Crises management

1. Climate change, poverty and
disaster management

2. Out line
1)Definition of climate change
2)The effect of climate change on health:
3)Proposed policy solutions
4)poverty
5)Types of poverty
6)Causes of Poverty
7)Why to measure and report poverty?
8)Two approaches of poverty measurement
9)Effects of poverty
10)The Cycle of Poverty

3. • Methods used at reducing povert
• Introduction of disaster management
• Definition of disaster
• Causes of disaster
• Definition of disaster management
• Goals of disaster management
• Phases of disaster management
• D-I-S-A-S-T-E-R Paradigm
• Reference

6. - Climate change may be limited
Climate change may be limited to a specific region, or
it may occur across the whole Earth.
It can be caused by recurring, often cyclical climate

7. • Climate Change and Health
• There is consideration worldwide on the potential health impacts from global
climate change.
• Three kinds of health impacts have been identified:
a) Relatively direct impacts, usually caused by weather extremes
b) Consequences of environmental change and ecological disruption in response
to climatic change
c) Consequences that occur when populations are demoralised and displaced by
the following climate change induced factors:
• economic dislocation,
• environmental decline and conflict situations including traumatic, infectious,
nutritional, psychological and other health consequences.

10. • Direct Impacts to Health from Heat
• The human body maintains body temperature in ambient temperatures not
exceeding 32 degrees C
• Above this temperature, heat lost through the skin and sweating
• Heat-related illness occurs when the body unable to adequately cool
• Minimum ambient temperatures are also important:
a) Difficulties cooling when minimum temperature is greater than 22 degrees C
• High humidity reduces effectiveness of sweating and increases the risk of
heat-related illness at any given temperature.

11. • Impacts to Health from Increased Temperatures
• Direct impacts to health:
a) Heat cramps – muscular pains and spasms
b) Heat exhaustion – body fluids are lost through heavy sweating
c) Heat stroke – is life threatening.
• Indirect impacts:
a) Range of areas that can potentially be affected with gradual and extreme temperature
increases
b) Includes impacts on ecosystems, water, food, disease-carrying vectors, lifestyle,
community resilience.

12. • Health Impacts of Floods
• Immediate deaths and injuries
• Non-specific increases in mortality
• Infectious diseases – leptospirosis, hepatitis, diarrhoeal, respiratory, and
vector-borne diseases
• Exposure to toxic substances
• Mental health effects
• Indirect effects
• Increased demands on health systems.

13. • Climatic Change: Air Quality
• Airflow on edges of a high-pressure system can transport ozone
precursors. Ozone levels are increasing in many areas
• An increase in fire events will mean increased toxic gases and
particulates
• Changes in wind pattern may increase long-range transport of air
pollutants
• Weather patterns can enhance urban “heat islands” which can lead to
elevated pollution levels.

14. Food Production: Land
Land based agriculture:
• Food production, loss of soil fertility, erosion and salinization:
a) Changes in crop yields and protein levels (+/-)
b) Effects on feed intakes and animal reproduction
c) Changes to pests, weeds and diseases
d) Changes to use of agrochemicals
• Dietary and nutritional changes

15. • Food borne disease may cause food poisoning:
a) May increase the proliferation of bacterial pathogens including Salmonella,
Campylobacter and Listeria spp.
b) May increase mycotoxins and aflatoxins in seafood.

16. • Social Impacts
Lifestyle and behaviour are likely to be affected in the following ways:
• Increased temperatures:
a) Increases in crime - particularly involving aggression
b) Accidents - workplace and traffic
c) Decline in physical health
d) Hot nights may cause sleep deprivation
e) Recreational opportunities - changes to exercise patterns
f) Changes in alcohol consumption
g) Stress
h) Lack of cold water- reduced ability to cool down

20. Proposed policy solutions
1)Mitigation efforts
• Climate change mitigation is the action to decrease the intensity of radiative forcing in order to
reduce the potential effects of global warming.

21. 2)The adaptation responses for health will fall into
the following categories:
• Direct impacts of extreme events
• Direct impacts of heat events and temperature
• Water related
• Vector-borne
• Air quality
• Food-borne
• Food production
• Social
• Generic.

22. • Stages of Adaptation
• Primary – prevent onset of health impact
• Secondary – preventative measures taken in response to early evidence
of impact
• Tertiary – actions to lessen the health effects

23. poverty
 Poverty is a major cause and effect of global environmental problems.
 poor people are forced to overuse environmental resources to survive from day
to day, and their impoverishment of their environment further impoverishes them,
making their survival more difficult and uncertain"
 Poverty
 the state of one who lacks a usual or socially acceptable amount of money or
material possessions.
 Poverty is said to exist when people lack the means to satisfy their basic
needs.

24. • Types of poverty
1)Absolute Poverty
• It is the extreme kind of poverty involving the chronic lack of basic food, clean
water, health and housing. People in absolute poverty tend to struggle to live and
experience a lot of child deaths from preventable diseases like malaria, cholera and
water-contamination related diseases.
• This kind of poverty is usually not common in the developed world.
2)Relative Poverty
• This kind is usually in relation to other members and families in the society.
• For example, a family can be considered poor if it cannot afford vacations, or,
cannot send its young to the university. Even though they have access to government
support for food, water, medicine and free housing, they are considered poor
because the rest of the community have access to superior services and amenities

25. 3)Situational Poverty (Transitory)
• People or families can be poor because of some adversities like earthquakes, floods
or a serious illness. Sometimes, people can help themselves out of this situation
quickly if they are given a bit of assistance, as the cause of their situations was just
one unfortunate event.
4)Generational or Chronic Poverty
• This is a more complicated type and we will see a detailed example here.
• This is when poverty is handed over to individuals and families from generations
before them.
• In this type, there is usually no escape from it, as people are trapped in its causes and
have no access to tools that will help them get out of it.

26. Causes of Poverty
• Unemployment
• Inflation
• Poor management of resources
• Government
• World hunger
• Epidemic diseases

27. • Automation - Technological Unemployment
• Overpopulation
• Under-Education
• Debt
• Corruption
• Extreme weather
• Lack of control in local food
• Lack of access to education
• Mental illness - lack of proper psychiatric care
• Wars

28. • Effects of poverty
• Education and schooling
• 67 million children worldwide, of whom approximately 53% are girls, do not have
access to basic education currently
• Hunger, Health and Deaths.
Absolute poverty results in extreme hunger, starvation and malnutrition.
• People (and children) become vulnerable to preventable diseases such as cholera,
dysentery and tuberculosis, with no access to health services and medications.
• Death rates rise.
• Over 10,000 children die every day because they live in poor housing.

29. Social and Political
• Relative poverty may cause people to indulge in social vices ‫أخالقيه‬ ‫عيوب‬ such as
drugs, prostitution and petty crimes as a means to meet their immediate needs.
• In many developing countries, political leaders and rebel leaders take advantage and
recruit young people, (especially those in relative poverty) to fight for their interests,
in return for food and basic needs.
Economic
• People in absolute poverty simply cannot afford food, water and shelter.
• They are not healthy enough to undertake any economic activity.
• They cannot send their young to school and the youth cannot get any skills.
• This results in economic breakdown of the community

30. • The Cycle of Poverty

31. Methods used at reducing poverty
• Provision of skills and Training
 The youth and able-to-work in the communities are provided skills to help with
farm work or other economic activity, which helps them earn money to make a
living and take care of their families.
• Education
 Quality education empowers people to take advantage of opportunities around
them.
 It helps children get knowledge, information and life skills they need to realize
their potential.
 Training teachers, building schools, providing education materials and breaking
down that prevent children from accessing education are important features of
poverty alleviation programmes .

32. • Health, food and water
 Many programs aim at feeding kids at school and providing health services
as well.
 This encourages parents to send the children to school and keep them
there.
 If children have food to eat, and are healthy, they can learn and respond to
the needs of the programme.
• Income redistribution
 It is important that the government extends its development programs such
as roads, bridges, and other economic facilities to rural areas, to make it
easy for goods and services and farm produce to move to and from the
farming communities.

33. • Enhancing economic growth through developing human resources and
technological foundations, attracting investments, and participating in the
global economy.
 Enhancing transparency and other regulatory mechanisms necessary for
fairnes and efficiency in economic transactions; and
 Creating an environment supportive of small enterprises including access
to micro credits which are particularly important for the poor segments of
the population

34. • Disaster Definitions
 Any emergency that disrupts normal community function causing concern for the
safety of its citizens including their lives and property.
 A serious disruption of the functioning of a community or a society causing
widespread human, material, economic and environmental losses which exceed
the ability of the affected community / society to cope using its own resources
 Is any natural or human made incident that causes a level of destruction that
exceeds the abilities of the affected community to respond without assistance.
E.g. hurricane ,storm, flood, accident
 Disaster nursing
 It can be defined as the adaptation of professional nursing skills in recognizing
and meeting the physical and emotional needs resulting from disaster.

35.  A disaster is present when need exceeds resources!
• Disaster = Need > Resources
• A response need that is greater than the response available!

36. Causes of Disaster
• Natural
• Earthquake
• Landslides
• Avalanche
• Volcano
• Tornado
• Fires
• Meteors
• Hurricanes, floods

37. • Man-made
• Fires
• Terrorist
• Explosive devices
• Firearms
• Structural collapse
• Transportation event
– Air, Rail, Roadway, Water

38. Definition of disaster management
• Disaster management can be defined as the organization and
management of resources and responsibilities for dealing with all
humanitarian aspects of emergencies, in particular preparedness, response
and recovery in order to lessen the impact of disasters.

39. • Goals of Disaster Management
(1) Reduce, or avoid, losses from hazards;
(2) Assure prompt assistance to victims;
(3) Achieve rapid and effective recovery.

40. Phases of Disaster
1.Mitigation:
• activities that reduce the effects of disasters.
2.Preparedness:
• activities prior to a disaster.
3.Response:
• activities during a disaster.
4.Recovery:
• activities following a disaster.

41. • Mitigation
 Mitigation is "sustained activities and measures aimed at eliminating or
reducing the long-term risk of property damage and loss of live from
hazards and their effects".
 This phase includes any activities that prevent and emergency, reduce
the chance of an emergency happening or reduce the effects of
unavoidable hazards.
 It can occur before or after an emergency or disaster.
 Attention to mitigation opportunities can make safer communities for all of
us.

42. • Mitigation Examples
 Building zoning and data analysis to determine where best to place
shelters or temporary housing.
 Educating the public in ways to reduce loss and injury.
 Allocations and interstate sharing of resources.
 Information resources and services important in mitigation activities.
 Evacuations may be orchestrated before hurricanes or floods and early
warning allows residents to seek shelter from tornadoes.

43. • 2.Preparedness
 Are We Prepared?
 Is the healthcare system prepared?
 Preparedness:
 Activities prior to a disaster.
 Planning how to respond.
 Building the emergency management function to respond effectively to,
and recover from any hazard.

44. Elements:
1. Plans.
2. Equipment
3. Training.
warning systems; emergency communications systems.

45. A- Disaster Plan:
• An effective disaster plan should incorporate the following basic principles:
Prepare in advance.
Anticipate the worst: loss of infrastructure, isolation and chaos.
Take what will be most needed.
Find the safest place for expensive or irreplaceable items.
Minimize the risk to the remaining practice structure.
Improvise with the resources on hand
Adapt to changing conditions and demands.

46. Disaster Planning:
• Disaster planning should be done at two levels:
1. External Planning
2. Internal Planning
* External Planning:
• External disaster plans sometimes rely on faulty assumptions that do not prove
true in actual disasters.
For example, planners may logically assume that the sickest patients will be transported first
during a disaster, when in reality this may not happen in many instances.
• External disaster plan encompassing both local and regional areas must focus on 3 possible
scenarios:

47. 1.The disaster occurs within the region and is confined and controlled with
existing resources.
2.The disaster occurs in a neighboring region, and regional assets are
requested through mutual aid agreements.
3.The disaster area is the region and requires state or federal assistance for
an effective response.

48. Internal Planning:
• Hospital disaster planners must take into account the scenarios previously
described, including the possibility that the disaster may involve the hospital.
The Joint Commission on Accreditation of Hospitals (JCAHO) requires
hospitals to exercise disaster plans periodically and to form disaster
committees.
• These committees should comprise key departments within the hospital,
including administration, nursing services, security, communications,
laboratory, physician services (including, but not limited to, Emergency
Medicine, General Surgery, and Radiology), medical records, and
maintenance/engineering.

49. The hospital disaster plan should include protocols and policies that
meet the following needs:
Recognition and notification.
Assessment of hospital capabilities.
Personnel recall and Public relations.
Establishment of a facility control center.
 Maintenance of accurate records.
Equipments resupply.

50. Elements of Disaster Plan:
1. Quick Reference Guide
 Procedures for immediate response to most common disasters
 Done with Security and Building personnel
* Basic information:
 Emergency phone numbers
 Phone tree
 Building proctors
 Post evacuation meeting locations
 Location disaster supplies
 List of vendors
• Floor plans with fire alarms, exits, etc

51. 2.The disaster team and list of responsibilities.
A Crisis Management Team is formed to
- protect an organization against the adverse effects of crisis.
- prepares an organization for inevitable threats.
-respond immediately to warning signals of crisis
-execute relevant plans to overcome emergency situations.
- analyze the situation and formulate crisis management plan to save the
organization’s reputation and standing in the industry.

52. Disaster scale & recovery operations
* Level 1: Emergency
1- Minor incidents that do not interrupt normal operations;
2- Handled by minimal staffing in less than 4 hours.
* Level 2: Small disaster
Limited to isolated area
Damages less than 100 items
Requires 1-3 staff members
Disruptions resume within a day.
* Level 3: Medium disaster
Damages less than 500 items
Service operations resumed within 48 hours
Outside vendors may be needed
* Level 4: Major/large scale disaster or wide-area disaster

53. • B- Equipment (Preparedness)
• Personnel protective equipment for all heath care persons.
• Medical equipments.
• Communication equipments.
• Tools to help commanders.
• C- Training (Preparedness)
• Effective disaster management relies more on solid human resources
than on equipment and technology.
• training is very important to maintain the required level of awareness,
skills and commitment to risk reduction.

54. • 3.Response
 Activities during a disaster.
 Efforts to minimize the hazards created by a disaster.
 Examples: search and rescue; emergency relief
 Conducting emergency operations to save lives and property by taking
action to reduce the hazard to acceptable levels (or eliminate it entirely);
evacuating potential victims; providing food, water, shelter, and medical
care to those in need; and restoring critical public services.

55. • major incident
• Any incident where number severity type or location of lives causalities require
extraordinary resources
• Mass causality incident : health care needs > resources
•
• All hazards structure response (cscattt)
 Command and Control.
 Safety (code 1,2,3).
• 1-staff
• 2-situation
• 3-survivor

56.  Communication (METHANE).
 Assessment.
• 1-major incident declared
• 2-exact location
• 3-type of incident
• 4-hazard:present-potential
• 5-access:road-landing area
6-number of causalities: type-severity
• 7-Emergency services: present-required
• Triage

58.  Treatment.
• Aim: to do the most for the most
 Transportation.
• Aim : get the right causaltly to the right place in the right time
• Casualties should be dispersed to different hospitals most appropriate to
their need

59. • 4.Recovery
 Activities following a disaster.
 Returning the community to normal.
 Rebuilding communities so that individuals, businesses, and governments can
function on their own, return to normal life, returning vital life-support systems ,
and protect against future hazards.
 Examples: temporary housing; claims processing and grants; long-term medical
care and counseling.
 Recovery is the effort to restore the infrastructure and the socioeconomic life of
a community back to normal after the disaster.
 Short term it includes bringing power, telephone, back into service, ensuring
social needs of individuals and the community are met.
 Long-term goals are restoring economic activity and rebuilding community
facilities and housing.