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PubMed2006

Setting priorities: global patterns of disaster risk.

Natural disasters are caused by the exposure and vulnerabilities to natural hazards of people, infrastructure and economic activities. Analysis of these factors has permitted identification of countries and areas within them where disaster-related mortality and economic losses are likely in the future. These high-risk areas are candidates for increased attention to, and investment in, disaster risk identification, reduction and transfer. Plans are underway to further identify disaster risk levels and factors on national and subnational scales in high-risk countries to create evidence for improved risk management decision-making. In this paper, I review selected recent global and regional risk analyses to highlight findings, areas for improvement and next steps in the overall process of using disaster risk information for more effective risk management and cost-effective reduction of losses.

Decision Support Techniques↗
PubMed2006

The pediatrician and disaster preparedness.

Recent natural disasters and events of terrorism and war have heightened society's recognition of the need for emergency preparedness. In addition to the unique pediatric issues involved in general emergency preparedness, several additional issues related to terrorism preparedness must be considered, including the unique vulnerabilities of children to various agents as well as the limited availability of age- and weight-appropriate antidotes and treatments. Although children may respond more rapidly to therapeutic intervention, they are at the same time more susceptible to various agents and conditions and more likely to deteriorate if not monitored carefully. The challenge of dealing with the threat of terrorism, natural disasters, and public health emergencies in the United States is daunting not only for disaster planners but also for our medical system and health professionals of all types, including pediatricians. As part of the network of health responders, pediatricians need to be able to answer concerns of patients and families, recognize signs of possible exposure to a weapon of terror, understand first-line response to such attacks, and sufficiently participate in disaster planning to ensure that the unique needs of children are addressed satisfactorily in the overall process. Pediatricians play a central role in disaster and terrorism preparedness with families, children, and their communities. This applies not only to the general pediatrician but also to the pediatric medical subspecialist and pediatric surgical specialist. Families view pediatricians as their expert resource, and most of them expect the pediatrician to be knowledgeable in areas of concern. Providing expert guidance entails educating families in anticipation of events and responding to questions during and after actual events. It is essential that pediatricians educate themselves regarding these issues of emergency preparedness. For pediatricians, some information is currently available on virtually all of these issues in recently produced printed materials, at special conferences, in broadcasts of various types, and on the Internet. However, selecting appropriate, accurate sources of information and determining how much information is sufficient remain difficult challenges. Similarly, guidance is needed with respect to developing relevant curricula for medical students and postdoctoral clinical trainees.

Child↗
PubMed2005

The human factors in a disaster.

Although natural disasters are claiming fewer lives now than even as recently as 30 years ago, they remain responsible for many premature deaths, most in third-world countries. This article highlights the relationship of human factors that can be found with third-world disasters and reviews interventions that have been used to reduce illness, injuries and deaths.

Developing Countries↗
PubMed1978

[The role of medical services in combating disasters].

Natural and man-made disasters are an ever present threat, particularly in densely populated cities. Doctors, and other people who provide medical care, plead for comprehensive action plans to ensure survival in cases of disaster. Diaster medicine represents a new, multidisciplinary and comprehensive approach. To combat disasters, however, requires knowledge of, and participation by, many disciplines within and outside the field of medicine. Guidelines, to initiate a comprehensive and coordinated anti-disaster programme, are presented. The purpose is to ensure that all resources are used with maximum effect and that all stumbling blocks to efficiency are removed.

Civil Defense↗
PubMed2006

Applying Roberts' Triple ABCD Model in the aftermath of crisis-inducing and trauma-inducing community disasters.

Natural and man-made community disasters, such as hurricanes, earthquakes, school shootings, and mass terrorist attacks, heavily impact the safety, mental health, and well-being of large numbers of individuals, families and groups. Millions of individuals who experience acute crisis episodes or psychological trauma are not consistently provided with the early psychological interventions they urgently need. There is a critical need for tools and a framework to quickly and effectively promote interventions. This article presents one such effort, the Roberts' Triple ABCD Model. This model is an up-to-date and integrated conceptual framework that helps to provide the foundation for developing a unified standard of care for crisis and disaster mental health interventions. This model can be useful in determining which early intervention methods and techniques are most likely to reduce traumatic stress, treat acute crisis and psychosocial symptoms, and promote recovery.

Clinical Competence↗
PubMed2006

Mass fatality management following the South Asian tsunami disaster: case studies in Thailand, Indonesia, and Sri Lanka.

BACKGROUND: Following natural disasters, mismanagement of the dead has consequences for the psychological well-being of survivors. However, no technical guidelines currently exist for managing mass fatalities following large natural disasters. Existing methods of mass fatality management are not directly transferable as they are designed for transport accidents and acts of terrorism. Furthermore, no information is currently available about post-disaster management of the dead following previous large natural disasters. METHODS AND FINDINGS: After the tsunami disaster on 26 December 2004, we conducted three descriptive case studies to systematically document how the dead were managed in Thailand, Indonesia, and Sri Lanka. We considered the following parameters: body recovery and storage, identification, disposal of human remains, and health risks from dead bodies. We used participant observations as members of post-tsunami response teams, conducted semi-structured interviews with key informants, and collected information from published and unpublished documents. Refrigeration for preserving human remains was not available soon enough after the disaster, necessitating the use of other methods such as dry ice or temporary burial. No country had sufficient forensic capacity to identify thousands of victims. Rapid decomposition made visual identification almost impossible after 24-48 h. In Thailand, most forensic identification was made using dental and fingerprint data. Few victims were identified from DNA. Lack of national or local mass fatality plans further limited the quality and timeliness of response, a problem which was exacerbated by the absence of practical field guidelines or an international agency providing technical support. CONCLUSIONS: Emergency response should not add to the distress of affected communities by inappropriately disposing of the victims. The rights of survivors to see their dead treated with dignity and respect requires practical guidelines and technical support. Mass fatality management following natural disasters needs to be informed by further field research and supported by a network of regional and international forensic institutes and agencies.

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↗
PubMedDate not supplied

Mother nature's disasters and their health effects: a literature review.

Each year global warming and climate changes are affecting Mother Nature, causing extreme weather events to occur (Patz & Khaliq, 2002). The impact of these disasters uproots populations, causes massive infrastructure destruction, and sets the stage for an increase of population mortality and morbidity. Before, during, and after the disaster, nurses provide health care to those in need. Nurses should be aware of the anticipated diseases, traumas, and short- and long-term illnesses that occur following the different types of natural disasters. The purpose of this article is to review existing data and alert nurses to the potential threats they may face following a natural disaster.

Disaster Planning↗
PubMed1991

Disaster preparedness.

A natural disaster can be a frightening experience, where events are out of our control. Safety in such an emergency cannot be taken lightly. It is important to remember that safety is everyone's responsibility; plan ahead and know what you are to do! Review and rehearse emergency plans, know your work area and be prepared. Above all, stay calm. Your survival may depend on it!

Disaster Planning↗
PubMed2002

[Malaria study in the cyclone risk zone: entomological , diagnostic and therapeutic approach in the southeastern region of Madagascar].

Madagascar is a tropical island affected by many natural disasters. The eastern coastal zone--an area of perennial malaria transmission--is regularly exposed to cyclones. Few malaria studies have been done in this area of Madagascar, and none have examined the potential relationship between malaria and natural disasters. A mobile team spent six weeks in the fields doing three lines of research: an entomological study by catching mosquitoes and determining their species: a therapeutic study of chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) according to a 14 days WHO protocol and also a study of physician's diagnostic ability. Physicians were asked to make a presumptive clinical diagnosis of all febrile patients, and these results were compared to those obtained from blood smear examinations. The entomological study found three major vectors species: Anopheles gambiae, An. funestus and An. mascarensis. The therapeutic study showed that SP was 100% effective (n = 13) and only one case of CQ treatment failure was recorded (1/15). Finally the diagnostic study demonstrated that presumptive diagnosis of malaria based on the only clinical signs leads to an over-estimation of malaria frequency. Over 68% (102/149) of febrile patients were diagnosed by physicians to have malaria while only 52 (34.9%) were proven positive. Of the 47 patients diagnosed clinically as malaria-negative, 12 (25.5%) turned out to be positive. Outbreaks of malaria during or after natural disasters in Madagascar can be successfully treated with either CQ or SP, but compliance may be better with SP since it requires only one dose. Perhaps equally important in the context of natural disasters is to have the capacity to make a definitive diagnosis, and the dipsticks should be made available.

Adolescent↗
PubMed2006

Psychotherapy for families in the aftermath of a disaster.

We have not seen the last of natural disasters; nor have we endured the last of the terrorist acts. This article offers clinical guidance in providing mental health services to families in the aftermath of such events. The trauma experienced by an individual victimized by a natural disaster or terror attack reverberates through an entire family. Although based in established clinical practice, intervention with survivors of disasters is a different process from other treatments. A case illustrates the key principles and central methods of family therapy with a traumatized family.

Adaptation, Psychological↗
PubMed2005

Public health issues in disasters.

OBJECTIVE: This article outlines a number of important areas in which public health can contribute to making overall disaster management more effective. This article discusses health effects of some of the more important sudden impact natural disasters and potential future threats (e.g., intentional or deliberately released biologic agents) and outlines the requirements for effective emergency medical and public health response to these events. CONCLUSION: All natural disasters are unique in that each affected region of the world has different social, economic, and health backgrounds. Some similarities exist, however, among the health effects of different natural disasters, which if recognized, can ensure that health and emergency medical relief and limited resources are well managed.

Communicable Disease Control↗
PubMedDate not supplied

The public health consequences of disasters.

Although disasters have exacted a heavy toll of death and suffering, the future seems more frightening. Good disaster management must link data collection and analysis to the decision-making process. The overall objectives of disaster management from the viewpoint of public health are: 1) needs assessments; 2) matching available resources with defined needs; 3) prevention of further adverse health effects; 4) implementation of disease-control strategies; 5) evaluation of the effectiveness of the application of these strategies; and 6) improvement in contingency planning for future disasters. The effects of sudden-onset, natural disasters on humans are quantifiable. Knowledge of the epidemiology of deaths, injuries, and illnesses is essential to determine effective responses; provide public education; establish priorities, planning, and training. In addition, the temporal patterns for the medical care required must be established so that the needs in future disasters can be anticipated. This article discusses: 1) the nature of disasters due to sudden-onset, natural events; 2) the medical and health needs associated with such events and disasters; 3) practical issues of disaster responses; and 4) the advance organization and management of disasters. The discussion also includes: 1) discussions of past problems in disaster management including non-congruence between available supplies and the actual needs of the affected population; 2) information management; 3) needs assessments; 4) public health surveillance; and 5) linking information with decision-making. This discussion is followed by an analysis of what currently is known about the health-care needs during some specific types of sudden-onset, natural disasters: 1) floods; 2) tropical cyclones; 3) tornadoes; 4) volcanic eruptions; and 5) earthquakes. The article concludes with descriptions of some specific public-health problems associated with disasters including epidemics and disposition of corpses. All natural disasters are unique in that the regions affected have different social, economic, and health backgrounds. But, many similarities exist, and knowledge about these can ensure that the health and emergency medical relief and limited resources are well-managed.

Disaster Planning↗
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↗
PubMed2004

[A review on disturbance ecology of forest].

More than 80% of terrestrial ecosystems have been influenced by natural disasters, human activities and the combination of both natural and human disturbances. Forest ecosystem, as one of the most important terrestrial ecosystems, has also been disturbed without exception. Under the disturbance from natural disasters and human activities, particularly from the unreasonable activities of human beings, forest decline or forest degradation has become more and more severe. For this reason, sustaining or recovering forest service functions is one of the current purposes for managing forest ecosystems. In recent decades, the studies on disturbed ecosystems have been carried out frequently, especially on their ecological processes and their responses to the disturbances. These studies play a very important role in the projects of natural forest conservation and the construction of ecological environment in China. Based on a wide range of literatures collection on forest disturbance research, this paper discussed the fundamental concepts of disturbance ecology, the relationships between forest management and disturbance, and the study contents of forest disturbance ecology. The major research topics of forest disturbance ecology may include: 1) the basic characteristics of disturbed forests; 2) the processes of natural and human disturbances; 3) the responses of forests ecosystem to the disturbances; 4) the main ecological processes or the consequential results of disturbed forests, including the change of biodiversity, soil nutrient and water cycle, eco-physiology and carbon cycle, regeneration mechanism of disturbed forests and so on; 5) the relationships between disturbances and forest management; and 6) the principles and techniques for the management of disturbed forests. This review may be helpful to the management of disturbed forest ecosystem, and to the projects of natural forest conservation in China.

Disasters↗
PubMed1991

Rapid assessment of health needs in mass emergencies: review of current concepts and methods.

The increase in the number of natural disasters and their impact on population is of growing concern to countries at risk and agencies involved in health and humanitarian action. The numbers of persons killed or disabled as a result of earthquakes, cyclones, floods and famines have reached record levels in the last decade. Population density, rampant urbanization and climatic changes have brought about risk patterns that are exposing larger and larger sections of populations in developing countries to life-threatening natural disasters. Despite substantial spending on emergency relief, the approaches to relief remain largely ad hoc and amateurish, resulting generally in inappropriate and/or delayed action. In recent years, mass emergencies of the kind experienced in Bangladesh or the Sahelian countries have highlighted the importance of rapid assessment of health needs for better allocation of resources and relief management. As a result, the development of techniques for rapid assessment of health needs has been identified as a priority for effective emergency action. This article sketches the health context of disasters in terms of mortality and morbidity patterns; it describes initial assessment techniques currently used and their methodological biases and constraints; it also discusses assessment needs which vary between different types of disasters and the time frame within which assessments are undertaken. Earthquakes, cyclones, famines, epidemics or refugees all have specific risk profiles and emergency conditions which differ for each situation. Vulnerability to mortality changes according to age and occupation, for earthquakes and famines. These risk factors then have significant implications for the design of rapid assessment protocols and checklists. Experiences from the field in rapid survey techniques and estimation of death rates are discussed, with emphasis on the need for a reliable denominator even for the roughest assessment. Finally, the importance of adapting normal epidemiological and statistical methodologies to crisis situations is underlined in order to rationalize the recurrent and substantial expenditures made in response to natural disasters today.

Disasters↗
PubMedDate not supplied

Salt Lake hospital survives close brush with twister, power outage.

LDS Hospital in Salt Lake City found that dealing with wounded and casualties from a natural disaster is just one problem; dealing with the natural disaster itself can be a whole other problem. A great success story in the midst of this summer's terrible tornado which hit Utah's capitol.

Disaster Planning↗