Disaster Management and

Preparedness

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 Chapter ONE
Overview of Disaster Management Introduction
I. Distinguishing between an emergency and a disaster
situation
II. Types of natural and non-natural disasters
III. Implications of disasters on your region and environment
IV. Unit summary
V. Self-Assessment
VI. References.

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• Disaster Management: Is more than just response and
relief (i.e., it assumes a more proactive approach)

• Is a systematic process (i.e., is based on the key

management principles of Planning, Organizing, and
Leading which includes Coordinating and Controlling).

• Aims to reduce the negative impact or consequences

of adverse events (i.e., disasters cannot always be
prevented, but the adverse effects can be minimized)

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“A disaster can be defined as any occurrence that cause
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”. (W.H.O.)

• It is any event, that causes damage, ecological disruption,

deterioration of health and health services, death, and
which require outside assistance

• “Is a natural or human-caused event which causes intensive

negative impacts on people, goods, services and/or the
environment, exceeding the affected community’s capability
to respond” (key words) 4
• Emergency is a state in which normal procedures
are suspended and extra-ordinary measures are
taken in order to avert a disaster.

• Mitigation: is permanent reduction of the risk of a

disaster.

• Disaster prevention refers to measures taken to

eliminate the root causes that make people
vulnerable to disaster.

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• Disaster preparedness is building up of capacities
before a disaster situation prevails in order to
reduce impacts.
Its measures include availability of food reserve,
emergency reserve fund, seed reserve, health
facilities, warning systems, logistical
infrastructure, relief manual, and shelves.

• Risk assessment is a term used widely for a

systematic approach to characterizing the risks
posed to individuals and populations by
potentially adverse exposures. 6
 Predisposing factors that make people vulnerable to disasters:

• Poverty: Wealthy population survives the disaster, remains

unaffected or recover quickly
• Population growth: Increasing population will limit
resources leading to conflict & crisis.
• Rapid urbanization: Competition for scarce resources may
lead to human-made disasters.
• Environmental degradation: Deforestation leads to rapid
rain runoff and flooding.
• Lack of awareness and information.
• Wars and civil strife are among the principal man made
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factors precipitating disaster.
 TYPES OF DISASTERS
Disasters are broadly divided into two types, Natural and
manmade (technological) disasters.

1. Natural disasters
They are the result of action of the natural forces and
tend to be accepted as unfortunate, but inevitable.

The natural disasters result from forces of climate and

geology.

• Natural disasters can be categorized as “acute” or “slow”

in their onset. 8
• Acute:- Earthquake, flood, hurricane, cyclone or
typhoon, tornado, fire, tsunami or storm surge,
avalanche, volcanic eruption, extreme cold or
blizzard, and heat wave.
• Slow or gradual: -Drought, famine, desertification,
deforestation, and pest infestation.
• Among the different types of natural disasters,
floods, tropical storms, droughts and earth-
quakes are the most destructive, followed by
landslides and storms.
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• During the period 1994-2003, Asia was
disproportionately affected by natural disasters.
The recent Indian Ocean Tsunami was even more
destructive that more than 150,000 lives lost.

• Around 75 % of the world’s population lives in

areas affected at least once by earthquake,
tropical cyclone, flood or drought.

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2. Human (technological) causes
It results from some human activities, such as
explosions, fires, the release of toxic chemicals or
radioactive materials, bridge or building collapse,
crashes, dam or levee failure, nuclear reactor
accidents, breaks in water, gas, or sewer lines,
deforestation, war, etc.

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 Another classification of disasters will be as follows:

1. Sudden-onset disasters include floods,

earthquakes, tsunamis, or tidal waves, tropical
storms, volcano, and landslides.

Floods are the most frequent type of natural

disaster associated with sudden migration of
large populations and food shortages.

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 Classification of disasters…

2. Slow-onset disasters include droughts, famine,

environmental degradation, deforestation (loss of
trees & vegetation), pest infestation and
desertification (conversion of arable lands to
deserts).

• These disasters are usually the result of adverse

weather conditions combined with poor land use.

• Slow-onset disasters can be prevented because

they happen over a long period of time. 13
 Classification of disasters…

3. Industrial/technological disasters result from a

society’s industrial and technological activities that
lead to pollution, spillage, explosions, and fires.

• They may occur because of poor planning and

construction of manmade facilities or from
neglect.

• Sudden-onset disasters such as earthquakes and

floods may trigger secondary disasters such as
fires or pollution. 14
 Classification of disasters…

4. Epidemic diseases are those diseases that

normally do not occur in stable communities but
have the potential to spread under certain
conditions, such as overcrowding and poor
hygiene.

• Eg:- cholera, measles, dysentery, respiratory

infections, malaria, and, increasingly, HIV.

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 Phases of Disasters:

Disaster situations are dynamic, always changing

and demanding a change in response. 6 phases:

1. Pre-emergency phase: the period before the

disaster strikes may be used to assess how often
a particular community is exposed to different
risks (risk mapping), how good is their
preparedness and early warning.
Eg:- identifying temporary shelters, stocking basic
supplies, planning evacuation routes, monitoring
trends, etc. 16
 Phases of disaster…

2. Impact and flight phase: when a disaster strikes

the hazard (fire, earthquake, floods, conflicts, etc)
may trigger the displacement of large number of
people from their homes.

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 Phases of disaster…

3. Acute phase: this phase begins immediately after the

impact of the disaster and marked by intense,
activities by many humanitarian agencies.
• Very high death rate is observed.

• The priority is to keep the affected people alive by

services like providing food, water, sanitation, basic
health care, protection from violence.

• This phase ends when crude death rate (CDR) falls

below 1/10,000 per day (CDR for stable population18in
 Phases of disaster…

4. Post emergency phase: the population

movement usually slows down.
• This enables critical services to be properly
established and maintained.

• During this phase the cause of displacement may

be evolving.
• As international support declines, the emphasis
shifts to building local capacity of and promoting
community participation.
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 Phases of disaster…

5. Repatriation phase: after the emergency is over,

displaced people are expected to return to their
place of origin on their own or with help.
Repatriation is forced or voluntary.

6. Rehabilitation or reconstruction phase: once

permanent solution is obtained, the focus shifts
from relief to development. The aim is to help the
community become self-reliant.

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 CHAPTER TWO
FACTORS LEADING TO DISASTERS

• There are numerous factors that trigger the

occurrence of disasters ranging from natural
to manmade predisposing factors.

• This chapter deals with some prominent

factors that lead to disasters.

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 Deforestation

• Deforestation is the removal or damage of

vegetation in a forest to the extent that it no
longer supports its natural flora and fauna.

• It is most frequently caused by humans taking

care of their immediate needs, while not being
aware of the long-term effects of their actions.

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 Deforestation…

Magnitude
• The rapid rate of deforestation in the tropics is a
key driving force in the yearly increase of flood
disasters.

• According to Food and Agriculture Organization

and United Nations Environmental Program
(FAO/UNEP) study, tropical forests are
disappearing at the rate of 7.3 million hectares
per year (1.3 million hectares a year in Africa).
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 Deforestation…

Impacts
Brings or worsens other disasters like:-
• Flooding, drought and desertification
• Climatic changes
• Siltation and an increased chance of landslides
• Impact on food production and supply
• Loss of topsoil and agricultural land.

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 Deforestation…

Impact on Economy
• Rising dependence on imported forest products,
particularly paper.
• Foreign exchange shortages and high prices
• Acute scarcities of firewood and timber plague
• Soaring firewood prices are also another inflation
source
• Harmful impact on housing construction

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 Deforestation…

Management
• Sound forestry policies
• Decisions on investment priorities, land tenure,
and the choice of technologies
• Tree planting
• Educating people
• Broader attention to rural energy needs,
alternative energy sources, and national energy
priorities

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 Drought and famine

Drought is defined as a water shortage caused by

deficiency of rainfall. Lack of rain for an extended
period severely disturbs the hydrologic cycle in an
area.

• Droughts involve water shortages, crop damage,

stream flow reduction, and depletion of
groundwater and soil moisture.

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 Drought and Famine…
A famine is a phenomenon in which a large
percentage of the populations of a region or
country are so undernourished and that death by
starvation becomes increasingly common.

• In spite of the much greater technological and

economic resources of the modern world, famine
still strikes many parts of the world, mostly in the
developing nations.

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 Drought and famine…

• While generally associated with semiarid

climates, drought can occur in areas that
normally enjoy adequate rainfall and moisture
levels.

• Drought is usually accompanied by hot, dry

winds and may be followed by damaging
floods.

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 Drought and Famine…

Geographical Distribution
• Droughts occur in all of the world's continents.

• In recent decades, the most severe and

devastating to human populations have been in
Africa.

• In addition to the droughts in Africa, there have

recently been major droughts in Brazil, Chile,
Philippines, Bolivia, India, USA and Russia.
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 Drought and famine…

• Primary (Immediate) Effects of drought

– Water supplies are overtaxed and finally dry up
– Loss of crops
– Loss of livestock and other animals, and
– Loss of water for hygienic use and drinking.

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 Drought and famine…

Secondary (Resulting) Effects of Drought

• Migration in search of better grazing lands
• Famine
• Permanent changes of settlement, social, and
living patterns.
• Major ecological changes (scrub growth, flash
flooding & increased wind erosion of soils)
• Desertification
• Sever impact on growth

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 Drought and famine…

Management
• Relief operations to provide food
– General food rations and
– Selective feeding programs to those with increased
vulnerability to malnutrition
• Public health programs, such as immunization campaign
and primary health care
• Intensive feeding program (therapeutic feeding) to
reduce mortality among cases of PEM
• Monitor health and nutritional status by assessing using
anthropometric measurements;
• Monitor death rate; 33
 Epidemic
• An epidemic is the occurrence of a number of cases
of a disease in excess of the usual occurrence for a
given place and time.

• In general, many natural and/or manmade disasters

that affect or disrupt one or more parts of the public
health infrastructure, including the sanitation
systems, potable water supplies, nutrition stores,
primary health care access (including routine
immunization program), vector control programs,
and established systematic surveillance mechanisms,
can trigger infectious disease outbreaks. 34
 Epidemic…

• Mortality exceeding a baseline of one death per

10,000 people per day is the index of concern.

An epidemic or threatened epidemic can become an

emergency when the following characteristics of
the events are present:-
• Risk of introduction to and spread of the disease in
the population;
• Large number of cases may reasonably be
expected to occur ;
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 Epidemic…

• Disease involved is of such severity as to lead to

serious disability or death;
• Risk of social or economic disruption resulting
from the presence of the disease;
• Authorities are unable to cope adequately with
the situation due to insufficient technical or
material supply
• Inadequate drugs, vaccines, laboratory diagnostic
materials, vector control materials…
• Risk of international transmission
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 Epidemic…

Public health intervention

• Rapid assessment to determine whether the
breakdown points of infrastructure have
occurred.
• Maintaining infection control measures

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 Floods
• Global statistics show that floods are the most
frequently recorded destructive events,
accounting for about 30% of the world’s
disasters each year.

• Floods may be related with deforestation, sea

surges during hurricanes and tsunamis following
earthquake.

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 Floods…

Acute effect/Impact
• Drowning
• Fall accidents
• Electrocution
• Landslides
• Homelessness
• Loss of food and water
• Sanitation problem
• Industrial waste risks
• Disruption of communications and health care systems
• Heavy loss of business, livestock and crops
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 Floods…

Long term effect/Impact

• Ideal breeding ground for mosquitoes and an
increased risk of diseases such as dengue, malaria
and Rift Valley Fever.
• Reduced sanitation and contamination cause
diarrhea, such as cholera, shigellosis and GI viruses.
• Damage to the infrastructure, roads, buildings,
equipment, drainage, sewerage and water supply
• The mental distress long after the floods receded
• High risk of morbidity and mortality
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 Floods…

Management/ Protective Measures

Before a Flood, you should:
• Elevate the furnace, water heater, and electric
panel if susceptible to flooding.
• Construct barriers (levees, beams, floodwalls) to
stop floodwater from entering the building.
• Seal walls in basements with waterproofing
compounds to avoid seepage.
• Learning swimming skill is helpful.

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 Floods…

Management during a Flood

• If a flood is likely in your area, you should:
• Listen to the radio or television for information.
• If there is any possibility of a flash flood, move
immediately to higher ground.
– Secure your home. Move essential items to an upper
floor.
– Turn off utilities at the main switches or valves if
instructed to do so.
– Disconnect electrical appliances.

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 Floods…

If you have to leave your home, remember these

evacuation tips:
– Do not walk through moving water.
– Six inches of moving water can make you fall.
– If you have to walk in water, walk where the water is
not moving.
– Use a stick to check the firmness of the ground in front
of you.
– Do not drive into flooded areas.
– If flood-waters rise around your car, abandon the car
and move to higher ground if you can do so safely.
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 Floods…

After a Flood:
• The following are guidelines for the period following
a flood:
• Listen for news reports to learn whether the
community’s water supply is safe to drink.
• Avoid floodwaters; water may be contaminated by
oil, gasoline, or raw sewage.
• Be aware of areas where floodwaters have receded.
Roads may have weakened and could collapse under
the weight of a car.
• Stay away from power lines, and report them to the
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 Floods…

• Return home only when authorities indicate it is safe.

• Stay out of any building if it is surrounded by

floodwaters.

• Be careful when entering buildings; there may be

damage, particularly in foundations.

• Repair damaged sewage systems, as they have serious

health hazards.

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• Clean and disinfect everything that got wet.
 Floods…

Public Health Interventions

• Conduct needs assessment to determine the status of
public health infrastructure, utilities (e.g. water, sewage,
electricity), and health, medical, and pharmaceutical needs.

• Conduct surveillance of drinking water sources, injuries,

increases in vector populations, and endemic, water-borne
and vector-borne diseases.

• Organize delivery of health care services and supplies, and

continuity of care.

• Educate public regarding proper sanitation and hygiene.46

 Tsunamis

• A tsunami is a series of waves generated by an

undersea disturbance such as an earthquake,
landslide, volcanic eruption, or meteorite.

• From the area of the disturbance, the waves will

travel outward in all directions.

• Then as the tsunami nears coastline, it may grow

to a great height and smash into the shore,
causing such destruction. 47
 Tsunamis…

Protective Measures
Guidelines for what you should do if a tsunami is likely in
your area:
• Turn on your radio to learn if there is a tsunami
warning

• Move inland to higher ground immediately and stay

there.

• If there is noticeable recession in water away from the

shoreline this is nature's tsunami warning and it
should be heeded. You should move away immediately 48
 Earthquakes
• Earthquakes are sudden slippages or movements in a portion
of the earth's crust accompanied by a series of vibrations.

• Aftershocks of similar or lesser intensity can follow the main

quake.

• Earthquakes can occur at any time of the year. An earthquake

is generally considered to be the most destructive and
frightening of all forces of nature.

• The Richter scale, used as an indication of the force of an

earthquake, measures the magnitude and intensity or energy
released by the quake. 49
 Earthquakes…

Impact
• Earthquake losses, like those of other disasters,
tend to cause more financial losses in
industrialized countries and, as the developed
countries have better early warning systems and
life saving means, more injuries and deaths occur
in undeveloped countries.

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 Earth quake…

Protective Measures during an Earthquake

• Minimize your movements.
• Move to a nearby safe place.
• Stay indoors until the shaking has stopped and you
are sure exiting is safe.

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 Earthquakes…

If you are in-door:

• Take cover under a table, or bench. Or cover your face
and head with your arms
• Stay away from glass, windows, outside doors and
walls, and anything that could fall
• Hold on and protect your head with a pillow
• Stay inside until shaking stops and it is safe to go
outside (Most injuries during earthquakes occur when
people are hit by falling objects when entering or
exiting)
• Be aware that the electricity may go out and fire alarms
may turn on. 52
 Earthquakes…

If you are Outdoors:

• Move away from buildings, streetlights, and utility
wires.

If you are In a moving vehicle:

• Stop as quickly and stay in the vehicle.
• Avoid stopping near or under buildings, trees and
utility wires
• Proceed cautiously once the earthquake has
stopped. Watch for road and bridge damage
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 Earthquakes…

If you are trapped under debris:

• Do not light a match. Do not move about or kick
up dust.
• Cover your mouth with a handkerchief or clothing.
• Tap on a pipe or wall so rescuers can locate you.
Use a whistle if one is available.
• Shout only as a last resort - shouting can cause
you to inhale dangerous amounts of dust.

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 Earthquakes…

After an Earthquake
• Be prepared for aftershocks

• These secondary shockwaves are usually less

violent than the main quake, but can be strong
enough to do additional damage to weakened
structures

• Be aware of possible tsunamis if you live in coastal

areas.
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 Earthquakes…

Public health interventions:

• Prepare items for extensive first aid care at home
and automobile
• Teach basic precautions on safe water and food
• Provision of emergency & continuing medical care

• Conduct surveillance for communicable disease,

injuries, building or bridge collapse,…

• Establish environmental control;

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Pollutions and health consequences of pollutions

• Pollution is the contamination of the air,

water, or earth by harmful or potentially
harmful substances.

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• A major reason for these adverse environmental
trends in Africa is that most people and
countries are poor.

• Their poverty is both a cause and a

consequence of environmental degradation.
There are many types of pollution.

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 Air pollution

• Air pollution is the presence of substances in

the air that interfere with health, comfort,
safety, or enjoyment.

• There are many types of Air pollution:

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 Particulate Matter (PM):
• Particulate matter consists of soot and dust
particles that are smaller than the diameter of a
human hair.
• Sources of PM include diesel exhaust, soil dust,
tire wear, and soot.
• These particles penetrate deeply into the lungs
and are captured by lung tissue.

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• Exposure to PM pollution has been associated
with respiratory and cardiac problems,
infections, asthma attacks, lung cancer and
decreased life expectancy.
• WHO has estimated that 500,000 premature
deaths each year may be associated with PM
pollution.
• Segments of the population that are more
susceptible to PM pollution include children,
athletes, senior citizens, and people with pre-
existing respiratory problems.
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 Ozone (O3):
• Ozone forms when hydrocarbons combine with
nitrogen oxides and chemically react in
sunlight.
• Hydrocarbons and nitrogen oxides are primarily
produced by motor vehicles and various
industrial practices.

• Ozone is a highly reactive oxidizing agent that

breaks down organic materials. Ozone is the
primary component of smog.
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• Symptoms of ozone exposure are coughing, shortness
of breath, wheezing, fatigue, throat dryness, chest
pain, headache and nausea.

• Pneumonia, reduced lung capacity, asthma, lung

cancer, reduced resistance to infections, accelerated
lung aging and high mortality has all been linked to
ozone exposure.

• Segments of the population that are more susceptible

to ozone pollution include children, athletes, senior
citizens, and people with pre-existing respiratory
problems. 63
 Hydrocarbons:
• Hydrocarbons are a class of reactive organic gases,
which are formed solely of hydrogen and carbon.
Hydrocarbons contribute to the formation of
ozone and the resulting smog problem.

• They are also carcinogenic. The incomplete

burning of any organic matter such as oil, wood, or
rubber produces hydrocarbons.

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• Combustion engine exhaust, oil refineries, and oil-fueled
power plants are the primary sources of hydrocarbons.

• Another source of hydrocarbons is evaporation from

petroleum fuels, solvents, dry cleaning solutions, and
paint.

• The primary health effect of hydrocarbons results from

the formation of ozone and its related health effects.

• High levels of hydrocarbons in the atmosphere can

interfere with oxygen intake by reducing the amount of
available oxygen through displacement. 65
 Nitrogen Oxides: - Nitrogen monoxide (NO) and nitrogen dioxide
(NO2)

• The two forms of nitrogen oxide found in the

atmosphere.

• Contribute to the formation of ozone, production of

particulate matter, and acid deposition.

• Produced by factories, motor vehicles and power

plants that burn fossil fuels

• NO2 irritates lung tissue, causes bronchitis, 66

 Carbon Monoxide (CO)
• CO is colorless, odorless gas produced by incomplete
burning organic matter such as oil, natural gas, fuel,
wood, and charcoal
• Displaces oxygen in RBC, which reduces the amount of
oxygen in cells

• Results in fatigue, angina, reduced visual perception,

reduced dexterity, and death
• The elderly, young children & people with pre-existing
respiratory conditions are sensitive
• Extremely deadly in an enclosed space, such as a
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 Sulfur Dioxide (SO2)

• A colorless gas produced by motor vehicles,

refineries, and power plants that burn fossil
fuels.
• Reduces respiratory volume and increases
breathing resistance, especially asthmatics.
• Increases nasal airway resistance

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 Water pollution and contamination
• Water is necessary for industries which are
therefore often located near a river. The industries
may release harmful materials such as organic
wastes and many toxic chemicals.
• Organic wastes are produced by animals and
humans, and include such things as fecal matter,
food wastes, and rubber, plastic, wood, and
disposable diapers
• Water supplies could become contaminated,
leading to greater incidence of faecal-oral diseases
such as cholera, typhoid, hepatitis A and diarrhea.
69
 Tornado

• Tornados are rapidly whirling, funnel-shaped air spirals

that emerge from a violent thunderstorm.

• They can have a wind velocity of up to 200 miles per

hour and destroy massive buildings.

• Injuries occur due to flying debris or people being

thrown by the high winds (i.e., head injuries, soft tissue
injury, and secondary wound infection).

• In the event of a tornado, the residents should take

shelter in a basement if possible, away from windows,70
 Fires
• There are two types of fire disasters. They are
– Domestic and
– Wild fires.
Fires can be triggered or exacerbated by
lightning, high winds, earthquakes, volcanoes,
floods and deliberate setting of fire by human
beings. Lightning is the most significant natural
contributor to fires.
• Fire spreads quickly; there is no time to gather
valuables or make a phone call. In just 2 minutes,
a fire can become life-threatening. 71
• In 5 minutes, you can be engulfed in flames. Heat
and smoke is more dangerous than the flames.
Inhaling the super-hot air can sear your lungs.

• Fire produces poisonous gases that make you

disoriented and drowsy.

• Instead of being awakened by a fire, you may fall

into a deeper sleep.

• Asphyxiation is the leading cause of fire deaths,

72
 Management (Before a Fire)

• Install smoke alarms and check whether it is

properly working
• Test and clean smoke alarms once a month and
replace batteries at least once a year.
• Replace smoke alarms once every 10 years.

• Have record of fire brigades telephone

• Take care of gasoline, benzene, naphtha, or similar
flammable liquids indoors.
• Never smoke near flammable liquids.
73
• Have the electrical wiring in your residence
checked by an electrician.
• Sleep with your door closed.

• Install fire extinguishers in your residence and

teach family members how to use them.

• Ask your local fire department to inspect your

residence for fire safety and prevention.
• Make buildings accessible to water source
74
 What to do during a Fire:
• Stop and roll on ground. Do not run. Running makes
the fire larger.
• Never use the palm of your hand or fingers to test for
heat. Burning those areas could impair your ability to
escape a fire (i.e., because you cannot hold
ladders…)
• Crawl low under any smoke to your exit - heavy
smoke and poisonous gases collect at ceiling
• Close doors behind you as you escape to delay the
spread of the fire.
• Treat burn and send to hospital for further
75
 Wildfires

• Negligent human behavior, such as smoking in

forested areas or improperly extinguishing
campfires, is the causes of many forest fires.
Another cause of forest fires is lightning.

• Prevention efforts include:

– Have a fire extinguisher or garden hose on hand when
burning debris.
– Build fires away from nearby trees or bushes,
– Be prepared to extinguish fire quickly and completely.
– Never leave a fire—even a burning cigarette—
unattended. 76
 Explosions
• Explosions can inflict multi-system life-threatening
injuries to many persons simultaneously.

• The most common injuries of explosions are

penetrating and blunt trauma.

• Blast lung is the most common fatal injury among

initial survivors.

• Blast injuries usually results in massive hemorrhage

77
• Explosions in confined spaces (buildings, or large
vehicles) and/or structural collapse are associated
with the greatest morbidity and mortality.

• Up to 10 percent of all blast survivors have

significant eye injuries.

• These injuries can occur with minimal discomfort

initially, but becomes sever after few period of
time.
78
 CHAPTER THREE
CONSEQUENCES OF DISASTER

• The prominent consequences of disasters are

summarized under the following headings:

79
 Social reactions

• Though reactions to disasters may vary between

individuals, there are common reactions that are
normal reactions to the abnormal event.
• Sometimes these stress reactions appear
immediately, or in some cases, they are delayed
for a few hours, a few days, weeks, or even
months.
• These stress reactions may be categorized as
physiological, cognitive/intellectual, emotional,
and behavioral symptoms and may include the
following: 80
 Physiological Symptoms

• Fatigue • Shock symptoms

• Nausea • Headaches
• Vomiting • Profuse sweating
• Fine motor tremors • Chills
• Teeth grinding • Muscle aches
• Dizziness

81
 Cognitive/Intellectual Symptoms
• Memory loss
• Concentration problems/distractibility
• Reduced attention span
• Decision making difficulties
• Calculation difficulties
• Confusing trivial with major issues

82
 Emotional Symptoms

• Anxiety
• Grief
• Depression and Irritability
• Anticipation of harm to self or others
• Identification with victims
• Feeling overwhelmed

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 Behavioral Symptoms
• Insomnia
• Crying easily
• Substance abuse
• Gait change
• Ritualistic behavior
• Hyper vigilance
• Unwillingness to leave scene
Although these may be normal reactions to
the event, to refer an individual for services of a
mental health professional, if reactions are severe
84
 Factors which may affect reactions

• Lack of warning
• Scope of the event
• Personal loss or injury
• Type of disaster
• Traumatic stimuli
• Nature of the destructive agent
• Human error
• Time of occurrence
• Lack of opportunity for effective action
• Degree of uncertainty
• Properties of the post-disaster and duration of threat
85
• Environment (temperature, humidity, pollution…)
 Who are more at risk for disasters?

• Disabled: physical, sight, hearing, speech

• Health and medical problems, receiving
medication
• Lack of support networks, divorced, widowed
• Age: - younger and older have more difficulties
• Sex: - women report more stress than men
• Past disaster experience/traumatic events
• Past mental illness or emotional problems

86
 PUBLIC HEALTH IMPACT OF DISASTER

1. Sexual violence
– Rape is specially common feature during war. Rapes
have resulted in the transmission HIV.
2. Population Displacement
3. Communicable diseases
– Infectious disease outbreaks usually occur in the post
impact and recovery phases and not during the acute
phase.
– The risks of epidemics increase; if drought, famine,
flooding and large displacements of people are
involved.
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4. Food shortage and malnutrition
– Famine and decreased per-capita food production in general can
result from natural disasters (e.g. extensive flooding, prolonged
drought, or gradual change in climate) or armed conflicts.
5. Mental Disorders (Post traumatic stress disorder)
– Risk factors for post traumatic stress disorder development after
disaster:
• 􀂃 Intense exposure to death and injury;
• 􀂃 Exposure of survivors to dead bodies;
• 􀂃 Overwhelming life threatening danger;
• 􀂃 Unexpected or first exposure to disaster;
• 􀂃 Intense initial phase (prolonged stress);
• 􀂃 Manmade disaster with no warning;
• 􀂃 High impact ratios;
• 􀂃 Dependence on outside agencies;
88
• 􀂃 Exposure to prolonged stress.
The development of post traumatic stress disorder
(PTSD) may be delayed from one week to three
years, and it is divided into three stages.

• Stage one is associated with an adrenergic surge that

occurs acutely. It may last up to one month, and, if
symptoms last more than six weeks, the patient has
entered stage two.

• Stage two is characterized by a sense of helplessness

and a loss of self-control. Autonomic and somatic
manifestations dominate. It is accompanied by 89
• Stage three is characterized by profound
despondency and demoralization

• The majority (70% to 90%) of the patients with

PTSD will do well or manifest only mild symptoms.
But 10% don’t recover or get worse.
• Those people having strong social net work, and
support usually recover well.

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 R e scu e w o rke rsin d isate r:

• The most common secondary victims of a disaster

are those providing care to the victims.
• These include rescue and search personnel,
physicians, nurses and other staff.

• Many professional responders also report serious

symptoms following disaster.
• Rescue workers will have more intense emotional
trauma if they are involved in a failed rescue
attempts (especially if children are involved).
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• However, more than 90% of the professionals
involved will have good coping skills.

• The most serious reactions occur among rescue

workers involved with body handling.
• These are due to in part the sensory stimulation
experienced by them.
• Inexperienced body handlers have significantly
more symptoms than those with previous
experience.
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 Factors for decreasing PTSD symptoms in disaster workers are:

• 􀂃 Prior disaster training;

• 􀂃 Specific disaster education;
• 􀂃 Maturity;
• 􀂃 Experience with prior disasters;
• 􀂃 Leadership type (good leadership)

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 Coping methods for disaster recovery workers include:

• To avoid humanization of the bodies;

• Not to look at the faces;
• Not to learn the name of the victims;
• To concentrate on the tasks at hand;
• To concentrate on the benefit to the society.

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 Five experiences borne by survivors are:

1. The death imprint: it consists of indelible

imaginary of the encounter with death, intruding
whilst awake, or during sleep in the form of
nightmares.
• It comprises considerations of experience - images
of the impact such as the sight of bodies
dismembered or crushed, the sounds of
screaming, or the smell of burning flesh.

95
2. Survivor guilt: when the person questions why
he/she survived when other did not.

3. Psychic numbing: - It is blocking the experience of

too much unbearable pain at any time.
Its first manifestations are present in the so
called ‘disaster syndrome’, where immediately
following the impact, behaving remarkable calmly.
They may seem to be in control and coping
bravely in fact, they have not yet to react.

96
4. Nurturance conflicts: refers to suspicion of offers
from outsiders, due to experience of distrust.
They may become ‘touchy and sensitive to
the response of others’. Sometimes develop
paranoia.

5. Quest for meaning: the survivors need to make a

‘formulation’ of their experience in the disaster
time.
They search to understand the experience of
the disaster exists on a number of levels, which
might be termed as ‘hierarchy of formulation’. 97
 Disruption of Development by Disasters:

Disasters can seriously disrupt development

initiatives in several ways, including:
• Loss of resources
• Interruption of programs
• Impact on investment
• Impact on the non-formal sector
• Political destabilization

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 How Development May Cause Disasters
• Development projects implemented without taking
into account existing environmental hazards may
increase vulnerability to natural disasters.

• Low-income people may move to developed area for

better jobs, and then have to seek housing in areas
previously avoided, on hillsides or in floodplains.

• Similarly, development projects may lead to

negative political consequences that increase the
vulnerability to civil conflict. 99
Development opportunities afforded by disasters
• Disasters create a political atmosphere wherein
extensive changes can be made more rapidly than
under normal circumstances
• Disasters can also highlight high-risk areas where
action must be taken before another disaster
strikes.
• The realization of vulnerability can motivate
policy-makers and the public to act
• Disasters can bring attention of donor
communities to apply to long-term development
100