Despite that disasters are usually named after the causing phenomenon or event; a disaster by itself is not the phenomenon or event. Unless an earthquake strikes a populated area of weak physical constructions, it is not described as a disaster. Also, the definition of a ‘disaster’ depends to a great extent on who is defining. (1) On another hand, man-made disasters can be divided into four categories: armed conflict and civil strife, technological disasters, disasters that occur in human settlements and severe accidents. (2) Here, with the fact that deaths following disasters are preventable, and also, most subjects affected by them do not die. A standardized and feasible incident management system along with Standard Operating Procedures are essential for linking site operations to health-facility based care during an occurring disaster. (3)Not to mention the important rule of multi-disciplinary efforts in the planning, organization, coordination and implementation of all measures to mitigate/prevent, prepare for, respond to and recover from disaster events.(4)

1. Disaster Epidemiology
and
Epidemiology of the
Disasters
Disaster management in Egypt; Where we
stand?
From the standpoint of public health, a disaster is defined on the basis of its consequences on
health and health services. A disaster is a serious disruption of the functioning of society,
causing widespread human, material or environmental losses, that exceeds the local capacity
to respond, and calls for external assistance
Nouran Hamza 8/9/2018

2. 1
Despite that disasters are usually named after the causing phenomenon or event; a
disaster by itself is not the phenomenon or event. Unless an earthquake strikes a
populated area of weak physical constructions, it is not described as a disaster. Also,
the definition of a ‘disaster’ depends to a great extent on who is defining. (1) On
another hand, man-made disasters can be divided into four categories: armed conflict
and civil strife, technological disasters, disasters that occur in human settlements and
severe accidents. (2)
Here, with the fact that deaths following disasters are preventable, and also, most
subjects affected by them do not die. A standardized and feasible incident
management system along with Standard Operating Procedures are essential for
linking site operations to health-facility based care during an occurring disaster. (3)Not
to mention the important rule of multi-disciplinary efforts in the planning,
organization, coordination and implementation of all measures to mitigate/prevent,
prepare for, respond to and recover from disaster events.(4)
The elementary axiom of epidemiology is that adverse health outcomes do not
occur randomly within a population but occur in somewhat predictable patterns. Such
patterns may be declared as clusters of disease, injuries, or other health outcomes in
time, space, or certain groups of people. (5)Similarly, epidemiologic methods can be
used to measure and describe the adverse health effects of natural and man-made
disasters and the factors that contribute to those effects; the overall aim of such
epidemiologic investigations is to assess the needs of the disaster-affected populations,
match available resources to needs, evaluate program effectiveness, prevent further
negative outcomes, and permit better contingency planning. (6)
By identifying the underlying risk factors for specific outcomes as death and injury,
epidemiologists can help develop effective strategies to prevent prospected disaster-
related mortality and morbidity. (5)In addition, epidemiologists’ role is essential in
providing informed advice about the potential future health effects of a disaster, in
establishing priorities for action by public health authorities, and in highlighting the

3. 2
need for feasible and timely data collection and analysis as the basis of prompt
decision-making. (7)
The greatest potential for preventing the adverse effects of natural disasters exists
during the pre-impact phase. (1) There are clear correspondence between the concept of
preventive medicine and that of disaster mitigation, which is determined as actions
taken to reduce the consequences of a disaster before it occurs. Thus, during the pre-
impact phase, disaster epidemiology involves delineating at-risk populations
(vulnerability analysis), assessing the level of emergency preparedness and the
workability of the existing surveillance systems, educating defined populations at risk,
and training health and safety personnel. (3, 4)For example, one cannot prevent an
earthquake; however the defined population at risk can be educated about safety
measures in case of an earthquake prior to the actual event.
The critical component of any disaster response is the early conduct of a proper
damage assessment to identify urgent needs and to determine relief priorities for an
affected population. (5) The techniques used to collect information (primarily sample
and systematic surveys and simple reporting systems) are methodologically
straightforward, and if suitable personnel and transportation are available, they should
provide reasonably accurate and rapid estimates of the relief needs of disaster-affected
populations. (5, 6)
During the post-impact phase, information is also needed on the complicated
process of long-term rehabilitation and health services reconstruction. (3) After a
disaster, epidemiologic methods can be used to evaluate the effectiveness of health
intervention programs. Following a natural or man-made disaster, epidemiological
studies should be conducted to identify risk factors for mortalities and morbidities to
develop evidence-based prevention strategies. (7)

4. 3
Natural hazard disasters have been documented for ages. According to data
published by Munich Reinsurance Company, the leading global reinsurance group
worldwide as of 2017, the tsunami struck in 2004 was amounted to the highest
mortality rates worldwide between the years 1980 and 2016. In that event, an
estimated 222,000 people were killed, followed by the mortalities caused by the
earthquake that affected Haiti in January 2010. There were 159,000 fatalities reported
in that event. (8)
According to death toll published by the United States Geological Survey (USGS),
the earthquake in Haiti in 2010 was the deadliest one to occur between 1990 and 2016.
It is also reported that the earthquake in Haiti took 316,000 lives, injured 300,000,
displaced 1.3 million, destroyed 97,294 and damaged 188,383 houses. Sixty percent of
the country’s hospitals and eighty percent of the country’s schools were destroyed. It
was the most destructive earthquake to hit the Caribbean in 200 years, with a
magnitude of 7.0 at its epicenter only 25 kilometers away from Haiti’s capital, Port-
au-Prince. Poor construction practices were to blame for the majority of mortalities
and morbidities. This event revealed that the Haiti’s buildings were not built according
to building code and were not earthquake resistant, due to a lack of licensed building
professionals. High population density was also other defined risk for the fatalities.
One fourth of the country’s inhabitants lived in the Port-au-Prince area, meaning one
half of the country’s population was directly affected by the earthquake. (9)
There were 301 catastrophic events in 2017, including 183 natural disasters and 118
man-made disasters, according to Swiss Re. Natural catastrophes resulted in $138.1
billion in insured losses, while man-made disasters caused $6.2 billion in insured
losses. The deadliest man-made event was a bomb explosion in a mosque in Egypt that
killed 311 people. Terrorism world-wide claimed 731 lives, up from 601 lives in 2016.
In terms of insured losses, major fires and explosion were the costliest with $5.4
billion in losses. The September 11 terrorist attack in the U.S. was the costliest man-
made disaster in history, based on Swiss Re data going back to 1970. It caused 26

5. 4
billion in insured losses (in 2017 dollars). In April 2014 A fire in a garment factory in
Bangladesh resulted in 1,127 deaths, making it one of the deadliest industrial fires in
modern history. (10)
Egypt is susceptible to a variety of natural and man-made disasters. Moreover,
severe accidents and urban disasters are also persistent in the country, that result in
massive disaster situations to a certain extent. During the second half of the past
century, six earthquakes had stricken and the majority of mortalities were reported in
the 1992 strike in Cairo. According to the Egyptian Water Research Centre, Egypt is
expected to experience massive water shortages by the year 2025 that might develop
into a drought. By that time, 60% of agricultural properties will suffer from water
scarcity due to increasing pollution and the rapid increase in population in Egypt. (2)
Several problems affront the concept of disaster management in the country. For
example, the Egyptian population is congested in about 5% of the total country’s
surface area, which would increase the vulnerability of communities and make it
extremely difficult to apply disaster management procedure (e.g. evacuation).
Similarly, high traffic congestion can delay the arrival of support and aid on time to
disaster affected areas. (2)
The roles of specialists in disaster management procedures could be tremendously
augmented through the presence of a disaster manager who can assign, coordinate and
monitor the various tasks in order to ensure maximum efficiency. Also, if a disaster
management activity is partially completed and data regarding duration, cost, and
events that occurred are available; it is possible to refine information about future
potential events and helps to forecast future disaster management activities. (7)
To sum up, results of epidemiologic studies of disasters have not only led to the
scientific measurement and description of disaster-associated health effects, but have
been used to identify groups in the population at particular risk for adverse health
effects, to help emergency managers match resources to needs, to monitor the
effectiveness of relief efforts, to improve contingency planning, and to formulate

6. 5
recommendations for decreasing the adverse public health consequences of future
disasters.
Routes to a better management of disasters in Egypt should be investigated, even as
Standardization of disaster terminology, technologies, methods and procedures,
Development of standardized protocols for gathering information and a Standard
Operating Procedures (SOPs) manual for disaster management where responses,
allocation of resources and action plans are well set and devised. (2,9)

7. 6
References
1) R. Ayothiraman, H. Hazarika, Earthquake Hazards and Mitigation, I.K.
International Publishing House Pvt., Ltd., New Delhi, 2008
2) Abulnour AH, Towards efficient disaster management in Egypt, 2013
3) Disaster Management Guidelines WHO
http://www.who.int/surgery/publications/EmergencySurgicalCareinDisasterSituations.
pdf
4) Queen Disaster Management Standards, Available from
https://www.disaster.qld.gov.au/dmg/Pages/DM-Guideline.aspx acesses [7 September
2018]
5) Malilay J, Heumann M, Perrotta D, Wolkin AF, Schnall AH, Podgornik
MN, et al. The role of applied epidemiology methods in the disaster management
cycle. Am J Public Health. 2014;104:2092–102.
6) van den Berg B, Grievink L, Gutschmidt K, Lang T, Palmer S, Ruijten M,
et al. The public health dimension of disasters – health outcome assessment of
disasters. Prehosp Disaster Med. 2008;23:s55–9
7) Council of State and Territorial Epidemiologists. Environmental health:
disaster epidemiology. Available at: http://www.cste.org/group/DisasterEpi. Accessed
7 September 2018.
8) Munich Re, The 10 most significant natural disasters worldwide by death
toll from 1980 to 2017. In Statista - The Statistics Portal. Retrieved September 8,
2018, from https://www.statista.com/statistics/268029/natural-disasters-by-death-toll-
since-1980/
9) Eberhard, M.O., Baldridge, Steven, Marshall, Justin, Mooney, Walter, and
Rix, G.J., 2010, The MW 7.0 Haiti earthquake of January 12, 2010; USGS/EERI
Advance Reconnaissance Team report: U.S. Geological Survey Open-File Report
2010-1048, 58 p
10) Swiss Re, sigma, 1/2018.

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