By Dr. Amur Abdullah Amur
Principal Specialist in Internal Medicine, Muhimbili National Hospital, Dar-Es-Salaam
The success of the plan of action to rescue miners in Chile reflects to well organized disaster preparedness activities by the Public Health Authorities. This rescue involved Chilean miners who had been trapped for almost 70 days some 600 meters underground after the mine they were working in collapsed around them 5th Aug.2010 , puzzled the attention of many.
The possibility of Public Health Emergencies concerns many people in the wake of frequent outbreaks of diseases and environmental mishap particularly in developing countries.
Many would agree with me that disaster preparedness helps people to deal with disasters of all sorts much more effectively when they do occur. Disaster preparedness is efficiently accomplished from family level to the national level. Charity starts at home! At a family level, keeping a three-day supply in the reserve and at least an additional four-day supply per person for use at home by each family is advisable. Public Health Disaster Preparedness teams are expected to provide operational requirements include tents and toilet facilities, contracted support for food, potable water, protective gears, transport , portable medical kits including oxygen cylinders, and biomedical waste disposal. Disaster Teams provide primary and acute care, initial resuscitation and stabilization, advanced life support and preparation of sick or injured for evacuation. Each team includes physicians, nurses, medical technicians, and supporting staff. The team is expected to sustain operations for 72 hours without external support.
Disasters disrupt hundreds of thousands of lives every year and have lasting effects, both to people and property. There is a need to establish tailor made Training Courses on Disaster Management that involve all walks of Life. During our school time, we used to have Scout Clubs that conduct elementary disaster preparedness programs. Such activities should be incorporated formally to an accredited level so as to produce cadres who can serve as Emergency Medical Responders, Paramedics and Members of Ambulance Teams. Institutes like Red Cross and Red Crescent play vital role in conducting short and long term First Aid Training. Provision of assistance consists of medical materiel, personnel, and technical assistance. These resources may provide response capability for the emergency response needs. Collaboration in advance with rescue teams helps to promote alertness, disseminate health information, minimize confusion, and identify appropriate actions and responses.
Due to increasing vulnerability of developing countries to suffer various natural disaster in a form of outbreak of infectious diseases and environmental hazards, there is a need to establish Disaster Management Institute within the Public Health Program.
Lesson from Chile has proved that appropriate disaster preparedness reduces the devastating impact on human life, economy and environment . This is achieved through education, implementing warning strategies , toll free numbers, safety measures, users friendly infrastructures, developmental plans to provide coverage to such disasters ,provision of resources and rehabilitation as well as post-disaster reconstruction.
Disaster Management is multidisciplinary approach which involves nationwide participation, different professions and different scientific fields, and has become an important measure for human, society and nature sustainable development. Developing countries that lack the necessary facilities, planning, expertise and resources for
disaster preparedness arguably need them the most. The development of Disaster Preparedness within a Public Health Program should be seen as an important opportunity for the development within the nationwide health program.
The responsibility of Disaster Preparedness is to provide for a comprehensive Emergency Management Program that meets the emergency needs of those who either have been or might be affected by an emergency or major disaster for example cholera outbreak .
The population explosion and exposure to inadequate space, substandard sanitation, pollution, poor housing and lack of safety measures in poor resource countries have increased the frequency and severity of disasters. Surface decontamination remains an uphill task in case of chemical or biological pollution in developing countries. With the prevailing background of the high disease burden an environmental hazards present in many poor resource countries, the cost of running Disaster Management could be very high. In any public health program, a well-integrated Disaster Preparedness ultimately result in cost savings through early recognition and management of the disasters.
Some countries have units of Medical Response Cops(MRC) consist of organized medical and public health professionals who serve as volunteers to respond to natural disasters and emergencies. The MRC helps to engage medical and public health personnel in response to an emergency. MRC team is capable of providing primary and secondary medical care as well as to stabilize victims for transportation to hospital facilities .
Application of proper disaster management strategies involves formation of disaster management teams ,identifying phases of disaster preparedness, pre-disaster planning, resources preparedness, monitoring including relief management capability, prediction, early warning, damage assessment and relief management. Disaster Preparedness aims to save lives, prevent injuries, preserve the environment and protect property and the economy. Disaster management is comprised of four interdependent risk-based functions: prevention/mitigation, preparedness, response and recovery. Mitigation provides a critical foundation for disaster management.
The followings are the Phases of Disaster Preparedness:
1.Mitigation/Prevention -- A period of time during which activities are undertaken by individuals/institutes to improve their capabilities to respond to a potential emergency and fulfill their assigned responsibilities. Mitigation efforts attempt to prevent hazards from developing into disasters altogether, or to reduce the effects of disasters when they occur. The mitigation phase concentrates on short and long-term measures for reducing or eliminating risk. The implementation of mitigation strategies can be considered as a part of the recovery process if applied after a disaster occurs. The need of Establishment of Curriculum to train cadres of Disaster Management Team should be emphasized. Strategies of mitigation eliminate or reduce the impacts and risks of hazards through proactive measures taken before an emergency or disaster occurs.
2. Preparedness --
A period of time during which activities are undertaken by individuals and disaster teams to increase their alertness during periods of heightened risk. The emergency managers develop plans of action to manage and counter their risks and take action to build the necessary capabilities needed to implement such plans during this phase. Common preparedness measures include communication plans, emergency population alertness, evacuation, shelters, and provision of supplies. Public Health Program have the task to ensure first responders and emergency management personnel are well-prepared through education, support and exercises.
3. Response --
A period of time during which activities are undertaken by individuals and institutes to respond to an occurrence that threatens or harms human beings and environment. The response phase includes the mobilization of the necessary emergency service and members of disaster teams in the affected area. A well organized emergency plan activities developed as part of the preparedness phase enables efficient coordination in saving life ,prevention of injuries and protection of environment . The earlier response commences the better the outcome . Depending on impact of disaster sustained by the victims, virulence in case of infections, and access to health management, the vast majority of those affected by a disaster will die within 72 hours after impact. Regardless of the cause of the disaster, hygienic precautions such as hand washing ,wearing protective gears must be the rule of the game. Thorough hand-washing with antiseptics between examining victims and after contact with blood, body fluids, secretions, excretions, and equipment contaminated by them is an important component of infection control during disaster.
4. Recovery --
A period of time during which activities are undertaken by individuals and institutes to provide for the welfare of the people following a Disaster and/or emergency. Recovery efforts are primarily concerned with actions that involve counseling, crisis intervention, rehabilitation , moral support and rebuilding destroyed property. Efforts should be made to build user friendly structures taking safety measure techniques into account . This requires collective responsibilities and commitment of the community and the nation to develop and deliver disaster financial assistance, determining the amounts and types of assistance that will be provided to those who have experienced losses.