Technological disasters: These are the results of failure of technology, such

as engineering failures, transport disasters or environmental disasters.

2. Sociological disasters: They have a strong human motive, such as criminal

acts, stampedes, riots and war. For example, setting of fires, epidemic,
deforestation, pollution due to prawn cultivation, chemical pollution, wars,
road/train accidents, food poisoning, industrial disaster/crisis, environmental
pollution.

Levels of Disaster

Depending upon the level of damage, disaster may be of:

Level 1 Disaster: It is considered as minor disaster as it involves minimal

level of damage.

Level 2 Disaster: It is considered as moderate disaster as it involves

moderate level of damage.

Level 3 Disaster: It is considered as massive disaster as it involves massive

level of damage. It has severe impact on life and economy.

Effects of Disaster

1. Loss of life-human, animals.

2. Severe physical injuries
3. Psychological trauma
4. Property damage
5. Environmental destruction
6. Economic and business loss.
7. Climatic exposures, extremes of temperature.
8. Food and nutrition-scarcity.
9. Problems in large scale distribution.
10. Mental health-acute mental illness, anxiety neurosis, depression.
11. Communicable diseases
12. Social reaction
 13. Damage to health infrastructure.
14. Direct consequences of disaster on victims.

mpact of Disaster on Victims

1. Severe stress and trauma due to disaster.

2. Sudden forced displacement.

3. Difficulties of living in the camps.

4. Uncertainty about the future and continuation of threat.

5. Process of rebuilding personal, family and community life.

Disaster Management

Definition

Disaster management is a process of organizing, planning and applying all

measures of preparation, responding and initiating recovery from disaster. It
is a continuous and collaborative performance based approach to manage
disaster.

The Principles of Disaster Management

1. Prevent the disaster

2. Minimize casualties
3. Prevent further casualties
4. Rescue the victims
5. First aid
6. Evacuate
7. Medical care
8. Reconstruction

The following members comprise the disaster manage ment committee

under the Chairmanship of Medical

Superintendent/Director.
1. Medical Superintendent/Director

2. Additional Medical Superintendent

3. Nursing Superintendent/Chief Nursing Officer

4. Chief Medical Officer (casualty)

5. Head of Departments (surgery, medicine, orthopedics, radiology,

anesthesiology, and neurosurgery).

6. Blood Bank Incharge

7. Officer I/C stores

8. Security Officer

9. Dietician

10. Transport Officer

11. Sanitary superintendent.

The disaster management committee is overall respon- sible for managing

the disaster situation, take administra- tive decisions, review the disaster
plan and inform authorities.

Overview of the Disaster Risk Management Programme

The recovery process

The protection process

The Recovery Process

1. Relief: Once a disaster has taken place, the first concern is effective relief
of helping all those affected to recover from the immediate effects of the
disaster. This is known as relief work.

a. Relief includes providing food, clothing, shelter and medical care to the
victims.
b. It takes place immediately after the disaster and usually lasts for several
weeks. With disasters such as droughts, it may last several months or even
years.

2. Restoration: This phase involves helping to restore the basic services

which the people need, so that they can return to the pattern of life which
they had before the disaster. For example, providing seeds for farmers or
helping businessmen to restart their business.

3. Rebuilding: This is linked to restoration. It involves the rebuilding of homes

and businesses. Safety is important in the design of stronger buildings, able
to withstand future disasters.

The Protection Process

Special attention needs to be given to preparing for any future disasters. This
process is known as protection or enabling the community to protect itself.
All protection measures need to be available to those most at risk of the
poorest in the community.

1. Risk reduction: This phase follows on from rebuild Ing. It describes things
which will help to reduce the tisks of damage from similar events in the
future. For example, Building walls to prevent flooding, including safety
features into houses to strengthen them against collapse during future
earthquakes. It could include building grain stores to store surplus food
during good years. Many actions in development programmes could also be
thought of as risk reduction.

2. Preparedness: There is a close link between risk reduction and

preparedness.

a. Risk reduction involves helping to reduce the risks faced by the

community.
b. Preparedness includes planning measures such as making an evacuation
plan for a community living near a possible source of flooding. It could
include leadership training or community participation in planting wind
breaks.

c. As the disaster cycle shows that the various phases are linked together
and all are important in responding to a disaster.

d. Involvement of all groups from initial phase can reduce the harmful effects
of a disaster even before it happened.

e. In a similar way, it is better to use health education to prevent ill health

from developing, instead of waiting until serious illness develops. Prevention
is better than cure.

Activation of Disaster Management Plan

A standard operating procedure should be developed that defines how each

task would be accomplished.

1. Activation of the plan: As soon as the information re- garding disaster is

received emergency control room officer on duty in consultation with Medical
Superintendent/Director would activate the disaster plan.

2. Reception area: Disaster control room act as reception area to receive the
casualties and screen for management.

3. Triage: A predetermined triage should be undertaken to classify the

casualties. Man-power permitting and for a large number of casualties the
triage team should incorporate a surgeon, an orthopedic surgeon, physi- cian
and anesthetist.

4. Creation of additional bed space under disaster beds

5. Mobilization of additional operation theatre tables

 6. Inventory of essential drugs and equipments and listed in logistic support
system.

7. Documentation: A comprehensive documentation is essential.

Documentation will be done at the casualty by Chief Medical Officer (CMO)
and attending health care professional.

All the MLCs will be recorded as per institutional policy. However, the
treatment of patients will get priority over the paper work.

9. Public relations: The identified officer would liaison with relatives of the
victims to inform them about their clinical status.

a. The list of casualties along with their status displayed at

prominent place outside casualty, in both English and local
language should be updated regularly.

b. The Medical Superintendent or the person autho rized by him/her

should brief the media.
10. Essential services: Adequate provision should be made to meet
additional requirement of water and power supply and other services
pertinent to patient care.

Assessment

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1. Assess the community (eg. Local climate conductive for disaster).

2. Past history of disaster.

3. Available community disaster.

 4. Personal available in the community.

5. Local agencies.

6. Health care facilities available.

Diagnosis

11. Crowd management/security arrangement: Immedi- ate

mobilization of security staff must be available within the hospital
campus to ensure security of ad- mitted patients, their belongings,
hospital staff, equip ment and crowd management. The local police
station should be informed to provide assistance in manag- ing the
crowd.

12. Disposal of dead: Required formalities as laid down for medico-

legal cases should be followed.

1. Diagnose community disaster threats.

2. Determine the actual and potential disaster threats.

3. Community disaster planning.

Planning
Problems Related to Disaster Management

1. Establishing techniques for dynamic monitoring of disasters.

2. Failure in maintaining communication links.

Develop Disaster Plan

Aim:

To provide prompt and effective medical care to the mortality. Maximum

possible in order to minimize morbidity and

3. The slow access to data which makes for poor updating of disaster
related information.

4. Difficulties in disaster related data collection and integration. 5.

Communication and collaboration among agencies.

Objectives:

1. Prepare the staff and institutional resources.

2. Create community awareness

Plan for:

5. Designing techniques for automated data processing from distributed

sources.

1. Constitution of disaster management committee.

2. Disaster control room.

3. To refer the calamities to treat.

6. Designing and developing decision support system to help emergency

managers achieve effective decision-making for different disaster
management activities such as mitigation, preparedness, response

And relief.

4. Rapid response team.

5. Information and communication.

6. Disaster beds.

7. Logistic support system-equipment and supplies.

8. Training and drills.

Elements of Disaster Plan

9. Varying environmental factors can significantly change the severity of

a disaster.

1. Chain of authority

2. Lines of communication.

3. Modes of transport

4. Mobilization

5. Warning

6. Equation

7. Rescue and recovery

8. Triage

9. Treatment
 10. Support of victims and families.

11. Care of dead bodies.

12. Disaster worker rehabilitation.

Activation of Disaster Management Plans

1. Develop a standard operating procedure.

2. Reception area: Disaster content room.