This document summarizes the health implications of disasters in the Philippines. It begins by outlining the country's high risk of various natural disasters such as earthquakes, typhoons, and volcanic eruptions. It then discusses the direct and indirect effects of disasters on health, including deaths, injuries, illness, infrastructure damage, and psychosocial impacts. The document also examines the health response required in emergencies such as mass casualty management and disease control. Finally, it outlines the many roles of nurses in disaster management, from planning and assessment to providing acute care, recovery support, and training.

1. HEALTH IMPLICATIONS OF
DISASTERS
IN THE PHILIPPINES
JOFREDM. MARTINEZ,MAN,RN
2ND ANTIQUE HEALTH CONGRESS
ST.ANTHONY’SCOLLEGE,SANJOSE,ANTIQUE
FEBRUARY26,2015
Faculty, Nursing Department

2. PHILIPPINE DISASTER RISK PROFILE
20 earthquakes
per day
22 active
volcanoes
36,289 kms. of
coastline
20 to 30
typhoons a year
Assessment of Disaster and Risk ReductionManagementat theLocalLevel,2014

3. PHILIPPINE DISASTER RISK PROFILE
"EM-DAT: The OFDA/CRED International Disaster Database www.em-dat.net – Université Catholique de Louvain - Brussels - Belgium"
8
28
18
136
314
25
0 50 100 150 200 250 300 350
Drought
Earthquake
Epidemic
Flood
Storm
Volcano
Natural Disaster Occurrence in the Philippines from 1900 to 2014

4. Super typhoon Haiyan

5. YOU HAVE JUST ARRIVED HERE.
YOU ARE IN CHARGE!

9. WHAT WILL YOU DO?

10. EFFECTS OF DISASTERS
• Death, injury, illness and disability
• Damage/loss of essential life support services
• Damage/loss of facilities, services, infrastructure
• Displacement of populations
• Psychosocial stress
• Environmental pollution
• Economic and social impact

11. EFFECTS OF DISASTERS
• Risk of infection or contamination for response
and relief personnel
• Breakdown in communication networks and
information flows
• Breakdown in security
• Delay or lack of access to routine services

12. HEALTH EFFECTS OF DISASTERS
• Increased number of deaths and injuries
• Population displacement, including missing
persons
• New cases of disease and disability
• Increased number of cases of psychological and
social behavioural disorders
• Possible food shortages and nutritional
deficiencies

13. HEALTH EFFECTS OF DISASTERS
• Contamination or injury of relief personnel
• Environmental health hazards
• Damage to healthcare facilities and other health
infrastructures
• Diversion of development resources to emergency
relief
• Disruption of routine disease surveillance
• Disruption of routine health services

14. HEALTH SERVICES IN EMERGENCIES
• Mass casualty management
• Management of the dead and missing
• Health information and communication
• Communicable disease control measures
• Environmental health
• Psychosocial services
• Reproductive health
• Feeding and nutrition

15. Vulnerabilities
Capacities
EMERGENCY INDIRECT
IMPACTS
DIRECT
IMPACTS
HEALTH RESPONSE
search and rescue
first aid
triage
medical evacuation
primary care
disease surveillance and control
curative care
blood banks
laboratories
referral system
special units (burns, spinal)
evacuation centres
shelter
water
food and nutrition
energy
security
environmental health
primary health care
care of the dead
psychosocial care
disability care
recovery
reconstruction
ASSOCIATED FACTORS
Climate/weather/timeof day
Location
Security situation
Political environment
Economic environment
Socio-cultural environment
Morale, solidarity, spirit
Competence, corruption
COMMUNITY
Damage
and
Needs
EMERGENCIES & HEALTH

16. ROLES OF NURSES IN EMERGENCIES
PLANNING
• meeting with national/local coordination bodies
• planning/implementing command systems
• planning for logistics and administrative
arrangements
• planning for safety and security arrangements

17. ROLES OF NURSES IN EMERGENCIES
COORDINATION
• with military
• with private sectors
• with professional associations
• with international assistance
• with forensics and mortuaries
• with social and welfare services

18. ROLES OF NURSES IN EMERGENCIES
ASSESSMENT
• conducting inter-sectoral damage analysis and
needs assessment
• conducting community risk assessment
• conducting patient assessment

19. ROLES OF NURSES IN EMERGENCIES
PROVIDING IMMEDIATE CARE
• search and rescue
• victim identification and reporting
• evacuation
• first aid
• triage
• transport of victims
• trauma/primary care

20. ROLES OF NURSES IN EMERGENCIES
PROVIDING ACUTE CARE
• treatment of disease or injury
• laboratory services and blood bank products
• medical supplies
• essential drugs

21. ROLES OF NURSES IN EMERGENCIES
PROVIDING REHABILITATION CARE
• orthotics and prosthetic
• dental care
• disability care

22. ROLES OF NURSES IN EMERGENCIES
PRIMARY HEALTH CARE
• emergency shelter
• water safety and quality
• food safety and nutrition
• food supply and food security
• energy, protection and security
• recovery of PHC activities (EPI, MCH, CDD, ARI)

23. ROLES OF NURSES IN EMERGENCIES
COMMUNICATION AND REPORTING
• emergency reporting system
• disability and infectious/outbreak surveillance

24. ROLES OF NURSES IN EMERGENCIES
RECOVERY AND REHABILITATION
• compensation of victims
• recovery, reconstruction and rehabilitation of
community
• post-event evaluation
• research and documentation
• community risk reduction programmed

25. ROLES OF NURSES IN EMERGENCIES
PROVIDING TRAINING IN EPR
• emergency drills
• risk communication
• mass casualty management

26. NURSE COMPETENCIES IN
DISASTER MANAGEMENT
PRE-INCIDENT PHASE
A. Assist in the assessment of communities to
determine pre-existing health issues and health
care resources in a given community
B. Contribute to the planning of health care needs
of individuals and communities in an
emergency/disaster
C. Mobilize community for health and intersectoral
plan on health emergency management

27. NURSE COMPETENCIES IN
DISASTER MANAGEMENT
PRE-INCIDENT PHASE
D. Collaborate with other health care professionals
to develop measures to reduce vulnerability of
populations
E. Support health policy and organizational
preparation for emergencies
F. Develop health education and advocacy materials
and provide training on health emergency
management

28. NURSE COMPETENCIES IN
DISASTER MANAGEMENT
PRE-INCIDENT PHASE
G. Demonstrate application of professional, ethical,
legal, cultural and gender considerations
H.Demonstrate leadership and management skills
in health emergency management

29. NURSE COMPETENCIES IN
DISASTER MANAGEMENT
INCIDENT PHASE
A. Perform situation and needs assessment and
prioritize care and management in the field and
health facility during emergencies
B. Provide initial relief and care during emergencies
C. Provide nursing care of individuals, especially the
vulnerable groups

30. NURSE COMPETENCIES IN
DISASTER MANAGEMENT
INCIDENT PHASE
D. Support and implement public health
interventions
E. Provide safety and security of patients and
personnel
F. Provide psychosocial support to patients and
staff

31. NURSE COMPETENCIES IN
DISASTER MANAGEMENT
INCIDENT PHASE
G. Facilitate coordination and communication
H. Supervise/support management of logistics and
supplies

32. NURSE COMPETENCIES IN
DISASTER MANAGEMENT
POST-INCIDENT PHASE
A. Provide long-term care to individuals and
families
B. Support recovery - reconstruction efforts in the
hospital and community
C. Evaluate the impacts of nursing intervention and
utilize these results to develop evidence-based
decisions

37. PSYCHOLOGICAL
FIRST AIDJOFREDM. MARTINEZ,MAN,RN
Faculty, Nursing Department

38. HOW SOMEONE RESPONDS
DEPENDS ON THESE FACTORS
• the nature and severity of the event(s) they
experience;
• their experience with previous distressing events;
• the support they have in their life from others;
• their physical health;

39. WHAT IS PFA?
PSYCHOLOGICAL FIRST AID
A humane, supportive response to a fellow
human being who is suffering and who may
need support.
AccordingtoSphere(2011)andIASC(2007)

40. WHAT IS PFA?
• providing practical care and support, which does
not intrude;
• assessing needs and concerns;
• helping people to address basic needs (for
example, food and water, information);
• listening to people, but not pressuring them to
talk;

41. WHAT IS PFA?
• comforting people and helping them to feel
calm;
• helping people connect to information, services
and social supports;
• protecting people from further harm.

42. WHAT IS PFA IS NOT
• It is not something that only professionals do.
• It is not professional counselling.
• It is not “psychological debriefing”.
• It is not asking someone to analyse what
happened to them or to put time and events in
order.

43. WHAT IS PFA IS NOT
• Although PFA involves being available to listen
to people’s stories, it is not about pressuring
people to tell you their feelings and reactions to
an event.

44. WHO NEEDS IT?
PFA is for distressed people who have been recently
exposed to a serious crisis event.
Who needs more immediate advanced support:
• people with serious, life-threatening injuries who need
emergency medical care
• people who are so upset that they cannot care for
themselves or their children
• people who may hurt themselves
• people who may hurt others

45. PFA TARGET OUTCOMES
Physical health:
RESTORE SAFETY
Psychological health:
FACILITATE FUNCTION
Behavioral health:
EMPOWER ACTION

46. PFA DO’S
 Be honest and trustworthy.
 Respect people’s right to make their own
decisions.
 Be aware of and set aside your own biases and
prejudices.
 Make it clear to people that even if they refuse
help now, they can still access help in the future.

47. PFA DO’S
 Respect privacy and keep the person’s story
confidential, if this is appropriate.
 Behave appropriately by considering the person’s
 culture, age and gender.

48. PFA DONT’S
x Don’t exploit your relationship as a helper.
x Don’t ask the person for any money or favor for
helping them.
x Don’t make false promises or give false
information.
x Don’t exaggerate your skills.

49. PFA DONT’S
x Don’t force help on people, and don’t be
intrusive or pushy.
x Don’t pressure people to tell you their story.
x Don’t share the person’s story with others.
x Don’t judge the person for their actions or
feelings.

50. PREPARING FOR PFA
• Learn about the crisis event.
• Learn about available services and supports.
• Learn about safety and security concerns.

51. ACTION PRINCIPLES OF PFA
LOOK LISTEN LINK

52. LOOK
• Check for safety.
• Check for people with obvious urgent basic
needs.
• Check for people with serious distress reactions.

53. PEOPLE WHO ARE LIKELY TO NEED
SPECIAL ATTENTION
• Children – including adolescents – especially
those separated from their caregivers
• People with health conditions or physical and
mental disabilities
• People at risk of discrimination or violence

54. LISTEN
• Approach people who may need support.
• Ask about people’s needs and concerns.
• Listen to people, and help them to feel calm.

55. LEARN TO LISTEN WITH:
• Eyes ›› giving the person your undivided attention
• Ears ›› truly hearing their concerns
• Heart ›› with caring and showing respect

56. KEEPING PEOPLE CALM
• Keep your tone of voice calm and soft.
• If culturally appropriate, try to maintain some
eye contact with the person as you talk with
them.
• Remind the person that you are there to help
them. Remind them that they are safe, if it is
true.

57. KEEPING PEOPLE CALM
If someone feels unreal or disconnected from their
surroundings, it may help them to make contact
with their current environment and themselves.
• Place and feel their feet on the floor.
• Tap their fingers or hands on their lap.
• Notice some non-distressing things in their environment,
such as things they can see, hear or feel.
• Encourage the person to focus on their breathing, and to
breathe slowly.

58. LINK
• Help people address basic needs and access
services.
• Help people cope with problems.
• Give information.
• Connect people with loved ones and social
support.

59. FREQUENT NEEDS
• Basic needs, such as shelter, food, and water and
sanitation.
• Health services for injuries or help with chronic
(long-term) medical conditions.
• Understandable and correct information about
the event, loved ones and available services.
• Being able to contact loved ones, friends and
other social supports.

60. FREQUENT NEEDS
• Access to specific support related to one’s culture
or religion.
• Being consulted and involved in important
decisions.

61. POSITIVE COPING
• Get enough rest.
• Eat as regularly as possible and drink water.
• Talk and spend time with family and friends.
• Discuss problems with someone you trust.
• Do activities that help you relax (walk, sing, pray,
play with children).
• Do physical exercise.
• Find safe ways to help others in the crisis and get
involved in community activities.

62. NEGATIVE COPING
• Don’t take drugs, smoke or drink alcohol.
• Don’t sleep all day.
• Don’t work all the time without any rest or
relaxation.
• Don’t isolate yourself from friends and loved
ones.
• Don’t neglect basic personal hygiene.
• Don’t be violent.

63. CRISIS AND SPIRITUALITY

64. CRISIS AND SPIRITUALITY
• Be aware of and respect the person’s religious
background.
• Ask the person what generally helps them to feel
better.
• Listen respectfully, and without judgment, to
spiritual beliefs or questions the person may
have.

65. CRISIS AND SPIRITUALITY
• Don’t impose your beliefs, or spiritual or religious
interpretations of the crisis, on the person.
• Don’t agree with or reject a spiritual belief or
interpretation of the crisis, even if the person
asks you to do so.

66. ENDING YOUR HELP
• Use your best judgment of the situation, the
person’s needs and your own needs.
• Explain to the person that you are leaving, and if
someone else will be helping them from that
point on, try and introduce them to that person.
• If you have linked the person with other services,
let them know what to expect and be sure they
have the details to follow up.

67. THANK YOU VERY MUCH!
For more information:
Psychological First Aid. Guide for field workers.
www.who.int/mental_health/publications/guide_field_workers/en/