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.
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
3
Q
Describe Disaster Epidemiology
A
- In the last 1/4 of the 20th century, it has caused:
- 3 million deaths
- 1 billion 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
4
Q
State some Natural Disasters
A
- Tsunami
- Pakistan earthquake
- Haiti
- Nepal earthquake
- Most commonly in developing world locations
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
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
7
Q
What are the problems with this low number of orthopaedic surgeons?
A
- Recruiting surgeons
- Medical migration
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
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
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
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
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
13
Q
What is the UK aid?
A
- UK aid 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
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
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
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
