M. Sc. Nursing 1st year community health nursing Disaster management and Disaster nursing

1. Disaster Management

2. Intoduction
o The first description of Disaster and its management comes from
mythological “Noah” and his ark.
o Similar Flood tales are widespread in- Greek Mythology, Puranas,
Mesopotamian stories, and many cultures.
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3. Intoduction
• Disasters are cause of trouble to human society since ancient times.
Human beings has to face and cope up with such disasters. Natural
and human made disasters create extensive harm to human life.
Although scientific invention, information revolution, latest
technology skills etc. are successful in reducing the dreadful effects of
disasters and their intensity but still many old and new forms of
natural calamities / disasters takes place here and there and we have to
suffer major threats of life and property.
• Due to climatical changes, biodiversity and various environmental
problems, the types of disaster and their occurrences is changed.
Therefore, we should take care of all the aspects of disaster
management.
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4. Disaster : Meaning
• The word 'Disaster' is derived from the French word
“Desater”. This is formed by two words “Des” and “aster".
The meaning of Des is "bad" or "calamity" and Astre is
“planet”. In ancient times disaster was considered to be the
result of effect of the planets which are of bad omen.
Nowadays, word disaster is used for an exceptional
occurrences, natural or man made, which causes such
intense catastrophic effects that, it is difficult to handle the
situation with local resources only. Hence, external help is
needed.
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5. Disaster : Definitions
• According to International Red Cross, A disaster is a
sudden calamitous event that seriously disrupts the
functioning of a community or society and causes human,
material and economic or environmental losses that exceeds
the community's or society's ability to cope using its own
resources. Though often caused by nature, disasters can
have human origin.
• Disaster is sudden and catastrophic.
• Disaster is sudden calamity which causes damage to life and
property to a big extent.
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6. The evaluation of disaster is done on following
basis :
01
Effect on Social
Infrastructure
03
Hindrance in
Routine Activities
02
Effect on Human
Beings
04
Effect on the
Necessities of
Community
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7. Disaster Nursing
• It is impossible to alienate community health nursing from the subjects
concerning public health. At the time of disaster, organizational structure
of health services either comes to an end in affected areas or cannot work
efficiently in its full capacity.
• In addition to this the large number of affected people coming to the
health institutions for treatment, may break, disturb or shatters the
services. In such condition, the role of community health nurses become
challenging as they have to shoulder the responsibility of aide and relief to
the affected populace.
• Nurses should always be ready to face such conditions in the society as
and when it arises. Although disaster nursing is a part of the General
Nursing and can be defined as a special branch of CHN but the nurses
need special training for it.
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8. Hazard and Disaster
• The possibility of disaster is always hidden in hazard. When
hazard become disaster it strikes at any place and disrupts the
normal lifestyle. If a cyclone hits at unhabited place like an
isolated coastal area then it cannot be considered disaster. But
if there is severe loss of life and property then it will be called
disaster. An early stage of disaster can be considered hazard if
it indicates the arrival of disaster which can cause harm to
general public. On the contrary, disaster is such dreadful
event which cause severe harm to life and property and
shatters the normal lifestyle of the people.
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9. Factors affecting Disaster
Poverty
Environmental
Deterioration
Change in
Cultural
Patterns
Population
Explosion
Rapid
Urbanization
Lack of
Vigilance and
Information
Unsecured
Shelter
Apart from these reasons, disaster get affected by excessive
exploration of natural resources, environmental imbalance, global
warming, climatic changes etc.
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10. Classification of Disaster
On the
basis of
origin
On the basis
of nature or
form
On the
basis of
intensity
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11. A. On the basis of Origin
1. Manmade Disasters :
These can be kept under CBRN headings :
• Chemical : Chemical war, poisoning (food, water etc.) illicit liquor, gas
leakage
• Biological : Pollution (air, water, sound), loss of quality of soil, loss of
biological diversities
• Radiological : Radiation hazards, leakage
• Nuclear : Explosion, bombing (atomic war)
• Others : Massive road, rail, sea accidents, collapse of buildings,
industrial accidents, security failure, fire in houses, coal
mines, oil storages or in forests (in some instances naturally
but mostly by human beings), terror attacks.
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12. A. On the basis of Origin
2. Natural Disaster :
• Related to Land : Earthquake, Tsunami (sea waves),
landslide, melting of ice, bursting of volcano.
• Related to Water : Floods, cloud burst, sudden floods,
heavy rainfall, thunderclap, drought.
• Related to Air : Storm, cyclonic storm, storm waves, crest
of the waves, heat waves etc.
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13. B. On the basis of Nature
1. Geophysical Disaster :
Earthquake
Volcanic explosion
Landslide
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14. B. On the basis of Nature
2. Climatic Disaster :
Cyclone Drought Flood
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15. B. On the basis of Nature
3. Environmental Disaster :
Environmental
pollution
Air pollution
Water
pollution
Deforestation
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16. B. On the basis of Nature
4. Industrial and technological accident :
Blasts in industrial and chemical plants, accidents in
transportation of chemicals, misuse of chemicals, firecrackers
storage, wrong garbage disposal, security lapses in industry,
technological flaws, fire, earthquake, landslide all these gives rise
to chemical and industrial accidents which create emergency
conditions.
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17. B. On the basis of Nature
5. Epidemiology :
This is a result of a particular disease which spread fast
with intensity leaving dangerous and destructive
consequences. Many stressful and serious situations can
emerge from epidemics.
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18. C. On the basis of intensity
Fast Intensity Disaster :
Such disaster occurs very fast
and can cause adverse effect.
It is difficult to predictor
control them e.g., earthquake,
flood, tsunami etc.
Slow Intensity Disaster:
These continue for prolonged
period, e.g., drought. Pre-
estimation is easy, and we get
time for remedial measures.
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19. India and disaster
o India is at risk for a large number of disasters. More than 58.6
% of the landmass is prone to earthquakes of moderate to very
high intensity; over 40 million hectares (12%) of its land is
prone to floods and river erosions; close to 5,700 kms, out of
the 7,518 kms long coastline is prone to cyclones and tsunamis;
68% of its cultivable area is vulnerable to droughts; and its hilly
areas are at risk from landslides and snow slide (avalanches).
o Moreover, our country is also vulnerable to Chemical,
Biological, Radiological and Nuclear (CBRN) emergencies,
and other manmade disasters.
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20. Disaster risks in India are further compounded
by following vulnerabilities :
Population explosion
Unplanned urbanization
Environmental degradation
Climate change
Geological hazards
Epidemics and pandemics
Change in socio-economic conditions
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21. 01 Flood
03 Cyclone
02 Drought
04 Tsunamis
05 Earthquake 06 Landslide
07 Hailstorms
Some natural disaster in India :
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22. Disaster and Community Health:
The effect of disaster can mainly be classified under two
heads :
DIRECT
EFFECT
INDIRECT
EFFECT
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23. Direct effect
o Due to sudden occurrence of natural disasters like earthquake,
tsunami or flood, the death rate and number of injured person
increases at higher rate. About 10% of affected population may lead
to death. The loss of human life in disaster depends on the following
factors:-
o It is seen that in disasters, the vulnerable people, children and aged
people are more affected. The weaker people are directly affected by
health-related issues. People get bone fractures, hemorrhage, deep
wound and burn.
Time of
disaster
Structure of
houses
Density of
population
Preparedness
of disaster
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24. Indirect effect
o Disaster brings with it diseases, disability and epidemics. The possibility of
spread of communicable diseases increases. Within 2 weeks of disaster,
water and food borne diseases increases, due to contamination and cycle of
infections.
o Health problems are at rise because of excess number of people living at one
place, Bacteria borne disease like malaria increases. Mosquitoes bitten
diseases spread up after 3-4 weeks of disaster.
o Lake of food caused malnutrition is the cause of worry, as it results in weak
immune system of the body, which could not fight diseases.
o There is no facility of garbage disposal with an acute shortage of public
toilets. They cause contamination of food and water and people fall sick.
o The mental and social problems also arises, immediately after an occurrence
of disaster. One person in every eight families gets mentally afflicted. People
remains under shock for long time.
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25. Disaster Management cycle
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26. Disaster Management
Disaster Management Can Be Categorized In Three Steps
Pre disaster activities
Facing the disaster
Post disaster activities.
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27. A. Pre-Disaster Activities
In this activity, ways of prevention from disaster and its mitigation
are included. These can be further sub-classified as following:
Prediction of
disaster
Disaster
preparedness plan
(general and
personal
measures)
Mitigation of
disaster
Community
participation in
disaster
prevention
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28. 1. Prediction of Disaster
o Disaster related predictions, forecasting and warning have great
importance in reducing the effects of disaster or in protection
from it. It is to be noted that all the disasters does not occur at
every place, every time. It occurs at different time at different
places. Also, there is a difference in nature, intensity,
extensiveness and effects of disaster.
o Predictability is viable in context to natural disasters. In case of
possibility of prediction of natural disaster, then its forecasting is
the next step in disaster management. After forecast, timely
warning in specified area is a must. To reduce the harm from
disaster, immediate dissemination of warning is very important.
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29. 2. Disaster Preparedness Plan
o Disaster related plans are useful before an occurrence of
disaster. The plan includes the general and personal measures
to be taken before disaster, during disaster and after disaster.
o To accomplish this, long term and short-term goals are also
made.
o Measures are two type :-
General Measures
Personal Measures
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30. General Measures
o To identify the potential disaster area and to evaluate it's risk factor.
o To decide the rules and standard of disaster management.
o To organize the information, communication, and warning system.
o To establish desired co-ordination between different departments and
institutions and ask them to be ready to reach the affected area at short
notice.
o To keep human and financial resources and other tools ready to counter
disaster.
o To form disaster management team with delegation of responsibilities.
o To form “Disaster health team” to cope up with health problems emanating
from disaster.
o To be in contact with print and electronic media.
o To enact disaster simulation and check the effectiveness of action plan
prepared to counter it. Jesus is my Savior

31. Personal Measures
o Avoid stampede (sudden rush) or confusion during disaster.
o Personal telephone calls to be made only if necessary. This is to
avoid overloading the communication network and retain the
power of battery. Else it may cause the failure of entire system.
o Attentively listen the messages from radio, T.V., mobile and
follow the instructions. Also pass the news to others.
o Keep emergency first aid kit ready at home.
o Beware of rumors or grapevine communication. Do not get
afraid.
o Follow the plans and instructions of disaster mitigation.
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32. 3. Mitigation of Disaster
o Mitigation of disaster means to try to reduce the
destruction and stampede caused by disaster. It is
helpful in fighting the natural disasters and has 2
approaches.
Structural
approach
Non-
structural
approach
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33. Structural approach
o It includes engineered and non-engineered structures.
Engineered structures are those structures which are planned,
designed, and constructed under supervision of architects and
engineers. These structures follow the principles of national
building construction code and are safe.
o Non-engineered structures are built by local untrained artisan,
mason and carpenters. Construction of these buildings are
unsafe, but through training of these untrained workers, the
quality could be improved.
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34. Non-structural approach
o In this approach, the safety of life and property can be
ensured through legal compulsion, incentives and
insurance of houses and buildings. Similarly, by giving
training to government officers and information to
common man about possible disasters, its negative
effects can be reduced. Prediction of disaster and
timely warning is also the part of mitigation of
disaster.
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35. 4. Community Participation for Disaster Prevention
o Active participation and awareness of community in
disaster management is necessary. There are many
advantages of community involvement in disaster
mitigation and rehabilitation programme. The local
community can play an effective role in disaster
management by coordinating with different
organizations working for the same cause. The
dangers of disaster can be prevented up to large
extent.
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36. The examples of community action and participation
in some disaster mitigation are as follows:
o Earthquake
o Drought
o Floods
o Landslide
o Tsunamis
o Cyclones
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37. Earthquake
o Construction of earthquake resistant
buildings in earthquake prone areas.
o To follow building construction norms in
all the types of permanent structures.
o To impart first-aid education to the people
of affected area.
o Repair the weak buildings.
o Keep fire extinguishing equipment’s ready
and at a known place.
o To give training to engineers and labours
for construction of safe buildings in
affected areas.
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38. Drought
o To pay attention to save water.
o To construct water reservoir and dams.
o To stop wastage and excessive extraction of
water.
o To promote water recharging techniques.
o To promote forestation and plantation.
o To promote cattle management.
o To change cycle of crops.
o To encourage the people of affected area to
resort to occupation or employment other
then agriculture.
o To adopt all the techniques of water
management.
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39. Floods
o Doing plantation and forestation in the
water catchment areas.
o Construction of flood resistant houses, on
strong foundation, with the help of water
resistant material.
o Cleaning of sludge from the bottom of
water tanks or wells.
o Doing agriculture in the flood affected
areas.
o Construction of dams and coastal
boundaries.
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40. Landslide
o To identify landslide prone areas.
o To avoid all sorts of construction in risk
prone areas.
o To keep strong foundation in construction.
o To do plantation or make temporary
structures on slopes, to check land from
sliding.
o To construct barricades to keep the rocks at
their place.
o To fortify land base.
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41. Tsunami
o Awareness about tsunami in coastal areas.
o Taking active participation in preparedness
to face potential forthcoming tsunami
attack.
o Help in developing evacuation sites and
camps.
o Involving in the development of local
warning services.
o Assisting in disseminate of warnings.
o Taking part in evacuation activities.
o Helping administration in post tsunami
management.
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42. Cyclones
o Construction of air-resistant-houses.
o To avoid the usages of metal sheets like
aluminum, iron or tin. These can be carried
away by wind at any place and could harm
physically.
o To construct shelter homes for affected
persons.
o To provide information about the uses of
resources like mobiles, battery operated
transistor, radio, and other medium of
communication.
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43. B. Facing the Disaster
o There is an immediate need of relief, just after occurrence
of the disaster. Disaster has to be faced by the use of
whatever resources available. The situation remains
critical as one never knows the number of persons affected
and the areas afflicted or suffered by disaster.
o The important remedial steps to face the disaster are as
under :
- Initial crisis management
- Intermediate management or relief phase
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44. Initial crisis management
Search and rescue
Transportation of victims
Classification of injured and application of identity cards
Identification of dead and care of dead bodies.
A
B
C
D
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45. Classification of Injured (triage system)
• First or top priority is given to those injured people who can be saved
through general intensive care and can later recover through long term care.
• Last priority is given to those injured people who require an excessive care,
but in spite of it there lies strong suspicion about their survival.
• On the basis of colour code and colour classification of patients the
following system
Top priority for treatment or transportation.
Second priority
Less injured. Wounded requiring first aid treatment.
Dead people or casualties nearer to death, who cannot be saved in
spite of best efforts.

46. Intermediate management or relief phase
(A) Epidemiological surveillance
(B) Control and prevention of disease
(C) Residential facilities
(D) Water supply and electric (lighting) arrangements
(E) Food arrangement
(F) Communication system
(G) Sanitation
(H) Safety and living facilities.
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47. C. Post Disaster Activities
Evaluation of
Harm/Damages
Rehabilitation
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48. Evaluation of Harm/Damages
• To evaluate the effect of disaster in affected areas for
immediate relief and help.
• To discuss about required foodstuff, clothing, medicines,
temporary dwelling units, quantity of necessary goods
and other methods of providing relief.
• To help for long term relief and rehabilitation.
• To determine the priority areas of activities of relief work.
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49. Rehabilitation
Development of
infrastructure
and housing.
Social and
psychological
rehabilitation
Economical
rehabilitation
Environmental
rehabilitation
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50. Role of Disaster Nurse
[Community Health Nurse in Disaster Management]
Communicator
Team
Coordinator
Rescuer
Health Care
Provider
Rehabilitator
Damage
Assessor
Health
Educator and
Counsellor
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