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Conflict And Catastrophe Medicine > Epidemiology Of Disasters > Flashcards

Epidemiology Of Disasters Flashcards

1
Q

Define “Epidemiology”

A
  • The study of how OFTEN diseases occur in different groups of people and why
  • Epidemiological information is used to plan and evaluate strategies to prevent illness and as a guide to the management of patients in whom disease has already developed.
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2
Q

Describe what a disaster is

A
  • Overall a small contributor to the global burden of injury
  • Receives a lot of media attention
  • Artificial distinction between “natural” and “man made”
  • Suggests where and how people live
  • Vulnerability of affected community
  • Poverty
  • Main threat to health is the mass movement of people, not orthopaedic injury
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3
Q

Describe Disaster Epidemiology

A
  • In the last 1/4 of the 20th century, it has caused:
  • 3 million deaths
  • 1billion people affected
  • 250,000 annual deaths
  • £23 billion cost
  • Raises questions of increasing incidence
  • By 2100, 17 of 23 cities with +10 million inhabitants will be within at risk zones
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4
Q

State some Natural Disasters

A
  • Tsunami
  • Pakistan earthquake
  • Haiti
  • Nepal earthquake
  • Most commonly in developing world locations
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5
Q

Describe some features of natural disasters

A
  • Delayed, haphazard international response
  • Average of 2 earthquakes with a Richter 8 per year
  • 33 earthquakes with +1000 deaths since 1980
  • Number & severity of injuries is predictable
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6
Q

Why are orthopaedic surgeons needed in natural disasters?

A
  • Provide immediate care and relief for patients
  • Take care of trauma inflicted patients
  • 80% of all ortho surgeons are in developed countries ( 26 of 191 nations)
  • There are only 40 in 8 East African countries with a population of 200 million
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7
Q

What are the problems with this low number of orthopaedic surgeons?

A
  • Recruiting surgeons
  • Medical migration
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8
Q

Describe “Conflict” in the current world

A
  • There has been 160 wars and armed conflicts since 1945
  • Mostly developing world
  • 50 conflicts currently
  • 22 million killed, 3x as many injured
  • 90-100 million landmines
  • 500 million small arms
  • 125 million AK 47
  • Duration of these conflicts are unknown
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9
Q

Describe what Complex emergencies are

A
  • Combine any of:
  • Natural disaster
  • Conflict
  • Famine
  • Mass population movement
  • Social & political breakdown
  • Ongoing, not time limited. E.g. Haiti
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10
Q

What are some problems associated with the assistance in emergency disasters?

A
  • Often Chaotic aftermath of natural disaster
  • Local infrastructure and resources overwhelmed
  • Delayed & inaccurate assessment
  • Lack of coordination between agencies / govts
  • Competition between NGOs
  • Inefficiency, duplication
  • Lack of accountability
  • Short term volunteers, no continuity of care
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11
Q

How were these problems resolved?

A
  • Led to the creation of the UN (IASC) cluster system
  • In 2005, the UN reviewed the global humanitarian system
  • Allowed coordination to be strengthened
  • Created a Central emergency response fund
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12
Q

What do these clusters do in the IASC system?

A
  • Increase capacity
  • Provide leadership (WHO for health, UNHCR for IDPs, WFP in logistics)
  • Ability to agree on specific objectives
  • Accepts accountability
  • Provides field level coordination
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13
Q

What is the UK aid?

A
  • UK is 2nd largest bilateral humanitarian aid donor
  • £528 million in 09/10
  • Mostly via partners
  • 11% on humanitarian emergencies
  • ECHO £100m, ICRC £66m
  • Small amount of “direct” aid; Ops team (CHASE OT) and UKISAR
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14
Q

Describe the Disasters and Emergencies Committee (DEC)

A
  • Created 1963
  • Up to 15 charities working in disaster field (currently 14)
  • Have Joint fundraising
  • Response focal point
  • Co-operation & coordination
  • Accountability & effectiveness
  • Each member: Have an Income > £4m / yr, Emergency work > £10m / yr, Good governance
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15
Q

Describe the Haiti earthquake

A
  • Occurred in 12 January 2010
  • Richter 7.0
  • First “mega-urban” less developed world disaster
  • 200,000 dead, 300,000 injured
  • Within 1 month: 600 organisations, 274 in health field built
  • Led to a “Wild market” , not coordinated help (fat mess)
  • UK were the major donor
  • DFID £7.5 million
  • DEC £101 million
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16
Q

What was the result due to the uncoordinated response from the Haiti earthquake?

A
  • International Emergency Trauma Register (IETR) was created
  • Following the Haiti earthquake
  • Meeting of DFID / DoH & interested NGOs
  • Hosted by UK Med
  • Database of volunteers
17
Q

Provide some features of the International Emergency Trauma Register (IETR)

A
  • Accredited / trained
  • Up to date
  • Prospective release agreements with employers
  • Funded
  • First used for Libya followed by Philippines, Gaza, Sierra Leona, Nepal
  • Rebranded Emergency Medical Register for Ebola
  • Recently relaunched with team based structure
18
Q

How is training for disaster relief used?

A
  • Provides:
  • Introduction to disaster relief
  • Speciality courses
  • “Under Canvas” simulation training
  • Security training
  • Health screening
  • Leadership courses
19
Q

Describe the Surgical training for the Austere Environment (STAE)

A
  • 5 day fresh frozen cadaver course at RCS England
  • Disaster relief, conflict, less developed world
  • Involves: Vascular, Abdominal, Surgery of pregnancy, Orthopaedics, Plastic surgery, Neuro / maxillofacial
  • Worth £2500
  • Aiming to export the course via digitalised media
20
Q

List some points that emergency projects entail

A
  • Unpredictable level of activity
  • “on-the-bus..off-the-bus”
  • Duration
  • Funding
  • Security
  • Personality factors / team dynamics
21
Q

What are Foreign Medical Teams?

A
  • Huge increase in FMTs responding to sudden onset disasters (SODs)
  • WHO cluster report
  • Classification include: Outpatient, Inpatient emergency surgical care, Inpatient referral care, Specialist teams
  • Registration
  • Minimum standards
    • Most lives are saved by early local provision not FMTs
22
Q

How are the military involved in Humanitarian Assistance

A
  • Long Hx of military involvement in disaster situations
  • Affected country
  • Foreign troops
  • Contentious
  • Have to follow Oslo guidelines
23
Q

List some advantages of Military Involvement in Humanitarian Assistance

A
  • Strategic planning
  • Surge deployment
  • Logistics / communications
24
Q

How is Disaster Risk Reduction (DRR) carried out?

A
  • Artificial distinction between “natural” and “man made
  • “At risk” areas can be identified
  • Measures taken to protect vulnerable populations
  • Investment in infrastructure as emergency preparedness
25
Q

What is the Hyogo Framework for action (HFA)?

A
  • World conference held in Kobe, Japan 2005
  • Based on Building resilience of nations and communities to disasters by 2015
  • Had 168 signatories
26
Q

What are the Hyogo Framework for Actions priorities? (5)

A
  • DRR as national / local priority
  • Assess risks, enhance early warning
  • Innovate / educate to build resilience
  • Reduce risk factors
  • Strengthen disaster preparedness
27
Q

What is the Sendai Framework for Disaster Risk reduction?

A
  • It is a successor to the Hyogo framework
  • Led to a greater understanding of disaster risk
  • Strengthening governance
  • Investing in resilience
  • Enhancing disaster response
  • Health perspective: Improving capacity & resilience, Reducing mortality
28
Q

How do we develop after a disaster?

A
  • Increasingly humanitarian aid and development aid is merging
  • Funding & access post disaster is opportunity for development
  • “Build back better”
29
Q

Conclusion

A
  • Though globally disasters are not a major cause of mortality there is a humanitarian & political imperative to assist
  • The UN Cluster system introduces better coordination and strategy to what was formerly a chaotic process
  • FMTs to be accredited & regulated
30
Q

Conclusion

A
  • The UK, long a major donor to disaster relief now aspires to become a more significant service provider
  • Save field hospital, UKIETR staffed
  • Disaster Risk Reduction can mitigate the injury burden
  • Disasters are often an opportunity for development

Conflict And Catastrophe Medicine (34 decks)

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