Sharing of experience as volunteer in Disaster Relief

1. 1
Assoc Prof Dr Mohamed Ikram
Mohamed Salleh
Center for Disaster & Relief Medicine
Cyberjaya University College of Medical Sciences
Consultant Anaesthesiologist, An Nur Specialist Hospital
Advisor, MERCY Malaysia & IMARET
Trustee, Humanitarian Care Malaysia
26 June 2019
Volunteerism in Disaster:
Sharing of Experience

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Contents of Presentation
 Overview of Disasters and Its
Responses
 Role of Volunteers
 Preparation & Training of
Volunteers

3. 3
Definitions
WHO: “A serious disruption of the functioning
of a society, causing widespread human,
material of environmental losses which
exceed the ability of the affected society to
cope using only its own resources”
“Any events that overwhelms existing
societal systems.”

4. Declaration of disaster occurs when:
the response needs exceeded
available resources
Disaster = needs > resources

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Facts
 There is a increasing in
incidences of disasters in the
world*
 Most Disasters occur in Asia*
* International Disaster Database (EM-DAT):www.emdat.be

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Number of natural disasters registered in EMDAT*
1900 - 2005
*International Disaster Database (EM-DAT):www.emdat.be

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Regional distribution of natural disasters by origin
1991 - 2005

9. Earthquakes
 An earthquake is caused by a
sudden slip on a fault.
 Richter Scale –describes the
energy released and the
amplitude waves by a
seismograph.
 Magnitude, distance from
epicentre and soil condition
determine how you feel.
Measured by Magnitude Scale.
Charles Richter

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Earthquakes
 An earthquake is caused by a sudden
slip on a fault.
 Richter Scale - describes the size of
earthquakes waves by a seismograph.
 Magnitude, distance from epicenter and
soil condition determine how you feel.

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Date Location
Seismic Moment
Magnitude
May 22, 1960 Chile 9.5
Mar 28, 1964 Alaska 9.2
Mar 9, 1957 Aleutians 9.1
Nov 4, 1952 Kamchatka 9.0
Dec. 26, 2004 Sumatra 9.0
Jan 31, 1906 Ecuador 8.8
Feb. 27, 2010 Chile 8.8
Feb 4, 1965 Aleutians 8.7
Nov 11, 1922 Chile 8.5
Mar 2, 1933 Japan 8.4
Source: K. Abe, Magnitudes and Moments of Earthquakes, in Global Earth Physics, A Handbook of
Physical Constants, American Geophysical Union Reference Shelf Volume 1, p. 206-213. Seismic
moment magnitudes determined by recalculation from seismic records for events prior to 2004.
Largest Recorded Earthquakes

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Year Month Day Magnitude Deaths Location
July 5, 1201 1,100,000 Egypt-Syria
Jan. 23, 1556 830,000 China: Shanxi
July 27, 1976 8 655,237 NE China, Tangshan
1139 6.8 300,000 Caucasus
1662 300,000 China
Oct. 11, 1737 300,000 India: Calcutta
115 260,000 Turkey: Antioch
1139 230,000 Syria: Aleppo
1876 215,000 India: Bay of Bengal, Andaman Islands
Dec. 22, 856 200,000 Iran
1703 200,000 Japan: Jeddo
Jan. 8, 1780 200,000 Iran: Tabriz
Dec. 16, 1920 8.5 200,000 China: Gansu and Shanxi
May 22, 1927 8.3 200,000 China: Qinghai
Jan. 12, 2010 7.0 200,000 Haiti
Dec. 14, 893 180,000 Iran-Armenia
Dec. 26, 2004 9.0 160,000 Sumatra
Sept. 1, 1923 8.2 142,807 Japan: Tokyo-Yokohama
Dec. 30, 1730 137,000 Japan: Hokkaido
Nov. 23, 533 130,000 Syria-Turkey
Dec. 28, 1908 7.5 110,000 Italy: Messina, Sicily
Source: K. Abe, Magnitudes and Moments of Earthquakes, in Global Earth Physics, A Handbook of Physical Constants,
American Geophysical Union Reference Shelf Volume 1, p. 206-213. Seismic moment magnitudes determined by
recalculation from seismic records for events prior to 2004.
Greatest Killer Earthquakes

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Impact
 Massively destroy infrastructure: medical
facilities, comm., transportation, gas,
electrical, water supply and sewage sys.
 Search and rescue missions important but
dangerous. Requires heavy equipment
 Medical response: Ortho injuries e.g.
crush injuries; public and primary health
care.
 Pitfalls: Slow response, poor comm. and
coordination.

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Turkey 1999

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South Asia
Earthquake

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Gunung
Sitoli
Lahewa
Afulu
Faighunna
MERCY Malaysia’s area of relief operations:
Nias Island 1995

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Tsunami
 Japanese: “harbour waves”
 Causes
– Earthquake
– Landslide
– Sub-sea explosion
 Characteristics
– Initially water recedes or rise
– Series of waves (ripples) 60- 500mph shallow-deep
water
– 1-2 feet up rise in deep sea, wave height (‘run up’)
and energy increases towards shore

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Impact
 Greatest over costal areas, danger areas:
50-100 feet above sea level and 1 mile of
the coast (distant origin)
 Initial seismic activity already causes
damage followed by tsunami
 Pitfalls: Devastating damage and injuries,
slow response due to total damage.

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Flood
 Most common (40%) of the natural
disaster.
 Cause: poor drainage sys, expanding
dev of wetlands, failure or release of
water from dam.
 Usually can be predicted, thus
preparedness and mitigation program
can be implemented.

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Impact
 Drowning, traumatic and burns injuries
from debris and electrical faults, water
chemical contamination and vector
borne illness.
 Pitfalls: Unprepared, rescue personnel’s
safety, Delayed evacuation and poor
camp management and rehabilitation.

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Country Date No Killed
China P Rep, General flood Jul-1931 3700000
China P Rep, -- Jul-1959 2000000
China P Rep, General flood Jul-1939 500000
China P Rep, -- 1935 142000
China P Rep, General flood 1911 100000
China P Rep, -- Jul-1949 57000
Guatemala, -- Oct-1949 40000
China P Rep, -- Aug-1954 30000
Venezuela, Flash flood Dec-1999 30000
Bangladesh, -- Jul-1974 28700
Source: "EM-DAT: The OFDA/CRED International Disaster Database
www.em-dat.net - Université Catholique de Louvain - Brussels - Belgium"

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Landslides
 Gravity induced land movements: rock
falls, avalanches, mud flows.
 Contributing factors
– Steep slopes
– Heavy rainfall
– Erosions from river, snow or infrastructure
development
– Earthquakes and volcanic eruptions
 Pitfall: Mortality and morbidity high

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Tornado / Cyclone
 Violent rotating columns of wind extending
from sky to the ground
 speed > 250 mph causes extensive
damage
 Severity: Fujita-Pearson scale: F0 – F5
 EWS and education helps reduce injury
 Injuries: Contaminated soft tissue wounds,
fractures and head injuries.

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War conflicts
 Complex disasters
 Political and cultural influences
 Relief workers are highly vulnerable to
attacks
 May cause famine, chemical, biological
and radiation injuries

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Disaster Management Cycle
Disaster
Preparedness
Prevention
Mitigation
Rehabilitation
Reconstruction
Emergency
Response

39. Relief Activities
 Search and Rescue
 Medical/Health
 Shelter
 Water and Sanitation
 Food
 Non Food items

40. Why Volunteer?
 Altruistic in Nature
 Spiritual gain
 Produce Self-Worth
and Respect
 Develop Soft Skills
 Socialization
 Fun! Addictive! Energy
Booster!

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Medical Responses
• Emergency Response
• Psychosocial Intervention
• Non Crisis Intervention
• WASH

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Malaysian Medical Relief Society

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52. Level of disaster Mgmt
Features level 1 level 2 level 3
Area small > 2 district > 2 states
Criteria Not complex
Under control
Complex
Difficult to control
Prolong
Very complex
overwhelm
prolong
Impact to
population
Small
Death:small
A lot evacuated
A lot of destruction
Death: high
Death: very high
Infrastru: extensive
damage
Daily activities:
impaired
Mgmt level Not difficult
Present/ local
expertise able to
handle
Difficult in term of S/R
Moderate expertise
needed
Able to handle by
state or national
agencies
Need foreign
expertise

53.  Disaster Responders
– Affected Country’s Government
– National Bilateral donors: OFDA, ECHO
– UN Agencies: OCHA, UNHCR, WFP,
WHO, UNDP
– Religious Organizations
– NGOs
– Military Forces

54. Relief Agencies
 Governmental Agencies
– E.g. SMART, Fire brigade, Army, Police
 Non-governmental organisation (NGO)
– Local and International e.g. UN, ICRC, MSF
– Faith Based, Political Based etc.

55. Response Issues
 Lack of Resources
 Collaboration
 Logistics and Communications
 Cultural, Political and Religious Issues
 Safety and Security
 Professionalism

56. Lack of Resources
 Information
 Time
 Manpower
 Facilities
 Medications

57. Ensuring effective and quality response
 ICRC Code of Conduct
 10 principles –humanity, impartial, neutrality and accountability
 The Humanitarian Charter
 International Humanitarian Law
 Universal Declaration of Human Rights / Geneva Conventions
 Refugee Law
 The SPHERE guidelines
 Minimum standards in response
 Key monitoring indicators
 Humanitarian Accountability Partnership (HAP)
 International self regulatory body
 Quality assurance
 7 principles

58. Example of an ineffective response
“ There is a bridge in Honduras that has been
rebuilt nine times with recovery funds.”

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Choluteca Bridge

60. Coordination During Disaster
NGO
NGO
NGO
ICRC
UN
Agencies
Donor
Donor Local
Government
Other
Governments
Military

61. Coordination
 Sharing information
 Maximizing resources
 Adequate and appropriate response
 Covers all areas and all aspects of relief
 Involving all relief agencies
 Work to compliment others
 Coordinating bodies
 Local authorities
 International agencies

62. Wastage

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Safety and
Security

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DEPLETED URANIUM
• It is thought that between 17 and 20 countries have weapons incorporating
depleted uranium in their arsenals. They include the U.S., the UK, France,
Russia, China, India, Turkey, Saudi Arabia, Israel, Bahrain, Egypt, Kuwait,
Pakistan, Thailand, Iraq and Taiwan. DU ammunition is manufactured in 18
countries.
(http://en.wikipedia.org/wiki/Depleted_uranium)
• DU Rounds (sometimes called DU bullets due to their shape) have been used
extensively in both Gulf War's, and in the former Yugoslavia, by Coalition and
NATO forces respectively. For example, according to Time Magazine... "NATO
aircraft rained more than 30,000 DU shells on Kosovo during the 11-week air
campaign".
(http://www.depleteduranium.info/about_depleted_uranium_bombs.html)
• Similar levels of rises in similar cancers/conditions have been recorded
amongst the returning US and UK soldiers who had been handling expired DU
shells, and firing live DU rounds, during their time in Iraq or Kosovo, as have
high levels of abnormalities and deformities in their subsequent newborn
children. This collective rise in health conditions amongst ex-soldiers and
their families has been widely termed the 'Gulf War Syndrome'.
(http://www.depleteduranium.info/about_depleted_uranium_bombs.html)

67. Logistics and Communications

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Cultural, Political and Religious Issues

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Preparation
Disaster preparedness and an
effective response minimizes
relief and maximizes recovery
World bank report: web.worldbank.org

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74. Risk Reduction
• Reducing Vulnerability
• Increasing Capacity
74

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HAZARD X VULNERABILITY
__________________________
CAPACITY
DISASTER
RISK =

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Disaster Preparedness
• Disaster Plan: MKN Arahan 20
• Education
• Early Warning System
• Emergency Medical System
• Response Team
• Training and Simulation Exercises
• Disaster Response & Evacuation Plan
• Incident Command System
• Stockpiling

77. MKN Arahan 20
 The national plan of
action on dealing with
disaster management
and support.
 Contain orders
 Coordinates rescue
work
 Outline the roles and
responsibilities of
agencies involved.
 Proposed: 18/5/1994
Approved: 11/5/1997

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80. The LuckyIsland
Hanya 5 kematian di Pulau
Simeuleu !

81. Tilly Smith
A 10-year-old girl saved her family and 100 other tourists
from the Asian tsunami because she had learnt about the
giant waves in a geography lesson.

82. Staff and Volunteer Training
 Volunteer Induction
 Coordination, Communication & Navigation
 Basic & Advanced Mission Training
 Field Hospital Exercises
 Life Support Courses
 Psychosocial support
 Safety & Security Training

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In-Hospital Disaster Preparedness
• Major Incident
• Chemical, Biological and
Radionuclear Accident
• Communicable Disease Outbreak
• Evacuation Plan

84. In-Hospital Disaster Response
The ABC of disaster response
1) Command & Control
2) Safety
3) Communication
4) Assessment
5) Triage
6) Treatment
7) Transport

85. Steps in Hospital Disaster Response
MESSAGE CONFIRM
Disaster ACTIVATION
All involve to report-in
At reporting center
Sign in, get ACTION CARD,
Take designated vest
Follow instruction
Ambulance services response
- On site response
-Basic ambulance, MMT,SMT
In-hospital MI response plan

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Summary
 There has been an increasing in frequency and
impact of disasters in the world, hence the need to
equip and prepare ourselves.
 Type of relief responses depends on the type,
available data, the phases of the disaster and the
capacity of the responding relief agency.
 An effective response minimises injury and
maximises recovery.
 Disaster Risks can be reduced by reducing
vulnerability and increasing capacity of the local
community at risk.

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 Same as first slide
lend us your support and spread the message of hope,
peace and humanity