DISASTER MANAGEMENT - the A, B, C’s Dr Isaac Kihurani

Scenario: Hurricane and flood in a coastal country A hurricane with excessive rainfall five times the normal volume caused considerable flooding in rural and urban coastal plains. More than 70,000 people living in the regional capital have been severely affected by the floods, along with an additional 100,000 people living in rural areas as estimated by flights over the region. The government has declared this region a disaster area.

Challenges seen: Logistics Coordination with local authorities Language barriers Cholera and trauma related injuries

Objectives: Definitions Kenya Government structure in disaster management The Pediatrician in disaster management Challenges

Definition:

Kenya’s disaster profile: Droughts Fires Floods Diseases and epidemics

National Disaster Management Unit: Established by Presidential decree in August 2013 Established command structure Own budget Standard operating procedure

Concept of operations: Upon activation: - Joint Operation Centre (JOC) - NMDU headquarters or other designated site NMDU mandated to manage disasters in Kenya

Sectoral leads:

Disaster response coordination:

What is our role as pediatricians?

Capacity building:

A – Data collection and use Demographics Pre-disaster health conditions Immunization rates Where are the most vulnerable children living? Are there vector-borne illnesses? What are the most prevalent diseases? What is the baseline malnutrition rate?

Needs assessment Emergency needs assessment Water Nutrition (food sources, storage, distribution, acceptability) Shelter Sanitation Environmental conditions Health needs

Health care system evaluation (buildings, equipment, human resources Surveillance system Community resources (security, communication, transport)

B – Intervention priorities Establish emergency intervention priorities Know how the modes of disease transmission affect intervention priorities

Analyze Act Gather Data C- Surveillance cycle Analyze Act Gather Data

Current challenges: Lack of public resources Lack of an emergency medical care policy by Division of Emergency/Disaster response at MOH No pre-hospital training Nearly all pre-hospital resources are in the private sector Behooves us to work with what we have

Summary: Disaster management in Kenya remains a major challenge Kenya Government efforts need to be supported – policy, resources Pediatricians need to get engaged – training, preparedness Prehospital management remains a concern

Thank you

Acknowledgements: Dr. Ra’ana Hussein – Aga Khan University Hospital, Nairobi Dr. Benjamin Wachira - Aga Khan University Hospital, Nairobi Kenya National Disaster Management Unit Website Dr. Dan Alaro – Kenya Pediatric Association