Disaster management

1.  Dr. M. Vijay Pandian
 Senior Assistant Professor
 Dept of Community Medicine
 GMC & ESI Hospital

2.  Introduction
 Problem Statement
 Types of Disasters
 Effects of disasters
 Disaster Cycle
 Concepts of Management
 Disaster Management in INDIA

3.  Disasters have existed ever since the existence
of mankind
 Globally and locally the damage and destruction
due to disasters is on the rise
 Disasters are complex phenomenon with
multiple causes and consequences
 India is one of the most disaster prone country
in the world.

4.  Disasters - natural or human-made are common
throughout the world.
 Increase in their magnitude, complexity, frequency and
economic impact.
 Second half of the 20th century- 200 worst natural
disasters 1.4 million people dead.
 Asia tops the list of casualties due to natural disasters

6.  Last thirty years - 431 major disasters resulting into
enormous loss to life and property.
 1,43,039 people were killed and about 150 crore were
affected by various disasters in the country during these
three decades
 Highly vulnerable to floods, droughts, cyclones,
earthquakes, landslides, avalanches and forest fires
 57% land is vulnerable to earthquakes. Of these, 12% is
vulnerable to severe earthquakes.
 68% land is vulnerable to drought.
 12% land is vulnerable to floods.

7.  8% land is vulnerable to cyclones.
 Apart from natural disasters, some cities in India are also
vulnerable to chemical and industrial disasters and man-
made disasters.
 Floods, earthquakes, cyclones, hailstorms, etc. are the
most frequently occurring disasters in India.
 India is one of the ten worst disaster prone countries of
the world.

9. World Health Organization
“Any occurrence that causes damage,
ecological disruption, loss of human life or
deterioration of health and health services on a
scale sufficient to warrant an extraordinary
response from outside the affected community
or area.”

10.  The Disaster Management Act, 2005 defines
disaster as
“a catastrophe, mishap, calamity or grave
occurrence in any area, arising from natural or man
made causes, or by accident or negligence which
results in substantial loss of life or human
suffering or damage to, and destruction of,
property, or damage to, or degradation of,
environment, and is of such a nature or magnitude
as to be beyond the coping capacity of the
community of the affected area”.

11. Natural Disaster Man made Disaster

12.  Natural phenomena beneath the earths surface
◦ Earth quakes
◦ Tsunami
◦ Volcanic eruptions
 Natural phenomena at the earths surface
◦ Land slides
◦ Avalanches
◦ Meteorological / hydrological
 Windstorms
 Tornadoes
 Cyclones
 Floods
 Droughts
 Bushfires
 Biological Insect Swarms, (e.g. locust) and Epidemics of Communicable
Diseases.

13.  Warfare: Conventional Warfare (bombardment, blockage and
siege)
 Non Conventional Warfare: Nuclear, Biological and Chemical
warfare, Guerrilla Warfare including Terrorism
 Civil Disturbances: Riots and Demonstrations
 Refugees: Forced movement of large number of people usually
across frontiers
 Accidents: Transportation calamities (land, air and sea),
Collapse of building, dams and other structures, mine
disasters.
Technological failures (e.g. a mishap at a nuclear power
station,

16. SL No.
Consequences
NATURAL CALAMITIES
Earth-Quake Cyclone Flood Fire Drought/
Famine
1. Loss of life X X X X
2. Injury X X X X X
3. Epidemiological threat X X
4. Loss of crops X X X
5. Loss of housing X X X X
6. Damage to infrastructure X X X X
7. Disruption of communications X X X X
8. Disruption of transport X X X X
9. Panic X X X X
10. Looting X X X X
11. Breakdown of social order X X X
12. Short-term migrations X X
13. Permanent migration #
14. Loss of Industrial production X X X X #
15. Loss of Business X X X X #
16 Distruption of marketing systems X X X X #
X - Direct Consequences # - Secondary Consequences

17.  Traditional model-DM cycle
 Expand-contract model
 The Disaster Crunch Model

18. Disaster Cycle
Disaster Impact
Response
Relief
Rehabilitation
Mitigation
Preparedness
Disaster Cycle

25.  Chances of survival after a disaster are greatly
improved when people, local governments
and emergency services, businesses and
national governments prepare survival plans
and assemble survival gear beforehand.
 What constitutes sufficient preparation is
highly dependent on the location and the
disasters that are likely to occur in the area.

26.  Most natural disaster recur in same areas
 Impossible to prevent, but…
 Can reduce their effects by being prepared

28.  Disaster Prevention: aimed at impeding the occurrence of a disaster
event and/or preventing such an occurrence having harmful effects on
communities. (long-range policies and programs.)
 Disaster Mitigation : Measures aimed at reducing the impact of a
natural or man-made disaster on a nation or community.
 Disaster Preparedness : Measures, which enable governments,
organizations, communities and individuals to respond rapidly and
effectively to disaster situations.
 Disaster Response : Response measures are those, which are taken
immediately, prior to and following disasters.
◦ saving life and protecting property and dealing with the immediate
damage

29.  Social reactions :
These could be grouped as follows :
(i) Spontaneous behavioral reactions e.g.
generalized panic or stunned waiting.
(ii) Widespread looting
 iii) Rumors regarding spread of epidemic
 (iv) Population displacements leading to excessive
burden on
 relatives and friends, parks city squares, vacant
lots and
 government buildings in urban areas where public
services can’t cope resulting in increased morbidity
and mortality.

30.  Exposure to elements : The need to provide
emergency shelter varies greatly with local
conditions.
 Food and Nutrition : Food shortages in the
immediate aftermath or Food stock destruction
 Communicable Diseases

31.  Disaster response
 Disaster preparedness
 Disaster mitigation

32.  Search, Rescue and First Aid
 Field Care & Triage
 Relief Phase
 Epidemiologic surveillance & Disease control
 Vaccination
 Nutrition
 Rehabilitation

33. The important aspects include provisioning of
appropriate
 Shelter for displaced population,
 Potable water supply,
 Food and nutrition and sanitation.
 Excreta Disposal
 Solid Waste
 Vector control
 Prevention & control of communicable diseases

34.  Awareness and Capacity of the community is
critical for Effective Response
 AWARENESS ON HEALTH IMPACTS AND THEIR HANDLING
 FIRST AID TRAINING
 WATER DISINFECTION
 HYGIENE & SANITATION
 ENSURING ADEQUATE NUTRITION
◦ Of Children, Pregnant & Lactating women, Chronically Ill,
Elderly
 PSYCHO-SOCIAL COUNSELLING

35.  A rush to health facilities
 Redirecting resources
 Maximising beds and surgical services
 Providing food & shelter
 Establishing an information centre
 Victim identification
 Mortuary space

36. “is a concept to sort victims so that
greatest help can be given to
maximum number in minimum
time & scarce resource”

37.  Triage officer does not treat
 Classify based on – severity & chances of
survival
 Prioritized into 4 categories

38. Severely injured victims who can be saved if
they receive appropriate stabilization,
transportation and treatment immediately
Eg;airway obstruction, external hemorrhage,
shock, etc
red

39. Injuries that could lead to death if not
treated promptly but are not in immediate
life threatening as the first priority
injuries.
Eg. penetrating or open injuries of the
abdomen, major burns
yellow

40. Need hospitalization but who are not in
urgent need of it. Their evacuation to the
hospital can be delayed even up several hours
without any serious threat to their life.
Eg. Moderate burns, fractures and dislocations.
green

41.  Hopelessly wounded, moribund cases -
moved outside the triage area
 Removal from scene
 Shifting to mortuary
 Identification
 Reception of relatives
Black

42. Cases with minor injuries
eg abrasions, contusions, foreign bodies in
the skin, sprains strains etc.
Encouraged to help treating each other and
moved to a site away form the main areas .

43. Dead or Moribund cases 3 or less
Severe Injury 4-8
Moderate Injury 9 – 12
Mild Injury > 13

44. Patient Status START
Military /
International
Color
Code
Priority
Immediate
Critical /
Immedia
te
Immediate Red 1
Delayed Minor Delayed Yellow 2
Hold
Urgent /
Delayed
Minimal Green 3
Deceased
Dead /
Dying
Expectant Black 4

45. Triage
Hospitalization
•Triage
•Definitive
Treatment
Disaster Area Transportation

46. Mass Casualty Management
Is a multi sectoral effort
POLICE
•Security -At disaster site & At hospital
•Traffic Control
•Crowd Control
•Incident Investigation
FIRE SERVICE
•Search and Rescue
•Fire Control
•Hazardous material Control
AMBULANCE SERVICE
•First responder
•Transportation of Victims to the Health Care Facility
HOSPITAL & EMERGENCY DEPARTMENT

47. Mitigation & Risk reduction of facilities,
Health Care in Relief & Recovery Phases
Disease Surveillance & Control,
Water & Sanitation,
Environment,
Vector control
Nutritional Security of special groups,
Mental Health,
Resources & Logistics
Training & Capacity building
Inter-sectoral coordination,
Damage and Needs Assessment
Mass
Casualty
Management

48. Public Health Aspects following
a Disaster

49.  The displaced population must be sheltered in temporary
settlements or camps.
 sites must be well planned to avoid risk factors for
communicable diseases transmission, such as
◦ overcrowding, poor hygiene and inadequate water supply,
◦ insanitary disposal of excreta, vector, inadequate sites and lack of
adequate shelter.
 Critical factors: water availability, means of transport,
access to fuel and access to fertile soil.

51.  Water and sanitation are vital elements in the
transmission of communicable diseases
 Diarrheal diseases are a major cause of morbidity and
mortality among affected populations
 Main objective is to reduce these transmissions through
◦ Promotion of good hygiene practices,
◦ Provision of safe drinking water
◦ Reduction of environmental health risks
◦ Establishing conditions that allow people to live with
good health, dignity, comfort and security

52. Assuming water point is accessible for
approximately eight hours a day
- 250 people per tap based on a flow of 7.5
lt/min
- 500 people per handpump based on a
flow of 16.6 lt/min
- 400 people per single-user open well
based on a flow of 12.5 lt/min

55.  There is a correlation between improper solid waste
disposal and the incidence of vector-borne diseases.
 Arrangements must be made to collect, store and dispose
of solid waste.
 Assess the situation, considering the number of people in
the shelter, existing services, collection service,
topographic conditions, accessibility and soil type
 Estimate the quantity, type and capacity of the water
storage containers
 The capacity of the containers should be 50-100 liters
and should not exceed 20-25 kg when full.

56.  Provide three or four containers per 100 persons and
distribute
 The containers should not touch the ground, for example
they should be on a wooden platform. They must be
emptied and washed daily
 Dead animals and excrement from domestic animals
must be buried immediately, since they can be a source
of contamination.
 Provide information and training to the population on
sanitary refuse handling.

57.  Food shortages and malnutrition are common features of
emergency situations.
 Micronutrient deficiencies such as iron-deficiency
anaemia, pellagra, scurvy and vitamin A deficiency are
common
 Food is also an important source of pathogens and there
is a risk of diarrhoeal disease epidemics when basic food
safety principles are not followed

58. To overcome this menace following actions are
recommended :
 Ensure an adequate water supply.
 When preparing food or washing utensils, use a
chlorinated water supply.
 Store food in sealed containers.
 Ensure that food is covered during cooking and prior to
serving.
 Ensure that cooked food is consumed once prepared.
 Cover food when served, if left unattended.

59.  Cover water containers at all times.
 Ensure that water is taken either from a tap or from a
clean container.
 Disposal of garbage safely.
 Place hand-washing facilities outside latrines, living areas
and kitchens.
 Ensure an adequate number of sanitary latrines and that
they are maintained and used.
 All areas in a feeding centre must be cleaned daily using
chlorine as a disinfectant.

60. Estimates for average population
requirements should be used
◦ 2,100 kcals per person per day
◦ 10-12% of total energy provided by protein
◦ 17% of total energy provided by fat
◦ adequate micronutrient intake through fresh or
fortified foods.
◦ Infants, children, pregnant women, nursing mothers and
sick persons should be given special attention

61.  A maximum of 20 - 50 people use each toilet
 Use of toilets is arranged by household(s)
and/or segregated by sex
 Separate toilets for women and men are
available in public places
 Shared or public toilets are cleaned and
maintained in such a way that they are used
by all intended users
 Toilets are used in the most hygienic way and
faeces are disposed of immediately and
hygienically

62.  Toilets are no more than 50 metres from
dwellings
 They are designed in such a way that
they can be used by all sections of the
population, including children, older
people, pregnant women and physically
and mentally disabled people
 They are sited in such a way as to
minimise threats to users, especially
women and girls, throughout the day and
night
 They are sufficiently easy to keep clean

63.  Pit latrines and soakaways (for most soils) are
at least 30 metres from any groundwater
source and the bottom of any latrine is at
least 1.5 metres above the water table
 People wash their hands after defecation and
before eating and food preparation

64.  Hygiene through the participation of the
community
 As a rough guide, in a camp scenario there
should be two hygiene
promoters/community mobilisers per 1,000
members of the target population

65.  The major biological vectors are mosquitoes, sand flies,
ticks, fleas, lice, mites.
 The diseases most commonly spread by vectors are
malaria, filariasis, dengue fever, leishmaniasis, typhus
and plague.
 Major diseases transmitted by intermediate hosts or
carriers are schistosomiasis, diarrhoeal diseases and
trachoma.
 Prevention:
◦ Residual spraying,
◦ Personal protection,
◦ Environmental control,
◦ Camp site and shelter design and layout,
◦ Community awareness.

66.  People avoid exposure to mosquitoes during
peak biting times by using all non-harmful
means available to them.
 Control of human body lice is carried out
where louse-borne typhus or relapsing fever
is a threat
 Bedding and clothing are aired and washed
regularly
 Food is protected at all times from
contamination by vectors such as flies,
insects and rodents
 Special attention of high-risk groups such as
pregnant and feeding mothers, babies,
infants, older people and the sick

67.  Overcrowding
 Migration / displacement
 Water supply disruption / contamination
 Routine control programme disruption
 Ecological changes
 Displacement of domestic and wild animals
 Emergency food and water

68.  Setting up a Surveillance System
 Disease Surveillance
 Vaccinations and Vaccination Programs
 Not effective on a large scale
 Implementation issues
 False sense of security
 Advised for health workers
 Burial / Disposal of the Dead

69.  Acquisition of supplies
 Transportation
 Storage
 Distribution

70.  Rehabilitation begins immediately after a
disaster
 Restoration to pre-disaster state
 The health care needs keep changing rapidly
following a disaster

71. RESCUE AND IMMEDIATE RELIEF (One to three Months)
 Rescue
 Food
 Water
 Shelter Predominantly
External Agents
 Clothing
 Emergency Medical Aid
 Communication
 Census

72.  Health
◦ Continuing Medical Aid
◦ Environmental Sanitation/ Safe Drinking
Water
 Economic
◦ Food / Money for Work
◦ Re-Establish Local Industry
 Social
◦ Find missing persons
◦ Start Comm. Organization
 Shelter / Bunds / Schools / Religious
Institutions. Community
INVOLVEMENT
External Agencies
+Community

73.  COMMUNITY ORGANISATION
For Social / Economic / Health
Development
 Preparing to face next disaster
PLANNING SHOULD IDEALLY AIM AT SELF-SUFFICIENCY OF COMMUNITY IN
TACKLING DISASTERS FROM PHASE-I ITSELF
Predominantly
community
Community
participation

74. Mitigation: comprises measures taken in advance of a
disaster aimed at decreasing or eliminating its impact on
society and the environment.
 Mitigation is generally categorised into two main types of
activities i.e. structural and non-structural.
 Structural Mitigation: physical construction and
engineering measures and construction of hazard-
resistant protective structures and infrastructure.
 Nonstructural mitigation: policies, awareness, knowledge
development, public commitment and methods and
operating practices

75. Earthquakes
 Earthquake and Seismic Zones: The entire Indian
landmass, susceptible to different levels of earthquake
hazards, referred to as Zone II to V as per the Seismic
Zoning Map of India
 National Earthquake Risk Mitigation Project (NERMP):
◦ structural and nonstructural earthquake mitigation efforts and
reducing the vulnerability in the high risk districts prone to
earthquakes
◦ techno-legal regime, institutional strengthening, capacity building
and public awareness etc.
 National Building Code (NBC): national instrument
providing guidelines for regulating the building
construction activities across the country

76.  National Flood Risk Mitigation Project (NFRMP): mobilise
the resources and capability for relief, rehabilitation,
reconstruction and recovery from disasters besides
creating awareness among vulnerable communities
 Flood Management Programme: Provide protection to
flood prone areas
Landslides
 ‘National Landslide Risk Mitigation Project’ (NLRMP)-
reducing the landslide risk and vulnerability

77. Cyclones
 National Cyclone Risk Mitigation Project (NCRMP)
Initiative:
◦ Community mobilisation and training,
◦ Cyclone Risk Mitigation Infrastructure (construction of cyclone
shelters, roads/missing links and
◦ Technical assistance for capacity building on Disaster Risk
Management (risk assessment, damage and need assessment),
◦ Capacity Building and knowledge creation along with project
management and implementation support.
 Integrated Coastal Zone Management Project (ICZMP):
and early warning system
Tsunami
 shoreline tree cover.

78.  Works to prevent floods
 Land use planning
 Better building construction and materials
 Building codes
 Safety of water supply and sewage systems
 Planning

79. “a programme of long term development
activities whose goals are to strengthen the
overall capacity and capability of a country to
manage efficiently all types of emergency. It
should bring about an orderly transition from
relief through recovery, and back to sustained
development.”

80. Forecasting about climate change is pre requisite for taking preparedness measure
to respond to the disaster is the most important element of disaster management.

81. Achieve a satisfactory level of readiness to
respond to any emergency situation through
programmes that strengthen the technical
and managerial capacity of governments,
organizations, institutions and communities.

82. 1. Members are the most to lose or most to gain
from preparedness
2. First to respond is from the community
3. Capability of resource management is best at the
community
4. Sustained development is best achieved by the
communities to design, manage and implement
an internal and external assistance programme.

83.  1970 a major cyclone hit Bangladesh at 223
km/hr. killing 500,000 people.
 Cyclone Preparedness Program
In May 1994, cyclone with 250 km/hr only
127 people lost their lives.
In May 1997, in a cyclone 200 km/hr only
111 people lost their lives.

84.  Various committees at the national level for disaster
management
 National Disaster Management Council (NDMC)
headed by the Prime Minister
 Inter-Ministerial Disaster Management Coordination
Committee
 National Disaster Management Advisory Committee

85.  DISASTERS NODAL MINISTRIES
Natural Disasters Agriculture
Air Accidents Civil Aviation
Civil Strife Home Affairs
Railway Accidents Railways
Chemical Disasters Environment
Biological Disasters Health & family Welfare
Nuclear Accident Atomic Energy
Health & fw ministry is support ministry in all disasters
except Biological Disasters

87.  STATE CABINET
 STATES CRISIS MANAGEMENT GROUP: HEADED BY
CHIEF SECRETARY.
 STATES/DISTRICTS CONTINGENCY PLAN S / RELIEF
CODES.
 State Level Control room is set up at the disaster
site

88.  Focal point at District level- District Collector (
Magistrate or Commissioner)
 Directing, supervising and monitoring the relief
measures
 District Relief Committee includes local
legislators and members of parliament – review
of relief activities.
 District level Control Room to monitor day to
day activities

89.  The Collector also keeps close contact with-
Army, Air Force and Navy who supplement the
effort of rescue and relief
 They all coordinate and mobilize NGO capable
of working in such situations
 The armed forces play a vital role especially in
inaccessible and remote areas of the country

95.  Defines a disaster
 Components:
◦ Prevention of Danger or threat of any disaster
◦ Mitigation or reduction of risk of any disaster
◦ Capacity building
◦ Preparedness to deal with any disaster
◦ Prompt response
◦ Assessing the magnitude of effects or severity of any disaster
◦ Evacuation, rescue and relief
◦ Rehabilitation and reconstruction.

96.  Various unique characteristics are crucial
for disaster management
 Appropriate planning and early response
mitigates damage and saves lives!!
 Disaster management is the responsibility
of every institution
 The Health Sector has a key role to play,
although it is not the lead sector

97.  Each disaster is an unique event requiring
specific and tailor made responses. A clear
understanding of these basic concepts is
necessary for scientific planning,
preparedness and emergency response

98.  WHO day health theme 1991
Should Disaster Strike ---- Be prepared
 1991 – 2000 was National Disaster
Reduction Decade
 National Disaster Reduction Day --- 2nd
Wednesday of October

99. All disasters are emergencies
Not all emergencies are necessary to be
converted to disasters