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Formulating disaster relief when needs are unknown.

As in most cases of natural disasters, relief needs arising out of the Mount St. Helens volcanic eruptions in May 1980 were greatly overestimated. Technical, bureaucratic, and political considerations all contribute to the upward bias in such cases. The errors in early estimates of relief needs can be reduced by systematic means. But more important than obtaining good early estimates is maintaining an effective control over actual disaster relief expenditures. As it turns out, the more effective systems of control usually go hand in hand with poorer early estimates, creating a dilemma for the management for disaster relief.

Disasters↗

National Disaster Medical System; medical manpower component establishment--Health Resources and Services Administration, HHS. Notice.

This notice announces the creation of the medical manpower component within the Health Resources and Services Administration (HRSA), Department of Health and Human Services/Public Health Service (HHS/PHS) as a part of the National Disaster Medical System (NDMS). The NDMS is an organized resource that may be activated to serve national needs in the event of disasters or other major emergencies requiring extraordinary medical services. The manpower component will contain volunteer medical response personnel and technical staff that will be made available in situations requiring substantial medical services from outside the area affected by the disaster or emergency. The manpower component of NDMS is being established by HRSA/HHS/PHS in cooperation with the Department of Defense (DoD), Federal Emergency Management Agency (FEMA), and the Veterans Administration (VA).

Disaster Planning↗

Community disaster planning and training.

In a major disaster there is no easy way to deal with the multitude of problems that occur unless there are plans prepared and regular exercises to provide practical training. Disaster planning is an ongoing process. Personnel from all response agencies should be trained in their roles and be familiar with the plan. Realistic planning takes into account the need to adjust plans to the people, not vice versa. It should not require people or agencies to deviate sharply from their normal, everyday behavior. Disasters require a prompt response, coordinated activities, and cooperative efforts by all concerned agencies in order to identify and evaluate actual and potential risks, control and eliminate hazards, mobilize resources, and provide effective action to save life and property.

Disaster Planning↗

Disaster psychosocial services in Hong Kong--make the unseen injury seen.

While intervention services for the physical consequences of disaster and trauma have been in evidence for decades, only within recent years has serious attention been paid to the psychological consequences of disaster. This paper describes the development of a program of psychosocial services designed to respond to the needs of the people of Hong Kong in the wake of a disaster.

Crisis Intervention↗

New standards issued for disaster planning.

New accreditation standards require you to work with community agencies as part of preparation for disasters. Invite community first responders to critique your disaster drills. Offer to use your ED as a training site for other agencies. Include jobs for volunteers in your disaster plan.

Accreditation↗

[Problems encountered during natural disasters: a questionnaire study].

Human being has been encountering huge natural mass disasters since the dawn of existence. In the earthquake both Marmara region on August 17 1999 and Duzce region on November 12 1999, according to official records, 18.287 people were dead and 46.857 were injured. The purpose of this study is to get information by bilateral interviews with those who witnessed this big earthquake in different districts and to contribute in forming a prepared "disaster administration" consciousness for the prospective disasters, under the basis of these information. This study was made by interviewing with 262 people, 82 of whom witnessed the earthquake in the city of Yalova, 90 in Izmit, Bolu and Golcuk and 90 in Istanbul, used a questionnaire form consisted of multi choice and commentary questions. It is of very importance to diffuse educational programmes to increase social consciousness and sensibility about earthquake. Some projects to meet the basic requirements like communication, rescue, accommodation, nutrition and urgent medical support must be developed and embodied. Measures enabling to determine the identities of those who lose their lives in the earthquake must be determined and organized with the collaboration of forensic medical units.

Adolescent↗

Keyword: help! Online resources for disaster preparedness.

Health care organizations such as home care agencies should have post-disaster contingency plans in place that include contacts with the local, county, or state emergency management office, local branch of the Red Cross, and a clearly identified point person within the agency to coordinate disaster response efforts. Home care agencies must plan for the far-reaching effects that disasters can have on people in the community. This article provides some online resources to help you, your organization, and your family prepare for unexpected events.

Disaster Planning↗

[Reproductive behavior after the flood disaster in Klodzko region--July 1997].

RATIONALE: Flood disasters destroy environment of many people by causing physical as well as psychological harm. This may affect procreational behavior of the victims. DESIGN: This study examines reproductive behavior (number of live births) among the survivors from the flood disaster in Klodzko Region which took place in July 1997. The observation period was three years (1998-2000). MATERIALS AND METHODS: The harmed population consisted of 3986 subjects. The population from Klodzko Region which was exposed to flood disaster in 1997 consisted of 107,032 people. Among the injured population there were 1037 women in reproductive age. This population was studied. RESULTS: The results show significantly higher number of live births per 1000 and birth-rate in studied women as compared to the total population of a district. Psychological background of an observed phenomenon was discussed.

Adaptation, Psychological↗

Joint Commission zeroes in on disaster plans: is yours up to par?

The Joint Commission says that surveyors are paying close attention to disaster planning. You'll need to demonstrate compliance with many new standards, including performing a hazard vulnerability analysis and working with community organizations. All ED staff members must be prepared to answer questions about their role in disaster planning. Include individuals from community organizations when developing your disaster plan and holding drills.

Bioterrorism↗

Emotional trauma associated with renal disease and natural disasters.

Emotional trauma frequently follows any disaster such as fire, flood, earthquake, accidents, war, bombings, and life-threatening disease. One such disease is end stage renal disease (ESRD), an irreversible, progressive loss of renal function (Lancaster, 1995). Since this is a "do or die" situation, it requires artificial methods of hemodialysis, peritoneal dialysis, or transplant, which require learned coping skills. Emotional trauma may occur pre or post-disaster and may include flashbacks when events trigger suppressed memories or unresolved emotions. Aftercare of disasters requires dedicated professionals to guide patients toward essential lifelines.

Adaptation, Psychological↗

Burns mass disasters: aetiology, predisposing situations and initial management.

Many agents that are encountered daily are liable to cause burns mass disasters. These include flames, hot water and steam, combustible gases and liquids, molten liquids, boiling liquid expanding vapour explosion, chemicals and explosives. They result in disaster when certain lacks in safety occur. The proper management of such burns victims begins with rescue. At the disaster site, triage is important to separate the living from the dead, decide on priorisation for initial treatment and then evacuation to an appropriate facility. Proper management requires team effort and should be continued en-route to hospital. Repeat triage and use of clear guidelines in the Emergency Department ensure optimal and rapid care of the casualties. Finally psychological support for victims, relatives, rescuers and health workers must not be forgotten.

Burns↗

[A study on the health status of residents affected by flood disasters].

OBJECTIVE: To study the immediate and long-term effects of disasters caused by floods on residents health status. METHODS: Stratified sampling by ranks of flood disaster occurred in 1996 and 1998, flood disaster areas and control areas were carried out. A retrospective study was also carried out to study all diseases involved during 1996 - 1999. RESULTS: The incident rates of acute infectious disease in flooding areas in 1996 and 1998 were both higher than those of non-flooding areas (863.181/100 000 and 736.591/100 000, respectively). But there was no different between the incident rate of the first years in flooding areas and that of non-flooding areas. The prevalence rates of 8 kinds of chronic diseases related to circulatory system, nervous system, digestive system, injury and poisonous diseases in flooding areas were also higher than that in the non-flooding areas. The highest incidence rates of most diseases were in the mountainous flooding areas, followed by areas collapsed by flooding, and the lowest were seen in soakedareas by floods. The incidence rates of intestinal infectious diseases and respiratory infectious diseases were lower in areas where prevention and control measures were weak. CONCLUSION: Flood could lead to the increase of incidence rates both on acute infectious diseases and non-infectious diseases. Interventions on non-infectious diseases should also be enforced to stop the epidemics when preventing and controlling acute infectious disease.

Acute Disease↗

Psychiatry and terrorism: the profession's role in disaster response planning.

While America wages the "war" on terrorism and endeavors to protect the physical safety of its citizens, it is imperative to plan for the population's mental health needs in future terrorist/disaster scenarios. The importance of psychiatry's potential role in preparing the community for the psychological impact of terrorism is underscored against the historical backdrop of the field being "carved out" from the organization, delivery, and financing of health services in our society. A practical framework is offered for designing an organization's mental health disaster plan, including recommendations for strategic infrastructure and tactical response capabilities. Finally, the unique features of clinical practice with disaster victims are noted, including intra-clinician conflicts between professional/community interests and personal/family obligations during acute disaster events.

Disaster Planning↗

Disaster drill at a university hospital.

The course of a disaster drill held on 23 October 2001 at Aga Khan University, Karachi is reported. The Hospital Emergency Plan was put to trial on that day. Volunteers were invited to become simulated casualties in the drill. Briefing seminars had been conducted with the key players of the hospital. The scenario was a man-made type disaster. A 747 jumbo jet with 200 passengers had crashed at the end of the runway at Quaid-e-Azam International Airport while taking off in a thunderstorm. Fifty casualties were sent to Emergency Room by ambulance. The Plan was activated and relevant units were mobilized according to the Plan. It took 2 hours to complete the disaster drill. Major difficulties were identified in the operations, communications, staff deployment, and emergency control center. Debriefing sessions reviewed difficulties encountered throughout the drill and the possible remedies.

Disaster Planning↗

After the Indian Ocean tsunami: Singapore's contribution to the international disaster victim identification effort in Thailand.

This paper describes the international disaster victim identification (DVI) response mounted in Thailand, with particular reference to Singapore's contribution to this process, in the wake of the Asian tsunami of 26 December, 2004, which devastated parts of more than 10 countries in and around the Indian Ocean and claimed more than 200,000 lives. Although Singapore was unscathed by this natural calamity, over 30 Singaporean visitors were counted amongst the thousands of deceased victims, mostly in Thailand. The systematic application of forensic pathology, forensic dentistry, DNA profiling, and fingerprinting to human identification, especially of the bodies of various nationalities that were in advanced states of putrefaction, was crucial to the entire DVI process. The authors perceive that the resource implications arising from such a disaster, which is unprecedented in both its scale and reach in the international history of DVI, are immense. Forward planning, adequate funding and international cooperation are essential to mounting an effective response to any major mass disaster of the future.

Bayes Theorem↗

Tsunami in South Asia: what is the risk of post-disaster infectious disease outbreaks?

The World Health Organization has warned that in the aftermath of the recent tsunami, infectious disease outbreaks will add to the heavy toll of the disaster itself, possibly even doubling the number of casualties. However, many experts believe the risks of infectious disease outbreaks following natural disasters have been overemphasised and have led to unnecessary and potentially harmful public health activities. This paper discusses the risk and prevention strategies of potential infectious diseases in the aftermath of the tsunami based on a literature review of previous similar disasters and current evidence. Infectious disease outbreaks, if any, will most likely be the consequence of post-tsunami camp situations involving large displaced populations rather than the tidal wave itself. Lessons have been learned from previous large-scale humanitarian crises about the provision of aid and the mitigation of epidemics. This paper examines the risk and preventive strategies of vector- and food/water-borne diseases, measles, acute respiratory infections and meningitis. Alert thresholds at which to trigger outbreak investigations, and standardised guidelines with regard to their control are outlined, based on the Sphere Project.

Communicable Diseases↗

Going down the drain: When children's fears become real--responding to children when disaster strikes.

In recent years our nation and world have experienced horrendous natural disasters as well as those inflicted by terrorism. Data collected following September 11, 2001 show that children residing in the areas closest to where the attack occurred were not optimally assessed or supported to assist their response to the trauma they experienced. Data also show that children's recovery from exposure to trauma associated with disasters is affected by how their parents are able to cope with the turmoil surrounding these events. Children's responses also reflect their development, which in turn affects their understanding of what has occurred. Recommendations for care of infants, toddlers, children and adolescents who have been exposed to disasters are offered. In addition, how children interpret media presentations of these events affects their response. Children should have their viewing of media presentations limited and accompanied by adults who can address their child's questions and concerns.

Child↗

Expanding disaster mental health response: a conceptual training framework for public health professionals.

The available research literature suggests that in disasters, individuals presenting acutely with psychologically-related complaints tend to outnumber those presenting with physical symptoms directly stemming from the injury-causing agent or event. This acute "mental health surge" can rapidly overwhelm existing community mental health resources, especially in the context of terrorism. Training professionals from outside the traditional mental health workforce in basic psychological crisis intervention may promote more efficient use of mental health services through a gatekeeper process of early intervention and appropriate referrals to mental health specialists. With their experience in patient and client services at the community level, public health professionals represent a cohort well-suited for training in and delivery of acute mental health services in disasters. In this paper, we outline a conceptual model and rationale for training public health professionals in basic crisis-oriented mental health functions (psychological first aid) in order to augment community-based mental health services for affected populations in a disaster.

Clinical Competence↗