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WHO/EHA

EMERGENCY HEALTH TRAINING PROGRAMME FOR AFRICA

1. Overview

1.8. Flow Charts for Emergency

Management

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1.8. Flow Charts for Emergency Management

Overhead Transparencies

1.8.1. Disasters and Health, General Flow Chart

1.8.2. Earthquake and Disaster Response, Flow Chart

1.8.3. Drought and Health Response, Flow Chart

1.8.4. Floods and Health, Flow Chart

1.8.5. Landslide and Health, Flow Chart

1.8.6. Volcanic Eruption and Health Response, Flow Chart

1.8.7. Epidemic Emergencies, Flow Chart

1.8.8. Fires and Health, Flow Chart

1.8.9. Food and Emergencies, Flow Chart

1.8.10. Violence and Public Health, Flow Chart

1.8.11. Displacement and Health, Flow Chart

1.8.12. Refugee and Internally Displaced Populations, Flows, Occasions and Priorities for

Assistance

1.8.13. Essentials for Contingency and Preparedness Planning for the Health Sector, Summary

1.8.14., 1.8.15. Essentials for Contingency and Preparedness Planning for the Health Sector,

Hand out

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1.8. Flow Charts for Emergency Management

Trainers' Guide

Objectives:

To show that Epidemiology is relevant to emergency management; to clarify causal chain in

disasters; to highlight elements of health preparedness and response. (Knowledge/Attitudes)

Key-message:

One can plan for emergency management, on the basis of good sense.

1.8.1. Disasters and Health, General Flow Chart

Introduce. This is a frame, which can be filled for any disaster. The result is a plan for

health response activities. Each emergency has specific implications for the health sector,

direct and indirect. Direct impact of floods is drowning and trauma. Indirect impact can

be a diarrhoea outbreak due to pollution of water sources. Associated factors will be the

displacement of population and the destruction of infrastructures that will hamper the

delivery of health care. Health Response must consider all these different issues.

1.8.2. Earthquake and Disaster Response, Flow Chart (Present and discuss).

1.8.3. Drought and Health Response, Flow Chart (Present and discuss).

1.8.4. Floods and Health, Flow Chart (Present and discuss).

1.8.5. Landslide and Health, Flow Chart (Present and discuss).

1.8.6. Volcanic Eruption and Health Response, Flow Chart (Present and discuss).

1.8.7. Epidemic Emergencies, Flow Chart (Present and discuss).

1.8.8. Fires and Health, Flow Chart (Present and discuss).

1.8.9. Food and Emergencies, Flow Chart (Present and discuss).1.8.10. Violence and Public Health, Flow Chart (Present and discuss).

1.8.11. Displacement and Health, Flow Chart (Present and discuss).


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that the first responsibility of the Health Sector is to address the Primary Causes of Death

or Illness. The capacities needed can be Technical, i.e. human resources and training,and Institutional, i.e. equipment, supplies, legislation, clear procedures, etc.

1.8.14., 1.8.15. Essentials for Contingency and Preparedness Planning for the Health Sector,

Hand-out

A two- page table, to be distributed as handout.

Complementary to The health sectorin Emergency Management (1.3.).

Essential Reading:

EPR Handbook for Africa, WHO/PTC, 1992 African Disaster Handbook, WHO/PTC, 1990 The Public Health Consequences of Disasters, E. K. Noji, Oxford University Press, 1997

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WHO/EHA/EHTP Draft 1-1999

1.8.1. Disasters and Health, General Flow ChartDisasters and Health

HEALTH

RESPONSE

DIRECT

IMPACT

INDIRECT

IMPACT

VULNERA-

BILITY

ASSOCIATED FACTORSHAZARD

DISASTER

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1.8.2. Earthquake and Disaster Response, Flow Chart

SPECIAL BUDGET

HEALTH

RESPONSE

Search and Rescue

Triage

First Aid

Medical evaluation

Special Delivery

Intensive Care

Personnel: professionals

and volunteers

education, training and

drills Supplies and

equipment

Hospital preparedness

plans and drills

Hospital vulnerability

assessment

Protection and

contingency plans

Back-up systems:

- Decentralized stand-by capacities- Generators, etc.Electrocution

LOSS OF HEALTH

FACILITIES AND SERVICES

LOSS OF OTHER

LIFELINES

Acute respiratory

distress

Acute and chronic

intoxications

Burns

Drowning

TRAUMA

Hypothermi

Asphyxia

Entrapment

Transport

incidents

Floods

Fire

Toxic

spills

Dust

Damage toelectric lines

Landslides

Collapse

ofstructures

Earth

Quake

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1.8.3. Drought and Health Response, Flow Chart

Drought and Health Response

HEALTH

RESPONSE

Epid. SurveillanceControl Guidelines

Training & supplies

Staff

Nut. Surveillance

Guidelines for

supplementation &

Rehabilitation Training& supplies staff

Programme

strengthening EPI,

MCH, ED, H.

Information referral

Special plans, policies& procedure

Special budget

Diarrhoea

cholera

Typhoid Fever

Skin diseases

Eye diseases, etc

Malnutrition

Avitaminoses

WaterShortage

Drought

Crop

Failure

Loss of

Livestock

ReducedFood Intake

Loss of

buying

power

Migration

Less time

and less

access toHealth

Other

Ilness

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1.8.4. Floods and Health, Flow Chart

Floods and HealthCAPACITY

FOR

HEALTH

RESPONSE

Drowning

Traumas

MalariaBreeding of

vectors

Diarrhoea

Loss ofproduction and

stocks

Malnutrition

Destruction of

infrastructureLoss of

access toPHC

Other

illness

Breeding of

vectors

Displacement

Damage to

communications &Health Facilities

Loss of

shelter

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1.8.5. Landslide and Health, Flow ChartLandslide and Health

Land-

slide

HEALTH

RESPONSE

1. Search and Rescue FirstAid Medical Evacuation

Hospital emergency

care Training Personneland Materials

2. Surveillance Guidelinesfor treatment and

control Training

Personnel and Materials

3. StrengtheningProgrammes: EPI,

MCH, HIE, vector

control Rehabilitation

of infrastructures

4. Special Strategies, Plansand Procedures

Suffocation

A.R.ILoss of shelterand production

Changes in

environment

Displacement &

temporary Shelter

Pollution of

Water

Trauma

Special Budget

Diarrhoea

Other Illness

Breeding of

Vectors

Damage to

InfrastructuresLoss of Access

to Health

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1.8.6. Volcanic Eruption and Health Response, Flow Chart

Volcanic Eruption and Health Response

SPECIAL BUDGET

HEALTH

RESPONSE

Search andRescue

TriageFirst Aid

SpecialIntensive

CarePersonnel:

Supplies,

equipment

Hospitalpreparedness

plans

Risk MappingVulnerability

Assessment

Education andInformation

Early WarningEvacuation

and Temporary Shelter

Pyroclastic Flows

Volcanic

Eruption

Destruction of

Infrastructures

Peoples panic

Traumas Burns Acute respiratory

distress

Asphyxiation Intoxication Suffocation Drowning

Mud streams

Lava flows

Ashes

Gases

Steam

Earthquake

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1.8.7. Epidemic Emergencies, Flow Chart

Epidemic Emergencies

SPECIAL BUDGET

HEALTH

RESPONSE Search and Rescue

Triage First Aid

Medical evaluation Special Delivery

Intensive Care

Personnel:professionals and

voluntoors education,

training and drills

Supplies and

equipment

Hospitalpreparedness plans

and drills

Hospitalvulnerability

assessment

Protection andcontingency plans

Back-up systems: Decentralized stand-

by capacities

Generators, ect.Difficult Access

Agent Unknown

Specific

Illness &

Death

Risk for HealthWorkers

In the

Community

In Health

Facilities

Spread of

Infection

Outbreak

ofInfectious

Disease

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1.8.8. Fires and Health, Flow Chart

Fires and Health Capacity forHealth

Response

Panic

Damage to

Communications &

Health Facilities

Burns

Asphyxiation

Acute and

Chronic

Poisoning

Explosion

Fire

Collapse of

structures

Trauma

Smoke

Toxic spills

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1.8.9. Food and Emergencies, Flow ChartFood and Emergencies

Households

vulnerability

Drought

Pests

Floods

Other natural

hazard

War

Political crisis

Economic crisis

Other man-

made hazard

Failure of

Production

Failure of

Distribution

Loss of

Access to

Food

Emergency

Communitys

vulnerability

Environmental

pollution

Other man-

made hazard

Large-scale Food

Contamination

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1.8.10.Violence and Public Health, Flow ChartViolence and Public Health: scenarioin complex emergencies and conflicts

Attacks on

Health facilities

Military

operations

Breakdown of

logistics and

communications

Loss ofaccess to

safe water

Destruction of

infrastructures

Occurrence IMPACT UPON HEALTH Associated Factors

Economic

Violent

Mortality &

Mortality

A.R.I

Diarrheas

Parasites

Measles

Malnutrition &

deficiencies

Displacement CampsWAR

Global

Mortality

Loss of

production

& stocks

Loss of

purchasing

power

Destruction

of

Migration

Capacity

of

Response

of theNational

Health

Services

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1.8.11.Displacement and Health, Flow ChartDisplacement and Health

Economic

Crisis

Demographic

Pressures

Environmental

Crisis

Political

Crisis

Natural

Disaster

Man-made

Disaster

Internally

Displaced

People

Refugees

New Hazards and

greater vulnerability

Loss of assets &

entitlementsOvercrowding

Poor access to water

Poor shelter & sanitation

Poor food security

Loss of social networks

New environment

New hazards lack of

information

Overload on the

resources and services

of the host area

Greater

Risk of

Illness

and

Death

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Assistance

Disaster

Destruction of

infrastructures

Flight of the

Population

MassiveIndividual/by

household

Fugitives

return to

the area

of origin

Fugitives

gather

sponta-

neously

Rescue team

gather and

organize the

fugitives

Fugitives move

into another,

existing

village

Reception by

village structuresTransit/

reception

centre

Spontaneous

settlement

Accommodation

centre

BRINK IN:

Security

Buckets/chlorineFood/potsShelter/blanketsSanitation/soapTriage/ medievalEpid. SurveillanceMeasles imm.

ENSURE:

SecurityWaterFoodShelterSanitationPHC

Improve at

medium termor evacuate Integration

in the host

community

ENSURE:

Cooked foodShelter /blanketsBuckets/ soapsanitationscreening/

referral

epid. surveillanceEssential drugsEPIInformation on

existin services

STRENGTHEN:

WaterFoodShelterSanitation

PHC

PRE-POSITION:

SecurityWater/buckets/soapFood/pots/fuelShelter/blanketsSanit./vector controlScreening/referralEpid. Surveillanceessential drugsEPI.

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1.8.13.Essentials for Contingency and Preparedness Planning for the Health Sector, SummaryEssentials for Contingency Planning and Preparedness

Planning for the Health SectorType of

Emergency

Primary

Hazard

Primary Causes of Death

& Illness

Main Responsibility of the

Health Sector

Risk to

Health

Capacities Needed

Network Technical Support

Epidemics of

Infectious Origin

Known disease Agent-specific Alert & Assessment,

Case management,

Outbreak control

+ Epidemiology & Disease control,

Medical/Nursing care,

Environmental health,

Communications, Laboratory facilities &

supplies, Inter-sectoral collaboration,

Funds

Emergencies byOther Natural

Causes

Floods Drowning, Trauma,Diarrhoea, ARI, Vector-

borne diseases

Search & Rescue, Triage,Need assessment,

Disease control,Assistance in temporary shelter

+ Mass casualty management,Environmental health & Vector

control,Health care in temporary shelter

Special training for staff & volunteers,Inter-sectoral collaboration, Coordination

of relief

Emergencies fromTechnological

Causes

TransportIncident

( Road,

railways, air,sea etc.)

Trauma, Drowning, Burns,Suffocation

Search & Rescue,Triage,

Casualty Management

+ Mass casualty management Intensive care facilities

Complex

Emergencies

Armed Conflict Trauma, Malnutrition, ARI,

Diarrhoea, Measles,Meningitis, Vector-borne

Diseases

Need assessment & advocacy,

Disease control,Nut. surveillance & Selective

feeding,Injury management

+++ Epidemiology & Disease control,

Nutrition,War surgery,

Health care in temporary shelters

Special agreements & procedures,

War surgery facilities/capacities,Safe transfusion facilities,

Coordination, International aid

Major Public

Functions

Pilgrimage Epidemic diseases, Illness

among spectators, Crowdincidents (stampede etc.)

Disease control,

Readiness for crowd incidents,Back-up for increased demand

- Epidemiology & Disease control,

Environmental health,Mass casualty management

Intensive care facilities,

Temporary outreach facilities

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