UNIT VII

DISASTER
MANAGEMENT
 “It was like when you make a move in chess and just as you
take your finger off the piece, you see the mistake you've
made, and there's this panic because you don't know yet the
scale of disaster you've left yourself open to.” 
― Kazuo Ishiguro
INTRODUCTION
 Disasters are a part of human experience
and has been with us from the beginning of
time……..
 Since then disasters have occurred in
various forms throughout the world.
 The increasing incidence of disaster and the
growing complexity of their nature have
created challenges.
 IN INDIA….
 India has its own share of disasters in recent years
 The Bhopal gas tragedy-1984-3000 lives
 Tsunami -2004-10.273 lives
 Bombing of the Taj hotel-2008 ………

 All these tragedies

 Countless people have been killed
 Injured
 Displaced
 Left homeless
 Negatively affected in other ways.

 Nurses play an important role in disaster preparedness and

management
MEANING OF DISASTER

 French word – “désastre”

 Old Italian - “disastro”,
 Greek prefix dus = “bad” + aster =
“star”.
 The root of the word disaster (“bad
star” in Greek)
DISASTER
 Disaster is defined as ’ecological disruptions, or emergencies, of
a severity and magnitude that result in deaths, injuries, illness,
and property damage that cannot be effectively managed using
routine procedures or resources, and that require outside
assistance.
-VEENEMA

 Disaster is defined as any occurrence that causes damage,

economic destruction, loss of human life, and deterioration in
health and health services on a scale sufficient to warrant an
extraordinary response from outside the affected community
or area.
-WHO
 HAZARD
Refers to the possibility of the occurrence of a
disaster caused by a
○ natural phenomena eg)hurricane , earthquake,
○ Failure of manmade sources of energy eg)nuclear
power plant
○ By human activity eg)war
Disaster nursing
The adaptation of professional nursing skills
in recognizing and meeting the nursing
physical and emotional needs resulting from
a disaster.
Goal: to achieve the best possible level of
health for the people and the community
involved in the disaster.
Types of disasters
 DISASTER
natural
 man made
technologic
complex
external
internal
 NATURAL
MAJOR
Flood
Cyclone
Drought
Earthquake
Volcano
Hurricane

MINOR
 Cold wave
 Thunderstorm
 Heat waves
 Mudslides
 Storm
 MAN MADE
MAJOR
Settingof fires MINOR
Epidemic  Accidents

Deforestation  Food poisoning

Wars  Industrial disaster

Biochemical terrorism  Environmental

Radiological
pollution
 CONTD…

Complex: Disaster as a result of war ,draught, diseases, and

political unrest resulting displacement of millions of people from
their homes…..
CONT……
Technological: are those in which large no: of
people, Community infrastructure and economic
welfare are directly and adversely affected by major
industrial accidents, unplanned release of nuclear
energy, fires or explosion from hazardous substance
CONT…..
External: Do not affect the hospital
infrastructure, but do tax hospital resources
due to number of patients or type of injuries.
 CONT….
 Internal: Cause disruption of normal hospital
function due to injuries or death of hospital
person or damage to physical plant.
Eg) hospital fire, power failure or chemical spill
CHARACTERISICS OF A DISASTER
 Sudden occurrence
 Vastness of damage
 Loss of life and property
 Disruption of communication
 Panic and anxiety
DIASTER CATEGORY
 1.onset
 2.impact
 3.duration

 Rapid onset events eg) earthquakes, tornadoes

Sudden impact, short durations
Yet evacuation is possible
 Eg)bio terrorism attack
 sudden, unanticipated, prolonged impact on the
community.
 Eg) drought
Creeping effect, gradual onset, prolonged impact.
 DISASTER MANAGEMENT

Disaster management can be defined as the organization and

management of resources and responsibilities for dealing with all
humanitarian aspects of emergencies, in particular preparedness,
response and recovery in order to lessen the impact of disasters.
(
International Federation of Red Cross and Red Crescent Societies
Disaster Management
.)

Purpose: to maintain a safe environment and continue to provide

essential services to the patient during the time of disaster.
 Aims and principles of Disaster
management
1. Prevent the occurrence of disaster
2. Minimize and prevent further causalities
3. Rescue the victim and provide first aid
4. Arrange definite medical care and other facilities
5. transport the victims to safer places
 DIASTER MANAGEMENT CYCLE
 1.prevention
 2.mitigation
 3.preparedness
 4.response(assessment,
evacuation, rescue and relief)
 5.recovery(rehabilitation and
reconstruction)
THREE FUNDAMENTAL PHASE OF
DISASTER MANAGEMENT
1. Disaster impact and response
2. Disaster preparedness
3. Disaster mitigation
 Mitigation - Minimizing the effects of disaster.
Examples: building codes and zoning; vulnerability analyses;
public education.
 Preparedness - Planning how to respond.
Examples: preparedness plans; emergency exercises/training;
warning systems.
 Response - Efforts to minimize the hazards created by a
disaster.
Examples: search and rescue; emergency relief .
 Recovery - Returning the community to normal.
Examples: temporary housing; grants; medical care
 PREVENTION PHASE
 Identify possible risk factors

 Steps to be taken to prevent it

Eg) vehicle or train accidents, toxic gas leaks

 Assessing the community for disaster risk factors and taking

action.eg)blind intersection where accidents can occur.

 Nurses can meet with community leaders and hospital

administrators and help eliminate them.
 mitigation
₰ Measures taken to remove the harmful effect of disaster
₰ Prevention measures
₰ Require significant amount of forethought, planning and
implementation
₰ Mitigation activities actually eliminate or reduce the probability of
disaster occurrence, or reduce the effects of unavoidable disasters.
Mitigation measures include building codes; vulnerability analyses
updates; zoning and land use management; building use regulations
and safety codes; preventive health care; and public education.
₰ the shaping of public policies and plans that either modify the
causes of disasters or mitigate their effects on people, property, and
infrastructure.
preparedness
₰ Proactive planning efforts designed to structure the
disaster response prior to its occurrence
₰ Communication plans
₰ Multiagency coordination
₰ Emergency services- emergency shelters with
evacuation plans
₰ Supplies and equipment's
 Cont..

The goal of emergency preparedness programs is to achieve a

satisfactory level of readiness to respond to any emergency
situation through programs that strengthen the technical and
managerial capacity of governments, organizations, and
communities.
These measures can be described as logistical readiness to deal
with disasters and can be enhanced by having response
mechanisms and procedures, rehearsals, developing long-term
and short-term strategies, public education and building early
warning systems.
Preparedness can also take the form of ensuring that strategic
reserves of food, equipment, water, medicines and other
essentials are maintained in cases of national or local
catastrophes.
 response
 The aim of emergency response is to provide immediate
assistance to maintain life, improve health and support the
morale of the affected population.
 Such assistance may range from providing specific but limited
aid, such as assisting refugees with transport, temporary
shelter, and food, to establishing semi-permanent settlement in
camps and other locations.
 It also may involve initial repairs to damaged infrastructure.
 The focus in the response phase is on meeting the basic
needs of the people until more permanent and sustainable
solutions can be found. Humanitarian organizations are often
strongly present in this phase of the disaster management
cycle.
 response
₰ Emergency relief such as saving lives, providing first aid,
minimizing and restoring damaged systems such as
communications and transportation , providing care and basic
life requirement to victim

₰ Organized its activities in sectors- fire, police hazardous

material management and emergency medical services
 recovery
₰ Stabilizing and returning the community to normal
₰ Rebuilding, repair, relocate, rehabilitate, reconstruct
₰ There is no distinct point at which immediate relief changes into
recovery and then into long-term sustainable development.
₰ There will be many opportunities during the recovery period to
enhance prevention and increase preparedness, thus reducing
vulnerability. Ideally, there should be a smooth transition from
recovery to on-going development.
 Cont..
Recovery activities continue until all systems return to normal or better.
Recovery measures, both short and long term, include returning vital
life-support systems to minimum operating standards; temporary
housing; public information; health and safety education;
reconstruction; counseling programs; and economic impact studies.
Information resources and services include data collection related to
rebuilding, and documentation of lessons learned.
 evaluation
₰ Phase that receive least attention
₰ To determine the specific problems, issues and
challenges
₰ Future disaster plan is based on the evaluation
 MITIGATION PHASE
 Means to make less severe or less painful.
 Mitigation is the action taken to reduce the harmful effects
of a disaster.

 Action is taken to prevent a disaster if possible

Eg)region prone to flood-action taken to protect the
vulnerable population.

 Assessing the community for disaster risk and taking action

Eg)in many natural disaster ,local weather service personnel and
fire fighters have the earliest information
Recommendations for evacuation of public
 CONT….
1.TRAINNING VOLUNTEERS
Disaster drills
Train community volunteers on evacuation plans and communication
system.
Spraying on roof tops in fire
Sandbagging the banks during a rising river
Canvassing neighbors with loud speakers warning disaster, different
languages

2.ESTABLISHING
AUTHORITY,COMMUNICATION,TRANSPORTATION
Clear and flexible chain of authority
During disaster due to heightened chaos and stress causes
misinformation and misinterpretation.
Clear communication minimize loss of life and damage
Routes of transportation eg)alternative route
 PREPAREDNESS PHASE
 Refers to proactive of advance planning.

 Efforts taken at every level to design a structure for

disaster response before it occurs.

 In disaster prone areas

Every individual, family, community are encouraged to have
a comprehensive preparedness.

 The public health nurse plays a vital role here.

 Emergency disaster preparedness – policies
and planning

A. Policy development - Formal statement of a course of

action.
The policy is strategic in nature and performs the following
functions:
1.Establishing long –term goals
2. Assigning responsibilities for achieving goals
3. Establishing recommended work practice
4. Determining criteria for decision- making

Policy vary from country to country

 The sectors involved in the policy development
are:
a. Communication
b. Health
c. Social welfare
d. policy and security
e. Rescue and transport
The emergency Department (ED) has been typically involved in
both, the external (community) and internal (Hospital) disaster
planning

ED acts as a control point to receive, screen and admit the

critically ill patients
 B. Institutional or Hospital disaster planning
a. Hospital preparedness
b. communication system
c. Medical management
1. Disaster 2. Control centre 3. Command centre 4. Reception centre
management and response reams
committee
5. Information and 6. Arrangement for 7. Emergency blood 8. triage
communication disaster beds bank

9. Documentation 10. Disposal of 11.staff 12.Stores and

death cases equipment

13. Dietary services 14. Engineering and 15. Prevention of 16. Logistic support
maintenance epidemics system
services
17. Control of
communicable
disease
COMPETENCIES OF A DISASTER NURSE

 Describe their roles in responding to likely

emergencies
Acquire knowledge and skills
How they will relate to other organization and agencies
during disaster.

 Describe the agency’s chain of command in

emergency response.
Lines of authority and communication in a response
situation
Should know whom to report and who reports to them.
 Identify and locate the agency’s emergency response
plan.
Familiar with agency’s plan and where it is present

 Describe and demonstrate one’s functional role and

responsibilities in emergency response.
Demonstrate in regular drills

 Demonstrate the correct use of equipment

Personnel protective equipment and other equipment

 Demonstrate the correct use of communication

equipment.
Plan for communication
Mobile phones, laptops, two –way radio, fax machines
 Describe communication roles in emergency
response.
Media and public
Family and friends

 Identify ones own knowledge ,skills and authority

and identify resources for help, if needed.
Nurse working with adults may need help in pediatrics.

 Apply creative problem solving and flexible

thinking to unusual challenges.
Every situation is different and things rarely go as
planned.
 Identify situations that are not normal or may
indicate an emergency situation.
Eg) public health nurse may notice similar symptoms in
the community-indicate an outbreak.
Unusual behavior of a visitor in the hospital

 Participate in continuing education to maintain up

to date knowledge in disaster management
nursing.
Courses offered by Indian red cross, The National
Disaster Management Authority.
Cont…
 Participate in planning , exercising, and
evaluating drills.
Encouraging community volunteers.
 RESPONSE PHASE
 Begins immediately after the onset of the disastrous
event.

 Action taken to save lives and prevent further damage.

 What has been learned in preparedness phase ,has to

be put into action.

 Respond is determined by the extent and level of

disaster.

 Respondents could be state and local govt, NGO’s,

Principle of Response management
Triage
Treat
Transfer
METHOD OF CLASSIFYING
DISASTER
 MINOR DISASTER
Minimal damaged, managed with local resources
Eg)RTA

 MODERATE DISASTER
Local, community , government resources must be mobilized.
Eg)derailment of train

 MASSIVE DISASTER
Massive and severe impact
Local and community resources are not enough
Warrant help from outside the country.
Eg) flood, earthquake.
CONT…
 Some hospitals cannot handle sudden influx of
patients-transportation to other care facilities.

1.The nurse as a first responder.

Begins with search and rescue
Once rescue workers have arrived at the scene,
plans for medical care area and triage should begin
immediately.
 TRIAGE in MEDICAL CARE
 Triage is a process which places the right patient in the right
place, at the right time, to receive the right level of care .
-RICE AND ABEL

 French word “trier” –to sort out or choose.

 First used in French military.

 It’s the corner stone for good disaster management.

 GOAL: doing greatest good for the greatest no: of people.

 Involved with a lot of challenges

Its success depends on the competence and the experience of the
nurses.
Good triage provider !!!
 Clinically experienced
 Good judgment and leadership
 Calm and cool under stress
 Decisive
 knowledgeable of available resources
 Sense of humor
 Creative problem solver
 Available
 Experience and knowledgeable regarding
anticipated casualties
TYPES OF TRIAGE
 Daily triage
 Mass casualty incident triage
 Disaster triage
 Tactical military triage
 Special conditions triage
 Daily triage:
Routine basis in the emergency dept
Goal is to identify the sickest patients in order.
Highest intensity of care is provided to the most seriously
ill

 Mass casualty incident triage:

Occurs when the emergency dept is stressed with large
no: of patients but remains functional.
Additional recourses ( on –call staff)
Disaster plans not activated
Dept delays are longer
 Disaster triage:
Employed when local emergency services are
overwhelmed to the point that immediate care cannot
be provided to everyone who needs it.

GOAL:”doing the greatest good for the greatest no:”

Patients are sorted into the following category

○ Lightly injured
○ Seriously injured
○ Critically injured
○ Hopelessly injured

Seriously and Critically injured are further assessed

and triaged for transportation on the level of injury.
 Tactical military triage:
Similar to disaster triage
Military mission objectives ,rather than nursing
guidelines drive the triage and transport decisions

 Special conditions triage:

Patients present from incidents involving weapons
of mass destruction
○ Eg) radiation, chemical contamination
These triage situations mandate personal
protective equipment for all health care personnel
Decontamination capabilities at the facility is
needed.
IN…… IN- HOSPITAL…
1. DAILY TRIAGE
Emergent
Urgent
Non-urgent
Four tier or five tier system may be used
2.DISASTER SITUATION TRIAGE

Class I-(emergent or critical)RED

○ Life threatening conditions eg)compromised airway
Class II(urgent)YELLOW
○ Victims with major illnesses or require treatment within 2o min to 2hrs
eg)open fracture
Class III(non urgent)GREEN
○ Minor injuries ,care may be delayed by 2hrs or more eg)closed fracture
Class IV(expectant)BLACK
○ Victims are dead or expected to die because of massive injuries
eg)severe head injuries, full thickness burns.

 Nurses who triage can also assist with life saving

interventions before transporting to hospital.
Should be competent with CPR and first aid.
 HIGH PRIORITY

 MEDIUM PRIORITY

 AMBULATORY

 DEAD OR MORIBUND
 CLASS I (EMERGENT)  RED    IMMEDIATE
 Victims with serious injuries that are life threatening
but has a high probability of survival if they received
immediate care.
 They require immediate surgery or other life-saving
intervention, and have first priority for surgical teams
or transport to advanced facilities; they “cannot wait”
but are likely to survive with immediate treatment.
 “Critical; life threatening—compromised airway,
shock, hemorrhage”
CLASS II (URGENT)   YELLOW      DELAYED
 Victims who are seriously injured and whose life is not
immediately threatened; and can delay transport and
treatment for 2 hours.
 Their condition is stable for the moment but requires
watching by trained persons and frequent re-triage, will need
hospital care (and would receive immediate priority care
under “normal” circumstances).
 “Major illness or injury;—open fracture, chest wound”
CLASS III (NON-URGENT)      GREEN      MINIMAL
 “Walking wounded,” the casualty requires medical attention
when all higher priority patients have been evacuated, and
may not require monitoring.
 Patients/victims whose care and transport may be delayed 2
hours or more.
 “minor injuries; walking wounded—closed fracture, sprain,
strain
CLASS IV (EXPECTANT) BLACK
 They are so severely injured that they will die of their
injuries, possibly in hours or days (large-body burns,
severe trauma, lethal radiation dose), or in life-threatening
medical crisis that they are unlikely to survive given the
care available (cardiac arrest, septic shock, severe head
or chest wounds);

 They should be taken to a holding area and given

painkillers as required to reduce suffering.
 “Dead or expected to die—massive head injury, extensive
full-thickness burns”
 CONT………
 The above discussed can be used in
disasters like earth quakes, traumatic
injuries etc
In chemical spills-decontamination and antidote
is given before transportation

 After the initial response

Search and rescue
Caring for the sick and wounded
 providing water , food and shelter
Coordination of assistance
DISASTER TRIAGE TEAM
STAFF
•EMERGENCY PHYSICIAN
•EMERGENCY NURSE 1
FUNCTINAL ROLE IN TRIAGE
TRIAGE OFFICER
•Evaluates patient and reports findings
to officer
•Supervises clerk, nursing aid, and
transporters

•EMERGENCY NURSE 2 •Records all assessments

•NURSE AID •Applies pre numbered ID bands

•TRANSPORTER •Moves patient from triage area to
assigned area in the emergency dept

Depending on the size and nature of the disaster several triage teams
can be formed and different levels of staff can be used.
 CONT…
 Many organization respond to a disaster.
Hospitals, out patient clinics, health professionals
Pharmacies, pharmaceutical companies ,medical supply
manufacturers.
Public health dept
Ambulance workers and emergency medical technicians
Fire fighters and police
NGO, govt officials, media and communication technicians
Engineers and equipment operators
Transportation workers
Bankers and financial officers
Community volunteers.
 DIASTER CYCLE/PHASES OF DIASTER
MANAGEMENT (WHO)
1. Non- disaster or inter disaster phase.
---stage for preparedness, before the disaster occurs

2. Pre-disaster or warning phase

---just before the disaster strikes

3. Impact phase
---when the disaster strikes lasts for sec or min

4. Emergency or relief phase or isolation phase

----immediately after the impact, providing relief and assistance.

5. Reconstruction or rehabilitation phase

-----restoration of pre disaster condition.
The disaster management plan- 4 R

 RESCUE
 RELIEF
 REHABILITATE
 REINTEGRATE
KEY ISSUES: preplanning, communication,
coordination, training and regular practice.
 ESSENTIAL ELEMENTS FOR
DIASTER MANAGEMENT
 An appropriate infra structure to support the disaster
response.
Maintaining services for pre existing communities and patients
and for new arrival’s.
Physical plant, utilities, staffing, supplies and equipment must be
available and functional

 An appropriately trained staff

Competency

 Clearly defined, executable, and practiced disaster plan.

Consistent with the mission of the organization
 COMPETENCY OF STAFF
 CORE PREPAREDNESS COMPENTCIES:

Describe the role of agency in responding to the emergencies

Describe the chain of command
Identify and locate the emergency response plan
Describe emergency response functional roles and demonstrate
during drills
Demonstrate the use of equipment
Demonstrate correct operation of equipment fro communication.
Describe communication roles within agency, media, public,
personal contacts etc)
Recognize deviation from the norm that might indicate an
emergency
Participate in CNE, drills
 COMPETENCY FOR DISASTER
NURSING
 Ensure hazard risk assessment has been
completed.

 Ensure that there is a written plan for all hazard

approach.

 Ensure all parts of the plan are practiced regularly.

 Ensure the identification gaps in the plan , and

staff knowledge/skills are filled.
SUGGESTED MEMBERSHIP OF Disaster
management committee
 Director/executive head of the hospital
 Department heads
 Nursing supdt
 Hospital administrator
 Casualty services
 Maintenance and engineering staff
 Staff representative
 Representative from other support
services and utility services as required.
 EVALUATON OF DIASTER PLAN
 It is very essential to check its effectiveness and completeness of the
disaster response plan.

 The comprehension of people who are expected to execute the plan.

 Availability and functioning of the equipment needs to be evaluated and

renewed.

 Disaster mock drills

Mock patients, computer simulations, seminar sessions etc
Include all health care disciplines, Govt officials , school and media.

 Disaster planners should review all observation and respond with

modifications.
CHRONOLOGICAL ACTION PLAN
 Initial alert
 Activate hospital action plan
 Formulation of command nucleus
 Management of casualty
 Hospital management
 Reception
 Resuscitation
 Operation theatres
 Radiology
 Blood transfusion
 Workload
 Training
 evaluation
 THE ROLE OF MEDIA IN DIASTER
MANAGEMENT
 Mass media is an integral part of disaster management esp in
bioterrorism or public health crisis.

 Doomsday scenario-”plenty of open space”

 Crisis managers and professionals must communicate the information

directly to the community , nationally and internationally.
Feeding the media with information is not an option but an imperative(beast).
Ensure that the information provided is sound accurate and no split second
judgment.
Need to designate persons that prepare for and deal with public information and
media relations.

 Radio, TV, and print press as platforms to “go public”.

Crisis managers must assure and calm an upset ,fearful and grieving public.
 CONT…
 Mass mediated emergency response efforts.
Radio, TV, internet

 The case for media monitors

False rumors must be corrected immediately
Constantly monitored by trained personnel

 “Cooperation is better than confrontation”

Relations are good when reporters and emergency responders can trust each other.

 Reporters are not always entitled to access

Eg)small pox outbreak

 The human face of emergency responders.

Crisis managers and everyone involved in responding to major emergencies must be
rational, cool under pressure and detached from human suffering.
Act in a professional way.
 RESTORING PUBLIC HEALTH UNDER
DIASTER CONDITIONS
 Maslow’s hierarchy of needs
Physiological, safety, love and esteem).

 Meet immediate basic survival needs of the population(water, food, shelter

and security).

 To identify the potential for a secondary disaster.

 Identify risk factors for infectious disease outbreak.

 Minimum standards of public health.

Water quality and supply, sanitation-toilets, food safety.
Shelter from elements—personal hygiene, vector control,.
Disposal of waste
 HEALTH EFFECTS OF A DISASTER
 Affects communities and their population.

 Physical destruction
Damaged and collapsed buildings
Roads, tunnels, bridges, rail lines, telephone cables,
transportation and communication.
Water, gas, electricity, sewage disposal
Homeless, forced to relocate
Illness , injury
Short and long term effects on population
DISASTER WORKERS AND
PSYCHOLOGIAL STRESS

 Survivors of disasters experience stress.

 Degree varies according to the

nature of stress, their role in disaster, individual stamina and
environmental factors(noise, physical danger, exposure to death
and trauma)

 management-
Rest, recovery time, focusing on accomplishments, relaxation
techniques, hobbies and concentrating on self care.

 Overall objective is to prevent post traumatic stress disaster.

both among victims and personnel who work with the victims
 MANAGEMENT OF
PSYCHOSOCIAL EVENTS
 Involvement of a psychiatric nurse practitioner and clinical nurse specialist in
disaster planning.

 Mental health response team-mental health coordinator

 Recruitment, screening and training

 Psychological triage and psychological first aid

 Listening, problem solving and crisis intervention.
Crisis intervention—allow silence, attend non verbally ,paraphrase, reflect feelings,
allow expression of emotions.
Mental heath referrals-disorientation, depression, anxiety, psychosis, inability to care
for self, suicidal thoughts, domestic violence, child abuse etc)…..
Acute stress disorder , post traumatic stress disorder.

“NOT EVERYONE IS SUITED FOR DISASTER WORK”

SEPTEMBER 11,2001
 National Commission on Terrorist
attacks upon the US,2004
The critical need for communication
resources
Common language communication
Communication center resources
Responsibilities and leadership strengths
were identified.
 UNDERSTANDING THE
PSYCHOLOGICAL IMPACT OF DISASTER
 Disaster by their very nature are stressful ,life alerting
experience.

 Living through the an experience like a disaster can cause

serious psychological effects and social disruption

 Disaster affects the individual, family and community

depending on the scope and the degree of the disaster.

 Nearly 54-60% develop psychiatric symptoms after a disaster

and reduces over the year.
CONT…….
 4 phases of disaster
The heroic phase-----shock
The honeymoon phase-----grateful
The disillusion phase------depression and
hopelessness
The reconstruction phase---- acceptance
and Increasing independence.
Role of a nurse in the hospital
Rapid assessment of the situation and of nursing care
needs
Triage and initiation of life saving measures
The selected use of essential nursing intervention
Adaptation of necessary skills to disaster
Evaluation of the environment and the mitigation
Prevention of further injury
 RECOVERY PHASE
 Occurs after the immediate response to disaster, the focus is to
recovery.

 Rehabilitation and reconstruction

 The Govt, NGO’s, private citizens are usually available to give

assistance.

 GOAL:To help people return to a normal way of life or “new normal”

 Natural disaster act 2005

Rehabilitation: Assistance to the loss of life, damage to house and
restoration of means of livelihood.
Reconstruction: construction or restoration of any property after a disaster.
 ROLE OF NURSE IN RECOVERY
PHASE
 1.continue to assess the community
Number and type of ongoing illness-GI,Resp etc
Availability of hospital beds, medical supplies
Clean water, food, shelter
Sanitation and waste disposal
Animals which carry the disease

 2.Educate people about hazards

Occurs due to post disaster clean up,
Eg) cutting devices, live wires, falls

 3.provide psychological support

Feelings of hopelessness , depression and grief will be present.
Volunteers for giving psychological support till “new normal” is achieved.
Psychiatry referral
 DISASTER MANAGEMENT IN
INDIA
 The disaster management act of 2005 was passed
by the Govt of India to manage disasters occurring
in India

 The act defines disaster management as the

process of
Planning
Organizing
Coordinating
implementing
 CONT….
 FUNCTIONS:
Prevention of danger or threat of any disaster
Mitigation or reduction of risk of any disaster or its
severity or consequences
Capacity building
Preparedness to deal with any disaster
Prompt response to any threatening disaster situation or
disaster.
Assessing the severity or magnitude of effects of any
disease.
Evacuation, rescue and relief and
Rehabilitation and reconstruction (recovery)
 THE NATIONAL DISASTER MANAGEMENT
AUTHORITY(NDMA)

It was created by the disaster

management act ,2005
PRINCIPLES
Set policies and to implement a wholistic
integrated approach to disaster management.
Set guidelines for state disaster management
authorities to follow in implementing a disaster
plan.
CONT…
 FOCUS:
Prevention
Risk reduction
Capacity building

 CAPACITY BUILDING:
Capacity building is defined as the identification and
acquiring of recourses needed to respond to disaster
It also includes the training of personnel for management of
disasters.
National Platform for Disaster Risk
Reduction (NPDRR)
 Government's Resolution No.47-31/2012-DM-III dated 26th February 2013,New Delhi

 AIMS
1. To bring together the whole range of India's disaster risk community from
Government, Parliamentarians, Mayors, Media, International Organizations, NGOs,
local community representatives, scientific and academic institutions and corporate
businesses etc.

2. It will help in sharing of experiences, views and ideas, present findings of research
and action and explore opportunities for mutual cooperation in the field of Disaster
Risk Reduction.

3. The output from the National Platform will offer a strategic direction and a road map
for the formulation of our future national action plans on DRR.
FUNCTIONS OF THE NATIONAL PLATFORM
 To review the progress made in the field of disaster management
from time to time.

 To appreciate the extent and manner in which the Disaster

Management Policy has been implemented by the Central and
State Governments, and other concerned agencies, and to give
appropriate advice in the matter.

 To advise on coordination between the Central and State

Governments/UT Administrations, local self-governments and civil
society organizations for Disaster Risk Reduction.

 To advise reference made by the Central Government or any other

State Government or a Union Territory Administration on any
question pertaining to disaster management.

 To review the National Disaster Management Policy.

 Disaster agencies
 WHO
 American and International Red cross Disaster Services
 United Nation’s agencies and united nations office for the co-
ordination of humanitarian affairs (OCHA)
 UNICEF
 WFP (world food program)
 Food and agriculture organization
 Centre of coordination for prevention of natural
disaster in central America
 Caribbean disaster emergency response agency
 Non – governmental organization are CARE
 International council of voluntary agencies (ICVA)
 International federation of Red cross and Red
crescent societies (IFRC) etc
 National Institute of Disaster
Management)  NIDM
 At the national level, the Ministry of Home Affairs is the nodal
Ministry for all matters concerning disaster management.

 The Central Relief Commissioner (CRC) in the Ministry of

Home Affairs is the nodal officer to coordinate relief operations
for natural disasters.

 The CRC receives information relating to forecasting/warning

of a natural calamity from India Meteorological Department
(IMD) or from Central Water Commission of Ministry of Water
Resources on a continuing basis
 LEGAL AND ETHICAL ISSUES
 The role of government in a public health crisis.
Local, state and central
○ Esp in terrorist attack, lack of supplies, supply of resources, declaration of an emergency,
curfew, limiting movement of individuals, and establishment of medical centers.

 Specific legal and ethical issues

Reporting of diseases eg)reporting new case of disease.
Disclosure of health information –privacy and confidentiality

 Vaccination
 Treatment of disease
 Professional licensing- staff
 Resource allocation
 Professional liability
Providing standard care
Refusing to help in a disaster due to fear
 CONCLUSION ……
 Disaster management involves a host of multi-discipline agencies of
which medical relief is one of the important steps.

 “THERE CAN BE NO TAILOR MADE DIASTER PLAN “

 It occurs in the most inopportune moment.

 No time for PLANNING but time for DOING

 Nursing management skills such as planning, coordinating,

communicating, budgeting, critical thinking, and delegating are
essential in disaster management.

 With our knowledge we can definitely play a significant role as

leaders in disaster management both nationally and internationally.
 There’s no disaster that cant become a blessing, and no
blessing that cant become a disaster.
- RICHARD