Conceptual Framework

of Disaster &
Disaster Management :
the Utstein Style

Hendro Wartatmo

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 Nama : Hendro Wartatmo Wardoyo
Tempat & tgll lahir : Purwokerto, 15 Juli 1952
Pendidikan terakhir : Spesialis Bedah, Konsultan Digestif & Trauma Curriculum Vitae
Pekerjaan sekarang : Staf bagian Bedah RSUP Dr. Sardjito
Divisi Menejemen Bencana, PMPK – FK UGM
Program Studi Menejemen Bencana, Fakultas Pasca
Sarjana UGM

Pelatihan :
Advanced Trauma Life Support ( Instructor ), 1995
Advanced Cardiac Life Support, 1996
Training Workshop on Disaster Management, WHO, Jakarta 1996
Workshop on Conceptual Framework of Disaster Management, APCDM, Tokyo 2006
Hospital Preparedness for Emergency and Disaster ( HOPE ), 2006
Workshop on Disaster Research, WCDEM, Amsterdam 2007

Organisasi :
Pusat Siaga Bantuan Kesehatan ( Pusbankes ) – 118, Yogyakarta
Komite Trauma, IKABI Pusat Keterlibatan pd penanggulan bencana :
Tim pakar PPK Departemen Kesehatan
Anggauta World Association of Disaster Emergency and Management ( Kekeringan, Lombok -West Nusa Tenggara,
WADEM ) 1979
Letusan Merapi, Jogjakarta, 1994
Kerusuhan sipil, Jogjakarta, 1998
Kontributor buku : Bom Bali I, Denpasar – Bali, 2003
-Standard Penanggulangan Gawat Darurat Trauma, Komisi Trauma, 1996 Kecelakaan pesawat, Solo, 2004
-Standard Pelayanan Gawat Darurat, DepKes 2000 Tsunami, Meulaboh, 2004
-Pedoman Penyusunan Peta Geomedik, DepKes2005 Gempa, Nias, 2005
-Penanggulangan Penderita Gawat Darurat seri 1 dan 2, DepKes, 2005 Gempa, Bantul, 2006
-Pedoman Evakuasi Medis, DepKes 2005 Tsunami, Pangandaran, 2006
-Pedoman Penanggulangan Korban Bencana Masal, DepKes 2004 Kecelakaan pesawat, Jogjakarta, 2007
-Pedoman Unit Gawat Darurat, Dinas Kesehatan tk I, DIY 2005 Gempa, Bengkulu, 2007
-Technical Guidance for Health Crisis Responses on Disaster, DepKes 2007 Gempa Padang, 2009 2
Janapria sub district,
West Nusa Tenggara,
Indonesia, 1978

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Meulaboh, West Aceh,
December 2004

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 OBJEKTIF

1. MEMAHAMI DAN MENGERTI TENTANG KONSEP DASAR BENCANA

2. MEMAHAMI DAN MENGERTI UPAYA PENANGGULANGAN BENCANA,

ORGANISASI, MEKANISME KERJA, SUMBERDAYA

3. MEMAHAMI, MENGERTI SERTA DAPAT MENGANALISA KEJADIAN

BENCANA

4. MEMAHAMI, MENGERTI ,DAPAT MENGORGANISASI UPAYA

PENANGGLANGAN BENCANA

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 Disaster
War

100 victims of train accident

Activation of Emergency
Response Team
landslide

Earthquacke on 9 Richter scale followed by Tsunami

Treatment of 180 patients after a big earth quake

by resque teams from abroads

Famine 6
 Bencana :
“ Bencana adalah peristiwa atau rangkaian
peristiwa yang mengancam dan mengganggu
kehidupan dan penghidupan masyarakat yang
disebabkan, baik oleh faktor alam dan/atau faktor
nonalam maupun faktor manusia sehingga
mengakibatkan timbulnya korban jiwa manusia,
kerusakan lingkungan, kerugian harta benda, dan
dampak psikologis.”

( UU Republik Indonesia no 24 Tentang Penanggulangan Bencana )

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 Disaster :

“ Sudden ecological phenomenon of sufficient

magnitude to require external assistence “
( WHO )

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 Disaster :

“ Destructive effect of natural or manmade force overwhelm

the ability of given area or community to meet the demand
for health care “
( American college of Emergency Physicians )

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 Disaster :

• Disaster are exeptional events which sudenlly

kill or injure a large numbers of people

Red Cross

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 Disaster
Deffinition :
A serious disruption of the functioning of society, causing
widespread human, material or environmental losses
which exceed the ability of affected society to cope using
its own resources.

Sudnes KO, Birnbaum ML 2003 : Health Disaster Management

Guidelines for Evaluation and Research in Utstein Style

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 Makna Beberapa Kata
• Gempa bumi, letusan gunung berapi, banjir, badai, konflik, adalah
contoh kejadian yang menjadi sumber bahaya (hazard), yang
memungkinkan timbulnya kerugian.
• Kelemahan (Vulnerability) adalah kondisi-kondisi akibat faktor
fisik, sosial, ekonomi dan lingkungan yang meningkatkan kepekaan
suatu masyarakat untuk mengalami efek buruk dari bahaya.
• Risiko (risk) adalah besar kemungkinan konsekuensi buruk
(kesehatan dan ekonomi) akibat interaksi antara bahaya dan
kelemahan
Risk = ƒ(Hazards x Vulnerability)/Capacity
• Bencana (disaster) adalah tiap kejadian bahaya yang
mengakibatkan kerusakan, gangguan ekonomi, kematian atau
penurunan kondisi kesehatan dan pelayanan kesehatan sedemikian
rupa hingga memerlukan tanggapan luarbiasa dari fihak di luar
wilayah atau penduduk yang sedang manyandangnya (WHO).
• Kegawatdaruratan (emergency) adalah kejadian tak terduga atau
memerlukan tindakan segera. Bencana acap menimbulkan situasi
kegawatdaruratan ini.
Bencana adalah interaksi antara bahaya dan penduduk.12
 Apa Akibat Bencana
• Fungsi normal dan kehidupan masyarakat terganggu
• Bencana melampaui kemampuan mekanisme masyarakat utk mengatasinya
• Gangguan yang diakibatkan bencana menyebabkan pulihnya kemampuan
untuk berfungsi normal memerlukan perbantuan dari luar.

• Kematian dan kecacatan (akibat langsung maupun tak langsung)

• Kerugian infrastruktur dan bekalan (akibat langsung)
• Kerugian atau terganggunya penyampaian pelayanan kesehatan
baik rehabilitatif, kuratif, penemuan kasus, protektif maupun
promotif (akibat tak langsung)

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 Siapa Korban Bencana dan Apa
yang Dialaminya
Kerusakan
pemukiman

Kecederaan

Bahaya yang
menimbulkan bencana Pengungsian & Masalah Kesehatan

Manusia mengalami akibat bencana :

harta, cedera / kesehatan & kematian
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 Anything that may cause a danger; a
Prevention, natural or type-specific manmade
to keep from phenomenon that has the potential to
happening Hazard adversely affect human health, property,
activity, and/or environment
Modification
changing the risk
The probability that an event related to a
that an event will Risk specific hazard will occur
occur or the
magnitude of
frequency of the An occurrence negatively influencing living
event when it Event beings and/or their environment (has
occurs amplitude, intensity, scale, and magnitude)

Vulnerability, The action of one force coming in contact

provided by nature, Impact with another body; a force striking an
augmented by man environment/society

The destruction and injuries resulting from

Resilience Damage the event

Absorbing capacity,
includes contingencies, Change of socal function
luxuries, and natural
resilience

Buffering capacity Disaster

Response 15
HAZARD Something contents energy

RISK(S) Probability that something negative will occur

EVENT Realization of hazard.

IMPACT Contact between an event and society(s)

DAMAGE Negative result from the impact of an event

Change of socal function

DISASTER Needs external aids for recovery

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 Disaster Risk

Hazard Exposure

Disaster Risk

Vulnerability

www.adrc.or.jp/publications/TDRM2005/TDRM_Good_Practices/PDF/Chapter1_1.2.pdf 17
-
 Prevention
HAZARD

Modification

RISK(S)

EVENT

Preparedness Mitigate

IMPACT Resilience

Absorbing capacity

DAMAGE Bufering capacity

Response

Recovery DISASTER
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Development
 HAZARD Something contents energy

Probability that
Something negative RISK(S)
will occur

EVENT Realization of hazard.

IMPACT Contact between an event

and society(s)

Negative result from the

DAMAGE impact of an event
Change of socIal function

NO needs external aids Needs external aids

for recovery for recovery

“ EVENT “ DISASTER 19
 Disaster Management
• The aggregate of all measures taken to reduce the likelihood of
damage that will occure related to hazard(s) and to minimize
the damage once an event is occuring or has occurred and to
direct recovery from the damage.

• The body of policy and administrative decisions and

operational activities that pertain to the various stages of a
disaster at all levels

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 Project : Jerebatan Sarnici / Cystern
Purpose : Water storage during War
Provider : East Roman Empire
Area covered : Constantinople
Number of citizen to be served : 300.000
Capacity : 80.000 m3 X 8 ( number of cystern )
Technology : High Tech
Safety : Bio indicator ( fish )
Time : 600 AC
Cost : ?

Project : Field Water Purifier & Storage

Purpose : Water Supply in Disaster Relief
Provider : Spanish Red Cross
Area covered : Meulaboh & Surrounding area
Time : 2005
Number of citizen to be served : 85.000
Technology : Medium Tech
Capacity : ?
Safety : Chemical
Cost : ….

Water in Disaster 21
 Operational Framework

Pre-Event
Event
Damage
Changes in Function
Responses
Recovery
Time
A B C D
Needs Assessments and Plans 22
 1. Pre-Event Status

2. Event

3. Damage

No
4. Disturbance of Health Function?
Yes
5. Needs Assessments and Plans

6. Responses

7. Changes in Health Status

No
8. Restored Health Status?
Yes 23
END
 Prevention
HAZARD
Mitigate

RISK(S)

Preparedness

EVENT

IMPACT
Resilience Disaster Management

Absorbing capacity
DAMAGE
Bufering capacity

Response Acute Medical Response :

DISASTER
Recovery
Development Pre Hospital Hospital
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Medical Emergency Response

* Hendro Wartatmo

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 Medical Emergency Response

Hospitalisation Transportation Damage

area - Transfer area

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 Disaster Plan

Pre Hospital Hospital Regional

Disaster Plan Disaster Plan Disaster Plan

M = major incident • C ommand • Coordinating

E = exact location • S afety Team
T = type of injury • C ommunication • Medical team
H = hazard, • A ssessment • Surveillance
A = Access • T riage • Management
N = number of cas • T reatment back up
E = emergency • T ransport
services, present and
required
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Medical Emergency Response

Extra Hospital :

Hospital
Disaster Plan

Pre Hospital
Disaster Plan

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 Red Cross

Public
Health Post
Hospital

Damaged
Area
Puskesmas

Field Hospital

Regional Response
of Health Sector 29
 Trunkey’s curve

Trauma deaths

Immediate Early deaths Late deaths

deaths

0 1 2 3 4 5 6 1 2 3 4

hours weeks
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PRE – HOSPITAL : HOSPITAL :

Triage Triage

Treatment: Treatment:
- Rescusitation - Rescusitation
- Stabilization - Stabilization
- Definitive procedure
Transfer
Transfer / Refer
PROBLEMS
- Limited time PROBLEMS
- Limited resources - Number of victims
- Severity of trauma
- Complicated procedure

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References :
• Carley S, Mackway-Jones K, 2005 : Major Incident Medical Management and Support,
Blackwell Publishing Ltd.
• Rush Robert M, 2006 : Surgical Response to Disaster, Surgical Clinics of North America, June
2006 vol 86 no 3. Elsevier Saunders
• Departemen Kesehatan RI 2007 : Standar Internasional Penanganan
Bencana Bidang Kesehatan.
• Jeff Jones 2006, NIMS Incident Command System Field Guide, Informed Tigard, Oregon
• USAID / OFDA 1994, Field Operations Guide for Disaster Assessment and Response, OFDA
• PAHO 2003, Bencana Alam Perlindunan Kesehatan Masyarakat, Penerbit Buku Kedokteran EGC
• Djoko Sumaryono dkk, 2005, Pedoman Nasional Manajemen Bencana di Indonesia, Kementrian
Koordnator Politik, Hukum, Keamanan RI.
• Jan de Boer, Jacquo van Remmen 2003, Order in Chaos, Modeliling Medical Disaster
Management using Emergo Metrics, LiberChem Publication Solutions The Netherlands.
• Stallings Robert A 2002, Methods of Disaster Research, International Research Committee in
Disaster USA.
• Sundness KO, Birbaum ML 2003, Health Disaster Management Guidelines for Evaluation and
Research in The Utstein Style, Prehospital and Disaster Medicine Vol 17 Supl 3.
• Departemen Kesehatan RI 2000, Standar Pelayanan Gawat Darurat RS.

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