Disaster is defined as sudden ecological phenomenon of sufficient magnitude to require external aids. It is also defined as an event or a series of events that are caused by natural factor or man-made factor, resulting in loss of human lives, environmental damage, loss of properties, and psychological problem. Consequently, human lives are harmed and disturbed.
Let's look at the conceptual framework of a disaster:
1) Hazard: Hazard is the cause of an event or a disaster. For example: the hazard of flood is the rain; the hazard of volcanic eruption is the volcano.
2) Risk: A factor which increases the probability of a hazard to become an event. For example: Deforestation will increase the probability of a flood to take place;
3) Event: It is caused by the hazard. For example: flood, volcano eruption.
4) Impact: When the event involves a population, but not yet a disaster. For example: There are 10 victims are injured in the volcanic eruption. However, the situation is handled well by the local authorities. So, there is no external aid requested.
5) Damage. For example: building collapse, loss of human lives.
7) Disaster: A situation where external aids are needed in order to recover the whole situation back to normal. For example: Reconstruction of all this needs a large number of resources, funds included, which cannot be accomplished by local people and government. They need help.
How do we manage a disaster?
1) Prevention: It is defined by Dr. Hendro Wartatmo as a step to eradicate the hazard. Hence, prevention can only be done for man-made disaster, but not natural disaster.
2) Mitigation: It is an effort to reduce the risk as well as the impact of an event and the vulnerability of objects or individuals. For example: build earthquake-proof houses.
3) Preparedness: It is a step to increase the capacity of objects/ individuals in order to be able to manage the the impact of an event and lessen the damage after an event happens. So, it embraces measures which enable governments, communities and individuals to respond rapidly to disaster situations to cope with them effectively. It includes:
a) Formulate emergency plans. For example, establish hospital incident command system. It provides hospital with tools needed to advance their emergency preparedness and response capability. It allows personnel from different agencies or departments to be integrated into a common structure that can effectively address issues and delegate responsibilities. Besides that, it provides needed logistical and administrative support to operational personnel.
b) Development of warning systems
c) The maintenance of inventories
d) The training of personnel. For example: train medical students for basic life support; train the personnel for psychological first aids: active listening, empathy, access the basic needs, don't force the victims to speak, avoid secondary stressors; train them to be able to identify people with depression, post-traumatic stress disorder or other psychological disorders.
4) Resilience: It consists of absorbing capacity, buffering capacity and response.
a) Absorbing capacity: According to Dr. Sulanto Saleh-danu R.,it can done to reduce the damage or prevent the event from causing damage. For example: build a dam to absorb the lava.
b) Buffering capacity: It is about how we cope with the impact and damage of the event. For example: We need logistic support in this step in order to support the organization and implementation of response, so that we can ensure the timeliness and efficiency. The logistic support can be: medicines, health supplies/kits, water and environmental health, food, logistic administration, shelter, electrical constructions, personal needs and education, human resources, agriculture, transportation and others.
How do we calculate the available resources?
c) Response. It is the activities done immediately after the event happens in order to handle and manage the negative impacts and damage. The activities includes:
- Rescue and evacuation of casualties. The medical response can be divided into prehospital and hospital. For prehospital stage, they need to do triage, resuscitation, stabilization. No definitive treatment is given. For hospital stage, they need to do the triage again (because the patient's condition may alter during the journey to hospital), resuscitation, stabilization and give definitive treatment.
- Fulfilment of basic needs.
- Protection, e.g. place the victims in a safe place.
- Management of refugee and dead bodies.
- Recovery of infrastructure and facilities.
5) Recovery, rehabilitation, reconstruction.
a) Recovery: It is the process, policies and procedures for recovery or continuation of technology and infrastructure critical to an organization after a disaster.
b) Rehabilitation: It is about the restoring and recovery of the public services and social functions, so that everything (the community's living and the administrative aspect) can be returned to the norm.
c) Reconstruction: Reconstruct the infrastructure, and institutions in order to restore and develop the economy, social and culture as well as the law and regulation in the region after the disaster.
In conclusion,
we as a doctor, can take part in preparedness, resilience and recovery. If a disaster happens and it is the 1st time in the country, there might be a lot of mistakes done and we might face a lot of shortages: e.g. hosp inable to provide enough medical supports or space to treat the victims, infections spread among the victims, etc. The important thing is WE HAVE TO LEARN FROM MISTAKEs, so that we will know what to do in the next time. That's how we will know what to do for the prevention, mitigation and preparedness.
we as a doctor, can take part in preparedness, resilience and recovery. If a disaster happens and it is the 1st time in the country, there might be a lot of mistakes done and we might face a lot of shortages: e.g. hosp inable to provide enough medical supports or space to treat the victims, infections spread among the victims, etc. The important thing is WE HAVE TO LEARN FROM MISTAKEs, so that we will know what to do in the next time. That's how we will know what to do for the prevention, mitigation and preparedness.
Reference:
1) Dr. Hendro Wartatmo. Lecture: Conceptual Framework of Disaster and Disaster Management.
2) Dr. Bambang Hastha Yoga. Lecture: Disaster Management in Mental Health.
3) Dr. Belladonna. Lecture: Preparedness, Response and Recovery.
4) Dr. Sulanto Saleh-danu R.. Lecture: Logistic (medical) and Disaster.
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