Natural Disasters

Benedicte Gonzale
PM 565
Natural Disasters

It is difficult to prepare for a natural disaster especially since we cannot predict when and where it will happen or what will be needed. As much as we want to prepare and have all resources readily available for when a natural disaster happens, I believe that it is important to address the attitude in which we handle the situation. It is also important to remember the ability and willingness of staff to come to work when a disaster hits. It is also important to remember to monitor and evaluate the tactics that we use in order to improve future efforts. All components need to be working together in order to have a successful plan of attack.

Surveillance in public health is necessary in order to ensure the equal distribution of resources and health care. That is why it is essential that public health administrators monitor populations in order to optimize all available opportunities. Knowing what the populations needs is the key factor to the development of any intervention plan. Monitoring a population’s risk of disease or incidence of disease during a natural disaster is essential when trying to start emergency response programs. In order to control various health events large amounts of data are collected in various nationwide public health programs such as WHO, CDC, and NNDSS (Sonesson 2003). Data collection is one of the key factors used in order to control the spread and possibly prevent the onset of disease. Data is also collected for various countries and ensures that the most accurate and culture sensitive program is created. This also goes for communities who have experienced war or natural disasters ( Toole 1997). It is in these cases of emergency in which the most surveillance is needed to ensure that all possible measure is used to help those in need.

Educating communities on prevention is one of the main priorities for public health, the creating and development of health programs. Kay Bartholomew and associates discuss how twenty years ago health education programs were seen as having three planning activities: needs assessment, program development, and evaluation. Now two decades later there is “Intervention Mapping”. Intervention mapping is a framework for health education intervention development. Composed of five steps: creating a matrix of proximal program objectives, selecting theory-based intervention methods and practical strategies, designing and organizing a program, specifying theory-based and implementation plans, and generating program evaluation plans (Bartholomew 1998). This framework was created in order to develop effective intervention programs. Along with these five steps there needs to be an evaluation of trends and past approaches. Looking at past programs and evaluating the pros and cons is what helps make stronger and more efficient programs (Stem 2003). This is a concept that can be followed by almost every field of work. Learning from the past is what helps make a better outcome in the future. We can look at past natural disasters and learn from the mistakes made from those emergency responses.

In order to help measure the performance of the public health system a framework was created by Arden Handler, Michele Issel and Bernard Turnock along with the help of Donabien and the CDC. It was created based on the model by Donabedian which focused on structures, processes, outputs, outcomes in a model for quality assessment and systems monitoring (Handler 2001). This framework has been useful in monitoring health status in communities, diagnose health problems and health hazards, inform educate and empower the community etc. This framework is very useful and it seems to be the most accurate when evaluating the performance of the public health system. This is a useful tool to have because it helps evaluate systems in order to make them better for the next emergency.

The most recent natural disaster that has been the root cause for a major reevaluation of emergency response in the US has been Hurricane Katrina.

August 29, 2005: Hurricane Katrina hits
“Never before Hurricane Katrina has a disaster caused such a massive displacement of a U.S. population. Never before has the country seen so vividly the exposure and vulnerability of displaced persons — primarily the poor, the infirm, and the elderly. We know from experience that disasters take their greatest toll on the disenfranchised, but the distressing television images of our citizens stranded without basic human necessities and exposed to human waste, toxins, and physical violence awakened the public health community to a frightening realization: given the ineffective response mechanisms that were in place, Katrina could become a public health catastrophe.” Greenough 2005

It is disappointing to say that for the United States Katrina became more of a pilot study for public health response. It was not until this devastating disaster hit that the public understood that magnitude of help that would be needed to help rebuild and aid a community in the 21st century. For those studying and or working in health or public service we immediately understood the consequences that would arise because of this disaster. The mental and physical state in which these people now found themselves along with lack of basic resources would be the largest consequence from the disaster and lack of preparedness. The amount of resources, time, money, and aid that was needed was definitely something that was not anticipated before hand.

All of the good and bad that came from the emergency response from Hurricane Katrina will serve as a lesson for the Public Health community. Not only to make sure that disaster victims have proper aid but most importantly equal access to it. During Katrina there was a huge difference seen with the low socio economic class and the wealthier (Greenough 2005). Equal access to health care is an issue whether there is a disaster or not. It is up to those administrating the aid to fully evaluate the need of the community and see that everyone receives the same amount of aid.

With the new tactics learned form Katrina and from previous disasters we can learn as much as we can from the mistakes made and from the success that they had on the community impacted.

References:

Bartholomew, L. K. EdD, MPH, Parcel, G.S. PhD, and Kok, G. PhD (1998) Intervention Mapping: A process for developing theory- and evidence-based health education programs: Health Educaiton and Behavior, Vol. 25 October 1998

Greenough, P. G., M.D. & Kirsch, T. D. , M. D. MPH., (2005) New England Journal of Medicine;Public Health Response — Assessing Needs Vol 353 Oct 13, 05, #1

Handler, A., DrPH, Issel, M., PhD, and Turnock, B., MD, MPH (2001) A conceptual framework to measure performance of the public health system: American Journal of Public Health. Vol 91, august 2001

Sonesson, C. and Bock, D. (2003) A review and discussion of prospective statistical surveillance in public health: Royal Statistical Society 2003

Stem, C. , Margoluis, R., Salafsky, N. and Brown, M. (2003) Monitoring and evaluation in conservation: a review of trends and approaches: Conservation Biology, Vol. 19 December 2003

Toole, MJ., and Waldman, RJ. (1997) The public health aspects of complex emergencies and refugee situations: Annu. Rev, Public Health. Vol 18, 1997