Transcript 32981

Revelation of 5.12 Quake,
Sichuan, China
Part 4a Short-term response after the
quake
Supercourse China 超级课程·中国
http://www.SuperCourse.cn/
2008-6-6
Outline
Response of ordinary people
4.1.Personal sanitation problem
4.2.Post-disaster self psychological
adjustment
Short-time response of professional agencies
4.3.Secondary disasters control
4.4.Medical treatment and transport for the
wounded
4.5.Public health and infectious disease control
4.6.Victims settlement
4.7.Post-disaster psychological assistance
Response of ordinary people
4.1 Personal sanitation problem
4.2 Post-disaster self psychological
adjustment
4.1Personal sanitation problem
• Sanitation of drinking water
– Water is necessary in daily life and it will cause
epidemics if there are bacteria in the water
• It is important to remind the victims not to drink raw
water but the boiled water.
• Management of the external environment
– Poor sanitation condition of the external environment
 proliferation of mosquito outbreak of the
epidemic such as haemophilus influenzae type B
meningitis  So it is necessary to sanitize and carry
out disinsection
• And we should make a hard effort into the development
of national sanitation movement and the prevalence and
education of health knowledge
信息来源：中国政府网，卫生部
4.1Personal sanitation problem
• Deal with the epidemic situation as soon as possible
after discover of the cases
-The victims should be reminded to keep an eye on their
health condition and report to the medical staff when
feeling uncomfortable.
4.2 Post-disaster self
psychological adjustment
国家CDC
国家CDC
Short-time response of professional
agencies
4.3 Secondary disasters control
4.4 Medical treatment and transport for the
wounded
4.5 Public health and infectious disease
control
4.6 Victims settlement
4.7 Post-disaster psychological assistance
Public Health Priorities
According WHO:
1) Treating The Injured
2) Communicable Disease Surveillance & Control
3) Ensuring Safe Water And Food Supply
4) Immediate & Long-term Mental Health & Psychosocial Support
5) Reconstruction Of Health Care System In The Affected Areas
4.3 Secondary disasters control
• The Wenchuan earthquke probably cause other
secondary disasters
• such as the threaten resulting from dams ：
• The biggest earth and stone work-dam is moved 30cm
because of the earthquake
• About 400 injured dams are likely to endanger the
people living downstream
• And the formation of natural dams and lakes is also
another threaten.
The response of the Ministry of
Land and Resources after this
quake
• The response of the Ministry of Land and Resources
after this quake
• Starting the preplanned emergency response scheme for
super geological disaster, organizing geologists to the
disaster area, establishing the check of the most
important hidden troubles and guiding the evading and
prevention and treatment of geological disaster.
• Assembling 7 aircrafts to carry out the aviatic
photography, arranging 6 high resolution radar-remote
sensing satellites to get the remote sensing pictures of
the disaster area after the quake. These measurements
had offered 19,000 pieces of relief maps for disaster
relief and 22,000 special maps on analysis of disaster
situation and rescue situation till May 25th
Ministry of Land and Resources
The response of the Ministry of
Land and Resources after this
quake
• Paying a close attention to the weather condition and
forecasting the happening of geological disasters, ruling out the
hidden troubles in the area where the water conservancy
facilities, roads and railways, power supply circuit and the
communication facilities stand. And 386 places of great
threaten and 34 barrier lake were discovered.
• Offering the mapping ensurence for the reconstruction.
Establishing the emergence-response check, resuming the
mining work, programming the land for reconstruction and
revising the plans of prevention and treatment for earthquake
properly. And ensuring the land for reconstruction after
earthquake, starting the green channel for the approval of the
land, practising special land-supply policy and enhancing the
effort for reclaiming of the destroyed plowland.
Ministry of Land and Resources
Lake Formation & Flood Threat
• Creating natural dams by moved down
rocks into rivers
• Formation of 21 lakes throughout the basin
Dangers due to earthquake-created dams:
– Upstream floods
– Instability of the piles of rubble
– Bursting the dam by another quake
– Downstream floods by cascade of water
– Evacuation of thousands of people from
Beichuan
4.4 Medical treatment and transport
for the wounded
The arrangement of transportation
of the injured after this earthquake
• 10015 injures had been
transported to 20 provinces
(district or city) by May 31st,
contributed with:
-21 appropriative trains
-99 charter flights
-10,000 over ambulances
-5000 over medical staff
-20 provinces
-And more than 340 levelthree hospitals.
Ministry of Health
Indian Examples: BHUJ Eathquake
• Large scale migration
of inhabitants
• Large scale scale
influx of relief
workers & material
Relief Agencies at work
•
•
•
•
•
•
•
International NGOs
: 55
National /Local NGOs
: 26
Government Bodies
:8
Donor Governments
:18
Inter Governmental Organisations :8
Red Cross and Red Cresent
:6
Total Organisations (2 weeks)
:125
• Immediate 48-72 hrs
Relief and Rescue
provided by Indian
Army Teams and the
Indian Army Hospital
• 12000 surgical
operations
performed in
makeshift Military
Hospital within first
60 hrs of the Disaster
4.5 Public health and infectious
disease control
ANTICIPATED PUBLIC HEALTH
PROBLEMS IN DISASTERS
1 Disruption of Water supply and Sanitation
2 Large scale migration
3 Overcrowding due to emergency housing situations with
poor personal hygiene
4 Mass feeding without adequate food handling, storage
and sanitary facilities
5 Disposal of Dead Bodies and Caracas
6 Rodent and Stray dog/animal problems
7 Relaxation of sterilization precautions and emergency
use of unscreened blood
8 Psycho-social and Mental health problems
COMMUNICABLE DISEASES HAVING DISASTER
IMPLICATIONS (HAVING POTENTIAL FOR OUTBREAK)
1.Amoebiasis
2.Camplyobacter Enteristis
3.Chicken Pox
4.Cholera
5.Coccidiomycosis
6. Dengue fever
14. Leptospirosis
15. Malaria
16. Measles
17. Meningitis
18. Pertusis
7.Diptheria
19. Plague
8.E. Coli Diarrhoea
20. Pnuemococcal Pneumonias
9.Food Poisoning
21. Rabies
10.Rotavirus Enteritis
22. Relapsing Fever
11.Hepatitis A, B & E
23. Salmonellosis
12.Hanta Virus Disease
24. Scabies
13.Influenzae
25. Typhoid Fever
Public Health Measures
• Situation Assessment
• Public Health Measures
– Water Borne disease
– Air Borne infections
– Vector borne diseases
– Biomedical wastes
– Disease Surveillance
– Dead Bodies and Animal Caracas Disposal
– Disinfecting of Rescue Sites and Teams
– Mental Health
Public Health Measures
• Situation Assessment
• Public Health Measures
– Water Borne disease
– Air Borne infections
– Vector borne diseases
– Biomedical wastes
– Disease Surveillance
– Dead Bodies and Animal Caracas Disposal
– Disinfecting of Rescue Sites and Teams
– Mental Health
CLIMATIC CONDITIONS PREVAILING IN BHUJ
IN FIRST WEEK OF FEB 2001
Day Time
Night Time
RH
Rainfall
Max
330 C
190 C
72
Nil
Min
220 C
090 C
61
Avg Temp 210C
Gujarat State has
experienced Drought
Conditions
since 1998
Water Borne disease
• Threat potential
– Breakdown of distributed piped water
supplies and water requirement being met
from alternate sources
– Drinking water available only from 4 to 5
deep bore wells scattered over the whole
town and nearby villages in the Public
Health Engineering Department.
– Drinking water is highly salty and at places
turbid (due to earthquake).
– The water is collected by water truck/water
bowsers/tankers and distributed manually
Water Borne disease
• Intervention
– The bore well water is collected in sump.
– Flocculation and sedimentation in the sump was
carried using Alum for a period of atleast 4 hours
– It is followed by super chlorinating at 2 ppm with
liquid chlorine and/or bleaching powder with a
contact period of minimum 20 minutes
– All water bowsers/tankers leaving the water point
were checked for free chlorine levels and due
records were kept.
Water Borne disease
• Outcome
– 70 to 75 percent of population was getting
chlorinated water supply.
– A 8000 litre desalination plant received as gift
from USAID was installed for exclusive issue of
drinking water.
–There were no cases of Gastro Intestinal
diseases among population in 3 week post
disaster period.
–A close monitoring has been instituted
combined with disease surveillance
Air Borne disease
• Threat potential
– All pers and families living in tentage and
makeshift arrangements
– Inadequate supplies of tentage resulting in
overcrowding by a factor of 80 to 100 percent.
– Sharp and high difference in max and min temp
(max daytime temp of 34 to 36 degrees centrigade
while min night temp was 8 degrees centigrade)
– Season ideal for Chicken pox, measles and
meningitis outbreaks
– Potential of outbreak of Bubonic plague was kept
in mind in view of earthquake disaster
• Intervention
Air Borne disease
– Health education campaign was undertaken to
ensure that there was minimal over crowding in
tentage accommodation. A minimum distance of 3
feet was advocated
– To adopt a head-foot alternate bed positions
– Adequate ventilation of tentage and exposure to
sun during daytime was adovacated
– Provision of adequate warm clothing
– Field and Hospital based Passive Disease
surveillance
– Active surveillance by random interviews was
carried out in select areas of high density. Every
day, a new area was visited. Health advice was
given.
Air Borne disease
• Outcome
– There were 4 cases (all adult males) of chicken
pox reported between 7 to 8 Feb in military areas
and 31 cases among civil population in
samkhayali village near Bachao. Of these, 28
were children under 12 years of age and 3 adults
– Outbreak control measures included
segregation and symptomatic treatment of the
affected individuals
– All cases recovered and no secondary outbreak
of communicable diseases was reported in
military and civil areas till 3 weeks after last case
Vector Borne disease
• Threat perception
– No piped distribution of water supply
leading to places with water point
collection
– Inadequate disposal of liquid and solid
wastes leading to fly nuisance
– Inadequate disposal of Bio Medical
waste
Vector Borne disease
Intervention
– Spraying operations using 0.1 % NUVAN (Dicholorvos)
solution in the areas where solid waste were disposed
– Daily sprinkle of Lime Slaked powder over and around
the Deep Trench/Shallow Trench latrines used for
excreta disposal in temperory shelters put up for living
– ‘Smoking’ of the Deep trench latrines to prevent and
fly breeding
– Spray water collection pockets with anti larval
measures - Baytex 1000 Conc and/or Baytex granules
or Abate (Temephos 0.5%)
– Space spraying of tentage accommodation with
Baygon and /or Malathion 50 % EC (in 0.5 % solution)
Bio Medical Waste
• Large quantity of Biomedical waste was generated in
the areas in military hospital and other places in whole
of district of Bhuj following disaster.
• No incineration facilities are available except in the
military hospital where rudimentary and sufficient
facilities are available only for routine workload
• The waste was segregated into open pits at a distance
from the hospital and burnt in the beehive incinerator
over a period of 7days
• Other non biodegradable waste like plastics, IV Sets,
were disposed by deep burial in open ground
• Biological medical waste generated in other areas
including animal dead was strewn all around in Bhuj
district and posed a potential public health problem
Disease Surveillance
• Active Disease
surveillance in 10 relief
centres were
established in and
around Talukas of Bhuj
district - Khavda, Anjar,
Baccaho (2 centers),
Samkhyali, Ratanpol,
Modvadar, Dhori,
Dharan and Mandvi.
• Passive Disease
surveillance launched
in consultation with
WHO Teams and the
State Health authorities