Environmental health services in emergency situation

Environmental Health Services in
Disaster and Emergency Situation
Adedotun T. ADEOLU

Disaster
A disaster is a serious disruption of the functioning of
a society, causing widespread human, material or
environmental losses which exceed the ability of the
affected society to cope using only its own resources.
It is a sudden unforeseen occurrence of an event that
causes damage to properties, ecological disruptions,
loss of human life, deterioration of health and health
services on a scale sufficient to warrant extraordinary
response from outside the affected community.
07/19/16 Adedotun T. ADEOLU, Dept of EHS, SAHES, KWASU 2

Features of Disaster
• It is an event
• It affects human beings i.e life, property,
infrastructure and environment
• It disrupts daily life
• It creates a need for external assistance
• It has a causative agent (hazard)
• It often occurs without warning

Types of Disasters
• Meteorological (Extreme weather events): e.g
Floods, cyclones, tornadoes, hurricanes, drought,
snow storms. These occurs regularly.
• Telluric or Tectonic (events related to extreme of
the earth’s geology): e.g earthquakes and volcanic
eruptions.
• Technological e.g chemical and industrial accidents,
oil spills, and radioactive contamination, wars and
civil strife, epidemics of disasters.

CLASSIFICATION OF DISASTERS
Main groups
Man Made
Natural
Overlapping natural and man-made
Nature of onset
Sudden e.g earthquake, tsunamis, storms, accidents
Slow/insidious e.g drougnt, famine, deforestation,
insurgency, epidemics, radiation from nuclear
activities

CLASSIFICATION OF DISASTER
Natural Disaster- event of nature that takes human
lives/and/or destroys property. Examples
Cyclones,
Hurricane
Tornado
Floods
Earthquakes
Drought
Volcanic eruption
Wind/rain storms

MAN-INDUCED
oil spillage
conflict /violence/wars
bombing
fire outbreak
suffocation: indoor air pollution, CO from generating set
pollution
road traffic accident
air traffic disasters
technological accident: Chernobyl disaster
air pollution: smog in winter
707/19/16 Adedotun T. ADEOLU, Dept of EHS, SAHES, KWASU

MAN-INDUCED
rail accident
disease epidemic
water pollution: heavy metals and toxic elements
deforestation: aridity, soil erosion, landslides
siltation: rivers, lakes, water pipes dams
disposal of tailings: mining waste disposal
acid drainage:- source: mines, chemical industries, etc.
destruction of eco-systems : sand-gravel mining,
construction of dams and houses, over-harvesting of edible
animal and plant species
social problems: child labour, weak health care,
immigration problem, overpopulation

Forms of Classification
• Natural-Sudden onset
• Natural-Slow onset
• Man-made-Sudden onset
• Man-made-Slow onset

Forms of Classification
• Natural Slow onset: Drought, desertification,
famine, flood, epidemics-cholera.
• Natural Sudden onset: Earthquakes, volcanic
eruptions, hurricanes, typhoon, landslides, bush
fires.
• Man-made Slow onset: wars, civil strife,
environmental pollution, economic crisis.
• Man-made Sudden onset: Toxic wastes, fires, wars,
oil spillages, transportation accidents, technological
and industrial accidents, terrorism
• Overlap Natural/Man-made: Landslide, drought,
desertification, famine, flood, epidemics and
infestations
• Medical disasters: epidemics e.g Cholera, yellow
fever, meningitis and diseases.

EMERGING DISASTER
Pipeline vandalisation
Kidnapping
Militancy
Religious Riots
Ethnic/Boundary disputes
Climate change
Oil spillage
Communal clash
Political uprising

Characteristics of disasters
•Increase in mortality and morbidity
•Overwhelming of resources
•Local and international stigmatization
•Disruption of social and economic activities
•Panic and confusion among residents
•Losses or deprivation of life
Of health temporarily and permanently
Of social welfare services
Of environmental integrity
Of socio-economic developmental advances e.g
destruction of properties and essential structures

Characteristics of disasters
•Injuries to individuals e.g burn, fractures
•Disruption of displacement of people i.e refugees
•Death
•Increased risk of communicable diseases due to lack
of water, poor environmental sanitation and
overcrowding
•Mental health effects; post disaster syndrome,
anxiety, depression, neurosis.
•Poverty
•Destitution

Some Occurrences of Natural & Man-made Disasters and
Emergencies
SS
NN
NameName LocationLocation PeriodPeriod
11 Jesse Oil Pipeline FireJesse Oil Pipeline Fire
DisasterDisaster
Jesse, EthiopeJesse, Ethiope
WestWest
OctOct
19981998
22 Oil Pipeline Fire DisasterOil Pipeline Fire Disaster WarriWarri 20012001
33 Kerosene ExplosionKerosene Explosion Benin CityBenin City Jan/FebJan/Feb
20012001
44 Kerosene ExplosionKerosene Explosion LagosLagos OctOct
20012001
55 Oil spillOil spill ForcadosForcados 1975,1975,
19791979
66 Oil SpillOil Spill Faniwa wellFaniwa well
blow outblow out
19801980
77 Oil Spill (Mobile IdohoOil Spill (Mobile Idoho
Pipeline BurstPipeline Burst
Quo IboeQuo Iboe
TerminalTerminal
19981998
88 The 6 Air DisasterThe 6 Air Disaster Many locationMany location 2005 &2005 &
20062006
SS
NN
NameName LocationLocation PeriodPeriod
11 Chenobyl Nuclear PlantChenobyl Nuclear Plant
DisasterDisaster
RussiaRussia 19861986
22 Hurricane CatrinaHurricane Catrina BahamasBahamas AugustAugust
20052005
33 Hurricane AndrewHurricane Andrew Florida, USAFlorida, USA 19921992
44 Asian TsunamiAsian Tsunami Some AsianSome Asian
CountriesCountries
DecDec
20042004
55 Nagasaki Spirit DisasterNagasaki Spirit Disaster Nagasaki,Nagasaki,
JapanJapan
19951995
66 Aegian Sea Oil DisasterAegian Sea Oil Disaster La Coruna,La Coruna,
SpianSpian
19921992
77 Exxon ValdezExxon Valdez Prince WilliamPrince William
PortPort
19891989

15
Hurricane Katrina crossing Gulf of Mexico
Yellow/orange/red areas at or above 82°F (27.8°C) –
the temperature needed for hurricanes to strengthen.
(NASA, 2005)07/19/16 Adedotun T. ADEOLU, Dept of EHS, SAHES, KWASU

Major Disasters in Nigeria
• JULY 10 2000, A PIPELINE EXPLODES, KILLING ABOUT 250 VILLAGERS,
WITH FIRES BURNING OUT OF CONTROL NEAR THE TOWN OF JESSE.
• ON JULY 16 2000, AT LEAST 100 VILLAGERS DIE WHEN A RUPTURED
PIPELINE EXPLODES IN THE TOWN OF WARRI.
• NOVEMBER 5 2000, UP TO 200 PEOPLE ARE KILLED WHEN A PETROL
TANKER CRASHES INTO A QUEUE OF VEHICLES AT ILE-IFE, OSUN
STATE, AT AN ILLEGAL CHECKPOINT SOUTHWEST NIGERIA.
• NOVEMBER 30 2000, A LEAKING OIL PRODUCTS PIPELINE CAUGHT
FIRE AT A BEACHHEAD NEAR THE FISHING VILLAGE OF EBUTE NEAR
LAGOS, KILLING AT LEAST 60 PEOPLE.

Major Disasters Cont
• MARCH 6 2001, TWENTY-THREE GIRLS DIE IN A BLAZE AT GINDIRI
GOVERNMENT GIRLS SCHOOL NEAR JOS IN CENTRAL NIGERIA, AFTER
THEY HAD BEEN LOCKED IN FOR THE NIGHT.
• January 2002, AT LEAST 600 PEOPLE ARE DROWNED AND THOUSANDS
MADE HOMELESS AFTER MULTIPLE BOMB EXPLOSIONS AT A NIGERIAN
MILITARY ARMORY TRIGGERED BY AN ACCIDENTAL FIRE CAUSED
MASS PANIC.
• MAY 4 2002, A NIGERIAN EAS AIRLINES' BAC 1-11-500 WITH 105
PEOPLE ON BOARD CRASHED INTO THE NORTHERN

• June 19 2003, A Nigerian oil pipeline punctured by thieves
explodes north of the Abia state capital Umuahia, killing 125
villagers.
• September 7 2003, At least 70 people are killed in a crash and
resulting fire involving a passenger bus and three other vehicles
near the Murtala Muhammad bridge on the Abuja-Lokoja highway.
• October 9 2003, At least 100 people drown when the Kuntu-Borong
ferry, traveling from Numan in Adamawa state to Jen in Taraba
state, hits a pillar of the Numan bridge and capsizes
• September 17 2004, Dozens of people are killed in a petroleum
pipeline explosion in the commercial capital Lagos. The explosion
happened as thieves tried to siphon petrol from a pipeline
belonging to state oil company NNPC.

• October 23 2005, Bellview Airlines Boeing 737 with 117 on board crashes
shortly after take-off from Lagos.
• December 10 2005, A passenger jet crashed on landing at the airport in the
city of Port Harcourt. Over 100 dead including 50 school children.
• Sept 18 2006, 10 generals among 12 killed in plane crash The plane had 18
people when it crashed Near Obudu in Cross River State.
• ADC plane, Boeing 737, with 104 persons
including Sultan Abubakar on board,
crashed near the Abuja airport shortly
after takeoff and burst into flames

•1st
October 2010 Abuja Bomb blast that killed over 12
persons and injured about 80 persons
•The 2010 Christmas eve Jos multiple bomb blasts that
killed over 32 persons and injured several others
•The 29th
Dec 2010 Abuja - Mugahiru Barrack Bomb blast
that killed about 5 persons and injured about 2 dozens
of others.

EMERGENCY
Can be described as a localized event within a
community that affects a limited number of
individuals or property when there is a definite
degradation in the resilience of a community in
terms of a threat that contributes to vulnerability.
A situation when an event threatens National
security.

THE “CRUNCH” DIAGRAM
Vulnerability
(exposure) Hazards
(trigger events)
D= H X V

RISK
The probability of harmful consequences, or expected
losses (lives lost, persons injured, damage to property
and/or the environment, livelihoods lost and
disruptions of economic activity or social system) due
to the interaction between humans, hazards and
vulnerable conditions.

RISKS-THE NIGERIAN SITUATION
Natural & Environmental risk
Geographical risk
Drought/Desertification
Flood
Soil Erosion
Fire
Pests
Coastal Erosion
Ocean surge
Deforestation
Pollution
Epidemics, storms.

SOCIAL ECONOMIC ASSOCIATED RISKS
-Religious/ethnic/border conflict
-Unemployment
-Corruption
-Urbanization
-Decline in Economic Act
-Unstable polity

Risk equation
•Risk = Hazard x Vulnerability
Level of Preparedness
•Risk Reduction:
- Prevent hazards from creating risks
or
- Lessen the distribution, intensity/ severity of hazards.

HAZARD
A potentially damaging physical event, phenomenon
or human activity, which may cause the loss of life
or injury, property damage, social and economic
disruption or environmental degradation.
For each hazard;
• What? - Natural, impact, severity
• Where? – Likely areas
• When? - Frequency, time and duration
• Potential growth
• Collection information:
records, maps, scientific data, reports( including
others) local experience
Analyse- produce hazard profile
Maps-GIS

VULNERABILITY
Set of prevailing or consequential conditions resulting
from physical, social, economical and environmental
factors, which increase the susceptibility of a
community to the impacts of hazards.
Vulnerability situation
Examples:
Slums situation malaria, typhoid, cholera etc.
Crowded environment CSM, measles,
whooping cough and spread of other communicable
diseases

Vulnerability
• An element’s vulnerability (fragility) is the result of a
community’s actions or nature’s actions that change
the destructiveness of the storm
Mankind’s contribution
• An element’s vulnerability (fragility) is the result of
flaws that enter during the planning, siting, design, and
construction of a community’s buildings and
infrastructure
• Urban development or industrial development alongalong
coastlines prone to severe windstorms that generatecoastlines prone to severe windstorms that generate
storm surges, high-velocity wind, and heavystorm surges, high-velocity wind, and heavy
precipitationprecipitation

Predisposing factors to disasters
Environmental factors
•Increasing deforestation
•Industrialization and urbanization
•Global warming and sea level rise
•Environmental degradation
Economic development
Level of socio-economic

Vulnerable groups
•Age
•Gender
•Poverty
•Educational levels
•Previous general health conditions of health
•Environmental conditions
•Culture of the people
•Geographical location
•Nature and the peculiarity of specific disasters

CAPACITY/MANAGEABILITY
Is the characteristics of a person or group in terms of
their ability to anticipate, cope with, resist and recover
from the impact of hazards.
CAPACITIES
Institutional Capacity fire hydrants, in
companies
& city, sick bays
Personal Capacity fire extinguishers in cars
& homes/offices,
raincoats/umbrellas
Municipal/Governmental hospitals/clinics in
cities and towns

Disaster Management
•Disaster management is the body of policies,
administrative decisions and operational activities
which pertain to various stages of a disaster.
•This is essentially an inter-sectoral activity and the
contribution of all sectors are crucial for its total
success.

DISASTER- MANAGEMENT CYCLE
Emergency
(Alertness + Defense) Response/ Relief
Preparedness
Mitigation/ Rehabilitation
Prevention
Reconstruction
Pre-disaster: risk reduction Post-disaster recovery
Disaster

Disaster Management- A developmental
approach
• Appropriate actions at all points of the cycle lead to greater
preparedness, better warnings, reduced vulnerability or
prevention of disasters during the next iteration of the cycle.
• The objectives of the such an approach are to reduce
hazards, prevent disasters and prepare for emergencies.
Aims and Objectives
• Reduced (or total avoidance of , if possible) potential losses
from hazards
• Assurance of prompt and appropriate assistance to victims
when necessary
• Achievement of a rapid and durable recovery.

Options
• Reduce hazards to the barest minimum
• Reduce man’s environmental vulnerability
• Combination of the two above and promotion of well being
of the general population.
Capacity for Disaster Management
Based on
• Information
• Authority
• Institutions
• Partnerships
• Plans, resources and procedures to activate them

Principles of Disaster Management
•These focus on the desirable outcomes while
considering the disaster profile of the area and the
population at risk
•It is essential to obtain all the essential information
required about previous disasters and determine
how best the information is made useful for future
programmes
•Such information includes hazard mapping,
vulnerability analysis, health care resource
inventories and manpower resources

RISK ASSESSMENT
• A risk assessment involves the probabilistic
integration of:
• The hazard (severe windstorms) and their potential
disaster agents (winds, storm surge, etc) that are
directly related to the location of the community and
the path/size of the storm.

HAZARDSHAZARDS
ELEMENTS OF A SCENARIOELEMENTS OF A SCENARIO
EXPOSUREEXPOSURE
VULNERABILITYVULNERABILITY LOCATIONLOCATION
RISKRISK

NATURE’S CONTRIBUTIONS THAT
INCREASE VULNERABILITY
•Increased earth’s temperature
•Warm ocean/sea water
•Acidic or porous soil structure

Emergency
Preparedness
Prevention
Reconstruction
Disaster

Mitigation
• Mitigation : Knowing the types of disasters that can occur,
where and when goes a long way in thinking through and
planning how to mitigate hazards and their effect
• Mitigation can be primary or secondary
• Primary mitigation involves reducing the presence of the
hazards or vulnerability
• Secondary mitigation focuses on reducing the effects of
the hazard (preparedness)

Reduction of the hazard
•Reduction or elimination of all hazards would be
ideal but this is not possible for all hazards,
however early warning could be obtained e.g. flood,
hurricane and tornado warnings
•At the extreme is the fact that some hazards are
completely unpredictable. e.g. earthquakes

Reduction of Vulnerability
•Similarly, vulnerability could be reduced but hardly
ever to an absolute zero for most populations.
•This is another aspect of mitigation.
•In technologically advanced countries a lot has been
done in this area and their populations tend to be less
vulnerable compared to those in the less developed
countries.
•However there are still multiplicity of factors which
cannot be easily controlled.

Emergency
Preparedness
Prevention
Reconstruction
Disaster

Disaster Preparedness
•Since disasters cannot be avoided or easily
reduced, the best approach is to prepare
(adequately) for the them.
•This is the focus of achieving desirable outcomes,
having been armed with all necessary information
such as the disaster profile of the area, and
considering the capability and resources available
to achieve the set objectives

•Entails taking measures that ensure the organized
mobilization of personnel, funds, equipment and
supplies with a safe environment for an effective
relief.
•These measures are policy, administrative
decisions, and operational activities which pertain
to various stages of a disaster at all levels.

•The aim of preparedness programmes is mainly to
minimize the adverse effects of a hazard through
precautionary actions and to ensure timely,
appropriate and efficient organization and delivery of
relief.
•Plans for these programmes are drawn up, usually
during the non/inter-disaster period.
•A large component of the plans are also implemented
during the non- disaster phase either as precautionary
activities or in anticipation of a disaster.

Focus for Disaster Preparedness
1. Manpower resources: Community education and
training for action during the emergency and relief
phase.
2. Material resources: Mobilization of needed supplies
and other materials, identification of sources of certain
supplies for use during the emergency phase.
3. Funds are either set aside or easily mobilize for use in
the event of it being required to facilitate relief.
4. Management of the environment: Policy guidelines
and administrative procedures designed to
accommodate a management option for effective
implementation of preparedness plans before, during
and after a disaster.

Disaster Preparedness Cont’d
•Intersectoral collaboration is crucial from the
planning stage for success as implementation of
plans cuts across sectoral and community lines.

Framework for Disaster Preparedness Programmes
1. Planning: Preparedness plans should have clear
objectives with roles and responsibilities also clearly
spelt out. As much as possible this should be an
integrated plan, involving all relevant sectors of the
economy, and the community
2. Hazard and vulnerability assessment: This is to
determine what impact should be expected with certain
hazards and what could be done about them
3. Information system: A viable and effective information
system which ensures feedback should be aimed at.

4. Resource base: Preparedness programmes should identify
resources for use and from where they could be obtained
for preparedness and response phase of disaster
5. Early warning system- A valid reliable and functional
warning system is essential though not applicable to all
disasters.
6. Public information, education and training:
• The ultimate purpose is to ensure that affected
communities can play their expected role in the case of
disaster.
7. Rehearsals and drills: Serve the purpose of sharpening
skills and testing systems.
• Drills give the opportunity to identify gaps and refine
plans.

8. Response mechanisms: i.e. activating that
portion of the preparedness plans which deals
with the relief phase, after impact.

Emergency
Preparedness
Prevention
Reconstruction
Disaster

Post-Disaster Recovery
•Response/Relief
•Rehabilitation
•Reconstruction

Balancing Response to
Disaster
Victims
Needs
Disaster
Available
Services

Relief
A set of activities implemented after the impact of a
disaster in order to
•Assess the needs
•Reduce suffering
•Limit the spread and consequences of the disaster
•Open the way for rehabilitation

Emergency Response
• Emergency response is the phase of the disaster
management cycle which often attracts the most attention
and resources.
• However the impact achieved in the early days of response
is largely a test of the previously planned local and national
response.
• Much of what contained in preparedness plans are designed
to give relief and assist the affected populations(s) to
recover during this phase.
• During the response phase, activities are implemented after
the impact of the disaster and can be summarized under
the following broad categories

Objectives of Response
•Assessment of needs
• Rapid initial assessment
• Detailed assessment
•Reduction of suffering
•Limiting the spread and consequences of the
disaster
•Opening the way for rehabilitation

Detailed Activities
1. Warning
2. Evacuation
3. Search and rescue
4. Assessment
5. Emergency relief –
Health, food, shelter
and social welfare
services
6. Logistics and supplies
7. Communication and
information management
8. Survivor response and
coping
9. Security
10. Emergency management
and co-ordination
11. Expedition of
rehabilitation and
reconstruction

Response
•Warning/Alert – The authorities should be
informed I.e. the Local government chairman, the
MOH/ PHC coordinator, armed forces, fire service
etc.
•Evacuation – Temporary transfer of a population
(and to a limited extent property).

Response
• Search and rescue - People may be trapped at
the site of the disaster, there is a need to search
for them and bring them out .
• The wounded must be found and given first aid
• Assessment - In terms of percentage of the
population affected, medical needs, degree of
personal damage, assessment of the risk of
secondary infection, the progression of the
disaster.

Emergency Assessments
Allow the following
- A decision to be made on whether local capacity is
required or external resources are required
- Priorities for intervention to be established
- Necessary resources to be identified
- Baseline data to be collected
- Information to be collected for fund raising and
advocacy

Transport for search and rescue
•Ambulances
•Taxis
•Private cars can be used for the rescue.
•Helicopters can be used to evacuate seriously
injured people.
•Trucks

Transportation Needs For
• Moving assessment and operational teams
• Road clearance
• Moving people affected by disaster
• Moving human bodies
• Moving animal corpse
• Disposing of other waste and debris.

Public Health Interventions
• Public health interventions and specific disease
control measures are a priority for reducing
morbidity and mortality in disaster affected
communities.
Main strategies
1. Adopting a multi-sectoral and preventive
approach.
2. Involving refugees in planning and
implementation
3. Specific needs of refugee children.

Strategies
• Children below 5 years constitute 15-20% of
refugees. And are the group at greatest risk of
increased mortality.
4. Meeting the needs of refugee women.
• Refugee women play a key role as primary health
care providers for the whole family.
• At the same time bear the brunt suffering and
hardship.
• They need to considered as an integral part of all
aspects of planning and delivery of health-related
services.

Strategies
5. Setting up an appropriate health and nutrition
information system.
• Reliable collection, analysis and interpretation of
basic information on health and nutrition are
essential prerequisite for effective planning, delivery
and evaluation of a primary health care programme.
6. Ensuring complementarity and effective co-
ordination among all partners.
• Quite often the efforts of the partners are
duplicated in certain areas, while some other areas
are neglected.

Services needed during Response/relief
•Medical & paramedical,
•Fire service, Army and police
•NGOs- Red Cross and Red Crescent Societies
•Media,
•National Emergency Management Agency
•UN agencies.

Priorities in early phase of emergency
1. Assess the situation
2. Water sanitation environmental hygiene and
shelter
3. Food and Nutrition
4. Health Services
5. Shelter and site planning
6. Health Education
7. Surveillance and control of communicable diseases
and epidemics

Assess the situation
• Find out how many displaced persons there are,
particularly women and young children
• Identify risk factors that increase the risk of
diseases
• Find out about people’s health needs and
priorities
• Assess the environment where the population
has settled, including water supplies, sanitation,
food supplies, malaria transmission, etc

Water sanitation environmental hygiene & shelter
•Provide clean water
•Distribute water containers and soap.
•Establish systems to dispose of garbage , medical
waste and dead bodies.
•Improvements in water and sanitation are often
the first priority.
•Direct contamination of water can occur where
unprotected surface water supplies are used or
where there is no control of sanitation

Food and Nutrition
•Provide general food rations and identify vulnerable
groups who require supplementary feeding
programmes
•Identify and treat children with malnutrition

Health Services
•Decide on essential drugs, case definitions and
standard treatment guidelines.
•Treat common diseases
•Establish referral system

Shelter and site planning
•Provide shelter and blankets.
•Plan citing of shelters to minimize overcrowding.
Overcrowding results in increased transmission of
both person to person transmitted disease such as
measles, meningitis,tuberculosis and vector
diseases such as louse borne typhus.
•The quality of housing is also important particularly
where the climate is harsh.

Health Education
•Find out about people’s beliefs, attitudes and
customary practices .
•Conduct community education with participation of
community leaders

Surveillance and control of communicable
diseases and epidemics
•Encourage the use of insecticide treated bed nets.
•Immunize all children against measles if there is risk
of disease outbreaks
•Monitor rates of illness and death to give early
warning of epidemics
•Prepare contingency plans and stocks of ORS and
vaccines
•Confirm outbreaks, conduct, investigations, plan
and implement control measures

Role of Hospitals in Response
• Hospitals are usually situated in densely populated
areas and during disasters people gravitate to the
hospitals.
• The management of mass casualties can be divided
into 4 sections
1. Rescue/First aid : everyone must be trained to
administration of first aid

Hospital Organization
2. Hospital organization
• Minor plan: has to do with few casualties not more
than 100.
• It should be simple aiming at taking care of the
few casualties with optimal use of hospital
facilities.
• Major plan: All other patients apart from the
seriously sick are discharged from the hospital and
room is made for the casualties from the disaster.
• Specialists and other doctors are invited.

Role of Hospitals
3. Diagnosis:
• Proper diagnosis of the different conditions must made.
• The patients must be sorted out according to urgency of
their condition.
• Those in shock must be observed for a few hours until
they stabilize, those with lacerations, open wounds, etc
should be treated and those in coma attended to by the
relevant specialist.
• Those who are seemingly calm must also have the vital
signs observed as the may have sustained to an internal
organ e.g. spleen and haemorrhage internally.

Role of Hospitals Cont’d
4. Treatment: May be minor or major, surgical
and /or medical, depending on the diagnosis .
5. Housing of victims/patients: The hospital wards
may be insufficient so other buildings will need
to be turned to wards to accommodate these
victims.

Drugs and medical supplies
• There is a standard drug list that has been
developed by the Red Cross and Red Crescent
societies, WHO, UNICEF and other NGOs
• This is the list is recommended for use in disaster
situations

Refugees
• A refugee is someone with a well-founded fear of
persecution on the basis of his or her race,
religion, nationality, membership in a particular
social group or political opinion, who is outside of
his or her country of nationality and unable or
unwilling to return
• Refugees are forced to leave their countries by
war, civil conflict, political strife or gross human
rights abuses.

Problems of Refugee Camps
•Restrictive
•Inadequate accommodation
•Overcrowding
•Small quantities of food supplied irregularly
•Poor environmental sanitation
•No defined plans for long term settlement provided
for the refugees.
•Poor funding

Problems of Refugees
•Frustration
•Violence
•Unemployment
•Poverty
•Lack of access to adequate health services and
drugs
•Rape

Issues Limiting Prompt response to Disasters
• Poor telecommunications.
• Poor electricity supply
• Limited capacity of local officials to detect problems
early which is the first step of forecasting and
designing adequate responses.
• The main emphasis has been on training of health
personnel who have received training on syndromic
recognition of frequently occurring epidemics such
as cholera and CSM.

Issues Limiting Prompt response to Disasters Cont’d
•Lack of regular up to date data from the disease
notification exercise
•Even when the disaster occurs there is lack of
sufficient information about the affected
populations to make emergency response planning
effective and the response and relief is often
inexact.
•The fatalistic attitude that God determines
outcomes and lack of the understanding about
early treatment interventions and containment
with vaccines.

Issues Limiting Prompt response to Disasters Cont’d
•Nigeria’s national capacity to respond to disasters is
still quite limited
•Few localities have functioning fire departments,
ambulances, referral health care facilities or
emergency stocks.
•These deficiencies have been evident in the fire
brigade approach by the authorities when disaster
have occurred in the country

Emergency
Preparedness
Prevention
Reconstruction
Disaster

Rehabilitation and Reconstruction
•Rehabilitation – The restoration of basic social
functions
•Reconstruction- The full resumption of socio-
economic activities plus preventive measures

Procedures in Disaster and Emergency
Management•Development and production of disaster and emergency
management plan
•Adoption of disaster and emergency preparedness and
response strategies
•Advocacy and public enlightenment
•Training and capacity building
•Mobilization of needed resources

EH Services in Disaster & Emergency
Situations• Environmental health practitioners, indeed EHOs, working with and
alongside other public health professionals, are key partners in local
and national efforts to protect and improve the health and quality of
life of individuals and communities and to reduce health inequalities
especially during disasters and emergencies.
• They will maintain a direct relationship with the general public, and
apply their expertise in responding to the needs of individuals, while
tackling the wider determinants of health by identifying, controlling
and preventing current and future risks during disasters and
emergencies.
• EH practitioners will play lead roles in coordination and
implementation of community health and wellbeing programs to
bring succour to the affected in time of crisis.
• EH will regulate, develop strategy and carryout advocacy/ brokerage
on behalf of individuals, local communities and neighborhood
(Green, Courage & Rushton, 2003.

EHS in Disaster & Emergency Cont.
Pre-disaster Activities
•develop EHS in emergency policies
•develop of environmental health safety regulations
•review environmental health development policies
•assess vulnerability and capacity of local communities
•map hazard and possible pollution and outbreaks
•assess environmental health needs
•train personnel
•involve in National or state or LGA emergency planning
process
•institutionalize early warning system

During Emergency
• organize emergency assessment
• organize evacuation
• provide environmental health services on evacuation route
• set up standard for settlement in evacuation
• strengthen health services in host community
• provide EHS in search & rescue operation
• ensure adequate medical services and referrals
• manage personnel, including volunteers
• manage equipment, funds and supplies
• manage logistics
• manage information and communication
• educate the affected and reassure them

EHS in Disaster & Emergency Cont
(Technical)
Water
•ensure the provision of adequate potable water
•carry out water quality monitoring & surveillance
•develop emergency water supply strategy
•carry out assessment of damage and available
water resources
•determine water movement, storage and
distribution

Technical Aspect cont.
Sanitation
• ensure prompt disposal of human waste
• use appropriate method for disposal of human waste, eg defecation
field, shadow trench latrines, deep trench latrine and simple pit
latrine
• adopt appropriate sullage disposal method
• ensure personal hygiene
• ensure proper storage and disposal of solid waste, medical waste and
rubbles
• carry out education of the public on sanitation

Food safety
•institute food control measure
•inspect food premises
•control donated and imported food items
•control mass-feeding centre
•encourage breastfeeding
•carry out education of the public on food safety

Vector & pest control
•embark on pest and vector control
•carry out education of the public on the control
pest & vector
•carry out disinfection and disinfestations

Control of Communicable Diseases and Prevention and
Prevention of outbreak
•carry out surveillance
•investigate outbreak
•carry out education of the public on the control of
communicable disease and prevention of outbreak

Tracking Chemical in the Environment
•assess possible chemical risk in the environment
•determine toxic effects of chemicals
•carry out EHIA
•liaise with local the local community
•work toward reducing the risk of chemical incidents
•advise on protection against chemicals
•organize sample collection and registration of samples
•undertake environmental monitoring
•communicate and inform the public
•carry out education of the public on chemicals in the
environment

Radiation Emergencies
• determine health consequences of radiation
• carry out education of the public on radiation and health
Mortuary Service and Handling the Dead
• recover and identify the dead
• organize mortuary service
• handle the dead
• burry the dead

Health Promotion and Community Participation
•define the contents of the health promotion
•identify health promotion materials
•develop message
•carry out health promotion and education and all
aspect of environmental health
•involve community members and encourage their
participation in what your are

After disaster
• Impact assessment
• Environmental clean-up
• Environmental/ social/ health audit
• Rehabilitation
• Preparedness for future disasters and emergencies

Constraints in the Provision of EHS during
Disaster and Emergency Situation
weak institutional arrangement
lack of adequate information and poor linkages
lack of adequate skills by the practitioners
lack of appropriate equipment
negative attitude some other professional groups behaving as if they
have more to offer than others
lack of adequate resources

Measures to Prevent Future Hazard
• Preparedness Planning : involves contingency measures to cope
with the emergency when it occurs .
• Mitigation Planning: involves the long-term control of land use,
building stock quality and other measures to reduce the impact of
a hazard when it eventually strikes. It also include identification of
facilities for management of risk reduction like shelters, schools,
hospitals, water supply, food supply, etc.
• Fundamental to these planning processes is an understanding of
what to expect. This needs to be quantified, if only in a crude and
approximate way, in terms of the degree of risk faced, the size of
event that is likely, and the consequences of an event if it occurs.
• Risk Assessment is a scientific-based process of hazard
identification, hazard characterization and exposure assessment,
including population most at risk, eg population below poverty
line, the aged, children, household without vehicles, etc.

Measures to Prevent Future Hazard
Cont.
• Vulnerability Assessment is the process of identifying and
quantifying vulnerabilities is a system.
• Scenario Mapping: presentation of the impact often used to
determine the magnitude and to estimate the resources likely to
be needed to handle an emergency. From these can be
estimated the resources needed for medical attention, to reduce
disruption in normal livelihood, accommodation for homeless,
and minimization of the recovery period.
• Potential Loss Studies: estimation of populations/ communities
likely to suffer heavy losses from hazard, to undertake priorities
for loss-reduction programs, and to determine those likely to
need most aid or rescue assistance in the event of a major
disaster, including economic quantification.

Prediction
•Data collection, analysis, interpretation &
utilization, (Interdisciplinary approaches will be
needed to tackle cross-cutting issues and make
proper decisions and application of data, e.g Health
and climate, Health and biodiversity, & Health and
disasters)
•Development of early warning system, (Leveraging
and connecting existing tools and data services);

Example of tools & methods for prediction
• Epidemiologic Modelling and Forecasting;
• Sand & Dust Storm Warning System; and
• Geo-informatic (Geo-informatics is a science which develops
and uses information and science infrastructure to address
the problems of geosciences and related environmental
issues.
It combines geospatial analysis and modeling, development
of geospatial databases, information systems design,
human-computer interaction and both wired and wireless
networking technologies.
Geo-informatics technologies include GIS,
spatial decision support systems, global positioning systems
(GPS), and remote sensing.

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Environmental health services in emergency situation

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