Describe the principles of disaster management.

Disaster Management

• The classification — natural: earthquakes, floods, cyclones, droughts, landslides, tsunamis, heat waves and epidemics; and man-made: industrial and chemical accidents, fires, building collapse, transport crashes, war, terrorism and displacement
• India is among the most disaster-prone countries, with a long coastline exposed to cyclones and tsunami, major seismic zones in the Himalaya and the north-east, extensive flood-prone river basins, and recurrent drought
• The disaster management cycle has four phases, and organising the answer around them is far better than a list of activities:
• 1. Mitigation (prevention) — reducing the risk before anything happens: hazard mapping and vulnerability assessment; earthquake-resistant building codes and their enforcement; flood control and embankments; land-use planning that keeps settlement off floodplains; and environmental protection such as mangroves, which reduce storm surge
• 2. Preparedness — planning for an event assumed to be coming: early warning systems; disaster plans at every level with defined roles; training and mock drills; stockpiling of drugs, vaccines, ORS, chlorine and equipment; identification of shelters and evacuation routes; and community education and first-aid training
• 3. Response (relief) — the immediate actions after the event
• 4. Recovery (rehabilitation and reconstruction) — restoring services and rebuilding, ideally better than before
• The phrase "build back better" captures the point — reconstruction is the one moment when a community can afford to change, and rebuilding identically guarantees a repeat
• The health priorities IN the response phase, in order, since the order is what is examined:
• 1. Search, rescue and first aid, most of which is in practice done by survivors themselves in the first hours, before any external help arrives — which is the argument for community training
• 2. Triage and medical care of the injured
• 3. Water supply — the first public health priority
• 4. Sanitation and excreta disposal
• 5. Food and nutrition
• 6. Shelter, with attention to overcrowding
• 7. Prevention of communicable disease and surveillance
• 8. Care of chronic disease and continuity of treatment, which is systematically forgotten
• 9. Mental health and psychosocial support
• 10. Disposal of the dead
• Water and sanitation rank above almost everything else, because the classical post-disaster epidemics are diarrhoeal, and they arise from crowding plus contaminated water rather than from the disaster itself
• Several persistent myths about disasters should be corrected, since they misdirect relief effort:
• Myth: dead bodies cause epidemics. Fact: they do not — victims died of trauma, not of infection, and pose little risk; the priority is dignified handling and identification for the sake of the families and of legal certainty, not hasty mass burial or cremation, which causes lasting grief and legal difficulty and diverts effort from the living
• Myth: epidemics are inevitable. Fact: they are not, and are prevented by water, sanitation and shelter rather than by mass vaccination
• Myth: any foreign assistance is useful. Fact: unsolicited donations of clothing, expired or unsorted drugs and unneeded equipment consume the scarce time of relief workers who must sort, store and dispose of them
• Myth: the affected population is helpless and passive. Fact: local people are the first and most effective responders, and relief that ignores them wastes the most available resource
• The epidemiological priorities — rapid needs assessment within the first hours; surveillance for outbreak-prone disease with a simple case definition and daily reporting; immunisation, with measles as the priority in a crowded camp with young children; vector control; and nutritional surveillance with MUAC screening
• Measles vaccination is prioritised because a crowded camp is exactly the setting in which measles spreads and kills malnourished children
• The INDIAN framework — the disaster management act, 2005; the national, state and district disaster management authorities; and the national disaster response force
• The Act marked a deliberate shift from a relief-centred to a preparedness and mitigation-centred approach, which is its significance
• Dead bodies do not cause epidemics; victims died of trauma, and hasty disposal causes grief and legal difficulty
• Water is the first public health priority after rescue, since post-disaster epidemics are diarrhoeal
• Epidemics after disasters are not inevitable, being prevented by water, sanitation and shelter rather than mass vaccination
• Survivors are the first responders, which is the argument for community training rather than external teams alone
• Unsolicited donations consume relief workers time, and expired or unsorted drugs are a burden rather than a help