environmental health services in emergency situation

Environmental Health Services in Disaster and Emergency Situation

Adedotun T. ADEOLU

DisasterA disaster is a serious disruption of the functioning of a society, causing widespread human, material or environmental losses which exceed the ability of the affected society to cope using only its own resources.

It is a sudden unforeseen occurrence of an event that causes damage to properties, ecological disruptions, loss of human life, deterioration of health and health services on a scale sufficient to warrant extraordinary response from outside the affected community.

05/02/23 Adedotun T. ADEOLU, Dept of EHS, SAHES, KWASU 2

Features of Disaster• It is an event• It affects human beings i.e life, property, infrastructure and environment

• It disrupts daily life• It creates a need for external assistance• It has a causative agent (hazard)• It often occurs without warning


Types of Disasters• Meteorological (Extreme weather events): e.g Floods, cyclones, tornadoes, hurricanes, drought, snow storms. These occurs regularly.

• Telluric or Tectonic (events related to extreme of the earth’s geology): e.g earthquakes and volcanic eruptions.

• Technological e.g chemical and industrial accidents, oil spills, and radioactive contamination, wars and civil strife, epidemics of disasters.


CLASSIFICATION OF DISASTERS Main groupsMan MadeNatural Overlapping natural and man-made

Nature of onsetSudden e.g earthquake, tsunamis, storms,

accidentsSlow/insidious e.g drougnt, famine,

deforestation, insurgency, epidemics, radiation from nuclear activities


CLASSIFICATION OF DISASTERNatural Disaster- event of nature that takes human lives/and/or destroys property. Examples

Cyclones,HurricaneTornadoFloodsEarthquakesDroughtVolcanic eruptionWind/rain storms


MAN-INDUCED

oil spillageconflict /violence/warsbombingfire outbreaksuffocation: indoor air pollution, CO from generating setpollutionroad traffic accidentair traffic disasterstechnological accident: Chernobyl disasterair pollution: smog in winter

705/02/23 Adedotun T. ADEOLU, Dept of EHS, SAHES, KWASU

MAN-INDUCEDrail accidentdisease epidemicwater pollution: heavy metals and toxic elementsdeforestation: aridity, soil erosion, landslidessiltation: rivers, lakes, water pipes damsdisposal of tailings: mining waste disposalacid drainage:- source: mines, chemical industries, etc.destruction of eco-systems : sand-gravel mining,

construction of dams and houses, over-harvesting of edible animal and plant species

social problems: child labour, weak health care, immigration problem, overpopulation


Forms of Classification• Natural-Sudden onset• Natural-Slow onset• Man-made-Sudden onset• Man-made-Slow onset


Forms of Classification• Natural Slow onset: Drought, desertification, famine, flood, epidemics-cholera.

• Natural Sudden onset: Earthquakes, volcanic eruptions, hurricanes, typhoon, landslides, bush fires.

• Man-made Slow onset: wars, civil strife, environmental pollution, economic crisis.

• Man-made Sudden onset: Toxic wastes, fires, wars, oil spillages, transportation accidents, technological and industrial accidents, terrorism

• Overlap Natural/Man-made: Landslide, drought, desertification, famine, flood, epidemics and infestations

• Medical disasters: epidemics e.g Cholera, yellow fever, meningitis and diseases.


EMERGING DISASTERPipeline vandalisationKidnappingMilitancyReligious RiotsEthnic/Boundary disputesClimate changeOil spillageCommunal clashPolitical uprising


Characteristics of disasters• Increase in mortality and morbidity• Overwhelming of resources• Local and international stigmatization• Disruption of social and economic activities• Panic and confusion among residents• Losses or deprivation of lifeOf health temporarily and permanentlyOf social welfare servicesOf environmental integrityOf socio-economic developmental advances e.g

destruction of properties and essential structures05/02/23 Adedotun T. ADEOLU, Dept of EHS, SAHES,

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Characteristics of disasters• Injuries to individuals e.g burn, fractures• Disruption of displacement of people i.e refugees• Death• Increased risk of communicable diseases due to lack

of water, poor environmental sanitation and overcrowding

• Mental health effects; post disaster syndrome, anxiety, depression, neurosis.

• Poverty• Destitution


Some Occurrences of Natural & Man-made Disasters and Emergencies

SSNN

NameName LocationLocation PeriodPeriod

11 Jesse Oil Pipeline Fire Jesse Oil Pipeline Fire DisasterDisaster

Jesse, Ethiope Jesse, Ethiope WestWest

Oct Oct 19981998

22 Oil Pipeline Fire DisasterOil Pipeline Fire Disaster WarriWarri 20012001

33 Kerosene Explosion Kerosene Explosion Benin CityBenin City Jan/Feb Jan/Feb 20012001

44 Kerosene ExplosionKerosene Explosion LagosLagos Oct Oct 20012001

55 Oil spill Oil spill ForcadosForcados 1975, 1975, 19791979

66 Oil SpillOil Spill Faniwa well Faniwa well blow outblow out

19801980

77 Oil Spill (Mobile Idoho Oil Spill (Mobile Idoho Pipeline BurstPipeline Burst

Quo Iboe Quo Iboe Terminal Terminal

19981998

88 The 6 Air Disaster The 6 Air Disaster Many locationMany location 2005 & 2005 & 20062006

SSNNNameName LocationLocation PeriodPeriod

11 Chenobyl Nuclear Plant Chenobyl Nuclear Plant DisasterDisaster

RussiaRussia 19861986

22 Hurricane Catrina Hurricane Catrina BahamasBahamas AugusAugust 2005t 2005

33 Hurricane Andrew Hurricane Andrew Florida, USAFlorida, USA 19921992

44 Asian TsunamiAsian Tsunami Some Asian Some Asian Countries Countries

Dec Dec 20042004

55 Nagasaki Spirit DisasterNagasaki Spirit Disaster Nagasaki, Nagasaki, JapanJapan

19951995

66 Aegian Sea Oil DisasterAegian Sea Oil Disaster La Coruna, La Coruna, SpianSpian

19921992

77 Exxon Valdez Exxon Valdez Prince Prince William PortWilliam Port

19891989


15

Hurricane Katrina crossing Gulf of MexicoYellow/orange/red areas at or above 82°F (27.8°C) – the temperature needed for hurricanes to strengthen.

(NASA, 2005)05/02/23 Adedotun T. ADEOLU, Dept of EHS, SAHES, KWASU

Major Disasters in Nigeria• JULY 10 2000, A PIPELINE EXPLODES, KILLING ABOUT 250 VILLAGERS,

WITH FIRES BURNING OUT OF CONTROL NEAR THE TOWN OF JESSE. • ON JULY 16 2000, AT LEAST 100 VILLAGERS DIE WHEN A RUPTURED

PIPELINE EXPLODES IN THE TOWN OF WARRI.

• NOVEMBER 5 2000, UP TO 200 PEOPLE ARE KILLED WHEN A PETROL TANKER CRASHES INTO A QUEUE OF VEHICLES AT ILE-IFE, OSUN STATE, AT AN ILLEGAL CHECKPOINT SOUTHWEST NIGERIA.

• NOVEMBER 30 2000, A LEAKING OIL PRODUCTS PIPELINE CAUGHT FIRE AT A BEACHHEAD NEAR THE FISHING VILLAGE OF EBUTE NEAR LAGOS, KILLING AT LEAST 60 PEOPLE.


Major Disasters Cont• MARCH 6 2001, TWENTY-THREE GIRLS DIE IN A BLAZE AT GINDIRI

GOVERNMENT GIRLS SCHOOL NEAR JOS IN CENTRAL NIGERIA, AFTER THEY HAD BEEN LOCKED IN FOR THE NIGHT.

• January 2002, AT LEAST 600 PEOPLE ARE DROWNED AND THOUSANDS MADE HOMELESS AFTER MULTIPLE BOMB EXPLOSIONS AT A NIGERIAN MILITARY ARMORY TRIGGERED BY AN ACCIDENTAL FIRE CAUSED MASS PANIC.

• MAY 4 2002, A NIGERIAN EAS AIRLINES' BAC 1-11-500 WITH 105 PEOPLE ON BOARD CRASHED INTO THE NORTHERN


Major Disasters Cont• June 19 2003, A Nigerian oil pipeline punctured by thieves

explodes north of the Abia state capital Umuahia, killing 125 villagers.

• September 7 2003, At least 70 people are killed in a crash and resulting fire involving a passenger bus and three other vehicles near the Murtala Muhammad bridge on the Abuja-Lokoja highway.

• October 9 2003, At least 100 people drown when the Kuntu-Borong ferry, traveling from Numan in Adamawa state to Jen in Taraba state, hits a pillar of the Numan bridge and capsizes

• September 17 2004, Dozens of people are killed in a petroleum pipeline explosion in the commercial capital Lagos. The explosion happened as thieves tried to siphon petrol from a pipeline belonging to state oil company NNPC.


Major Disasters Cont• October 23 2005, Bellview Airlines Boeing 737 with 117 on board crashes

shortly after take-off from Lagos. • December 10 2005, A passenger jet crashed on landing at the airport in the

city of Port Harcourt. Over 100 dead including 50 school children.• Sept 18 2006, 10 generals among 12 killed in plane crash The plane had 18

people when it crashed Near Obudu in Cross River State. • ADC plane, Boeing 737, with 104 persons

including Sultan Abubakar on board, crashed near the Abuja airport shortly after takeoff and burst into flames


http://www.cnn.com/2006/WORLD/africa/09/18/nigeria.crash.ap/

http://www.cnn.com/2006/WORLD/africa/09/18/nigeria.crash.ap/

Major Disasters Cont• 1st October 2010 Abuja Bomb blast that killed over 12

persons and injured about 80 persons• The 2010 Christmas eve Jos multiple bomb blasts that

killed over 32 persons and injured several others• The 29th Dec 2010 Abuja - Mugahiru Barrack Bomb blast

that killed about 5 persons and injured about 2 dozens of others.


EMERGENCYCan be described as a localized event within a community that affects a limited number of individuals or property when there is a definite degradation in the resilience of a community in terms of a threat that contributes to vulnerability. A situation when an event threatens National security.


THE “CRUNCH” DIAGRAM

Vulnerability(exposure) Hazards

(trigger events)

D= H X V


RISKThe probability of harmful consequences, or expected losses (lives lost, persons injured, damage to property and/or the environment, livelihoods lost and disruptions of economic activity or social system) due to the interaction between humans, hazards and vulnerable conditions.


RISKS-THE NIGERIAN SITUATIONNatural & Environmental riskGeographical riskDrought/DesertificationFloodSoil ErosionFirePestsCoastal ErosionOcean surgeDeforestationPollutionEpidemics, storms.


SOCIAL ECONOMIC ASSOCIATED RISKS

-Religious/ethnic/border conflict-Unemployment-Corruption-Urbanization-Decline in Economic Act-Unstable polity


Risk equation• Risk = Hazard x Vulnerability

Level of Preparedness

• Risk Reduction: - Prevent hazards from creating risks

or

- Lessen the distribution, intensity/ severity of hazards.


HAZARDA potentially damaging physical event, phenomenon or human activity, which may cause the loss of life or injury, property damage, social and economic disruption or environmental degradation.

For each hazard;• What? - Natural, impact, severity• Where? – Likely areas• When? - Frequency, time and duration• Potential growth• Collection information:records, maps, scientific data, reports( including others) local experience

Analyse- produce hazard profileMaps-GIS05/02/23 Adedotun T. ADEOLU, Dept of EHS, SAHES,

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VULNERABILITYSet of prevailing or consequential conditions resulting from physical, social, economical and environmental factors, which increase the susceptibility of a community to the impacts of hazards.

Vulnerability situation

Examples: Slums situation malaria, typhoid, cholera etc.Crowded environment CSM, measles, whooping cough and spread of other communicable diseases


Vulnerability• An element’s vulnerability (fragility) is the result of a

community’s actions or nature’s actions that change the destructiveness of the storm

Mankind’s contribution• An element’s vulnerability (fragility) is the result of

flaws that enter during the planning, siting, design, and construction of a community’s buildings and infrastructure

• Urban development or industrial development along along coastlines prone to severe windstorms that generate coastlines prone to severe windstorms that generate storm surges, high-velocity wind, and heavy storm surges, high-velocity wind, and heavy precipitationprecipitation


Predisposing factors to disastersEnvironmental factors• Increasing deforestation• Industrialization and urbanization• Global warming and sea level rise• Environmental degradation

Economic developmentLevel of socio-economic


Vulnerable groups

• Age• Gender• Poverty• Educational levels• Previous general health conditions of health• Environmental conditions• Culture of the people• Geographical location• Nature and the peculiarity of specific disasters


CAPACITY/MANAGEABILITYIs the characteristics of a person or group in terms of their ability to anticipate, cope with, resist and recover from the impact of hazards.

CAPACITIES

Institutional Capacity fire hydrants, in companies & city, sick bays

Personal Capacity fire extinguishers in cars & homes/offices, raincoats/umbrellas

Municipal/Governmental hospitals/clinics in cities and towns


Disaster Management

•Disaster management is the body of policies, administrative decisions and operational activities which pertain to various stages of a disaster.

•This is essentially an inter-sectoral activity and the contribution of all sectors are crucial for its total success.


DISASTER- MANAGEMENT CYCLE

Emergency(Alertness + Defense) Response/ Relief Preparedness

Mitigation/ Rehabilitation Prevention

ReconstructionPre-disaster: risk reduction Post-disaster recovery

Disaster


Disaster Management- A developmental approach• Appropriate actions at all points of the cycle lead to greater

preparedness, better warnings, reduced vulnerability or prevention of disasters during the next iteration of the cycle.

• The objectives of the such an approach are to reduce hazards, prevent disasters and prepare for emergencies.

Aims and Objectives • Reduced (or total avoidance of , if possible) potential losses

from hazards • Assurance of prompt and appropriate assistance to victims

when necessary • Achievement of a rapid and durable recovery.


Options • Reduce hazards to the barest minimum• Reduce man’s environmental vulnerability• Combination of the two above and promotion of well being

of the general population.

Capacity for Disaster Management Based on • Information • Authority• Institutions • Partnerships • Plans, resources and procedures to activate them


Principles of Disaster Management • These focus on the desirable outcomes while

considering the disaster profile of the area and the population at risk

• It is essential to obtain all the essential information required about previous disasters and determine how best the information is made useful for future programmes

• Such information includes hazard mapping, vulnerability analysis, health care resource inventories and manpower resources


RISK ASSESSMENT• A risk assessment involves the probabilistic

integration of:

• The hazard (severe windstorms) and their potential disaster agents (winds, storm surge, etc) that are directly related to the location of the community and the path/size of the storm.


HAZARDSHAZARDS

ELEMENTS OF A SCENARIOELEMENTS OF A SCENARIO

EXPOSUREEXPOSURE

VULNERABILITYVULNERABILITY LOCATIONLOCATION

RISKRISK


NATURE’S CONTRIBUTIONS THAT INCREASE VULNERABILITY• Increased earth’s temperature

• Warm ocean/sea water

• Acidic or porous soil structure






Disaster


Mitigation• Mitigation : Knowing the types of disasters that can occur,

where and when goes a long way in thinking through and planning how to mitigate hazards and their effect

• Mitigation can be primary or secondary

• Primary mitigation involves reducing the presence of the hazards or vulnerability

• Secondary mitigation focuses on reducing the effects of the hazard (preparedness)


Reduction of the hazard • Reduction or elimination of all hazards would be

ideal but this is not possible for all hazards, however early warning could be obtained e.g. flood, hurricane and tornado warnings

• At the extreme is the fact that some hazards are completely unpredictable. e.g. earthquakes


Reduction of Vulnerability • Similarly, vulnerability could be reduced but hardly

ever to an absolute zero for most populations.

• This is another aspect of mitigation.

• In technologically advanced countries a lot has been done in this area and their populations tend to be less vulnerable compared to those in the less developed countries.

• However there are still multiplicity of factors which cannot be easily controlled.05/02/23 Adedotun T. ADEOLU, Dept of EHS, SAHES,

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Disaster


Disaster Preparedness

•Since disasters cannot be avoided or easily reduced, the best approach is to prepare (adequately) for the them.

•This is the focus of achieving desirable outcomes, having been armed with all necessary information such as the disaster profile of the area, and considering the capability and resources available to achieve the set objectives


Disaster Preparedness• Entails taking measures that ensure the organized

mobilization of personnel, funds, equipment and supplies with a safe environment for an effective relief.

• These measures are policy, administrative decisions, and operational activities which pertain to various stages of a disaster at all levels.


Disaster Preparedness• The aim of preparedness programmes is mainly to

minimize the adverse effects of a hazard through precautionary actions and to ensure timely, appropriate and efficient organization and delivery of relief.

• Plans for these programmes are drawn up, usually during the non/inter-disaster period.

• A large component of the plans are also implemented during the non- disaster phase either as precautionary activities or in anticipation of a disaster.


Focus for Disaster Preparedness1. Manpower resources: Community education and

training for action during the emergency and relief phase.

2. Material resources: Mobilization of needed supplies and other materials, identification of sources of certain supplies for use during the emergency phase.

3. Funds are either set aside or easily mobilize for use in the event of it being required to facilitate relief.

4. Management of the environment: Policy guidelines and administrative procedures designed to accommodate a management option for effective implementation of preparedness plans before, during and after a disaster. 05/02/23 Adedotun T. ADEOLU, Dept of EHS, SAHES,

KWASU 49

Disaster Preparedness Cont’d• Intersectoral collaboration is crucial from the

planning stage for success as implementation of plans cuts across sectoral and community lines.


Framework for Disaster Preparedness Programmes

1. Planning: Preparedness plans should have clear objectives with roles and responsibilities also clearly spelt out. As much as possible this should be an integrated plan, involving all relevant sectors of the economy, and the community

2. Hazard and vulnerability assessment: This is to determine what impact should be expected with certain hazards and what could be done about them

3. Information system: A viable and effective information system which ensures feedback should be aimed at.


Framework for Disaster Preparedness Programmes4. Resource base: Preparedness programmes should identify

resources for use and from where they could be obtained for preparedness and response phase of disaster

5. Early warning system- A valid reliable and functional warning system is essential though not applicable to all disasters.

6. Public information, education and training:• The ultimate purpose is to ensure that affected

communities can play their expected role in the case of disaster.

7. Rehearsals and drills: Serve the purpose of sharpening skills and testing systems.

• Drills give the opportunity to identify gaps and refine plans.


Framework for Disaster Preparedness Programmes

8. Response mechanisms: i.e. activating that portion of the preparedness plans which deals with the relief phase, after impact.






Disaster


Post-Disaster Recovery

•Response/Relief •Rehabilitation •Reconstruction


Balancing Response to Disaster

VictimsNeeds

Disaster

AvailableServices


Relief A set of activities implemented after the impact of a

disaster in order to • Assess the needs • Reduce suffering• Limit the spread and consequences of the disaster • Open the way for rehabilitation


Emergency Response • Emergency response is the phase of the disaster

management cycle which often attracts the most attention and resources.

• However the impact achieved in the early days of response is largely a test of the previously planned local and national response.

• Much of what contained in preparedness plans are designed to give relief and assist the affected populations(s) to recover during this phase.

• During the response phase, activities are implemented after the impact of the disaster and can be summarized under the following broad categories


Objectives of Response • Assessment of needs

• Rapid initial assessment • Detailed assessment

• Reduction of suffering

• Limiting the spread and consequences of the disaster

• Opening the way for rehabilitation


Detailed Activities

1. Warning 2. Evacuation3. Search and rescue 4. Assessment 5. Emergency relief –

Health, food, shelter and social welfare services

6. Logistics and supplies

7. Communication and information management

8. Survivor response and coping

9. Security 10. Emergency management

and co-ordination11. Expedition of

rehabilitation and reconstruction


Response

• Warning/Alert – The authorities should be informed I.e. the Local government chairman, the MOH/ PHC coordinator, armed forces, fire service etc.

• Evacuation – Temporary transfer of a population (and to a limited extent property).


Response • Search and rescue - People may be trapped at

the site of the disaster, there is a need to search for them and bring them out .

• The wounded must be found and given first aid

• Assessment - In terms of percentage of the population affected, medical needs, degree of personal damage, assessment of the risk of secondary infection, the progression of the disaster.


Emergency Assessments Allow the following - A decision to be made on whether local capacity is

required or external resources are required - Priorities for intervention to be established - Necessary resources to be identified - Baseline data to be collected- Information to be collected for fund raising and

advocacy


Transport for search and rescue

• Ambulances• Taxis• Private cars can be used for the rescue.• Helicopters can be used to evacuate seriously

injured people.• Trucks


Transportation Needs For

• Moving assessment and operational teams• Road clearance • Moving people affected by disaster • Moving human bodies • Moving animal corpse • Disposing of other waste and debris.


Public Health Interventions

• Public health interventions and specific disease control measures are a priority for reducing morbidity and mortality in disaster affected communities.

Main strategies

1. Adopting a multi-sectoral and preventive approach.

2. Involving refugees in planning and implementation

3. Specific needs of refugee children.


Strategies • Children below 5 years constitute 15-20% of

refugees. And are the group at greatest risk of increased mortality.

4. Meeting the needs of refugee women.• Refugee women play a key role as primary health

care providers for the whole family. • At the same time bear the brunt suffering and

hardship. • They need to considered as an integral part of all

aspects of planning and delivery of health-related services.


Strategies 5. Setting up an appropriate health and nutrition

information system. • Reliable collection, analysis and interpretation of

basic information on health and nutrition are essential prerequisite for effective planning, delivery and evaluation of a primary health care programme.

6. Ensuring complementarity and effective co-ordination among all partners.

• Quite often the efforts of the partners are duplicated in certain areas, while some other areas are neglected.


Services needed during Response/relief • Medical & paramedical, • Fire service, Army and police • NGOs- Red Cross and Red Crescent Societies • Media, • National Emergency Management Agency• UN agencies.


Priorities in early phase of emergency 1. Assess the situation2. Water sanitation environmental hygiene and

shelter3. Food and Nutrition4. Health Services5. Shelter and site planning6. Health Education7. Surveillance and control of communicable diseases

and epidemics


Assess the situation• Find out how many displaced persons there are,

particularly women and young children • Identify risk factors that increase the risk of

diseases • Find out about people’s health needs and

priorities • Assess the environment where the population

has settled, including water supplies, sanitation, food supplies, malaria transmission, etc


Water sanitation environmental hygiene & shelter

• Provide clean water • Distribute water containers and soap.• Establish systems to dispose of garbage , medical

waste and dead bodies.• Improvements in water and sanitation are often

the first priority.• Direct contamination of water can occur where

unprotected surface water supplies are used or where there is no control of sanitation


Food and Nutrition

• Provide general food rations and identify vulnerable groups who require supplementary feeding programmes

• Identify and treat children with malnutrition


Health Services• Decide on essential drugs, case definitions and

standard treatment guidelines.

• Treat common diseases

• Establish referral system


Shelter and site planning• Provide shelter and blankets.

• Plan citing of shelters to minimize overcrowding.Overcrowding results in increased transmission of

both person to person transmitted disease such as measles, meningitis,tuberculosis and vector diseases such as louse borne typhus.

• The quality of housing is also important particularly where the climate is harsh.


Health Education

• Find out about people’s beliefs, attitudes and customary practices .

• Conduct community education with participation of community leaders


Surveillance and control of communicable diseases and epidemics• Encourage the use of insecticide treated bed nets.• Immunize all children against measles if there is risk

of disease outbreaks• Monitor rates of illness and death to give early

warning of epidemics • Prepare contingency plans and stocks of ORS and

vaccines • Confirm outbreaks, conduct, investigations, plan

and implement control measures


Role of Hospitals in Response

• Hospitals are usually situated in densely populated areas and during disasters people gravitate to the hospitals.

• The management of mass casualties can be divided into 4 sections

1. Rescue/First aid : everyone must be trained to administration of first aid


Hospital Organization

2. Hospital organization • Minor plan: has to do with few casualties not more

than 100. • It should be simple aiming at taking care of the

few casualties with optimal use of hospital facilities.

• Major plan: All other patients apart from the seriously sick are discharged from the hospital and room is made for the casualties from the disaster.

• Specialists and other doctors are invited.


Role of Hospitals3. Diagnosis: • Proper diagnosis of the different conditions must made.

• The patients must be sorted out according to urgency of their condition.

• Those in shock must be observed for a few hours until they stabilize, those with lacerations, open wounds, etc should be treated and those in coma attended to by the relevant specialist.

• Those who are seemingly calm must also have the vital signs observed as the may have sustained to an internal organ e.g. spleen and haemorrhage internally.


Role of Hospitals Cont’d4. Treatment: May be minor or major, surgical

and /or medical, depending on the diagnosis .

5. Housing of victims/patients: The hospital wards may be insufficient so other buildings will need to be turned to wards to accommodate these victims.


Drugs and medical supplies

• There is a standard drug list that has been developed by the Red Cross and Red Crescent societies, WHO, UNICEF and other NGOs

• This is the list is recommended for use in disaster situations


Refugees • A refugee is someone with a well-founded fear of

persecution on the basis of his or her race, religion, nationality, membership in a particular social group or political opinion, who is outside of his or her country of nationality and unable or unwilling to return

• Refugees are forced to leave their countries by war, civil conflict, political strife or gross human rights abuses.


Problems of Refugee Camps

• Restrictive• Inadequate accommodation• Overcrowding • Small quantities of food supplied irregularly • Poor environmental sanitation • No defined plans for long term settlement provided

for the refugees.• Poor funding


Problems of Refugees

• Frustration • Violence • Unemployment • Poverty • Lack of access to adequate health services and

drugs • Rape


Issues Limiting Prompt response to Disasters • Poor telecommunications.• Poor electricity supply• Limited capacity of local officials to detect problems

early which is the first step of forecasting and designing adequate responses.

• The main emphasis has been on training of health personnel who have received training on syndromic recognition of frequently occurring epidemics such as cholera and CSM.


Issues Limiting Prompt response to Disasters Cont’d

• Lack of regular up to date data from the disease notification exercise

• Even when the disaster occurs there is lack of sufficient information about the affected populations to make emergency response planning effective and the response and relief is often inexact.

• The fatalistic attitude that God determines outcomes and lack of the understanding about early treatment interventions and containment with vaccines.


Issues Limiting Prompt response to Disasters Cont’d

• Nigeria’s national capacity to respond to disasters is still quite limited

• Few localities have functioning fire departments, ambulances, referral health care facilities or emergency stocks.

• These deficiencies have been evident in the fire brigade approach by the authorities when disaster have occurred in the country






Disaster


Rehabilitation and Reconstruction• Rehabilitation – The restoration of basic social

functions

• Reconstruction- The full resumption of socio-economic activities plus preventive measures


Procedures in Disaster and Emergency Management• Development and production of disaster and emergency

management plan• Adoption of disaster and emergency preparedness and

response strategies• Advocacy and public enlightenment• Training and capacity building• Mobilization of needed resources


EH Services in Disaster & Emergency Situations

• Environmental health practitioners, indeed EHOs, working with and alongside other public health professionals, are key partners in local and national efforts to protect and improve the health and quality of life of individuals and communities and to reduce health inequalities especially during disasters and emergencies.

• They will maintain a direct relationship with the general public, and apply their expertise in responding to the needs of individuals, while tackling the wider determinants of health by identifying, controlling and preventing current and future risks during disasters and emergencies.

• EH practitioners will play lead roles in coordination and implementation of community health and wellbeing programs to bring succour to the affected in time of crisis.

• EH will regulate, develop strategy and carryout advocacy/ brokerage on behalf of individuals, local communities and neighborhood (Green, Courage & Rushton, 2003.


EHS in Disaster & Emergency Cont.Pre-disaster Activities• develop EHS in emergency policies• develop of environmental health safety regulations• review environmental health development policies• assess vulnerability and capacity of local communities• map hazard and possible pollution and outbreaks• assess environmental health needs• train personnel• involve in National or state or LGA emergency planning

process• institutionalize early warning system


EHS in Disaster & Emergency Cont.During Emergency• organize emergency assessment• organize evacuation• provide environmental health services on evacuation route• set up standard for settlement in evacuation• strengthen health services in host community• provide EHS in search & rescue operation• ensure adequate medical services and referrals • manage personnel, including volunteers• manage equipment, funds and supplies• manage logistics• manage information and communication• educate the affected and reassure them


EHS in Disaster & Emergency Cont (Technical)

Water• ensure the provision of adequate potable water• carry out water quality monitoring & surveillance• develop emergency water supply strategy• carry out assessment of damage and available

water resources• determine water movement, storage and

distribution


Technical Aspect cont.Sanitation

• ensure prompt disposal of human waste• use appropriate method for disposal of human waste, eg defecation

field, shadow trench latrines, deep trench latrine and simple pit latrine

• adopt appropriate sullage disposal method• ensure personal hygiene• ensure proper storage and disposal of solid waste, medical waste and

rubbles• carry out education of the public on sanitation


Technical Aspect cont.Food safety

• institute food control measure• inspect food premises• control donated and imported food items• control mass-feeding centre• encourage breastfeeding• carry out education of the public on food safety


Technical Aspect cont.Vector & pest control• embark on pest and vector control• carry out education of the public on the control

pest & vector• carry out disinfection and disinfestations


Technical Aspect cont.Control of Communicable Diseases and Prevention and

Prevention of outbreak• carry out surveillance• investigate outbreak• carry out education of the public on the control of

communicable disease and prevention of outbreak


Technical Aspect cont.Tracking Chemical in the Environment

• assess possible chemical risk in the environment• determine toxic effects of chemicals • carry out EHIA• liaise with local the local community• work toward reducing the risk of chemical incidents• advise on protection against chemicals• organize sample collection and registration of samples• undertake environmental monitoring• communicate and inform the public• carry out education of the public on chemicals in the

environment


Technical Aspect cont.Radiation Emergencies

• determine health consequences of radiation• carry out education of the public on radiation and health

Mortuary Service and Handling the Dead• recover and identify the dead• organize mortuary service• handle the dead• burry the dead


Technical Aspect cont.Health Promotion and Community Participation

• define the contents of the health promotion• identify health promotion materials• develop message• carry out health promotion and education and all

aspect of environmental health• involve community members and encourage their

participation in what your are


EHS in Disaster & Emergency Cont.

After disaster• Impact assessment • Environmental clean-up• Environmental/ social/ health audit• Rehabilitation• Preparedness for future disasters and emergencies


Constraints in the Provision of EHS during Disaster and Emergency Situationweak institutional arrangementlack of adequate information and poor linkageslack of adequate skills by the practitionerslack of appropriate equipmentnegative attitude some other professional groups behaving as if they

have more to offer than otherslack of adequate resources


Measures to Prevent Future Hazard• Preparedness Planning : involves contingency measures to cope

with the emergency when it occurs .

• Mitigation Planning: involves the long-term control of land use, building stock quality and other measures to reduce the impact of a hazard when it eventually strikes. It also include identification of facilities for management of risk reduction like shelters, schools, hospitals, water supply, food supply, etc.

• Fundamental to these planning processes is an understanding of what to expect. This needs to be quantified, if only in a crude and approximate way, in terms of the degree of risk faced, the size of event that is likely, and the consequences of an event if it occurs.

• Risk Assessment is a scientific-based process of hazard identification, hazard characterization and exposure assessment, including population most at risk, eg population below poverty line, the aged, children, household without vehicles, etc.


Measures to Prevent Future Hazard Cont.

• Vulnerability Assessment is the process of identifying and quantifying vulnerabilities is a system.

• Scenario Mapping: presentation of the impact often used to determine the magnitude and to estimate the resources likely to be needed to handle an emergency. From these can be estimated the resources needed for medical attention, to reduce disruption in normal livelihood, accommodation for homeless, and minimization of the recovery period.

• Potential Loss Studies: estimation of populations/ communities likely to suffer heavy losses from hazard, to undertake priorities for loss-reduction programs, and to determine those likely to need most aid or rescue assistance in the event of a major disaster, including economic quantification.


Prediction• Data collection, analysis, interpretation &

utilization, (Interdisciplinary approaches will be needed to tackle cross-cutting issues and make proper decisions and application of data, e.g Health and climate, Health and biodiversity, & Health and disasters)

• Development of early warning system, (Leveraging and connecting existing tools and data services);


Example of tools & methods for prediction

• Epidemiologic Modelling and Forecasting;• Sand & Dust Storm Warning System; and • Geo-informatic (Geo-informatics is a science which develops

and uses information and science infrastructure to address the problems of geosciences and related environmental issues.

It combines geospatial analysis and modeling, development of geospatial databases, information systems design, human-computer interaction and both wired and wireless networking technologies.

Geo-informatics technologies include GIS, spatial decision support systems, global positioning systems (GPS), and remote sensing.


http://en.wikipedia.org/wiki/Science

http://en.wikipedia.org/wiki/Information_science

http://en.wikipedia.org/wiki/Geosciences

http://en.wikipedia.org/wiki/Engineering

http://en.wikipedia.org/wiki/Spatial_decision_support_system

http://en.wikipedia.org/wiki/Global_positioning_system

http://en.wikipedia.org/wiki/Remote_sensing

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