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PubMedDate not supplied

A study of intersectoral co-ordination in disaster management in flood prone districts of West Bengal.

Disaster management is essentially a multi-sectoral and multidisciplinary endeavor. The status of disaster preparedness, coordination among different sectors and its impact on disaster management performance were studied and compared in two flood prone comparable districts viz. Midnapore and Murshidabad of West Bengal. The perception of state level officers about important job responsibilities of other departments in relation to disaster management and its intersectoral co-ordination was found mostly satisfactory; but this desired status did not prevail at district level. Lack of co-ordination among some sectors at district levels persisted in Murshidabad district, indicating comparatively better intersectoral co-ordination in Midnapore district. Thus, 'early response following flood' the most important indicator of adequacy of pre-disaster preparedness was found significantly better in Midnapore district. On the contrary, due to liberal use of Radio transmission set for flood warning, a significantly higher proportion of affected families in Murshidabad district received early flood warning compared to Midnapore. Organisational aspects of disaster management need to be improvised with role clarity of different departments in relation to other sectors involved in this endeavor.

Disaster Planning↗
PubMed2005

Disaster preparedness in health care.

Natural disasters frequently cause major problems which affect a population's health and hinder a nation's socioeconomic development by draining its scarce financial resources in an effort to repair damages. For example, the tsunami disaster in the Indian Ocean is one of the worst natural disasters in modern times. Well over 200,000 people died and more than 1.5 million people lost their homes and often their livelihoods. Losses are estimated to total more than US dollar 7 billion. Private assets, including housing and business equipment, account for the largest share of the losses. In the largest countries, the impact on GDP is likely to be minimal, but the damage in the affected areas is extreme. Poor people were disproportionately affected. A country's health systems and public health infrastructure must be organised and ready to act in disaster situations as well as under normal conditions and must be cognisant of the type of measures to be taken in event of a disaster. These will differ according to the severity of the disaster's impact on the national health system.

Delivery of Health Care↗
PubMed2006

Disaster planning for peritoneal dialysis programs.

Because of increased intensity of hurricanes in the Gulf Coast region of the United States, peritoneal dialysis (PD) programs have been disrupted and patients relocated temporarily following these catastrophic events. We describe the disaster planning, implementation, and follow-up that occurred in one such PD program in New Orleans following Hurricane Katrina. Each year at the beginning of the North American hurricane season, the PD program's disaster plan is reviewed by clinic staff and copies are distributed to patients. Patients are instructed to assemble a disaster kit and are provided with contact numbers for dialysis suppliers and for a PD program in their planned evacuation city. In July 2005, this disaster plan was tested when an early tropical storm and hurricane entered the Gulf and several patients briefly relocated or evacuated because of power loss and then returned without incident. However, when Hurricane Katrina, a category 5 storm, was predicted to strike the metropolitan area, patients were notified by telephone to evacuate, and contact information, including their evacuation city and telephone and cellular phone numbers, was obtained. Patients were also reminded to take all medications, bottled water, antibacterial soap, hand sanitizer, and 4-5 days of PD supplies. Following the storm, telephone and cellular phone services were severely disrupted. However, text messaging was available to contact patients to confirm safety and to provide further instructions. Arrangements with the major dialysis suppliers to ship emergency supplies to new locations were made by the PD nurse and the patients. Only 2 of 22 patients required hospitalization because of complications resulting from evacuation failure, contamination, and inability to perform dialysis for a prolonged period of time. Both of these patients were quickly released and have continued PD. Following the event, all patients remained on PD, and most have planned to return to their home PD program. Thorough preparation, planning, practice, and implementation and effective communication are necessary to prevent complications in PD patients who are affected by disasters. With advdnce preparation, maintenance of communication with health care providers, and planning for alternative sites of care, patients can be safely maintained on PD without complications following catastrophic natural disasters.

Communication↗
PubMed2006

The public health response to disasters in the 21st century: reflections on Hurricane Katrina.

Ten years ago, in 1996, the author published a commentary on disasters, the environment, and public health, reviewing progress in the field. Despite many advances, significant events have occurred during the intervening decade, including the September 11, 2001, terrorist attacks and the 2005 Hurricane Katrina disaster. The recent lessons from Hurricane Katrina indicate that public health professionals still need to do more to protect the public in times of national disasters. Since recurring disasters will continue to adversely affect human health, public health providers and others involved with disaster management should again reflect on the importance of this issue and the need for action. Such action includes key public health professionals being present and actively involved in the field before and immediately following disaster impact.

Centers for Disease Control and Prevention, U.S.↗
PubMed1991

Manmade disasters.

A disaster that produces a multitude of patients may severely stress a community's health-care system, from the EMS system to the hospitals. Physicians involved in such an event must realize that they will have to change their normal mode of delivering care, having to make decisions with less than the normal amount of information, and doing the most good for the most salvageable patients. Some understanding of and appreciation for the unique problems that face emergency personnel in the field are important for physicians who do not normally interact with fire and EMS personnel, because it will allow them to realize that they are not alone in the chaos of a disaster. Many manmade disasters produce patients with medical or surgical problems with which one is familiar, the only difference being the sheer number of patients. Other manmade disasters, however, most notably those involving hazardous materials and radioactive materials, are capable of producing patients who not only have unfamiliar medical problems but also have problems about which little information is readily available in the medical literature. Hospital physicians can do much to prepare themselves for these eventualities. Discussion and planning should be done among separate staffs (ICU, operating suite, emergency department), as well as among staff of the various disciplines so they can interact more effectively when a disaster occurs. Local disaster planners should receive input from hospital staffs so hospital capabilities are known and the field operation can mesh well with the hospital's operation.

Chemical Warfare↗
PubMedDate not supplied

[Role of a surgical emergency department in the management of a disaster bringing a great number of patients with burns].

Definition of a disaster would follow prescriptions from the "International Trauma Foundation" (Brighton 1981, document A). This disaster may be: simple (where the structure of community remains intact), compound (where the structure of community and function of the community are disrupted). The classification of disasters is realized: by cause, by number of casualties, by nature of pathology, by time while cause operating, by time of rescue procedures at site, by affected area, by rural or urban location. Belgian legislation about disaster is described. Disaster related to major technological risks will be characterized by high probability of traumatic and burns injuries. The authors prepare medical responses to this eventually, defining the role of a "base hospital", the role of a medical team at site and the management of different groups of burned patients. Propositions are made to bring together actors of "disaster plan".

Burns↗
PubMed1993

Natural and man-made disasters: the vulnerability of women-headed households and children without families.

Since 1980, over 2 million people have died as an immediate result of natural and man-made disasters and by 1992, the refugee population registered nearly 16 million people. This article reviews the human impact of disasters as a composite of two elements: the catastrophic event itself and the vulnerability of people. It also examines the specific case of women and children in the current world emergency context. It identifies four broad policy areas that affect women and children in disaster situations and discusses them with examples and field evidence. The first policy area addresses humanitarian assistance and armed conflicts, and armed conflict and international humanitarian law, the use of food as instrument of war, mines and civilian disability, and rape and sexual violence are discussed within this context. The second problem discussed is the issue of unaccompanied and abandoned children in terms of its magnitude and implications for relief response. Thirdly, the article examines the differential risks in emergencies for mortality and morbidity, specifically for women and children. Finally, it addresses certain policies and approaches to disaster rehabilitation which effectively mirror and reinforce inherent inequities in the affected society. The article notes that: (i) the largest proportion of disaster victims today arise from civil strife and food crises and that the majority of those killed, wounded and permanently disabled are women and children; and (ii) the ability of any country to respond effectively to disasters depends on the strength of its health and social infrastructure, and its overall developmental status. It concludes by identifying seven areas where concrete measures could be taken to improve the current situation.

Adult↗
PubMed2003

Disaster management in India: the case of livestock and poultry.

Developing countries are becoming increasingly aware of the importance of disaster management systems, and increasing efforts are being made to streamline preparedness, response and recovery mechanisms at all levels. It is well known that many developing countries, including India, are not always well-prepared to deal with disasters. A lack of well-developed disaster management plans results in a severe loss of human life, animal life and property, which could be saved if the necessary mechanisms were in place. A lot needs to be done to improve the situation, particularly in regard to livestock. This paper describes in detail, with particular reference to India, what can be done to care for animals when natural disasters occur. The authors review various types of natural disasters and their impact on livestock, and outline different preparedness, response, recovery, and mitigation strategies. The roles of different agencies, including veterinarians, are also considered.

Animals↗
PubMed1982

Planning for disaster: a new community outreach program for mental health centers.

Disaster victims typically do not request services from the mental health system. Victims must be contacted through innovative outreach programs linked to the disaster relief network. Advance planning for disaster programs by mental health centers is highly desirable, but barriers may be encountered related to (a) external support, (b) information on victim needs, (c) intervention methods, (d) linkage with disaster agencies, or (d) planning guidelines. Advice and information are offered on how to overcome each potential barrier. A model disaster plan is outlined that is consistent with NIMH guidelines for disaster preparedness planning, and with three criteria considered essential for an effective plan.

Community Mental Health Centers↗
PubMed1989

An explanatory model of recovery from disaster loss.

The development and testing of an explanatory model of recovery from disaster loss are described. The sample consisted of 155 persons at Time1-1981, 101 persons at Time2-1983, and represented five magnitudes of disaster loss: bereaved of disaster victims presumed dead; bereaved of disaster victims confirmed dead; persons whose permanent homes were destroyed; persons whose recreational property was destroyed; and a no disaster-loss comparison group. Data tested in the model were collected 1 and 3 years following the volcanic eruption of Mt. St. Helens in 1980 on eight variables: magnitude of loss, mass media coverage, negative rating of change, change in income, self-efficacy, social support, satisfaction with financial settlement, and mental distress. Path analysis was selected to estimate the magnitude of hypothesized direct and indirect linkages between variables presumed as causes of variables treated as effects. Results showed an improvement of goodness of fit by testing the model with the 1981 data, respecifying the model, and testing it again with the 1983 data. The greatest explanatory effects on mental distress 3 years postdisaster were mental distress reported 1 year postdisaster and negative ratings of change associated with disaster loss.

Bereavement↗
PubMed1990

The psychological sequelae of disaster stress prospectively and retrospectively evaluated.

Aimed to document the psychological sequelae of a disaster in the adult (17-68 years) population of the Caribbean island of Puerto Rico, by surveying 912 persons (including 375 previously interviewed) with a Spanish version of the Diagnostic Interview Schedule. A rigorous methodology, which included both retrospective and prospective designs, was used, enabled by the occurrence of a catastrophic disaster only a year after a comprehensive survey was completed. Framed in a stress theoretical perspective, disaster effects for new depressive, somatic, and posttraumatic stress symptoms were identified, even after adjusting for demographic and methodologic factors. All the effects, however, were relatively small, suggesting that most disaster victims were rather resilient to the development of new psychological symptoms. Comparison of results with previous findings and its implications for both disaster and stress research are discussed, as well as the role of community psychologists in disaster action.

Adaptation, Psychological↗
PubMed1991

Crisis intervention following disasters: are we doing enough? (A second look).

During mass casualty events the consequences of psychological trauma are an important cause of morbidity among survivors and rescue personnel. Data available from military and civilian disasters over the past 70 years has shown a fairly predictable ratio of acute and severe emotional trauma associated with mass casualty events. Long-term morbidity from psychological trauma can rival or exceed that of the physical injuries of survivors. Psychological intervention reduces this morbidity, and early psychological intervention is more effective before adverse psychological symptoms have fully developed. However, the widely accepted value of early psychological intervention is not universal, with controversy over the degree of emotional trauma expected after a large-scale catastrophic mass casualty event, as well as the number of victims and the effectiveness of immediate psychological intervention. Some research even suggests that there is only a minor risk of acute emotional trauma among survivors of a major disaster. The United States faces the possibility of mass casualties from national disasters--particularly earthquakes--and conventional warfare. It has been predicted that 100,000 major injuries requiring hospitalization and 20,000 deaths would result from the maximum plausible natural disaster incident in the United States. Pentagon planners expect thousands of servicemen to be evacuated to the United States for hospitalization on a daily basis during an overseas conventional war. With these estimates of potential casualties, it is imperative that this controversy be resolved as quickly as possible. The National Disaster Medical System recently established plans to provide immediate treatment for psychological trauma to disaster survivors and rescue personnel.(ABSTRACT TRUNCATED AT 250 WORDS)

Crisis Intervention↗
PubMedDate not supplied

Microcomputer-assisted transmission of disaster data by cellular telephone.

Voice communication of information during disasters is often inadequate. In particular, simultaneous transmission by multiple callers on the same frequency can result in blocked transmissions and miscommunications. In contrast, nonvoice transmission of data requires less time than does voice communication of the same data, and may be more accurate. We conducted a pilot study to test the feasibility of a microcomputer assisted communication (MAC) network linking the disaster scene and the command hospital. The radio chosen to transmit data from the field disaster site to the command hospital was a cellular telephone connected to the microcomputer by modem. Typed communications between the microcomputer operators enabled dialogue between the disaster site and the hospitals. A computer program using commercially available software (Symphony by Lotus, Inc.) was written to allow for data entry, data transmission, and reports. Patient data, including age, sex, severity of injury, identification number, major injuries, and hospital destination were successfully transmitted from the disaster site command post to the command hospital. This pilot test demonstrated the potential applicability of MAC for facilitating transmission of patient data during a disaster.

Computer Communication Networks↗
PubMed2005

The impact of disaster on culture, self, and identity: increased awareness by health care professionals is needed.

Self, identity, and culture are important psychosocial concepts in the analysis of how individuals perceive self in social context, self across the lifespan, and self in relation to cultural context. Contemporary theories emphasize the importance of a holistic perspective and promote the idea of identity as opposed to self-concept. This article explores the application of these ideas to disasters to provide guidance for health care professionals on how disasters impact individuals, groups, and communities. Disasters have a major impact on social infrastructure and culture, and in turn result in a range of human responses. Placing identity and maintenance of cultural integrity at the heart of practice,health care professionals are encouraged to take a holistic perspective across all phases of the disaster. Individuals, groups, and communities exhibit a range of responses influenced by levels of vulnerability or resilience. Facilitating expression of feelings related to the disaster experience is an important focus for health care. Always working within the cultural context and being sensitive to the rituals related to remembering and mourning help preserve dignity and possibly facilitate creation of a new identity and a revised culture after a disaster.

Adaptation, Psychological↗
PubMedDate not supplied

Defining "disasters" with implications for nursing scholarship and practice.

Nurses have long been a part of disaster care, yet the nurses' unique approaches to disaster victims have not been reported in the nursing literature. This situation raises the questions, "How does disaster nursing differ than general nursing?" and "What defines the specialty care of disaster nursing?" An analysis of the term "disaster" and the concepts that have been used to build a theoretic base for disaster nursing are presented.

Disasters↗
PubMed2004

Approaching disaster mental health research after the 9/11 World Trade Center terrorist attacks.

The article describes the author's experiences with disaster research in the post-9/11 period, first in application of prior research findings to the new situation and later in consultation on the design and development of new research specific to 9/11. The article begins by reviewing the important role of the science of disaster mental health, which was reinforced by the many requests for information from prior research for application to the post-9/11 situation. Next, the article summarizes enduring principles of disaster research application that apply across disaster sites, including 9/11. Addressing unique aspects of the post-9/11 setting, novel considerations for the disaster mental health field are introduced with a new model for conceptualization of subpopulations based on exposure level. Experience in developing research in the post-9/11 setting encountered a number of issues, suggesting need for new policy recommendations that may facilitate research in future disaster settings.

Disasters↗
PubMed2006

Psychological distress among American Red Cross disaster workers responding to the terrorist attacks of September 11, 2001.

This study investigated American Red Cross disaster workers' symptoms of distress and posttraumatic stress resulting from exposure to disaster stimuli during their response to the September 11, 2001 terrorist attacks. A sample of 3055 Red Cross disaster workers was surveyed 1 year after the terrorist attacks regarding demographic characteristics, function during the response, and exposure to disaster stimuli. Participants were grouped by function and self-reported exposure, with the hypothesis that workers in Direct Services and/or those reporting to be directly exposed to disaster stimuli would experience greater levels of posttraumatic stress symptoms and distress than workers in indirect services or reporting no exposure. Findings revealed that while there were significant differences between both Function and Exposure groups on dependent measures, the multivariate eta2 was very small for both and did not meet medium effect size criteria. The results indicated that workers directly exposed to disaster stimuli reported no more distress than those who were not directly exposed.

Demography↗
PubMed2005

Mental and social health in disasters: relating qualitative social science research and the Sphere standard.

Increasingly, social scientists interested in mental and social health conduct qualitative research to chronicle the experiences of and humanitarian responses to disaster We reviewed the qualitative social science research literature in relation to a significant policy document, the Sphere Handbook, which includes a minimum standard in disaster response addressing "mental and social aspects of health", involving 12 interventions indicators. The reviewed literature in general supports the relevance of the Sphere social health intervention indicators. However, social scientists' chronicles of the diversity and complexity of communities and responses to disaster illustrate that these social interventions cannot be assumed helpful in all settings and times. With respect to Sphere mental health intervention indicators, the research largely ignores the existence and well-being of persons with pre-existing, severe mental disorders in disasters, whose well-being is addressed by the relevant Sphere standard. Instead, many social scientists focus on and question the relevance of posttraumatic stress disorder-focused interventions, which are common after some disasters and which are not specifically covered by the Sphere standard. Overall, social scientists appear to call for a social response that more actively engages the political, social, and economic causes of suffering, and that recognizes the social complexities and flux that accompany disaster. By relating social science research to the Sphere standard for mental and social health, this review informs and illustrates the standard and identifies areas of needed research.

Altruism↗