERINFLATION
● Hyperinflation occurs when people lose faith in
their currency, and it loses value.
● During the hyperinflation in Yugoslavia in the
1990s, the currency lost value so quickly that
people used their worthless money as wallpaper.
14. TERRORISM
● Terrorism has many definitions but in general
used to instill fear in the population. There are
many forms of terrorism. These include:
1. Mass shootings
2. Bioterrorism
3. Hostage-taking
4. Hijacking
5. Bomb attacks
6. Cyber attacks
7. Biological weapons
15. PANIC, OVERCROWDING, AND STAMPEDES
● The combination of panic and overcrowding can
lead to stampedes.
● There have been numerous stampede events that
rose to the status of man-made disaster.
● For example, 100 people died in the Station
nightclub in Rhode Island when a fire broke out,
and people rushed to leave the building.
16. GLOBAL WARMING AND GREENHOUSE EFFECT
● Climate change is considered the “biggest threat”
to modern humanity.
● If climate change goals are not met, researchers
predict that there will be widespread
displacement of people, famine, and warfare for
resources.
● Climate change also intensifies natural disasters
like drought, wildfires, and hurricanes.
17. DEFORESTATION
● Deforestation is not always considered a disaster
in its own right.
● However, deforestation can cause other disasters
like landslides, mudslides, and flooding.
● Deforestation also causes habitat loss and
increases global warming.
Example would be the recent occurrence in Baybay and
other areas in the South. All of those could be the
consequences of deforestation.
18. POLLUTION
● Pollution usually isn’t thought of as a natural
disaster, but it actually has a very high death toll.
● Some reports say pollution kills more people each
year than war, natural disasters, and hunger.
Take note that for the occurrence of those disasters, each
emergency is different. It may require different actions for
different individuals to keep their families safe.
Instructions are being given by local authorities. There are
updates being made on the TV, radio, internet, and social
media pages. Depending on the emergency, authorities
will ask you to stay where you are or instructions will be
given that you go somewhere else such as during
evacuations. If it takes place in schools, school authorities
usually evacuate children to a safer place or these children
will be transferred to an emergency shelter. Should it take
place, it is not recommended to go during emergencies
because you also have to take care of yourself and this
also puts you and your family members at greater risk.
School authorities would also provide updates to parents
if it is safe to pick up their children.
● Infants, children, and adolescents have unique
physiological and psychosocial needs during and after
disasters and public health emergencies.
● The injury and illness patterns following exposure to
nuclear, biological, and chemical agents may be
different from those patterns assessed in adults.
● Treatment options for adults may be inappropriate or
unavailable for children.
● Children with special health care needs also require
refinements to their care. Nurses and health care
professionals must be aware of pediatric
considerations during disaster preparedness,
mitigation, response, recovery, and evaluation
efforts, and must be prepared to modify their
approaches accordingly.
EMERGENCY MANAGEMENT THEORY
● Disasters can be caused by a variety of Man-made or
Natural events. It is not the magnitude of that event,
but its impact on human populations that makes any
event a disaster.
CHEMICAL SPILLS AND STRUCTURE COLLAPSE
 Chemical spills commonly result from the unsafe
handling of chemicals, improper chemical storage,
chemical storage tank ruptures, improper containers
for chemical disposal, and failure to dispose of
chemicals in a timely manner.
 Chemical spill is one of the most devastating
environmental disasters that can happen because it
affects people, animals, the land and the coastal
waters. They can kill wildlife, destroy habitats, and
contaminate critical resources in the food chain.
 The US Agency for Toxic Substances and Disease
Registry (ATSDR) states that pregnant women,
children and elderly individuals are more sensitive to
chemical exposure.
 In 1993, a report from the National Research Council
titled Pesticides in the Diets of Infants and Children
first suggested that children, specifically the
developing fetus, are significantly more sensitive to
the toxic effects of chemicals than adults.
 A chemical emergency occurs when a hazardous or
poisonous chemical is released into the environment
and has the potential to harm people’s health.
Chemical releases can be unintentional, such as the
release of toxic gas from a volcanic eruption or an
industrial accident, or intentional, such as in a
terrorist attack.
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 DISASTER MENTAL HEALTH AND HIGH VULNERABILITY
7 POPULATIONS
NCM 120: Disaster Nursing
Ms. Ma. Concepcion B. Sekito • April 28, 2022

NEEDS OF INFANTS AND CHILDREN

● Having a safe, stable, and supportive relationship
serves as a protective factor for children who are
later impacted by disasters.
WHAT YOU MAY SAY OR DO:
● (for infants) Knowing that infants look to you to
understand the world, you use your tone of voice
and facial expressions to communicate safety and
danger and your actions to keep them safe.
● You should be patient in redirecting infants since
infants and young children learn by repetition.
● (for young children) You speak to children
about safety, focusing on how they can be
protected rather than focusing on the dangerous
situations.
DURING DISASTER
● Always check in with yourself first. If you feel
overwhelmed or frozen, pause and take a deep breath
(or use whatever strategy works for you) so that you
can effectively follow your gas lead, chemical spill, or
hazardous material emergency plan. Call for help if
you need it.
● It is important to talk to children even before they
understand the words. Talk about what is going on
around them. In times of danger, assure them you
are there to keep them safe.
● Be honest
● Use simple language that is appropriate for the
children’s ages
● Let children know what’s happening next
● How you speak to children is as important as the
words you use. Children respond to your volume and
tone of your voice. They notice your emotions, facial
expressions, and body language.
AFTER DISASTER
● Infants and young children will share their thoughts
and feelings through behavior, emotions, play, and,
when they are able, language.
● Watch and listen closely.
● Expect that some children will show emotion and
behavior dysregulation. Be available to provide
support.
● Remember that it is ok, and even helpful, to talk
about what happened. When children hear adults
talking about experiences and feelings, they know
they can too.
● Children who have had their personal lives or normal
routines impacted are more likely to show reactions
following a gas leak, chemical spill, or hazardous
material event. Notice times when children are
reminded of the event. It is not always possible to
know, but common reminders include smells, alarms,
seeing adults upset, or times when someone is late to
pick them up.
● Communicate with children’s parents/caregivers.
● Listen to parents’ concerns and share any concerns
you have. Work together to find ways to best support
the child.
TOXIC EXPOSURES DURING PREGNANCY
● If a pregnant woman is worried that she may have
been exposed to dangerous chemicals or
substances during or following the disaster, she
should be encouraged to talk to a healthcare
provider.
● The Organization of Teratology Information
Specialists (OTIS, 2018) offer free telephone
counseling and a fact sheet on pregnancy and
natural disasters to pregnant women worried about
toxic exposures.
HEALTH EFFECTS ON CHILDREN AND
PREGNANT
● Any chemical that can cross the placenta influences
the development of the embryo and fetus. This is
particularly true at the time when cells are dividing
and differentiating into specific tissues of the
nervous, circulatory, and immune systems.
● According to the World Health Organization, the
embryo, fetus, or child is particularly sensitive to
even minute concentrations of toxic chemicals.
STRUCTURAL COLLAPSE
● Building collapse is a common phenomenon
associated with multiple disasters, including those
caused by so-called “natural hazards”, such as
earthquakes and tsunamis and landslides, as well
as “technological hazards”, such as sub-standard
construction and maintenance practices, and
conflict. Pregnant women, infants, and children are
most vulnerable during this situation. Pregnant
women may be wary for the possibility of having an
abortion as they are evacuating, infants have no
capability to protect themselves, and children have
the tendency to panic during this very stressful
event.
INFANT NEEDS
Physiological Needs
● Proper nutrition
● Keep an emergency stock of the following items:
diapers, formula, bottles, water for mixing formulas,
wipes, blankets, age-appropriate clothing, and toys.
● Comfort: Be sure to keep baby’s diapers and clothes
clean and dry. Remember that babies have difficulty

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 DISASTER MENTAL HEALTH AND HIGH VULNERABILITY
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NCM 120: Disaster Nursing
Ms. Ma. Concepcion B. Sekito • April 28, 2022
regulating their body temperatures, so be sure to
dress them, keeping them cool enough in hot weather
and warm enough on cool days.
Safety Needs
● Safe place to stay temporarily.
● Create a way to transfer infants to a safe place in the
event.
Love and Belonging
● Being safe with family.
● Be provided with care and comfort when separated
from family.
Esteem Needs
● Even though they may not be able to communicate
verbally with us adults, there is a lot of
communication going on with infants. The infant
consistently sends out communication signals by
crying when it is hungry, cold, or wet. They also need
to feel love, need to be held and cuddled, talked to,
and played with. During a disaster, there may be lack
of comfort provided to infants which can lead to the
baby feeling insecure by being crankier, crying more
than usual or want to be held and cuddled more,
which will add to the issue of low self-esteem, or low
self-worth. It is important that adults in their lives are
responsive to them and in meeting their needs. When
infants consistently get responsive, and nurturing
care, it will have a positive impact on a child’s
psychological wellbeing, they will feel confident, and
have a good self-esteem.
Self-actualization
● Infants most likely do not fulfill this need yet because
they do not have enough life experiences and they do
not have a perception of reality.
NEEDS OF CHILDREN
Physiological Needs
● Proper nutrition
● Comfort
Safety Needs
● Safe place to stay temporarily.
● Children who are away from parents, in the care of
schools, child care providers, Head Start, or other
child congregate care environments, which must be
prepared to ensure children’s safety
● Stress debriefing: Assess children for risk factors of
PTSD and provide mental health counseling for those
at risk. Children may experience long-lasting effects
such as academic failure, PTSD, depression, anxiety,
bereavement, and other behavioral problems. Stress
debriefing helps them to understand what has
happened and how they are feeling.
Love and Belonging
● Being safe with family: Children are dependent on
adults for care, shelter, transportation, and protection
● Children must be expeditiously reunited with their
legal guardians if separated from them during a
disaster
Esteem Needs
● During a disaster it is important to talk to children
about what is happening in a way that they can
understand. Keep it simple and appropriate for each
child’s age.
● Provide children with opportunities to talk about what
they went through or what they think about it.
Encourage them to share concerns and ask questions.
Acknowledging their thoughts and feelings can help
make him feel safe and calm and boost a child’s self-
esteem.
● You can help your children feel a sense of control and
manage their feelings by encouraging them to take
action directly related to the disaster. For example,
children can help others after a disaster, including
volunteering to help community or family members in
a safe environment.
● Give older school children tasks and small jobs that
they can be responsible for during the sheltering
process. This creates a sense of accomplishment to
make them feel proud of what they can do.
● Self-esteem grows when children get to see that what
they do matters to others.
Self-actualization
● Children most likely do not fulfil this need yet because
they do not have enough life experiences and they do
not have a perception of reality.
NEEDS OF PREGNANT WOMEN
Physiological Needs
● Providing the body with the nutrients and physical
activity it needs
● Clean Air, Water, and Clothing
● While sleep is often disrupted during pregnancy,
proven mindfulness and relaxation strategies can
be used to provide the body and mind with the
rest it needs to support the baby.
Safety Needs
● Safe place to stay temporarily.
● Blankets, pillows, cushions, scarves, beanbags
allow pregnant women to build a sense of security
in our space in the lead up to birthing. This also
gives a sense of control over the environment
which is lacking in our wider situation.
● Hospitals that provide maternity services should
implement a standing perinatal subcommittee in
charge of disaster preparedness, which can be
mobilized quickly in the event of an emergency.
● Hospitals with maternity services should develop
specific strategies for stabilizing and transporting
obstetric patients, managing surge capacity and
the need for consultative services, sheltering-in-
place, and incorporating regional facilities that do
not provide maternity services.
Love and Belonging
● Emotional support, as well as empathy of the social
environment.
● Staying connected is vital to meeting the need for
acceptance and relationship.
● These needs include being reunited with family,
friends, and neighbors, who serve
as a support system and often have a buffering effect
on disaster survivors through
their support and love.
Esteem Needs
● Health education should be given so that pregnant
women can confidently meet their esteem needs
during pregnancy and birth.
● Self-accomplishment, confidence, and
empowerment. Esteem needs are a little harder to
meet at this period in human development. The most
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 DISASTER MENTAL HEALTH AND HIGH VULNERABILITY
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NCM 120: Disaster Nursing
Ms. Ma. Concepcion B. Sekito • April 28, 2022
logical way to meet these needs is by using much of
the same tactics in meeting the belonging and love
needs. Talking to the fetus in a soothing way may
give it a sense of comfort and enjoyment. Using a
positive happy voice will make the fetus feel
comfortable in what it is doing, giving it a feeling of
worth.
Self-actualization
● Realizing that your fulfilling, positive experience of
birth does not have to rest in the hands of others nor
does it have to be driven by fear. The woman has
the potential to steer her birth toward her version of
a positive birthing experience.
● In times of disaster, in order to achieve positive
birthing experience one should:
● If a woman has any signs of labor, call the healthcare
provider or 911, or go to the hospital immediately if
it is safe to travel.
● If there is a place to leave home, find out where to
shelter. Be prepared to leave quickly and have an
emergency kit that includes copies of medical
records, health care providers’ information, and
prenatal vitamins or medicines, ready to go. Tell the
shelter staff as soon as possible that you are
pregnant and if you have any health problems.
● Continue taking your prenatal vitamins or
prescription medicines as directed.
● Protect yourself from infections by washing your
hands often and staying away from moldy or dirty
places and people who are sick. If you do get sick,
talk with a healthcare provider right away.
DRINKING WATER CONTAMINATION
● The Safe Drinking Water Act defines the term
"contaminant" as meaning any physical, chemical,
biological, or radiological substance or matter in
water. Therefore, the law defines "contaminant"
very broadly as being anything other than water
molecules. Drinking water may reasonably be
expected to contain at least small amounts of some
contaminants. Some drinking water contaminants
may be harmful if consumed at certain levels in
drinking water while others may be harmless. The
presence of contaminants does not necessarily
indicate that the water poses a health risk.
CATEGORIES OF CONTAMINANTS
1. Physical contaminants primarily impact the
physical appearance or other physical properties of
water.
2. Chemical contaminants are elements or
compounds. These contaminants may be naturally
occurring or man-made.
3. Biological contaminants are organisms in water.
They are also referred to as microbes or
microbiological contaminants.
4. Radiological contaminants are chemical
elements with an unbalanced number of protons and
neutrons resulting in unstable atoms that can emit
ionizing radiation.
HEALTH EFFECTS OF DRINKING
CONTAMINATED WATER
NITRATES
● In the intestines, nitrates are converted to nitrites,
which prevent blood from transporting oxygen.
● An enzyme present in the system of older children
restores the blood's ability to carry oxygen
CRYPTOSPORIDIUM
● Pathogen that sometimes gets into water supplies. It
can cause a gastrointestinal disease that could be
fatal
LEAD
● Can cause both physical and mental developmental
problems in infants and children.
● Adults who have been drinking lead-tainted water for
a number of years can experience kidney problems
and high blood pressure.
IMPORTANT NEEDS OF NEWBORN, CHILDREN,
AND PREGNANT WOMEN
● General fluid needs increase during pregnancy in
order to support fetal circulation, amniotic fluid, and
a higher blood volume. In addition to maintaining
fluid volume needs, most municipal water contains
fluoride, which can aid the development of teeth and
bones in the growing fetus. An adequate fluid supply
also ensures that the mother has enough reserves to
tolerate blood loss during delivery.
● Need for proper education of the mother and
pregnant woman regarding the sources, effects and
management of contaminated drinking water.
● Need for proper water disinfection.
● Need for safe drinking water. It is important for
children because they are more vulnerable to harm
from contaminated water. If a water source may be
contaminated with flood waters, children, pregnant
women and nursing mothers should drink only bottled
water, which should also be used to mix baby formula
and for cooking. We also recommend you sponge
bathe your children with warm bottled water until you
are certain your tap water is safe to drink.
● During an emergency, mothers of exclusively
breastfed infants do not need to store any food-
related items for their babies. Exclusive breastfeeding
could be considered an emergency preparedness
activity.
EFFECTS OF CONTAMINATED DRINKING
WATER ON CHILDREN AND THE PREGNANT
● According to the study of Currie et al (2013) living in
a water district with contaminated water during
pregnancy is associated with an increase in low birth
weight of 14.55% among less educated mothers.
Similarly, potential exposure to contaminated water
increases the incidence of prematurity by 10.3%
among less educated mothers.
● Biological contaminants such as:
 Escherichia coli (E. coli): dehydration,
pyelonephritis, severe bleeding, miscarriage
or preterm delivery and neonatal meningitis
 Toxoplasma gondii: affects mainly the
eyes and the nervous system of the fetus;
can progress to behavioral abnormalities,
hearing loss, visual impairment, and mental
retardation
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 DISASTER MENTAL HEALTH AND HIGH VULNERABILITY
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NCM 120: Disaster Nursing
Ms. Ma. Concepcion B. Sekito • April 28, 2022
● Exposure to drinking water contaminants such as
lead, nitrates, pesticides and even the
byproducts of processes that disinfect water
supplies can harm the baby by retarding growth,
stunting mental development and causing birth
defects
● Children are also susceptible to gastrointestinal
and stomach illnesses like nausea, vomiting,
cramps, diarrhea and headaches by drinking
contaminated water.
● Contaminated water causes parasites in children
which also contribute to chronic malnutrition with
children unable to absorb sufficient nutrients.
● Microbiologically contaminated drinking water
can also transmit diseases such as cholera,
dysentery, typhoid and polio and is estimated
to cause 485,000 diarrheal deaths each year.
DRINKING WATER MANAGEMENT
● Improve sanitation facilities by providing toilets and
latrines that flush into a sewer or safe enclosure.
● Promote good hygiene habits through education.
Proper hand washing with soap and water can reduce
diarrhea cases by up to 35 percent.
● Implement rainwater harvesting systems to collect
and store rainwater for drinking or recharging
underground aquifers. Build wells to extract
groundwater from underground aquifers.
● Provide home water-treatment capability through the
use of filters, solar disinfection, or flocculants, to
make drinking water safe.
● Promote low-cost solutions, such as chlorine tablets
or plastic bottles that can be exposed to sunlight, to
improve water quality.
TRANSPORT DISASTERS
● Infants and toddlers can be severely affected by
trauma. An example of a traumatic and life-
threatening situation might be a car accident,
bushfire, sudden illness, a fatality in the family,
violent crime, or abuse of children.
● Before the age of three, trauma can profoundly affect
key aspects of child development. Rebuilding the
family’s safety, security, and nurturing environment
will aid the baby or toddler in their recovery.
● It is necessary to establish a regional
neonatal/pediatric transport network, in order to
provide a platform for effective information
communication and resource sharing.
INFANT NEEDS
1. Infant and Pediatric Transport
 This service provides safe transportation of the
pediatric victims with transporting team members
that are knowledgeable and skilled in the needs of
the critically ill or injured infants.
 After an incident happens, the first thing to do is
to call for help. Police and emergency medical
technicians (EMTs) should arrive at the accident
scene. A police report can be issued after an
investigation has been conducted. In the event
your child’s condition requires hospitalization.
2. Physical Assessment
● After a neonatal/pediatric transport. The thing that
you should do is to check on the infant.
●
Try not to move him or her if seriously injured,
until EMS arrives.
● It may be possible for you to calm the infant or do
basic assessment such as checking up for vital
signs while waiting for the EMT’s to arrive:
● You look into your infant’s eyes with a special torch
to check how their eyes look and move.
● Once the EMT arrives, they will quickly assess his
or her condition. Allow them to take the child out
of the car seat and perform an examination and
determine the extent of the injury.
3. Immediate Medical Treatment
Seeking The Advice of a Pediatrician
 After your child has been treated by emergency
room doctors, it is important that you follow up
with his or her primary care physician to ensure
proper treatment.
 Your pediatrician may schedule an appointment
for your infant to follow up with him/her in the
office after your infant is discharged from the ER,
or if your infant is admitted to a facility where the
pediatrician has privileges, your physician may visit
your infant in the hospital.
 If necessary, your infant’s doctor may refer you to
additional doctors and specialists. You could seek
the help of an orthopedist, neurologist, plastic
surgeon, or physical therapist, depending on the
condition your child has.
MINING ACCIDENTS
INFANT NEEDS
 Continue medical care through regular examinations
 Continue breastfeeding especially when clean water
is not available.
 If not breastfed, try looking for a safe source of clean
water and properly prepare a commercial infant
formula.
 Secure clean sets of clothing and a blanket to keep
the infant warm.
 Always be with the infant to ensure its safety.
 Evacuate as necessary.
NEEDS OF CHILDREN
 The first and most important thing is always to seek
medical attention. If time is of the essence, your
health should always be your top priority. You will also
want to inform your supervisor as soon as possible.
 Assess physical, emotional and psychological stability
of children after the accident.
 Move persons and children to a safe place
immediately.
 Protective clothing must be provided to the children
in the cold and exposure to the outside must be kept
to a minimum.
 Mining ventilation equipment including mine
ventilation fans, cooling systems, and heating
systems along with damper systems, silencers, and
electrical and control hardware should be readily
available.
 Isolate the person from the accident site by guarding,
space or time separation.
 Having a reunification plan and knowing reunification
resources can help you reunite with your loved ones
as soon as it is safe to do so.
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NCM 120: Disaster Nursing
Ms. Ma. Concepcion B. Sekito • April 28, 2022
 Survival Kit (Ready to eat foods, water, flashlights and
extra batteries, whistle)
 Wearing of personal protective gears
 Modes of communication must be readily available.
Mobile devices are currently used to pass on updates,
but the signal for these can be weak or nonexistent
underground. On-site communication systems are
another technique for transferring messages to
miners.
PREGNANT WOMEN NEEDS
 Mining workplace employers have a legal
responsibility to ensure the health and safety of their
employees. As the number of female employees
increase in the industry, questions and concerns
related to the health and safety of pregnant and
breastfeeding employees are becoming more
prevalent. An understanding of the potential impact
of workplace hazards on the pregnant and
breastfeeding employee and her developing fetus and
ways to eliminate or reduce the exposure risk are
essential.
 Due to the fetus’ demands for oxygen, the mother’s
respiratory depth increases. "means that the total
amount of air breathed into and out of the lung per
minute is larger during pregnancy. As a result, the
amount of inhaled toxicants may be significantly
greater during pregnancy compared to the non-
pregnant state. In order to prevent acute inhalation
injuries, employers have substantial responsibility for
the most frequently used personal respirators.
Provision and periodic maintenance of respirators and
training of the workers are among these
responsibilities. Having respirators in proper size and
model and their disinfection are essential.
 Regular consumption of water is also vital to avoid
dehydration and also because of extra fluid demands
during pregnancy.
 Review the potential sources of heat exposure to
recognize and avert risks. Survival kits should also be
provided. Heat exposure causes increased risk of
dehydration, causing risk of early labor, heat stress
and fainting. This is under safety and biological
needs.
 Educate workers on increased risk and symptoms of
heat exhaustion, heat stroke and dehydration.
 Recommend wearing ‘cooling vests’ when known to
be exposed to high temperatures.
 Recommend elevating legs during all rest breaks
 During the entire pregnancy, avoid continuous (> 8
hours) exposure to noises greater than 85dBA
because it may cause hearing impairment to the
fetus.
 During the entire pregnancy, keep whole body
vibrations to a minimum as this may result a
miscarriage and pre-term delivery.
 Tobacco smoke is an important environmental source
of cadmium. Cadmium is a product of mechanical
extraction of ores or minerals as well as a product
from the smelting of zinc, lead and copper ores.
Cadmium has associated risks of preterm delivery and
low birth weight; therefore, educating workers on the
importance of quitting smoking and avoiding second-
hand smoke to reduce cumulative effects.
 Ensure proper lifting, pushing, pulling and bending
techniques are practiced.
EXPLOSION
 Explosions and bombings remain the most common
deliberate cause of disasters involving large numbers
of casualties, especially as instruments of terrorism.
These attacks are virtually always directed against the
untrained and unsuspecting civilian population. Unlike
the military, civilians are poorly equipped or prepared
to handle the severe emotional, logistical, and medical
burdens of a sudden large casualty load, and thus are
completely vulnerable to terrorist aims.
INFANT NEEDS
Infants are especially vulnerable in a disaster, and helping
them get to safety requires extra planning and
preparation. This is because children between birth and
three have unique needs, such as:
 Reliance on caregivers for physical, nutritional, and
emotional needs
 Communication limitations
 Limited mobility
 Need for safety and protection from harmful items
 Greater susceptibility to hazards, including chemicals
and smoke
WHAT TO BRING DURING A DISASTER FOR
INFANT:
o 100 nappies and 200 nappy wipes
o If you have an infant, your kit should also have:
o a thermometer
o copies of vaccination records
o antibacterial wipes and hand sanitizer
o dish soap
o a portable crib
o baby food in pouches or jars and disposable
feeding spoons
o two baby blankets
o extra baby clothes and shoes for older infant
o baby sling or carrier
o diapers, wipes and diaper rash cream
o medications and infant pain reliever, such as
ibuprofen or acetaminophen
o small disposable cups
 Emergency management authorities should provide
those who care for infants with accurate and detailed
information on the supplies necessary to care for
them in an emergency, distinguishing between the
needs of breastfed infants and the needs of formula
fed infants.
 Those who care for formula fed infants should be
provided with detailed information on the supplies
necessary for an emergency preparedness kit and
with information on how to prepare formula feeds in
an emergency.
o Ready-to-use liquid infant formula
o 56 serves of ready-to-use liquid infant formula,
84 L water, storage container, metal knife, small
bowl, 56 feeding bottles and teats/cups, 56 zip-
lock plastic bags, 220 paper towels, detergent,
120 antiseptic wipes, 100 nappies and 200 nappy
wipes
o Powdered infant formula
o Two 900 g tins powdered infant formula, 170 L
drinking water, storage container, large cooking
pot with lid, kettle, gas stove, box of
matches/lighter, 14 kg liquid petroleum gas,
measuring container, metal knife, metal tongs,
HIDALGO, JOLBITADO| 7
 DISASTER MENTAL HEALTH AND HIGH VULNERABILITY
7 POPULATIONS
NCM 120: Disaster Nursing
Ms. Ma. Concepcion B. Sekito • April 28, 2022
feeding cup, 300 large sheets paper towel,
detergent, 100 nappies and 200 nappy wipes.
NEEDS OF CHILDREN
 The possibility of exposure to inhaled toxins and
poisonings
 Blast injuries should be considered
 Wounds can be grossly contaminated. Ensure close
follow-up of wounds, head injuries, eye, ear, and
stress-related complaints.
 Auditory system injuries and concussions may occur
 Communications and instructions may need to be
written because of tinnitus and sudden temporary or
permanent deafness.
 Health and mental health resources may be strained
or overwhelmed
 Schools and workplaces may be closed and travel
may be prohibited. Children’s educational needs may
be compromised.
 Infants and young children in emergency shelters
have different nutritional needs than adults and
require age-appropriate supplies
 Children are more likely to die following blast injuries
and experience injuries of a greater intensity than
adults.
 Children are overwhelmingly likely to experience
head injuries, with head and burn injuries from blast
injuries a significant cause of death in young
children.
 Most children affected by blasts experience multiple
injuries. Injuries such as burns, affect a much larger
proportion of the body than in adults. Children under
two have thinner skin compared with older children
and adults.
 Full thickness burns are more likely, with resultant
rapid loss of heat, fluid and protein. This can lead to
dehydration, nutritional deficiencies and
hypothermia.
 Children under ten are more likely to experience
traumatic brain injuries (TBI) than adolescents which
include concussion, loss of hearing and nerve cell
damage.
 Children suffering severe injuries need long-term
rehabilitation across a continuum of care
 Children who are exposed to stress for prolonged
periods of time without adequate caregiver support
are at risk of toxic stress.
 If left untreated, the long-term consequences are
likely to be even greater, affecting children’s mental
and physical health for the rest of their lives.
BIOLOGICAL AND PHYSIOLOGICAL NEEDS
 Shelter
 3-day supply of non-perishable food
 3-day water supply (at least a gallon per person per
day)
 First-aid kit (basic over the counter and prescription
medicine)
 Flashlight and plenty of extra batteries
 Cell phone and AC/DC chargers;
 Change of clothing, rain gear and comfortable sturdy
shoes
 Pillows, blankets, and/or sleeping bags
 Whistle to signal for help
 Beloved or comfort items – toys, favorite stuffed
animals, etc.
 Identification to be carried by each child in case their
family members become separated.
 Phone numbers and contact information of family
members, friends or relatives to call if separated
during a certain disaster.
EMERGENCY PREPAREDNESS FOR CHILDREN:
 In some chemical emergencies, emergency
authorities decide when it is safe to evacuate the
immediate area and give instructions for going to an
emergency shelter, if necessary. If you have children
in a school in the exposed area, school authorities
may evacuate your children to a safer place or
emergency shelter. In these cases, do not go to your
children during the emergency. This can put you and
your children at greater risk. Wait until emergency or
school authorities say it is safe for you to pick up your
children.
 Some chemical emergencies make going outdoors or
leaving the immediate area too dangerous. When this
happens, emergency authorities will tell you to shelter
in place (stay indoors where you are). If you have
children at school, they may have to stay at the
school.
 If you and your children are in a vehicle during a
chemical emergency, you should not try to shelter in
the vehicle unless you have no other choice. Vehicles
are not airtight enough to give adequate protection
from chemicals. Helping children prepare for
emergencies
 Teach them about hazards
 Make a family emergency plan, and preparing an
emergency kit together.
 Teach your kids what to do in case of a fire.
 Make sure your kids know what to do at school if
an emergency happens. Helping children cope
 Children in particular can feel the stress deeply
and may react in different ways. The key to
helping your children cope is simply by being
there and making them feel safe.
 Take their fears seriously and tell them that it's
okay to be scared.
 Explain the events as best you can and
acknowledge what's frightening about what
happened.
 Tell your kids what you think and feel. Doing so
helps them feel less alone if they know that their
feelings are similar to yours.
 Maintain familiar routines, like mealtimes and
regular bedtime hours.
 While parents can play a huge role in helping
children deal with anxiety, it may be helpful to
talk to a professional such as a psychologist or
social worker, who can help children understand
and cope with their emotions.
HIDALGO, JOLBITADO| 8