Session 1.3 need for disaster responses


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from DRR and WASH workshop

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  • Read chapter 2 of the diseases handbook for more details on these.
  • Helminths: Any of a diverse group of worms which are internal parasites of man and animals, as nematodes, flukes, etc. Read chapter 2 of the diseases handbook for more details on these.
  • Session 1.3 need for disaster responses

    1. 1. Basics in emergencies
    2. 2. Why Health?• Our aim: – Saving lives – Reducing suffering - both through ensuring public health• Along with food and shelter, safe water and sanitation health is the highest priority intervention in emergency situations. Unless adequate health services are quickly provided to emergency-affected children and their families, disease and death will follow.• And unless good hygiene is consistently practiced by affected people, the danger of diarrhoea, cholera and other disease outbreaks will persist.• This is true in all types of emergencies, from rapid onset natural disasters to long-term crises caused by a range of complex factors.
    3. 3. Why Health? (cont’d)• Public health response is usually the first intervention in emergencies as it directly associates with saving lives because the high morbidity and mortality rates are attributed to WASH infectious diseases in the first phase of emergency.• Some diseases, especially diarrhoeal diseases cause considerable dehydration, which can lead to death if not promptly treated. Diarrhoeal diseases can be prevented through access to clean, safe drinking water and through proper hygiene and sanitation measures, including hand washing and safe disposal of human waste.Source: Oxfam India WASH strategy 2010-2015
    4. 4. Water and diseasesWater- Due to faecal-oral Diarrhoeas and Water contaminationborne bacteria and non- dysenteries , Poor sanitation(and faecal oral bacteria Typhoid Poor personal hygienefaecal- in water Shigellosis ,oral) Hepatitis AWater- Due to lack of water Skin and eye Inadequate waterwashed infections Poor personal hygieneWater- Due to long Schistosomiasis, Water contaminationbased exposure to Guinea worm microbes living naturally in waterWater- Due to insect Malaria, River Breeding in waterrelated vectors which breed blindness, Filariasis, Biting near waterinsect- in water Dengue, Yellowvector Fever
    5. 5. Sanitation and diseasesExcreta-related Helminths transmitted Roundworm, Open defecationhelminths through soil Hookworm, Ground Whipworm contaminationExcreta-related Transmitted by flies Diarrhoea and Dirty and unhygienicinsect-vector and cockroaches dysentery environment
    6. 6. Key Health Threats• Poor drainage, stagnant water• People drinking contaminated water• Unsafe excreta disposal• Solid waste deposition• Inappropriate shelter• Insecure environment• People not washing hands at key times
    7. 7. Major communicable diseases inemergencies• Cholera• Malaria• Shigellosis• Scabies• Dengue• Leptospirosis• …… etc.
    8. 8. Groupwork: Factors affecting risk ofoutbreaks• Population displacement• Population density• Disruption and contamination of water supply and sanitation services• Disruption of public health programs• Ecological changes that favour breeding of vectors• Displacement of domestic and wild animals
    9. 9. Key Health Interventions• Provision of treatment in hospitals• Provision of immunization• Promotion of antenatal care• Provision of delivery services Which of the above has the most impact?
    10. 10. Epidemiological terms and definitions• Endemic – The continuing presence of disease within a given geographical area or population groups• Epidemic – An outbreak of disease that attacks many people at about the same time and may spread through one or several communities• Pandemic – When an epidemic spreads throughout the world• Epidemiology – Study of distribution and determinants of diseases & health related events and application of this knowledge for prevention and control of diseases
    11. 11. Epidemiological Triad HOST Age genetic susceptibility nutritional status previous exposure immunization status general physical condition ENVIRONMENT AGENT Shelter, altitude, Bacteria, Viruses, humidity, sanitation, Parasites, fungi food supply, water Vector (or) their products supply, temperature overcrowding
    12. 12. Key indicators of health status: Mortality• Measured as number of deaths per 10000 population per day. It is known as Crude Mortality Rate because it uses the crude numbers for deaths and the population without any adjustment for the composition of the population.• Crude mortality rate (CMR) is for entire population and under 5 mortality rate (U5MR) is for children under 5 years of age No. of deaths X 10000 CMR = Population X Period21 people are reported dead in a camp with population of 20000, in aperiod of one week. What is the CMR in this case?
    13. 13. Benchmark mortality rates in emergencies• Crude Mortality Rate: – 0.5 Baseline – 1.0-2.0 Serious – >2.0 Crisis• U5MR – 0.8-1.2 Baseline – >2.0-4.0 Serious
    14. 14. Key indicators for health status: Morbidity• Morbidity is the number of NEW cases of a GIVEN DISEASE among the population over a certain period of TIME.• Measured per 10000 population per day.
    15. 15. WEEKLY MORBIDITY / MORTALITY SURVEILLANCE FORMDistrict/Town/Settlement/CampHealth ClinicReporting PeriodName of reporting officerReported main cause of <5 years 5 years and older Totalillness/death(final diagnosis) Cases Deaths Cases Deaths Cases DeathsAcute watery diarrhoeaBloody diarrhoeaSuspected choleraSevere RTI/pneumoniaSuspected malaria/fever ofunknown originMalnutritionMeaslesMeningitisAcute jaundice syndromeOther/unknownTotalAverage CMRAverage U5MR
    16. 16. Faecal-Oral transmission routes Fingers Flies New Faeces Food host Fields Fluids
    17. 17. Barriers to break the faecal-oral chain Hand-washing at key times Fingers Protection of food (e.g. storage) Safe eating (e.g. washing fruits and vegetables before Flies eating them raw New Faeces Food host Fields SE Pit latrines C O Protection of food VIP latrines N (e.g. handling, preparation) Fluids Protection of water in DProtection of water sources transit and in the shelter A R PRIMARY BARRIERS Y B