Ethiopia

1. Managing Public Health
Disasters and Threats
By: ABINET G.(BSC-PHO, MPH-N)
Contact: 0921250602

2. LEARNING OBJECTIVES
At the end of this chapter, students will be able to:
• Define common terms related to disaster
• Explain causes of disaster
• Discuss the relationship between development and
disaster
• Describe the different phases of disaster
• Explain the public health impact of disaster
• Describe the concepts of emergency management

3. Discussion points
1. Define and differentiate the following terms: Crisis,
Disaster, Hazard, Vulnerability, Risk, Emergency
2. Mention and explain some types of disasters
3. Discuss the causes of disasters
4. Explain the prevention mechanisms of disasters
5. Share your experience to your friends if you have
participated in disaster management?

4. Definition of Terms
• Crisis: an event or series of events representing a critical threat
to the health, safety, security or wellbeing of a community,
usually over a wide area
• The World Health Organization (WHO) defines a disaster as “a
sudden ecological phenomenon of sufficient magnitude to
require external assistance”.
• It is also defined as any event, typically occurring suddenly, that
causes damage, ecological disruption, loss of human life,
deterioration of health and health services, and which exceeds
the capacity of the affected community on a scale sufficient to
require outside assistance (Landsman, 2001).

5. • Emergency: A sudden occurrence demanding
immediate action. It is a state in which normal
procedures are suspended and extra-ordinary
measures are taken in order to avert a disaster.

6. • Hazard: any phenomenon that has the potential to cause
disruption or damage to people and their environment
• It is a rare or extreme event in the natural or human made
environment that has the potential to adversely affect
human life, property or activity to the extent of causing a
disaster.
• Vulnerability: is the conditions determined by physical,
social, economic and environmental factors and processes,
which increase the susceptibility of a community to the
impact of hazards.

7.  Risk: the probability of harmful consequences, or
expected losses resulting from interactions between
hazards and vulnerabilities
• Risk is a function of the hazards to which the
community is exposed and the vulnerability of that
community
• Risk is modified by the level of the local preparedness
of the community at risk

8. • Prevention: is defined as those activities taken to
prevent a natural phenomenon or potential hazard
from having harmful effects on either people or
economic assets.
• For developing nations, prevention is perhaps the most
critical components in managing disasters, however, it
is clearly one of the most difficult to promote.
• Prevention planning is based on two issues:

9. – Hazard identification (identifying the actual threats
facing a community) and
– Vulnerability assessment (evaluating the risk and
capacity of a community to handle the consequences
of the disaster).
• Disaster prevention refers to measures taken to
eliminate the root causes that make people vulnerable
to disaster.

10. Causes of Disaster
• Man-made disasters: e.g. civil wars
• Natural disasters: drought, earthquake, flooding,
volcanic eruption…

11. Development and disaster
• How do you see the effect of development on disaster
(Is development fastens or protects disasters)? Justify
your answer.

12. Disasters do not kill or strike people in the same way, it
depends on who you are and to what society you
belong
. According to World Bank’s estimations, 97% of deaths
related to natural disasters occur in the developing
countries.

13. Phases of Disasters
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) and how good is their preparedness.
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.

14. 3. Acute phase: this phase begins immediately after the
impact of the disaster and marked by intense, often
reactive activities by many humanitarian agencies
responding to media reports of very high death rate
(may be 5-60 times the normal death rate).
4. Post emergency phase: the population movement
usually slows down.

15. 5. Repatriation phase: after the emergency situation is over,
displaced people are expected to return to their place of
origin either on their own or with the help of relief
agencies.
Repatriation may be either 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 affected community become self-
reliant.

16. PUBLIC HEALTH IMPACT OF DISASTER
• Sexual violence
• Population displacement
• Communicable diseases
• Climatic exposure
• Food shortage and malnutrition
• Mental Health

17. Emergency management
❑ Emergency management (Disaster management) is the
discipline of dealing with and avoiding risks.
• It involves preparing for disaster before it occurs, disaster
response, and supporting, and rebuilding society after
disasters have occurred.
• In general, any emergency management is the continuous
process by which all individuals, groups, and communities
manage hazards in an effort to avoid or ameliorate
/improve the impact of disasters resulting from the
hazards

18. • The process of emergency management involves four
phases:
1. Mitigation
2. Preparedness
3. Response, and
4. Recovery.

19. 1. Mitigation Definition :
• These are actions aimed at reducing or eliminating the
impact of future hazard events by avoiding hazard
or strengthening resistance to it.

20. • Mitigation: is permanent reduction of the risk of a disaster.
– Primary mitigation refers to reducing the resistance of the
hazard and reducing vulnerability.
– Secondary mitigation refers to reducing the effects of the
hazard (preparedness)
• Mitigation includes:
– recognizing that disasters will occur;
– attempts are made to reduce the harmful effects of a disaster,
– limiting their impact on human suffering and economic assets.

21. Objectives:
❖ Reduce vulnerability of the system
❖ Reduce magnitude of hazard.

22. Vulnerability Assessment Definition:
• Also known as risk assessment, threat assessment or hazard analysis
• It is a procedure for identifying hazards and determining their
possible effects
– To build capacity to prevent & respond
– To develop strategies
– To devise emergency prevention/mitigation and preparedness
measures
– To take rapid, relevant emergency response
– To identify gaps in resources

23. ❑ Vulnerability assessment provides information
essential for:
• Sustainable development
• Emergency prevention, mitigation, and preparedness
• Emergency response
• Emergency recovery

24. The Processes/Steps of Vulnerability Assessment
The parts of vulnerability assessment are:
1) Project definition – determines the aim, objectives, scope
and context of the vulnerability assessment, the tasks to
be performed, the resources needed to perform them
2) Formation of representative planning group
3) Hazard identification – reveals the hazards that exist in
the community

25. 4) Hazard description
• Five basic characteristics to describe most hazards:
– Intensity (how big, fast, and powerful)
– Frequency (the likelihood of a hazard causing an event of a
given magnitude)
– Extent (the area that a hazard may affect)
– Time frame (warning time, duration, time of day, week,
year)
– Manageability (whether any thing can be done about it)

26. 5)A community and environment description
• People, property, or environment that may be affected
by the hazards
6)A description of effects
– is an account of community vulnerability
– Addresses what is likely to happen in an emergency/or
disaster involving a single hazard or multiple hazards

27. 7) Hazard prioritization (Hazard ranking)
• Criteria for prioritization may include:
– Seriousness (the relative impact of a hazard in terms of
financial cost, or number of people affected or both) - High,
medium or low
– Manageability (can anything be done about the hazard?)High,
medium, or low
– Urgency – High, medium, low
– Growth (if nothing is done about the hazard, will it grow worse
or remain as it is?)

28. 8) Recommendations for action
• Recommendations focus on the work that needs to be
accomplished in:
– emergency preparedness,
– response
– recovery
9) Documentation of results & decision

29. Mitigation to reduce to community vulnerability
1. Reduce risk of communicable diseases.
2. Improve general health status of population
3. Local emergency planning in disaster
4. Public education/awareness

30. 2. Disaster Preparedness
Definition:
• Activities designed to minimize loss of life and damage,
to organize the temporary removal of people and
property from a threatened location & facilitate
timely & effective rescue, relief & rehabilitation

31. Preparedness: are the measures that ensure the
organized mobilization of personnel, funds,
equipments, and supplies within a safe environment
for effective relief.
• Disaster preparedness is building up of capacities
before a disaster situation prevails in order to reduce
impacts. • $ 1 invested in disaster preparedness can
save $ 5 10 of disaster-related losses

32. Objectives
• To prevent excess mortality by impact, rescue, relief,
appropriate health care & disruption .
• To provide appropriate & timely health care for causalities,
malnutrition & communicable diseases.
• To prevent exposure to adverse climatic & environmental
conditions.
• To prevent long term & short term disaster related morbidities.
• Reestablishment of health services to or above the pre-disaster
level.

33. • Emergency preparedness requires that:
– emergency plans be developed,
– personnel at all levels and in all sectors be trained,
– communities at risk be educated,
– measures be monitored and evaluated regularly

34. Emergency planning
• Emergency plan is an agreed set of arrangements for
responding to and recovering from emergencies
• It describes:
– responsibilities,
– management structures,
– strategies, and
– resources

35. Steps
1) Project definition
• aims, objectives, scope and context of emergency plan
• tasks required
• resources needed to perform tasks
❑ Recommendations based on the vulnerability
assessment should be used in the planning process.

36. 2) Form a representative planning group
3) Analysis of potential problems
• Examines in more detail the hazards & vulnerabilities,
their causes, possible preventive strategies, response and
recovery strategies, and trigger events for these strategies
• The trigger event should indicate when the strategy is
required
• Problem analysis will provide information for later steps of
the process

37. 4) Resource analysis
• what resources are required?
• What resources are available?
• What is the variation between requirement &
availability?
5) Roles and responsibilities
• Outline who does what

38. 6) The management structure
• Defines the authority and reporting relationships
between different organizations and some times the
relationships within organization
• Each organization involved in the plan should agree on
the management structure

39. 7) Development of strategies and systems • Strategies &
systems that are commonly required for response and
recovery:
– Alerting
– Command, control, and coordination
– Information management
– Resource management
– Evacuation
– Hazardous materials

40. Alerting
Alerting consists of a number of response phases, including:
A) alert– the period when it is believed that resources may
be required, which prompts an increased level of
preparedness
B) standby– the period normally following an alert, when
the controlling organization believes that deployment of
resources is imminent and personnel are placed on
standby to respond immediately

41. C) call-out – the time when command is given to deploy
resources
D) stand-down – the time when the controlling
organization declares that the emergency is controlled
and that resources may be recalled.

42. Command, control, and coordination
• It consists of the following elements:
– Information management
– Resource management
– Decision making
– Problem solving
– Reporting to higher levels of authority

43. Information management
• Involves the gathering, handling, use, and
dissemination of information related to emergency
• Tasks and systems include:
– Warning systems
– Public information
– Emergency assessment

44. 3. Response
• It is the set of activities implemented after the impact
of a disaster in order to assess the needs, reduce the
suffering, limit the spread and the consequences of
the disaster, open the way to rehabilitation.

45. 4. Recovery
• Aim: to restore the affected area to its previous state.
• It differs from the response phase in its focus
• Recovery efforts are concerned with issues and decisions
that must be made after immediate needs are addressed.
• Recovery efforts are primarily concerned with actions that
involve rebuilding destroyed property, re-employment,
and the repair of other essential infrastructure.

46. Thank You!!!