SEMINAR 10.pptx

DR PRINCY
II YEAR MDS
DEPARTMENT OF PUBLIC HEALTH DENTISTRY
SEMINAR- 10
DISASTER MANAGEMENT

CONTENTS
• Introduction
• Definition
• History
• Disaster Management
• Personal Protection in different Types Of
emergencies
• WHO- Disaster management
• UNDRR
• National Disaster Management Act, 2005
• Dentist and Disaster Management
• Public Health Significance
• Conclusion
• References

DISASTER
The United Nations Office for Disaster Risk Reduction (UNDRR), 2009
“A serious disruption of the functioning of a community or a society involving
widespread human, material, economic or environmental losses and impacts, which
exceeds the ability of the affected community or society to cope using its own
resources”

INTRODUCTION
• Disaster is a sudden, calamitous event, bringing great damage, loss,
destruction and devastation to life and property.
• Statistics gathered since 1969 show a rise in the number of people
affected by disasters.

HAZARD
A "hazard" can be defined as any phenomenon that has the
potential to cause disruption or damage to people and their
environment
WHO (1999). Community Emergency Preparedness . a manual for managers and policy - makers, WHO.

HISTORY
YEAR EVENT COUNTRIES
AFFECTED
DEATH TOLL
2003 European heat wave Europe 72,000
2004 Indian Ocean earthquake and
tsunami
Indonesia, Sri
Lanka, Thailand,
India, Somalia
227,898
2008 Cyclone Nargis Myanmar 138,373
2010 Haiti earthquake Haiti 2,00,000
2011 earthquake and tsunami Japan 20,000
2022 European heat waves Heat wave 26,304

MAJOR DISASTER IN INDIA
YEAR EVENT DEATH TOLL
1984 Bhopal Gas Tragedy 3,787
2001 Gujarat earthquake 20,023
2004 Indian Ocean tsunami 2,30,000
2013 Uttarakhand floods 5,700
2014 Jammu Kashmir floods 300
2016 Uttarakhand forest fires 9
2018 Indian dust storms 130
2019- till
date
Corona virus pandemic 5.31L

CLASSIFICATION
NATURAL HAZARDS
1. Geophysical
• Earthquake
• Volcano
• Tsunami
2. Hydrological
• Floods
• Land Slides- Avalanche, mud flow
HUMAN- INDUCED
C- Chemical
B- Biological
R- Radiological
N- Nuclear
Deslnventar 2016
3. Meteorological
Cyclones, storm, tornado
4. Climatological
• Drought, Forest wild fire, Extreme hot
or cold conditions
5. Biological
• Epidemic- Viral, Bacterial, Parasitic,
Fungal or Prion
• Insect infestation

SHORT TERM EFFECTS
EFFECT EARTHQUAKES HIGH WINDS TIDAL WAVES SLOW- ONSET
FLOODS
LAND SLIDES VOLCANO
Death Many Few Many Many Many
Severe injuries
requiring
extensive
treatment
Many Moderate Few Few Few Few
risk of
communicable
diseases
Damage to
health facilities
Severe Light Severe Light Severe Severe
Damage to
water systems
& Food storage
Rare Rare Common Common Rare Rare
Population
movements
Rare Rare
Potential risk following all major disaster
Common ( Gen limited)

Morbidity which results from a disaster situation
a. Injuries
b. Emotional stress
c. Epidemic of disease
d. Increase in indigenous diseases.

DISASTER MANAGEMENT
• Disaster Management under UNDRR
Systematic process of using administrative decisions, organizations, operational
skills and capacities to implement policies, strategies and coping capacities of the
society and community to lessen the impacts and related environmental and
technological disaster.

FUNDAMENTAL ASPECTS OF DISASTER MANAGEMENT
a. Disaster Response
b. Disaster Preparedness
c. Disaster Mitigation

MANAGEMENT SEQUENCE OF A SUDDEN-ONSET DISASTER
RECOVERY PHASE AFTER A DISEASE
RISK REDUCTION
PHASE BEFORE A
DISEASE
Mitigation

DISASTER IMPACT AND RESPONSE
Greatest need for emergency care occurs in the first few hours.
• Search, rescue and first-aid
• Field care
• Triage
• Tagging
• Identification of dead

DISASTER IMPACT AND RESPONSE CONT.
Search, rescue and first-aid - Uninjured survivors.
Field care –
oTransport
oBed availability and surgical services
ofood and shelter.
oCentre - inquiries
oAdequate mortuary space

TRIAGE
Dominique-Jean Larrey (1766-1842)
Quantity and severity of injuries overwhelm the operative
capacity of health facilities,
“First come, first treated", Not followed
Rapidly classifying the injured
• Severity
• Likelihood of survival with prompt medical intervention.
PRIORITY
Immediate or long-term
prognosis achieved with
simple intensive care.
Moribund

TRIAGE
• Maximum benefit to the greatest number of injured
• Common classification
• High priority treatment or transfer
• Medium priority
• Ambulatory patients
• Dead or moribund patients.

DISASTER IMPACT AND RESPONSE (CONT.)
• Tagging
• Identification of dead
Essential part - Respect
Care of the dead
1) Removal of the dead (disaster scene)
2) Shifting- mortuary
3) Identification
4) Reception of bereaved relatives.

RELIEF PHASE
Begins when assistance from outside starts to reach the disaster area
Relief supplies is determined by 2 factors
1. Type of disaster
2. Type and quantity of supplies available locally.
Most critical health supplies needed
1. Treating casualties
2. Preventing the spread of communicable diseases

RELIEF PHASE
• A rapid damage assessment carried out to identify needs and
resources.
• There are four principal components in managing humanitarian
supplies
a) Acquisition of supplies
b) Transportation
c) Storage
d) Distribution.

RELIEF PHASE- EPIDEMIOLOGIC SURVEILLANCE AND
DISEASE CONTROL
• Overcrowding and poor sanitation- acute respiratory infections
• Population displacement may lead to introduction of communicable diseases
• Disruption and the contamination of water supply
• Ecological changes may favour breeding of vectors
• Zoonoses- Leptospirosis, Anthrax
• Emergency food, water and shelter in disaster situation

RELIEF PHASE- PRINCIPLES OF PREVENTING AND
CONTROLLING COMMUNICABLE DISEASES
• Implement public health measures as soon as possible
• Organize reliable disease reporting system to identify
outbreaks and to promptly initiate control measures
• Investigate all reports of outbreaks rapidly

RELIEF PHASE (CONT.)
• Vaccination
Policy to be adopted should be decided at senior level only.
• Nutrition- immediate steps for ensuring
(a) Assessing the food supplies
(b) Gauging the nutritional needs of the affected population
(c) Calculating daily food rations and need for large population groups
(d) Monitoring the nutritional status of the affected population.

REHABILITATION
• In first weeks after disaster, Priorities will shift from health care towards environmental health measures
Water supply
Chlorine level to about 0.2-0.5 mg/litre.
Existing and new water sources
1. Restrict access to people and animals
2. Ensure adequate excreta disposal
3. Upgrade wells to ensure that they are protected from contamination
4. Estimate the maximum yield of wells and if necessary, ration the water supply.

DISASTER MITIGATION IN HEALTH SECTOR
• Involves measures designed either to prevent hazards from causing
emergency or to lessen the effects of emergencies.
• Measures include
o Flood mitigation works
o Appropriate land use planning
o Improved building codes
o Reduction or protection of vulnerable population and structures.

DISASTER PREPAREDNESS
The objective of disaster preparedness is to ensure that
appropriate systems, procedures and resources are in place
to provide prompt effective assistance to disaster victims,
thus facilitating relief measures and rehabilitation of
services

DISASTER PREPAREDNESS(CONT)
Depends on the coordination of a variety of sectors to carry out the following tasks
• Evaluate the risk- disaster (country/ region)
• Adopt standards and regulations
• Organize communication, information and warning systems
• Ensure coordination and response mechanisms
• Measures to ensure that financial and other resources are available for increased readiness
• Develop public education programmes

POLICY DEVELOPMENT
Policy performs the following functions
(a) Establish long-term goals
(b) Assign responsibilities for achieving goals
(c) Establish recommended work practice
(d) Determine criteria for decision making.

PERSONAL PROTECTION IN DIFFERENT TYPES OF
EMERGENCIES
• Do not panic
• Do not use the telephone
• Listen to the messages broadcast
• Carry out the official instructions
• Keep a family emergency kit ready.

•Battery operated torch
•Extra batteries
•Battery operated radio
•First aid kit and manual
•Emergency food (dry items) and
water (packed and sealed)
•Candles and matches in a
waterproof container
•Knife
•Chlorine tablets or powdered water
purifiers
•Can opener.
•Essential medicines
•Cash, Aadhar Card and Ration Card
•Thick ropes and cords
•Sturdy shoes
EMERGENCY KIT

FLOODS
What to do before-hand
• Individuals should find out about risks in the area (foghorns)
• Regularly listening to the weather forecasts.
During a flood
• Turn off the electricity
• Protect people and property
• Beware of water contamination
• Evacuate danger zones- Secure your home

FLOODS
After a flood
Do not return home until told by the local authorities,
• Clean and disinfect any room that has been flooded
• Get rid of all consumables
https://ndma.gov.in/Natural-Hazards/Floods/Do-Donts
Evacuation tips

2013 NORTH INDIA FLOODS
Deaths 6,054
Property damage 4,550 villages were
affecte
June 2013, a mid-day cloudburst centered on the North Indian state
of Uttarakhand caused devastating floods and landslides, becoming
the country's worst natural disaster since the 2004 tsunami

2021 GLACIAL OUTBURST FLOOD AND AFTERMATH- 2021
UTTARAKHAND FLOOD
A part of the Nanda Devi glacier broke off Uttarakhand's
Chamoli district on 7 February 2021, causing flash flood, 200
killed
A two year study released in 2023 by the Indian Institute of
Remote Sensing determine the area was sinking 6.5
centimetres (2.6 in) each year

EARTHQUAKES
• Repair deep plaster cracks in ceilings and foundations
• Build in accordance with urban planning regulations for
risk areas.
• Ensure safe that all electrical and gas appliances in houses
• Avoid storing heavy objects and materials in high positions.

DURING EARTHQUAKE
Indoors
• DROP to the
ground; take COVER
• Stay inside until the
shaking stops
Outdoors
Move away from
buildings, trees,
streetlights, and utility
wire
Moving vehicle
• Stop as quickly as safety
permits and stay in the
vehicle
• Avoid damaged roads,
bridges, or ramp-
Ref- https://ndma.gov.in/Natural-Hazards/Earthquakes/Dos-Donts

If trapped under debris
•Do not light a match.
•Do not move about or kick up dust.
•Tap on a pipe or wall so rescuers can locate you. Use a whistle
if one is available. Shout only as a last resort.
Ref- https://ndma.gov.in/Natural-Hazards/Earthquakes/Dos-Donts
DURING EARTHQUAKE

V- Very high risk
IV- High risk
III- Moderate
II- Low

Local date 26 January 2001
Duration 90 seconds
Magnitude 7.6 Mw
Areas affected India, Pakistan
Max. intensity X (Extreme)
Casualties 20,023 dead
166,800 injured
GUJARAT EARTHQUAKE

CLOUDS OF TOXIC FUMES
• Find out about evacuation plans and facilities
• Be familiar with alarm signals
• Equip doors and windows with the tightest possible fastenings
During an emergency
• Close doors and windows.
• Seal any cracks or gaps
• Turn off ventilators and air conditioners.

BHOPAL GAS TRAGEDY
Date 2 December 1984
Location Bhopal, Madhya Pradesh,
India
Type Chemical accident
Cause Methyl isocyanate leak
from the E610 storage
tank on the Union
Carbide India
Limited plant
Deaths At least 3,787
Non-fatal injuries At least 558,125

LANDSLIDE
India has the highest mountain chain on earth
Ref- https://ndma.gov.in/Natural-Hazards/Landslide

LANDSLIDE
Do's
•Move away from landslide path
•Keep drains clean.
•Grow more trees that can hold the soil through roots,
•Identify areas of rock fall and subsidence of buildings, cracks that indicate landslides
and move to safer areas. Even muddy river waters indicate landslides upstream.
•Notice signals and contact the nearest District Head Quarters.
Stay alert, awake and active (3A's)

Don’ts
•Try to avoid construction and staying in vulnerable areas.
•Do not touch or walk over loose material and electrical wiring
•Do not built houses near steep slopes and near drainage path.
•Do not move an injured person without rendering first aid
LANDSLIDE

TSUNAMI
RECOVER AND BUILD
•Radio
•Check yourself for injuries and get first aid if necessary before helping injured
or trapped persons.
•If someone needs to be rescued, call professionals
•Avoid disaster areas. (contaminated water, crumbled roads, landslides,
mudflows, and other hazards)

•Re-entering buildings
•Wear long pants, a long-sleeved shirt, and sturdy shoes (cut feet)
•Look for fire hazards.
•Watch out for wild animals
•Check food supplies
•Watch your animals closely.
RECOVER AND BUILD- TSUNAMI
Ref- https://ndma.gov.in/Natural-Hazards/Tsunami

Indian Ocean earthquake and tsunami
Time 2004-12-26
00:58:53
Local date 26 December 2004;
18 years ago
Magnitude 9.1–9.3 Mw
Areas affected Indian Ocean
coastline areas
Death 227,898
TAMIL NADU- 6000
Countries affected
•India
•Indonesia
•Malaysia
•Maldives
•Myanmar
•Somalia
•Sri Lanka
•Thailand

MAN-MADE DISASTERS
a. Sudden disasters -Bhopal Gas Tragedy in India on 3rd December 1984
b. Insidious disaster-
• Research laboratories releasing radioactive substances
• Chemical plants releasing their toxic by-products into rivers
• Long term- global warming
c. Wars and civil conflicts.

MAN-MADE DISASTERs (cont.)
• The public health response to man-made disaster is the
primary prevention
• People around the world have turned towards efforts to
stop the: arms race and prevent nuclear war.

2008 Mumbai attacks
Date 26 November 2008 –
29 November 2008
Attack
type
Bombings, shootings, mass murder
Deaths 175 (including 9 attackers)
Injured 300+
Motive Islamic terrorism

COVID-19 PANDEMIC
Background
On 11 January 2020, the WHO confirmed that a novel coronavirus was the cause
of a respiratory illness in a cluster of people in India
Death toll 5.31L

• Identification of lines of authority
• Financial arrangements for funding emergency work
• Arrangements to ensure that government and
community activities are maintained
• National stockpiling of appropriate resources
DISASTER AND EMERGENCIES, 2007

• Database of national experts for advice on specific
problems
• Protocols and formal arrangements for coordinated
efforts with other countries, or between
provincial/state governments within the country

United Nations Office for
Disaster Risk Reduction
Accelerate global efforts in disaster risk
reduction

INDIA
CONTACT NUMBER
Govt. of India- 91-11-26701700
Tamil Nadu State- 1070
District- 10777

National disaster management act, 2005
The NDMA is responsible for "laying down the policies, plans and guidelines for disaster
management" and to ensure "timely and effective response to disaster"
Parliament of India (23 December 2005). "Disaster Management Act, 2005, [23rd December, 2005.] NO. 53 OF 2005" (PDF).
Ministry of Home. Archived from the original (PDF) on 29 January 2016. Retrieved 30 July 2013.

CHAIR PERSON
& MEMBERS
(9)
Meetings of National Authority
Advisory committee
(experts in the field of
disaster management)
National Executive Committee
(Assist the National Authority)
One or more sub-committee
STATE DISASTER
MANAGEMENT
AUTHORITIES
CHAIR PERSON
& MEMBERS
(9)
Meetings
DISTRICT DISASTER
MANAGEMENT
AUTHORITY
CHAIR PERSON &
MEMBERS (7)
CHAIR PERSON-
Collector or District
Magistrate or Deputy
Commissioner

• Develop training modules, undertake research and documentation
• Formulate and implement a comprehensive human resource
development plan
• Provide assistance in national level policy formulation
• Provide required assistance to the training and research institutes for
development of training and research programmes for stakeholders

National Disaster Response
Force
• Formed- 19 January 2006
• Ministry of Home Affairs
• Employees – 13,000
• Annual Budget- 1.2 crores
MOTTO- Sustained Disaster Response Service

The NPDRR is a multi-stakeholders National Platform headed by the Union Home Minister and it
promotes participatory decision making in disaster management, and strengthens federal policy of
our country.

Ensure coordinated steps towards mitigation, preparedness and coordinated response when a
disaster strikes.

DENTISTRY-DISASTER MANAGEMENT
SURVEILLANCE
• Effective surveillance network
• Unusual syndromes/ clinical presentations in Community
• Intra-oral or cutaneous lesions or both, thus helping the early detection of a
bioterrorism attack.
• Early detection of an infectious agent -> Therapeutic and preventive action
Dutta SR, Singh P, Passi D, Varghese D, Sharma S. The role of dentistry in disaster management and victim identification: an overview of
challenges in Indo-Nepal scenario. Journal of maxillofacial and oral surgery. 2016 Dec;15(4):442-8.

DISTRIBUTION OF MEDICATION
• Prescribe and dispense the required medications, after the
outbreak of the disease; this can be guided by public health
officials.
• Patients can be monitored by dentists for adverse reactions
and side effects, and if necessary, they can be referred to
physicians for further treatment.

DENTAL OFFICES ACTING AS MEDICAL SITES
• Dental offices are well equipped - auxiliary hospitals.
• Availability of suction lines, X-ray equipment and
sterilizing techniques

IMMUNIZATION
• In emergencies, trained dentists can participate in mass immunization
programs.
• Dental clinics can also be considered as immunization sites

DEFINITIVE TREATMENT
• DENTISTS are appropriately trained to provide first aid, cardiopulmonary
resuscitation as well as aesthetic and surgical services to patients with different
injuries.
• Dentists regularly collect salivary samples, nasal swabs, or other specimens for
laboratory processing, leading to proper diagnosis, information about progress of
the treatment and the status of the infection of patient

FORENSIC ASSISTANCE
• Dental identifications play a key role in victim identification
during natural and manmade disaster events.
• The legislation compels dental professionals to produce and
maintain adequate patient records.

DISASTER VICTIM MANAGEMENT
• A quick, valid and reliable method of age estimation during the times of
disasters can also be offered by dental tissues.
• The role of dentists has been reported in treating facial injuries sustained during
the earthquake that struck China in 2008.
• About 8.9 per cent of the patients who sustained facial injuries in that
earthquake were under the care and treatment of dental team members

SUPPORTING OTHER HEALTH PROFESSIONALS
• Dentists can be recruited to provide certain services that only
physicians can do.
• Dentists can enhance the surge capacity of the local medical system
until another team of physicians can arrive or the demand for
immediate care decreases.

EXISTING CURRICULUM IN DENTAL INSTITUTIONS
• Knowledge and skills of an average dental graduate may be utilized by
the public healthcare system in times of crisis.
• However, a revised curriculum with the inclusion of handling of medical
emergencies needs to be enforced in all dental teaching institutions.

PUBLIC HEALTH SIGNIFICANCE
Upstream
Policies
Mid-stream
Community- outreach programs
Training other professional groups
Media campaigns
PPP
Downstream
Education and awareness
76

PUBLIC HEALTH SIGNIFICANGE
• A public health emergency occurs when the ordinary health service
abilities of a community are stunned by a dangerous situation or
incident.
• Emergency preparedness is that facet of public health intended
minimalize the impact of emergencies on affected populations, and
nurture safe and healthy environments before, during, and after an
emergency.

CONCLUSION
• Dentists provide valuable service to their patients and communities
• Dental personnel form an additional source of assistance in response activities.
• The need of the hour is to develop defence by full international cooperation
and to educate the populations about precautions and protective measures

Hazards do not have to turn into disasters.
To break the vicious cycle of "Disaster, respond, recover, repeat.",
we need a better understanding of disaster risk, in all its dimensions.

REFERENCES
• Dutta SR, Singh P, Passi D, Varghese D, Sharma S. The role of dentistry in disaster management and
victim identification: an overview of challenges in Indo-Nepal scenario. Journal of maxillofacial and
oral surgery. 2016 Dec;15(4):442-8.
• WHO (1995). Coping with major emergencies - Srrategy and Approaches to Humanitarian Action.
Geneva. World Health Organization, 1995.
• WHO (1999). Community Emergency Preparedness . a manual for managers and policy - makers,
WHO. 3. Maxy - Rosenay - Last (1992), Public Health and Preuentiue Medicine, 13th Edition.
• WHO (1989). Coping with Natural Disasters: The Role of Local Health Personnel and the Community.
• PAHO (2000). Natural Disasters, Protecting the Public's Health , Scientific Publication No. 575.
• Govt. of India (2001). Annual Report 2000- 2001. Ministry of Health and Family Welfare, New Delhi.

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