3. Strengthening response capacity in technical areas
The active participation of the technical units in charge of health care, such health care facilities, surveillance units, environmental and mental health entities, health laboratories, etc., is critical during response operations.
An effective response depends on these units being adequately prepared and equipped to deal with emergencies. This section outlines the action to strengthen key technical units.
3.1. Detection and control of communicable diseases
Disasters may increase the risk of disease. Therefore, epidemiological surveillance systems and disease prevention and control programs and should be in place.
- National epidemiological surveillance system and tools available for disease monitoring and control should be adequate and/or easy to use in disaster situations.
- An epidemiological surveillance system in disaster situations is based on the rapid establishment of sentinel sites, surveillance of notifiable diseases, use of practical report forms, and reporting based on symptoms and syndromes. Examples of the forms, along with main types of health information needed for decision-making, can be found in the guide to epidemiological health surveillance in disaster situations.
3.2. Water and sanitation
One of the immediate and common effects of disasters usually involves damage to water supply, sewerage, and drainage systems, as well as damage to basic sanitation services. The multi-agency publication The Challenge in Disaster Reduction for the Water and Sanitation Sector: improving quality of life by reducing vulnerabilities illustrates the severity of the situation for the disaster-affected population when problems are compounded by the absence of safe water. Along with real examples, it describes actions that can be taken to reduce the vulnerability of water and sanitation systems.
3.3. Mental health and psychosocial support
For more information on the impact of disasters on mental health of a variety of population groups, as well as guidelines for action, consult the PAHO publication on Mental Health and Psychosocial Support in Disaster Situations in the Caribbean. The behavior of disaster victims changes over time, and is affected by factors such as age, economic situation, mental health history, extent of loss suffered as a result of the disaster, cultural characteristics, and resilience. The following factors are also considered:
- The nature of the event: Sudden disasters have a major emotional impact and can inhibit defensive reactions or can produce panic. The situation of refugees who are victims of violence entails its own specific needs.
- The characteristics of victims: Children, elderly, and women, as well as the disabled and mentally ill are more vulnerable.
- Environment and circumstance: Disasters have a greater effect on poor populations. Mental health preparedness plans must consider elements of the environment previous to, during, and after a disaster. Teams with training in mental health and stress management should be present.
Apart from the necessary participation of mental health professionals, it is important to train health workers in basic community level interventions. Early interventions to provide individual or collective support are of very significant value.
Given the complexity of mental health issues, plans should include short- and medium-term actions, tools to evaluate affected groups, and guidelines for intervention on major psychosocial problems, as well as assessment tools on the effectiveness of interventions.
Health workers and rescue groups require preventive interventions for stress management and psychosocial support. Useful information on controlling stress is provided in a pamphlet that the International Federation of the Red Cross prepared for people whom it delegates to participate in response operations.
3.4. Public communications and mass media
Limited knowledge of media on disaster management issues can generate incorrect information, adversely affecting public perceptions or leading to erroneous decisions or are counterproductive. The publication Information management and communications in emergencies and disasters describes how to plan communications, manage information, work with the media and prepare messages. It is also a reference for developing a strategic communications plan.
3.5. Damage and needs assessment
Evaluating the damage and health needs caused by a disaster is a critical function that should begin immediately after a disaster. A technical, objective approach will help decision-makers and, if necessary, guide the effective mobilization of appropriate humanitarian aid.
The post-disaster assessment should follow a pre-established plan that should be clearly defined prior to a disaster or emergency. Teams that conduct the assessments should have prior knowledge of the dynamics of disasters and the tools that are available for impact assessment. This article describes some of the best practices in conducting needs assessments.
3.6. Information management
Disasters require rapid response to save lives and mitigate the impact on communities. This is particularly critical in the health sector. Effective and timely response depends on the availability of information—from the site of the disaster through to the most senior decision-making level. The information should flow through the different levels in an orderly and consistent manner.
3.7. Health in temporary shelters and camps
The displacement of large numbers of people to temporary shelters or camps as a result of a disaster or social violence creates a risk factor for health. Overcrowding, lack of basic services, and exposure to environmental changes can encourage emergence of disease, especially if shelter or camp operations are not well organized or continue over a long period of time. We have learned the importance of incorporating beneficiaries in the process of organizing shelters and camps. The provision of community-based services in these situations is very important.
3.8. Mass casualty management
Saving lives and providing early care to disaster victims is the highest priority in response operations. However, as with other activities, this requires prior planning. In the preparedness phase, national authorities and health disaster institutions responsible for disaster management at various levels should take the necessary actions so that when disasters strike, the country and community will be as self-sufficient whenever possible. This will also involve training at the community level.