Nutrition Planning for

Emergencies/Disasters

Nutrition in Emergencies
 LEARNING OBJECTIVES
By the end of this module, you should be
able to:
 Explain the objectives of E/D
preparedness
 Define what is meant by the terms hazard,
vulnerability, and disaster
 Outline the scope of emergency/disaster
preparedness

Nutrition in Emergencies
 LEARNING OBJECTIVES

 Identify key emergency/disaster

preparedness, response, & recovery
actions related to nutrition

Nutrition in Emergencies
 Country’s Vulnerability

Nutrition in Emergencies
Maplecroft
Natural Disaster Risk Index, 2010
Figure 1: Top 10 countries by number of reported events, 2009: (The Philippines, China and the United
States were most often hit by natural disasters)
Figure 2: Top 10 countries in terms of disaster mortality and distributed by disaster type, 2009
Nutrition in Emergencies
Figure 3: Top Nutrition
10 countries byin Emergencies
victims and distributed by disaster type, 2009
Disaster Risk Reduction Management Framework
“Recover back for better…”
Response
(Capacity utilization)
Preparedness
(Capacity Development) Recovery
(Capacity rebuilding
for better)

Mitigation
Prevention (Capacity to
(Capacity to
reduce/prevent lessen impact
hazard) of hazard)

Nutrition in Emergencies
 HYOGO FRAMEWORK FOR ACTION 2005 - 2015
Building the Resilience of Nations and Communities to Disasters

Expected Outcome: The substantial reduction of disaster losses, in lives and in the social, economic
and environmental assets of communities and countries

Strategic Goals

The integration of disaster The development and Systematic incorporation of risk

risk reduction into strengthening of institutions, reduction approaches into
sustainable development mechanisms and capacities to implementation of emergency
policies and planning build resilience to hazards preparedness, response and recovery
programmes

Priorities for Action

1. Ensure that disaster Identify, assess Use knowledge, Reduce the Strengthen
risk reduction (DRR) is a and monitor innovation and underlying risk disaster
national and a local disaster risks and education to build a factors preparedness
priority with a strong enhance early culture of safety and for effective
institutional basis for warning resilience at all levels response at all
implementation levels

Cross Cutting Issues

Gender perspective and Community and Capacity building and

Multi–hazard approach
cultural diversity volunteers participation technology transfer
 Seven Fundamental Terms in Risk Management

A Logical Framework of Terminology (the relationships between the key words)

Hazard Risks
Any potential threat to public safety Anticipated consequences of a specific
and / or public health hazard interacting with a specific community
(at a specific time)

Emergency Vulnerabilities
An actual threat to public safety and Factors which increase the risks arising from a
/ or public health specific hazard in a specific community (risk
modifiers)

Disaster Capacities
Any actual threat to public safety An assessment of ability to manage to an
and / or public health where local emergency (a risk modifier) – total capacity is
government and the emergency measured as readiness
services are unable meet the
immediate needs of the community
Community is people, property, services, livelihoods and environment i.e. the elements exposed
to hazards
1) Hazard Examples:
• 4 classes of hazard: – Earthquakes
1. Natural hazards – Floods
– Volcanoes
2. Technological – Civil unrest
hazards – Sporting events
3. Biological – Chemical
hazards factories
4. Societal hazards
2) Vulnerabilities - (risk modifiers)
Examples:
– Poor access to nutrition program
– Low Measles vaccination coverage rate
– High Under 5 malnutrition rate
– High Under 5 mortality rate
– Limited access to safe water
– Poor sanitation
– Low breastfeeding rate

Nutrition in Emergencies
3) Risks
Examples:
– Death of SAM
– Injury (mental, physical, psychosocial)
– Communicable Disease
– Contamination
– Displacement
– Breakdown in security including food
– Damage to food warehouses
– Breakdown in essential services
– Loss of property
– Loss of income
– Secondary hazards (fire, mudflow, etc.)

Nutrition in Emergencies
4) Emergency
Examples:

– Marasmic child developed fever

– Micronutrient supply run out of supply
– SAM with dehydration
– Anemic mother became dizzy

Nutrition in Emergencies
5) Disaster
 Any actual threat to public safety and/or
public health where local government
and the emergency services are unable
to meet the immediate needs of the
community, whereby the event is
managed from outside the affected
communities

Examples: ?
Nutrition in Emergencies
6) Capacities
 An assessment of ability to manage to
an emergency (a risk modifier) – total
capacity is measured as readiness

Nutrition in Emergencies
 Defining Capacity

Sum of:
– capability
– resources
– relationships

Within Aims
– community – Reducing illness,
– organization disability and death
– country from risks
– region – Promoting food
safety and security
– world
Elements
Of capacity
To manage
Health
risks of
emergencies
Organizations
Systems
People

Nutrition in Emergencies
7) Community
 Elements exposed to hazards: People,
property, services, livelihoods and
environment

Nutrition in Emergencies
Impact of Disaster to the Community

Livelihood Services

Community People
Disaster

Environment Properties

Manage the following:

> Event > Environment
> Victims > Resources
> Responders > Partners
Nutrition in Emergencies
 Disaster
N Disruptions Food Chain Adaptations
U Changed habits
Reduced/
T
Destroyed
Production Different crops
R
Production
T
Price increase
I Lack/limited
subsistence
O Food Distribution
Economize
N Resources
Barter
Massive Migration of
in
Population Accessibility Certain groups
Migration
E Changed Resource
M Consumption
Distribution within
E Increase of the household
R Communicable Biological
E Diseases Utilization Traditional care
G
E Malnutrition Nutritional Stunting
N Death
C Status
Y
Planning for Nutrition in Emergencies
RISK MANAGEMENT is a comprehensive
strategy for reducing threats and consequences
to public health and safety of communities by:
preventing exposure to hazards (target =
hazards)
reducing vulnerabilities (target =
community)
developing response and recovery
capacities (target = response agencies)
 RISK ASSESSMENT
Probable consequences to public health and
safety of a hosp. being exposed to hazard
• Probability of death
• Prob. of disease or injury (mental, physical)
• Prob. of secondary hazard (fire, disease, etc)
• Prob. of contamination
• Prob. of displacement
• Prob. of loss of lifelines
• Prob. of loss of income or property
• Prob. of breakdown in security
• Prob. of damage to infrastructure
• Prob. of breakdown in essential services
Nutrition in Emergencies
 Comprehensive Risk Reduction & Management Framework
Preparedness Phase Response Phase
1. Policy development 1. Hospital/PH Response
2. Plan development 2. 24/7 Operation Center
3. People (HRD) 3. Surveillance & RNA
4. Physical /Facility 4. Cluster Services (WASH,
Development Nutrition, Health, MHPSS)
5. Partnership building 5. Primary Health Care and
6. Promotion/Advocacy Referral Services
7. Peso & Logistics 6. Risk Communication
8. Practice documentation 7. Networking
9. Program development 8. Resource Mobilization
10. Package of services
Recovery Phase
1. Post Mortem Evaluation
2. Facility Rehabilitation
3. Livelihood Projects
4. Resource Stockpiling / Replenishment
5. Case Follow-up
6. Documentation of Lessons Learned
7. Research
Nutrition Management
1. Plan Development/Integration
2. Policy review, updating,
dissemination
3. Organization of the Nutrition
Cluster / Public Health Team
(PPP)
4. Technical assistance in the
conduct of NiE and IFE
training/orientation
5. Conduct of Advocacy,
Promotion, & IEC
6. Risk Communication
 Nutrition Management
1. Rapid Assessment (Nutrition & IFE)
2. Nutrition Monitoring & Surveillance
3. Collaboration on Food Safety & Food
Security Interventions
Response 4. Implementation of Nutrition
Phase Interventions
- Micronutrient Supplementation
- IFE
- Supplementary Feeding/ CMAM
- Psychosocial Support
5. Resource Mobilization
6. Policy and Program Monitoring and
Evaluation
Nutrition Component

1. Participation in DANA
2. Case Follow-Up/Referral
3. Support in the documentation of
lessons learned and good
practices
4. Inventory of available stockpiles
5. Collaboration on Livelihood
Interventions
6. Research & Documentation
Public Health
Services Hospital
In Emergency
Health
System

Epidemiology and
Surveillance

Communicable Disease
Prevention and Control

Food and Nutrition/ Water and Sanitation

Nutrition in Emergencies
 The Planning Process
 Determine the authority responsible for the
process
 Establish a planning committee
 Conduct a risk analysis - hazards and
community vulnerabilities
 Set the planning objectives
 Define the management structure for the
program
 Assign responsibilities

Nutrition in Emergencies
 The Planning Process
 Identify and analyse capacities and resource
 Develop the emergency management systems
and arrangements
 Document the plan
 Test the plan
 Review and update the plan on a regular basis

Nutrition in Emergencies
 Every agency should have 3 sets of plans,
each composed of sub-plans, and
collectively known as the
“Emergency Preparedness, Response, and
Recovery Plan”
1) A risk reduction plan
– A hazard prevention plan
– A vulnerability reduction plan
– An emergency preparedness plan
2) An emergency response plan
3) A recovery and reconstruction plan

Nutrition in Emergencies
 Elements of the NiE Plan
I. Background
II. Plan description
III. Goals and objectives
IV. Planning Group
V. Emergency Preparedness Plan
Hazards prevention
Vulnerabilities reduction
Risk reduction
VI. Management Structures
VII. Roles and responsibilities
VIII. Response Plan
Policies, guidelines, protocols for the developed
systems
IX. Recovery and Reconstruction Plan

Nutrition in Emergencies
 Example

I. Background
• Name of the LGU and address Geographic
description (narrative, tabular, graphs,
map, etc)
• Demographic profile
• LGU facilities
• Relevant LGU profile/statistics
• LGU Manpower
II - Define the Plan

• Aim, objectives, and scope

• Tasks to be performed
• Resources to be needed
• Framework which emergencies will be
managed
Example
II - Plan Definition/Description
The LGU of ______ Disaster
Preparedness (Risk Reduction) and
Management Plan defines the direction of the
PHO/CHO in preparing for an effective and
efficient response in any event of emergency
or disaster. This embodies a set of strategies
and activities based on the hazards and
vulnerabilities or risk analysis of the LGU.
 Example
Goals and Objectives
Goal:
“To minimize injuries, disabilities and death
during emergency or disaster”
“ To retain the functionality of the
LGU/PHO/CHO even during and after
emergencies and disasters”

(Write in paragraph form the purpose of the

plan from a
broader to more specific perspectives.)
Example

Goals and Objectives

General Objectives:

To build the LGU’s capacity for

effective and efficient
response to and recovery from
emergency or disaster
Specific Objectives:

• To strengthen the LGUs emergency,

preparedness, response and
recovery plan
• To develop systems for emergency management
• To update existing guidelines, procedures,
protocols of developed
emergency/disaster management systems
• To develop human resource competencies for
emergency response
• To upgrade the LGU services for better
emergency management
• To ensure availability of logistics, funds, and
other resources in times
of emergency or disaster
IV - Formation of Planning
Group
In identifying the composition:

• Key people and organizations

• Appropriateness of existing group

 authority
 representation
 sufficient expertise
 cooperation of local experts & other
sectors
 Example

C - Formation of Planning Group

• PHO/Asst.
PHO/CHO/Asst.
• PHN
Nutrition Staff
• Tech Staff
Health Staff
• Program Staff
WASH Staff
• Administrative Officer
MHPSS Staff
• Others
 HAZARD ANALYSIS
Hazard Severity Frequency Extent Duration Manageability Total
(A) (B) (C) (D) (E) (A+B+C+D) - E

Natural

Biological

Technological

Societal

Score each hazard based on above 5 considerations. Use a scale of 1 – 5 with 5

as the highest. In getting the Total, double the Manageability Score minus the
sum of the scores of the 4 other considerations [(A+B+C+D) - E]. This concept of
this exercise is based on the following equation:

Nutrition in Emergencies
 HAZARD PREVENTION PLAN
Hazards Strategies/ Time Frame Resource Requirement Person Responsible Indicators
Activities
Required Available Source

Nutrition in Emergencies
 VULNERABILITY ASSESSMENT MATRIX
Vulnerable Areas Vulnerabilities
Hazard
People Properties Services Environment

Nutrition in Emergencies
 VULNERABILITY REDUCTION PLAN
MATRIX
Vulnerability Reduction
Vulnerability Strategies/ Activities Time Resource Requirement Person Responsible Indicator
Frame
Required Available Source

Nutrition in Emergencies
Emergency Preparedness Plan
• the target are the people, the systems
and the arrangements – BUILDING
CAPACITIES

• the aim is to improve response

• examples are policies, plans,

guidelines, training, drills and
exercises, management structures,
information management, logistics
management, management structure,
incident command system
 Preparedness Plan
Preparedness Resource Requirement
Risks Capacity Strategies/ Activities Time Person Indicators
needed Frame Responsible
Required Available Source

Nutrition in Emergencies
 Emergency Response Plan
Operational Plan
 Evacuation plan - protocols/procedures in activation;
 Alert warning - steps in announcement of hazard
signals; borderline malnutrition indicators
 Emergency procurement – procedures for making
arrangements for rapid acquisition of emergency relief
supplies and equipment
 Procedures for relief distribution
 Procedures for registering the evacuees
 Procedures in opening the evacuation center
 Protocol/Procedures in Networking/Meetings

Nutrition in Emergencies
EMERGENCY RESPONSE PLAN
HEALTH RESPONSE
Search and rescue
First aid
Triage
Community
Medical evacuation
Primary care
DIRECT
IMPACTS Disease surveillance and control
Curative care
Damage
Blood banks
and
VULNERABILITIES Laboratories
Needs
CAPACITIES Referral system
Special units (burns, spinal)
EMERGENCY INDIRECT Evacuation centres
IMPACTS Shelter
Water
Food and nutrition
Energy
ASSOCIATED FACTORS Security
Climate/weather/time of day Environmental health
Location Primary health care
Security situation
Political environment Care of the dead
Economic environment Psychosocial care
Socio-cultural environment Disability care
Morale, solidarity, spirit
Competence, corruption
Nutrition in Emergencies Recovery
Reconstruction
 Response Plan
Response Resource Requirement
Risks Capacity Strategies/ Activities Time Person Indicators
needed Frame Responsible
Required Available Source

Nutrition in Emergencies
Recovery and Rehabilitation Plan
A plan to restore services and replace
damaged elements of the LGU for the better

• Repair/construct damaged buildings and

utilities
• Replace LGUs supplies and equipment
• Psychosocial services for evacuees,
communities and even the health staff
• Return to normal activities of the
PHOs/CHOs
• Post Incident Evaluation; Lessons
Learned; Plan review and amendments
 RECOVERY PLAN
Recovery Resource Requirement
Damages Capacity Strategies/ Time Person Indicators
needed Activities Frame Required Available Source* Responsible

Nutrition in Emergencies
Next Actions
1. Write the Plan and have it
approved by the head of the
agency. The Plan is not a plan
until written and approved by the
head of agency

2. Disseminate the plan to all the

stakeholders and staff. Everyone
needs to know the plan so that in
emergency no one would ever
say, “he does nothing cause he
knows nothing”.
Next Actions
3. Test the plan. The plan is believed to be
effective only when it is tested, be able to
know its functionality, acceptability, and
doability in the hands of the implementers.

4. Implement the plan.

5. Monitor and evaluate the implementation of

the plan

6. Review and update the plan regularly.

Nutrition in Emergencies
 Pointers in Formulating an
Emergency Management Plan
 A plan should be written so as not to be
forgotten
 A plan should be simple so as to be
understood
 A plan should be disseminated to be in the
hands of those who will implement it.
 A plan should be tested so as to be realistic.
 A plan should be revised so as to be up – to
– date.

Nutrition in Emergencies
 “By failing to prepare you are preparing to fail” –
Ben Franklin

 “If ye are prepared , ye shall not fear” – Doctrine &

Covenants 38:30

 “It wasn’t raining when Noah built the ark” –

Howard Ruff

 “ Remember, when disaster strikes, the time to

prepare has passed” – Steven Cyros
 Today, as never before, the fates of men are so
intimately linked to one another that a disaster
for one is a disaster for everybody” -- Natalia
Ginsburg

Nutrition in Emergencies
Thank You