DISASTER

Renville Ladera, MAN RN

Romeo Papa, DMD RN
Definition of Disaster

Disaster is a result of hazard, such as

typhoon, earthquakes and so on, that
strikes a vulnerable community whose
inherent capacity is not enough to
withstand or cope with its adverse effects
and impacts.

- Citizen's Disaster Response Center

(CDRC Phils./W.H.O.)
“Disaster”

A disaster is present when

need exceeds resources!

Disaster = Need > Resources

A response need that is

greater than the resources
available!
D - Destructions
I - Incidents
S - Sufferings
A - Administrative, Financial Failures.
S - Sentiments
T - Tragedies
E - Eruption of Communicable diseases.
R - Research program and its implementation
Types of Natural
Disasters

1. Earthquakes
2. Floods
3. Tornadoes
4. Hurricanes
5. Volcanic eruptions
6. Tsunamis
7. And other geological and
metrological phenomena
Earthquakes
HYATT HOTEL
BAGUIO 1990
Earthquakes

Shaking caused by movements of plates in the earth’s crust

Occur along faults – borders between two plates

Ring of Fire

Occur most often along the Ring of Fire

The primary health concern:

Injuries arising from structural collapse

Well known prevention

strategy is to prevent

buildings from collapsing

Bohol 2013 magnitide 7.2

 BEFORE
EARTHQUAKE:

• Disaster prevention and planning

• Prepare your place of work and

residence for the event.

• Familiarize yourself with your place

of work and residence.

• Protect yourself from injuries.

 DURING EARTHQUAKE:

• If you are inside a structurally

sound building, stay there.
“Duck, cover, & hold”.

• When driving a vehicle, pull to

the side of the road and stop.

• Run away from the shore

toward higher ground.
 AFTER EARTHQUAKE:

1 2 3 4 5
If you are inside an old Unless you need Obey public safety Check your If you must evacuate
structure, take the emergency help: do not precautions. surroundings; your residence, leave a
fastest and safest way use telephone to call chemical spills, fire, message stating where
relatives; do not use your
out. car and drive around
damage water supply you are going.
areas of damage. and electric lines.
FLOOD
 Flood
• Floods may originate very quickly
following a quick rain storm, a
heavy rain, or they may develop
over a short period following an
extended period of rain or quick
snow melt
• May involve rivers overflowing,
storm surge/ocean waves, & dams
or levees breaking
• Flashfloods = floods that happen
very fast
• The primary hazard from flooding
is drowning
• Health concerns from flooding is
the development of disease from
contaminated water and lack of
hygiene.
 Tornadoes

• Rotating,funnel-shaped clouds from powerful

thunderstorms which form over land
• Generates stronger winds up to 300 MPH
which form within a short time thus, warnings
are harder to get out in time
• The primary hazard: risk for injuries from
flying debris. The high winds and circular
nature of a tornado leads to the elevation and
transport of anything that is not fastened
down.
• Some individuals are injured while on the
ground. Others are lifted into the air by the
tornado and dropped at another location.
Manila 2016
 Hurricane

• Originates from the ocean, gathers

strength as it glides across the water
causing tidal surge which in turn brings
flood
• Clouds & winds greater than 75 MPH spin
around the eye
• Follows a loosely defined course, giving
time for safety warnings
• Primary health hazard: risk of drowning
from the storm surge associated with
the landfall of the storm. Secondarily, a
hazard exists for injuries from flying
debris due to the high winds.
Man Made
Disaster
Classification of
Man-Made
Disaster
• Complex
Emergencies
• Technological
Disaster
• Combination or
NA-TECHs
 Biological Weapon

• "the provision of any infectious agent or toxin by any

means of delivery in order to cause harm to humans,
animals, or plants.“
- North Atlantic Treaty Organization (NATO)
 Biological Agents and
Bioterrorism
 Includes microorganisms, especially certain bacteria and
viruses, and biological toxins as botulinum toxin, which
act like chemical agents.

 May be directed at humans, plants, animals, and be a

threat to crops, livestock, food products (agroterrorism)
during processing, distribution, storage and
transportation which could cause illness and also have
severe economic consequences such as bovine spongiform
encephalopathy, and foot and mouth disease.

 Biological agents can be used as weapons in:

• Biocrimes
• Bioterrorism
• Biowarfare
 Bacteria: Anthrax, Brucella, Melioidosis, Tularaemia,

Toxins: Botulinum, Ricin

Biological
Agents and Rickettsiae: Q fever, Rickettsia

Bioterrorism Fungi: Histoplasma, Cryptococcus

Viruses: Smallpox, Dengue, Yellow Fever, Ebola

ALSO: Animal, Plant Pathogens

What is a Chemical
Weapon?

 Uses the toxic properties of chemicals

 Inexpensive to produce
 Thousands of chemicals can be
weaponized
 Both conventional and unconventional
means of delivery
Chemical Weapons

A. Lethal Agents B. Non-Lethal Agents

• Blood Agents: Nerve Agents: • Incapacitating Agents: Riot Control Agent

• Cyanogen chloride (CK) Tabin (GA) • Agent 15 (BZ) Pepper
• Hydrogen Cyanide (AC) Sarin (GB) Spray (OC)
• Blister Agents: Pulmonary
Agents:
• Lewisite (L)
Chlorine
• Sulfur mustard gas
Phosgene (CG)
• (HD, H, HT, HL, HQ)
Atomic Bombs

Atomic bombs work by the principle of

atomic fission (splitting the atomic
nucleus) which results in a
mushroom cloud explosion

Following an atomic bomb, the area is

completely levelled. After several
minutes, precipitation begin falling
that consisted of dirt, soot, dust and
various debris; all of which are highly
radioactive.
CAR Accidents

1. Driver Error
2. Speeding
2. Mechanical Defects
3. Overtaking
4. Turning
5. Overloading
6. Self Accidents
7. Road Defects
8. Hit and Run
9. Drunk Driving
10. Using Cellular Phones
 Aircraft Accidents
1. Pilot error (weather related)
2. Pilot error (mechanical related)
3. Other human error
a. air traffic controller errors
b. improper loading of aircraft
c. fuel contamination
d. improper maintenance
procedures
4. Sabotage (explosive devices,
shoot downs &
hijackings)
Sea Accidents

1. Overloading of the ship

2. Ageing facilities
3. Badly trained crewmembers
4. Poor compliance with safety
precautions and measures
5. Bad weather
 ARMED CONFLICTS
A political conflict in which armed combat
involves the armed forces of at least one state
 Health Effects of
Disaster

1. Premature deaths, illnesses & injuries

2. Destroy local health care infrastructure

3. Create environmental imbalances, increasing the risk

of communicable diseases & environmental hazards

4. Affect the psychological, emotional, & social well-

being of the population.
 Health Effects of
Disaster

5. Shortages of food & cause severe nutritional

deficiencies

6. Large population movements (refugees) creating a

burden on other health care systems & communities.

7. Displaced populations & their host communities are at

risk for communicable diseases & the health
consequences of crowded living conditions.
 Types of Victim

1. Direct victims
– those killed, injured, or
who lost properties
2. Indirect victims
– family, friends, co-workers and
those identified with the victims
3. Hidden victims
– crisis workers, police, red cross
volunteers, rescuers, firemen,
staff, disaster managers, hospital
workers
Levels of Disasters
Level 1
– if the organization, agency, or
community is able to contain
the event & respond effectively
utilizing its own resources
- employees and community
should be capable
Levels of Disasters
Level II
– if the disaster requires
assistance from external
sources, but these can be
obtained from nearby agencies
- linkages with other
organizations & agencies in the
surrounding community is
important
Levels of Disasters
Level III
- If the disaster is of a
magnitude that exceeds the
capacity of the local
community or region and
requires assistance from
state-level assets
- agency must assure that it
has adequate linkages with
state & federal-level org.
Mass Casualty • Any incident that exceeds the responder’s or receiving hospital’s capability
Incident to treat or transport victims

(MCI)
Professional Role of Nurses
1. Member of Response Team
2. First Responder
3. Coordinator
4. Supervisor
5. Investigator/Epidemiologist
6. Researcher
7. Educator
8. Counsellor
 Common
Reactions of
Disaster Survivors
1. Emotional
- depression, sadness; irritability, anger,
resentment; anxiety, fear; despair,
hopelessness; guilt, self-doubt;
unpredictable mood swings

2. Behavioral
- sleep problems; crying easily;
avoiding reminders; excessive activity level;
increased conflicts with family;
hypervigilance; isolation or social
withdrawal
 Common Reactions of
Disaster Survivors

3. Cognitive
- confusion, disorientation; recurring dreams or
nightmares; preoccupation with disaster ; trouble
concentrating/remembering things; difficulty making
decisions; questioning spiritual beliefs

4. Physical
- fatigue, exhaustion; gastrointestinal distress; appetite
changes; tightening in throat, chest or stomach;
worsening of chronic conditions; somatic complaints
Phases of Disaster
 Phase 1: Pre-Disaster

* could be as short as hours or even minutes

Phases of • Terrorist Attack

Disaster * long as several months

• Hurricane Season

* Characterized by fear and uncertainty.

 No warning

* Feelings of vulnerability

* Lack of security
• - Fears of future
• - Unpredicted tragedies

Pre-Disaster •
•
- Sense of loss of control
- Loss of ability to protect oneself and
• one’s family

With warning

* Guilt

* Self blame for failure to heed the warnings

• - Feel responsible
 Phase 2: Impact Phase

* Shortest of all the phases

Phases of
Disaster * Characterized by range of intense
emotional reactions
• - Shock to overt panic
• - Initially confusion and disbelief leads to focus
• on self and family preservation.
 Phase 3: Heroic phase

Phases of * Passes quickly to next phase

Disaster • * Characterized by high level of activity
with low level of productivity.
• - Altruism
• - Adrenaline - induced rescue behavior
• - Risk assessment may be impaired
 Phase 4: Remedy or Honeymoon Phase

* Lasts only a few weeks

Phases of • * Characterized by dramatic shift in emotions.
Disaster • - Optimism
• - Assistance readily available
• - Community bonding
• * Good time to build rapport with affected
people and groups
Phases of
Disaster
Phases of
Disaster
Basic Principles of Disaster
Mental Health Intervention
 Basic Principles of Disaster
Mental Health Intervention

4. Majority are resilient & will

recover
5. Many tools to assist recovery
6. Do no harm!
7. Respect individual coping
styles
8. Conservative intervention
recommendations