Disaster management


## Basic introduction

  • A disaster is defined as an event that kills 10 or  more people  or leaves  at least  100 people injured, homeless, displaced or evacuatedc


  • A major disaster is defined as a situation where the number, type, and severity of injuries require extra-ordinary arrangement by the hospital to cope withb
  • Disasters are classified into natural or man-made (anthropogenic) disasters
  • Natural disaster:

_Account for more than 70% of all disasters

_They nclude the following:

 ||| Drought

 ||| Floods

 ||| Landslides

 ||| Tornadoes

 ||| Blizzards

 ||| Cyclones

 ||| Earthquakes

 ||| Volcanic eruptions

 ||| Tsunamis

 ||| Avalanches

 ||| Diseases such as HIV/AIDS

  • Man-made (anthropogenic) disasters:

_They are classified into technological, sociological, and transportation disasters

_Include the following:

 ||| Accidents (road, train, airline and ferry among others)

 ||| Chemical leaks

 ||| Man-made fires

 ||| Nuclear leaks

 ||| Politically instigated violence  

 ||| Spillovers

 ||| Structural collapse

 ||| Terrorist activities

  • Risks of disaster in communities include the following:



_Settlement in areas prone to perennial flooding

_Settlement in areas with poor infrastructure and services

_Poorly constructed buildings.

## Phases of a national disaster management include the following:

  • Preparation

_Hazard Analysis

_Vulnerability Analysis that analyze factors that increase risks such as:

||| Number of people exposed to the hazard

||| Area covered by the hazard

||| Dose or intensity of power of the hazard

||| Time duration

||| Frequency

_Prevention and mitigation

||| Response planning by the institution

||| It includes formulation of policies and legislations that is required to prevent disasters

||| Resource mobilization

||| Public education

||| Prevention-elimination of hazards e.g. installation of a security wall.

||| Mitigation (which is reduction of destruction and disruption) e.g. construction of earthquake resistant buildings and air-bags in vehicles

_General preparedness

  • Warning phase
  • Impact
  • Emergency response
  • Recovery
  • Rehabilitation
  • Back to more preparation

## Disaster management – Hospital perspective

  • Every hospital should have a Disaster Management Plan
  • This plan should include:

_A well-constituted Hospital Disaster Management Team

_Provision of emergency equipment and drugs

_Communication equipment

_Means of transport

  • Pre-hospital organization in disaster management include:

_Consideration of security and safety of the medical team and victims

_Effective crowd control

_Preliminary assessment of the victims and taking the necessary life-saving action(s)

_Transport to the hospital:

||| Ambulance – reserved for the seriously injured victim

||| Helicopter or airplane (if available and required)

||| May make a decision to refer the victim directly to a consultant

  • Hospital organization in disaster management include:

_Establishment of the Command and Control Center under a senior medical officer

_The triage sieve:

||| Triage 1 for victims with life-threatening injuries but their lives can be saved by surgery

||| Triage II for victims whose injuries are so severe that their chance of survival is practically nil

||| Triage III for victims with minor injuries and they will probably recover even if the treatment is delayed. This group is operated last.

## Statistics

  • Some recent disasters globally:

_Earthquake and tsunami, 2011, Japan: caused about 20,000 deaths

_Earthquake, 2010, Port au Prince, Haiti’s Capital City: caused over 200,000 deaths, left 2M homeless, and left 3M people in need of emergency assistance, more than 250,000 homes destroyed along with 30,000 other buildings.

_Tsunami in Sumatra (Earthquake in the Indian Ocean), 2004 shores of Indonesia, Sri Lanka, South India, and Thailand: 200,000- 310,000 deaths (it lasted for only ten seconds!!)

  • Some recent disasters in Kenyad:

_Traffic fireball, 2016, Karai, Naivasha: 43 deaths and 50 other casualties

_Cholera, 2015, 21 counties: 131 deaths

_Terrorist attack, 2015, Garissa University: 147 deaths

_Terrorist attack, 2014, Mpeketoni, Lamu: 50 deaths 

_Terrorist attack, 2013, Westgate mall, Nairobi: 67 deaths and >175 wounded

_Petrol leak fire, 2011, Mukuru-Sinai: 100-300 deaths and 116 hospitalized

_Fire, 2009, Nakumatt Downtown, Nairobi: 29 confirmed deaths and 47 missing

_Petrol tanker explosion, 2009, Sachang’wan, Molo: 113 deaths

_Cholera, 2008, various counties: 122 deaths

_Measles, 2007, various counties: 41 deaths

_Measles outbreak, 2006, countrywide: 41 deaths

_Meningitis outbreaks, 2006, Kacheliba: 20 deaths and 70 cases

_Illicit brew “Kumi kumi”, 2005, Kyumbi, Machakos: 50 deaths and 10 blinded

_Aflatoxin poisoning, 2004, Makueni, Machakos, Mbeere, Thika and Kitui: 123 deaths and 333 cases

_Leptospirosis, 2004, Bungoma: 12 dead and 859 affected

_Dormitory fire, 2001, Kyanguli Boys High School: 68 deaths

_Terrorist attack, 1998, Nairobi: 214 deaths and 5,600 cases

_Petrol tanker explosion, 1998, Kisumu/Busia road: 36 deaths

_Ferry accident, 1994, Mtongwe, Mombasa: 270 deaths

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