MODULE 17: DISASTER MANAGEMENT (4HOURS)

MODULE COMPONENTS
The student will acquire knowledge, skills and attitudes on disaster, mitigation, management
and apply it in provision of health care;
Learning objectives
By the end of the module the learner should be able to:
1. Define disaster
2. Describe the concept and elements of disaster management
3. Explain country’s national plan for disaster management
4. Discuss how to prepare the community for disaster management
5. Discuss concept of triaging in disaster management
6. Describe health care activities during disaster management
7. Discuss mitigation factors in disaster preparedness
Module content
Disaster and emergencies; definition of terms, types, phases, disaster management cycle,
management of accidents.

INTRODUCTION TO DISASTER MANAGEMENT.

Disaster cannot be predicted, when they happen they create emergency situation and impact
on the health care system through increased demand for essential services, such as the
provision of health care and destruction.
For this purpose, health care professionals should be prepared for, and participate in preparing
for, responding to, and recovering from the impacts of disasters.
DEFINITION OF TERMS
Disaster – this is a sudden or severe event that causes significant damage, destruction or loss of
life and disrupts the normal functioning of a community or society. Disasters can be natural
such as floods, earthquakes or droughts or man-made like industrial accidents, fires, or terrorist
attacks.
Crisis-this is a sudden, unexpected and often dangerous or unstable situation that requires
immediate attention and action .it can threaten the health, safety or well-being of individuals,
organizations or societies.
Hazard-this is a potential source of harm or danger that can cause injury, illness, damage to
property or disruption of services if not controlled or prevented
Emergency-is a sudden, urgent and often unexpected situation that requires immediate action
to prevent serious harm, injury or death.
Risk –is the chance or likelihood that a hazard will cause harm to people, property or the
environment.

Types of disaster and hazards

There are four main types of disasters:
1.Natural disasters
they are caused by natural forces
Examples
 Earthquakes
 Floods
 Hurricanes
2.Technological or man-made disasters
They result from human actions or failures in systems
Examples
 Industrial accidents
 Fires and explosions
 Chemical spills
 Cyberattacks
3.Biological disasters
It involves living organisms that cause illness or death
Example
 Epidemics and pandemics like (COVID 19, Ebola)
 Foodborne diseases
4.Social or humanitarian disasters
They are related to human behavior, conflict or social instability
Examples
 Wars and terrorism
 Refugee crises
 Civil unrest
 Gender based violence

THE CONCEPT AND ELEMENTS OF DISASTER MANAGEMENT

Disaster management refers to the organized and coordinated efforts to prepare for, respond
to, recover from and reduce the impact of disasters. It’s a goal is to protect lives, property and
the environment and to restore normalcy as quickly as possible.
It involves a continuous cycle of planning, action and improvement –before, during and after a
disaster.

The key phases of disaster management/the disaster management cycle

The disaster management cycle is a cyclical process. The end of one phase is the beginning of
the another. Timely decision making during each phase results in greater preparedness, better
warnings, reduced vulnerability and or the prevention of future disasters. A complete disaster
management cycle includes the shaping of public policies and plans that either addresses the
causes of disaster or mitigates their effects on people, property and infrastructure.
The four main phases in disaster management cycle are;
 Mitigation
 Preparedness
 Response
 Recovery
Mitigation – measures put in place to minimize the results from a disaster e.g. installing smoke
detectors, fire alarms and sprinkler systems to reduce risk of fire outbreaks.
Preparedness- planning how to respond e.g. preparedness plans, emergency exercises/training
and early warning systems
Response –initial actions taken as the event takes place. it involves efforts to minimize the
hazards created by a disaster e.g. evacuation, search and rescue and emergency relief.
Recovery –returning the community to normal. ideally, the affected area should be put in a
condition equal to or better than it was before the disaster took place e.g. temporary housing,
financial support and medical care.

Disaster management cycle

prepared
ness

disaster
mitigation response
impact

recovery

Objectives of disaster management

 To reduce damage and deaths
 To reduce personal suffering
 To speed recovery
 To protect victims
NATIONAL POLICY FRAMEWORK ON DISASTER MANAGEMENT
Disaster preparedness is an ongoing multi-sectoral activity.it requires coordination and
organization by different departments of the government to facilitate assessment of a country’s
disaster risk, adoption of standards and regulations and action to ensure that resources can be
mobilized rapidly in disaster situations.
The health objectives of disaster preparedness are to;
 Prevent morbidity and mortality
 Provide care for causalities
 Manage adverse climatic and environmental conditions
 Ensure restoration of normal health
 Re-establish health services
 Protect staff and
 Protect public health and medical assets

The preparedness includes policy development, vulnerability assessments, disaster planning,

training and education and monitoring and evaluation

Policy development
National government must designate a branch of the ministry or organization with the
responsibility to develop, organize and manage an emergency preparedness program for the
country. this group must work with the central government, county, provisional and community
organizations and NGOS whether local or international to develop a set of policies agreed upon
by all. The policies end point must allow quick decision making, ensure the actions are legal and
free from liability and ensure the actions are legal and free from liability and ensure that
appropriate pre-defined actions are taken during a state of emergency.
Vulnerability assessments
Potential hazards at all levels of society are identified and prioritized in a vulnerability
assessment. The community’s capacity can be determined by the availability of resources of the
community and how the community is able to utilize these resources.
Disaster planning
Planning is only one component of preparedness. A disaster outputs plan should provide;
 An understanding of organizational responsibilities in response and recovery
 A stronger emergency management networks
 Improve society awareness and participation
 Effective response and recovery strategies
 Be documented
Training and education
All important component of preparedness is to train and educate public health officials and
other stakeholders (responders)about the disaster plan. training all levels should ensure
adequate distribution of important skills and knowledge needed for an effective disaster
response.
Monitoring and evaluation
The objective in monitoring and evaluation is to measure how well the disaster preparedness
plan and program is being implemented and if it is achieving its health objectives.

National policy for disaster management in Kenya

The Kenya health policy commits to provide and ensure free access to trauma care, critical care,
emergency care and disaster care services and an adequate response to health effects of
disasters and emergencies and including putting in place appropriate financial mechanisms for
emergency health services. Risk reduction and emergency preparedness are the responsibility
of all sectors and stakeholders at all levels of society (country, county, community). At the
national level, the ministry of health is the lead agency of the health sector.
The national policy for disaster management in Kenya (2010) has four key objectives;
 To establish a policy /legal and institutional framework for management of disasters,
including promotion of a culture of disaster awareness and for building the capacity for
disaster risk reduction at all levels
 To ensure that institutions and activities for disaster risk management are coordinated,
focused to foster participatory partnerships between the government and other
stakeholders at all levels including international, regional, sub regional, national and sub
national bodies
 To promote linkages between disaster risk management and sustainable development
for reduction of vulnerability to hazards and disasters.
 To mobilize resources, including establishment of specific funds for disaster risk
reduction strategies and programs.
PREPARING THE COMMUNITY FOR DISASTER MANAGEMENT
Disaster preparedness in healthcare is not solely the responsibility of hospitals and medical
professionals. communities play a vital role in disaster management, particularly in the early
response and recovery phases. Educating and empowering communities enhances resilience,
reduces mortality and morbidity and supports health systems under strain during disasters.
Steps in preparing the community for disaster management
1.Community awareness and health education
Its main objective is to inform the community about potential health risks and appropriate
responses during various disasters. It includes
2.Public education campaigns using media (radio, social media, posters) to spread information
about disease prevention, hygiene and emergency contacts
3.Health talks and forums
School health programs to educate students on first aid, sanitation and disease prevention
during disasters.
Culturally appropriate messaging to tailor messages to locals to improve understanding and
compliance
e.g. using drama and local songs to teach about handwashing and safe water storage
4.community –based risk assessment and mapping
To help communities identify their specific health risks and vulnerabilities related to disasters.
it’s done by:
 participatory mapping: involve community members in mapping out hazards (flood
zones, clinics, water points)
 vulnerability analysis: assess populations at higher risk (elderly, pregnant women,
chronically ill)
 resource inventory: identify available local resources such as trained health volunteers,
first aid kits and safe building
5.training and capacity building
it’s to help equip community members with practical skills to support healthcare delivery during
emergencies
it’s done through;
 first aid training: teach basic wound care, CPR and handling trauma cases before
professionals arrives.
 Community health volunteer (CHV) training: train CHVs to provide basic care, identify
symptoms of common diseases and support surveillance
 Stimulation drills: conduct mock disaster response exercises (e.g. earthquake or
outbreak drills)
 Training in mental health first aid: prepare communities to support trauma –affected
individuals
6.Establishing community emergency health committees
Its objective it to create local leadership local leadership that coordinates community –based
disaster health preparedness
It comprises of health workers, CHVs, teachers, religious leaders, youth leaders and local
government representatives.
7.Communication and information systems
Its objective is to ensure timely and reliable flow of information before, during and after
disasters.
Strategies:
 Establish early warning systems: use SMSs alerts, sirens or community messengers
 Distribute contact information: share emergency contacts for nearby hospitals,
ambulance services and health authorities
 Use local media: leverage local radio and churches /mosques for rapid dissemination of
health messages
 Feedback mechanisms: create platforms (e.g. suggestion boxes, call lines) for the
community to report health concerns or outbreaks.
8.Stockpiling and resource mobilization
It’s to ensure that essential supplies and personnel are ready for use during emergencies
Integration with health facilities and local authorities
This is to foster collaboration between the community and formal health systems for a
coordinated response.
9.Strengthening public health measures
It is to prevent disease outbreaks and maintain hygiene during and after disasters
Key areas being;
 Water sanitation and hygiene
 Waste management
 Nutrition
 Immunization awareness
 Psychological and social preparedness
 To support mental well-being during and after disasters
10.Monitoring, evaluation and continuous improvement
To assess the effectiveness of community preparedness efforts and make necessary
improvements

CONCEPT OF TRIAGING IN DISASTER MANAGEMENT IN HEALTHCARE

Triage
It is the process of sorting and prioritizing patients based on the severity of their condition, the
urgency of treatment required and the availability of resources especially during a disaster or a
mass casualty incident.
In disaster management, triaging ensures that limited medical resources (like personnel,
equipment and time) are used to maximize the number of lives saved.
Objectives of triage in disaster management
 Save as many lives as possible
 Identify patients who need immediate care
 Avoid wasting resources on cases beyond recovery in emergency settings
 Provide fair and ethical patient prioritization]
Triage categories (Common in Mass Casualty Incidents)
These are often color-coded for quick identification:

Color Category Description

Red Immediate Life-threatening conditions
that require urgent
intervention (e.g., severe
bleeding, airway
obstruction). High survival
chances if treated promptly
Yellow Delayed Serious but not immediately
life-threatening. Can wait for
medical care (e.g., fractures,
moderate wounds).

Green Minor Walking wounded with minor

injuries. Do not require
urgent care (e.g., abrasions,
small cuts).

Black Deceased Dead or No signs of life or

injuries so severe that
survival is unlikely even with
care (e.g., massive head
trauma). Comfort care may
be provided.

Triage Systems Used

 START (Simple Triage and Rapid Treatment): Used for adult patients in the field.
 JumpStart: Pediatric version of START.
 SALT Triage: Sort, Assess, Lifesaving Interventions, Treatment/Transport—used in
complex scenarios.
 Hospital triage protocols: Customized systems for use inside hospitals or emergency
departments.
Triage in Healthcare Facilities During Disasters
 Initial Triage (at site or ER entrance): Quick assessment to assign triage category.
 Ongoing Triage: Continuous reassessment as patients’ conditions may change.
 Ethical Triage: In large-scale disasters, difficult decisions may be needed based on
survivability and available resources.

Role of Healthcare Workers in Triage

 Rapid assessment using ABCDE (Airway, Breathing, Circulation, Disability, Exposure).
 Clear documentation and tagging of patients.
 Communication with other responders and coordinating patient transport.
 Providing psychological support to patients and families.
HEALTH CARE ACTIVITIES DURING DISASTER MANAGEMENT
During a disaster, healthcare activities focus on minimizing harm and providing essential
medical care.
This includes activating disaster plans, triaging victims, offering emergency treatment,
coordinating evacuations and ensuring a smooth transfer of patients.
Specific roles may involve providing initial medical aid, administering medication and stabilizing
patients until further help arrives.

Key healthcare activities during disaster management

Activation of disaster plans;
Healthcare facilities and personnel must activate their disaster plans, which outline procedures
for managing a disaster response.
Triage;
Victims need to be quickly assessed and prioritized for treatment based on the severity of their
injuries
Emergency treatment;
Providing immediate medical care to injured individuals including wound care, medication and
basic life support.
Coordination of evacuations
Working with other agencies to ensure safe and efficient evacuation of patients and medical
personnel
Transfer of patients
Facilitating transfer of patients to other medical facilities, if needed, to ensure adequate care
and treatment.
Public health intervention
Implementing public health measures to prevent the spread of diseases and manage outbreaks
Mental health support
Providing counselling and support to affected individuals and communities to address mental
health needs
Resource management
Ensuring the availability of essential resources such as medications, medications, medical
supplies and personnel
Inter-agency coordination
Collaborating with other agencies and organizations to coordinate disaster response efforts.
Training and education
Providing training to healthcare professionals and educating the public on disaster
preparedness and response

MITIGATION FACTORS IN DISASTER PREPAREDNESS

Mitigation – measures put in place to minimize the results from a disaster e.g. installing smoke
detectors, fire alarms and sprinkler systems to reduce risk of fire outbreaks.
This includes both preventing disasters from happening in the first place and lessening the
impact of unavoidable ones. Mitigation factors can be structural like building codes and flood
control or non-structural like awareness campaigns and preparedness.
Structural mitigation
These involves physical constructions or engineering solutions to reduce disaster impact
Examples;
Flood control dams and levees
Control river flow and prevent flooding in low-lying areas
Earth quake resistant buildings
Use of reinforced concrete, flexible materials and shock absorbers
Storm drains and improved drainage systems
Prevent waterlogging and reduce flood risks in urban areas
Cyclone shelters
Strong buildings designed to protect people during hurricane or cyclones
Tsunami sea walls
Barriers along coastlines to absorb or deflect tsunami waves
Firebreaks and fire resistant construction
Gaps in vegetation to stop wildfire spread and use of non-flammable building materials
Emergency operation centers
Well equipped, structurally sound buildings for managing disaster response

Nonstructural mitigation
These includes policies, knowledge and planning rather than physical construction
Examples of non-structural mitigation
1. Public education and awareness campaigns
Teaching communities about disaster risks and safety measures
2. Early warning systems
Use of alerts via radio, sms, sirens or TV to warn people in advance
3. Land use planning and zoning laws
Preventing construction in flood plains, landslide zones or coastal areas
4. Disaster preparedness drills and simulations
Practicing evacuation, search and rescue and first aid
5. Development of emergency response plans
Creating clear plans for evacuation, communication and resource distribution
6. Training of emergency personnel
Ensuring first responders are equipped to handle different disasters
7. Legislation and policies
Laws and regulations that promote safety (e.g. fire safety codes, health regulations)
8. Insurance programs
Encouraging people to get disaster insurance to recover financially
 9. Monitoring and risk assessment
Ongoing observation of hazards and vulnerabilities (e.g. weather forecasting, disease
surveillance)
10. Community based disaster management(CBDM)
Engaging local communities in identifying risks and planning for mitigation

EXAMPLES OF MITIGATIONS IN THE MINISTRY OF HEALTH IN KENYA FOR DISASTER

PREPAREDNESS
Disaster surveillance and early warning systems
IDSR (integrated disease surveillance and response) which tracks outbreaks like cholera,
measles and malaria
DHIS 2which does real time data reporting for early detection of health emergencies
Health infrastructure strengthening
Construction and renovation of resilient health facilities especially in disaster prone areas (e.g
arid and semi-arid lands)
Prepositioning of medical supplies
Stockpiling essential medicines, vaccines and emergency kits at national and regional levels
Emergency preparedness plans and rapid response teams
Development of county level disaster response plans
Training and deployment of rapid response teams for outbreaks and natural disasters
Health worker training and simulation exercises
Regular capacity building on emergency care, infection control and disaster response
Community health strategy
Use of community health volunteers (CHVs) to educate the public and report early signs of
health threats
Public awareness campaigns
Health education on hygiene, disease prevention and climate related risks (e,g during El-Nino or
COVID 19 outbreaks).
Coordination with national and international partners
Collaboration with agencies like WHO, red cross, UNICEF and NDOC. Mitigation – measures put
in place to minimize the results from a disaster e.g. installing smoke detectors, fire alarms and
sprinkler systems to reduce risk of fire outbreaks.