Disaster Medicine Public Health in Emergencies – Factors to

Consider

Fr-. Scott Binet MD, MICamillian Task Force

SOS DRS

Sao Paulo, Brazil - October 22, 2011

Disaster MedicinePublic Health in Emergencies – Factors to

Consider

Presentation Outline

1. Objectives 2. Introduction to the Camillian Task Force (CTF)3. Public Health in Emergencies: Factors to Consider 4. Disasters: Nature, Trend, Consequences5. Disasters: The Six Phases6. Disasters: Internally Displaced Persons - A Common

Element7. Questions/Comments

Disaster Medicine Public Health in Emergencies – Factors to Consider

Presentation Objectives

Inform you about factors to consider when providing public health services in disasters and how the Camillians are responding to the signs of the times through providing disaster relief. Sensitize you to the suffering of those affected by man-made and natural disasters

Inspire you to get involved and dialogue amongst yourselves and with me about how we might collaborate in disaster relief - mercyvolunteermail@gmail.com

Core

Ministers of the Infirm (Camillians)CTF Central

SOS DRS*Missionaries of Mercy*

Camillian Task Force – A Network

Caritas

Archdiocese of Miami, USA

Archdiocese of Port au Prince

Misericordiae

CRS

MoC ?

Church and State

Camillian Task Force -SOS DRSA Vision

To be Jesus’ merciful presence to the neediest of the needy who are suffering from man-made and natural disasters.

To respond globally through a community-based, Eucharist-centered, Marian-inspired disaster relief organization.

A Mission

To witness the merciful love of Christ for the poor and the sick in word, deed, and sacrament

To serve the medical, pastoral, educational and humanitarian needs of people affected by man-made and natural disasters regardless of race, religion, or ethnicity.

Camillian Task Force

1- [

SOS DRS Office]

2 [Haiti -

Earthquake, Cholera, Hurricane, Slum]

3 - Italy [CTF Central/Earthquake]

4 - Horn of Africa [Famine]

5 - Pakistan [Floods]

6 - Thailand [Floods]

Responding to the Signs of the Times: Disaster Relief and the Camillians – Parts 1 and 2

Cholera - Life and Death in the Balance - Presentation of Fr. Scott Binet MD,MI at 2nd International Conference of St. Camillus Hospital in Brazil on Medical and Surgical Emergencies - October 20, 2011

Disaster Medicine Factors to Consider when Providing Public Health Services in Emergencies

1. The nature of disasters, trends, consequences 2. The management aspect of emergency health

services including design, implementation and evaluation according to recognized needs, available resources, a community based approach and accepted standards. (2)

3. Human resource management including the concerns of relief workers in emergencies and ways of improving performance.

4. Disaster epidemiology – the principles needed for rapid assessment and the monitoring and reporting of the progress of public health programs.

·

Disaster Medicine Factors to Consider when Providing Public Health Services in Emergencies

5. The environment and its relationship to the health of populations in humanitarian emergencies including steps for managing and monitoring water supply, sanitation, and vector-control programs

6. Food and nutrition including ways of assessing food security and nutritional status during humanitarian emergencies and short and long-term strategies for reducing malnutrition.

7. Control of communicable disease threats including disease-specific strategies for preventing, monitoring, and controlling outbreaks – particularly of diarrheal diseases, which cause high morbidity and mortality among displaced populations and which, along with other illness, can be ameliorated by emergency immunization programs.

8. Primary Health Care (PHC) which provides the framework for delivering healthcare in emergencies in order to restore damaged health infrastructures.

9. The establishment of emergency health services and the consequences of mass casualty incidents that indicate a need to build the capacity of local health facilities, and the affected community, to provide basic health care.

10. Incident Management System (IMS) - a proven tool for coordinating the relief response.

11. Reproductive health care in the emergency and post-emergency phase

Disaster Medicine Factors to Consider when Providing Public Health Services in Emergencies

12. Emergency mental health care is concerned with the psychological problems of people exposed to violence and other stressors and the need to set up mental health programs for affected, vulnerable populations.

13. Technologies in humanitarian emergencies and their use to enhance the effectiveness of disaster operations.

14. The role of the media in humanitarian emergencies and how good media relations to benefit the relief response

Disaster Medicine Factors to Consider when Providing Public Health Services in Emergencies

Disaster Medicine Public Health in Emergencies

Factors to Consider when Providing Public Health Services in Emergencies

1. The nature of disasters, trends, consequences

What is a disaster?(1)

“a serious disruption of the normal functioning of a society, causing widespread human, material, or environmental losses which exceed the ability of the affected society to cope using its own resources.”

Disasters do not occur every time a community is exposed to a drought, fire, conflict, etc. The consequences of a disaster will depend on the nature of the hazard as well as the vulnerability and level of disaster preparedness of the population at risk.

Classification of Disasters Factors to Consider when Providing Public Health Services in Emergencies

NATURAL DISASTERSSudden Impact— earthquakes, floods, tropical storms,

tsunamis, volcanic eruptions, etc.Slow-Onset— drought, famine, pest infestation,

deforestation, desertification, etc.Epidemic Diseases— water-borne, food-borne, vector-

borne including cholera, measles, dysentery, respiratory infections, and malaria

MAN-MADE DISASTERSIndustrial/Technological— pollution, fires, spillages,

explosions, etc.Complex Emergencies— wars, civil strife, armed

aggression, etc.Others — transportation accidents, material shortages.

NATURAL DISASTERS Flood – August 2010 – Pakistan

NATURAL DISASTERS Earthquake – January 12, 2010 – Haiti

Presidential Palace – Port au Prince

NATURAL DISASTERS Cholera Epidemic – October, 2010 -

Haiti Between Life and Death

Chile – Pelluhue

NATURAL DISASTERS Earthquake/Tsunami – February 27, 2010 – Chile

Tent City in the Slum of Solino, Port au Prince, Haiti

NATURAL/MAN-MADE DISASTERS Earthquake, Slum, IDP Camp - Haiti

NATURAL/MAN-MADE DISASTERS Conflict, Drought, Famine, Camps – Somalia and Kenya

Disasters – Trends - Increasing in Incidence and Severity

Consequences

Floods Earthquake Drought Complex Emergencies

Deaths Few Many Many May be many

Severe injuries

Few Overwhelming

Few May be many

Disease outbreaks

Possible(water-borne)

Possible Possible(due to malnutrition)

Common(all types)

Food shortages

Common Rare Overwhelming

Common

Mass displacement

Common Not common Common Common

Potential Consequences of DisastersFactors to Consider when Providing Public Health Services in Emergencies

The Phases of Disasters Factors to Consider when Providing Public Health Services in Emergencies

Disaster situations are dynamic, always changing and demanding a change in response.

There are six phases of disasters. 1. Pre-Emergency : before disaster; time to prepare 2. Impact and Flight: disaster strikes, people flee, rescue3. Acute Emergency: death rate > 1/10,000*; relief, keep

alive!4. Post-Emergency : uncertainty ; relief, primary health

care 5. Repatriation: forced or voluntary6. Rehabilitation – relief to self-reliant development

Tent City in the Slum of Solino, Port au Prince, Haiti

Disasters – Natural and Man-Made Internally Displaced Persons (IDPs)

A Common Element - A Factor to Consider

Haiti – An Island in the Caribbean

Port au Prince – the Capital of Haiti

Internally Displaced Persons (IDPs)

Persons who:

1. Have been forced to flee their homes suddenly or unexpectedly in large numbers, as a result of armed conflict, internal strife, systematic violations of human rights, or natural or man-made disasters

2. Are within the territory of their own country

(UN Secretary General 1992).

Effects of Displacement on Displaced Persons Factors to Consider when Providing Public Health Services in Emergencies · Loss of livelihood/increased poverty

· Hunger, malnutrition, and starvation· Lack of shelter· Lack of heating and cooking fuels· Lack of potable water· Spread of communicable diseases· Overcrowding· Loss of land tenure· Long-term psychosocial trauma· Breakdown of traditions, common values and

norms· “Community” functioning is disrupted

Effects of Displacement on Displaced Persons Factors to Consider when Providing Public Health Services in Emergencies

Increased Vulnerability

1. In many emergency situations, up to 80% of the affected population are women, children, and elderly persons. Displacement makes these groups more prone to violence, starvation, and even death.

2. They are vulnerable at several levels:

· Physiologically vulnerable — those who lack access to basic needs, including health care, e.g., malnourished, sick, pregnant and lactating women, young children, and the elderly.

· Socially vulnerable — those who lack access to education and social support, e.g., female-headed households, unaccompanied minors, AIDS orphans and the disabled.

· Economically vulnerable — those who lack sufficient income, e.g., the poorest

· Politically vulnerable — those who lack autonomy and have no control over their situation

· Sexually and Physically Vulnerable – women, children, the elderly

Six Phases of DisastersInternally Displaced Persons (IDPs) in Haiti

Living Multiple Disaster Phases Simultaneously – A Factor to Consider

1. Pre-Emergency : before disaster; time to prepare 2. Impact and Flight: disaster strikes, people flee, rescue3. Acute Emergency:

death rate > 1/10,000*; relief (A);keep alive!4. Post-Emergency : uncertainty ; relief ,primary health care 5. Repatriation: forced or voluntary6. Rehabilitation – relief to self-reliant development (B)

A. The initial assistance in an emergency is usually provision of food, clean water, shelter and protection.B. After the relief phase, reconstruction begins. This should lead to

restoration of pre-disaster conditions (repaired facilities, functioning services, self-reliance).

Obrigado! Many Thanks!

References (1) Johns Hopkins and Red Cross/Red Crescent

Public Health Guide for Emergencies*(2) The Sphere Project:

The Humanitarian Charter and Minimum Standards in Humanitarian Response *