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Abdulhakim Oun 1
 Disaster medicine

Dr. Abdulhakim Mohamed Oun

Disaster Medicine Specialist
ADDM – HP

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Defination :
A disaster can be defined as any occurrence that
cause damage, ecological disruption, loss of
human life or deterioration of health & health
services on a scale sufficient to warrant an
Extraordinary response from outside the
affected Community or area)

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  Hazard : defined as ( Any phenomena that
has a potential to cause disruption or
damage to people or environment).

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Disaster can occur any where at any time and
Major emergencies and disasters have occurred
throughout the history and as worlds population
grows and resources become more limited,
communities are increasingly becoming
vulnerable to the hazards that cause disaster.

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 Disaster types

 Natural cause :-
e.g. cyclones ,earthquakes,
floods, landslides, volcanic
eruption,tornados, hurricanes, snow
storm, heat waves, famines,
epidemic, building collapse.

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 Man made disaster :-

e.g. Sever Air pollution,

RTA, warfare, nuclear

accident, toxicological

accident, terroristic attacks.

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Every catastrophic events has its on special
features, Some of disasters can be predicated
hours or days beforehand as in the case of
cyclones or floods others such as earthquakes
occur without warning.

Warfare is a special
category because the
damage is the intended
goal of action.

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Factors affected the size of disaster :-
several factors affecting the size of the disaster :-
 Type of the disaster.

 density and distribution of the population.

 Condition of the environment.

 Degree of the preparedness & opportunity of warning

 Time of the disaster, e.g earthquakes at night are more deadly.

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 Even the type of injury is related to the time of
disaster (e.g. in the evening earthquakes the
common injuries are fracture of pelvis, spin and
thorax the people are lying in bed, But in the
morning time most of the injuries to the arm and

skull is very common.

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Injuries exceed deaths in
explosions, earthquakes,
typhoons, hurricanes, fires,
tornados, etc.

Death exceed injuries in

landslides, volcanic eruption,
tidal waves, floods, etc.

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Type of morbidity due to disaster

* Injuries.

* Emotional stress

* Epidemic of disease

* Increase indigenous disease.

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 Disaster Management

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 Disaster impact & response

 Medical treatment for large number of casualties is

likely to needed only After certain type of disasters.

 Great need for emergency Care occur in first few hrs.

 The management of mass casualties can be divided

in to ( Search, rescue, first Aid, triage, stabilization of
the victims, hospital treatment and redistribution of
patient to other hospital if needed.

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 A. Search, rescue & first Aid.

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 B: Triage.
 Triage is a dynamic process.

 the principle of first come, first treated is not

followed in mass casualties .

 Triage consists of rapidly classifying the injured

on the basis of the severity of their injuries.

 Tagging: All patient should be identified with tags

stating their name, age, place of origin, triage
category, diagnosis and initial treatment
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 C : Identification of the dead
Taking care of dead is an essential part of disaster
management, which include:-
1- removal of the dead from the disaster scene.
2- shifting to mortuary.
3- identification.
4- reception of bereaved relatives.
If the death was due to trauma the
cadavers is unlikely to cause outbreaks disease
but of the human bodies contaminate the water
source they could transmit the disease.

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 D: Relief Phase

This phase is start when assistance from out side start to

reach the disaster area.

The type & quantity of humanitarian relief supplies are

usually determined by two main factor:-

a)- type of disaster

b)- the type & quantity of supplies

available locally.

 Four principle component in managing the humanitarian

supplies (Acquisition of supplies, transportation, storage & distribution )
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 E. Epidemiological surveillance
& disease control.
Disaster can increase the Transmission communicable
Disease through :-
1- Overcrowding & poor sanitation.

2- Population displacement may lead to

introduction of communicable disease
either to the immigrant or indigenous
population.
3- Disruption & contamination of water Supply or
damage of sewerage system.
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4 - disruption of routine control programs as funds &
personnel are diverted to relief work.

5 -Ecological changes may favour breeding of vector

6 – displacement of domestic & wild animals , who

carry with them zoonoses can be transmitted to
human as well as to other animal (e.g Anthrax, rickettsia).

7 – provision of emergency food, water & shelter in

disaster situation from different source may it self be
source of infectious disease.

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 Prevention and control of Communicable disease

The principle of preventing & controlling communicable

disease after disaster are:-

1- implement as soon as possible all public health

measures.

2- organize a reliable disease reporting system to

identify the outbreaks & to initiate control measures.

3- investigate all reports of disease out breaks rapidly.

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 F. Vaccination
Health authorities are often under the public & pressure
to begin mass vaccination programs, usually against
the cholera, tetanus & typhoid.
The WHO doesn't recommend typhoid & cholera
vaccines in routine use in endemic area.
Challenges for using vaccine:-
1- multi dose vaccine.
2- require large number of workers.
3- supervision of injection techniques
and sterilization may be impossible.
However, vaccination are recommended for
health workers and the other public health prevention procedure
are more helpful to community than the vaccination.
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 G: Nutrition
 Natural disaster may affect the nutritional status of
the population By affecting one more component of
the food chain, depending on The type & duration
of disaster & The food & nutritional condition
existing the area before catastrophe.

 Infants, children, pregnant women, nursing mother &

sick people are more porn to nutritional problem.

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 Important steps for ensuring food relief program:-

1- assessing the food supplies after the disaster.

2- gauging the nutritional need for affected people.

3- calculating daily food ration & need for large group.

4- monitoring the nutritional state of affected

population.

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 Rehabilitation Phase (recovery)
The final phase in a disaster should lead to restoration of
pre-disaster condition.

Priorities also will shift from health care toward

environmental health measures, like :-
1- water supply.
2- food safety .
3- basic sanitation and personal hygiene.
4- vector control .e.g. plaque (flies),typhus (lice), malaria(mosquito)

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Disaster Mitigation in health sector
 Emergency prevention & mitigation involve measures
designed either to prevent hazard from causing
emergency or to lessen the likely effect of emergency.

 These measures include flood

mitigation works, appropriate land

use planning, improved building Codes , and protection

of vulnerable population & structure.

 In most cases mitigation measures

aim to reduce the vulnerability of the system.

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 Disaster Preparedness Phase
Emergency preparedness is ( a programm of long
term development activities whose goal are to
strengthen the over all capacity and capability of a
country to manage efficiently all types of
emergency).

The objective of disaster preparedness is to ensure

that appropriate systems, procedures & resources
are in place to provide effective assistance to
disaster victims .
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 The individual are responsible for
maintaining their well-being.
Community members, resources,
organization & administration should
be the corner stone of an emergency
preparedness programme.

 Disaster preparedness is multi-sectoral activity,

it form integral part of national system responsible
developing plans & programmes for disaster
managment, prevention, mitigation, preparedness,
response, rehabilitation and reconstruction

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The system depends on the coordination of variety of
sectors to carry out the following tasks:-

1- evaluate the risk of the country or particular region to

disaster.

2- adopt standard & regulation.

3- organize communication,

information & warning system.

4- ensure coordination & response mechanism.

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5- Adopt measures to ensure that financial & other
resource are available for increased readiness & can
be mobilized in disaster situation.
6- Develop public education programmes.
7- organize disaster simulation exercise that test
response mechanism.
8- coordinate information session with news media.

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 Policy development

The policy development, It’s the formal statement

of a course of action . Policy is strategic in
nature and performs the following functions:-
a. Establish long term goal.
b. Assign responsibility to achieving goals.
c. Establish recommended work practice.
d. Determine the criteria for decision making.
There are six sectors required for response &
recovery strategies ( communication, health, social
welfare, police, security search & rescue and transport).
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 General measures to be observed
There's number of measures must be observed by
all persons in all types of emergency :-

 Don't use telephone except to call for help.

 Listen to the message broadcast by media.

 Carry out the official instruction given over the

radio.

 Keep family emergency kit ready.

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 Man made disaster
Man made disasters can be divided to 3 categories:-
1- sudden disaster :
Such as Bhopal Gas tragedy in India on 1984 in which
tons of methyl isocyanate released in Air where 2
million exposed and 3000 dead.
2- insidious disaster :
Such as insidious chemical & radiation exposure, as in
nuclear weapons production factories.
3- Wars and civil conflict :
e.g. attack on twins building o world Trade center in
New york in which 6000 people lost there lives and
thousand were injured.

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 The public health response to man-made
disaster is the primary prevention.

 Much can be done to prevent not only the

consequences but also the occurrences of fires,
explosions, crashes and sudden chemical and
radiation exposure.

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 QUESTIONS ??

THANK YOU

Dr.Abdulhakim Oun
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