Natural Disasters and Complex Emergencies

Pandemic influenza would lead to what?
Social disruption, illness and death

What are examples of pandemics?
SARS, Spanish flu, Asian flu, HK flu, H5N1

Natural disasters and complex emergencies lead to what?
– Increased death, illness, and disability
– Large economic impacts
– Measures taken to reduce costs of disaster and conflict would be most effective if those involved worked together on the most important priorities

Where is the biggest relative impact for natural disasters?
– Near large bodies of water
– Developed & high income countries are better equipped to handle disasters
– Can be rapid or slow (eg.flood), Natural or manmade (eg.Tsunami)

Droughts, hurricanes, typhoons, cyclones, heavy rains, tsunamis, earthquakes and volcanoes are all examples of what?
Natural disasters

What is happening to the number of natural disasters?
They are increasing, affecting larger numbers of people, causing more economic losses, but causing proportionally fewer deaths

Natural disasters have the biggest relative impact on who?
The poor and low and middle income countries

Natural disasters cause damage to what?
Health systems and other infrastructure

What are examples of direct deaths?
Rubble falling down on people
Drowning from tsunamis

What are examples of indirect deaths?
They come after the disaster
Cholera outbreaks
Starvation d/t no food

What is a pandemic?
Occurs when a specific influenza virus to which people have little or no immunity, spreads around the world to people from many different countries

Seasonal influenza is a common what?
Infection of the airways and lungs that can spread easily among humans
– Sometimes however the genetic material of influenza viruses can change or mutate causing a new influenza strain to emerge. Since people have no immunity to the new strain it can spread rapidly around the world causing what is known as a pandemic. The pandemic influenza virus can cause severe complications such as pneumonia, and death in people who were otherwise healthy.

Influenza pandemics usually occur how many times in a century?
three to four times

What is the Canadian Pandemic influenza plan?
Created by federal, provincial and territorial officials and more than 200 experts. Explains how Canada will prepare for and respond to a pandemic influenza outbreak. The plan was created for governmental departments of health, emergency workers, public health officials and health care workers. It includes an emergency response plan, along with guidelines and check lists

What are the goals of influenza pandemic preparedness and response?
– The goals are to minimize serious illness and overall deaths, as well as to minimize any social disruption among Canadians as a result of an influenza pandemic. if identifies in particular the prevention and preparedness activities that need to be addressed before a pandemic, such as surveillance, vaccine programs, antivirals, health services, public health measures and communications

How often is the plan updated?
The plan is updated as new info becomes available. The 2009 H1N1 influenza provided a real life pandemic response experience and the lessons learned from this experience will help strengthen pandemic planning preparedness in Canada
(Updates are continuous)

What are the characteristics of complex emergencies?
-Often go on for long periods of time
– Sometimes groups that are fighting will not allow humanitarian assistance to be provided
– Combatants often target civilians
– Systematic abuse of human rights (abuse, torture, rape)
– Food shortages
– Breakdown of publicly supported health system
– Unhealthy living circumstances in refugee camps.

Natural disasters have what kind of effects?
Direct and indirect effects depending on the type of disaster
– Some effects are short term such as death others are long lasting like mental problems
– Very old, very young and very sick are most vulnerable

What is the nurses role in a disaster?

Humanitarian emergencies are what?
Large and underestimated
– Between 320 000 and 420 000 killed each year as a direct result of CHE’s
– Malnutrition, lack of safe water, food shortages and breakdown of health services can lead to illness, disability and death

What are some causes of death in CHE (complex humanitarian emergencies)?
– In the early stages. most death occur from diarrheal diseases, respiratory infections, measles or malaria
– Populations affected are generally poor and may suffer from protein-energy malnutrition in camp

What are some examples of things that can lead to death following a CHE?
Contaminated lake water
Violence against women > Survival sex (exchange sex for water)

How is mental health affected during CHE’s?
Social and psychological shocks due to changes in way of living, loss of livelihoods, damaged social networks and physical and mental harm
– Children and adults suffer from high rates of depression and PTSD
-Important to help people rebuild their lives and social networks as quickly as possible

How can nurses help with mental health and CHEs?
Debriefing and counselling

How does assessment and surveillance play into CHE’s?
– Carry out assessment of displaced population
– System for disease surveillance for diseases that cause epidemics among displaced persons
– Daily crude mortality rate is used as an indicator of the health of the affected group and will signify a public health emergency

What is some of the basic information that you would want to collect?
Population, mortality rate, vaccine coverage, water and sanitation indicators, drug supply availability

What kind of health effects need to be addressed when it comes to natural disasters?
– Health situation assessed immediately
– Care for trauma cases
– Other injured people who are in need of easy treatment
– Establishment of continuous disease surveillance
– Provision of food, water and shelter

To be most helpful, external services will have to do what?
– Include all external partners
– Be based on a cooperative relationship
– Have partners working in complementary ways
– Be evidence-based and transparent
– Involve affected communities
– Disasters preparedness plan are also helpful for reducing impact

What are the typical stages of disaster plans?
– Mitigation
– Preparation
– Respond
– Rebuild

Describe mitigation?
– Lessen impact (Eg. Plan, have things ready, immunizations up to date, public education)

Describe preparation?
Building resources, what is out there that we can use (eg. Flood: Evacuation shelters, how to communicate, measures used to prevent spread of disease, public education on how to respond in response to disaster)

Describe responding?
– Start responding (eg. get people to shelters)
– Search and rescue

Describe rebuilding?
– Activities undertaken by community after disaster to recover damages
– Funding, assistance
Rebuilding can take a while

How can we promote a safe and healthy environment?
– Maintenance of environmental and personal hygiene
– Adequate clean water for drinking, cooking and bathing (15L/person recommended per day, no more than 500 meters of walking to get water, wait no more than 15 mins in line to get water)
– Adequate number of toilets segregated by sex (to prevent rape)
– Effective and culturally appropriate shelter

How can food remain adequate during a CHE?
– At least 2100 kilocalories of energy per day for adults
– Care taken to make sure that female-headed households and children get their rations
– Vitamin A given to all children
– Urgent nutrition supplementation to children who need it

How can we control diseases in CHE’s?
– Vaccinate children from 6-15 for measles
– Ensure children up to 5 years get vitamin A
– Proper management of diarrhea
– Appropriate diagnosis and treatment for malaria
– Health education and hygiene promotion

What are some future challenges in meeting the health needs of complex humanitarian emergencies and natural disasters?
– Reducing negative health impact
– Developing and using standard approaches among all actors
– Responding with the most cost-effective approaches

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