My Final Post: The Key Points That I Will Remember About Disaster Management

For my last post, I’ve decided to put together a summary of the key pieces of information that I have taken away from this course regarding disaster impacts and management.  In particular, I wanted to make sure that I included topics and any other bits that I did not have a chance to discuss in my other posts.

Disaster can either occur as a result of natural process, man-made ones or a combination of both (hybrid).

Prior to disaster

Appropriate prevention and disaster preparedness activities are the most effective and efficient ways to avoid the significant impacts of disasters on health, livelihoods and infrastructure.

Disaster relief

Organisations should never enter a country to provide aid without being expressly asked by its government, unless there is no stable government and/or the United Nations declares a state of disaster.

Aid organisations should operate through and in conjunction with the local whenever and however possible.  Local governments should be encouraged to lead the efforts and supported in doing so.  

The specifics of the organisation’s role and responsibilities should be explicitly outlined and agreed to by the agency and host country early on (although this might be amended depending on the circumstances).  A time frame for the completion of activities should also be established and agreed upon.

It is important to promote the autonomy and independence of the host nation and its people.  Do not treat the populations receiving assistance like they are helpless and get them involved in response efforts and activities as much as possible.

Proceed in accordance with all applicable international and domestic laws as well as the code of ethics of your organisation and any other rules or agreements that are in place. 

Response efforts should also follow the rights and guidelines of the Humanitarian Charter and the Protection principles outlined in the Sphere Handbook.  Ensure that everyone has equal access to assistance and security.  Avoid any activities or behaviors that may compromise the dignity of individuals or put them at risk of further danger.

When providing assistance, be sure to follow the core standards outlined by the Sphere project in the Sphere Handbook.  Some key standards are

Water:

•      Minimum 15 liters of water per person per day for drinking, cooking, personal hygiene and house cleaning.
•      Households should be no further than 500 meters from a water point.
•      Wait time at water source should not exceed 30 minutes.
•      250 people per tap, 500 people per hand pump and 400 people per single-user open well

(Sphere 2011)

Hygiene and Sanitation:

•      Provision of feminine hygiene products for menstruation
•      Water containers (two 10-20 liters containers per household, one for storage and one for transport)
•      250 grams of bathing soap and 200 grams of laundry soap per person per month.
•      One toilet for no more than 20 people and toilets are no more than 50 meters away (although the number of people per toilet changes in public settings, see page 130 of the Sphere Handbook).  The different types of toilets for different situations are outlined on page 109.

(Sphere 2011)

Food and Nutrition:

• Minimum nutritional requirements for a population include: 2,100 kcals per person per day, 10% of which is protein and 17% of which is fat.  Adequate micronutrient intake is also essential.
• Ready-to-Use supplements such as plumpy sup (peanut-based paste) can be given to children affected by or at risk of malnutrition to increase their caloric intake.

(Sphere 2011)

Shelter:

• People must be provided with a covered living space that offers protection from the elements outside including precipitation, wind and disease vectors.  Other amenities such as toilet facilities should be close by.
• Shelters should be appropriate to the season and situational context (i.e. temporary shelter, transitional shelter or permanent shelter).
• Whenever possible, people should be involved in the construction of their own shelters.

(Sphere 2011)

Non-Food Items:

•       Blankets, clothing, fuel, lighting and cooking and cleaning supplies, etc should be provided to help maintain the health and dignity of individuals and provide comfort.
•       The items and the materials they are made of should be appropriate to the situation, which may require some consideration.

(Sphere 2011)

Health Action:

• Health assessments (usually performed in the initial relief wave), mass vaccinations and the management of communicable diseases and any other serious threats to health.
• There should be at least:
• 22 qualified health workers (doctors, nurses and midwives) per 10,000 people.
• One doctor per 50,000.
• One nurse and one midwife per 10,000.
• One community health worker per 1,000.
• Clinicians should not regularly see more than 50 patients a day.
• Field hospitals may be necessary if existing hospitals are too damaged and mobile clinics may be required for reaching isolated communities.
• If measles vaccination coverage in children aged 9 months to 5 years appears to be less than 90%, is unknown or not clear, a vaccination campaign should be carried out.  Priority should be given to those aged 6 to 59 months, but vaccination coverage could be widened to reach children up to 15 years of age.

(Sphere 2011)

It is also important to address:

Sexual and reproductive health, including everything from contraception to the prevention and treatment of sexually transmitted diseases (including HIV/AIDS) to treatment for victims of rape and/or assault. 

The mental health of disaster victims and witnesses to facilitate their recovery and help them return to being productive and healthy individuals.

Severe injuries and long-term disabilities.  It is no use fixing someone’s broken hip if they do not receive the therapy to help him or her return to an adequate level of functioning afterwards.

Chronic diseases such as diabetes and heart disease, which can complicate and hinder the recovery of patients and the population as a whole.

HIV/AIDS prevalence will be a concern for relief efforts, as it will make people more vulnerable to various conditions including malnutrition.  Those infected may suffer from discrimination because of their status.  Finally, if not handled properly, the situation could also exacerbate transmission among the population and humanitarian workers.

Family unity.  Getting families back together so that they can look out for each other and care for each other as they recover.

Important/vulnerable groups to look out for:

Children – particularly vulnerable to the impacts of disasters because they are still growing and developing, have few resources and little advocating power.  They are also vulnerable to abduction if separated from their families.

The elderly - their age often means that they cannot move as fast as those who are younger to escape disaster scenarios.  They may have various conditions such as Alzheimer’s, dementia or osteoporosis for which they may require medication.  Those conditions will make them even more vulnerable overall and may make the recovery process harder for them.  Older people are also often viewed as being more expendable because of their age and the fact that they have “lived a good long life”.

Women – are more at risk of suffering from severe impacts during a disaster (they may have to look after the children and therefore struggle to take care of themselves).  They are also at increased risk of sexual and/or gender-based violence.

Transgender, homosexual and bisexual people – are at increased risk of discrimination and violent attacks.

People with disabilities or special needs – are at increased risk because they may not be able to help themselves as easily as others during a disaster.  However, it is imperative that they are treated the same way anyone else would be (i.e. no

Ethnic or cultural minorities – could be at risk of discrimination and/or violence, particularly during conflict or very culturally tense situations. 

Refugees and displaced persons – are extremely vulnerable to a number of problems including the spread of communicable diseases, violence (possibly conflict or ethnicity-related), discrimination, mental distress, malnutrition, diarrheal diseases, etc.  Displaced individuals and refugees may remain so for decades.

Humanitarian staff – are vulnerable to communicable diseases, physical and mental exhaustion (or burnout), psychological and physical trauma, violence and abduction.  It is the responsibility of aid agencies to adhere to best practices when it comes keeping staff members safe and healthy (of body and of mind).  This is particularly helpful if you want staff members to stay or come back to work for your organisation.  They should be monitored for various conditions, be offered counseling and appropriate rest periods and opportunities to grow professionally.  In turn, staff members are expected to follow the rules and regulation established by their organisation to ensure that they are providing assistance in an appropriate and safe manner.  This also helps protect the organisation’s reputation and their future ability to provide humanitarian aid.

It is beneficial to, whenever possible, incorporate strategies that will help with the long-term recovery in the relief stage.

Successfully and efficiently providing these services will depend strongly on good organization, preparation, communication and coordination within and between agencies.  It will also rely heavily on the logistics of getting the right resources and people to the right place at the right time safely (which is why logisticians are so highly valued).  The Red Cross Red Crescent has a great website for browsing the emergency relief items that they have available in their catalogue:

http://www.ifrc.org/en/what-we-do/logistics/procurement/catalogue-/

Post-disaster

Recovery is the least researched but longest part of disaster response.  There can easily be gaps that form in the provision of services during the transition from relief to recovery as external assistance begins to pull out of the area.  It is important for more permanent local service providers to try and fill these gaps as soon as possible.  It is generally a long and arduous process that receives a lot less funding than the initial relief phase, yet it is the most important in terms of getting populations to return to normal life and building resiliency in case of future disasters.

A final word...

This course, while at times overwhelming, has really opened my eyes to the various health impacts of disaster in addition to all of the factors that need to be considered when preparing for and managing a crisis.  In the end, I rated all of my course objectives 4-5 out of 5.  The only thing that I still feel uncomfortable with was the in-class disaster response assignment.  Many of my group members were confused about what we were expected to do, which clearly showed when it came time to present.  I thought that I had managed to figure out my section, but as the marks and feedback were given for the combined group effort, I am still unsure about whether or not I was in fact successful.  I feel all of the information that I have taken in will be of great use to me if I ever find myself working in a disaster scenario or in a disaster-related sector (i.e. emergency preparedness, relief or recovery).  However, I think until I actually am put in that situation, it is not possible for me to know how prepared I truly am.  My guess is that reality would be somewhat different to what we did in class or read about.

References:


The Sphere Project 2011, Humanitarian Charter and Minimum Standards in Humanitarian Response, 3rd edn, The Sphere Project, Geneva.

Eryn