Disasters and CMDs

A Report on Flood in
Belgaum district
Audience- MOHs of Belgaum dist.
Date – 14-08-08

Dr.Nuchin MD,MBA.
Epidemiologist

Dec 13, 2009 1

 Submerged building of
Petrol Bunk
(Maharastra)

Dec 13, 2009 2

• A ‘disaster’ is “any occurrence that
causes damage, economic
disruption, ecological disruption, loss
of human life or deterioration of
health and health services on a scale
sufficient to warrant an extraordinary
response from outside the affected
community or area”

Dec 13, 2009 3

• A ‘hazard’ is defined as any
phenomenon that has the potential
to cause disruption/ damage to
people.

Dec 13, 2009 4

 Risk
• The level of damage that can be
predicted from a particular place or time

Susceptibility- the factors which allow a

hazard to become an emergency

Vulnerability- the factors which cause the

hazard to cause a disaster

Dec 13, 2009 5

 Classification of Disasters
• A disaster may be natural or Man-
made.
• Natural disasters are responsible for
35% of all disasters and 94% all
deaths in the last 15 years globally
• Natural disasters are catastrophic
events with atmospheric,
geologic, and hydrologic origins.

Dec 13, 2009 6

 Natural Disaster of Sudden impact
or Acute onset
Earthquakes Floods Avalanches

Tsunamis Hurricanes Wildfires

Tornadoes Cyclones Epidemics of water/food borne

diseases

Typhoons Tropical Epidemics of vector borne

storms diseases

Volcanic Landslides Epidemics of infections of

eruptions person to person transmissions
Dec 13, 2009 7
 Natural Disasters Of Slow or
Chronic-Onset

Drought, famine, environmental

degradation, chronic exposure to
toxic substances, desertification,
deforestation, pest infestation
(locusts).

Dec 13, 2009 8

 Disaster generated by
people
• Industrial/technological (system
failures/accidents, chemical/radiation,
spillages, pollution,
• Transportation (vehicular)
• Deforestation
• Complex emergencies (wars and civil
strife, armed aggression, insurgency,
and other actions resulting in displaced
persons and refugees)

Dec 13, 2009 9

 Disasters occur in varied
forms

Some are predictable in advance

Some are annual or seasonal
Some are sudden and
unpredictable
Floods -Days and weeks
Earthquakes
-Seconds/minutes
Cyclones -Days
Dec 13, 2009 10
• All Man-made disasters are preventable.
Some of NDs can be predicted and their
impact can be reduced significantly
• To meet the challenges of emergency and
disaster situations, GOI has identified the
nodal ministries to earmark the
responsibilities.
• Emergency is any occurrence which
requires immediate response

Dec 13, 2009 11

 Disaster Management in India
Types of Nodal Ministry Support
Disaster ministry
All natural disasters Ministry of Home Affairs Ministry of Health &
excluding drought F.W.

Drought Ministry of Agriculture Ministry of Health &

F.W.
Air accidents Ministry of Civil Aviation Ministry of Health &
F.W.
Railway accidents Ministry of Railways Ministry of Health &
F.W.
Chemical disasters Ministry of Env. & Forest Ministry of Health &
F.W.
Biological disaster Ministry of Health & F.W. Public Health
Eng.
Nuclear accident Department of Atomic Ministry of Health &
Energy F.W.
CivilDec
Strife
13, 2009 Ministry of Home Affairs Ministry of Health
12 &
F.W.
 World-
1994-2004: A Decade of Natural Disasters ( India is observing
the current decade as National decade for Disaster reduction)

1 million thunderstorms
100,000 floods
Tens of thousands of landslides,
earthquakes, wildfires & tornadoes
Several thousand hurricanes, tropical
cyclones, tsunamis & volcanoes

Sources: CDC & EK Noji, The Public Health Consequences of

Disaster
Dec 13, 2009 13
Major Disaster Events in last Decade
•1991 Bangladesh Cyclone, casualities 1,40,000 people
died
•1993 Latur Earthquake in Maharastra : 10,000 people
died
•1995 Kobe-Japan earthquake , death more than
15,000.
•1998 a powerful hurricane damaged 70%
infrastructure in Honduras and Nicaragua.
•1999 worst cyclone in 100 years in Orissa – destroyed
18,000 villages in one night, 9,885 people died. Loss of
property – Rs.1,733 crores.
•1999, worst flood in Maxico since 1600. almost
300,000 made homeless.
•1999 Turkey Earthquake, deaths above 18,000.
•2001 a powerful typhoon caused 500 dead in
philippines and Vietnam.
•2001, 26th January – the Gujarat earthquake. Killed
several thousand people. Crores of rupees lost.
The trend during the last three decades shows
Dec 13, 2009 14
an increase in the number of natural hazards, the
 In India
57% of the land area is
prone to Earthquakes
 12% to Floods
 8% to Cyclones
 70% of the cultivable
land is prone to drought
85% of the land area is
vulnerable to number of
natural hazards
22 states are prone to
Dec 13, 2009 multi hazards. 15
 Hazard Vulnerability in India

16%
60% 12%
3%

8%
Dec 13, 2009 16
Dec 13, 2009 17
 Belgaum district

Flood started on 09-08-08 at 8.30 pm

Dec 13, 2009 18

Dec 13, 2009 19
 A flood affected village in
Chikkodi tq.

Dec 13, 2009 20

Dec 13, 2009 21
 Health team in the village

Dec 13, 2009 22

 Channel of
communication
Floods in Chikkodi Taluk
9/08/08 8.30 PM

Information to Status of All the sectors-

media flood Taluk level
assessed/inf
ormed by
MOHs/THO
District
DHO and
administration
ADHO
Dist.Surveillance
informed
Unit Belgaum
State H & FW
Dec 13, 2009 23
All the sectors
 Rapid Needs Assessment
 To determine the magnitude of the emergency.
 To define the specific health needs of the affected
population.
 To establish priorities and objectives for action.
 To identify existing and potential public health
problems.
 To evaluate the capacity of the local response
including resources and logistics.
 To determine external resource needs for priority
actions.
 To set up the basis for a health information system.

Dec 13, 2009 24

 Status of flood in Belgaum district
as on 10/08/08
When flood began 09/08/08
Total no. of taluks 6
affected
Total no. of villages 103
affected
Athani 32
Chikkodi 22
Raibagh 13
Gokak 28
Hukkeri 7
Khanapur
Dec 13, 2009
1 25
Total population affected 70763

No. of injured Nil

persons/deaths

No. of rehabilitation 6
centres established

No. of animal deaths in NIL

flood affected villages

Is there any unusual rise NO

in rat population
Total no. of mobile clinics 6

Rivers involved Krishna, Hiranya Keshi, Veda

Ganga and Dooda Ganga

Dec 13, 2009

 Phases after Floods
Phase Duration Likely Health Problem

Phase I 0-3 Days Disposal of dead bodies, injuries,

drowning, Snakebites
Phase II 4-10 Days Cholera, Bacterial dysentery

Phase III 11 Days – Pneumonia, Hepatitis, Meningitis, Polio,

Measles
3Weeks

Phase IV 3 - 6 Malaria, Chikungunya, Dengue, Plague,

Rehabilitation of injuries
Weeks
Phase V >6 Weeks Psychological problems, Malnutrition, etc.
Dec 13, 2009 27
 Factors which rise the
Vulnerability
 Overcrowding and poor sanitation in temporary
settlements
 Population displacement
 Disruption of water supply
 Diversion of health staff leads to disruption of routine
control programmes
 Favourable environment for the vectors
 Displacement of domestic/wild animals leads to spread
of zoonoses ( Leptospirosis in Orissa after super
cyclone in 1999)
 Provision of food/water/shelter from different sources
in affected areas may itself be a source of infection

Dec 13, 2009 28

 Measures to be taken in a flood
affected area by MOH
1. List out the no. of flood affected villages/total
population affected/deaths/total no. of
houses/total no. of dead animals
2. Communicate (Inform) directly with
THO/DHO/DSO
3. Strict sanitary measures in Ganji Kendras
4. Deputation of health staff in Ganji Kendras/
frequent visits by MOH
5. Establishment of mobile clinics for PPCR
6. Keep ready an ambulance in all mobile clinics
7. Provision of safe drinking water
8. Proper disposal of waste and human excreta
9. Dec
Fly proofing by bleaching
13, 2009 29
8. Health education- By IPC, radio, TV, NPs, P,L,
repeatedly on – a) Personal Hygiene, b)
Water consumption c) Food consumption
9. Keep sufficient stock of drugs, halogen tabs,
ORS packets and bleaching powder

10. Surveillance- on occurrence and trend of

diseases
11. Immunisation and nutritional status
12. Preparedness to tackle any outbreak

Dec 13, 2009 30

 Entry to a flood affected village
with open air defeacation

Dec 13, 2009 31

 Water supply- R.C.-0.5ppm

Dec 13, 2009 32

 PHC Mangur –Building is
submerged in flood water

Dec 13, 2009 33

Dec 13, 2009 34
Dec 13, 2009 35
 Gruel centre (Ganji kendra)

Dec 13, 2009 36

 Kitchen and cook

Dec 13, 2009 37

An emergency meeting held with DHO
in the affected village at night on 09-
08-08

Dec 13, 2009 38

 Disaster management
• Disaster Planning is a
FLOOD
sequence of 4 activities:

1.Disaster preparedness &

prevention

Response 2.Disaster response

3.Disaster recovery

4.Disaster follow-up and

Recovery
Preparedness planning update

Mitigation
Prevention DISASTER CYCLE

Dec 13, 2009 39

 Disaster Preparedness
The community should be educated in the
following areas to help them tackle the
Rescue and Recovery phase more efficiently.
• Ensuring safety of drinking water
• Simple and safe waste and excreta disposal
practices
• Control of vector borne diseases
• Management of diarrheal diseases

Dec 13, 2009 40

Dec 13, 2009 41
 Rehabilitation Phase

Concentrate on the restoration of:

At the Domestic level
• Water storage methods
• Waste disposal techniques
• Food and personal hygiene
• Fuel supplies

Dec 13, 2009 42

 At the Administrative level

• Sewage Lines/Excreta Disposal

• Disposal of solid waste
• Prevention of the breeding of Vectors: Files,
mosquitoes
• Centralization of the water disinfection process
• Piped Water Supply
• Wells, hand pumps

Dec 13, 2009 43

 Proportion of m ortality and m orbidity in prepared and
unprepared com m unity

Unprepared

P repared

1 2 3 4 5 6

Time

Dec 13, 2009 44

Dec 13, 2009 45
 HEALTH SERVICE
SUBUNITS
Medical and First Aid Unit
Field Emergency Unit
Sanitation Service Unit
Health Supply Unit
Mortuary Unit
Records Unit

Dec 13, 2009 46

 Medical and First Aid
(Function)
• Sorts cases at the scene of the disaster;
• Administers first aid;
• Attends to the cases referred to emergency
aid stations;
• Evacuates patients to emergency hospitals;
and
• Detects and control communicable diseases
in coordination with other agencies
specifically assigned for the purpose

Dec 13, 2009 47

 Field Emergency Unit
(Function)
• Pre-determines site of facilities that
may be used as field hospitals;
• Administers appropriate treatment to
less serious patients and attends to
all dispensary cases; and
• Attends yto all medical cases which
should be referred to appropriate
medical institutions.

Dec 13, 2009 48

 Sanitation Service Unit
(Function)
• Supervises the sanitary conditions of
the community during and after
emergency;
• Enforces sanitary regulations relative
to housing and shelters; and
• Promulgates and implements control
measures in contaminated areas and
in evacuation centers.

Dec 13, 2009 49

 Health Supply Unit
(Function)
• Procures, stores and issues medical
supplies and equipment during
emergencies, and
• Keeps an accounting of the medical
and first aid instruments and
supplies.

Dec 13, 2009 50

 Mortuary Unit (Function)
• Assists in identifying and tagging the
dead
• Certifies to the cause of death; and
• Supervises the proper disposal of the
dead.

Dec 13, 2009 51

 Records Unit (Functions)
• Keeps records of dead, injured and
sick; and
• Issues certificates pertaining to
persons who were ill, injured and
recovered or died pursuant to
existing laws, rules and regulations

Dec 13, 2009 52

Dec 13, 2009 53