A disaster can be defined as any occurrence that occur damage , ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area.
According to WHO
Characteristics of disaster :-
1.Predictability
2.Controllability
3.Speed of onset
4.Length of forewarning
5.Duration of impact
6.Scope and intensity of impact
Types of disaster :-

PRINCIPLES OF DISASTER MANAGEMENT :-
1.Ethical principal :-
Observe basic rights of beneficence
Share risk information
Share assignment data
2. Strategic principle :-
Recognize strategic consider
Balance of trust VS control
3. Tactile principle :-
Recognize Tactile consideration
Establish baseline portions
Ensure relevance of indicators
4. Implementation principles :-
The implementation is the final step of principal implementing all planned strategies.
Principles of disaster management: -Sanford(1984)
1. Prevention of occurrence
2. Minimizing casualty number only
3. Preventing further casualties
4. Rescuing the injured
5. Providing first aid
6. Evacuating the injured
7. Providing definitive care
8. Facilitating reconstruction recovery
The fundamental aspects of disaster management program :-
Disaster prevention
Disaster preparedness
Disaster response
Disaster mitigation
Rehabilitation
Reconstruction
Disaster cycle :-
Mitigation - Minimizing the effects of disaster.
Examples: building codes and zoning; vulnerability analyses; public education.
Preparedness - Planning how to respond.
Examples: preparedness plans; emergency exercises/training; warning systems.
Response - Efforts to minimize the hazards created by a disaster.
Examples: search and rescue; emergency relief
Recovery - Returning the community to normal.
Examples: temporary housing; grants; medical care.
PHASES OF DISASTER :-
1.Pre impact phase
2.Impact phase
3. Post impact phase
A. PRE- IMPACT PHASE :-
1.Disaster preparedness :-
Is an ongoing multipurpose activity, integral part of the national system responsible for developing plans and programs for disaster management, prevention, mitigation, response ,rehabilitation and reconstruction.
Co-ordination of a variety of sectors to carry out:
1.Evaluation of risk
2.Adopt standard and regulation.
3.organize communication and response mechanism.
4.Ensure all the resources-ready &easily mobilized.
5.Develop public education programs.
2.Disaster Mitigation :-
1.It is virtually impossible to prevent occurrence of most Natural Disasters, but it is possible to minimize or mitigate their damage effects.
2.Mitigation measures aim to reduce the vulnerability of the system. E.g. By improving and enforcing building codes etc.
3.Disaster Prevention implies complete elimination of damages from a hazrd , but it is not realistic in most hazards. E.g. Relocating a population from a flood plain or from beach front
4.Medical casualty could be drastically reduced by improving the structural quality of houses, schools, and public or private buildings.
5.Also ensuring the Safety of Health facilities, public Health Services , Water supply , Sewerage system etc.
The mitigation program will direct the following activities :-
1.Identify areas exposed to natural hazards and determine the vulnerability of key health facilities and water systems.
2.Coordinate the work of multi disciplinary teams in designing and developing building codes and protects and water distribution for damages .
3.Hospitals must remain operational to attend to disaster victims.
4.Include Disaster Mitigation Measures in the planning and development of new facilities.
5.Inform , sensitizeand train those personnel's who are involved in planning , administration , operation , maintenance and use of facilities about disaster mitigation .
6.Promote the inclusion of disaster
Policy development:-
The policy development is the formal statement of a course of action .
1.Establish long- term goals.
2.Assign responsibilities for achieving goal
3.Establish recommended work practice.
The recognition of the problem associated with disaster as being part of a total.
Govt.responsibility and to ensure the best possible arrangements, given available resources.
1.The adoption of all hazards and people centered approach to Disaster Risk Management.
2.The recognition of disaster risk and vulnerability reduction as essential for sustainable development planning.
3.The development of effective risk management arrangements that links various level of government.
4.The development of an attitude of self - help within the community through ongoing education and awareness programs.
INSTITUTIONAL OR HOSPITAL DISASTER PLANNING
Disaster planning is important and necessary in every hospital . Every hospital , therefore, should be able to initiate immediate action in the event of :-
1. An internal disaster e.g. fire and explosions , for which fire fighting system and fire extinguishers are kept ready.
2. Some external disaster , like vehicular accidents , fire and explosions.
3. Major external disaster like tornado, earthquake .
4. Threats of disaster Eg. warning of tornado, volcanic eruptions
The hospital planning includes :-
A. Hospital preparedness
B. Communication system
C. Medical management
1.Constitution of a disaster management committee.
2.Control centre
3.Command centre
4.Reception centre and rapid response team
5.Information and communication
6.Arrangement of disaster bed
7.Logistic support system
8.Emergency blood bank
9.Triage
10.Documentation
11.Disposal of death cases
12.Staff
13.Stores and equipments
14.Dietary services
15.Prevention of epidemics
IMPACT PHASE :-
Disaster response:-
Immediate reaction to disaster is anticipated,or soon after it begins in order to assess the need,reduce the suffering, limit the spread and consequences of the disaster, open up the way to rehabilitation by:-
1.Mass evaluation
2.search and rescue
3.Emergency medical services
4.securing water and food
5.maintenance of law and order
6.Implementing the disaster management plan.
7.Development of search and rescue team
8.Setting up medical camps and mobilizing
providing adequate shelter and sanitary facilities.
9.Epidemiologic surveillance and disease control.
10.Vaccination
1.Search,rescue and first-aid:
Major disaster, the need for search ,rescue and first-aid is likely to be so great that organized Relief services will be able to meet only a small fraction of the demand.most immediate help comes from the uninjured survivors.
2.Field care:
most injured person converge spontaneously to health facilities, using whatever transport is available, regardless of the facilities, operating status.
3.Triage:
Triage classified Four color code systems:-
Red -indicates high priority treatment or
transfer.
Yellow - medium priority
Green - indicates ambulatory patient's
Black - dead or moribund patients.
4.Tagging - All patients should be identified with tags stating their name , age,place of Origin ,
triage category, diagnosis and treatment.
5.Identification of dead:
Taking care of the dead is an essential part of the disaster management care of the dead includes:-
a. Removal of the dead from the disaster scene
b. shifting to the mortuary
c. Identification
d. Reception of bereaved relatives . proper respect for the dead is of great importance.
POST IMPACT PHASE
1.Rehabilitation :- Rehabilitation starts from the very first moment of a disaster . In first week of disaster , the pattern of health needs , will change rapidly , moving from casualty treatment to more routine primary health care .services should be recognised and restructured . Priorities also shift from health care towards environmental heath measures.
Some of them are as follows :-
1.Water supply
2.Food safety
3.Basic sanitation and personal hygiene
4.Vector control
5.Psychosocial rehabilitation and relocation :-
The rehabilitation measures are :-
1.Public education :- under the national disaster planning itself , people should be educated about keeping themselves healthy and to meet any disaster situation skillfully .
2.Reception centers should be opened to receive a large number of displaced people with govt. Direction and financial support and sometimes international support.
3.Welfare centers need to be established at various strategic points for providing food, clothing , lodging , registration of refuges , electing registration booth centres.
4.Medical care centres these include facilities for prevention of disease, control of spread of infection , provision for emergency surgery , obstetric care and infant care.
EFFECTS OF DISASTER :-
1.Death
2.Disabilities
3.Increase in communicable diseases
4.Psychological problem
5.Food shortage
6.Socio economic losses
7.shortage of drugs and medical supplies
8.Environmental disruption
TEAM , GUIDELINES, PROTOCOLS, EQUIPMENTS , RESOURCES
DISASTER TEAM :-
A disaster action team (DAT) is a group of volunteers who have been trained by the Red Cross to respond to the scene of a disaster.
DMAT are categorised according to their ability to response an MCI
level - I DMAT can be deployed within 8 hours notification and remain self - sufficient for 72 hrs within enough food , water, shelter , medical supplies to treat patient
Level - II Lack enough equipment to be self sufficient but are used to replace a level I
Team members :-
1.Chairman
2.Vice chairman
3.Min. National Defence
4.Rep. Min . Of communication, transport , post and constructions (CTPC ) - Member
5.Rep. Min of health - member
6.Rep. Of min .of industry - member
7.Rep. Min of information and culture - Member
8.Rep. Min of education - Member
9.Rep. Lao Red Cross Society (LRCS) -Member
10.Ministry of labor and Social Welfare
11.Office casework
12.Training team
13.Recruitment team
Guidelines for disaster preparedness :-
Assessment is the process of determining :-
1.The impact which a hazard has had on a society.
2.The needs and priorities for immediate emergency measures to save and sustain the lives of survivors
3.The possibilities for facilitating and expediting
4.Longer term recovery and development
5.Three general priorites are to be identified for early assessments :-
a. Location of problem
b. Magnitude of problem
c. Immediate priorities
6.Emergency medical and health
7.Search and rescue
8.Personal and household needs
9.Economic needs
Equipment for disaster management :-
1.First aid article
2.Medical supplies needed
3.Communication
4.Transport
Resources :-
1.Medical personal
2.Medical equipments
3.Basic needs (food, shelter , water )
COORDINATION AND INVOLVEMENT OF COMMUNITY NATIONAL AND INTERNATIONAL VOLUNTARY AGENCIES
National and international voluntary agencies :-
Red cross society
District hospital
UNICEF
WHO
voluntary organisation
Local government
Functions of UNICEF during disaster period
Education
Nutrition
Water
Sanitation
Technical support
Training
Function of Red cross society during disaster :-
Identify and trains
Collaborative with other voluntary
Active disaster group
Educate
Information
Support
District hospital
Treatment
Training
Awareness
Local government
Co - ordination
Training
Repair Republic building
Public health services
Effect of disaster
Role of nurse ;working
1. Prepare the triage protocol : triage consist of rapidly classifying the injured on the basis of the severity of their injuries and the level promote medical intervention .
Red - high injury
Yellow - medium injury
Green - ambulatory patient
Black - dead
2. Managing behavioural issue:
3. Creating awareness
Technological needs
Self reliance
Communication
Preparation of first aid kit
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