India’s geo-climatic conditions as well as its high degree of socio-economic
vulnerability, makes it one of the most disaster prone country in the world. A
disaster is an extreme disruption of the functioning of a society that causes
widespread human, material, or environmental losses that exceed the ability of
the affected society to cope with its own resources. Disasters are sometimes
classified according to whether they are “natural” disasters, or “human-made”
disasters. For example, disasters caused by floods, droughts, tidal waves and
earth tremors are generally considered “natural disasters.” Disasters caused by
chemical or industrial accidents, environmental pollution, transport accidents
and political unrest are classified as “human-made” or “human induced”
disasters since they are the direct result of human action.
‘DISASTER’ alphabetically means:
D - Destructions
I - Incidents
S - Sufferings
A - Administrative, Financial Failures.
S - Sentiments
T - Tragedies
E - Eruption of Communicable diseases.
R - Research programme and its implementation
A disaster can be defined as any occurrence that cause damage, ecological
disruption, loss of human life, deterioration of health and health services, Vs
a scale sufficient to warrant as extraordinary response from outside the
affected community or area.
An occurrence of a severity and magnitude that normally results in death,
injuries and property damage that cannot be managed through the routine
procedure and resources of government.
- FEMA (Federal Emergency Management Agency)
Disaster is an event or series of events, which gives rise to casualties and
damage or loss of properties, infrastructures, environment, essential services
or means of livelihood on such a scale which is beyond the normal capacity of
the affected community to cope with. Disaster is also sometimes described as
a “catastrophic situation in which the normal pattern of life or eco-system
has been disrupted and extra-ordinary emergency interventions are required
to save and preserve lives and or the environment”.
2.The Disaster Management Act, 2005 defines disaster as “a catastrophe, mishap, calamity or
grave occurrence in any area, arising from natural or man made causes, or by accident or
negligence which results in substantial loss of life or human suffering or damage to, and destruction
of, property, or damage to, or degradation of, environment, and is of such a nature or magnitude as
to be beyond the coping capacity of the community of the affected area”.
.The United Nations defines disaster as “the occurrence of sudden or major misfortune which
disrupts the basic fabric and normal functioning of the society or community”
TYPES OF DISASTER:
Disasters can take many different forms,
and the duration can range from an hourly
disruption to days or weeks of ongoing
Natural Types of Disasters
•Agricultural diseases &
•Drought and water
•Floods and flash floods
•Hurricanes and tropical
•Landslides & debris flow
•Thunderstorms and lighting
•Winter and ice storms
IMPACT OF DISASTER
Impact of natural disaster in the last 30 years.
Ø Death of 3 million people
Ø Economic loss increased due to disaster like flood
Ø In Indian scenario, 34jmijlion people affected per year and 5116 death per
Ø In US, economic loss is 400 million dollar and 3 million people died.
The Symptoms related to Trauma Produced by disaster usually occurs
in Five Phases.
a. Impact Phase: It includes event itself and is characterized by shock, extreme
b. Heroic Phase: Characterized by co-operative spirit exist between friends, neighbor and
emergency teams. Constructive activity at this time can help to overcome feelings of anxiety
c. The honeymoon phase: It begins to appear one week to several months after the disaster,
the need to help others is sustained, and the money, resources and support received from
varying agencies allow life to begin again in the community.
d. Disillusionment phase: It last from two months to one year._ A time of disappointment,
resentment, frustration and anger. Victims often begin to compare their neighbors with their
own and may start to resent or show hostility towards others.
e. Reconstruction and reorganization phase: In this individual recognize that they must adjust
with their own problems. They begin to rebuild their homes, business and lives in cons
Disaster impact and response
Medical treatment for large number of casualties is likely to be needed only
after certain types of disaster. Most injuries are sustained during the impact,
and thus, the greatest need for emergency care occurs in the first few hours.
The management of mass casualties can be further divided into search and
rescue, first aid, triage and stabilization of victims, hospital treatment and
redistribution of patients to other hospitals if necessary.
Search, rescue and first aid
After a major disaster, the need for search, rescue and first aid is likely to be
so great that organized relief services will be able to meet only a small
fraction of the demand. Most immediate help comes from the uninjured
Most injured persons converge spontaneously to health facilities, using
whatever tansport is available, regardless of the facilities, operating status.
Providing proper care to casualties requires, that the health service resources
be redirected to this new priority. Bed availability and surgical services should
be maximized. Provisions should be made for food and shelter. A centre should
be established to respond to inquiries from patient's relatives and friends.
Priority should be given to victim's identification and adequate mortuary
space should be provided.
When the quantity and severity of injuries overwhelm the operative capacity
of health facilities, a different approach to medical treatment must be
adopted. The principle of "first come, first treated", is not followed in mass
All patients should be identified with tags stating their name, age, place of origin,
triage category, diagnosis, and initial treatment.
Identification of dead
Taking care of the dead is an essential part of the disaster management. A large
number of dead can also impede the efficiency of the rescue activities at the site
of the disaster. Care of the dead includes : (1) removal of the dead from the
disaster scene; (2) shifting to the mortuary; (3) identification; (4) reception of
bereaved relatives. Proper respect for the dead is of great importance.
The health hazards associated with cadavers are minimal if death results from
trauma and corps are quite unlikely to cause outbreaks of disease such as typhoid
fever, cholera or plague. If human bodies contaminate streams, wells, or other
water sources as in floods etc., they may transmit gastroenteritis or food
poisoning to survivors. The dead bodies represent a delicate social problem.
This phase begins when assistance from outside starts to reach the disaster area.
The type and quantity of humanitarian relief supplies are usually determined by
two main factors : (1) the type of disaster, since distinct events have different
effects on the population, and (2) the type and quantity of supplies available
Immediately following a disaster, the most critical health supplies are those
needed for treating casualties, and preventing the spread of communicable
diseases. Following the initial emergency phase,
Disasters can increase the transmission of communicable diseases through
following mechanisms :
1. Overcrowding and poor sanitation in temporary resettlements. This
accounts in part, for the reported increase in acute respiratory infections etc.
following the disasters.
2. Population displacement may lead to introduction of communicable
diseases to which either the migrant or indigenous populations are
3. Disruption and the contamination of water supply, damage to sewerage
system and power systems are common in natural disasters.
4. Disruption of routine control programmes as funds and personnel are
usually diverted to relief work.
5. Ecological changes may favour breeding of vectors and increase the vector
Health authorities are often under considerabie public and political pressure
to begin mass vaccination programmes, usually against typhoid, cholera and
tetanus. The pressure may be increased by the press media and offer of
vaccines from abroad.
A natural disaster may affect the nutritional status of the population by
affecting one or more components of food chain depending on the type,
duration and extent of the disaster, as well as the food and nutritional
conditions existing in the area before the catastrophe.
There are three fundamental aspects of disaster management:
a. disaster response ;
b. disaster preparedness ; and
c. disaster mitigation.
The final phase in a disaster should lead to restoration of the pre-disaster
conditions. Rehabilitation starts from the very first moment of a disaster. Too
often, measures decided in a hurry, tend to obstruct establishment of normal
conditions of life. A provision by external agencies of sophisticated medical
care for a temporary period has negative effects. On the withdrawal of such
care, the population is left with a new level of expectation which simply
cannot be fulfilled.
In first weeks after disaster, the pattern of health needs, will change rapidly,
moving from casualty treatment to more routine primary health care.
Services should be reorganized and restructured. Priorities also will shift from
health care towards environmental health measures. Some of them are as
A survey of all public water supplies should be made. This includes
distribution system and water source. It is essential to determine physical
integrity of system components, the remaining capacities, and bacteriological
and chemical quality of water supplied.
The main public safety aspect of water quality is microbial contamination.
The first priority of ensuring water quality in emergency situations is
chlorination. It is the best way of disinfecting' water. It is advisable to
increase residual chlorine level to about 0.2-0.5 mg / litre. Low water
pressure increases the risk of infiltration of pollutants into water mains.
The existing and new water sources require the following protection
measures : (1) restrict access to people and animals, If possible, erect a
fence and appoint a guard; (2) ensure adequate excreta disposal at a safe
distance from water source; (3) prohibit bathing, washing and animal
husbandry, upstream of intake points in rivers and streams; (4) upgrade
wells to ensure that they are protected from contamination
Poor hygiene is the major cause of food-borne diseases in disaster situations.
Where feeding programmes are used (as in shelters or camps) kitchen sanitation is
of utmost importance. Personal hygiene should be monitored in individuals
involved in food preparation.
Basic sanitation and personal hygiene
Many communicable diseases are spread through faecal contamination of drinking
water and food. Hence, every effort should be made to ensure the sanitary
disposal of excreta. Emergency latrines should be made available to the displaced,
where toilet facilities have been destroyed. Washing, cleaning and bathing
facilities should be provided to the displaced persons.
Control programme for vector-borne diseases should be intensified in the
emergency and rehabilitation period, especially in areas where such diseases are
known to be endemic. Of special concern are dengue fever and malaria
(mosquitoes), leptospirosis and rat bite fever (rats), typhus (lice, fleas), and
plague (fleas). Flood water provides ample breeding opportunities for mosquitoes.
NURSE’S ROLE IN DISASTER
Definitions of Disaster Nursing
Disaster Nursing can be defined as the adaptation of professional nursing skills
in recognizing and meeting the nursing physical and emotional needs resulting
from a disaster. 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 Nursing is nursing practiced in a situation where professional
supplies, equipment, physical facilities and utilities are limited or not
Nurse along with the health team needs to utilize primary health care
intervention in acute emergencies as follows:-
· Nursing Management
· Immunization and preventive health
· Management of diarrheas and dehydration.
· Management of acute respiratory infections.
· Setting up a health information system.
· Safe drinking water supply.
· Training and support for health workers.
· Other basic services.
In addition to above the following psychosocial intervention are provided by the nurses:
· Crises intervention / counseling
· Group work
· Telephone contact services.
· Disaster response managements
· Health education
· Community services like facilitation of self help groups etc.
Community measures in DisasterA nurse should be the part of the team for disaster planning.
a. Community Participation: It is the process by which individuals, families and communities
assume the responsibility of promoting their own health and welfare. The community heath nurse
maintains the link between professional group pf experts in disaster management and community.
b. Mock trails/training: The training of various inter-disciplinary forces like school children,
voluntary organizations can be imparted by community health nurse and her team,
c. Mass awareness: The community should have the knowledge of all the Channel communication
system, stand by equipment supplies and other resources; otherwise disaster preparedness will be
d. Education: Mass awareness through media, booklets, panel discussion, films and televisions
information is very essential.
Basic community Education should incorporate the
a. Setting up the first aid post
b. Causality evaluation
c. Basic hygiene and sanitation
d. Safety measures
e. Maintenance of food and water supply
f. Maintenance of law and order.
g. Provision of shelters
h. Rescue streaming
i. Significance of traffic control and communication
j. Use of fire services
k. Hazards of radiation and preventive measures
l. Prevention of future disasters.
m. Grant in aid
Disasters are of different types which can happen any time ,any where, in the world causing
tremendous after effects such as loss of human life ,economical imbalances, food scarcity
epidemics , forced relocation of population etc. Disasters usually affect the developing countries
comparing with the developed countries. While deserting the matter we could come to the
conclusion that the adverse effects of natural disasters can be minimized by proper preventive
measures alert technologies at high risk areas, proper mobilization of resources, decreased
corruption in the field and also the mock training programmes in the community.
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