DISASTER RISK MANAGEMENT AND MITIGATION:

Disaster is a natural or man-made hazard resulting in an event of substantial extent causing significant physical damage or destruction, loss of life, or drastic change to the environment. A disaster can be defined as any occurrence that cause damage, ecological disruption, loss of human life, deterioration of health and health services, Vs a scale sufficient to warrant as extraordinary response from outside the affected community or area. (W.H.O.) An occurrence of a severity and magnitude that normally results in death, injuries and property damage that cannot be managed through the routine procedure and resources of government.- FEMA (Federal Emergency Management Agency) A disaster can be defined as an occurrence either nature or manmade that causes human suffering and creates human needs that victims cannot alleviate without assistance.- American Red Cross (ARC) United Nations defines disaster is the occurrence of a sudden or major misfortune which disrupts the basic fabric and normal functioning of a society or community. DISASTER alphabetically means:

DISASTE-

R-

Destructions Incidents Sufferings Administrative, Financial Failures. Sentiments Tragedies Eruption of Communicable diseases. Research programme and its implementation

Vulnerabilities can be manifested as physical, social, or attitudinal vulnerability. The disruption of a community can reduced if it is better prepared Disaster Agents / Epidemiology of Disaster:

Agent: Environment Host: Primary Agents: It includes falling of buildings, heat wind rising waters and smoke. Secondary Agents: It includes bacteria and viruses that produce contamination or infection after the primary agent has caused injury or destruction. Factors affecting disaster: Host factors: host is human-kind. Host factors are those characteristics of humans that influence the severity of the disaster effect. Host factors include: o Age o Immunization status o Degree of mobility o Emotional stability Environmental factors:

Disasters are the consequence of inappropriately managed risk and a product of hazards and vulnerability. Hazard is a phenomenon, an event or occurrence that has the potential for causing injury to life or damage to property or the environment (e.g. flood, tornado, volcano eruption, earthquake, landslide or man-made hazards). The magnitude of the phenomenon, the probability of its occurrence, and the extent and severity of its impact may vary. In many cases, these effects can be anticipated or estimated. Vulnerability refers to the susceptibility of a community to a hazard and the prevailing condition, including physical, socio-economic and political factors that adversely affect its ability to respond to hazards or disaster events.

Physical Factors Weather conditions, the availability of food, time when the disaster occurs, the availability of water and the functioning of utilities such as electricity and telephone service. Chemical Factors Influencing disaster outcome include leakage of stored chemicals into the air, soil, ground water or food supplies. Biological Factors: Are those that occur or increase as result of contaminated water, improper waste disposal, insect or rodent proliferations improper food storage or lack of refrigeration due to interrupted electrical services. Bioterrorism: Release of viruses, bacteria or other agents caused illness or death. Social Factors: contribute to the individual social support systems. Loss of family members, changes in roles and the questioning of religious beliefs are social factors to be examined after a disaster. Psychological Factors:

are closely related to agents, host and environmental conditions. Levels of disaster: Level l disasterconsidered a massive disaster. This involves a massive level of damage with severe impact Level ll disasterconsidered a moderate disaster. The local and community resources has to be mobilized to manage this situation Level III disaster considered a minor disaster. These involves minimal level of damage Disaster Nursing: The adaptation of professional nursing skills in recognizing and meeting the nursing physical and emotional needs resulting from a disaster. 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. Disaster Nursing is nursing practiced in a situation where professional supplies, equipment, physical facilities and utilities are limited or not available. Nurses Roles in Disasters: I. II. Determine magnitude of the event Define health needs of the affected groups

III. IV.

V.

VI.

VII. VIII.

Establish priorities and objectives Identify actual and potential public health problems Determine resources needed to respond to the needs identified Collaborate with other professional disciplines governmental and nongovernmental agencies Maintain a unified chain of command Communication

Disaster risk management: Disaster risk management is the systematic process of using administrative directives, organisations, and operational skills and capacities to implement strategies, polices and improved coping capacities in order to lessen the adverse impacts of hazards and their possibility of disaster. Disaster risk management aims to avoid, lessen or transfer the adverse effects of hazards through activities and measures for prevention, mitigation and preparedness. Disaster risk management aims to avoid, lessen or transfer the adverse effects of hazards through activities and measures for prevention, mitigation and preparedness. THE DISASTER MANAGEMENT CYCLE AND NURSING ROLE: Disaster management includes four stages: I. prevention (or mitigation ) II. preparedness III. response IV. recover

Human-made hazards and the ability to deter potential terrorists, detect terrorists before they strike, and take decisive action to eliminate the threat.

Disaster risk reduction: Disaster risk reduction (also referred to as just disaster reduction) is defined as the concept and practice of reducing disaster risks through systematic efforts to analyse and manage the causal factors of disasters, including through reduced exposure to hazards, lessened vulnerability of people and property, wise management of land and the environment, and improved preparedness for adverse effects. Disaster reduction strategies include, primarily, vulnerability and risk assessment, as well as a number of institutional capacities and operational abilities. The assessment of the vulnerability of critical facilities, social and economic infrastructure, the use of effective early warning systems, and the application of many different types of scientific, technical, and other skilled abilities are essential features of disaster risk reduction.

Prevention activities may include heightened inspections; improved surveillance and security operations; public health and agricultural surveillance; and testing, immunizations, isolation, or quarantine and halting of CBRNE threats: chemical, biological, radiological, nuclear, and explosive. NURSING RESPONSIBILITIES: Nurses partner for environmental health by identifying environmental hazards and serving on the public health team for mitigation purposes. Involved with organizing and participating in mass prophylaxis and vaccination campaigns to prevent, treat, or contain a disease. The nurse should be familiar with the regions local cache of pharmaceuticals and how will be distributed. In terms of human-made disaster prevention, the nurse should be aware of high-risk targets and current vulnerabilities and what can be done to

PREVENTION (MITIGATION) Prevention can include: Structural measures, such as protecting buildings and infrastructure from the forces of wind and water Non-structural measures, such as land development restrictions.

eliminate or mitigate the vulnerability. Targets may include military and civilian government facilities, health care facilities, international airports and other transportation systems, large cities, and high-pro le landmarks. Terrorists might also target large public gatherings, water and food supplies, banking and nance, information technology, postal and shipping services, utilities, and corporate centers PREPEAREDNESS Personal Preparedness nurse assisting in disaster relief efforts must be as healthy as possible, both physically and mentally Disaster kits should be made for the home, workplace, and car The Nursing Tip lists emergency supplies specic to nursing that should be prepared and stored in a sturdy, easy-tocarry container Important documents should always be in waterproof containers. One way a nurse can feel assured about family member protection is by

working with them to develop the skills and knowledge necessary for coping in disaster. Long term benets will occur by involving children and adolescents in activities such as writing preparedness plans, exercising the plan, preparing disaster kits, becoming familiar with their school emergency procedures and family reunication sites, and learning about the range of potential hazards in their vicinity to include evacuation routes.

Professional Preparedness nurses need to be dedicated, resourceful, and visionary leaders nurse must be prepared to advocate for the community in terms of a focus on populationbased practice Disaster produces conditions that demand an aggregate care approach, increasing the need nurses involvement in community service during disaster and catastrophe (Availability). Disaster response teams need nurses with disaster and emergency management training, especially those who have

served previously in disaster. It is also expected that nurses know how to use personal protective equipment (PPE), operate specialized equipment needed to perform specic activities, and safely perform duties in disaster environments. Also requires that nurses become aware of and understand the disaster plans at their workplace. Nurses need to review the disaster history of the community, including how past disasters have affected the communitys health care delivery system It is important for nurses to understand and gain the competencies needed to respond in times of disasters before disaster strikes

Community Preparedness The Public Health Security and Bioterrorism Preparedness and Response Act of 2002 addressed the need to enhance public health and health care readiness and community health care infrastructures. It reaffirmed the public health department role on the front line of disaster prevention, preparedness, response, and recovery, to include a national need for emergency-ready

public health and healthcare services in every community Mutual aid agreements establish relationships between partners prior to the incident at the local, regional, state, and national levels and ensure seamless service Emergency management is responsible for developing and coordinating emergency response plans within their dened area, whether local, state, federal, or tribal. Good disaster preparedness planning involves simplicity and realism with back-up contingencies because (1) plans never exactly t the disaster as it occurs, and (2) all plans need implementation viability, no matter which key members are present at the time The community must have an adequate warning system and an evacuation plan that includes measures to remove those individuals from areas of danger who hesitate to leave. The nurses visibility in the community helps develop the trust and credibility needed to help in contingency planning for evacuation. Nurses should be involved in identifying and

educating these vulnerable populations about what impact the disaster might have on them, including helping them set up a personal preparedness plan In addition to identifying high-risk individuals in neighborhoods, locations of concern include schools, college campuses, residential centers, prisons, and high-rise Nurses can assist in community preparedness with their knowledge of the communitys diversity such as non Englishspeaking groups, immunocompromised clients, children, and the physically challenged.

was written to approach a domestic incident in a unied, well-coordinated manner, enabling all emergency responding entities the ability to work together more effectively and efficiently Emergency Support Functions (ESFs) which provide a mechanism to bundle federal resources/capabilities to support the nation

Response The rst level of disaster response occurs at the local level with the mobilization of responders such as the re department, law enforcement, public health, and emergency services. If the disaster stretches local resources, the county or city emergency management agency (EMA) will coordinate activities through an emergency operations center (EOC) National Response Framework (NRF)

National Incident Management System (NIMS) the nations common platform for disaster response, to include universal protocols and language. provides a systematic, proactive approach to guide departments and agencies at all levels of government, nongovernmental organizations, and the private sector to work seamlessly to reduce the loss of life and property and harm to the environment

Response to Bioterrorism BioWatch is an early warning system for biothreats that uses an environmental sensor system to test the air for biological agents in several major metropolitan areas.

BioSense is a datasharing program to facilitate surveillance of unusual patterns or clusters of diseases in the United States. It shares data with local and state health departments and is a part of the BioWatch system. Project BioShield is a program to develop and produce new drugs and vaccines as countermeasures against potential bioweapons and deadly pathogens. Cities Readiness Initiative is a program to aid cities in increasing their capacity to deliver medicines and medical supplies during a largescale public health emergency such as a bioterrorism attack or a nuclear accident. Strategic National Stockpile (SNS) is a CDCmanaged program with the capacity to provide large quantities of medicine and medical supplies to protect the American public in a public health emergency to include bioterrorism

disaster plan, and prior disaster knowledge to include personal readiness nurses bring leadership, policy, planning, and practice expertise to disaster preparedness and response

Nursing Role in First Responder There may be times when the nurse is the rst to arrive on the scene. In this situation, it is important to remember that life-threatening problems take priority Highest priority is always given to those who have life-threatening injuries but who have a high probability of survival once stabilized Triage Nursing Role in Epidemiology and Ongoing Surveillance Health care providers and public health ofcers are the rst line of defense. A comprehensive public health response to outbreaks of illness consists of ve components. They include detecting the outbreak, determining the cause, identifying factors that place people at risk, implementing measures to control the outbreak, and informing the medical and public communities about treatments, health

Role of the Public Health Nurse in Disaster Response The role of nurse during a disaster depends a great deal on the nurses experience, professional role in a community

consequences, and preventive measures Nursing Role in Rapid Needs Assessment Elements of a rapid needs assessment include: determining the magnitude of the incident, dening the specic health needs of the affected population, establishing priorities and objectives for action, identifying existing and potential public health problems, evaluating the capacity of the local response including resources and logistics, and determining the external resource needs for priority actions Disaster assessment priorities relate to the type of disaster. Sudden-impact disasters such as tornadoes and earthquakes involve ongoing hazards, injuries and deaths, shelter requirements, and clean water. Gradual-onset disasters such as famines produce concerns with Mortality rates, nutritional status, immunization status, and environmental health. Nursing Role in Disaster Communication Nurses working as members of an assessment team need to

return accurate information to relief managers to facilitate rapid rescue and recovery A part of that communication is involved with the rapid and ongoing needs assessment just described. Lack of or inaccurate information regarding the scope of the disaster and its initial effects can contribute to a mismatched resource supply Risk communication is the science of communicating critical information to the public in situations of high concern. The objectives in emergency communication are to identify and respond to the barriers of fear, panic, distrust, and anger: build or re-establish trust; resolve conflicts; and coordinate between stakeholders so that the necessary messages can be received, understood, accepted and acted on

near the level that it would have had if the event had not occurred The recovery phase is often the hardest part of a disaster. It involves ongoing work beyond the preparedness and the rush to response Recovery involves a shift from short-term aid to long-term support for communities: sustainment of effort. Long-term support should include the disaster affected population representation in the recovery effort, using local knowledge and skills to prioritize use of resources, personnel, and surviving systems and infrastructure.

Recovery In recovery, the immediate response actions to address initial consequences subside. Recovery is about returning to the new normal, a community balance of infrastructure and social welfare that is

Role of the Public Health Nurse in Disaster Recovery Flexibility remains important for a successful recovery operation Nurses need awareness of the potential public health challenges specic to the disaster area and should monitor the physical and psychosocial environment. Disruption of the public health infrastructurewater and food supply, sanitation system, vector control programs, and access to primary and mental health carecan lead to increased disease and community dysfunction

ongoing accurate data about the population Nurses should also be aware that post-disaster cleanup creates opportunities for unintentional injury and hazards, including those occurring from falls, contact with live wires, accidents with cutting devices, heart attacks from overexertion and stress, and auto accidents resulting from road conditions and missing traffic controls Nurses should also educate the public of the hazards related to carbon monoxide poisoning stemming from using lanterns, gas ranges, or generators or from burning charcoal for a heat source in enclosed areas.

http://www.fig.net/pub/figpub/pub3 8/pub38_screen.pdf http://www.gfdrr.org/sites/gfdrr.org /files/Sendai_Report_051012.pdf http://www.preventionweb.net/files /26081_kp1concepdisasterrisk1.p df Azarcon, Gerald Mike Cioco, Hannah Mae