Managing Health Related Problems in Disasters Effectively: Use of ICT from Pre to Post Disasters

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Managing Health Related Problems in Disasters
Effectively Use of ICT from Pre to Post
Disasters

• Presentation for IVth International Conference on
  Transforming Health Care with IT
• Dr. Sunita Reddy
• Asst. Prof.
• Center of Social Medicine and Community Health,
• Jawaharlal Nehru University
• New Delhi
• sunitareddyjnu_at_gmail.com

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Risk Society

• Anthony Giddens and Ulrich Beck have termed "Risk
  society", a society that is organized in response
  to risk, a society increasingly preoccupied with
  the future (and also with safety), which
  generates the notion of risk" (Giddens 1999 3)
• With modernization comes a manufactured risk,
  with a significant level of human
  agency operating in the production and mitigation
  of it (Beck 1992 21).
• Its a Global World with Global Threats-
  Disasters natural man-made- Biological,
  Chemical, Nuclear

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Have We learnt from Past Lessons? Bhopal Accident

• Methyl Isocyanides (MIC leak in 1984 in Bhopal)
• Deaths- around 16,000
• Severely injured 5,58,000
• Still birth rate gone up by 300 and Neonatal
  mortality by 200.
• Shortage of hospitals and doctors.
• Medical staff were unprepared for thousands of
  casualties and were not even aware of treatment
  methods of MIC inhalation.
• Disposal of dead- concern- dumbed in Narmada
  along with mass burial.

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Building ICT Services

• Building critical ICT services, having a
  pre-planned response to any major disruption by
  invoking a Disaster Recovery Plan (DRP), and
  defining the procedures to recover fully is the
  need of the hour.
• Prepare ICT based Disaster Reduction Planning in
  Health Care System.
• Following figure gives a framework to plan ICT in
  heath care system at a community level.

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Risk/Impact Assessment Pre-planned list of
critical systems to be recovered Recovery
Strategy DR contractor to assist the ICT
Department with recovery of affected systemsDR
Plans ICT Security Specialist co-ordinates the
implementation of the DR PlansEducate
Structured Test Programme to train ICT Systems
staff in recovery proceduresTest Plans Planned
testing of nominated systems by ICT Systems
staffUpdate Plans Regular review of the DR
Plan and training new staff 
Risk/Impact Assessment
Recovery strategy
Prepare DR plans
Update plans
Educate
Test Plans
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CBRN Disasters

• History is witness to all kinds of Chemical,
  Biological, Radiological or Nuclear Disasters
  across the world.
• Today we are able to take precautions and
  contained the disaster due to ICT- example in
  JAPAN, India etc. unlike in history.
• In contrast to chemical, conventional, and
  nuclear weapons that generate immediate effects,
  biological agents are generally associated with a
  delay in the onset of illness (hours to days).

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Biological Weapons

• Moreover, illness from biological weapons are not
  likely to be recognized in their initial stages.
  With highly transmissible agents (eg. Plague and
  smallpox), the time delay in recognition can
  result in widespread secondary exposure to
  others, including doctors and health staff.
• IT can enable to keep surveillance on any change
  in disease pattern- immediate or slow.

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Disasters and Destruction of Health Services

• Large-scale disasters also affect the public
  health personnel, in terms of lives lost- takes
  some time to restore to normalcy.
• The destruction of health care centres and the
  equipment contained within is only a part of the
  problem because some of the members of the health
  care team may also lose their life during the
  disasters.

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PH implications

• Disasters have severe impact on Public Health
• In Tsunamis, Floods etc. mosquitoes thrive due to
  large scale stagnation, leading to the spread of
  mosquito-borne diseases, respiratory problems,
  skin problems, like rashes, allergies and
  psychological problems such as anxiety,
  depression and post traumatic stress adds to the
  complexities post-disaster.
• Ex. From Clash of Waves

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Clash of Waves
Post Tsunami Relief Rehabilitation in Andaman
And Nicobar Islands
Dr. Sunita Reddy
Clash of Waves Post-Tsunami Rehabilitation in
Andaman and Nicobar Islands is located in
anthropological discipline, based on longitudinal
research covering five years of post tsunami
rehabilitation. Often media and government focus
on the disaster event, the emergency and relief
period activities, but long-term rehabilitation
are given a short shrift. What happens to
peoples lives, livelihoods and shelters
devastated in disaster, is not known and not
documented. This book traces and documents
experience of the effected people and the gaps
emerging out of this long and arduous attempt to
rehabilitate them. Most important being
livelihoods and the most contentious issue is
shelters. Above all, the top down rehabilitation
packages on the Nicobarese have changed their
culture forever  
Book Released on 24 Dec 2012, NDMA
Published by INDOS BOOKS F-4, Shaheen
Bagh,Okhla,New Delhi-25. Email-indosbooks_at_gmail.
com and anthroposif_at_gmail.com, Cont No.
91-9810521404
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Public Health Implications

• Public health implications of large-scale
  disasters are felt for months and years to come.
  Each disaster leads to immense public health
  problems, which varies from disaster to disaster.
  
• Providing health care pre and post disaster is
  important. Preparedness to any disaster can be
  improved with prior planning.
• ICT can be of immense value to plan, prepare and
  mitigate in disaster scenarios

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Disaster Epidemiology

• The primary concern of the disaster epidemiology
  is to improve decisionmaking, by emergency
  response personnel and reduce the adverse public
  health consequences of disasters.
• IT can be of immense help to scientifically
  measure health effects of disasters, in order to
  assess the needs of the disaster affected
  populations, to match resources and needs
  efficiently, to prevent further adverse health
  effects, to evaluate programme effectiveness and
  to plan for contingencies (Noji 1992).

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Pre and Post incident care check list using IT

• Pre- Disasters- IT based Data base base line
  survey of the disease profile, health services,
  availability of beds and specialists known to the
  DDMA and SDMA
• prepared check list for Self Assessment by
  responders / Supervisors
• After action review of successes and failures.
• Community post incident response checklist.
• Media Public Relations and Documentation /
  Reporting using ICT.
• IT surveillance for Unusual swarm or insects and
  Unexplained casualties.
• ICT for identification and Disposal of Dead
  facilitated through technology

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Community Involvement - IT

• Using Web, media, mobiles the community can be
  involved in pre- during and post disasters.
• Children fond of interesting video games- design
  games which teach a lesson/ build skills for
  disaster response and mitigation.
• IT based disaster management courses in schools
  be made compulsory.
• Interactive IT programs, where people can report
  any unusual cases of diseases to the hospitals .

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Information to the Community

• Giving credible and need based information
  relating to hazardous biological / chemical
  elements.
• A regular system of information for accessing and
  recruiting a suitable nodal person called
  community information representative (CIR) to
  disseminate the information and create awareness
  in the community.
• Communication material in simple, local language,
  pictorial audio-videos.
• Various representatives of the communities can
  play an important role in training and awareness
  programmes (NDMA guidelines, 2007).

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References

• Davis Lee. 2002. Man- Made Catastrophes.
  Checkmark Books. New York.
• BBC. "Bhopal Could it happen again?". 16 Dec
  2008. http//news.bbc.co.uk/2/hi/programmes/bhopal
  /4034829.stm. Retrieved on 7 January 2009.
• http//en.wikipedia.org/wiki/ 
• Giddens Anthony  (1999) Risk and
  Responsibility Modern Law Review 62(1) 1-10.
• Beck Ulrich (1992) Risk Society Towards a New
  Modernity. New Delhi Sage. (Translated from the
  German Risikogesellschaft published in 1986
• NDMA (National Disaster Management Authority)
  (2007) National Disaster Management Guidelines
  Chemical Disasters (Industrial). Govt. of India.
• Ronan R. Kevin and David M. Johnston (2005)
  Promoting Community Resilience in Disasters The
  role schools, youth, and families. Springer.

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Thank You