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PubMed2006

Administrative issues involved in disaster management in India.

India as a country is vulnerable to a number of disasters, from earthquakes to floods. Poor and weaker members of the society have always been more vulnerable to various types of disasters. Disasters result in unacceptably high morbidity and mortality amongst the affected population. Damage to infrastructure and reduction in revenues from the affected region due to low yield add to the economic losses. Poor co-ordination at the local level, lack of early-warning systems, often very slow responses, paucity of trained dedicated clinicians, lack of search and rescue facilities and poor community empowerment are some of the factors, which have been contributing to poor response following disasters in the past. The first formal step towards development of policies relating to disaster care in India was the formulation of the National Disaster Response Plan (NDRP) which was formulated initially by the Government of India for managing natural disasters only. However, this was subsequently amended to include man-made disasters as well. It sets the scene for formulating state and district level plans in all states to bring cohesiveness and a degree of uniform management in dealing with disasters. A National Disaster Management Authority has been constituted which aims to provide national guidelines and is headed by the Prime Minister of India. It is the highest decision-making body for the management of disasters in the country. The authority has the responsibility for co-ordinating response and post-disaster relief and rehabilitation. Each state is required to set up Disaster Management Authorities and District Disaster Management Committees for co-ordination and close supervision of activities and efforts related to the management of disasters.

Disaster Planning↗
PubMed2001

Dialysis and disaster: San Francisco's dialysis community remembers the Loma Prieta earthquake. Interview by Susan L. Robertson.

Unlike many regions of the United States that live with seasonal disasters such as hurricanes, snow storms, or flooding from torrential rains, the greatest threat of natural disaster in California still comes from earthquakes (TransPacific Renal Network, 1998). This was proven on October 17, 1989 when the Loma Prieta earthquake rolled through northern California. Measured as 7.1 on the Richter scale, the quake's epicenter was located about 10 miles northeast of Santa Cruz along a segment of the San Andreas Fault near the town of Loma Prieta in the Santa Cruz Mountains. The impact, however, was felt throughout most of the northern portion of the state.

Adaptation, Psychological↗
PubMed2005

Preparing health professions students for terrorism, disaster, and public health emergencies: core competencies.

The recent increased threat of terrorism, coupled with the ever-present dangers posed by natural disasters and public health emergencies, clearly support the need to incorporate bioterrorism preparedness and emergency response material into the curricula of every health professions school in the nation. A main barrier to health care preparedness in this country is a lack of coordination across the spectrum of public health and health care communities and disciplines. Ensuring a unified and coordinated approach to preparedness requires that benchmarks and standards be consistent across health care disciplines and public health, with the most basic level being education of health professions students. Educational competencies establish the foundation that enables graduates to meet occupational competencies. However, educational needs for students differ from the needs of practitioners. In addition, there must be a clear connection between departments of public health and all other health care entities to ensure proper preparedness. The authors describe both a process and a list of core competencies for teaching emergency preparedness to students in the health care professions, developed in 2003 and 2004 by a team of experts from the four health professions schools of Columbia University in New York City. These competencies are directly applicable to medical, dental, nursing, and public health students. They can also easily be adapted to other health care disciplines, so long as differences in levels of proficiency and the need for clinical competency are taken into consideration.

Allied Health Personnel↗
PubMed2005

Worldwide disaster medical response: an historical perspective.

OBJECTIVE: Disaster medicine and disaster medical response is a complex and evolving field that has existed for millennia. The objective of this article is to provide a brief review of significant milestones in the history of disaster medicine with emphasis on applicability to present and future structures for disaster medical response. RESULTS: Disaster medical response is an historically necessary function in any society. These range from response to natural disasters, to the ravages of warfare, and most recently, to medical response after terrorist acts. Our current disaster response systems are largely predicated on military models derived over the last 200 yrs. Their hallmark is a structured and graded response system based on numbers of casualties. In general, all of these assume that there is an identifiable "ground zero" and then proceed with echelons of casualty retrieval and care that proceeds rearward to a hospital(s). In a civil response setting, most civilian models of disaster medical response similarly follow this military model. This historical approach may not be applicable to some threats such as bioterrorism. A "new" model of disaster medical response for this type of threat is still evolving. Using history to guide our future education and planning efforts is discussed. CONCLUSION: We can learn much from an historical perspective that is still applicable to many current disaster medical threats. However, a new response model may be needed to address the threats of bioterrorism.

Disaster Planning↗
PubMedDate not supplied

Hospital responses to acute-onset disasters: a review.

INTRODUCTION: Hospitals the world over have been involved in disasters, both internal and external. These two types of disasters are independent, but not mutually exclusive. Internal disasters are isolated to the hospital and occur more frequently than do external disasters. External disasters affect the community as well as the hospital. This paper first focuses on common problems encountered during acute-onset disasters, with regards to hospital operations and caring for victims. Specific injury patterns commonly seen during natural disasters are reviewed. Second, lessons learned from these common problems and their application to hospital disaster plans are reviewed. METHODS: An extensive review of the available literature was conducted using the computerized databases Medline and Healthstar from 1977 through March 1999. Articles were selected if they contained information pertaining to a hospital response to a disaster situation or data on specific disaster injury patterns. Selected articles were read, abstracted, analyzed, and compiled. RESULTS: Hospitals continually have difficulties and failures in several major areas of operation during a disaster. Common problem areas identified include communication and power failures, water shortage and contamination, physical damage, hazardous material exposure, unorganized evacuations, and resource allocation shortages. CONCLUSIONS: Lessons learned from past disaster-related operational failures are compiled and reviewed. The importance and types of disaster planning are reviewed.

Disaster Planning↗
PubMed1997

Utilization of Special Forces medical assets during disaster relief: the Hurricane Andrew experience.

Special Forces units and their innate assets are presented as the ideal first-response unit to natural disasters due to their breadth of skill, speed of response, and ability to work independently in remote areas. "Green Beret" soldiers are particularly suited to work under the most extreme hardships, with little or no supervision, and can demonstrate tremendous amounts of initiative and creativity in unique and changing situations. The compact, versatile, and adaptable detachments of which Special Forces Groups are composed can serve as vital resources in humanitarian and disaster relief operations as well as in combat.

Disaster Planning↗
PubMed1986

Posttraumatic morbidity of a disaster. A study of cases presenting for psychiatric treatment.

The study of unsolicited psychiatric patients who became ill because of their experience in a natural disaster can assist in the design of future disaster research. A clinical report of 36 such patients illustrates the problems of case detection, the delayed presentation of much of the morbidity, and the need to separate stress-related symptoms which are common in disaster victims from psychiatric illness. Unless these issues are taken into account, estimates of the prevalence of psychiatric disorders after major disasters may be subject to substantial error. The role of vulnerability factors assessed to be operating in these patients suggests that exposure and losses sustained in the disaster alone are inadequate predictors of psychiatric disorder. The risk factors for the development of disaster-related psychiatric morbidity will be more accurately defined if the contribution of a range of constitutional, personality, and social factors as well as the personal impact of the disaster are investigated in future research.

Adaptation, Psychological↗
PubMed2005

Evidence against disaster-induced migration: the 2004 tornado in north-central Bangladesh.

Migration is generally considered to be one of the primary responses to a natural disaster. The existing literature widely acknowledges the fact that disaster victims migrate from affected areas. This paper, though, provides empirical evidence of the non-occurrence of out-migration in the aftermath of the 14 April 2004 tornado in Bangladesh. Data collected from 291 respondents from eight tornado-affected villages suggest that no one from these locations migrated to other areas. The constant flow of disaster aid and its proper distribution by the government and non-governmental organisations (NGOs) were the main reasons why victims did not leave. This study contributes to the disaster literature by providing three important findings: disasters do not always create out-migration; emergency aid can compensate in monetary terms for damage caused by disasters; and some of the arguments made in the literature against the provision of emergency relief for disaster victims are not always valid for all countries.

Adult↗
PubMed2006

Differences in individual-level terrorism preparedness in Los Angeles County.

BACKGROUND: Increasing individual preparedness for disasters, including large-scale terrorist attacks, is a significant concern of public health planners. As with natural disasters, individuals can help protect their health and safety by preparing for the emergency situation that may follow a terrorist event. Our study describes variations in preparedness among the population of Los Angeles County after the September 11, 2001 and subsequent anthrax attacks. METHODS: In 2004, the data were analyzed from the Los Angeles County Health Survey, a random-digit-dialed telephone survey of the non-institutionalized population in Los Angeles County fielded October 2002 through February 2003. RESULTS: Overall, 28.0% of respondents had emergency supplies, and 17.1% developed an emergency plan in the past year in response to the possibility of terrorism. Factors associated with having emergency supplies included African American (adjusted odds ratio [AOR] 1.8, 95% confidence interval [CI]=1.1-3.1) and Latino (AOR=1.5, 95% CI=1.0-2.4) race/ethnicity; having a household dependent aged<or=18 years (AOR=1.4, 95% CI=1.0-2.0); being born outside the United States (AOR=1.9, 95% CI=1.3-2.9); some college or trade school education (AOR=1.9, 95% CI=1.3-2.9); and higher perceived likelihood of a bioterrorist attack (AOR=2.2, 95% CI=1.6-3.0). Factors associated with having an emergency plan included African American (AOR=2.6, 95% CI=1.5-4.6) race/ethnicity; having a household dependent aged<or=18 years (AOR=2.4, 95% CI=1.6-3.5); and physical disability (AOR=1.7, 95% CI=1.1-2.7). CONCLUSIONS: Some groups were more likely to adopt some, but not all, recommended preparedness activities. Identifying subpopulation differences in preparedness is important since different public health messages, programs, and distribution channels are required for different subgroups.

Adult↗
PubMed2000

Editorial.

Many children and adolescents do not have the peaceful and carefree youth they are entitled to, because they have been exposed to adverse environmental influences that disturb a normal development. These influences may be caused directly by adults whose task it is to protect these children, but sometimes traumatic experiences, including those caused by natural disasters or war conditions, are beyond the control of parents or other adults. The first three articles of this issue pertain to traumatic events that have a great impact on the child's development. The Practitioner Review in this issue by Perrin, Smith, and Yule provides the most up-to-date summary of the literature on the assessment of Post-traumatic Stress Disorder (PTSD) in young people. Considerable controversy has surrounded PTSD since its inception into the diagnostic nomenclature. The authors make the case that whatever the limits of the diagnostic criteria, children do indeed suffer from post-traumatic stress reactions. The authors draw on their extensive experience working with children exposed to war, natural and man-made disasters, and domestic violence, to give the reader an expert-eye view of the assessment and treatment of childhood PTSD. They make a strong case based on the available literature that cognitive and behavioural approaches hold the most promise as a treatment for childhood PTSD. The reader will find this article useful from both a conceptual and a clinical-practical point of view.

Journal Article↗
PubMed2006

Sustainable ecosystem management using optimal control theory: part 1 (deterministic systems).

The concept of sustainability, an abstract one by its nature, has been given a mathematical representation through the use of Fisher information as a measure. It is used to propose the sustainability hypotheses for dynamical systems, which has paved the way to achieve sustainable development through externally enforced control schemes. For natural systems, this refers to the task of ecosystem management, which is complicated due the lack of clear objectives. This work attempts to incorporate the idea of sustainability in ecosystem management. The natural regulation of ecosystems suggests two possible control options, top-down control and bottom-up control. A comparison of these two control philosophies is made on generic food chain models using the objectives derived from the sustainability hypotheses. Optimal control theory is used to derive the control profiles to handle the complex nature of the models and the objectives. The results indicate a strong relationship between the hypotheses and the dynamic behavior of the models, supporting the use of Fisher information as a measure. As regards to ecosystem management, it has been observed that top-down control is more aggressive but can result in instability, while bottom-up control is guaranteed to give a stable and improved dynamic response. The results also indicate that bottom-up control is a better option to affect shifts in the dynamic regimes of a system, which may be required to recover the system from a natural disaster like the hurricane Katrina.

Animals↗
PubMed2003

A review of the history of traumatic stress studies in Japan: from traumatic neurosis to PTSD.

Based on available literature, this review article investigates traumatic stress studies in Japan from the late 19th century to the present for English speaking audiences. First, traumatic neuroses of war victims, A-bomb survivors, and victims of work-related accidents are discussed. Second, traumatic stress studies of victims of other manmade disasters, such as the sarin gas attacks in Tokyo, domestic violence, and burn injuries. Third, psychological outcomes of natural disaster studies are discussed in relation to social support and help-seeking tendencies of Japan disaster victims.

Burnout, Professional↗
PubMed2005

Hospital response to acute-onset disasters: the state of the science in 2005.

The level of emergency preparedness in US hospitals is a concern in light of the steady threat of natural disasters, transportation and industrial accidents, and the possibility of terror attack resulting in mass casualties. The science of hospital emergency preparedness is in an early stage of development. For research to logically expand knowledge, an accurate assessment--or examination of the state of the science--is conducted to determine the current state of knowledge, gaps in knowledge, and opportunities for future research. Milsten reviewed the literature on hospital response to acute-onset disasters from 1977 to 1999. His review of 107 articles contains research studies, case studies,and lessons learned pieces largely published in the medical literature.Milsten's analysis provides a substantial starting point. This article examines Milsten's review, identifies articles that have been published that add to this knowledge base, and identifies additional phenomena of interest.

Disaster Planning↗
PubMedDate not supplied

Post-disaster malaria in Costa Rica.

INTRODUCTION: In recent years, controversy has surrounded the issue of whether infectious disease should be considered a serious potential consequence of natural disasters. This article contributes to this debate with evidence of a significant outbreak of malaria in Costa Rica's Atlantic region after the 1991 earthquake and subsequent floods. METHODS: This study is an epidemiologic investigation of the incidence of malaria for the periods of 22 months before the April 1991 Limón earthquake and for 13 months afterward. Data were obtained from the Costa Rican Ministry of Health's malaria control program. RESULTS: Some of the cantons in the region experienced increases in the incidence of malaria as high as 1,600% and 4,700% above the average monthly rate for the preearthquake period (p < or = 0.01). Causal mechanisms are postulated as relating to changes in human behavior (increased exposure to mosquitoes while sleeping outside, and a temporary pause in malaria control activities), changes in the habitat that were beneficial to mosquito breeding (landslide deforestation, river damming, and rerouting), and the floods of August 1991. CONCLUSIONS: It is recommended that there be enhanced awareness of the potential consequences of disaster-wrought environmental changes. Date of Event: 22 April 1991; Type: Earthquake, 7.4 Richter scale; LOCATION: Costa Rica; Number of deaths and casualties: 54 deaths and 505 moderate to severe injuries.

Costa Rica↗
PubMed1996

A modified cluster-sampling method for post-disaster rapid assessment of needs.

The cluster-sampling method can be used to conduct rapid assessment of health and other needs in communities affected by natural disasters. It is modelled on WHO's Expanded Programme on Immunization method of estimating immunization coverage, but has been modified to provide (1) estimates of the population remaining in an area, and (2) estimates of the number of people in the post-disaster area with specific needs. This approach differs from that used previously in other disasters where rapid needs assessments only estimated the proportion of the population with specific needs. We propose a modified n x k survey design to estimate the remaining population, severity of damage, the proportion and number of people with specific needs, the number of damaged or destroyed and remaining housing units, and the changes in these estimates over a period of time as part of the survey.

Cluster Analysis↗
PubMed1993

Special report. Dealing with disasters: what hospitals learned from recent crises.

In times of crisis, hospitals are relied on to provide simultaneous emergency treatment to a large number of victims of natural disasters, accidents, or other traumatic events. Sometimes the hospital itself faces a crisis situation. Hospital officials recognize that the only way to continue providing patients with the best care possible in dire circumstances is through the activation of an effective disaster plan. "Disaster planning is something that cannot be planned enough," says Louis Gasbarro, president of the International Association for Healthcare Security and Safety (IAHSS) and security and safety director at Tampa General Hospital, Tampa, FL. "There's no such thing as over-planning or over-drilling. You must have a written plan known by all people, all departments, all personnel in the building. Everyone has to know their role." This special report will look at several events that brought an influx of patients to hospitals around the country, the disaster plans that were implemented, and what hospital officials learned from those experiences.

Accidents↗
PubMed1998

A review of contributions to disasters: 1977-1996.

Since the first issue in 1977. Disasters has been one of the pre-eminent refereed journals on the study and reporting of disasters. This article reviews 703 articles and reports in the journal through 1996 to provide a snapshot of the nature of the journal throughout 20 years of publication. The results indicate the most common contributions: first, were research articles by authors from the North Atlantic; second, most often dealt with natural disaster relief or impact; and third, most frequently focused on Africa. These generalisations, however, do not reflect attention paid to food-related and political disasters and greatly understate the broad diversity of material presented in the journal. To improve the topical and geographic coverage of Disasters probably requires a proactive effort to close gaps in the journal's coverage of disasters.

Authorship↗
PubMed2000

[Principles of management of All-Russia Disaster Medicine Services].

Experience of liquidation of earthquake consequences in Armenia (1988) has shown that it is extremely necessary to create the system of management in regions of natural disaster, large accident or catastrophe before arrival of main forces in order to provide reconnaissance, to receive the arriving units. It will help to make well-grounded decisions, to set tasks in time, to organize and conduct emergency-and-rescue works. The article contains general material concerning the structure of All-Russia service of disaster medicine (ARSDM), organization of management at all levels and interaction between the components of ARSDM and other subsystems of Russian Service of Extreme Situations. It is recommended how to organize management of ARSDM during liquidation of medical-and-sanitary consequences of large-scale extreme situations.

Disaster Planning↗