Disasters preparedness and response in Papua New Guinea, 13° National Nurses Research Symposium

1. DISASTER NURSING
PREPAREDNESS & RESPONSE
Francesco Barbero, RN CCNS
International SOS (Niugini)

2. 2
‘Disaster’
A serious disruption of the functioning of a community or a
society involving wide spreading human, material, economic,
or environmental losses and impacts, which exceeds the
ability of the affected community or society to cope using its
own resources.
- United Nations International Strategy for Disaster Reduction (UN ISDR)

3. 3
Natural Disasters
3

4. 44
Human-made Disasters

5. 5
Complex Emergencies
5

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Disaster
- Great damage
- Loss of life
Natural hazards
- Usually inevitable
- Potential harm if no mitigation strategy
Natural Disasters?
6

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Why
does
it
matter?

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EM-DAT: The OFDA/CRED International Disaster Database - www.emdat.be - University Catholique de Louvain, Brussels, Belgium
Natural Disasters

9. 9
PNG ranks in the top six countries for the highest percentage
of population exposed to earthquake hazard and has the
highest percentage of population exposed to severe volcanic
risk.
- GFDRR PNG Country Profile, 2013

10. 10
volcanoes, 21%
landslide, 16%
epidemics, 10%
cyclones, 10%
tsunami, 3%
drought, 1%
wildfire, 1%
earthquake, 16%
floods, 22%
Papua New Guinea
OFDA/CRED www.emdat.be
° Including Volcanic events from 1900
1955-2015°

11. People affected (%) 11
drought, 69%
volcanoes, 6%
cyclones, 6%
earthquake, 1%
floods, 16%
Papua New Guinea
OFDA/CRED www.emdat.be
° Including Volcanic events from 1900
1955-2015°
tsunami, ?%

12. 12
volcanoes, 49%
cyclones, 3%
earthquake, 1%
floods, 1%
tsunami, 30%
drought, 1%
landslide, 8%
Deaths (%)
epidemics, 6%
Papua New Guinea
OFDA/CRED www.emdat.be
° Including volcanic events from 1900
1955-2015°

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“To further advance the Disaster Risk Management agenda,
priorities include addressing … the lack of available historic
natural hazard data, which hinders the assessment risks.”
- GFDRR PNG Country Profile, 2013

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Mitigation
- Pre disaster mitigation efforts
Preparedness
- Education and training
- Business continuity & emergency management planning
Response
- Immediate assistance
- Establish command and control
Recovery
- Ongoing assistance
- Restoration and reconstruction
Phases of Disaster

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Disaster cycle
Preparedness
Mitigation
Response
Recovery
Disaster

16. Disaster Healthcare
• preparedness & planning
• response
• recovery
(aka Disaster Medicine)
Disaster cycle
Physicians, Nurses, HEOs, HCWs, Hospital
Administrators, Governments & Policy-makers
16

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Disaster Nursing
Disaster nursing can be defined as “the adaptation of
professional nursing knowledge, skills and attitude in
recognising and meeting the nursing, health and emotional
needs of disaster victims.”

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“Nurses are often the first medical personnel on site after
disaster strikes. In these situations where resources are
scarce, nurses are called upon to take roles as first
responder, direct care provider, on-site coordinator of care,
information provider or educator, mental health counsellor
and triage officer.”
- Dr Eric Laroche, WHO Assistant Director for Health Action in Crises (2008)

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The overall goal of disaster nursing is to achieve the
best possible level of health for the people and the
community involved in the disaster, where professional
supplies, equipment, physical facilities and utilities are
limited or not available.

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• Risk reduction, Disease prevention and Health promotion
• Policy development and Planning
• Ethical practice, Legal practice and Accountability
• Communication and Information sharing
• Education and Preparedness
• Care of Communities, Individuals and Families
• Psychological care
• Care of Vulnerable Populations
• Long-term Care Needs
- WHO/International Council of Nurses, 2009

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Disaster Nursing
Asia Pacific Emergency and Disaster Nursing Network
• Tools, materials and training programmes in emergency
and disaster nursing education, services and research
• Best-practice and evidence-based guidelines for disaster
nursing practice
• Cooperation with ICN and WHO for DN competencies

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Nurses…
• Save life by managing emergencies in all settings
• Take responsibility for providing health services to clients in all settings
• Support clients and significant others in illness and other stressful
situations
• Use professional judgment in carrying out nursing and/or medical
interventions
• Ensure that clients receive safe and adequate treatment/care as a
moral and professional obligation
The Code

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The Competencies
Management of Care
• Acts appropriately to protect self and others in crisis/emergency/
disaster situations
• Participates in management of emergency and disaster situations
• Utilizes resources effectively and efficiently in providing care
• Conducts formal and informal education sessions with clients/groups

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• Uses a structured approach in the process of assessment, delivery and
evaluation of health promotion and health education for individuals and
groups
• Participates in health promotion
• Assists in management of epidemics
Public Health and Health Promotion
• Recognises the role of each member of the team in the delivery of
healthcare
• Establishes and maintains working relationships with all members of
the healthcare team
• Participates with other members of the healthcare team and clients/
groups in decision making
Partnership with Community and Services
The Competencies

25. Disaster Healthcare
• healthcare to disaster survivors
• management of victims
• preparedness
• planning
• response
• recovery
(aka Disaster Medicine)
Disaster cycle
25

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Phases of the disaster response
search and rescue

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Phases of the disaster response:
triage and stabilization
of victims

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Phases of the disaster response:
hospital treatment
GCU AMPS (ITA) - HAITI 2010

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Phases of the disaster response:
evacuation of patients to other hospitals

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The ability of a health service to expand beyond normal
capacity to meet an increased demand for clinical care.
- WHO/EU, Hospital Emergency Response Checklist
Surge Capacity
Staff
Stuff
Structure System
Space

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Effects on the Health Care system
Hospitals, clinics and their personnel may also become
victims of disasters. Even when not directly affected,
damage to external infrastructure that the health system
relies upon can compromise its services.

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Effects on the Health Care system
Healthcare Facility Public Private Total Density per
100,000 pax
Regional hospital 3 4 7 0.096
Provincial hospital 19 n/a 19 0.260
District hospital 89 n/a 89 1.216
CT Scan 1 2 3 0.410
WHO, Global Atlas of Medical Devices - 2014

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1. Malaria
2. Occupational risk burden
3. Water
4. Hygiene
5. NCDs
6. Sanitation
7. Hepatitis B
8. WaSH mortality
9. MMR
10. Air pollution mortality
11. Disaster

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Disaster
Management
Cycle
Emergency care

36. A field hospital is a mobile, self-contained and self-
sufficient health care facility capable of rapid
deployment and expansion or contraction to meet
immediate emergency requirement for a specific period
of time.
Foreign Field Hospitals
36

37. GCU AMPS (ITA)

38. ANA AMPS (ITA)

39. • request from the authorities of
an affected country
• as part of the local health
services
• when roles and responsibilities
have been defined (eg. MOU)
Field Hospital deployment:
WHO, 2003
39

40. Use of Field Hospitals:
1. Early emergency medical care (incl. ATLS) - first 48 hrs
2. Follow-up of traumas/emergencies and routine health care - day 3 to 15
3. Temporary facility to substitute damaged installations - day 30 up to 2 yrs
40
SAMUR MADRID AMPS (ESP)

41. GCU AMPS (ITA) - HAITI 2010

42. ARES AMPS (ITA) - PHILIPPINES 2013

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The Cluster Approach

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“Nurses and national nursing associations in
every nation (must) assume a leadership role
in efforts to prepare their countries and
regions in the event that disaster strikes”
- Dr Hiroko Minami, ICN President 2007

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47. CIVES FIELD CLINIC (ITA)

48. Thank you for your attention!