Disaster nursing

can be defined as “the adaptation of professional nursing knowledge, skills and attitude in recognizing and
meeting the nursing, health and emotional needs of disaster victims.”

The overall goal of disaster nursing is to achieve the best possible level of health for the people and the
community involved in the disaster

THE GOAL OF DISASTER NURSING involves ensuring that the highest achievable level of care is delivered
through identifying, advocating, and caring for all impacted populations throughout all phases of a disaster event,
including active participation in all levels of disaster planning and preparedness.

1. To meet the immediate basic survival needs of populations affected by disasters (water, food,
shelter, and security).
2. To identify the potential for a secondary disaster.
3. To appraise both risks and resources in the environment.
4. To correct inequalities in access to health care or appropriate resources.
5. To empower survivors to participate in and advocate for their own health and well-being.
6. To respect cultural, lingual, and religious diversity in individuals and families and to apply this
principle in all health promotion activities.
7. To promote the highest achievable quality of life for survivors.
The basic principles of nursing during special (events) circumstances and disaster conditions include:
1. Rapid assessment of the situation and of nursing care needs.
2. Triage and initiation of life-saving measures first.
3. The selected use of essential nursing interventions and the elimination of nonessential nursing
activities.
4. Adaptation of necessary nursing skills to disaster and other emergency situations. The nurse must use
imagination and resourcefulness in dealing with a lack of supplies, equipment, and personnel.
5. Evaluation of the environment and the mitigation or removal of any health hazards.
6. Prevention of further injury or illness.
7. Leadership in coordinating patient triage, care, and transport during times of crisis.
8. The teaching, supervision, and utilization of auxiliary medical personnel and volunteers.
9. Provision of understanding, compassion, and emotional support to all victims and their families.
The Nurse’s Role in Disaster Response Plans
 The role of the nurse during a disaster varies. Nurses may be asked to perform duties outside their areas
of expertise and may take on responsibilities normally held by physicians or advanced practice nurses. For
example, a critical care nurse may intubate a patient or even insert a chest tube.
 A nurse may perform wound debridement or suturing.
 A nurse may serve as the triage officer.
 A nurse or physician is in charge of a given patient care area and which procedures each individual nurse
may or may not perform. Assistance can be obtained through the HICS, and nonmedical personnel can
provide services where possible. For example, family members can provide no skilled interventions for
their loved ones.
 Nurses should remember that nursing care in a disaster focuses on essential care from a perspective of
what is best for all patients.
 New settings and atypical roles for nurses arise during a disaster;
 for example, the nurse may provide shelter care in a temporary housing area or bereavement
support and assistance with identification of deceased loved ones.
 People may require crisis intervention, or the nurse may participate in counseling other staff members
and in Critical Incident Stress Management. Special care may be warranted for at- risk populations during
a disaster (Chart 72-3).

Considering Ethical Conflicts

Disasters can present a disparity between the resources of the health care agency and the needs of the victims.

This generates ethical dilemmas for nurses and other health care providers. Issues include conflicts related to
the following:

• Rationing care
• Futile therapy
• Consent
• Duty
• Confidentiality
• Resuscitation
• Assisted suicide

Nurses may find it difficult to not provide care to the dying or to withhold information to avoid spreading fear and
panic.

Clinical scenarios that are unimaginable in normal circumstances confront the nurse in extreme instances. Other
ethical dilemmas may arise out of health care providers’ instincts for self-protection and protection of their
families. For example, what should a pregnant nurse do when incoming disaster victims have been exposed to
radiation yet too few nurses are available?

Nurses can plan for the ethical dilemmas they will face during disasters by establishing a framework for
evaluating ethical questions before they arise and by identifying and exploring possible responses to difficult
clinical situations. They can consider how the fundamental ethical principles of utilitarianism, beneficence, and
justice will influence their decisions and care in disaster response (see Chapter 3).

Managing Behavioral Issues

Although most people pull together and function well during a disaster, both people and communities suffer
immediate and sometimes long-term psychological trauma.
Common responses to disaster include the following:
• Depression
• Anxiety
• Somatization (fatigue, general malaise, headaches, gastrointestinal disturbances, skin rashes)
• Posttraumatic stress disorder (PTSD)
• Substance abuse
• Interpersonal conflicts
• Impaired performance
Factors that influence a person’s response to disaster include
1. degree and nature of the exposure to the disaster,
2. loss of friends and loved ones,
3. existing coping strategies
4. available resources and support, and the personal meaning attached to the event.

Other factors,
 loss of home and valued possessions,
 extended exposure to danger,
 exposure to toxic contamination also influence response and increase the risk of adjustment problems.

Those exposed to the dead and injured, those endangered by the event, the elderly, children, emergency first
responders, and health care personnel caring for victims are considered to be at higher risk for emotional
sequelae.

Nurses can assist disaster victims through

 active listening and providing emotional support,
 giving information,
 and referring patients to therapists or social workers.

Health care workers must refer people to mental health care services because experience has shown that few
disaster victims seek these services, and early intervention minimizes psychological consequences. Nurses can also
discourage victims from subjecting themselves to repeated exposure to the event through media replays and news
articles, and encourage them to return to normal activities and social roles when appropriate.

Critical Incident Stress Management

Critical Incident Stress Management (CISM) is an approach to preventing and treating the emotional trauma that
can affect emergency responders as a consequence of their jobs and that can also occur to anyone involved in a
disaster or MCI. CISM is handled by its own teams

All branches of emergency services have CISM teams.

Components of a management plan include education before an incident occurs about critical incident stress and
coping strategies; field support (ensuring that staff get adequate rest, food, and fluids, and rotating workloads)
during an incident; and defusing, debriefings, demobilization, and follow-up care after the incident.

Defusing is a process by which the person receives education about recognition of stress reactions and
management strategies for handling stress.

Debriefing is a more complicated intervention; it involves a 2- to 3-hour process during which participants are
asked about their emotional reactions to the incident, what symptoms they may be experiencing (eg, flashbacks,
difficulty sleeping, intrusive thoughts), and other psychological ramifications. In follow- up, members of the CISM
team contact the participants of a debriefing and schedule a follow-up meeting if necessary. People with ongoing
stress reactions are referred to mental health specialists.

Health Effects of Disaster- in the following ways

 Disasters may cause premature deaths, illnesses, and injuries in the affected community,
generally exceeding the capacity of the local health care system.
 Disasters may destroy the local health care infrastructure, which will therefore be unable to
respond to the emergency. Disruption of routine health care services and prevention initiatives
may lead to long-term consequences in health outcomes in terms of increased morbidity and
mortality.
 Disasters may create environmental imbalances, increasing the risk of communicable diseases
and environmental hazards.
 ·Disasters may affect the psychological, emotional, and social well-being of the population in the
affected community. Depending on the specific nature of the disaster, responses may range
from fear, anxiety, and depression to widespread panic and terror.
 . Disasters may cause shortages of food and cause severe nutritional deficiencies.
 Disasters may cause large population movements (refugees) creating a burden on other health
care systems and communities.
 Displaced populations and their host communities are at increased risk for communicable
diseases and the health consequences of crowded living conditions
Preparedness and Response
There are three phases of disaster.
Pre-Impact Phase
 It is the initial phase of disaster, prior to the actual occurrence. A warning is given at the
sign of the first possible danger to a community with the aid of weather networks and
satellite many meteorological disasters can be predicted.
 The earliest possible warning is crucial in preventing toss of life and minimizing damage.
This is the period when the emergency preparedness plan is put into effect emergency
centers are opened by the local civil, detention authority.
 Communication is a very important factor during this phase; disaster personnel will call
on amateur radio operators, radio and television stations.
 The role of the nurse during this warning phase is to assist in preparing shelters and
emergency aid stations and establishing contact with other emergency service group.
Impact Phase
 The impact phase occurs when the disaster actually happens. It is a time of enduring
hardship or injury end of trying to survive.
 The impact phase may last for several minutes (e.g. after an earthquake, plane crash or
explosion.) or for days or weeks (eg in a flood, famine or epidemic).
 The impact phase continues until the threat of further destruction has passed and
emergency plan is in effect.
 This is the time when the emergency operation center is established and put in
operation. It serves as the center for communication and other government agencies of
health tears care healthcare providers to staff shelters.
 Every shelter has a nurse as a member of disaster action team. The nurse is responsible
for psychological support to victims in the shelter.
Post – Impact Phase
 Recovery begins during the emergency phase and ends with the return of normal
community order and functioning. For persons in the impact area this phase may last a
lifetime (e.g. – victims of the atomic bomb of Hiroshima). The victims of disaster in go
through four stages of emotional response.
Recognition and Awareness

Preparedness for terrorism and other disasters includes awareness of the potential ,for covert use of WMD, self-
protection, and early detection, containment, or decontamination of substances and agents that may affect others
by secondary exposure.

The strength of many toxins, mobility of many members of society, and long incubation periods for some
organisms and diseases can result in an epidemic that can quickly and silently spread across the entire country. For
example, a formerly healthy person with a rapid onset of flulike symptoms can have an ominous illness, such as
anthrax or severe acute respiratory syndrome (SARS), both of which are discussed in more detail later in the
chapter.

Nurses should have a heightened awareness of trends that may suggest deliberate dispersal of toxic or
infectious agents, including the following:
• An unusual increase in the number of people seeking care for fever, respiratory, or gastrointestinal symptoms

• Clusters of patients who present with the same un- usual illness from a single location. For example, clusters can
be from a specific geographic location, such as a city, or from a single sporting or entertainment event.

• A large number of rapidly fatal cases, especially when death occurs within 72 hours after hospital admission.

• Any increase in disease incidence in a normally healthy population.

These cases should be reported to the state health department and to the CDC. If any of these trends are noted,
an extensive patient his- tory is taken in an attempt to identify the possible agent involved.

This history includes an occupational, work, and environmental assessment, in addition to the regular admission
history. An exposure history contains, at a minimum, information about current and past exposures to possible
hazards and an assessment of the patient’s typical day and any deviations in routines. The work history includes, at
a minimum, a description of all previous jobs, including short-term, seasonal, and part-time employment and any
military service.

The environmental history includes assessment of present and previous home locations, water supply, and any
hobbies, to name a few factors.

The admission his- tory should include such information as recent travel and contact with others who have been ill
or have recently died of a fatal illness. This is just a brief review of the extensive history that may need to be
obtained to identify an exposure agent (Agency for Toxic Substances and Disease Registry, 2009). Suspicions or
findings are reported to the appropriate resources in the facility and to proper authorities in the community.
Resources can include the infection control department, material safety data sheets (MSDS) or the Chemtrac
database, the state health department, the CDC, the local poison control center, and many Internet sites (Dara, et
al., 2005). Reporting furnishes data elements to those agencies responsible for epidemiology and response.
Reporting also allows for sharing of information among facilities and jurisdictions and can help determine the
source of infections or exposure and prevent further exposures and even deaths. Personal Protective Equipment

PERSONAL PROTECTIVE EQUIPMENT (PPE). A protection for heath care

Chemical or biologic agents and radiation are silent killers and are generally color- less and odorless. The purpose
of PPE is to shield health care workers from the chemical, physical, biologic, and radiologic hazards that may exist
when caring for contaminated patients. The U.S. Environmental Protection Agency (EPA) has divided protective
clothing and respiratory protection into the following four categories

• Level A
- protection is worn when the highest level of respiratory, skin, eye, and mucous membrane protection is
required. This includes a self-contained breathing apparatus (SCBA) and a fully encapsulating, vapor- tight,
chemical-resistant suit with chemical-resistant gloves and boots.

• Level B
- protection requires the highest level of respiratory protection but a lesser level of skin and eye protection than
with level A situations. This level of protection includes the SCBA and a chemical-resistant suit, but the suit is not
vapor tight (Hoyt & Selfridge- Thomas, 2007).
• Level C
- protection requires the air-purified respirator, which uses filters or sorbent materials to remove harmful
substances from the air. A chemical-resistant coverall with splash hood, chemical-resistant gloves, and boots are
included in level C protection.
• Level D
-protection is the typical work uniform. Levels C and D PPE are the levels most often used in hospital facilities
(Hoyt & Selfridge-Thomas, 2007).
Protective equipment must be donned before contact with a contaminated patient. The acute care facility’s
standard precaution PPE (level D) generally is not adequate for protection from a chemically, biologically, or
radiologically contaminated patient.

Level C PPE is adequate for the average patient exposure. The health care provider must use equipment that is
capable of providing protection against the agent involved. This may mean using a splash suit along with a full-face
positive-pressure or negative-pressure respirator (a filter-type gas mask) or even an SCBA for medical personnel in
the field. No single PPE is capable of protecting against all hazards. Under no circumstances should responders
wear any PPE without proper training, practice, and fit testing of respirator masks as necessary.
Decontamination
Decontamination, the process of removing accumulated contaminants, is critical to the health and safety of health
care providers by preventing secondary contamination. The decontamination plan should establish procedures and
educate employees about decontamination procedures, identify the equipment needed and methods to be used,
and establish methods for disposal of contaminated materials (Dara, et al., 2005). Although many principles and
theories surround decontamination of a patient, authorities agree that, to be effective, decontamination must
include a minimum of two steps.
The first step is removal of the patient’s clothing and jewelry and then rinsing the patient with water. Depending
on the type of exposure, this step alone can remove a large amount of the contamination and decrease secondary
contamination.

The second step consists of a thorough soap-and-water wash and rinse. When patients arrive at the facility after
being assessed and treated by a prehospital provider, it should not be assumed that they have been thoroughly
decontaminated. The hospital must be prepared to perform additional decontamination prior to entry into the
facility. The hospital personnel may also treat “walking wounded” who did not receive any decontamination at the
scene.

Disaster: is a result of vast ecological breakdown in the relation between humans and their environment, as
serious or sudden event on such scale that the stricken community needs extraordinary efforts to cope with
outside help or international aid.

WHO defines Disaster as “any occurrence that causes damage, ecological disruption, loss of human life,
deterioration of health and health services, on a scale sufficient to warrant an extraordinary response from outside
the affected community or area.”(1995)

Thus, a disaster may have the following main features:

i. Unpredictability
ii. Unfamiliarity
iii. Speed
iv. Urgency
v. Uncertainty
vi. Threat
Disasters are classified in various ways, on the basis of its origin/cause.
1. Natural disasters
2. Man-made disasters
Disasters are classified in various ways,
On the basis of speed of onset-
1. Sudden onset disasters
2. Slow onset disasters

Natural Disasters
A serious disruption triggered by a natural hazard (hydro-metrological, geological or biological in origin) causing
human, material, economic or environmental losses, which exceed the ability of those affected to cope. Natural
hazards can be classified according to their

(1) hydro meteorological,

(2) geological or
(3) biological origins.
 Chart 72-1•Disaster Levels
Disasters are often classified by the resultant anticipated necessary response:
Level I: Local emergency response personnel and organizations can contain and effectively manage the
disaster and its aftermath. : If the organization, agency, or community is able to contain the event and respond
effectively utilizing its own resources
Level II: Regional efforts and aid from surrounding communities are sufficient to manage the effects of the
disaster. If the disaster requires assistance from external sources, but these can be obtained from nearby
agencies
Level III: Local and regional assets are overwhelmed; statewide or federal assistance is required. If the
disaster is of a magnitude that exceeds the capacity of the local community or region and requires assistance
from state-level or even federal assets.

Hydrometer logical disaster -

Natural processes or phenomena of atmospheric hydrological or oceanographic
nature. Phenomena /
Examples Cyclones, typhoons, hurricanes, tornados, Storms, hailstorms, snowstorms, cold spells,
heat waves and droughts.
Geographical disaster
Natural earth processes or phenomena that include processes of endogenous origin or tectonic
or exogenous origin such as mass movements, Permafrost, snow avalanches. Phenomena
Example Earthquake, tsunami, volcanic activity, Mass movements landslides, Surface collapse,
geographical fault activities etc.
Biological Disaster –
Processes of organic organs or those conveyed by biological vectors, including exposure to
pathogenic, microorganism, toxins and bioactive substances. Phenomena
Examples – Outbreaks of epidemics Diseases, plant or animal contagion and extensive
infestation etc.

HUMAN-INDUCED DISASTERS
A serious disruption triggered by a human-induced hazard causing human, material, economic
or environmental losses, which exceed the ability of those affected to cope.
These can be classified into –
(1) Technological Disaster and
(2) Environmental Degradation.
Technological disaster –
Danger associated with technological or industrial accidents, infrastructure failures or certain
human activities which may cause the loss of life or injury, property damage, social or economic
disruption or environmental degradation, sometimes referred to as anthropological hazards.
Examples include ;
industrial pollution,
 nuclear release and radioactivity,
 War,
 toxic waste,
 dam failure,
 transport industrial or technological accidents (explosions fires spills).
Environmental Degradation –
 Processes induced by human behaviors and activities that damage the natural resources base
on adversely alter nature processes or ecosystems. Potentials effects are varied and may
contribute to the increase in vulnerability, frequency and the intensity of natural hazards.
Examples include
 land degradation,
 deforestation,
 desertification,
 wild land fire,
 loss of biodiversity,
 land, water and air pollution climate change,
 sea level rise and ozone depletion.
KEY ELEMENTS OF DISASTERS -Disasters result from

A. combination of hazards,
B. conditions of vulnerability
C. the potential negative consequences of risk

Hazards
Hazards are defined as “Phenomena that pose a threat to people, structures, or economic assets
and which may cause a disaster. They could be either manmade or naturally occurring in our
environment.”
Capacity
Capacity is the combination of all the strengths and resources available within a community,
society or organization that can reduce the level of risk, or the effects of a disaster.
Capacity may include physical, institutional, social or economic means as well as skilled personal
or collective attributes such as ‘leadership’ and ‘management.’
Capacity may also be described as capability.
RISK
is the probability of harmful consequences, or expected losses
(deaths, injuries, property, livelihoods, economic activity disrupted or environment damaged)
resulting from interactions between natural or human-induced hazards and vulnerable
conditions.
. The DISASTER PARADIGM
D – Detect
I - Incident Command
S- Security and Safety
A – Assess
S – Support
T – Triage and Treatment
E – Evacuation
R – Recovery
D- DETECTION
Awareness of a Disaster,- defines as a situation where need exceeds the response capabilities
This does not require an understanding of the cause
I – INCIDENT COMMAND
Controlling the flow of Resources available for response.
 An effective Response requires multiple arms of operations with well defined responsibilities
such as
Extrication and rescue
Triage,
Transfortation
communications
S - Scene Security and Safety
« When you arrive at a Code, the first Pulse you take should be your own
Your own safwety and that of your team must be your own concern
Thereafter your priorities is the safety of the public
A- ASSESS HAZARDS
Scene must be continually reassessed
You should have an awareness of the dangers that could potentially cause further injury
T – TRIAGE AND TREATMENT
Sorting Patient according to categories
E – EVACUATIONS
Evacuations from the scene of the Injured
Then the Uninjured who are without transfortation and finally the rescue personnels
In large number of people are involved trains or school bus maybe helpful in tranporting people
R – RECOVERY
Long term objective of the disaster response
Long term implications of the wevent on the injured which may include crisis management
counseling and shelter access
Natural disasters may result in mass casualties.
Natural disasters can occur anywhere at any time and include events such as tornadoes, hurricanes, floods,
avalanches, tidal waves (eg, tsunamis), earthquakes, and volcanic eruptions. In the event of a natural disaster, loss
of communications, potable water, and electricity is usually the greatest obstacle to a well- coordinated
emergency response, and preparatory planning is essential. Even wireless technology (eg, cellular phones,
computers, other communication devices) may not be functional. The majority of the immediate casualties are
trauma related. These mass casualties tax the trauma system to its limits to provide triage, transport of patients (in
poor weather and road conditions), and management within the trauma centers. The majority of patients usually
begin arriving within an hour of the event.

However, the “walking wounded” may not seek care for 5 days to 2 weeks after the event or may seek care for
injuries received during clean-up activities

Casualties arrive at hospitals in three waves.

The first wave consists of minimally (generally) injured people who arrive of their own accord.
The second wave consists of severely injured patients.
The third wave consists of injured patients who arrive after they are discovered by rescuers.
 For example, in the event of earthquakes, buildings collapse and cause the majority of fatalities
from injuries that primarily involve the head and chest (Kano, 2005).
 The majority of the patients usually begin arriving within an hour of the event; the “walking
wounded” may not seek care for 5 days to 2 weeks after the event or may seek care for injuries
inflicted during the clean-up activities.
 Excessive exposure to the natural elements and the need for food and water (by both patients
and emergency responders) are critical issues.
 Without cover (eg, buildings may be unsafe or destroyed) or potable water (eg, water may, cold,
or contaminated food or water can occur.
  Safety equipment that protects rescue workers from injury, exposure, and potentially dangerous
animals (eg, snakes, alligators, spiders) must be readily available.
 Rescue workers may also injure themselves in the process of extrication or cleanup (eg, chain
saws, building collapse).
 Hypothermia can occur rapidly in workers who are exposed to water at temperatures of 23.9C
(75F) or less. As is true during all disasters, mental health workers and shelters are needed
throughout the community. Veterinary assistance is also essential because pets are frequently
abandoned and injured.
 In addition, emergency response workers must be prepared to treat the most common ailments
experienced after exposure to a specific natural disaster. For instance, pulmonary problems peak
with earthquakes and volcanic eruptions because of the increased particulate matter in the air.
Most volcano-related deaths are from suffocation.

After floods or water disasters, waterborne transmission of agents such as Escherichia coli, salmonella, shigella,
typhoid, leptospirosis, malaria, and tularemia are common and cause widespread disease. In addition, other
waterborne hazards can include human exposure to poisonous snakes and alligators in the flood waters. In some
instances, early warning systems have assisted in decreasing the number of deaths from tornadoes and hurricanes.

 However, even with the advent of early warning systems, some people are unable or unwilling to leave
prior to the occurrence of the natural disaster. When buildings collapse, rapid response to identify and
remove trapped victims is the only means of improving survivability. There is a direct relationship
between time trapped and survival; fewer than 50 percent of people survive if they are trapped more
than 2 to 6 hours. Water-damaged buildings are not safe and require extensive examination before
experts can ensure safe occupancy. Larger-scale issues that can cause significant later morbidity and
mortality include the absence of water purification, waste removal, removal of human and animal
remains, and vector control. Removal or disposal of bio- logic, chemical, and nuclear agents must also be
considered.

Disaster nursing can be defined as “the adaptation of professional nursing knowledge, skills and attitude
in recognizing and meeting the nursing, health and emotional needs of disaster victims.
at the scene.
The Disaster management Cycle
THE DISASTER EVENT or impact
This refers to the real-time event of a hazard occurring and affecting the ‘elements at risk’. The duration
of the event will depend on the type of threat, for example, ground shaking may only occur for a few
seconds during an earthquake while flooding may take place over a longer period of time.
FIVE BASIC PHASES TO A DISASTER MANAGEMENT CYCLE (KIM & PROCTOR, 2002),

1.RESPONSE
 The response phase is the actual implementation of the disaster plan.
The best response plans use an incident command system, are relatively simple, are routinely
practiced, and are modified when improvements are needed.
 Response activities need to be continually monitored and adjusted to the changing situation.
Activities a hospital, healthcare system, or public health agency take immediately before,
during, and after a disaster or emergency occurs.
Search , rescue and first aid ,field care , triage activation , referral services clearing debris, and
feeding and sheltering victims

2.RECOVERy
 Once the incident is over, the organization and staff needs to recover. Invariably, services have
been disrupted and it takes time to return to routines. Recovery is usually easier if, during the
response, some of the staff have been assigned to maintain essential services while others were
assigned to the disaster response.
 Activities undertaken by a community and its components after an emergency or disaster to
restore minimum services and move towards long-term restoration.
Debris Removal
Care and Shelter
Damage Assessments
Funding Assistance
3. EVALUATION/DEVELOPMENT
 Often this phase of disaster planning and response receives the least attention. After a disaster,
employees and the community are anxious to return to usual operations.
 It is essential that a formal evaluation be done to determine what went well (what really
worked) and what problems were identified. A specific individual should be charged with the
evaluation and follow-through activities.
4. DISASTER MITIGATION
 These can be considered as prevention and risk reduction measures.
refers to actions or measures that can either prevent the occurrence of a disaster
reduce the severity of its effects. (American Red Cross).
installing and maintaining backup generator power to mitigate the effects of a power failure
cross training staff to perform other tasks to maintain services during a staffing crisis that is due
to a weather emergency
 Mitigation activities include awareness and education and disaster prevention measures.
 Activities that reduce or eliminate hazard
5.Preparedness/risk assessment
Evaluate the facility’s vulnerabilities or propensity for disasters.
 Issues to consider include: weather patterns; geographic location; expectations related to public
events and gatherings; age, condition, and location of the facility; and industries in close
proximity to the hospital (e.g., nuclear power plant or chemical factory).
 Disater Preparedness refers to measures taken to prepare for and reduce the effects
of disasters. That is, to predict and, where possible, prevent disasters, mitigate their impact on
vulnerable populations, and respond to and effectively cope with their consequences.
 (International Red Cross)
 Disaster Preparedness Plan
 Emergency communication plan
 Prevent spread of disease outbreak
 Public Education and awareness