INTRODUCTION
Preparedness focuses on preparing equipment and procedures for use when a disaster occurs, i.e., planning. Preparedness measures can take many forms including the construction of shelters, installation of warning devices, creation of back-up life-line services (e.g., power, water, sewage), and rehearsing evacuation plans. Two simple measures can help prepare the individual for sitting out the event or evacuating, as necessary. For evacuation, a disaster supplies kit may be prepared and for sheltering purposes a stockpile of supplies may be created. The preparation of a survival kit such as a “72-hour kit” is often advocated by authorities. These kits may include food, medicine, flashlights, candles and money. Also, putting valuable items in safe area is also recommended.
The objectives of the disaster preparedness is to ensure that appropriate systems, procedures and resources are in place to provide prompt, effective assistance to disaster victims, thus facilitating relief measures and rehabilitation services.
Disaster preparedness is an ongoing, multi-sectoral activity to carry out the following activities;
- Evaluate the risk of the country or particular region to disasters.
- Adopt standards and regulations
- Organize communication, information and warning systems
- Ensure coordination and response mechanisms
- Adopt measures to ensure that financial and other resources are available for increased readiness and can be mobilized in disaster situations.
- Develop public education programs
- Coordinate information sessions with news media
- Organize disaster simulation exercises that test response mechanisms
For the Health Sectors Disaster Preparedness plan to be successful, clear mechanisms for coordinating with other sectors and internationally must be in place.
The Health Disaster Coordinator is in charge of preparedness activities and coordinating plans with
- Agencies
- Foreign Relations- UN, UNICEF.WHO & other international agencies
- NGO’s- Red Cross etc
- Those responsible for power, communication, Housing, water services etc
- Civil Protection agencies-Police, armed forces
EMERGENCY PREPAREDNESS
Agents, Diseases and Other Threats
- Natural Disasters
Earthquakes, Floods, Cyclones, Typhoons, Tsunamis, Winter
- Bio-Terrorism Agents
Anthrax, Plague, Smallpox
- Chemical Emergencies
Ricin, Phosgene, Bromine, Sarin
- Radioactive Emergencies
- Mass Trauma
Explosions, Blasts, Burns, Injuries
- Recent Outbreaks and Incidents
Bird flu, SARS, West Nile Virus, Mad Cow Disease
DISASTER MITIGATION
It is virtually impossible to prevent occurrence of most Natural Disasters, but it is possible to minimize or mitigate their damage effects.
Mitigation measures aim to reduce the Vulnerability of the System [ e.g. By improving & enforcing building codes etc]
Disaster prevention implies complete elimination of damages from a hazard, but it is not realistic in most hazards. [e.g. relocating a population from a flood plain or from beach front]
Medical Casualty could be drastically reduced by improving the Structural Quality of Houses, Schools, and Public or Private Buildings.
Also ensuring the Safety of Health facilities, Public Health Services, Water Supply, Sewerage System etc.
Mitigation complements the Disaster Preparedness and Disaster Response activities.
A specialized Unit within the National Health Disaster Management Program should coordinate the works of experts in the field of
- Health, Public Policy & Public Health
- Hospital Administration
- Water Systems
- Engineering & Architecture
- Planning, Education etc
The Mitigation Program will direct the following activities
- Identify areas exposed to Natural Hazards and determine the vulnerability of key health facilities and water systems
- Coordinate the work of Multi Disciplinary teams in designing and developing building codes and protect the water distribution from damages
- Hospitals must remain operational to attend to disaster victims
- Include Disaster Mitigation Measures in the planning and development of New facilities
- Identify priority hospitals and critical health facilities that complies with current building codes and standards
- Ensure that mitigation measures are taken into account in a facility’s maintenance plans
- Inform, sensitize and train those personnel’s who are involved in planning, administration, operation, maintenance and use of facilities about disaster mitigation
- Promote the inclusion of Disaster Mitigation in the curricula of Professional training institutes
TECHNICAL HEALTH PROGRAMS
- Treatment of casualties
- Identification and disposal of bodies
- Epidemiological surveillance and disease control
- Basic sanitation and sanitary engineering
- Health management in shelters or temporary settlements
- Training health personnel and the public
- Logistical resources and support
- Simulation exercises / Mock Exercises
EPIDEMIOLOGIC SURVEILLANCE AND DISEASE CONTROL
Natural disasters may increase the risk of preventable diseases due to adverse changes in the following areas
- Population density
- Population displacement
- Disruption and contamination of water supply and sanitation services
- Disruption of public health programs
- Ecological changes that favor breeding of vectors
- Displacement of domestic and wild animals
- Provision of emergency food, water and shelter in disaster situation
The principles of preventing and controlling communicable diseases after a disaster are to;
- Implement as soon as possible all public health measures to reduce the risk of disease transmission
- Organize a reliable disease reporting system to identify outbreaks and to promptly initiate control measures
- Investigate all reports of disease outbreaks rapidly. Early clarification of the situation may prevent unnecessary dispersion of scarce resources and disruption of normal progress
ENVIRONMENTAL HEALTH MANAGEMENT
Post disaster environmental health measures can be divided into two priorities
- Ensuring that there are adequate amounts of safe drinking water, basic sanitation facilities, disposal of excreta, waste water and solid wastes and adequate shelter
- Providing food protection measures, establishing or continuing vector control measures, and promoting personal hygiene
Water Supply
Alternate water sources
Mass distribution of Disinfectants
- Food Safety
- Basic Sanitation and Personal Hygiene
- Solid Waste Management
- Vector Control
- Burial of the Dead
- Public information and the Media
EVALUATION
In the case of disaster management, the Evaluator will be looking at the “actual” verses the “desired” on two levels, i.e. the overall outcome of disaster management efforts and the impact of each discrete category of relief efforts (Provision of food, shelter, management of communications etc)
A critical step in the management of any disaster relief is the setting of objectives, which specify the intended outcome of the relief.
The general objectives of the disaster management will be the elimination of unnecessary morbidity, mortality and economic loss directly and indirectly attributable to mismanagement of disaster relief.
The comparison of the “actual” with “desired” is the first critical step of evaluation. If the objectives were met, those who have participated in the relief have demonstrated that they have accomplished what they set out to do.
On the other hand, if the objectives were not met, it is desirable for those conducting the evaluation to continue with the evaluation process, identify the reasons for the discrepancy and suggest corrective action.
Simulated Disaster Preparedness Operations should be undertaken to test the various components before actual need arise.
Evaluation of the health disaster management program
- Evaluation of the preparedness program
- Evaluation of the mitigation measures
- Evaluation of the training
PREVENTION OF DISASTERS
Existing knowledge that might reduce the undesirable effects of disasters is often not applied.
- Hurricane/Tornado/ Cyclone warning systems
- Legislation preventing building in the flood prone areas
- Requirement of protective cellars/shelters in disaster prone areas
- A Seismic housing code for earthquake-prone area
- Strict procedural code followed to prevent Nuclear, Toxicological and Chemical disaster.
- Early warning systems and Disaster preparedness which will help to minimize morbidity, mortality and economic loss
Disaster Preparedness Plan and Development in Kenya
Located on the eastern side of the African continent is one of the most developed and industrialized countries in East Africa known as the Republic of Kenya. However, one aspect that has always been an enduring development challenges in Kenya is the way the country responds to disasters.
Republic of Kenya is one country that has a vast history of being at the receiving end of numerous natural and man-made disasters. In fact, the list of disasters in Kenya almost goes on endlessly. Some of these major disasters that happened in Kenya include El Nino floods, Kyanguli fire disaster, droughts, poverty, USA embassy bombing, ethnic clashes in the coastal region, health-related disasters such as malaria and HIV/AIDS and frequently occurring political conflicts that result in massive loss of lives, property and displacement of people. Over the years, Kenya did not have a proper disaster preparedness plan. However, the situation seems to be changing in the recent times with the intervention of several national and international organizations including the International Red Cross Society.
As per the International Red Cross Society, every country should have an effective disaster preparedness plan so as to respond to the disaster in an effective way. Any disaster should be first handled at the local level by local organizations. An international response is then built up on these local efforts.
Under the disaster preparedness plan, the Government of Kenya is doing a lot to ensure that preventive measures are properly in place so as to reduce the impact caused by these dangers. Some of the achievements include
- Installation of early warning systems and weather forecasts
- Development of local disaster management teams. These teams are structured in accordance with the disasters that frequently happen at a particular place. In order to know about the disasters happening at one place, information and data is gathered from the local people and accordingly a disaster preparedness plan is developed. Training is also provided to disaster management teams at the local level.
- Disaster committees comprising of government, non-government, national and international agencies.
- Creating public awareness and imparting education to local people regarding health-related issues so as to reduce the spread of conditions like HIV/AIDS and other infections.
All these plans are a step towards improvement. There are several other challenges that the country is facing and is looking for ways to tackle them. Some of these include poverty, illiteracy, extreme weather conditions and increased crime rate.
Disaster management aims to reduce, or avoid the potential losses from hazards, assure prompt and appropriate assistance to victims of disaster, and achieve rapid and effective recovery. The Disaster management cycle illustrates the ongoing process by which governments, businesses, and civil society plan for and reduce the impact of disasters, react during and immediately following a disaster, and take steps to recover after a disaster has occurred. Appropriate actions at all points in the cycle lead to greater preparedness, better warnings, reduced vulnerability or the prevention of disasters during the next iteration of the cycle. The complete disaster management cycle includes the shaping of public policies and plans that either modify the causes of disasters or mitigate their effects on people, property, and infrastructure.
The mitigation and preparedness phases occur as disaster management improvements are made in anticipation of a disaster event. Developmental considerations play a key role in contributing to the mitigation and preparation of a community to effectively confront a disaster. As a disaster occurs, disaster management actors, in particular humanitarian organizations become involved in the immediate response and long-term recovery phases. The four disaster management phases illustrated here do not always, or even generally, occur in isolation or in this precise order. Often phases of the cycle overlap and the length of each phase greatly depends on the severity of the disaster.
- 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.
Disaster Risk Management Cycle
The disaster risk management cycle, consists of four phases: Prevention/Mitigation and Preparedness in the pre-disaster stage, and Response and Rehabilitation/Reconstruction in post-disaster stage. In the “Prevention/Mitigation” phase, efforts are made to prevent or mitigate damage (e.g. construction of dikes and dams against floods). Activities and measures for ensuring an effective response to the impact of hazards are classified as “Preparedness” (e.g. emergency drills and public awareness) and are not aimed at averting the occurrence of a disaster. “Response” includes such activities as rescue efforts, first aid, fire fighting and evacuation. In the “Rehabilitation/Reconstruction” phase, considerations of disaster risk reduction should form the foundations for all activities.
Developmental considerations contribute to all aspects of the disaster management cycle. One of the main goals of disaster management, and one of its strongest links with development, is the promotion of sustainable livelihoods and their protection and recovery during disasters and emergencies. Where this goal is achieved, people have a greater capacity to deal with disasters and their recovery is more rapid and long lasting. In a development oriented disaster management approach, the objectives are to reduce hazards, prevent disasters, and prepare for emergencies. Therefore, developmental considerations are strongly represented in the mitigation and preparedness phases of the disaster management cycle. Inappropriate development processes can lead to increased vulnerability to disasters and loss of preparedness for emergency situations.
Mitigation
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.
Mitigation will depend on the incorporation of appropriate measures in national and regional development planning. Its effectiveness will also depend on the availability of information on hazards, emergency risks, and the countermeasures to be taken. The mitigation phase, and indeed the whole disaster management cycle, includes the shaping of public policies and plans that either modify the causes of disasters or mitigate their effects on people, property, and infrastructure.
Preparedness
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.
During the preparedness phase, governments, organizations, and individuals develop plans to save lives, minimize disaster damage, and enhance disaster response operations. Preparedness measures include preparedness plans; emergency exercises/training; warning systems; emergency communications systems; evacuations plans and training; resource inventories; emergency personnel/contact lists; mutual aid agreements; and public information/education. As with mitigations efforts, preparedness actions depend on the incorporation of appropriate measures in national and regional development plans. In addition, their effectiveness depends on the availability of information on hazards, emergency risks and the countermeasures to be taken, and on the degree to which government agencies, non-governmental organizations and the general public are able to make use of this information.
Humanitarian Action
During a disaster, humanitarian agencies are often called upon to deal with immediate response and recovery. To be able to respond effectively, these agencies must have experienced leaders, trained personnel, adequate transport and logistic support, appropriate communications, and guidelines for working in emergencies. If the necessary preparations have not been made, the humanitarian agencies will not be able to meet the immediate needs of the people.
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.
Recovery
As the emergency is brought under control, the affected population is capable of undertaking a growing number of activities aimed at restoring their lives and the infrastructure that supports them. 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.
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.
