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

2. 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.

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

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

11. Definition:

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

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

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

19. Sectoral leads:

21. Disaster response coordination:

22. What is our role as pediatricians?

23. Capacity building:

24. 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?

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

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

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

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

29. 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

30. 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

31. Thank you

32. 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