Disaster - Sudden or great misfortune DISASTER MANAGEMENT MinakshiGautam, Assistant Professor, IIHMR
Introduction • ‘Disaster • Originated from a french word • Combination of two terms • Des and astre • ‘Des’ meaning bad or evil and ‘astre’ meaning star • The expression of term disaster is bad or evil star.
Disaster is a……… • “A major incident arising with little or no warning” • Affecting in high magnitude • Calls for special mobilization and organization of services
Disaster is a calamity of sudden occurrence, a catastrophe causing injury and death to a large number of people during a short span of time.
Disaster – WHO definition “WHO defines a disaster as any occurrence that causes damage, economic disruption, loss of human life and deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the effect community or area.”
Disaster – UNISDR* Definition - 2004 “A serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses which exceed the ability of the affected community or society to cope using its own resources.” *United Nations International Strategies for Disaster Reduction
Definition • Situation or event, which overwhelms local capacity, necessitating a request to national or international level for external assistance (CRED*). * Centre for Research on Environmental Decisions
Disaster Management • For centuries, examined and treated as an expression of supernatural • Scientific explanation and knowledge based on ‘Cause and Effect’ • This helped in disaster preparedness and mitigation
Disaster Management in India • Both central and state governments share responsibility • Basic responsibility of relief and rescue operations is of state government • Central government plays a supportive role in terms of financial and other resources • Many countries have detailed policy and legislations giving comprehensive direction to prevention, preparedness and response. • The focus of current contingency action plan is relief activities but modifications are being made
Disaster Management in India • 10th Five Year Plan – a detailed chapter of Disaster Management • 12th Finance Commission mandated to review financial arrangements for Disaster Management –abolished national fund for calamity relief and created national calamity contingency fund with initial corpus of 500 crores • Department of Agriculture and Cooperation of Ministry of Agriculture is nodal department in Disaster Management • Central Relief Commissioner coordinates relief operations
International relief* under the aegis of the League of Nations in 1927 Beginning in the late 1960’s and early 1970’s the international community became increasingly aware of inadequacies of international relief assistance One of the outgrowths of these debates in early 1970’s was creation of UNDRC** in 1971 by UN General Assembly Under this government of disaster stricken country bears primary responsibility In the federal Set up of India, both the central and State governments share the responsibility *United Nations Disaster Relief Organization. WHO, International Red Cross ** United Nations Disaster Relief Coordination
Contingency Action Plan for Natural Calamities issued by the Ministry of Agriculture, GoI in 1990 High Power Committee 1999 Earthquake in Gujarat (26 Jan 2001) resulted in creation of Nation Disaster Commission and formulation of National Disaster Policy 2002-2009 national initiative namely Disaster Risk Management Programme was implemented in collaboration with State Governments by Government of India and UNDP (reduce vulnerabilities of communities in some of the most hazard prone districts of India) 23rd Dec 2005 GoI envisaged NDMA*** headed by PM and SDMA^ headed by CM for holistic and integrated approach In India – Act is ministerial level document, not a comprehensive document which has functional, informational and operational linkages *United Nations Disaster Relief Organization. WHO, International Red Cross ** United Nations Disaster Relief Coordination ****national Disaster Management Authority ^ State Disaster Management Authority
Agencies in Disaster Management • Central and State Government • District Administration • Armed Forces • Paramilitary Forces (BSF, CRPF, Assam Rifles, national security guard, etc. • NGOs • International agencies including UN agencies • Media
Organizational Structure at National Level Apex level – Cabinet Committee under chairmanship of PM National Crisis Management Committee under the chairmanship of Cabinet Secretary Crisis Management Group CMG under chairmanship of Central Relief Commissioner and Additional Secretary, Ministry of Agriculture meet regularly *United Nations Disaster Relief Organization. WHO, International Red Cross ** United Nations Disaster Relief Coordination
Agencies in Disaster Management • At national level depending on type of disaster, nodal ministries are assigned the task • Natural Disaster – Ministry of Agriculture • Railway Disaster – Ministry of Railways • Air Disaster – Ministry of Civil Aviation • Biological Disaster – Ministry f Health
Transmission of Information Indian Meteorological Department and Central Water Commission informs Central Relief Commissioner about forecast of natural disasters CRC informs Secretary (Agriculture and Cooperation) Informs Cabinet Secretary CS informs Prime Minister, Agriculture Minister, National Crisis Management Committee CRC informs other concerned central and state government departments including Mohfw through Emergency Medical Relief Division (EMRD) of DGHS
Transmission of Information • Present state of warning system in country includes • 158 flood forecasting stations • 56 seismic stations • Disaster warning system – INSAT Satellite
Disaster Management at State Level • Each state has its own organization pattern, policies and plan • Broad pattern based on guidelines by GoI • Each state has Relief Commissioner and Chief Secretary • Primary responsibility – relief operations, preparedness and rehabilitation instead of comprehensive plan encompassing prevention • District is the basic unit • District administration prepares contingency plans
Committees and various organizations • Cabinet Committee • National Crisis Management Committee • Commando Force – professional well equipped specialized in calamity specific operations • Disaster High Power Committee 1999 • Crisis management Group • State Crisis Management Group • District Administration • District Relief Committee • district collector has the authority for requisition to the Armed Forces
Committees and various organizations • National Centre for Disaster Management • International consortium known as Prevention Consortium (coalition of World Bank, Insurance companies, government, universities, NGOs)
Group Activity : 30 minutes • Activity 1: Classification of Disasters • Activity 2: Difference and relationship between risk, vulnerability and disaster • Activity 3: action to be taken at health centre when casualties reach there • Activity 4: health problems related to disasters • Activity 5: What is triage? Discuss • Activity 6: Public health measures to prevent vector borne and communicable diseases
Classification of Disasters • Natural Disasters • Earthquakes • Floods and famines • Cyclones, hurricane, typhoons (cyclones – Indian and pacific Oceans, Hurricane – Northeast Pacific, typhoons – northwest Pacific) • Tsunami, tidal waves • Landslides and Avalanches • Volcanic eruptions • Man-made Disasters • Nuclear, Biological, Chemical Disaster (NBC) • Accidents
Earthquakes • Earthquakes have caused huge damage to life and property worldwide • Significant threat to India also because of falling of almost 59% of its geographical area in earthquake vulnerable zones. • Impacts of an earthquake are the loss of human lives and property, economic & social losses and environmental degradation. • Over the last century, about 75% of fatalities attributed to earthquakes have been caused by the collapse of buildings.
Earthquakes • A great number of victims die in the collapse of non-engineered weak masonry buildings • absence of knowledge in earthquake resistant construction & retrofitting techniques at the grassroots and • non-compliance of appropriate building regulations and town planning legislations for earthquake safe guided physical development in towns.
Earthquakes • Besides, ignorance of basic tips of earthquake survivability • Further, least expertise by rescuers in search & rescue • Deaths almost more than 10% of population • The ratio of dead to injured approx 1:3 resulting from primary shock • Use of thermal imaging, sniffer dogs, multiple sensors
Destructive Winds • Unless complicated by secondary disasters such as floods or sea surge cause relatively few deaths and injuries Flash Floods and Sea Surge • Deaths mainly due to drowning • Commonest amongstt weakest members of population
Floods • Slow flooding causes limited immediate morbidity and mortality • Slight increase in deaths from venomous snake bites • Traumatic injuries caused by flooding requires limited healthcare
Hurricane Earthquake Floods
Landslides and Avalanches • Landslides & Avalanches are among the major hydro-geological hazards that affect large parts of India, especially the Himalayas, the Northeastern hill ranges, the Western Ghats, the Nilgiris, the Eastern Ghats and the Vindhyas, in that order. • Landslides in the Darjeeling district of West Bengal as also those in Sikkim, Tripura, Meghalaya, Assam, Nagaland and Arunachal Pradesh pose chronic problems causing recurring losses.
Nuclear, Biological and Chemical Warfare • In 1995, the Japanese religious cult, Aum Shinrikyo, released the nerve gas, Sarin, in the Tokyo Subway. • 12 persons were killed and several thousands suffered illness • Investigation disclosed attempts to disseminate aerosols of anthrax • Unsuccessful as he used weakened strain of Anthrax
Salient features in medical management of NBC causalities • The lack of experience and skills of professionals will adversely affect the medical management • Healthcare workers may themselves suffer significant damage • Triage protocol during NBC scenario is different – difficult to save victims with burns of more than 30% total body surface area (TBSA) and exposure to more than 450 rads of ionising radiations
Salient features in medical management of NBC causalities • Nuclear Warfare • Segregated and monitored casualty evacuation, separately for radioactive, biologically contaminated and non contaminated cases. • Significant numbers are burn casualties which are caused due to ‘flash’, ‘fire’ or ‘beta’particles • Immediately after a nuclear explosion temperature may go upto 106 degree C and pressure 105 atmospheres • 50% energy due to blast, 35% heat and 15% nuclear radiation after detonation
Salient features in medical management of NBC causalities • All casualties of nuclear warfare must be regarded as radiation victims unless proven otherwise. • Use of dosimeters and PPE
Salient features in medical management of NBC causalities • Chemical Warfare • Potent means of mass destruction • Lethal agents like Sarin or incapacitating agents like Distilled Mustard • Blister agents, nerve agents, blood agents, choking agents, tear agents (riot control agents) • Blister agents were used by Germans against the British during 1st world war • Phosgene (choking agent) accounted for 85% of deaths attributable to chemical weapons during the 1st world war.
Salient features in medical management of NBC causalities • Biological Warfare • Use of living organisms or their toxic products to cause disability, damage and death. • Recipes for making biological weapons are now available on internet. • 14th century – targets besieging the Italian in a fortress in Cremea threw over walls bodies of plague victims • Red Indians in North America were given smallpox infected blankets • Use of mycotoxins in Afganisthan
Salient features in medical management of NBC causalities • Biological Warfare • In 1972, Biological and Toxic Weapons Convention attended by almost all the countries agreed to cease bio-weapons research programs • Also the agreed to destroy all stocks • Despite this reported fact is that during 1990s countries had stockpiled tons of dried spores of Anthrax, smallpox, plague, etc • Indicators of biological attack – number of persons affected, time relationships, sharply defined geographical boundaries and clinical profile
Salient features in medical management of NBC causalities • Biological Warfare • Lab diagnosis by antigen-antibody detection • Application of fluorescent antibody technique (FAT) • PPE – Ultra high efficient filter masks which are capable of filtering more than 99% particles of 1-5 microns • Isolation of cases- negative pressure isolation • Immunoprophylaxis – vaccines during Gulf War to protect from Anthrax • Chemoprophylaxis
Health Problems related to Disasters • Pre-existent level of disease • Ecological changes • Population displacement • Sewage disposal, water and other public utilities may be interrupted • Interruption of basic public health services
Global Scenario • Second major human problem after war • In terms of monetary damage and number of people killed or effected. • Greatest economic and social impact in poorest countries
Global Scenario • An event that causes deaths of 125 people in a high income economy tends to cause 33,000 deaths in low-income economy*. • Average per event mortality per 1000 population was 69 in low income, 28 in middle income and one in a high income economy* * Debrati, Guha, Sapir, Michal F Lechat. Disaster Management. Report of Workshop organised by Directorate General of Health Services, Mohfw, GoI, 1986
Global Scenario • Estimated that disaster events globally cost about 50,000 million US dollar each year* • Results in approx 2,50,000 deaths in a year* • Nearly 20 major disaster strike the world every year * Carter W Nick. Disaster Management. A disaster management handbook. Asian development bank, Manila, 1991
Global Scenario • Amongst the major disasters are floods, cyclones and earthquakes • World Disaster Report 1999 indicates 89,546 people were killed in 542 disaster events with average estimates of 71.9 million dollors. • Nearly 80% of deaths were due to Natural Disasters* * IFRC World disaster report 1999
Global Scenario • Asia-pacific region witnesses a large number of natural disasters due to geographical location • 60% of major natural disasters reported in the world occur in this region.
Global Scenario • World’s worst disaster occur in regions between Tropic of Cancer in north and Tropic of Capricon in south • It has approx 20 major disasters annually