Beruflich Dokumente
Kultur Dokumente
Howard Ruff
INTRODUCTION
A disaster is an event or series of events, which give rise to casualties and damage or loss
of property, infrastructure, environment, essential services or means of livelihood on a scale that is
beyond the normal coping capacity of the affected community. Disasters disrupt progress and destroy
the developmental efforts, often pushing nations, in their quest for progress, back by several decades.
Thus, efficient management of disasters, rather than mere response to their occurrence, has received
increased attention both within India and abroad1. India is one of the most disaster prone
countries in the world. This is largely due to its geo-climatic conditions combined with high
population density and other socio economic factors. India is vulnerable, in varying degrees,
to a large number of natural as well as man-made disasters. Floods, droughts, cyclones,
earthquakes and landslides have been recurrent phenomena2.
Definition of disaster
“A disaster can be defined 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”3. (W.H.O)
Environmental degradation: Removal of trees and forest cover from a watershed area have
caused, soil erosion, expansion of flood plain area in upper and middle course of rivers and
groundwater depletion.
Industrialization: This has resulted into warming of earth and frequency of extreme weather
events has also increased4.
Disasters are classified as per origin, into natural and man-made disasters. As per
severity, disasters are classified as minor or major (in impact).
Natural disasters are sudden ecological disruptions or threats that exceed the adjustment
capacity of the affected community and require external assistance.
Natural disasters can be broadly classified into categories including geophysical such as earthquakes
and volcanic eruptions; hydrological such as floods; meteorological such as
hurricanes; climatologically such as heat and cold waves and droughts; and biological such as
epidemics.
Man-made disasters can include hazardous material spills, fires, groundwater contamination,
transportation accidents, structure failures, mining accidents, explosions and acts of terrorism4.
Disaster impacts individuals physically (through loss of life, injury, health, disability) as well
as psychologically.
Disaster results in huge economic loss due to destruction of property, human settlements and
infrastructure etc.
Disaster can alter the natural environment, loss of habitat to many plants and animals and cause
ecological stress that can result in biodiversity loss.
After natural disasters, food and other natural resources like water often becomes scarce resulting
into food and water scarcity.
The disaster results in displacement of people, and displaced population often face several
challenges in new settlements, in this process poorer becomes more poor.
Disasters increase the level of vulnerability and hence multiply the effects of disaster4.
These comprise all forms all activities including structural and non- structural measures to
avoid (prevention) or to limit (mitigation and preparedness) adverse effects of hazards.
1. Before a disaster: to reduce the potential for human, material, or environmental losses caused by
hazards and to ensure that these losses are minimized when disaster strikes;
3. After a disaster: to achieve rapid and durable recovery which does not reproduce the original
vulnerable conditions.
The different phases of disaster management are represented in the disaster cycle diagram.
Disaster risk reduction is the concept and practice of reducing disaster risks through systematic
efforts to analyze and reduce the causal factors of disasters.
1. Prevention/Mitigation
Prevention/Mitigation is defined as “sustained actions that decrease the risk of a hazard (probability of
occurrence) of a hazard, or to reduce the potential negative consequences suffered by people and/or
property.”
2. Disaster Preparedness
Definition
Disaster preparedness refers to measures taken to prepare for and reduce the effect
of disasters. This is to predict and where possible prevent them, mitigate their impact on vulnerable
population, and respond to and effectively cope with their consequences.5
The United Nations Disaster Relief Office (UNDRO) uses the following definition of
Disaster Preparedness:
“It may be described as (a series of) measures designed to organize and facilitate timely and effective
rescue, relief and rehabilitation operations in cases of disaster…. Measures of preparedness include
among others, setting up disaster relief machinery, formulation of emergency relief plans, training of
specific groups (and vulnerable communities) to undertake rescue and relief, stockpiling supplies and
earmarking funds for relief operations”.5
1. Participation and local ownership : It is important that arrange of people participate in the
process of preparedness planning for a number of reasons:
1) It helps to increase awareness of the plan, imbed it in the organization and build commitment
for its use.
2) Decisions are based on arrange of experience and knowledge, increasing the validity of the
plan produced.
3) Skills and knowledge of staff and volunteers are built through taking part , increasing the
capacity of the organization as a whole.
4) Valuable relationships between staff, volunteers’ community members and external actors
are built through working together.
2. Ongoing learning: Learning through doing Disaster preparedness planning is first and foremost an
exercise in capacity building for the organization and individuals involved.
3. Commitment to good practice: All disaster response work should adhere to Humanitarian
principles of good practice. It is essential therefore that these are taken into account when preparing
plans for response. Adhering to these principles increases accountability to beneficiaries and donors
and has less chance of causing unintentional harm
4. Collaboration not isolation: When disasters occur people are affected in multiple ways and
require a wide range of help and support. It’s unlikely that one organization alone can provide
everything needed, so any organizations provide responses. These organizations need to work in
coordination with each other to ensure an effective and efficient response. In order to coordinate
effectively, relationships between organisations, communities and governing bodies must be built.
5. Prevention before response: The final principle recognizes that preparedness is about reducing the
impact before the event as well as after it. Planning response activities helps reduce impacts in the
event o f a disaster by increasing the speed and quality of response work.6
Types of preparedness
1) Target-Oriented Preparedness: Preparedness plans are also target specific, for instance, we
may require different types of planning for the vulnerable groups of women, children, elderly
and disabled. Livestock would need a specific preparedness plan. Then there could be health
preparedness plans, risk reduction preparedness plans, and awareness generation plans.
2) Task-Oriented Preparedness: the various tasks to do as preparedness are;
Mapping
Planning
Forming Disaster Task Forces
Training of Members of Task Force and other Volunteers
Creating Structures for Coordination
Promoting Awareness Campaigns
Operationalizing Disaster Management
Recruiting Personnel for Relief and Distribution Tasks
3) Disaster-Oriented Preparedness: Disaster Preparedness, thus, takes place at two different levels,
structural and non-structural:
Non-structural preparedness measures include:
Administrative and Regulatory Legislation
Insurance Schemes
Information, Education and Training
Community Participation
Community Action Groups
Responding to Warning Systems
Institution Building
Provision of Incentives
Creation of Public Awareness
Response
Response is defined as the actions taken to decrease mortality and morbidity, and to prevent further
property damage when the hazard occurs. Response is putting preparedness plans into action.
Response activities may include
Recovery
Repairing buildings
Replacing homes.5
2. Emergency Management Theory: Under the emergency management theory there are four
theories.
1. Risk perception and communication
2. Preparedness and improvisation
3. Emergent behavior
4. Organizational behavior
3. System Theory: Four theories are categories under the system theory
Disaster management is a part of good governance which includes active interactions among various
stake holders like administrative machinery, citizen groups, formal and informal institutions. Disasters
are episodic but are recurrent. Preparedness is the key to the success of Disaster Management Plan
and without citizens’ involvement and participation any effective plan is rendered ineffective. It is
becoming increasingly evident now that a relatively smaller investment in disaster preparedness can
save thousands of lives and vital economic assets, as well as reduce the cost of overall relief
assistance. 8
Due to location and climate, India itself is one of the most disaster-prone areas of the world.
The country is exposed to many natural hazards including floods, cyclones, droughts, and earthquakes
and these disasters often cause significant damage to property and loss of life.
In May 2019, more than 20 young people died due to a deadly fire at a coaching centre in
Surat. According to National Crime Records Bureau data, India’s record is appalling on fire safety.
More than 17,000 people nationwide died in fire related incidences in 2015. These tragedies highlight
the gaps in Disaster Management framework of India. In this context, there is a need to understand the
various facets of Disaster Management and what should be done for fixing accountability and
updating of disaster management protocol countrywide.9
Floods are becoming a common phenomenon in India. Over the past few decades, areas
facing recurring calamities have become relatively better prepared, with an increased understanding of
the risks. This does not hold true for areas that have not experienced a major calamity in the recent
past. Ignoring all the safety guidelines, dwellings, factories and infrastructure facilities have been
constructed in areas that are potentially vulnerable to natural hazards like floods.
This year, Kerala received unprecedented rainfall, forcing the authorities to open the gates of
all major dams, resulting in the worst flooding in 100 years, with 86% of the territory (12 out of 14
districts) affected. The floods in Kerala highlighted an emerging threat in the country: the danger from
dams. A report published in 2017 by the Comptroller and Auditor General (CAG) about India’s
performance audit on flood control and management schemes categorically stated that only 7% of
dams (349 out of 4,862) have Emergency Action Plans. Kerala has 44 rivers and 61 dams, but as per
the CAG report none of these dams have Emergency Action Plans and Operation and Maintenance
manuals. The audit also draws attention to the absence of flood forecasting systems in 15 states and
Union Territories.
Until August 2016, only 5% dams (231 out of 4,862) had an operational maintenance manual.
Various committees have been formed for flood management, such as the Rashtriya Barh Ayog. But
their recommendations, with regards to identification of flood prone areas, have not yet been put into
action.
After every disaster, its aftermath and adverse impacts raise a lot of questions about the status
of preparedness. It is important to acknowledge that we are still not completely ready. This is because
disaster management agencies continue to be reactive in their actions. Following the Uttarakhand
floods in 2013 and Kashmir floods in 2014, it was only after a lot of questions were raised and
criticism directed at preparedness practices that flood forecast stations were set-up in these two states.
The non-structural measures for flood forecasting — provide early warning in flood prone
areas — have proved to be successful for flood management. However, for the early warning systems
to be effective, continuous and collaborative efforts are required, rather than a one-time action. For
instance, high-tech warning systems on the ground will not be useful until the authorities, key
stakeholders and communities are trained to act upon the information obtained from these facilities.
People affected by the Kerala floods reported that they had heard a faint announcement on the
loudspeakers, but the message could not be heard clearly, so they were unsure about what it meant till
the water entered their houses. Different stakeholders need to come together for mapping risks,
vulnerabilities, and resources; engage in regular preparedness actions like drills and capacity building;
develop and update emergency plans; check the availability of resources at the local level; and act
upon early warning intimations. While the government works towards strengthening systems and
mechanisms for preparedness and response, civil society has a major role to play, at the community
level, for disaster preparedness.
Disaster management plans exist on paper, but implementation remains a challenge. Despite the
emphasis on a paradigm shift to a preparedness approach by the government, most parts of the
country continue to follow a relief-centric approach in disaster management, rather than a proactive
prevention, mitigation and preparedness path. There is a need for investing in disaster preparedness
and mitigation across the country, irrespective of whether any state has been hit by a disaster or not.
India needs to adopt a collaborative approach, where the roles of the government, corporations,
academia, civil societies and communities are recognized, and all actors work hand-in-hand towards
achieving disaster resilience.10
There are some very important reasons why you should prepare for a disaster:
Saves Lives – Different disasters require different responses. Being prepared for various
disaster emergencies can make a huge difference in saving lives as well as money.
Reduces Danger – Knowing the steps to take during a disaster – whether flooding,
tornadoes, earthquakes or another crisis – can greatly reduce the danger and distress your
family may face.
Reduces Uncertainty – Not having a complete understanding of a hazard threat can leave
you frightened and uncertain of what to do to protect yourself and your loved ones. Being
prepared by knowing what to do reduce uncertainty.
A Cross-sectional descriptive study was conducted to examine nurses' knowledge, attitudes, practices
and familiarity regarding disaster and emergency preparedness-using five tools to obtain data from
252 two registered batches of bridging nurses students. Based on the present study results; lacking of
knowledge and practices with acceptable level of attitude regarding disaster preparedness and neutral
familiarity with emergency preparedness were concluded.
Baack S and Alfred D conducted a descriptive analysis on 620 Rural Nurses’ Preparedness and
Perceived Competence in Managing Disasters with a 58‐item Disaster Readiness Questionnaire
through survey method. Findings revealed that most nurses are not confident in their abilities to
respond to major disaster events. The nurses who were confident were more likely to have had actual
prior experience in disasters or shelters. Self‐regulation of behavior (motivation) was a significant
predictor of perceived nurse competence to manage disasters only in regard to the nurse's willingness
to assume the risk of involvement in a disaster situation. 13
REVIEW OF LITERATURE
Common disasters and Vulnerability Profile of India
India is vulnerable, in varying degrees, to a large number of disasters. Around 59% of the
landmass is prone to earthquakes of moderate to very high intensity.
About 12% (over 40 million hectares) of its land is prone to floods and river erosion.
Close to 5,700 kms, out of the 7,516 kms long coastline is prone to cyclones and tsunamis.
68% of its cultivable area is vulnerable to droughts; and, the hilly areas are at risk from
landslides and avalanches.
Moreover, India is also vulnerable to chemical, biological, radiological and nuclear (CBRN)
emergencies and other man-made disasters.1
Kerala floods (2018), the worst flooding in 100 years, with 86% of the territory (12 out of 14
districts) affected.
Kashmir Floods (2014) affected Srinagar, Bandipur, Rajouri etc. areas of J&K have resulted into
death of more than 500 people.
Uttarakhand Flash Floods (2013) affected Govindghat, Kedar Dome, Rudraprayag district of
Uttarakhand and resulted into death of more than 5,000 people.
The Indian Ocean Tsunami (2004) affected parts of southern India and Andaman Nicobar
Islands, Sri Lanka, Indonesia etc., and resulted in the death of more than 2 lakh people.
Odisha Super Cyclone or Paradip cyclone (1999) affected the coastal districts of Bhadrak,
Kendrapara, Balasore, Jagatsinghpur, Puri, Ganjam etc., and resulted into death of more than
10,000 people.
The Great Famine (1876-1878) affected Madras, Mysore, Hyderabad, and Bombay and resulted
into death of around 3 crore people. Even today, it is considered as one of the worst natural
calamities in India of all time.
Coringa Cyclone (1839) that affected Coringa district of Andhra Pradesh and Calcutta Cyclone
(1737) are some other instances of natural calamities faced by the country in the past.
The Bengal Famine in the years 1770 and 1943 affected Bengal, Odisha, Bihar very badly and
resulted into death of nearly 1 crore people.
Bhopal Gas tragedy (December, 1984) is one of the worst chemical disasters globally that
resulted in over 10,000 losing their lives (the actual number remains disputed) and over 5.5 lakh
persons affected and suffering from agonizing injuries.1
o cases of railway accidents (Dussehra gathering on the railway tracks crushed by the trains in
2018),
o fire accidents in hospitals due to negligence and non implementation of existing mandatory fire
safety norms,
o Stampede at large public gathering like Kumbha Mela caused by poor people management
and lack of adequate infrastructure to monitor and manage large crowd gathering.1
Kerala state is frequently ravaged by the disastrous consequences of numerous hazards and hence
it is a multi-hazard prone State. A study conducted on migration suggested that in the past 80
years the coastal plains recorded a population growth of 306%, whereas the highlands, foot hills
and uplands together experienced a growth of 1342% (Nair et al., 1997). This population with a
density of 819 people/km2 (Census of India, 2001) is more or less widely distributed across all
geomorphic units of the state, exposing them to multiple hazards.
5642.68 km2 of area which is 14.52% of the total area of the state is prone to floods.
Kerala is prone to high incidence of lightning, especially during the months of April, May,
October and November.
Apart from floods the mountain regions of the state experience several landslides during the
monsoon season. It is known that a total of 65 fatal landslides occurred between 1961 and 2009
causing the death of 257 individuals. The west facing Western Ghats scarps that runs the entire
extent of the mountain system is the most prone physiographic unit for landslides
Between 1871 and 2000, the state experienced 12 moderate drought years.
The 570 km long coast line of Kerala is prone to erosion, monsoon storm surges and sea level
rise. Land subsidence due to tunnel erosion or soil piping which is a slow hazard, is recently
noticed to be affecting the hilly areas in the state. This often goes unnoticed and is a hazard with
potential of causing landslides, infrastructural damages and crop loss covering vast areas in the
high land regions of the state.
The high density of population of 860 people/km 2 (2011 Census), narrow roads, high density of
road network, density of coastal population and the general higher standard of living of the public
as compared to the rest of the country are factors that increase the vulnerability of the population
to disasters.
Natural forest fires are reported in Kerala. It is usually the dry and moist deciduous forests of the
state which experience forest fire. From 2009 to 2014, 18,170 hectares of forest land were
destroyed by recurring forest fires in the state.
The 590 km coast of Kerala is one of the most densely populated land areas in the country. This
coastline is exposed to high waves, storm surges, ‘Kalla kadal’ and Tsunami.
Disaster preparedness is achieved partially through readiness measures that expedite emergency
response, rehabilitation, and recovery and result in rapid, timely and targeted assistance. It is also
achieved through community based approaches and activities that build the capacity of people and
communities to cope with and minimize the effects of a disaster on their lives.
1. Hazard, risk and vulnerability assessments
2. Response mechanisms and strategies
3. Preparedness plans
4. Coordination
3. Preparedness planning
The concept of preparedness planning is very important for those involved in disaster
management. During an actual emergency, quick and effective action is required.
This action often depends on having made and implemented preparedness plan. If appropriate
action is not taken or if the response is delayed, lives may be needlessly lost.
Disaster preparedness planning involves identifying organizational resources, determining
roles and responsibilities, developing policies and procedures and planning preparedness
activities aimed at ensuring timely disaster preparation and effective emergency response.
The aim of preparedness planning is to identify the assignments and specific activities
covering organizational and technical issues to ensure that response systems function
successfully in the event of a disaster.
4. Coordination
National society plans ideally should be coordinated with the plans and intentions of other
agencies and organizations. Effective disaster response requires mutual trust and coordination
of efforts and resources among the many agencies and people involved in emergency
response including the affected local population and local community based organizations.
Working on disaster preparedness planning prior to the disaster helps involved agencies better
understand each other’s aims, objectives and capacities. Such understanding and
7. Resource mobilization
National Societies should develop strategies, agreements and procedures for
mobilizing and acquiring emergency funds., supplies and equipments in the disaster event. A
preparedness plan should spell out the policies for acquisition and disbursement of funds, use
of outside equipment and services, and emergency funding strategies.
8. Public education, training and rehearsals
Disaster preparedness must be supported by public education campaign,
training of response teams, and rehearsals of emergency response scenarios. The aim of
public awareness and education program is to promote an informed, alert and self reliant
community, capable of playing its full part in support of and in co-operation with government
officials and others responsible for disaster management activities.
As the preparedness plan is being developed, and upon completion, it is
important to rehearse its major elements. Rehearsals invariably expose gaps that otherwise
remain overlooked. Rehearsals also keep the plans fresh, during extended periods of time
when no disaster strikes.
9. Community based disaster preparedness
Disaster preparedness and response are not solely the work of experts and
emergency responders from National Societies and government disaster organizations. Local
volunteers, citizens, organizations and business have an active and important role to play
A cross sectional descriptive study was conducted on disaster preparedness among members
of staff at kenyatta national hospital, nairobi county, Kenya to find out whether members of
staff at Kenyatta National Hospital are prepared for disasters. Data was collected using self -
administered questionnaire containing both closed and open ended questions. The study
involved 361 respondents sampled from 4646 being the total population of members of staff at
Kenyatta National Hospital. Most members of staff of KNH were aware of the existence of a
disaster management committee and the existence of a disaster plan in the hospital. Majority
of the respondents felt that firefighting equipments and evacuation plans are inadequate. The
study found out that 58% of the respondents had no training on disaster management. Majority
of the respondents indicated that there was no adequate infrastructure to manage disaster with
62.3 % indicating there was inadequate fire fighting equipments. The study will assist KNH
and other health facilities in formulating policies on disaster preparedness. The study
recommends that Kenyatta national Hospital improves on the training of staff on disaster
management in order to respond to emergencies effectively and efficiently.15
Though all of India’s states have departments of disaster management or relief and
rehabilitation, they are still poorly prepared to lend support in times of disasters, according
to the UN Development Programme (UNDP).
In a number of recent disasters, 2010 mudslides in Leh, Sikkim earthquake in 2011 and
the Uttarakhand floods of 2013, the level of preparedness was inadequate, leading to high
levels of mortality and displacement of people.
Facilities such as emergency operations centres, emergency communications, and search and
rescue teams are being made available but these systems and facilities need to be
strengthened.
In India Disaster management is yet to be seen as an essential part of good governance and
integral to development planning.
The northeast region is most at risk from earthquakes and lacks seismically secure
infrastructure and buildings. It is also vulnerable to landslides, floods and erosion.
Flooding on the country’s plains is a regular occurrence, and although communities are
resilient, the intensity of floods has reduced their capacity to adapt.
The local adaptation efforts driven solely by communities are no longer sufficient
and additional, scientifically planned adaptation is needed, which will require
government support.
The division of responsibilities under the Disaster Management Act is not very clear,
resulting in its poor implementation. There also exists an overlap between the
implementing agencies
Intense public and media scrutiny after disasters automatically leads to a higher priority
being given to response, rather than risk reduction.
As a result, risk-reduction activities are driven by schemes and external projects, rather
than by guidelines in SDMPs.
Because risk-reduction needs are locations specific, this gap is an opportunity for
stronger, locally led risk-reduction planning by Strengthening disaster risk management
in India.
There are insufficient levels of implementation for each monitored activity. For
example, Disaster risk management plans or a risk sensitive building codes exist but they
are not enforced because of a lack of government capacity or public awareness.
There is lack of local capacities to implement disaster risk management. Weak capacity
at the local levels undermines the implementation Disaster preparedness plans.
Due to poor coordination between stakeholders, there is inadequate access with respect
to risk assessment, monitoring, early warning, disaster response and other Disaster related
activities.
Insufficient investment in building disaster resilient strategies, also private sector are
least contributors in the share of investment.17
I. Planning: Most of the assessment and planning is done in the pre-disaster phase, the hospital plans
are formulated and then discussed in a suitable forum for approval.
II. Preparation of written disaster manual: The hospital disaster plan should be written down in a
document form and copies of the same should be available in all the areas of the hospital.
III. Staff education and training: It is very important for the staff to know about and get trained in
using the hospital disaster/emergency manual. Regular staff training by suitable drills should be
undertaken in this phase.
I. Planning
• Formation of hospital Disaster Management Committee
• Initiation of central Command structure (Incident command system)
• Preparation of Job Cards
• Plan activation of different areas of hospital
• Increase bed capacity in emergencies
• Planning of public information and liaison
• Planning for security of hospitals in emergency situation
• Logistics planning: It include
a) Planning for communications (within and outside the hospital)
Communication from the state level to lower level & back As a member of the State Level
Disaster /Crisis management Committee, Principal Secretary Health will co-ordinate the
overall Disaster /Crisis management for the Health Department.
Updated information on the details of the hospitals coming under various Govt. departments,
private sector, Co Operative Sector etc. with the telephone numbers of the RMO and Supt will
be compiled at the District level and updated periodically.
c) Stores planning
It is recommended that adequate stores of linen, medical items, surgical items should be kept
separately in the Emergency/Casualty and should be marked the “Disaster Store”.
The activation of this store is done only after the Disaster has been notified by the appropriate
authorities.
As immediate measures, the buffer stocks earmarked for the Casualty/Emergency Services
should be utilized till the fresh stocks are replenished from main Hospital stores/ disaster
stores.
d) Personnel Planning – Medical and Non-Medical
Medical and Non-Medical and Medical Staff: In addition to the members of clinical staff,
Para and preclinical disciplines (if present in the facility) should render their services in
managing the casualties.
Duty roster for standby staffs should be available in the control room/Command center
Nursing Staffs: The Nursing Superintendent should be able to prepare a list of nursing staffs
who may be made available at a short notice.
The nursing personnel officer should be also able to mobilize additional nursing staffs from
non-critical areas.
Other Staff: Duty roster (including those on standby duty) of all ancillary medical services
(e.g. Radiology, Laboratory, Blood Bank) and also other hospital services (e.g. house-
keeping, sanitation, stores, pharmacy, kitchen etc.) should be available with the duty officer/
hospital administrator.
1. State level inter-sectoral co-ordination meeting involving the line departments NGOs etc.
by the fifth month of every year.
2. Convening of the state level Rapid Response team shall be done in conjunction with the
state level inter-sectoral co-ordination meeting.
3. Senior Medical Officers Conference: As usual all the district Medical officers of the health
and other senior medical officers and Programme officers will be attending the above
meeting. Brief presentation of the disaster Preparedness plan of every district will be done
and activities to be done at state level, district level and other area specific activities will be
specifically identified.19
1. Institution level and LSGI level disaster preparedness plan finalization/ updating: This will be
done every year from January to March, and will be a part of the annual LSGI plan.
2. PHC Level full day zonal meeting of the last working day of April of every year the finalized
disaster preparedness and epidemic preparedness plan of the Panchayat will be presented.
3. CHC (Block Level) Conferences of May, June: In the CHC (Block level) conferences convened
on the block level disaster preparedness plan and the disaster preparedness plan of every panchayath
NURSING IMPLICATIONS
Disaster nursing requires the application of basic nursing knowledge and skills in difficult
environments with scarce resources and changing conditions. Nurses must be able to adapt nursing
practices to the specific disaster situation while working to minimize health hazards and life-
threatening damage caused by the disaster .Nurses must work collaboratively with other health
professionals, disaster responders, nongovernmental organizations and governments. Nurses must be
capable of shifting focus of care from one patient to large numbers of patients.
In the response phase of a disaster, nurses provide care in a variety of areas, including trauma, triage,
emergency care, acute care, first aid, infection control, supportive and palliative care, and public
health. Hospitals, emergency aid stations, shelters, homes, mass immunization sites, mortuaries and
makeshift clinics are examples of where nurses may be required to practice.
Nursing comprises the largest healthcare workforce, and yet there is very little research examining
nurses’ readiness for disaster.13
Assessment
(1) Performs a rapid assessment of the disaster situation and nursing care needs.
(2) Conducts a health history and age appropriate assessment that includes physical and
psychological responses to the disaster.
(3) Recognizes symptoms of communicable disease and takes measures to reduce exposure to
survivors.
(4) Describes the signs and symptoms of exposure to chemical, biological, radiological, nuclear and
explosive agents.
(5) Identifies unusual patterns or clustering of illnesses and injuries that may indicate exposure to
biological or other substances related to the disaster.
(6) Determines need for decontamination, isolation or quarantine and takes appropriate action.
(7) Recognizes health and mental health needs of responders and makes appropriate referrals.
Implementation
(1) Implements appropriate nursing interventions including emergency and trauma care in accordance
with accepted scientific principles.
(2) Applies critical, flexible and creative thinking to create solutions in providing nursing care to
meet the identified and anticipated patient care needs resulting from the disaster.
(3) Applies accepted triage principles when establishing care based on the disaster situation and
available resources.
(4) Adapts standards of nursing practice, as required, based on resources available and patient care
needs.
(11) Maintains personal safety and the safety of others at the scene of a disaster.
(13) Provides care in a manner that reflects cultural, social, spiritual and diverse background of the
individual.
(14) Manages the care of the deceased in a manner that respects the cultural, social and spiritual
beliefs of the population as situation permits.
(16) Works with appropriate individuals and agencies to assist survivors in reconnecting with family
members and loved ones.
Psychological Care
(1) Describes the phases of psychological response to disaster and expected behavioural responses.
(2) Understands the psychological impact of disasters on adults, children, families, vulnerable
populations and communities.
(5) Identifies an individual’s behavioural responses to the disaster and provides appropriate
interventions as required (e.g. psychological first aid).
(6) Differentiates between adaptive responses to the disaster and maladaptive responses.
(8) Identifies appropriate coping strategies for survivors, families and responders.
(9) Identifies survivors and responders requiring additional mental health nursing support and refers
to appropriate resources.
(1) Describes vulnerable populations at risk as a result of a disaster (e.g. older persons, pregnant
women, children, and individuals with a disability or chronic conditions requiring continued care)
(2) Creates living environments that allow vulnerable populations to function as independently as
possible.
(4) Identifies available resources, makes appropriate referrals and collaborates with organizations
serving vulnerable populations in meeting resource needs.
(5) Implements nursing care that reflects the needs of vulnerable populations impacted by a disaster.
(6) Consults with members of the health care team to assure continued care in meeting special care
needs.
(1) Develops plans to meet short- and long-term physical and psychological nursing needs of
survivors.
(2) Identifies the changing needs of survivors and revises plan of care as required.
(6) Collaborates with the existing health care community for health maintenance and health care.
(2) Evaluates nursing response and practices during the disaster and collaborates with nursing
organizations to resolve issues and improve response.
(4) Identifies areas of needed improvement and communicates those areas to appropriate personnel.
(5) Assists the community in transitioning from the response phase of the disaster/emergency through
recovery and rehabilitation to normal functions.
(6) Shares information about referral sources and resources used in the disaster.
(7) Assists in developing recovery strategies that improve the quality of life for the community.
(8) Collaborates with appropriate groups and agencies to re-establish health care services within the
community.21
The complexity of disasters seen today requires an educated health care workforce capable of working
in all areas of the disaster continuum. At the 2006 American Public Health Association Meeting, Dr
Frederick Slone (2006) emphasized the importance of having a health workforce prepared to respond
quickly in the time of a catastrophic event, making disaster education a national priority. Recent
disasters have demonstrated that the lack of knowledge in disaster response and management creates
confusion among the responders and delays effective humanitarian response.
(3) Seeks to acquire new knowledge and maintain expertise in disaster nursing.
(5) Evaluates the need for additional training and obtains required training.
(7) Describes the nurse’s role in various disaster assignments (e.g. shelters, emergency care sites,
temporary health care settings disaster coordination and management units).
(8) Maintains a personal disaster/emergency kit (e.g. identification card, appropriate clothing, insect
repellent, water bottle) in the event of deployment to a disaster.
(10) Assists in developing systems to address nursing and health care personnel capacity-building for
disaster response.
(11) Takes on a leadership role in the development and implementation of training programmes for
nurses and other health care providers.
(12) Evaluates community readiness and takes actions to increase readiness where needed.22
Nurses who have an understanding of health issues in the community play a major role in disaster
planning, programme development, mitigation, training and education at the community, state,
national and international level. Their knowledge of community resources, populations at risk,
vulnerable individuals, workforce issues, supply needs and nursing roles and practices are crucial
contributions to disaster planning.
Nurses play an important role in disaster preparedness by: educating the community on disasters;
working to reduce hazards in the workplace, homes and communities; contributing to the
development, implementation and evaluation of community readiness; participating in and evaluating
disaster drills; and coordinating and working with community organizations. In the workplace, where
Nurses can also be found assuming responsibility for management of the other aspects of the disaster
response, such as sheltering and health centres. As the disaster situation transitions to the long-term
recovery phase, nurses take on the role of managing the ongoing health threats to individuals, families
and the community, as well as the continuing care needs of those with injuries, illnesses, chronic
disease and disability.
(3) Describes the role of government and organizations in disaster planning and response.
(4) Understands the community disaster plan and how it relates to the national and international
response plans.
(5) Recognizes the disaster plan in the workplace and one’s role in the workplace at the time of a
disaster.
(7) Contributes to the development, evaluation and modification of the community disaster plan.
(8) Ensures that the needs of vulnerable populations are included in the community disaster plan
(including children, women, pregnant women, individuals with mental or physical disabilities, older
people and other vulnerable persons/households).
(10) Participates politically and legislatively in the development of policies related to disaster
preparedness and response.
(11) Describes the role of public health in disaster and how it relates to the nurse’s role.
(2) Delegates to others in accordance with professional practice, applicable laws and regulations and
the disaster situation.
(3) Identifies the limits of one’s own knowledge, skills and abilities in disaster and practices in
accordance with them.
(4) Practices in accordance with the laws and regulations governing nurses and nursing practice.
(1) Describes the chain of command and the nurse’s role within the system.
(2) Communicates in a manner that reflects sensitivity to the diversity of the population.
(3) Describes the principles of crisis communication in crisis intervention and risk management.
(6) Coordinates information with other members of the disaster response team.
(7) Provides up-to-date information to the disaster response team regarding the health care issues and
resource needs.
(8) Works with the disaster response team to determine the nurse’s role in working with the media
and others interested in the disaster.
The integration of clearly titled theory and practice teaching courses about disaster and emergency
preparedness into nursing curricula are crucial needed and provided in respect to their
learning/training preferences. Further, follow up research are necessary for maximizing nursing
education and nursing quality in these critical areas applied to healthcare and community setting.12
But the Research and therefore the evidence base for disaster nursing are critically sparse.
There are three international agreements within the context of the post- 2015 development agenda.
These are:
National Disaster Response Force (NDRF):- The command and supervision of the NDRF
would be under the Director General of Civil Defense and National Disaster Response Force
selected by the Central Government. Currently, the NDRF comprises eight battalions and
these battalions will be positioned at different locations as per the varying requirements.
The objective of NDMA is, to build a safer and disaster resilient India by a holistic,
proactive, technology driven and sustainable development strategy.
The NDMA is chaired by the Prime Minister of India and has a vice chairman with the
status of Cabinet Minister and eight members with the status of Ministers of State.
The NDMA Secretariat is headed by a Secretary and deals with mitigation, preparedness, plans,
reconstruction, community awareness and financial and administrative aspects.
The NEC consists of members like Union Home Secretary as Chairperson, and the Secretaries
to the Government of India (GoI)like Ministries/Departments of Agriculture, Atomic Energy,
Defence, Drinking Water Supply, Environment and Forests and so on. The NEC prepares the
National Plan for Disaster Management as per the National Policy on Disaster Management.
1. Act as the national level coordinating and monitoring body for disaster management.
2. Prepare the National Plan to be approved by the NDMA.
It was released in 2016, it is the first ever national plan prepared in the country for disaster
management.
With National Disaster Management Plan (2016) India has aligned its National plan with the
Sendai Framework for Disaster Risk Reduction 2015-2030, to which India is a signatory.
The objective of the plan is to make India disaster resilient, achieve substantial disaster risk
reduction. It aims to significantly decrease the losses of life, livelihoods, and assets in terms of
economic, physical, social, cultural, and environmental. To maximize the ability to cope with
disasters at all levels of administration as well as among communities.
The National Disaster Response Fund & The National Disaster Mitigation Fund
1. The response fund will be made available to the NEC and the mitigation fund to the NDMA.
2. Besides, every ministry shall make provisions in its annual budget, for funds for actions set out
in its disaster management plans.
At State level, State Disaster Management Authorities are established under Disaster
Management Act 2005.
SDMA is chaired by the Chief Minister of the State and has not more than eight members
who are appointed by the Chief Minister.
The SDMA prepares the state disaster management plan and implements the National Disaster
Management Plan.
The State Disaster Management Plan (Prepared by SEC and approved by SDMA)
includes
1. The vulnerability of different parts of the State to different forms of disasters.
2. The measures to be adopted for prevention and mitigation of disasters.
3. Measures to be taken for integration of mitigation measures in the development plans.
4. Measures to be taken for preparedness and capacity building to effectively respond.
6. The roles and responsibilities of different state ministries
1. Lay down guidelines for preparation of plans by the various state ministries and the DDMAs.
2. Monitor the implementation of the national policy, the national plan, the state plan and the plans
prepared by various state ministries and the DDMAs. Also monitor the implementation of
guidelines laid down by the SDMA and evaluate the level of preparedness.
3. Provide necessary technical assistance or give advice to DDMAs and state ministries.
4. Coordinate response in the event of any disaster. Give directions to any Department or
agency regarding response actions to be taken.
5. Promote general education and community training.
6. Advise the State Government regarding all financial matters in relation to disaster management.
7. Examine the vulnerability of different parts of the state and specify measures to be taken.
8. Examine the construction in any area and if it is of the opinion that the standards for the
prevention of disaster have not been followed, may direct the DDMA to take needed action.
9. Ensure that communication systems are in order and the disaster management drills are carried
out periodically.
Under Disaster Management Act 2005, every State government shall establish a DDMA for every
district in the State.
o Co-Chairperson - is the elected representative of the local authority. In the Tribal Areas, the
Chief Executive Member of the district council of autonomous district is the co-chairperson.
The Disaster Management Committee governed under District Magistrate will formulate village
level disaster management plans for concern villages.
The DDMA makes District Disaster Management Plan and implements the state Disaster
Management Plan.
LOCAL AUTHORITIES:- Local authorities would include Panchayati Raj Institutions (PRI),
Municipalities, District and Institutional and Legal Arrangements Boards, and Town Planning
Authorities which control and manage civic services.
Natural disasters are very much part of the natural cycles. But accelerated
changes in demographic and economic trends disturb the balance between the ecosystem and leading
to increased frequency and the negative impact of disaster. As the 21st century approaches, we face a
challenging mix of demographic, ecological and technological condition which make population more
vulnerable to the impact of natural calamities. However, the number of natural disasters are not more
than they were in the past, but what has increased is the magnitude of the effect of each disaster. The
important and related factor is the population-pressure in almost all the countries, for people to live on
and use marginal land which by its very nature may put inhabitants and property at great risk. Disaster
preparedness should be a collective effort and it should be built up with self-reliance and confidence
at the village level. A well preparedness approach requires the development of better institution
mechanism for community participation in planning and their involvement in implementation process;
strengthening of existing mechanism; creating better atmosphere for dissemination of know-how;
training thereby helping institutions, community groups, NGO's Governmental agencies and people to
take preparedness measures against earthquake disaster; and also establishing or building up a reliable
information system
Our vision 2020 is to build a safer and secure India through sustained collective
effort, synergy of national capacities and people’s participation. What looks a dream today will be
transformed into reality in the next two decades. This is our goal and we shall strive to achieve this
goal with a missionary zeal. The path ahead, which looks difficult today, will become a lot easier as
we move along together.2