Presentation on theme: "DISASTER MANAGEMENT AND PUBLIC HEALTH EXPERIENCE IN THE AFTERMATH OF THE EARTHQUAKE AT BHUJ IN INDIA Dr HS Ratti,"— Presentation transcript:
1 DISASTER MANAGEMENT AND PUBLIC HEALTH EXPERIENCE IN THE AFTERMATH OF THE EARTHQUAKE AT BHUJ IN INDIA Dr HS Ratti, MDIndia
2 DATE LOCATION MAGNITUDE 1819 JUN 16 KUTCH,GUJARAT 8.0 1869 JAN 10 NEAR CACHAR, ASSAM1885 MAY 30 SOPOR, J&K1897 JUN 12 SHILLONGPLATEAU1905 APR 04 KANGRA, H.P1918 JUL 08 SRIMANGAL, ASSAM1930 JUL 02 DHUBRI, ASSAM1934JAN 15 BIHAR-NEPALBORDER1941 JUN 26 ANDAMAN ISLANDS1943 OCT 23 ASSAM1950 AUG 15 ARUNACHAL PR – CHINA BDR 8.51956 JUL 21 ANJAR, GUJARAT1967 DEC 10 KOYNA, MAHARASHTRA1975 JAN 19 KINNAUR, HP1988 AUG 06 MANIPUR-MYANMAR BORDER 6.61988 AUG 21 BIHAR-NEPAL BORDERSIGNIFICANT EARTHQUAKES IN INDIA AND ITS NEIGHBOURHOOD ( )
3 SIGNIFICANT EARTHQUAKES IN INDIA AND ITS NEIGHBOURHOOD (1801 - 2000) DATE LOCATION MAGNITUDE DEATH INJURED1991 OCT UTTARKASHI, UP HILLS1993 SEP LATUR1997 MAY JABALPUR,MP1999 MAR 29 CHAMOLI DIST, UP
4 ANTICIPATED PUBLIC HEALTH PROBLEMS IN DISASTERS 1Disruption of Water supply and Sanitation2Large scale migration3Overcrowding due to emergency housing situations with poor personal hygiene4Mass feeding without adequate food handling, storage and sanitary facilities5Disposal of Dead Bodies and Caracas6Rodent and Stray dog/animal problems7Relaxation of sterilization precautions and emergency use of unscreened blood8Psycho-social and Mental health problems
5 COMMUNICABLE DISEASES HAVING DISASTER IMPLICATIONS (HAVING POTENTIAL FOR OUTBREAK)AmoebiasisCamplyobacter EnteristisChicken PoxCholeraCoccidiomycosisDengue feverDiptheriaE. Coli DiarrhoeaFood PoisoningRotavirus EnteritisHepatitis A, B & EHanta Virus DiseaseInfluenzaeLeptospirosisMalariaMeaslesMeningitisPertusisPlaguePnuemococcal PneumoniasRabiesRelapsing FeverSalmonellosisScabiesTyphoid Fever
6 26 Jan 2001 at 0856 AM (IST), Bhuj in western India and its surrounding areas were struck with severe earthquake, measuring 7.9 on the Richter scale
12 Mortality and Morbidity Dead 19727Injured 1,66,000Homeless 6,00,000House Destruction total : 3,48,000House Destruction partial : 8,44,000Total cattle Killed : 20,000Direct Estimated Economic Loss :USD 1.3 bn
13 Large scale migration of inhabitants Large scale scale influx of relief workers & material
14 Relief Agencies at work International NGOs : 55National /Local NGOs : 26Government Bodies : 8Donor Governments :18Inter Governmental Organisations :8Red Cross and Red Cresent :6Total Organisations (2 weeks) :125
15 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
16 Public Health Measures Situation AssessmentPublic Health MeasuresWater Borne diseaseAir Borne infectionsVector borne diseasesBiomedical wastesDisease SurveillanceDead Bodies and Animal Caracas DisposalDisinfecting of Rescue Sites and TeamsMental Health
17 CLIMATIC CONDITIONS PREVAILING IN BHUJ IN FIRST WEEK OF FEB 2001MaxMinDay Time330 C220 CAvg Temp 210CNight Time190 C090 CRH7261RainfallNilGujarat State has experienced Drought Conditionssince 1998
18 Water Borne disease Threat potential Breakdown of distributed piped water supplies and water requirement being met from alternate sourcesDrinking 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
19 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 hoursIt is followed by super chlorinating at 2 ppm with liquid chlorine and/or bleaching powder with a contact period of minimum 20 minutesAll water bowsers/tankers leaving the water point were checked for free chlorine levels and due records were kept.
20 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
21 Air Borne disease Threat potential All pers and families living in tentage and makeshift arrangementsInadequate 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 outbreaksPotential of outbreak of Bubonic plague was kept in mind in view of earthquake disaster
22 Air Borne disease Intervention Health education campaign was undertaken to ensure that there was minimal over crowding in tentage accommodation. A minimum distance of 3 feet was advocatedTo adopt a head-foot alternate bed positionsAdequate ventilation of tentage and exposure to sun during daytime was adovacatedProvision of adequate warm clothingField and Hospital based Passive Disease surveillanceActive surveillance by random interviews was carried out in select areas of high density. Every day, a new area was visited. Health advice was given.
23 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 adultsOutbreak control measures included segregation and symptomatic treatment of the affected individualsAll cases recovered and no secondary outbreak of communicable diseases was reported in military and civil areas till 3 weeks after last case
24 Vector Borne disease Threat perception No piped distribution of water supply leading to places with water point collectionInadequate disposal of liquid and solid wastes leading to fly nuisanceInadequate disposal of Bio Medical waste
25 Vector Borne disease Intervention Spraying operations using 0.1 % NUVAN (Dicholorvos) solution in the areas where solid waste were disposedDaily 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 breedingSpray 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)
26 Bio Medical WasteLarge 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 workloadThe waste was segregated into open pits at a distance from the hospital and burnt in the beehive incinerator over a period of 7daysOther non biodegradable waste like plastics, IV Sets, were disposed by deep burial in open groundBiological medical waste generated in other areas including animal dead was strewn all around in Bhuj district and posed a potential public health problem
27 Disease SurveillanceActive 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
28 Each relief centre had a team of one Medical Officer and Two Nursing Assistant. Besides, additional Mobile Teams from each centre were sent out daily to cover different villages.No mass immunisation was recommended. However, UNICEF promoted mass vaccination against measles for all children 9 mths - 5 yrs was undertaken in the the Kutch areas by the state health authorities
29 Disinfection of Rescue Sites and Teams Personal Protective MeasuresGloves, Face Masks and Head ProtectionDisinfecting The Dead Bodies with 40% Formalisn and 10 % Creosol SolutionDeodourisation of the work are at the relief site
30 MENTAL HEALTH Acute Post Stress Disorder In need of Post Traumatic CounselingA much relieved lady rescued after 96 hours.
31 REHABLITAION & RECONSTRUCTION First steps towards future ?