Disaster Management
DISASTER MANAGEMENT
Introduction
India is prone to a number of disasters. The super cyclone of Odissa(1999),the Gujarat earthquake(2001), the Tsunami(2004) and Kerala floods( 2018,2019) were just a few of the disasters that led to heavy loss of life and left many stranded. We need to be aware of potential hazards, their frequency of occurring, where they might occur and the problems that may result in a disaster.
The National Disaster Management Authority (NDMA), headed by the Prime Minister of India is responsible for the management of disasters in the country. As per the Disaster Management Act, 2005, State and District statutory bodies are created for smooth functioning.
Every state in the country has a State Disaster Management Authority that is responsible for taking steps towards mitigating the damage and destruction after a disaster and to make sure the state is prepared.A well-coordinated and unified response of various departments of the State, its agencies, the Central Government, its departments and agencies appropriate to the demands of the district administration minimizes the loss of time wasted in response and improves the process of recovery.
Disaster management:
Disaster Management can be defined as the preparedness, response and recovery methods in order to lessen the impact of disasters. A disaster disrupts the normal function of the society to the extent that it cannot function without outside help.
Disasters can be classified as natural, technological or complex emergencies. Let's take a look at the natural disasters in Kerala.
In August 2018,Kerala was hit by incessant rains followed by one of the worst floods that the state has witnessed in decades. All the dams of the state were filled to capacity and gates had to be opened to keep the dams safe. Hundreds died and thousands of homes were affected and damaged. More than a million people had to take shelter in relief camps. Normal life came to a standstill. The heavy rain acted as a triggerfor more than 600 landslides in the state.
The entire nation came forward to lend a helping hand to the Kerala flood victims. Central Government, State Governments, Union Territories, Multi National Corporations, Big Business Houses, Celebrities, Sportsmen and women, schools, colleges, and common people have contributed to Kerala’s Chief Minister’s Relief Fund generously. Apart from these generous donations, it was the local community coming together for rescue missions and volunteering in relief camps that had an enormous impact on the return to normalcy.
Awareness and preparedness are the most effective prevention and mitigation measures against all disasters.
Prevention Of Natural disasters
Floods and Landslides being the most common natural disaster in the state, prevention methods of floods and landslides can be categorised into three.
· .Vegetative measures: Preserving vegetation, grasses and trees can minimize the amount of water infiltrating into the soil, slow the erosion caused by surface-water flow, and remove water from the soil.
· Structural Measures: Retaining and Diverting water using dams,floodplains,levees etc Constructing piles & retention walls Improving surface & subsurface drainage Rock-fall protection
· Management measures: Integrated river basin approach Public awareness, participation and insurance Land use zoning & risk assessment Flood forecasting and warning systems
However, it is impossible to be prepared for any kind of disaster since it is impossible to predict or foresee it. The Corona Pandemic took the world by surprise. There may occur many more kinds of disasters that may require the community and state to respond to differently.
The community is the first responder to any disaster. It is important that we prepare ourselves to face and respond to disasters.
Community Contingency Plan
A community contingency plan is a set of activities that a neighbourhood, community or group of people agree to follow inorder to respond well in times of an emergency. Developing a contingency plan involves making decisions in advance about the management of human and financial resources, coordination and communications procedures, and being aware of a range of technical and logistical responses.
The planning process can be answered with three questions.
What is going to happen?
What are we going to do about it?
What can we do ahead of time to get prepared?
Shelter
· Inhabitants should be protected from adverse effects of the climate
· Sufficient warmth, air, security and privacy must be maintained
General administration of the camp
· A camp officer should co-ordinate and supervise the day-to-day activities in the camp
· Any government officer can be asked to assist depending upon the requirements in the camp.
Management of the camp
· Treat every inhabitant of the camp with dignity and respect
· Make effective arrangement for distribution of food and aid to the people in the camp
· Special care should be taken to ensure that vulnerable people like disabled, elderly, pregnant women and children get adequate aid and supply of food and other facilities.
· Voluntary Organizations and leading citizens may be encouraged and involve in management of relief camp
Basic Facilities
· Lighting Arrangement and Generator Set
· Water Facilities
· Sanitation
· Food and clothing
· Medical Facilities & Psycho-social Support
Briefly, these are the following steps involved in Setting up a FLTC:-
· Identifying a suitable building
· Procurement of goods
· Setting up of Doffing & donning areas
· Creating partition and Laying of beds
· Prepping of washrooms, drinking water facility, recreational area
· Setting up of the nursing station
· Demarking and sealing isolation area
· Setting up of Administrative area
· Identifying the staff and training them
These steps are to be dealt with in-depth in the coming chapters.
A First-Line Treatment Centre(FLTC) is a facility where the most mildly symptomatic or asymptomatic COVID patients are treated. 70-80% of COVID patients are asymptomatic and only exhibit mild symptoms.
All such patients will be admitted into the FLTCs so that hospitals may be reserved for the most critically ill. FLTCs are not hospitals in the strict sense but only makeshift healthcare centres.
FLTCs are usually created as and when the need arises for such a facility within the Panchayat. A suitable Community Hall or any building is identified and the same is converted into a FLTC for a definite time period.
· Demarcate the isolation area as per the facility layout
· Identify separate entry and exit points for patients and staff
· Place the furniture and fittings as per the facility layout.
· Set up enclosed Doffing and Donning areas
· Set up an administrative office. The office must have a computer, a printer and one smart phone.
· Set up a room for medical staff and non-medical staff each and a store room
· Arrange for charging points both inside the isolation area for the patients and at the officer space outside the isolation area
· Internet connectivity through Wi-Fi must be enabled both for the patients as well as staff
· Drinking water must be made available in the isolation area
· The electric lines and plumbing must be checked
· Place signages to clearly establish a circulation flow for patients staff as well as stock
· Place one smart phone permanently within the isolation area and the other smart phone in the administrative office outside the isolation area. This will be the primary mode of communication between the staff within the isolation area and the administrator stationed outside.
· Seal the isolation area securely.
· The building identified to be converted into a FLTC must have the following facilities:-
· The Facility must be spacious enough to accommodate large numbers of patients easily.
· It must be airy and naturally lit.
· It must be a closed building so that the isolation area can be easily sealed.
· The building must be ideally located away from hospitals and schools to protect the sick, elderly and children from any possible spread of the infection.
· The building must be located within a short distance from a Taluk Hospital so that support can be sent from the Taluk Hospital in case of any medical emergency.
· The facility must have separate entry and exit for patients and staff.
· The proposed isolation area must have a partition to house Male and Female Patients separately (If the facility is open for both men and women)
· There must be an adequate number of washrooms with at least one washroom per 4 patients.
· There must be a dining area and a recreational area within the isolation area
· There must be room outside the isolation area to set up the administrative office, area for staff and to set up a storeroom.
· There must be a secure storeroom to store the medical supplies and other necessary items.
· There must be an ambulance bay and waiting area outside the building
· There must be enough space to create Donning (putting on of PPE kits) and Doffing (Putting off PPE kits) areas for nurses and doctors.
Most patients who reach the First Line treatment centers are Covid 19 cases who have mild symptoms. With minimum but efficient use of PPE, triage the patient into stable & unstable.
All patients should sanitize their hands & wear masks before entry.
If a patient is a direct entry case and not referred through the Telehealth Helpline Unit, then a screening questionnaire needs to be applied for initial categorization and admission to FLTC.
B.COVID CARE AREA
The isolation area should have 3 entry/exit points:
· STAFF ENTRY
· STAFF EXIT
· PATIENT ENTRY/EXIT
The area is completely sealed shut at all other places to ensure that no unauthorised entry or exit takes place.
C. ISOLATION AREA:The isolation patient area should have
1.Nurse Station
2.Sample Collection Area
3.Utility Area (Dining Area and Recreational Area)
4.Cots should be kept at least 2-3 m apart
5.Separate personal properties to be given to each patient
D. DONNING AREA
This is for the staff to wear personal protective equipment (PPE). This space should have
· One table and stool
· Hand washing area
· Disinfectant dispenser(preferably with Lysol, in 10% *dilution)
· Hand sanitizer dispenser (containing 60-80% Isopropyl alcohol)
· Micropore tape dispenser
· Hanging Mirror (for checking proper positioning of PPE )
E. DOFFING AREA :This is for the staff to safely remove PPE to safely dispose of them later.
· Stool
· Laundry Bins
· Disinfectant spraying units
· Hand washing area
· Wash rooms (For staff to take bath after doffing. Each wash room to be disinfected after every use.)
IMPORTANT POINTS
· Ideally there must be CCTV cameras in the patient isolation area
· A separate phone (ideally a smart phone with internet service) must be kept in the isolation unit to enable communication with the outside world
Inflow and outflow of patients
A clear circulation flow for patients must be set on the ground. The patients will be taken in the ambulance straight till the entry into the isolation area. If the FLTC also has a triage facility, then to the Triage Area.
Once the patient enters the isolation area, the door must be secured to avoid any unauthorised entry or exit
Inflow and outflow of Staff
Staff must enter the facility through the staff entry close to the administrative area. They must then wear PPE Suits in the Donning area before entering the Isolation area. While exiting the isolation area, they must first doff within the doffing area, bath in the washroom and exit through the separate staff exit only.
Flow of stock and consumables
The inventory management component of the CARE system is used in managing inventory within a FLTC. A secure Store room is identified to store all the durables.
The flow of goods must also be clearly laid out. The goods must be dropped off close to the store room near the reception area. The same must be transported to the store room. As per need this stock must be drawn while recording the same in the inventory management tool.If such goods need to be taken into the isolation area, the same must be done by a staff donning the PPE suit. The channel of entry and exit will be the ones marked for staff.
The problems faced by our community are many-folds. Problems like poverty, unemployment, food insecurity etc are increasing because of the socio-economic impact caused by the Pandemic.
Our country already has a system to solve issues faced by the community. Just like any other system, this system is also far from perfect. It is upon us civilians to supplement the efforts of the state and work towards increasing the efficiency of the governmental projects.
There are various existing government programs for poverty alleviation, generating employment for the unemployed etc. A few of these programs are listed below:-
Ashraya:
In this scheme, families which are the weakest financially in a Panchayat or Municipality is identified. A clear criterion is set to identify the most deprived. Income, health, assets, etc. are factors.
The objective of the scheme is to elevate them till they do not require the support and integrate them to the mainstream society. The scheme requires every Grama Panchayat to prepare separate micro-projects for each destitute household identified. These micro-projects are then integrated with the annual plans of the Grama Panchayats. This program is implemented through Kudumbashree. Kudumbashree updates the Ashraya List every year. Eligible families are identified by NHGs, verified by ADS, followed by eligibility checking at the CDS and finally approved by the Grama Panchayat Committee.
Multi-year projects are considered under this scheme. Three-year duration initially, extendable through projects for continued support to the needy.
The Panchayat must see to it that the benefit of any project or scheme must first fall upon this population. If there is a scheme by the Water authority, it must be made sure that the people under Ashraya have a priority. The same goes for any scheme under health, education etc.This project has been financed by central, State government support, contributions by District and Block Panchayats, and plan funds of the respective Grama Panchayats. Attempts to mobilize financial and other support from agencies and individuals may also be helpful. The existing schemes which are considered under the project are:
· Land for house construction for the homeless by Grama Panchayat
· House under Indira Awas Yojana (IAY)
· Electrification through Rajiv Gandhi Grameen Vidyutikaran Yojana
· Drinking water through the special scheme of Kerala Water Authority (KWA) covering BPL families etc.
