1. HEALTH IMPACTS
IN DISASTER
Glen Glady Prakasa, MD
Disaster Management laboratory
Faculty of Medicine Jendral Achmad Yani
University
ggprakasa@gmail.com
+6282221332009
2. INTRODUCTION
Disasters affect a community in numerous ways. Roads, telephone lines, and other
transportation and communication links are often destroyed. Public utilities and energy supplies
may be disrupted.
Substantial numbers of victims may be rendered homeless. Portions of the community's
industrial or economic base may be destroyed or damaged.
Casualties may require medical care, and damage to food sources and utilities may create
public health threats.
3. The more remote the area, the longer it takes for external assistance to arrive. In that case the
community will have to rely on its own resources.
Good disaster management requires accurate information and must link data collection and analysis
to an immediate decision-making process.
The overall objective of disaster management from a public health perspective is:
•to assess the needs of disaster-affected populations,
•to match available resources to those needs,
•to prevent further adverse health effects,
•to implement disease control strategies for well-defined problems
4.
5. public health emergency preparedness
(PHEP)
- Definition of Disaster Management according to Indonesia’s law No. 24 of 2007 is “implementation of
disaster management is a series of efforts that include the establishment of development policies that are at
risk of disaster, disaster prevention activities, emergency response, and rehabilitation”
- A dynamic, integrated and sustainable process to improve the quality of measures related to handling, is a
series of activities that include prevention, mitigation, preparedness, emergency response, rehabilitation and
rebuilding.
- Public health responses to disasters, and disasters themselves in general, must be addressed with a sustainable
and comprehensive approach. Sustainable in the sense of starting from before the disaster with a good and
accurate early warning system to post-disaster handling with the reconstruction of health facilities and
services. Comprehensive covers various aspects of physical, mental, social, and economic, as the definition of
“healthy” contained in law no. 36 of 2009 on health
6. public health emergency preparedness (PHEP) is the capability of the public health and health
care systems, communities, and individuals, to prevent, protect against, quickly respond to, and
recover from health emergencies, particularly those whose scale, timing, or unpredictability
threatens to overwhelm routine capabilities.
Preparedness involves a coordinated and continuous process of planning and implementation
that relies on measuring performance and taking corrective action. In developing the definition,
we considered what constitutes a public health emergency, what public health emergency
preparedness requires, and who is involved in it.
7. PHEP should include a full range of prevention, mitigation, and recovery activities, not just those
designed to enable responses to events. It also involves operational capabilities—the ability to
quickly execute preparedness tasks. Although possessing capabilities requires capacity
(infrastructure, personnel, plans, and so on), capacity alone does not ensure readiness. PHEP is
not a steady state; it requires continuous improvement, including frequent testing of plans
through drills and exercises and the formulation and execution of corrective action plans. PHEP
also includes the practice of improving the health and resiliency of communities
8. Health Emergent
The consequences of health problems can potentially paralyze the ability to live day-to-day
community because:
- Scale beyond limits
- Sudden or protracted time
- Unexpected at all
- Not just focus on momentary disasters
- Optimal development of community capabilities in all circumstances
- Better prepare communities for potential disaster risks
13. Health Impacts
1. Injuries
In the immediate aftermath of a natural disaster, injuries are the first impacts that must be addressed. Community health workers may need to set
up temporary triage areas to treat the wounded, depending on how severely local infrastructure has been affected. Earthquakes tend to result in the
highest number of injuries, compared to other events such as tsunamis, floods, storms, or wildfires.2
2. Chronic Disease Emergencies
While some natural disasters have a high rate of injuries, most result in power outages and infrastructure damage that lead to trouble for patients
suffering from chronic diseases. Those living with diabetes, kidney disease, lung disease, or other conditions requiring constant care will often be
the first to suffer if healthcare services are interrupted.
3. Hygienic Impacts and the Spread of Disease
When a natural disaster destroys infrastructure such as roads, water pipes, and gas lines, additional potential health impacts emerge. Contaminated
water and the lack of a functioning sewer system can result in the spread of disease. Sustained power outages can cause food shortages, lost
medicine, and the inability to run healthcare facilities safely.
14. 4. Food and water Shortages
One short-term consequence of natural disasters that can stretch into a long-term problem is the issue of food shortages. While the disaster itself
might have interrupted supply logistics in the area, damage to farms and factories could also spark longer-lasting food shortages. This can lead to
an increase in food prices, putting a financial burden on disadvantaged populations who may not be able to afford basic groceries.
5. Mental Health Problems
The trauma of experiencing a natural disaster can cause widespread mental health problems. Immediate mental impacts include shock and grief,
but as victims suffer the loss of homes, businesses, and loved ones, they often face longer-term problems such as post-traumatic stress disorder,
depression, and anxiety. In the long term, natural disasters may also drive an increase in alcohol and drug abuse.
6. Damage to Healthcare Infrastructure
Anything from an extended power outage to physical damage at hospitals and other healthcare facilities can lead to a public health crisis for some
citizens. Medicines are lost, equipment is damaged or destroyed, and hospital facilities are unable to treat patients adequately. Many people might
also flee the area following a disaster, leaving healthcare facilities short-staffed. And with fewer residents, sometimes there is less impetus to
rebuild broken healthcare infrastructure.
15. Behavior Change
According to Lazarus and Cohen There are three typologies of stressors, namely :
a. Dially hasles is an event that every day and has a very small magnitude, among others: go to work
and study abroad .
b. Personal stressors, namely disasters that have a strong effect on a person in the form of feelings of
fear or loss of something, including losing a livelihood and losing loved ones. For example: layoffs or
companies where work is acquired by other parties;
c. Cataclysmic events are events that have the power and potential to damage / destroy the broader
situation. For Example: Economic Recession;
Based on these three typologies, we can divide the victims of the disaster into 2 large groups :
refugees
Loss and shortage of
material
Usia
Sosial
Ekonomi
Ketahanan
mental
Pendidikan Pendidikan
16. The post-disaster recovery phase occurs. In this phase, post-disaster rehabilitation and reconstruction will be carried out, all
services will be restored to their original condition before the disaster occurred.
Improvement and recovery are meant in all aspects of public services in post-disaster areas with the main target of normalizing
or running reasonably all aspects of government and public life in the health sector health services are aimed at helping people
affected by disasters in order to restore public health conditions through the restoration of the public health service system.
Forms of recovery of health conditions are
(a) assist in the further care of disaster victims who are sick and injured;
(b) provide medicines;
(c) providing medical equipment;
(d) providing medical personnel and medics;
(e) re-functioning of the health care system including referral system
Post-Disaster Recovery
17. PROMOTIVE AND PREVENTIVE
(Undang-Undang No 36 Tahun 2009 Tentang Kesehatan)
Pasal 1 ayat (7)
Determine that the health care facility is a tool and or place used to organize health care efforts both
promotive, preventive, curative and rehabilitiative conducted by the Government, Local Government and /
or the community
Pasal 1 ayat (12)
Formulate promotive health services is an activity and or a series of health service activities that prioritize
activities that are health promotion;
Pasal 1 ayat (13)
States that preventive health care is a preventive activity against a health problem/disease;
18. PROMOTIONAL EFFORT
1. Health Cluster coordination meetings including with local governments, NGOs, and other potential partners to map
programs and activities that can be integrated /collaborated;
2. Installation of Health Promotion media in the form of banners, posters, stickers and social media2;
3. Film screenings health, religion, education, entertainment and interspersed with health education messages;
4. Activities komunitas2 sports, such as community runners, cyclists and gymnastics together (Gymnastics elderly);
5. Counseling, group counseling, family and environment with various health messages (PHBS in refugee camps)
6. The implementation of integrated Posyandu (emergency) includes elderly Posyandu in refugee camps or in temporary
shelters.
7. Advocacy of healthy living movement implementation to local government;
8. Approach to religious leaders / community leaders to disseminate health information;
9. Strengthening the capacity of regional health promotion personnel through post-disaster health promotion orientation
activities;
10. Partnership with community organizations, businesses through CSR programs, health NGOs, health care groups, donor
agencies;
11. Monitoring and Evaluation program (MONEV);
19. PREVENTIVE EFFORT
1. sosialisasi tentang transmisi penularan berbagai penyakit yang secara umum dengan risiko penularan
yang mungkin terjadi di berbagai tatanan, baik rumah, tempat kerja, sekolah, tempat-tempat umum,
fasilitas publik, dan sebagainya;
2. sosialisasi tentang cara hidup bersih dan sehat, seperti mencuci tangan yang benar;
3. mengoptimalkan media sosial melalui jejaring kader kesehatan pada faskes swasta untuk
memperluas dan mempercepat informasi kesehatan dan pelaporan;
4. Melakukan edukasi kepada berbagai pihak yang rentan dalam penularan berbagai penyakit yang
berkembang pasca bencana;
5. Menggunakan perlengkapan dan peralatan pelindung diri yang dibutuhkan sesuai dengan kondisi
bencana yang terjadi agar terhindar dari risiko bencana susulan yang dapat terjadi;
20. SURVEILANS
Permenkes No 45 Tahun 2014
Health surveillance is a systematic and continuous observation of data and information about the
incidence of diseases or health problems and conditions that affect the increase and transmission of
diseases or health problems to obtain and provide information to direct control and response actions
effectively and efficiently
Tujuan
1. Reduce the number of sick people, the risk of disability and death during disasters;
2. Prevent or reduce the risk of the appearance of infectious diseases and their spread;
3. Prevent or reduce risks and address the environmental health impacts of disasters (e.g. improvement of
sanitation facilities and infrastructure);
21. SURVEILANS
Form BA-3 Register Harian Penyakit pada Korban Bencana
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Tanggal : ...................... Bulan : ......................
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