DISASTER MANAGEMENT AND ROLE DENTIST IN THE EVENT

1. 1

2. 2
PRESENTED BY
DR RIPIKA SHARMA
POST GRADUATE
DEPARTMENT OF PUBLIC
HEALTH DENTISTRY

3. Scope
Introduction
Definition
Classification & Types of Disasters
Disaster Management
Disaster Preparedness
Medical and Public Health Response
Public Health Impact of Disaster
Disaster Mitigation
Recent Disasters in India
Disaster Management in India
Role of dentist in mass disaster
Conclusion
References
Scope
3

4. • Almost everyday, newspapers, radio and television channels
carry reports on disaster striking several parts of the world.
4
Nepal-India earthquake
A massive earthquake killed
hundreds in Nepal and India on
25 April. The massive 7.9
magnitude earthquake hit Nepal
with devastating force less than
50 miles from the capital,
Kathmandu causing tremors in
northern India as well.

5. India and Natural Disasters
India is one of the most disaster prone countries in the world.
Over 65% land area vulnerable to earthquakes;
70% of land under cultivation prone to drought;
5% of land (40 million hectares) to floods;
8% of land (8,000 km coastline) to cyclones.
A Major Disaster occurs every 2-3 years;
50 million people affected annually
1 million houses damaged annually along with human,social and
other losses
During 1985-2003, the annual average damage due to natural
disasters has been estimated at 70 million USD
Source: Ministry of Agriculture, GOI: BMTPC, Ministry of Urban Development, GOI

6. Scope
• Disasters are as old as Mankind.
• The first description of Disaster and its management
comes from mythological “Noah” and his ark.
• Similar Flood tales are widespread in- Greek Mythology,
Puranas, Mesopotamian stories, and many cultures.
Introduction
6

7. • Disasters and emergencies are fundamental reflections of
normal life.
• They are consequences of the way societies structure
themselves, economically and socially; the way societies
and states interact; and the way relationships between
decision-makers are sustained.
• The last decade 1990-1999 was observed by the
International Community as the ‘International Decade for
Natural Disaster Reduction’, a decade dedicated to
promoting solutions to reduce risks from natural hazards.
• As part of the International Decade for natural Disaster
Reduction activities, every year, the 2nd Wednesday of
October has been designated as World Disaster Reduction
Day.
7

8. • The international dimension of disasters was realized and a
protocol sought to be established so that when it comes to
suffering of humanity, help from the International
community flow in right earnest.
• In development circles today, disaster management is often
treated holistically rather than as a single issue.
• It is an essential component of any development framework.
• Proper disaster management has been recognized as a key
requirement towards achieving the Millennium
Development Goals (MDGs) by the specified target of
2015.
8

9. Introduction
Etymology
Originated from Greek pejorative prefix
δυσ-, (dus-) “bad”+ αστήρ (aster), “star”.
Calamity due to position of a planet or a star.
Then evolved in Italian as disastro,
To become French désastre (de.zastʁ).
& then disaster .
It comes from an astrological theme in which the ancients used to
refer to the destruction or deconstruction of a star as a disaster.
9

10. • Crisis : Is an event or series of events representing a critical threat to
the health, safety, security or wellbeing of a community, usually over a
wide area.
• Emergency : A sudden occurrence demanding immediate action that
may be due to epidemics, to natural, to technological catastrophes, to
strife or to other man-made causes.
• Risk : The probability of harmful consequences, or expected losses
(deaths, injuries, property, livelihood, economic activity disrupted
or environment damaged) resulting from interactions between natural
or human-induced hazards and vulnerabilities
10
Definition for reference

11. Definition
Disaster -
Any occurrence that causes
damage, ecological disruption,
loss of human life,
deterioration of health and health services
on a scale, sufficient to warrant an extraordinary response from outside
the affected community or area.(WHO).
• The Disaster Management Act, 2005
• “a catastrophe, mishap, calamity or grave occurrence in any area,
arising from natural or man made causes, or by accident or negligence
which results in substantial loss of life or human suffering or damage
to, and destruction of, property, or damage to, or degradation of,
environment, and is of such a nature or magnitude as to be beyond the
coping capacity of the community of the affected area”.
11

12. Definition
Hazard -
Any phenomenon that has the potential to cause
disruption or damage to people and their environment.
“A hazard is natural event while the disaster is its
consequence. A hazard is perceived natural event which
threatens both life and property……
A disaster is a realization of this hazard.”
-John Whittow
• When hazard involves elements of risks, vulnerabilities and
capacities, they can turn into disasters.
• Hazards may be inevitable but disasters can be prevented.
12

13. Hazards are external factors that affect the society or
elements at risk.
Vulnerabilities are internal factors that affect the
transformation of hazards into disaster.
It determine the hazards impact on society or element
at risk
14
Vulnerability
It is the potential for loss.

14. • A disaster can be analyzed by determining the three pre
impact conditions :
Hazard exposure
Physical vulnerability
Social vulnerability
15

15. A community hazard exposure is determined by the
geographical location of its people and the event that
threaten their lives.
Physical vulnerability is defined as “ the properties of
physical structure that determine their potential damage
in case of disaster.
Social vulnerability is defined as “ peoples capacity to
anticipate , cope with, resist and recover from the impacts
of natural hazard”.
16

16. Disaster occurs when hazards meet vulnerability
Progression of vulnerability
Root causes Dynamic pressures Unsafe conditions
Limited
Access to -
• Power
• Structure
• Resources
Ideologies-
• Political -
system
• Economic
- system
Lack of –
•Local institutes
•Training
•Appropriate skills
•Local investment
•Local market
•Media freedom
•Ethical standards
in public life
Macro forces-
•Rapid population
growth
•Rapid
urbanization
•Arms expenditure
•Debt repayments
•Deforestation
•Decline in soil
productivity
Fragile physical
environment
•Dangerous
locations
•Unprotected
buildings &
infrastructure
Fragile local -
economy
•Livelihoods at risk
•Low income levels
Vulnerable society
•Special groups at
risk
Public actions
•Lack of
preparedness
•Endemic disease
Earthquake
High winds
Hurricane
Cyclone
Typhoon
Flood
Volcanic -
eruptions
Landslides
Drought
Virus
Bacteria
Pests
Fire
Chemicals
Radiation
Armed -
conflicts
Hazards
NOT PREVENTED

17. C l a s s i f i c a t i o n o f D i s a s t e r s
Natural
Disasters
Meteorological
Topographical
Environmental
Man made
Disasters
Technological
Industrial
Warfare
18

18. Meteorological
Disasters
• Floods
• Tsunami
• Cyclone
• Hurricane
• Typhoon
• Snow storm
• Blizzard
• Hail storm
Topographical
Disasters
• Earthquake
• Volcanic
Eruptions
• Landslides
and
Avalanches
• Asteroids
• Limnic
eruptions
Environmental
Disasters
• Global
warming
• El Niño-
Southern
Oscillation
• Ozone
depletion-
UVB
Radiation
• Solar flare
19

19. Technological
• Transport
failure
• Public place
failure
(Stampede)
• Fire
Industrial
• Chemical
spills
• Radioactive
spills
Warfare
• War
• Terrorism
• Internal
conflicts
• Civil unrest
• CBRNE
20

20. Disaster Management
Goals of Disaster Management:
(1)Reduce, or avoid, losses from hazards;
(2)Assure prompt assistance to victims;
(3) Achieve rapid and effective recovery.
Encompasses all aspects of planning for, and
responding to disasters, including both pre and post
disaster activities.
21

21. Integrated
Disaster
Management
Prepared-
ness
Response
Recovery
Mitigation
Activities prior to a
disaster.
• Preparedness plans
• Emergency exercises
• Training,
• Warning systems
Activities during a
disaster.
• Public warning
systems
• Emergency
operations
• Search & rescue
Activities following a
disaster.
• Temporary
housing
• Claims processing
• Grants
• Medical care
Activities that reduce
effects of disasters
• Building codes &
zoning
• Vulnerability
analyses
• Public education
22

22. Disaster management continuum
PROACTIVE STRATEGY
FUNDAMENTAL
OF PROMPT &
EFFECTIVE
RESPONSE
HOLISTIC
AND
CONTINUOS
PROCESS
Incident
23
PRE-
DISASTER
PHASE
POST
DISASTER
PHASE
A MULTI-
DIMENSIONAL
STRATEGY

23. Illustrates the ongoing process by which
governments, businesses, and civil society plan for and
reduce the impact of disasters.
Appropriate actions at all points in the cycle lead to
greater preparedness, better warnings, reduced
vulnerability or the prevention of disasters during the
next iteration of the cycle.
24
Disaster Management Cycle

24. PHASES OF DISASTER MANAGEMENT
Disaster Preparedness
Disaster Impact
Disaster Response
Disaster Recovery
Disaster Mitigation
25

25. Disaster Preparedness
Disaster preparedness - is ongoing multisectoral activity.
Integral part of the national system responsible for
developing plans and programmes for
disaster management,
prevention,
mitigation,
response,
rehabilitation and
reconstruction.
26

26. Disaster Preparedness
Co-ordination of a variety of sectors to carry out-
 Evaluation of the risk.
 Adopt standards and regulations.
 Organize communication and response mechanism.
 Ensure all resources- ready and easily mobilized.
 Develop public education programmes.
 Coordinate information with news media.
 Disaster simulation exercises.
27

27. Medical Preparedness &
Mass Casualty Management
Developing and capacity building of medical team for
Trauma & psycho-social care,
Mass casualty management and Triage.
Determine casualty handling capacity of all hospitals.
Formulate appropriate treatment procedures.
Involvement of private hospitals.
Mark would be care centers that can function as a
medical units.
Identify structural integrity and approach routes.
28

28. Disaster Response
Immediate reaction to disaster as the disaster is
anticipated, or soon after it begins in order to assess
the needs, reduce the suffering, limit the spread and
consequences of the disaster, open up the way to
rehabilitation.
By-
 Mass evacuation
 Search and rescue
 Emergency medical services
 Securing food and water
 Maintenance of Law & Order
29

29. Disaster impact and response
Search, rescue and first aid
Field care
Triage and stabilization of victims
Hospital care
Identification of the dead

30. Search, rescue and first aid
• After a major disaster, the organized relief
services will be able to meet only a small fraction
of the demand.
• Most immediate help comes form the uninjured
survivors.

31. Field care
Most injured persons converge spontaneously to
health facilities.
Health service resources be redirected to provide
care.
Bed availability and surgical services should be
maximized.
Provisions should be made for food and shelter
A center should be established to respond to
inquiries form patient’s relatives and friends.
Priority should be given to victims’ identification and
adequate mortuary space should be provided.

32. 33
• The principle of “first come, first treated” is not
followed in mass emergencies.
• Triage :
- It is a way of categorizing patients in the order of their
injuries and to make the most efficient use of the
available resources.
- Triage is the only approach that can provide maximum
benefit to the greatest number of injured in a major
disaster event.

33. 34
• Triage has to carried out at the site of disaster itself.
This helps
- to determine transportation priority
- admission to the hospital or treatment
centre
Here the patients needs and priority of medical care
will be reassessed.

34. The most common classification for triage uses
the internationally accepted 4 color code system.

35. Noji et al, NEJM

36. 37

37. Tagging
• Complements Triage
• Rapid Identification of patient
• Color Coded / Bar Coded system
• Plastic “bands” can substitute tags.
• All patients should be identified with tags
stating their name, age, place of origin,
triage category, diagnosis, initial treatment.

38. 39
• Identification of dead : Care of the dead includes
1. Removal of dead from the disaster scene
2. Shifting to the mortuary
3. Identification
4. Reception of bereaved relatives
Proper respect for the dead is of great importance.

39. 40
• Relief phase :
- Begins when assistance from outside starts to reach
the disaster area.
- The type and quantity of relief supplies are
determined by
a. the type of disaster – because distinct events
have different effects on the population
b. the type and quantity of supplies available
locally

40. 41
• Immediately following a disaster, the most critical health
supplies are those:
needed for treating casualties and
preventing the spread of communicable diseases.
• The supplies needed in the initial emergency phase include –
food, blankets, clothing's, shelter, sanitary engineering
equipment, construction material.

41. 42
• There are four principal components in
managing humanitarian supplies :
a. Acquisition of supplies
b. Transportation
c. Storage
d. Distribution

42. 43
Epidemiologic surveillance and disease control
• Disasters can increase the transmission of
communicable diseases through :
1. Overcrowding and poor sanitation in temporary resettlements.
2. Population displacement may lead to introduction of
communicable diseases.
3. Disruption and contamination of water supply, damage to
sewerage system and power systems.

43. 44
4.Disruption of routine control programmes as funds and personnel are diverted
to relief work
5.Ecological changes – favors breeding of vectors.
6. Displacement of domestic and wild animals – carry zoonoses that can be
transmitted to humans and other animals.
7. Provision of emergency food, water and shelter in disaster situation from
different or new source may be the source of infectious disease.

44. 45
• The principles of preventing and controlling
communicable diseases after a disaster are to –
a. Implement as soon as possible all public health measures,
to reduce the risk of disease transmission.
b. Organize a reliable disease reporting system to identify
outbreaks and to promptly initiate control measures.
c. Investigate all reports of disease outbreaks rapidly.

45. Medical and Public Health response
Food safety and Water Safety
Animal control- Carcasses can foul water,
Zoonotic diseases.
Vector control- Mosquito and Rodents
Communicable disease control:
Measles, diarrheal diseases, ARI, and malaria
Breakdown in environmental safeguards.
Crowding of persons in camps, Malnutrition.
Waste management
Temporary latrines
Chemical toileting
Sewage disposal damage.
46

46. Medical and Public Health response
Management of hazardous agent exposure
Particular matter
Also Infectious agents if hospital or scientific
laboratories damaged
Mental health
Specialized psychological triage and treatment
significant in terrorism.
Information
Behavioral Contagion handling
Risk communication
47

47. Consequences of Disaster
Health -
Physical – Entanglement, Injuries, Disabilities,
Coma ,Death.
Psychological- Cognitive, Behavioral, Social.
Structural Damage – to variable extent.
Ecological- Changes in eco system.
Economical-Financial losses.
48

48. Symptoms after disaster
Physiological
Symptoms
• Fatigue
• Shock
symptoms
• Profuse
sweating
• Fine motor
tremors
• Chills
• Teeth
grinding
• Muscle aches
• Dizziness
Cognitive
Symptoms
• Memory loss
• Distractibility
• Reduced
attention
span
• Decision
making
difficulties
• Calculation
difficulties
• Confusing
trivial with
major issues
Emotional
Symptoms
• Anxiety
• Feeling
overwhelmed
• Grief
• Identification
with victims
• Depression
• Anticipation
of harm to
self or others
• Irritability
Behavioral
Symptoms
• Insomnia
• Substance
abuse
• Gallows
humor
• Gait change
• Ritualistic
behavior
• Hyper
vigilance
• Unwillingness
to leave
scene
49

49. Factors which may affect reactions
Disaster Related Factors
• Lack of warning
• Scope of the event
• Abrupt contrast of scene
• Personal loss or injury
• Type of disaster
• Traumatic stimuli
• Nature of the destructive
agent
• Human error
• Time of occurrence
• Lack of opportunity for
effective action
• Environment (temperature,
humidity, pollution…)
Host Related Factors
• Health
• Disabled, Invalid
• Medical problems
• Social
• Lack of support network-
Divorced, Widowed
• Cultural: language barriers
• Demographic
• Age: younger and older
have more difficulties
• Sex: more stress in women,
but more resilient
• Past History
• Traumatic events
• Mental illness or emotional
problems
50

50. Disasters and Diseases
Epidemic diseases
 May be consequences of disasters.
 Some tend to become pandemics, to evolve as disaster
Plague of Justinian from 541 to 750 AD , killed
about 60% (100 Millions) of Europe's population.
The Black Death of 1347 to 1352 AD killed 25
million in Europe .
Spanish flu killed 50 million people in 1918-1919,
more than those died in precedent First World War.
51

51. Communicable Diseases after Disasters
Pre existing Diseases in the Population :
dysentery, cholera, measles, tuberculosis, malaria,
intestinal parasites, scabies, skin infections.
Ecological Changes :
Altered ecology- vector borne and water
borne diseases
Living conditions - plague, louse borne typhus
and relapsing fever.
Stray animals and wild animal displacement-
rabies.
Damage to public Utilities :
Water supplies & sewage disposal disrupted.
52

52. Communicable Diseases after Disasters
Population Movements :
 Introduction of new disease or vector.
 In settlements - diarrheal diseases , measles, viral
hepatitis, whooping cough, malaria etc.
Interruption in Public Health Services :
Disruption of curative and preventive services.
Interrupted vector control - malaria, dengue
Interrupted immunization - measles, whooping cough, and
diphtheria.
Altered Individual Resistance to diseases :
Malnutrition increases susceptibility to diseases .
53

53. Diseases after Man Made Disasters
 Will depend upon particular exposure type.
 Symptoms and diseases differ widely.
 Spectrum may range from simple non fatal injuries to
chromosomal defects.
 Again technology that is capable of producing mass
destruction weapons and developments in bio-technology
leading to invention of deadly bio-attack organisms ,is of ever
growing concern for world .
54

54. 55
on the night of December 2, 1984, the Union Carbide pesticide
plant in Bhopal, India began to leak methyl isocyanate gas and
other poisonous toxins into the atmosphere. Over 500,000 were
exposed and there were up to 15,000 deaths at that time. In
addition, more than 20,000 people have died since the accident
from gas-related diseases.

55. Other Public Health Impacts of Disasters
Sexual violence
Rape, Exploitation & Sexual violence
Causes: Separation of women from family
Weakened social structures
Increased aggressive behavior
Human right violations
Torture of civilian
Physical and psychological harms
Sex trafficking
Child labour
Denial of basic needs
56

56. Mental Health Impact of Disasters
Post traumatic stress disorder
Stage one- Adrenergic surge.
Stage two- Helplessness and a loss of self-control.
Stage three - Despondency and demoralization.
Children -Developmental age is more important
Preschoolers- Increased arousal, fear.
School-age children- reckless ,psychosomatic signs.
Adolescents- some partake in rescue and recovery,
regression & withdrawal possible.
Elderly - increased risk for physical injury, than mental.
57

57. Rescue workers in Disaster
Secondary victims of a disaster.
Stress reactions seen in non-professionals.
More emotional trauma if involved in a failed rescue
attempts (especially if children are involved).
Inexperienced body handlers become more sensitive.
19 August is observed as World Humanitarian Day in
honour of aid workers, who lost their lives.
58

58. Disaster Recovery
Repatriation - after the emergency is over, displaced
people return to their place of origin.
Rehabilitation -restoration of basic social
functions.
Providing temporary shelters,
Stress debriefing for responders and victims,
Economic Rehabilitation,
Psycho-social Rehabilitation,
Scientific Damage Assessment,
Elements of recovery
Community recovery (including psychological).
Infrastructure recovery (services and lifelines).
Economy recovery ( financial, political ).
Environment recovery. 59

59. Reconstruction
Rebuilding homes.
Permanently repairing and rebuilding infrastructures.
Elements -
Owner Driven Reconstruction.
Speedy Reconstruction.
Linking Reconstruction with Safe Development.
60

60. Emergency prevention and mitigation involves measures designed either to
prevent hazards from causing emergency or to lessen the likely effects of
emergencies.
Permanent reduction of risk of a disaster,
to limit impact on human suffering and economic assets.
Primary mitigation - reducing hazard & vulnerability.
Secondary mitigation- reducing effects of hazard.
Components:
Reducing hazard - protection against threat by
removing the cause of threat.
Reducing vulnerability - reducing the effect of threat
Natural hazards are inevitable, reduce vulnerability.
61
Disaster Mitigation

61. Components of Disaster Mitigation
Hazard identification and mapping –
Assessment – Estimating probability of a damaging
phenomenon of given magnitude in a given area.
Considerations-
History
Probability of various intensities
Maximum threat
Possible secondary hazards
Vulnerability analysis –
A process which results in an understanding of the types
and levels of exposure of persons, property, and the
environment to the effects of identified hazards at a
particular time.
62

62. Components of Disaster Mitigation
Risk analysis –
Determining nature and scale of losses which can be
anticipated in a particular area.
Involves analysis of
Probability of a hazard of a particular
magnitude.
Elements susceptible to potential loss/damage.
Nature of vulnerability.
Specified future time period.
Prevention –
Activities taken to prevent a natural phenomenon or
potential hazard from having harmful effects on either
people or economic assets.
63

63. VULNERABILITY PROFILE OF INDIA
Asian region is most disaster prone region with 60%
of the major natural disasters of world.
India is vulnerable in varying degrees to a large
number of natural as well as man-made disasters.
• 12 % land is prone to floods and river erosion.
• 58 % landmass is prone to earthquakes.
• 5,700 km coastline is prone to cyclones and tsunamis.
• 68% cultivable area is vulnerable to drought.
• Hilly areas are at risk from landslides and avalanches.
• Further, the vulnerability to Nuclear, Biological and
Chemical (NBC) disasters and terrorism has also increased.
64

64. Major Disasters in India (last 40 years)
S.
N
Event Year State & Area Effects
1 Drought 1972 Large part of country 200 million affected
2 Cyclone 1977 Andhra Pradesh
10,000 people & 40,000
cattle died
3 Drought 1987 15 states 300 million affected
4 Cyclone 1990 Andhra Pradesh
967 died. 435,000 acres
land affected
5 Earthquake 1993 Latur, Maharashtra
7,928 people died.30,000
injured
6 Cyclone 1996
Andhra Pradesh 1000 people died.5,80,000
houses destroyed
7
Super
cyclone
1999 Orissa Over 10,000 deaths
8 Earthquake 2001 Bhuj,Gujrat
13,805 deaths,6.3 millions
affected 65

65. Major Disasters in India (last 40 years)
S.
N
Event Year State & Area Effects
9 Tsunami 2004
Coastline TN, Kerala,
AP, A&N islands &
Puducherry
10,749 deaths.5,640
missing,2.79 Millions
10 Floods
July
2005
Maharashtra
1094 deaths
167 injured, 54 missing
11 Earthquake 2008 Kashmir 1400 deaths
12 Kosi floods 2008 North Bihar
527 deaths,19,323 cattle
died
13 Cyclone 2008 Tamilnadu 204 deaths
14
Krishna
floods
2009
Andhrapradesh &
Karnataka
300 died
15 Flash flood
June
2013
Uttarakhand
5,700 deaths,
70,000 affected
16
Phailin
Cyclone
Oct
2013
Coastline of Orissa,
Jharkhand
27 died, 10,00,000
evacuations 66

66. Floods,
Mumbai,
26 July 2005
Tsunami
26 Dec 2004
Cyclone
29 Oct 1999
Flood, Assam
& Bihar 2004
MAJOR DISASTERS
(1980-2005)
Earthquake
Uttarkashi, 20
Oct 1991
Bhuj,
Earthquake,
26 January,
2001
Avalanche
Feb 2005
Earthquake,
Latur, 30
Sept 1993
Tsunami
26 Dec 2004
Alia Cyclone
2009
Bhopal Gas
Tragedy, Dec
1982
Earthquake,
Oct, 2005
PHAILIN
Cyclone 2013
Flood,
Uttarakhand
2013
A f e w d i s a s t e r s i n
67

67. High Powered Committee set up in August 1999.
Until 2001 – Responsibility with Agriculture Ministry.
Transferred to Ministry of Home Affairs in June 2002.
National Disaster Management Authority established 28th
September 2005.
Inclusion of Disaster Management in the Seventh Schedule of
the Constitution.
On 23 December, 2005, Disaster Management Act .
Developments in Disaster Management

68. Changes in Disaster Management in India
Paradigm
Shift
Response centric to Holistic &
Integrated Approach
Backed
By
Institutional
Framework
Legal Authority
Supported
By
Financial
Mechanisms
Creations of
Separate Funds

69. SALIENT FEATURES DM ACT
• DM STRUCTURE ƒ
Provides for the constitution of the following institutions at national,
state and district levels.
National disaster management authority: (NDMA) set up as the
Apex Body with Hon’ble PM as Chairperson. ƒThe apex body is
responsible for laying down policies, plans and guidelines on
Disaster Management.
• State Disaster Management Authorities:
• SDMA at State Level, headed by Chief Minister .
• State Executive Committee (SEC), headed by Chief Secretary, will
coordinate and monitor implementation of National Policy, National
Plan and State Plan.
70

70. • District Level ƒ
• DDMA headed by District Magistrate . ƒ
• Chairperson of Zila Parishad as Co-Chairperson – interface
between Govt. and Public.
• SUPPORTING INSTITUTIONS ƒ
• National Disaster Response Force (NDRF). ƒ
• National Institute of Disaster Management (NIDM)
71

71. • APPROACH ƒ
• Paradigm Shift from Response Centric to a Holistic and
Integrated Approach.
• ƒBacked by – Institutional Framework and Legal Authority. ƒ
• Supported by Financial Mechanism, Creation of new Funds,
i.e., Response Fund and Mitigation Fund At national state and
district level.
• VISION To build a Safe and Disaster Resilient India.
72

72. Nodal Ministries related with Disasters
Type of Disaster Nodal Ministry
Natural- Flood, Tsunami, Cyclone,
Earthquake
Manmade-Civil strife
Home Affairs
Drought Agriculture
Biological, Epidemics Health & Family Welfare
Chemical, Forest related Environment & Forest
Nuclear Atomic Energy
Air Accidents Civil Aviation
Railway Accidents Railway
Industrial Accidents Labour
73

73. Mitigation Projects
• Cyclones - 308 Million US $.(World Bank)
• Earthquakes - Rs. 1597 Cr.
• Pilot Project for School Safety: Rs. 48 Cr.
• Disaster Information & Communication Network - Rs. 821 Cr.
Also projects are being implemented for-
 Landslides.
 Floods.
 Medical Preparedness.
 Creation of National Disaster Response Reserves
74

74. Disaster Management in Development
• All new Projects/ Programmes will mandatorily have inbuilt
disaster resilience. (at conceptualization level).
• Planning Commission and the Ministry of Finance to give
approval to the projects only if disaster resilience self
certification is provided.
• Ongoing Projects to be revisited to include disaster resilience
audit.
• Infrastructural loans to be sanctioned by the Banks only after
due diligence on disaster resilience audit.
75

75. Response and Rescue
Composition: 10 battalions
Tasks
Specialized Response during disasters.
Well equipped and trained in search and rescue.
Impart basic and operation level training to SDRF.
Proactive Deployment during impending disaster situations.
Liaison, Rehearsals and Mock Drills.
76

76. NDRF Battalions in India
Suradevi &
Waregaon
77

77. Research
Involvement of various Universities and Research
Institutes to carry out research for Disaster
Management
• Case studies and lesson learnt exercises by NIDM
• Preparation of Digital Maps.
• Preparation of Upgraded Hazard Maps.
• Development of GIS Platform for Vulnerability Analysis
and Risk Assessment.
• Seismic Microzonation.
• Improved Modeling for Advanced Forecasting
Capability.
• National Disaster Management Information System
(NDMIS). 78

78. Resource and Knowledge Network
• India Disaster Resource Network (IDRN)
 Inaugurated on 1st September 2003.
 Web-enabled, centralized database for quick access
to resources to minimize response time.
 Updated every year ,at District & State level.
226 items, 69,329 records in 545 districts uploaded.
• India Disaster Knowledge Network (IDKN)
Web portal for knowledge collaboration, maps,
networking, emergency contact information system .
Goal - easy to use unified point of access to disaster
management ,mitigation and response.
IDKN is a part of South Asian Disaster Knowledge
Network (SADKN).
79

79. Other Institutional Arrangements
• Armed Forces
• Central Para Military Forces
• State Police Forces and Fire Services
• Civil Defence and Home Guards
• State Disaster Response Force (SDRF)
• National Cadet Corps (NCC)
• National Service Scheme (NSS)
• Nehru Yuva Kendra Sangathan (NYKS)
80

80. Stakeholders’ Participation
• Corporate Social Responsibility (CSR)
• Public Private Partnership (PPP)
• Media Partnership
• Training of Communities
• DM Education in Schools
81

81. 82

82. International Co-operation
UN Office for Coordination of Humanitarian Affairs (UNOCHA)
for all international disaster response.
United Nations Development Programme (UNDP),
for mitigation and prevention aspects
UN Disaster Assessment and Coordination (UNDAC) System.
Streamlining Institutional Arrangements for Disaster Response.
The Asian Disaster Reduction Center in Kobe(1998)
to enhance disaster resilience of the 30 member countries,
to build safe communities,
to create a society where sustainable development is possible.
83

83. Disaster Reduction Day
• NIDM observes "Disaster Reduction Day" on the
Second Wednesday of October.
• UN General Assembly in 2009, designated October 13
as International Day for Disaster Reduction.
• 2013 Theme -“Living with Disability and Disasters”.
• Rallies and lectures for awareness for disaster reduction
amongst youth, children and general people.
84

84. 85
THE ROLE OF DENTISTS IN
DISASTER EVENTS

85. 86
The role dentists can play in disaster
events
There is a profound role for dentistry in the disaster
response paradigm, both in personnel and infrastructure
support.
The oral health community offers skilled man-power and
orthogonal medical supply caches, which provide a high-
impact contribution to disaster planning and management
activities.

86. • Dentists along with other health professionals can act as first
responders and bring well-honed skills to an emergency.
• Although dentists comprise an important aspect of health
team, their role or utility has not been emphasized.
87

87. 88
• Dentists are well prepared to play an important
role in response to catastrophic events as they
are:
Experts in barrier techniques and infection control
Trained and skilled in administering drugs by
injection
Skilled in placing sutures and controlling bleeding
Able to participate in interdisciplinary professional
groups; and
Adept at managing uncomfortable patients

88. DENTAL PROFESSIONALS CAN PROVE TO BE HELPFUL DURING
A MAJOR PUBLIC HEALTH DISASTER IN THE FOLLOWING WAYS:
1. SUPPORTING OTHER HEALTH PROFESSIONALS :
• When the local medical resources are unable to cope
adequately with huge number of victims, dentist can be
recruited to provide certain services that will allow
physicians to do things only they can do.
• Dentists can enhance the surge capacity of the local
medical system until additional physicians arrive or
demand for immediate care decreases.
2.DENTAL OFFICES ACTING AS MEDICAL SITES :
• Dental offices are equipped with potentially useful
equipment and supplies and should be prepared to serve
as decentralized auxiliary hospitals in case the need
arises.

89. 3. DENTAL SURVEILLANCE :
• Dentists can contribute to bioterrorism surveillance by being
alert to clues that might indicate a bioterrorist attack.
• Since dentists are scattered throughout a community they can
be a part of effective surveillance network with their eyes and
ears open to information on unusual syndromes in the
community as well as unusual clinical presentations.
• 4.FORENSIC ASSISTANCE :
• Forensic odontology continues to be a crucial element in nearly
all mass disasters whether natural, accidental, or intentional.
Dental identifications have always played a key role in victim
identification during natural and manmade disaster situations
and in particular mass casualties normally associated with
aviation disasters

90. 5. TRIAGE SERVICES:
6. DEFINITIVE TREATMENT :
• Dental professionals along with other health care
personnel may be able to provide treatment to the
people during any disaster event.
• Dentists have training and experienced in many areas
that may be a part of casualty care in mass casualty
events. Oral and maxillofacial (OMS) practitioners are
qualified trauma surgeons who can provide first aid.
• For this reason, it is advocated that civilian dentists
should be trained along with dental personnel in
armed services in augmenting and teaming with their
medical counterparts .

91. 7.DISTRIBUTION OF MEDICATION
• In mass casualty situations, particularly after a bioterrorism attack or
the unfolding of a pandemic infection, the population may
require medication.
• Dentists can be called on to prescribe and dispense the
medications required after the determination has been made
by the physician and public health officials managing the
disease outbreak.

92. • 8. IMMUNIZATION
• To limit the spread of infectious agent followed by rapid
immunization of great numbers of individual may be
required in a short amount of time.
• Dentists can participate in mass immunization programs
with minimum of additional training and may be critical
factor in the success of urgent programs.
• Dental offices can be used as immunization sites

93. CONCLUSION
• Disasters are events that can’t be controlled or predicted. These malicious events
will happen every now and then. We can never be prepared enough; hence,
measures such as have been stated above, should be taken, in case of medical
emergencies, when disaster strikes. Oral health care providers and governmental
bodies which are related to emergency medicine, rescue and natural disasters,
should always be on the alert, to be able to provide help during such events. There
is a need of a disaster team organization that follows continual education on mass
disaster management and bioterrorism, and that works in co-operation with a dental
team. Dental professionals form an integral part of the health care community and
they can provide care to the public by playing various health care roles, following
natural mass disaster events. 94

94. • FOR INFORMATION ON DISASTERS
DIAL TOLL FREE No. 1070
• Contact
NDMA Control Room
26701728,730;Fax-26701729
9868891801,9868101885
controlroom@ndma.gov.in; ndmacontrolroom@gmail.com
WEBSITE
• Republic of India-http:// ndma.gov.in
95

95. References
96

96. References
1. Risk reduction and emergency Preparedness, WHO six-year strategy for the
health sector and community capacity development, ISBN 978 92 4 159589 6
© World Health Organization 2007.
2. Communicable diseases following natural disasters, Risk assessment and
priority interventions, World Health Organization 2006.
3. Disaster Prevention and Preparedness, LECTURE NOTES For Health Science
Students, Jimma University in collaboration with the Ethiopia Public Health
Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the
Ethiopia Ministry of Education 2006. Funded under USAID Cooperative
Agreement No. 663-A-00-00-0358-00.
4. Wallace/Maxcy-Rosenau-Last-Public Health & Preventive Medicine, Fifteenth
edition,2008, The McGraw-Hill Companies, Inc.; United States of America.
5. K Park, Park’s Text book of Preventive and Social Medicine,22nd Edition
2013, Bhanot Publications, Jabalpur,India.
6. Position Paper on Crowd Management at Places of Mass Gatherings, 2013,
NDMA downloads, assessed on 01/12/2013.
7. THE DISASTER MANAGEMENT ACT, 2005, NO. 53 OF 2005, 23rd December,
2005, enacted by Parliament in the Fifty-sixth Year of the Republic of India.
97

97. References
8. Emergency Triage Assessment and Treatment (ETAT), Manual for
Participants, © World Health Organization 2005.
9. EMERGENCY SURGICAL CARE IN DISASTER SITUATIONS, WHO manual
Surgical Care at the District Hospital (SCDH), a part of the WHO Integrated
Management on Emergency and Essential Surgical Care (IMEESC) tool kit.
10. The Global Platform for Disaster Reduction, The official agenda for the 4th
Session from Tuesday 21 to Thursday 23 May 2013,assessed on
05/012/2013.
11. National Policy on Disaster Management(NPDM) ,NDMA publication
online assessed on 07/12/2013.
12. Public Health Risk Assessment and Interventions, Typhoon Haiyan,16
November 2013.
13. National Disaster Management Guidelines, Preparation of State Disaster
Management Plans, July 2007,NDMA,GOI.
14. Disaster management and risk reduction: strategy and coordination; plan
2010-2011,International Federation of Red cross and Red Crescent Societies.
15. http://reliefweb.int/ assessed on 09/01/2014
16. http://samples.jbpub.com/9780763781552/81552_CH02_FINAL.pdf
98

98. • 17.Dentistry’s Role In Disaster Response – Michael D.
Colvard - Dental Clinics Of North America; 2007; Vol 51;
No.4.
• 18.Gambhir Rs, Kapoor D, Singh G, Singh G, Setia S.
Disaster Management: Role Of Dental Professionals. Int J
Med Sci Public Health. Online First: 12 Feb, 2013.
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99. 100