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General Concepts and Definitions

General Concepts and Definitions. Leaders course Jamaica February 11, 2003 “Knowledge comes, but wisdom lingers”( Tennyson). General Concepts. Disasters: low probability-high impact events “Sudden ecological phenomenon of sufficient magnitude to require external assistance” (WHO)

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General Concepts and Definitions

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  1. General Concepts and Definitions Leaders course Jamaica February 11, 2003 “Knowledge comes, but wisdom lingers”( Tennyson)

  2. General Concepts • Disasters: low probability-high impact events • “Sudden ecological phenomenon of sufficient magnitude to require external assistance” (WHO) • “I know a disaster when I see one” • Risk Management vs. Disaster Management • Attitude Change vs. Product Improvement

  3. General Concepts • Risk: Probability of harmful consequence or expected loss of lives/property resulting from interaction between natural or human induced hazards and vulnerable conditions. • Hazard: Probability of occurence of a given threat • Vulnerability: Degree of susceptibility of the element exposed. • Capacity:Ability of people to cope with the situation. • Risk = H x V/C

  4. The Disaster Cycle Prevention Mitigation Response Rehabilitation Preparedness Reconstruction AFTER BEFORE DURING

  5. Definitions • Preparedness - Pre-disaster activities aimed at strengthening the capacity for rescue, relief, and rehabilitation. • Prevention - Measures designed to provide complete protection from natural disasters by controlling effects of natural phenomena. • Mitigation - Prevention in an imperfect world!Reduction of the impact! (Structural, non-structural and functional)

  6. Disasters and Health Effects • World-wide: 3.4 mil deaths due to natural disasters in 25 years • Japan: 63 deaths/event • Peru: 2,900 deaths/event • Population: 6 bil increase = 1.33% yearly increase (the poor outnumber the rich) • Trends: • Increase in # of hazards • Deaths toll per event reduced • Financial toll increased • What Matters More??

  7. Global Trends Climate change and variables – El Niño EXTREME EVENTS • Poverty • Ignorance • Environmental degradation • Urban growth • Increasing un-sustainability • Increasing obstacles to development • Increased value of constructed environment VULNERABILITY

  8. Current Trends Source: OFDA/CRED International Disaster Database

  9. Current Trends Source: OFDA/CRED International Disaster Database

  10. Disasters and Health Effects • General Effects on Health • Natural vs Technological • Potential Effects vs. Inevitable Threat (ex. BCR) • Sudden vs Creeping/Slow Development • Requirements for food, shelter and primary health care vary with type & length of event.

  11. Disasters and Health Effects • General Effects on Society • Deaths and Injuries • Damage to Health Infrastructure • Water Supply and Sanitation • Communicable Diseases (overcrowding, vectors, water supply, waste management, PH programs) • Social Burden (poverty, age and gender) • Food Shortage • Population Displacement • Mental Health Impact

  12. Disasters and Health Effects • Floods • Most Frequent Natural Hazard • Most Deaths (flash floods) 146/year in USA • Drowning - 77% • Cardiac arrest - 10% • Trauma - 10% • Hypotermia - 3% • Public Health: water quality, waste disposal, vectors, disease • Associated Hazards: electrical, chemical

  13. Disasters and Health Effects • Volcanic Eruption • Most Deadly • Pyroclastic flows - 70% from blast, heat or asphyxiation • Rock fall injuries, BURNS • Difficult Access for First Responders • Damage to Health Infrastructure • Water Contamination

  14. Disasters and Health Effects • Tsunami • Water and Debris = Damage to Structures • More deaths then injured (50-80%) • Drowning -Vulnerable Groups • Trauma Injuries • Dehydration • Sunburn

  15. Disasters and Health Effects • Hurricanes • Most Deadly • Hurricane Flora 1963 - Haiti & Cuba → 8,000 • Hurricane Fifi 1974 -Honduras → 10,000 • Hurricane Mitch 1998 - Central America → 11,000 • Injuries • Lacerations - 80% (during the clean up phase) • Damage to Infrastructure and Public Health Systems

  16. Disasters and Health Effects • Earthquakes • Most Costly - Life and Property • No Warning • Evacuation Not Possible • Initial Medical Response - Delayed • Health Infrastructure - Damaged • Most Deaths - Collapsed Buildings • 95% Survivers are Rescued in First 24 hours • Injuries - Simple fractures to crush injury

  17. Disasters and Health Effects • Technological • Biological, Chemical, Radiological • Accidental or Intentional Release • Terrorist Threat • Possible? Plausible? Probable? • Effective Use of Resources • Personnel • Funding • Infrastructure

  18. Disasters and Health Effects • Technological • Enhancing Capabilities • Training • Infrastructure • Shifting Priorities in Preparedness • Cost Effective • Social Consequences • Reality or Perception

  19. Health SectorandDisaster Management

  20. Recurring Issues • Success is Difficult to Quantify • Management of International Assistance • Information Management • More Actors on the Scene

  21. Recurring Issues • Mass Casualty Management • Care for Victims • Dual Wave Phenomenon • Walking Patients - 30 min • Priority 1 Patients - 2 hours • Geographic Effect (closest facilities most impacted) • BABEL Effect (communication, people, or equipment problem??)

  22. Recurring Issues • Laymen Enthusiasm • Disaster Supply Management • Local Sources • Donations • Tetanophobia • Fear of Epidemics • Management of Human and Animal Remains • Field Hospitals

  23. Planning Assumptions • NO “Best Option” • Plans • Adapted to Disaster • Improvisation Can Be Costly • First Responders Are Not Always First • Infrastructure Capacity • Specialized Care May Be Needed

  24. Planning Assumptions • Local Capacity Response Capability • Stockpile of Equipment & Supplies • Shortage or Flood of Supplies and Staff • Decentralization of Authority • Private Business/Organization Support

  25. Health Sector Actors • Government Sector: Min of Health, Min of Foreign Affaires, Min of Finance, Min of Environment, Water Authorities, Fire Services, Police, Defense Force, Public Works, National Disaster Office, Airport Managers, MEDIA…….. • Private Sector: Hospitals, Ambulances, Doctors, Manufacturers,…….. • Local Authorities: Mayors, Community Groups….

  26. Health Sector Task • Promotion of Disaster Reduction Activities • Include Risk Management Concept in Development Projects • Staff, Fund, and Prepare Response Resources • Care of Victims • Enviromental Needs (water, food, vector control) • Inform Public

  27. Health Sector Task • Coordinate With All Sectors • Plan for Rehabilitation • Window of Opportunity for Reform

  28. Ministry of Health Disaster Reduccion Program • Mandate: • Promote, Coordinate, and Support Efforts of the Entire Health Sector to Reduce Impact of Disasters • Scope: • Multi-Hazard and Inter-Disciplinary

  29. Functional Areas of Responsibility • Promote Health & Social Issues with Other Sectors • Include Reduction/Mitigation Measures into Development Activities • Equitable Access to Healthcare • Public Awareness

  30. Normative Functions • Develop Construction Standards • Develop Contingency Planning, Response, and Simulation Standards/Guidelines • Develop Criteria for Disaster Preparedness and Safety Accreditation of Health Facilities • Develop Communications Protocol • Develop Standards/Guidelines for Registration of Humanitarian Assistance Organizations (NGO´s, external military forces)

  31. Educational Functions • In-Service Training of Health Staff • Include Disaster Management into Pre- and Post-Graduate Curriculum Medical School • Presentation of Health Related Topics in Training of Other Sectors

  32. Coordination/Liaison • National Disaster Office (Civil Protection) • Disaster Focal Points of Other Agencies • Disaster Programs in Neighboring Countries • Humanitarian and Developmental Organizations (national, international)

  33. Operational Functions • Mobilize and Coordinate Immediate Response • Coordinate Health Sector Assessment • Formulate Priorities and Assign Resources • Mobilize External Resources • Contribute to Formulation of Rehabilitation Plans (include mitigation) • Compile and Disseminate Lessons Learned

  34. Reporting ChannelsStaff and Budget • Highest Decision-Mmaking Level in the MOH • Access to All Administrative Areas and Technical Departments in Health • Funds to be Assigned Specifically for Risk Reduction Program • Staff Trained, Qualified/Certified, and Full- Time

  35. General Concepts and Definitions Leaders course Jamaica February 11, 2003 “Knowledge comes, but wisdom lingers”( Tennyson)

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