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DISASTER MANAGEMENT PROGRAMME IN INDIA

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Information about DISASTER MANAGEMENT PROGRAMME IN INDIA
Health & Medicine

Published on March 6, 2014

Author: maheswarijaikumar

Source: slideshare.net

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DISASTER MANAGEMENT PROGRAMME IN INDIA
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DISASTER MANAGEMENT PROGRAMME IN INDIA DR. MAHESWARI JAIKUMAR

DEFINITION  DISASTER is ―Any occurrence that causes damage, ecological disruption, loss of human life or deterioration of health & health related services on a scale sufficient to warrant an extraordinary response from outside the affected community

HAZARD ―Any phenomenon that has the potential to cause disruption or damage to people & their environment‖

CAUSES  1.High birth rate.  2.Problems of land tenure.  3.Problems of economic opportunity.  4.Lack or mis allocation of resources. to meet human needs.  5.Population explosion.  6.Rapid urbanization.

7.Deforestation. 8.Invasion of the ecology. 9.Global warming. 10.Expansion of industries. Wrath of God

CONSEQUENCES OF DISASTER 1. Affect health & well being of people. 2. Large number of people are affected & displaced. 3. People are killed or injured.

 4. Subjected to a greater risk of diseases.  5. Results in considerable economic harm.  6. Harm to existing infrastructure.

7. Damage to health facilities. 8. Damage to water systems. 9. Food shortage. 10 .Major population movements.

RESULT OF A DISASTER 1.Injuries. 2.Emotional stress. 3.Epidemic of disease. 4.Increase in indigenous disease.

FACTORS DECIDING THE CONSEQUENCES 1.Type of disaster. 2.Density & distribution of population. 3.Condition of the warning. 4.Degree of preparedness.

TYPES OF DISASTER 1.Earth quakes. 2.Cyclones. 3.Floods. 4.Tidal waves. 5.Land slides. 6.Volcanic eruptions.

7.Tornadoes. 8.Fires. 9.Hurricanes. 10.Severe air pollution.(smog) 11.Heat waves.

13.Epidemics. 14.Building collapse. 15.Toxicologic accidents. 16.Nuclear accidents.

TYPES OF DISASTERS According to CAUSE/OCCURRENCE•Natura l-caused by forces of nature•e.g. earthquake, typhoons,volcanic eruptions

MAN-MADE- CAUSED BY ERRORS OF MAN• war, civil strife or other conflicts •Technological •e.g. air crashes,pollution,nuclear accidents, explosions 

ACCORDING TO PREDICTABILITY  •Sudden Onset- no warning issued  •Slow Onset-disasters that come with warnings•e.g. typhoons, volcanic eruptions

ACCORDING TO EXTENT OFDAMAGE •Large scale-effects mostly limited to the impact area •Small scale-effects are localized, limited only to the impact area

DISASTER MANAGEMENT 1.Disaster response. 2.Disasrer preparedness. 3.Disaster mitigation.

DISASTER CYCLE DISASTER IMPACT RISK REDUCTION PHASE RESPONSE PREPARDNESS MITIGATION RECOVE RY PHASE REHABILITATION RECONSTRUCTION

TSUNAMI WARNING

I DISASTER IMPACT & RESPONSE  Greatest need for emergency care occurs in the first few hours.  2.The management of mass causalities can be further divided into search & rescue, first aid, triage & stabilization of victims, hospital treatment & re distribution of patients to other

SEARCH, RESCUE & FIRST AID. Comprises of :  FIELD CARE.  TRIAGE.  TAGGING.  IDENTIFICATION OF THE DEAD.

FIELD CARE  Most injured persons converge to the health care facility spontaneously, using what ever transport is available, regardless of the facilities, operating status.  This requires health care resources be properly re directed to this new priority.

 Bed availability & surgical services should be maximized.  Provisions should be made for food & shelter.  A centre should be established to respond to enquiries from patient’s relatives & friends.  Priority should be given to victim’s identification & adequate mortuary space should be

TRIAGE When the quantity & severity of  injuries overwhelm the operative capacity of health facilities, a different approach must be adopted.  The principle of ―first come, first treated‖ is not followed in mass emergencies.  Therefore a system of triage is

 Triage consists of rapidly classifying the injured on the basis of the severity of their injuries & the likely hood of their survival with prompt medical treatment.  High priority is granted to victims whose immediate or long term prognosis can be dramatically affected by simple intensive care.

 Moribund patients who require a great deal of attention, with questionable benefit, have the lowest priority.  Triage is the only approach that can provide maximum benefit to the greatest number of injured in a major disaster situation.  The most often used triage system is the four colour code

 Red indicates high priority & tretment or transfer.  Yellow signals medium priority,  Green indicated ambulatory patients &  Black for dead or moribund patients.  Triage should be carried out at the site of disaster in order to

 Persons with minor or moderate injuries should be treated at their own homes to avoid social dislocation & the added drain on resources of transporting them to central facilities.  The seriously injured should be transported to hospitals with specialized treatment facilities.

TAGGING All victims should be identified with tags stating their name, age, place of origin, triage category, diagnosis & initial treatment.

IDENTIFICATION OF THE DEAD. Taking care of the dead is an essential part of the disaster management.  A large number of dead can impede the efficiency of the rescue operation.  Care of dead includes :  1.Removal of the dead from the disaster scene.  2.Shifting to the mortuary.  3.Identification. 

 4.Reception of bereaved relatives & proper respect of the dead. ( If human bodies contaminate wells or other water sources as in floods, they may transmit gastroenteritis or food poisoning to survivors.  The dead bodies represent a delicate social problem.

II RELIEF PHASE.  This phase starts when assistance from outside starts to reach the disaster area.  The type & quantity of humanitarian relief supplies are determined by two factors.  1.The type of disaster.  2.Type & quantity of supplies available locally.

 The most critical health supplies are those needed for treating causalities & preventing of communicable diseases.  Following the initial emergency phase , needed supplies will include food, blankets, clothing, shelter, sanitary engineering equipment & construction material.

 Disaster managers must be prepared to receive large quantities of donations.  There four components in managing humanitarian supplies.  1.Acquisition of supplies.  2.Transportation.  3.Storage.  4.Distribution.

INTERVENTIONS – RELIEF PHASE 1. Epidemiological surveillance & disease control. 2.Nutrition. 3.Vaccination. 4.Rehabilitation.

EPIDEMIOLOGICAL SURVEILLANCE & DISEASE CONTROL  Disasters can increase the transmission of communicable diseases through following mechanisms :  1.Overcrowding & poor sanitation in temporary resettlements. (ARI).  2.Population displacement may lead to introduction of communicable diseases to which either the migrant

 Disruption & contamination of water supply damage to sewerage system & power systems are common in natural disasters.  Disruption of routine control programmes as funds & personnel are usually diverted to relief work.  Ecological changes may favour breeding of vectors & increase the vector population density.

 Displacement of domestic & wild animals, who carry with them zoonoses that can be transmitted to humans as well as to other animals. (Leptospirosis).  Provision of emergency food, water & shelter in disaster situation from different or new source may itself be a source of infectious disease.

 The principles of preventing & controlling communicable diseases after disaster are  1.Implement as soon as possible all public health measures, to reduce the risk of disease transmission.  2.Organize a reliable disease reporting system to identify outbreaks & to promptly initiate

Investigate all reports of disease outbreaks rapidly

VACCINATION  Mass vaccination programme is to be organized, usually against cholera, typhoid & tetanus.  The pressure may be increased by the press media & offer of vaccines from abroad.  Routine vaccination programme may be organized with camps with a large number of children population.

NUTRITION A natural disaster may affect the nutritional status of the population by affecting one or more components of food chain depending on the type, duration & the extent of the disaster.  Specially if vulnerable population is more. (Pregnant mothers, children)  Measures for an effective food relief

 1.Assessing the food supplies after a disaster.  2.Gauging the nutritional needs of the affected population.  3.Calculated food rations & need for large population groups.  4.Monitoring the nutritional status of the affected population.

REHABILITATION  The final phase in a disaster should lead to restoration of the pre disaster conditions.  Rehabilitation starts from the very first day of disaster.  Services should be reorganized & re structured.  Priorities will shift from health care towards environmental health

WATER SUPPLY A survey of all water supply should be made.  This includes water source & distribution system.  It is important to determine physical integrity of system components, the remaining capacities & bacteriological &

 The main public safety aspect of water quality is microbial contamination.  The first priority of ensuring water quality in emergency situations is chlorination.  It is the best way of disinfecting the water.  It is advisable to increase residual chlorine level to about 0.2 – 0.5 mg /litre.

 Low water pressure increases the risk of infiltration of pollutants into water mains.  Repaired mains, reservoirs & other units require cleaning & disinfection.  Chemical contamination & toxicity are a second concern in water quality & potential chemical contaminations have to

 The existing & new water sources require the following protection measures :  1.Restrict access to people & animals, if possible, erect a fence & appoint a guard.  2.Ensure adequate excreta disposal at a safe distance from water source.  3.Prohibit bathing, washing & animal husbandry, upstream if intake points in rivers & streams.

 4.Upgrade wells to ensure that they are protected from contamination.  5.Estimate the maximum yield of wells & if necessary, ration the water supply.  In many emergency situations, water has to be

 6.All water tankers should be inspected for fitness & be cleaned & dis infected before transporting water.

FOOD SAFETY  Poor hygiene is a major cause of food – borne disease in disaster situations.  Kitchen sanitation is important in the feeding camps.  Personal hygiene of individuals handling food should be monitored.

BASIC SANITATION & FOOD HYGIENE  Many diseases spread through fecal contamination of water & food.  Hence every effort should be made to ensure the sanitary disposal of excreta.  Emergency latrines should be made available to the displaced where toilet facilities have been destroyed.

 Washing, cleaning & bathing facilities should be made available for the displaced persons.

VECTOR CONTROL Control programme for vector borne diseases should be intensified in the emergency & rehabilitation period.  Of special concern are malaria, dengue fever, leptospirosis, plague.  Flood water provides ample breeding opportunities for mosquitoes. 

PREVENTION / MITIGATION            Zoning / land use management Building codes Building use regulations Relocation Safety improvements Legislation Public Information Community awareness and education Tax, insurance incentives or disincentives

PREPAREDNESS Community awareness and education  Disaster Plans  Training and test exercises  Disaster communications  Mutual aid agreements  Warning systems  Resource inventories  Provision of special resources 

PREPAREDNESS: PLANNING  Failure to plan is planning to fail‖.  Planning provides the opportunity to network and engage participants prior to the event.  Planning provides the opportunity to resolve issues outside of the ―heat of battle‖.

PREPAREDNESS: SURVEILLANCE Mechanisms to identify disease trends Mechanisms to monitor risks including monitoring vector disease e.g. Avian Influenza in birds Diagnostic capability – Laboratories Reporting of infectious

TRAINING There is a need to do this better.  Key area is decision making  Trained staff will make better decisions  Training improved team efficiency especially in a crisis (DeVita 2004) Leadership training needed (Cuny

PRINCIPLES OF DISASTER MANAGEMENT Disaster management is the responsibility of all spheres of government.   No single service or department in itself has the capability to achieve comprehensive disaster management. Each affected service or department must have a disaster management plan which is coordinated through the Disaster

 Disaster management should use resources that exist for a day-to-day purpose.   There are limited resources available specifically for disasters, and it would be neither cost effective nor practical to have large holdings of dedicated disaster resources. However, municipalities must ensure that there is a minimum budget allocation to enable appropriate response to incidents as they arise, and to prepare for and reduce the risk of disasters

 Organisations should function as an extension of their core business.   Disaster management is about the use of resources in the most effective manner. To achieve this during disasters, organisations should be employed in a manner that reflects their day-to-day role. But it should be done in a coordinated manner across all relevant

 Individuals are responsible for their own safety.  Individuals need to be aware of the hazards that could affect their community and the counter measures, which include the Municipal Disaster Management Plan, that are in place to deal with them.

 Disaster management planning should focus on large-scale events.  It is easier to scale down a response than it is to scale up if arrangements have been based on incident scale events. If you are well prepared for a major disaster you will be able to respond very well to smaller incidents and emergencies, nevertheless, good multi agency responses to incidents do help in

 Disaster management planning should recognise the difference between incidents and disasters.  Incidents - e.g. fires that occur in informal settlements, floods that occur regularly, still require multiagency and multi-jurisdictional coordination. The scale of the disaster will indicate when it is beyond the capacity of the municipality to respond, and when it

 Disaster management operational arrangements are additional to and do not replace incident management operational arrangements  Single service incident management & operational arrangements will need to continue, whenever practical, during disaster operations.

 Disaster management planning must take account of the type of physical environment and the structure of the population.  The physical shape and size of the Municipality and the spread of population must be considered when developing counter disaster plans to ensure that appropriate prevention, preparation, response and recovery mechanisms can be put in place in a timely manner.

 Disaster management arrangements must recognise the involvement and potential role of non-government agencies.  Significant skills and resources needed during disaster operations are controlled by non-government agencies. These agencies must be consulted and included in the planning process.

DISASTER NURSING- DEFINITION  Disaster nursing can be defined as ―the adaptation of professional nursing knowledge, skills and attitude in recognizing and meeting the nursing, health and emotional needs of disaster victims.‖

A PARADIGM SHIFT ALL FOR ONE‖―ONE FOR ALL‖

GOALS OF THE DISASTER NURSING The overall goal of disaster nursing is to achieve the best possible level of health for the people and the community involved in the disaster. Other goals of disaster nursing are the following: 1.To meet the immediate basic survival needs of populations affected by disasters (water, food, shelter, and security). 2 To identify the potential for a secondary disaster. 3 To appraise both risks and resources in the

4.To correct inequalities in access to health care or appropriate resources. 5.To empower survivors to participate in and advocate for their own health and well-being. 6.To respect cultural, lingual, and religious diversity in individuals and families and to apply this principle in all health promotion activities.

7.To promote the highest achievable quality of life for survivors.

PRINCIPLES OF DISASTER NURSING The basic principles of nursing during special (events) circumstances and disaster conditions include: 1.Rapid assessment of the situation and of nursing care needs. 2.Triage and initiation of life-saving measures first.

3.The selected use of essential nursing interventions and the elimination of nonessential nursing activities. 4. Adaptation of necessary nursing skills to disaster and other emergency situations. The nurse must use imagination and resourcefulness in dealing with a lack of supplies, equipment, and personnel. 5.Evaluation of the environment and the mitigation or removal of any health hazards.

6.Prevention of further injury or illness. 7.Leadership in coordinating patient triage, care, and transport during times of crisis. 8.The teaching, supervision, and utilization of auxiliary medical personnel and volunteers.

9.Provision of understanding, compassion, and emotional support to all victims and their families.

DISASTER MANAGEMENT CYCLE

MANAGEMENT OF MASS CASUALTIES  Mass Casualty Management is a multi-sectoral coordination system based on daily utilized procedures, managed by skilled personnel in order to maximize the use of existing resources; provide prompt and adapted care to the victims; ensure emergency services and hospital return to routine

OBJECTIVES · The application of triage and tagging procedures in the management of mass casualties · Understand the priorities in triage and tagging, and orders of evacuation

RESPONSE Implementing plans  Implementing disaster legislation or  declarations  Issuing warnings  Activating disaster operations centres  Mobilizing resources  Notifying public authorities  Providing medical assistance  Providing immediate relief  Search and rescue 

THE RESPONSE MANAGEMENT FRAMEWORK           A set of principles which provide a framework for managing any event.

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