GENERIC AND INTEGRATED TEACHING

Examination: 3rd Professional MBBSExamination,November 2025

Submitted By:4th Year MBBSStudents(BM-36)

Registration No:
Roll No:

Community Medicine and Public Health

 TABLE OF CONTENTS
GENERIC TEACHING INTEGRATED TEACHING

[Link] Cervix
[Link] and Accountability
[Link]&Dr. Zafrana Zahir
Prof. Sharmeen Yasmeen
[Link] & Control of Dengue, Chikungunya & COVID-19
Prof. Dr. Raihana Begum
[Link] of a Good Doctor
Dr. Shabnam Imam [Link] Management
Dr. Shabnam Imam

[Link] of Disasters in Bangladesh

Prof. Sharmeen Yasmeen
 Prof. Sharmeen Yasmeen
Professor and Head
Dept. of CommunityMedicine&Public Health
BMC
 THE STRENGTH OF A NATION

Objectives
DERIVES FROM THE

INTEGRITY OF THE HOME.

Integrity: doing the
right thingwhen no
one is watching

Ø Define integrity and accountability

YOUR
DICTIOMARY Ø Explain the importance of integrity and accountability
Ø Outline behavior that demonstrate integrity and
CREATE,
accountability
Ø Explain contribution of team & system to integrity &
INSPIRE, INVENT

Today
Innovate
INSPIRING
QUOTES

東
accountability
Ø State means of developing integrity and accountability
Ø Mention some examples of integrity and accountability

Origin of the word Integrity Definition of Integrity

•Integrity can be defined as aligning your conduct with what

•Originated from Latin word (Adjective) – you know to be excellent.
“Integer” means Whole or Complete or
•Integrity is the quality of having strong ethical principles that
•Undivided or unbroken completeness. are followed at all times regardless of the circumstances.

•Keep your promises even if it takes extra effort.

 Importance of Integrity
[Link] integrity reflects your sense of professionalism, character
and builds your reputation.

[Link] you reliable, dependable, acceptable and trust worthy

So in brief
[Link] you a better & potential resourceful person in terms of
knowledge, wisdom and efficiency,

[Link] you to feel at peace- Integrity inhibits/prevents moral

failure. You do the right thing towards excellence.

Importance of Integrity-contd.
Importance of Integrity-contd. •9. Boost energy, inspiration in youand peers,students-

5. Improve your decisiveness- You can make decisions much more •10. Become an example for others to follow- you become an
easily as you already determined to do what is excellent. exemplary example to people to follow.

6. High up your self-esteem, confidence, competence, credential and •11. You become a natural leader-

courage. •12. Maintaining your integrity will make you a respected teacher,
valued by colleagues, and students
7. Help to do justice, equity to profession, colleagues, students
•13. Remembered with honour by others when you/we would be no
8. Never make you questionable, double standard
more (by retirement or death)
 What is Academic Integrity? 5 Ways to Increase Student Integrity
Academic integrity is the commitment from students, faculty, and staff
•Infuse integrity into the classroom culture. Teachers make integrity as the norm in their
to demonstrate honest and moral behavior in their academic lives.
classrooms in several important ways.
Breaching academic integrity is known as Academic misconduct or
•Develop a moral vocabulary.
Academic dishonesty.
•Respond appropriately when cheating occurs. Report unethical behavior, act to concerned
authority.

•Use quotes of integrity to ignite meaningful conversations.

•Help students believe in themselves.

How to Maintain Professional Integrity in Workplace How to Maintain Professional Integrity in Workplace
Your ability to maintain professional integrity in the workplace •Believe in all your students-Prevent ragging;
has a powerful impact on your/institutional productivity,
•Trust colleagues, think positive
performance and reputation.
•Create a culture of integrity throughout entire organization. •Be respectful during conflicts and make dialogue for solution.
•Integrity in regards to gender, religion, power & politics •Practice accountability.
•Consistent integrity is your power and will safeguard when
you will encounter situations that make you questionable for •Follow and enforce organizational policies, be loyal
your opinion and action. •Take care of properties, stationaries, instruments of your org .

•Do the right thing at right time

How to Maintain Professional Integrity in Workplace How to Maintain Professional Integrity in Contd....

Workplace
•Arrive at your workplace on time and be ready to complete tasks. •Take responsibility and Keep your commitments.

•Make work plans of the day. Spend quality time. •Treat everyone the same.

•Don’t waste time with gossip. •Admit your mistakes.

•Never consider your work as burden, it is your job responsibility. Enjoy it. •Encourage teams to speak freely and be a good listener

•Set a positive notion to work, negative attitude will turn you as •Conduct self-assessments.

organizational liability. •Ask your conscience at the end of day.

•Put in maximum and best efforts.
•Reward honesty.

Contd....

How to Maintain Professional Integrity in Workplace

or
•Teaching with integrity means knowing there is a time to
cooperate to get the task done.
•Integrity is the Basis of Social Harmony and Action
•When students learn integrity in classroom settings, it helps
them apply similar principles to other aspects of their lives.
•Most educators recognize that the students they teach
today will become the leaders of tomorrow
Integrity must be visible and transparent
 Accountability Accountability comprises
Definition •Responsibility to the patients
•Procedures and processes by whichone party justifies •Patient-Physician relationship
and takes responsibility for its activities. •Responsibilities to colleagues
•Responsibilities to Profession
•Accountability usually refers to reliability and •Responsibilities to society and public (The healthcare
answering to those who trust us, including our patients,
compliance puzzle)
colleagues, authority and society in general.

Social accountability of medical students

Importance of accountability Social accountability for medical student refers to the
§ It isthe key forprovidingoptimalhealth care services obligation and responsibility of future doctors to
contribute to he health needs and priorities of the
§ It enables continuing improvements in the health care community they serve.
system at its different levels
§ It helps in protecting the rights of patients
§ It is essential for resolving conflicts Medical students should not only focus to clinical
§ It is essential for building trust and ensuring that
workplace environment is safe and healthy excellence but also be aware of, responsive to and
§ It reflects behavior and attitude of responsible people actively engaged in addressing social determinants of
health, health equity and public health challenges.
Ways to develop Social accountability- Examples of social accountability

by educating medical students (promotion of health, § Volunteer in rural health camp

prevention and early detection of diseases) § Organizing health literacy session in slums
by promoting the skills and attitude of future doctors to § Conducting small researches or survey on local health
respond to population need issues
by committing yourself to volunteer work that help in § Organizing health care in flood affected area, cyclone area
improving Healthcare and awareness about diseases in the § Managing first aid activities in and accident
community
by conducting research in clinical and basic Medical
Sciences and working with a research team conducting
such studies

Ways and means to develop accountability in

workplace
•Lead by example
•Exercise open communication
•Be accountable for your action
•Report inappropriate and unethical behavior
•Be civil and respectful
•Exercise patience and emotional control
•Valuating as growth parameter
•Rewarding
 Academic misconduct by students
• Following unfair means during • Using device to record lecture Academic misconduct by teachers
• exam • Use another student’s work
• Giving proxy attendance • Using false medical certificate •Taking any biased decision by
• To get involved with collection of • for taking advantage • Taking gift of any kind
pressure, request or other
• leaking question. • Using power of parents for temptation. • Involving in private coaching
• Refrain students from class. • getting any favour. • Involving students connection
• Influencing by higher authority to • Inappropriate behavior in the •Vindictive attitude for some • for any personal advantage
• make a student pass class personal issue, social class, attire
• Not taking preparation for
Going into auto-vacation Not following etiquette in online •Not accepting answer if not said in conducting classes
Provoking students not to appear classes same language-discouraging
schedule exam/item Buzzing in class or annoyance in Bullying students
Paraphrasing.
Noncompliance to institutional rule class

Conclusion
Academic misconduct by teachers • Integrity and accountability arethe cornerstones of ethical
medical practice and professional trust.
•Long waiting time to appear item •Use of offensive and abusive • Accountability means being answerable to patients, peers,
language to students and institutions, and society for one’s actions and decisions.
exams and disrupting other
department’s class hour. colleagues • Violation of integrity and failure to be accountable can erode
•Checking ans. scripts by others •Revealing confidentiality of patient trust, harm public health and damage the professional
any student reputation.
•Putting mark without examining
•Sexual harassment • Fostering culture of integrity within medical teams &
answer scripts inside. •Misuse of power and position,
•Overlook the students unfair means institutions help to prevent misconduct and promote patient
political influence safety.
•To create a threatened environment
during exam • Ultimately Integrity and Accountability ensure quality care,
social justice and uphold dignity of the noble profession
Aspects of a good doctor

Dr. Shabnam Imam

Associate Professor
Dept. of Community Medicine & Public Health
Bangladesh Medical College
 Objective:
At the end of the lesson the learners will be able to-
ØExplain the concept of medical ethics its
principles, relevance and important issues.
ØQualities of good doctors.
ØRoles of a doctor in the society.
ØExpectations of the patients, attendants and
society from a doctor.
ØState the factors affecting the expectation of the
patients, attendants and society from a doctor.
ØMeans of developing as a good doctor.
ØCurrent examples of good doctors.

Medical ethics is an applied branch of ethics

which analyses the practice of clinical
medicine and related scientific research. Ethics is an understanding of the nature of
conflicts arising from moral imperatives
It is based on a set of values that and how best we may deal with them.
professionals can refer to in the
case of any confusion or conflict. Specifically it deals with conflicts in potential
outcome (consequences of actions) or with
These values include the respect for duties and obligations.
autonomy, non-maleficence,
beneficence, and justice.
 The term medical ethics first dates back to
Ethics does not decide what is morally right or 1803.
wrong rather it considers how we should act
best in the light of our duties and obligations When English author and physician Thomas
as moral agents. Percival published a document describing
the requirements and expectations of
Clinicians have specific duties of care to their medical professionals within medical
patients and to society. facilities.

The Code of Ethics was then adapted in 1847

relying heavily on Percival’s words. The four basic principles of health care ethics
when evaluating the merits and difficulties of
Over the years in 1903, 1912 and 1947 medical procedures.
revisions have been made to the
original document. Ideally for a medical practice to be considered
“ethical” it must respect all four of these
The practice of Medical Ethics is widely principles:
accepted and practiced throughout the
world.
Autonomy: Requires that the patient have
autonomy of thought, intention and action Beneficence: Requires that the procedure be
when making decisions regarding health provided with the intent of doing good for the
care procedures. patient involved.

Non- maleficence: Requires that a procedure

Justice: This principle calls for fair & equitable does not harm the patient involved or others
distribution of healthcare & treatment among in society.
all groups in society.

•These four principles are interconnected &

often need to be balanced when making
ethical decisions in health care. Code of Medical Ethics Declaration:

The Declaration of Geneva was adopted by

•For instance, respecting patient autonomy the General Assembly of the World Medical
might sometimes conflict with the principles
of beneficence if a patient refuses a Association at Geneva in 1948 amended in
treatment that is deemed medically 1968, 1983, 1994 editorially revised in 2005
necessary. and 2006 and amended in 2017.
•Health care professionals must carefully
consider all aspects of a situation to make
the most ethical decision.
As a Member of the Medical Profession: I WILL NOT PERMIT considerations of age,
disease or disability, creed, ethnic origin, gender,
nationality, political affiliation, race, sexual
I SOLEMNLY PLEDGE to dedicate my life to the
orientation, social standing or any other factor
service of humanity.
to intervene between my duty and my patient.
THE HEALTH AND WELL- BEING OF MY
PATIENT will be my first consideration.
I WILL RESPECT the secrets that are confided in
I WILL RESPECT the autonomy and dignity of
me, even after the patient has died.
my patient.
I WILL MAINTAIN the utmost respect for I WILL PRACTICE my profession with conscience
human life. and dignity and in accordance with good medical
practice.

I WILL FOSTER the honour and noble I WILL SHARE my medical knowledge for the
traditions of the medical profession. benefit of the patient and the advancement
of healthcare.
I WILL GIVE to my teachers, colleagues and
students the respect and gratitude that is I WILL TAKE PROMPT ACTION if patient safety
their due. is compromised from either internal
physiological or external environmental
causes.
I WILL ATTEND TO my own health, well-being Qualities of a good doctor:
A good doctor should be-
and abilities in order to provide care of the
A: Attentive (to patient’s needs), analytical (of self),
highest standard. authoritative, accommodating, adviser,
approachable, assuring.
I WILL NOT USE my medical knowledge to
violate human rights and civil liberties, B: Balanced, believer, bold (yet soft), brave.
even under threat.
C: Caring, concerned, competent, compassionate,
confident, creative, communicative, calm
I MAKE THESE PROMISES solemnly, freely
comforter, conscientious, compliant, cooperative,
and upon my honour. cultivated.

D: Detective (a good doctor is like a good H: “Human being,” honest, humorous,

detective), a good discussion partner, decisive, humanistic, humble, hopeful.
delicate (don’t play “God”)
I: Intellectual, investigative, impartial,
E: Ethical, empathy, effective, efficient, informative.
enduring, energetic, enthusiastic.
J: Wise in judgment, jovial, just.
F: Friendly, faithful to his or her patients,
flexible. K: Knowledgeable, kind.

G: “Good person,” gracious. L: Learner, good listener, loyal.

M: Mature, modest.
R: realistic, respectful (of autonomy),
N: Noble, nurturing. responsible, reliever (of pain and
anxiety), reassuring.
O: Open minded, open hearted, optimistic,
objective, observant. S: Sensitive, selfless, scholarly, skilful,
speaker, sympathetic.
P: Professional, passionate, patient, positive,
persuasive, philosopher. T: Trustworthy, a great thinker (especially
lateral thinking), teacher, thorough,
Q: Qualified, questions self (thoughts, beliefs, thoughtful.
decisions, and actions)

U: Understanding, unequivocal, up to date ØKnowledge & expertise: A good doctor

(with literature). possesses a strong foundation in medical
science and stays updated on the latest
advancements in their field.
V: Vigilant, veracious.

W: Warm, wise, watchful, willingness to listen, Exp: A cardiologist who is knowledgeable

learn, and experiment. about new treatments for heart failure
and can effectively explain the risks and
Y: Yearning, yielding. benefits to the patient.

Z: Zestful.
ØCommunication skills: Effective ØEmpathy & compassion: Showing
communication is vital for building trust empathy & compassion allows doctors to
and ensuring patients understand their connect with their patients on a human
conditions and treatment plans. level, making them feel heard & cared for.

Exp: A doctor who uses clear, simple Exp: A doctor who acknowledges a patient’s
language to explain complex medical fear about surgery & offers reassurance &
terms and actively listens to the support.
patient’s concerns.

Ø Ethical standards: Maintaining high ethical Ø Attention to detail: Being detail-oriented

standards is crucial for building trust and helps doctors make accurate diagnosis and
ensuring patient safety. provide appropriate treatment.

Exp: A doctor who respects patient’s Exp: A surgeon who carefully checks all
confidentiality and avoids conflicts of interest. instruments before a procedure & is
meticulous in their surgical technique.
Ø Problem - solving skills: Doctors need to Ø Ability to work under pressure: Medical
be able to analyze information, identify professionals often face stressful situations
problems and develop effective solutions. and need to remain calm & focused.

Exp: A doctor who can quickly diagnose a Exp: A doctor who can handle a medical
rare illness based on a patient’s symptoms emergency calmly and effectively, while
& medical history. delegating tasks to the appropriate team
members.

Ø Teamwork: Doctors often work as part of a

Ø Willingness to learn: The field of medicine is larger healthcare team, so the ability to
constantly evolving, so a good doctor is collaborate effectively is essential.
committed to lifelong learning & staying up-
to-date with new research and technologies
Exp: A doctor who works closely with nurses,
specialists & other healthcare professionals to
Exp: A doctor who regularly attends medical provide comprehensive patient care.
conferences & reads professional journals to
expand their knowledge.
 Ø A good doctor possesses a combination of
Ø Positive attitude & professionalism: A essential qualities including medical
positive attitude professional demeanor expertise, strong communication skills,
can help build rapport with patients & empathy & a commitment to patient well-
colleagues. being.

Exp: A doctor who is always respectful, Ø Additionally they are ethical, with strong
courteous & maintains a positive problem solving skills, detail-oriented,
outlook even during challenging capable of working effectively under
situations. pressure & continually strive to improve
their knowledge .

Role of a Doctor in a Society

• Doctors play a significant role in our lives. •His primary role is to diagnose, treat ,
prevent illness & promote health-
• The absolute first and the last event of a human are both saving & extending lives--ultimately
certified by doctors, in maternity hospitals and morgue. enhance the quality of life for
individuals & communities.
•A doctor is a person with extensive knowledge in the
domain of medical science, who applies and dedicates his •Beyond clinical care, they play vital roles in
knowledge to identify the medical problem faced by the
patient and then uses his skill to prevent or cure it. public health, education, advancing medical
knowledge & advocacy for health equity.
• Hippocrates and Imhotep are some of the Expectations of the society, patients &
most ancient doctors in the world who attendants from a doctor
contributed a lot towards mankind.
•Society expects that doctors will fulfil their
roles as healers who provide timely and
• Their dedication and passion for saving
competent care and demonstrate
lives and mending them are what makes trustworthiness with high levels of integrity
them stand together. and honesty and a focus on the greater
public good.
• They represent themselves in the
community as doctors.

Some of the general expectations of patients

• Every patient who comes for consultation include:
has expectations based on his ØNeed to be listened to.
understanding of the illness, cultural ØNeed to receive clear explanation and
background, health beliefs, attitudes and
level of understanding. instructions about their condition.

• How far the physician reaches an ØTo be treated by staff who show
understanding with the patient care/concern/compassion and to be
will also have an impact on the treated by staff who are
successful outcome of the professional in their work.
consultation.
 Some examples of unrealistic expectations
of patients would include:
• Thinking that the physician will always
• Wanting to discuss several major know the exact diagnosis at first
consultation and start treatment
problems, all in one standard consultation.
immediately.
• Prescription to be given without a
• To manage unrealistic expectations and
consultation.
unreasonable requests from patients,
• Ability to call the physician 24 hr. a day for the astute physician would know.
any problems.

Factors affecting the expectations of Means of Developing as a good doctor

the patients, attendants & society
•Respect people, healthy or ill, regardless of
•The kind of health service of which the patient is in who are Supporting patients and their loved
need ones when and where they are needed.
•Its characteristics
•Economic facilities
•Past experience •Promote health as well as treat disease.
•Environmental factors
•Existing health organizations •Embrace the power of information and
•Social insurance communication technologies to support.
 • Give unbiased advice, let people
participate actively in all decisions related
to their health and health care, assess each
• People with the best available
situation carefully and help whatever the
information, while respecting their
situation.
individual values and preferences.

• Always ask courteous questions, let • Use evidence as a tool, not as a

people talk and listen to them carefully. determinant of practice, humbly
accept death is an important
part of life and help people
make the best possible
arrangements when death is
close.

• Finally, to be a doctor one should have a

balanced life and should care for him/her
• Work cooperatively with other members selves and own families as well as for
of the healthcare team. Be proactive others.
advocates for their patients, mentors for
other health professionals and ready to • In short, doctors to be caring, courageous,
learn from others, regardless of their age, cheerful, healthy, competent and good
role or status. travel companions for people through the
journey --that’s life.
•We should use our own knowledge, skills
and endeavors to make the good doctors--
and it’s an awesome responsibility.
Carcinoma Cervix
 Objectives
Presented by
Dr. Mainul Alam Chaklader
Assoc. Professor,
Dr. Zafrana Zahir
§ To mention the Global Ca cervix epidemiology
Asst. Professor
§ To describe etiology and the risk factors of Ca cervix
Dept. of Community Medicine & Public Health
§ To state the Ca cervix epidemiology in Bangladesh
§ To describe Prevention of Ca cervix
 Prevalence

•Cervical cancer is the 4th most common cancer among women globally, with an
estimated 6,04,000 new cases and 3,42,000 deaths in 2020. About 90% of these
occurred in low and middle income countries.
•It is the 2nd most frequent cancer among women between 15 to 44 years of
age in Bangladesh.
•Current estimates indicate that every year 8268 women are diagnosed with
cervical cancer and 4971 died from the disease in Bangladesh.

Etiology Risk factors

•High-risk (also called oncogenic or cancer-causing) type of human papillomavirus

(HPV). Two high-risk types, HPV 16 and HPV 18, cause 70% of cervical cancers •Sexually active at a young age: Before 18 years of age.
worldwide. •Multiple sexual partners
•50% of virus after infection is cleared with in 8 months and 90% with in 2 years •A male partners with multiple previous sexual partners
depending on HPV type and immune status of the person (Women living with HIV •Immunocompromised people: Having HIV infection or another disease or took
are 6 times more likely to develop cervical cancer compared to women without
HIV) medicine to suppress the immune response like to treat a cancer or autoimmune
disease.
•Increased persistence of this virus cause cervical cell changes called precancers. If
•Smoker or breathe in secondhand smoke
these precancers are not found and removed in time, they may eventually
develop into cervical cancer. •Past and/or presence of genital warts
•Reproductive factors:
use of oral contraceptives •Prevention of Cervical Cancer
multipara women
• Obesity
•Family history
•Drug exposure: Diethylstilbestrol(DES)
•Lower socio economic group
reflecting poor genital hygiene.

Prevention
• The World Health Organization (WHO) aims to eliminate cervical
cancer as a public health problem by 2100.
Comprehensive cervical cancer prevention includes; (By WHO) • This involves reaching an incidence rate of fewer than 4 new cases per
•Primary prevention (health education and vaccination against HPV) 100,000 women per year in all countries.
•Secondary prevention (screening and treatment of pre-cancerous lesions) • The WHO's strategy, adopted in 2020, focuses on three key pillars
•Tertiary prevention (diagnosis and treatment of invasive cervical cancer)
and palliative care.
 WHO's Global Strategy for the Elimination of
Ca cervix

90-70-90 targets for 2030:

90% of girls fully vaccinated with the HPV vaccine by age 15.
70% of women are screened with a high-performance test by 35 and 45
years of age.
90% of women identified with cervical disease receive treatment.

- Girls 9–14 years -Women from the general -All women as needed
HPV vaccination population : From 30 years of age
-Women living with HIV: from 25
years of age

- Girls and boys should also - Screening with a high-performance - Treatment of invasive cancer at
be offered, appropriate test equivalent or better than HPV any age with
Health information and warnings test • Surgery
regarding, •Radiotherapy
•tobacco use - Followed by immediate treatment •Chemotherapy
or as quickly as possible after an And
•Sex education according to age and HPV molecular positive test. - Palliative care
culture
•Barrier method promotion and
provision for those in sexual activity
•Male circumcision
 Specific protection:
Primary prevention HPV vaccine in Bangladesh
• HPVvaccineinthe country in theyear2016
• 3 doses of 0.5-ml each, by intramuscular injection.
• Health promotion
• schedule: 1st dose between 9-45 years,
• Education on personal hygiene 2nd dose: after 1 month
• Birth control 3rd dose: after 6 months.
• Stop early marriage • Each dose of Papilovax costs Tk 2,500.
• The GOB took a policy decision to incorporate HPV
vaccination as a part of Expanded Program on
Immunization (EPI) in middle of 2023.

Secondary prevention

§ Screening:
•According to the WHO, the screening guideline of Bangladesh recommends screening
of women above 30 years of age with a screen coverage between 30 and 60 at every 5
years.
•But only 7.5% women aged between 30 and 49 years had gone under cervical
screening in their lifetime according to Health Bulletin 2020.
•Regular screening has been proved to reduce the risk of advanced cancer by 90% on
average for women aged 35-64.
§Treatment of precancerous lesions
 Tertiary prevention

Treatment of invasive cancer at any age with;

• Surgery
• Radiotherapy
• Chemotherapy
And
Palliative care:
It involves managing patients' pain and relieving the discomfort from physical
symptoms, as well as attending to the emotional and spiritual needs of patients to
ensure that , they are as comfortable as possible. Palliative care also includes the
provision of terminal care.

National Strategy for Cervical Cancer

Prevention and Control in Bangladesh

•GOB designed and developed the cervical cancer control strategy (2017 –
2022) according to the needs of the country, community and facility-
based clinical services.
• This strategy discusses the determinants of a successful and organized
HPV vaccination and cervical cancer screening programme.
 Theme: 2023

"Ending cervical cancer within a few

generations,"
with the goal of raising cervical cancer and HPV
vaccination awareness. The month of January
has been designated as cervical cancer
awareness month, and it is indicated on the
medical calendar with a teal ribbon.
THANK YOU
 Prevention & Control of
Dengue, Chikungunya & COVID-19

Professor Dr. Raihana Begum

Department of Community Medicine
Bangladesh Medical College
 The mosquitoes, which spread dengue, are active
during the day.

•You have already been introduced to the epidemiology,

Prevention & To lower risk of getting dengue, one should protect

clinical picture, diagnosis & clinical management of the 3 control of him/her from mosquito bites by using:
•clothes that cover as much of the body as possible;
diseases in question, viz., Dengue, Chikungunya & COVID-
Dengue
Introduction 19 . •mosquito nets, ideally sprayed with insect repellent, if
•No doubt you have also experienced the situations, at sleeping during the day;
least seriously heard about these diseases. •window screens;
•I shall simply share with you the latest prevention &
•mosquito repellents, containing DEET
control measures as suggested by the WHO.
(diethyltoluamide), Picaridin (insect repellent) or
IR3535 (Ethyl butyl-acetyl-amino-propionate, prevents
mosquito bites); & coils and vaporizers.

Prevention & control of Chikungunya

To prevent mosquitoes from breeding:
Like that for Dengue prevention & control
• It needs to implement environmental management & modification practices to stop
mosquitoes from accessing egg-laying habitats;
Prevention & • disposal of solid waste properly & removal of artificial habitats that can hold water (old tires,
plastic cups, bottles, sinks, coconut shells, etc.);
• Avoidance of mosquito bites offers the best protection against Chikungunya Virus (CHIKV)
infection.

control of • covering, emptying & cleaning domestic water storage containers on a weekly basis; and
Patients suspected of having CHIKV infection should avoid getting mosquito bites during the
• first
week of illness to prevent further transmission to mosquitoes, that may in turn infect other
Dengue… • applying appropriate insecticides to water storage outdoor containers.
If someone gets dengue, it’s important to:
people.
The main method to reduce transmission of CHIKV is through control of the mosquito
• vectors and reduction of mosquito breeding sites.
Take
• rest;
Drink
• plenty of liquids; •Through mobilization of communities, who are critical in reducing mosquito breeding sites,
Use
• acetaminophen (paracetamol) for pain; on weekly basis, through emptying and cleaning containers that contain water, disposing of
Avoid
• non-steroidal anti-inflammatory medication (e.g., ibuprofen and aspirin); and waste, and supporting local mosquito control programs.

•Watch for severe symptoms & contact doctor as soon as possible if s/he notices any.
• During outbreaks,
Vaccine
•Insecticides may be sprayed to kill flying adult mosquitoes
• Currently, one vaccine (QDenga) is available and licensed in some countries. •Applied to surfaces in and around containers where the mosquitoes land, and
• However, it is recommended only for those aged 6–16 years in high transmission settings. •Used to treat water in containers to kill the immature mosquito larvae.
• Several additional vaccines are under evaluation. This may also be performed by health authorities as an emergency measure to control the
mosquito population.
Prevention & control of Chikungunya… SARS1-CoV-2 variant circulation: Global situation
29 June to 27 July 2025

•People living in or visiting areas with CHIKV transmission are advised to • Variants of Interest: JN.1

wear clothing that minimizes skin exposure to the day-biting mosquitoes. • Variants Under Monitoring: XFG, NB.1.8.1, LP.8.1, KP.3, KP.3.1.1, and XEC
• Globally, in the reporting period:
•Window & door screens should be used to prevent mosquitoes from entering
• The most prevalent variant is XFG, accounting for 54% of all submitted sequences,
homes. which is an increase from 34% in the week ending on 29 June 2025.
• Repellents can be applied to exposed skin or to clothing in strict accordance • NB.1.8.1, accounting for 30% of all submitted sequences, a decrease from 34% in the
with product label instructions. Repellents should contain DEET, IR3535 or week ending on 29 June 2025.
During this reporting period, all other variants showed a decreasing or stable trend.
Icaridin. •

• Available evidence suggests that XFG and NB.1.8.1 do not pose additional
•Insecticide-treated mosquito nets should be used against day-biting
public health risks relative to other currently circulating SARS-CoV-2
mosquitoes by persons who sleep during the daytime, for example young
variants.
children, sick patients or older people.

1. Severe acute respiratory syndrome (SARS)

Prevention & control of COVID-19 Prevention & control of COVID-19…

• People should get vaccinated as per thelocal national guidance.
Vaccination
•COVID-19 vaccines provide strong protection against serious illness,
hospitalization and death.
•Priority groups such as people aged 60 years and over, and those with
•To prevent the spread of COVID-19: underlying medical problems such as high blood pressure, diabetes,
•avoid crowds & keep a safe distance from others, even if they don’t chronic
health problems, immunosuppression (including HIV), obesity, cancer,
appear to be sick; pregnant persons, and unvaccinated people.
•wear a properly fitted mask - if you feel sick; you have been close to
people who are sick; if you are at high-risk; or in crowded or poorly •WHO’s updated recommendations (March 2023): two doses of any vaccine)
ventilated areas; as well as the need for booster doses (WHO may update depending on
situation)
•clean your hands frequently with alcohol-based hand rub or soap & water;
•cover your mouth & nose with a bent elbow or tissue when you cough or •Since its introduction, COVID-19 vaccines have saved millions of lives across

sneeze;
the world by providing protection against severe disease, hospitalization, and
•dispose of used tissues right away and clean your hands. death.
If you develop symptoms or test positive for COVID-19, self-isolate until you • Even though vaccines protect against severe disease and death, it is still
recover. possible to spread SARS-CoV-2 to others after being vaccinated.
 Disaster objectives

Management At the end of the lesson the learners will be able to-
•Define disaster
•Classify disaster
•Mention the consequences of disaster
Dr. Shabnam Imam
Associate Professor
Department of Community Medicine & Public Health
Bangladesh Medical College

Definition
Types of disasters
The World Health Organization (WHO) has
defined disaster as-
• Natural disasters.
“Any occurrence that causes damage, economic • Man- made disasters.
disruption, loss of human life and deterioration
in health and health services on a scale
sufficient to warrant an extraordinary response
from outside the affected community or area.”
Natural disasters
• Flood
• Cyclone
• Snow-storms
• Tidal waves
• Famines
• Tornado
•Forest fires
• Earthquake
•Heat waves
• Landslide
• Volcanic eruption
• Drought

Flood in Bangladesh Flood in Bangladesh

 Flood
•Floods are the most frequent type of natural
disaster and occur when an overflow of water
submerges land that is usually dry.
•It is often caused by heavy rainfall, rapid snowmelt
or a storm surge from a tropical cyclone or tsunami
in coastal areas.
•Floods can cause widespread devastation,
resulting in loss of life and damages to personal
property and critical public health infrastructure.

• Between 1998- 2017, floods affected more than

• This weather condition brought torrential rains
2 billion people worldwide.
and strong winds exacerbating the flood
• The ongoing flood crisis in Bangladesh began in particularly in the northeastern and southeastern
mid-May 2025, primarily triggered by heavy regions of the country.
monsoon rainfall and upstream water flow from
India.
• The situation has worsened significantly • As of 1 June 2025, several districts including
Sylhet, Sunamganj, Moulvibazar, Habiganj,
towards the end of May when a deep Netrokona, Noakhali, Bhola, Khagrachari,
depression formed over the Bay of Bengal Bandarban and Rangamati have been severely
making landfall near the West Bengal- affected.
Bangladesh coast on 29th May ,2025.
 Cyclone Cyclone aftermath in Bangladesh

cyclone

Cyclones usually bring heavy rain, strong winds and thunder

stroms.
Depending on where they form, they may be called:
•Hurricanes ( Atlantic ocean & Northeast Pacific)
•Typhoons ( Northwest Pacific)
•Cyclones (Indian ocean & South Pacific)

Cyclone aftermath in Bangladesh

Historical cyclones - bangladesh
•1970 Bhola cyclone: Deadliest on record,
claiming up to 500,000 deaths
•1991 cyclone ( Gorky) struck in April –May,
roughly 138,000-140,000 deaths.
•Cyclone Sidr ( 2007) : causing 3447-15000
deaths, damaging homes,crops & Sundarban
mangroves.
•Cyclone Aila (2009): Caused 190 deaths, over
7000 injuries.
•Cyclone Amphan (2020): One of the strongest in
decades, caused severe damage in coastal areas.

Tidal Waves

Tidal Waves in Bangladesh Landslide

 Landslide Landslide in urban area

Drought

Drought in Bangladesh Drought in Bangladesh

 Earthquake Earthquake

Man-made Disasters

• Nuclear accidents
• Leaks of toxic chemicals
• Armed conflicts, ethnic and civil strifes
• Technological- Explosions, Fire.

Volcanic eruption
 Nuclear accident

Leaks of toxic chemicals Armed conflicts

 Health effects of major natural disasters
Effect Earthquake Tidal Floods High winds
waves
Deaths Many Few Few Moderate
Severe Injuries Many Few Few Moderate

Increased risk of
communicable Potential risk following all major hazards
diseases

Damage to health Severe Severe Severe Severe

facilities

Food shortage May occur due to Common Common

economic & logistic
factors
Major population Rare (may occur in heavily Common
movement damaged urban areas)

Technological- Explosions, Fire

Consequences of disaster •Displacement and homelessness: Many people

are forced to leave their homes, leading to
homelessness and long-term instability
Physical & Health Consequences
Psychological Consequences
•Loss of life and injury: Disaster often result
in numerous deaths and injuries, from •Mental health issues: Exposure to trauma can
direct trauma to indirect causes like lead to acute stress disorder, anxiety,
diseases or carbon monoxide depression, complicated grief and post-
poisoning.
•Health impacts :Disrupted access to clean traumatic stress disorder (PTSD)
water and food can lead to malnutrition
and communicable diseases.
•Long- term effects: These psychological issues
can become chronic and affect individuals for •Business disruption: Businesses close,
months or years, with effects like survivor’s guilt leading to loss of employment and
and emotional distress often resurfacing on significant damage to Gross Domestic
anniversaries.
Product (GDP).

Economic Consequences
•Increased inflation and unemployment:
•Infrastructure damage: Buildings, roads, power The loss of jobs and damage to supply
chains can result in rising prices and high
lines and other essential infrastructure are
destroyed, crippling local economies. unemployment

Social and Environmental Consequences •Environmental degradation: Disasters can lead

to pollution of land, water and air and damage
•Disruption of services: essential services like ecosystems and habitats.
power, water and communication become difficult
or impossible to access. •Vulnerability of children: Children are
•Social System Paralysis: Disaster can paralyzed particularly at risk due to interrupted livelihoods,
social systems, fracturing family and community disrupted support systems and developmental
support networks. impacts that can lead to abuse or neglect.
Political Consequences •In short disasters cause human suffering, economic loss,
social disruption, environmental damage and political
•Pressure on government resources challenges.
•Social unrest or conflict over aid distribution
•Weakening of governance structures
 Prevention of Disasters in
Bangladesh-a holistic approach

Prof. Sharmeen Yasmeen

Professor and Head
Dept. of Community Medicine and Public Health
BMC
 Disaster Management-cont.
Disaster Management
•Preparednessto deal withanydisaster.
A continuous and integrate process of planning, organizing, directing,
•Prompt response to any threatening disaster
coordinating and implementing measures which
are necessary for; situation or disaster.
•Prevention of danger or threat of any disaster. •Assessing the severity or magnitude of effects of any
•Reduction of risk of any disaster or its severity disaster.
•Evacuation, rescue and relief.
or consequences. •Rehabilitation and reconstruction.
• Capacity-building.
Encompasses all the needful during disasters, including
both pre, and post disaster activities.

Disaster cycle

+ Community
Resilience
 1. Mitigation
Measures to reduce the impact of a disaster by
preventing it or decreasing its severity.

Activities:
qImplementing measures like building flood defenses
(dikes or dams)
qConstructing earthquake-resistant buildings
qDeveloping public awareness campaigns.
Dam

2. Preparedness

To ready communities for a disaster when it occurs.

Activities: qPre-stocking relief supplies qDeveloping
emergency plans qEstablishing warning systems q
Conducting emergency drills
 3. Response

Measures to provide immediate assistance to those affected by the

disaster.
Activities:
qRapid damage assessments
qProviding food, water, shelter, health services including mental
health care
qConducting search and rescue operations
qMedia coverage
qSocial and community support or engagement

4. Recovery and Rehabilitation Health Impacts of Disasters need to be

Measures to help communities return to normal life taken care
after a disaster. •Injuriesand trauma
Activities:
qLivelihood development •Waterborne diseases
qRebuilding damaged infrastructure •Vector-borne diseases
qTreatment and follow up •Impairment and Disability
qMental health care in PTSD and depression
qRestoring formal education systems to support long- •Mental health issues
•Care of the vulnerable groups like pregnant
term stability
women, children, elderly people
Disaster Management Framework Role of Medical Students
•Disaster Management Act 2012 • Awareness and education
•National Plan for Disaster Management • First aid and emergency response
•Multi-ministries and multi-sectoral involvement • Local team lead
•Community mobilization • Research and data collection
• Counseling
• Awareness building

Prevention-Structural Measures
• Flood
• Coastal embankments or dams
• River dredging and flood control structures
• Improved drainage systems
• Flood embankments
• Creating water reservoir
• Saving river
• Urban planning

Disaster Prevention in Bangladesh • Prepared for MBBS/PH

BMSS in action
Cyclone Preparedness Earthquake Preparedness
• Cyclone shelters (multi-purpose) and raised platforms
•Warning dissemination • Building codes enforcement
•Remodeling construction • Public drills
•Identifying vulnerable habitation • Hospital disaster plans
•Community response teams • Resilienthousingandcritical infrastructure
(hospitals, schools)
•Mass media for awareness building

Fire and Industrial Accident Prevention Disease Prevention Post-Disaster

•Firesafety training •Clean water and sanitation
•Proper infrastructure
•Emergency response teams •Vaccination drives
•Mandatory emergency exit •Medical camps and outreached
•Mass media and social media
service in hard to reach area
Ecosystem-based Risk Reduction Use of Technology
•Nature-based solutions: •GIS mapping
•Mobile alerts
•Mangroveconservation& restoration to attenuate storm surges
•Wetland (haor) management to buffer flash floods •Data-driven decision making
•Urban green-blue infrastructure to manage runoff
•Agroforestry and soil moisture conservation in drought-prone areas
•One heath approach

Disaster Prevention in Bangladesh • Prepared for MBBS/PH

Awareness Recommendations
• Community awareness • Investment in healthcare preparedness
• National awareness • Training and capacity building
• Global awareness • Research and innovation
Conclusion
• Importance of multi-sector collaboration
• Resilience society
• Future outlook for disaster prevention