|Health Services Organization in the Event of Disaster (PAHO, 1989, 129 pages)|
|Chapter 1: Introduction|
The vast majority of natural and man-made disasters occur suddenly and unexpectedly, disrupting normal health care systems. The importance of preventive planning for disaster management is undeniable. Good intentions and interest in the welfare of others are not enough for dealing with the serious consequences often inflicted upon the population by a disaster.
Experience has shown that mistakes are made in the absence of proper organization or of a staff prepared to act in accordance with a prearranged plan, or when rescue operations are not efficiently directed, coordinated, and controlled. Such mistakes lead to confusion, delays, omissions, and duplication of effort, complicating the already difficult task of those responsible for the speedy mobilization of all available resources.
A country's health systems and public health infrastructure must be organized and ready to act in disaster situations as well as under normal conditions and must be cognizant of the type of measures to be taken in the event of a disaster. These will differ according to the severity of the disaster's impact on the national health system.
The health care preparedness plan for disaster management should be an integral part of the overall national disaster preparedness plan. In addition, there should be all the necessary elements to ensure the greatest possible coordination and timing, thereby avoiding misuse of resources and duplication of effort and promoting optimal benefits.
It should be kept in mind that many sectors will be involved in the national plan. These will include, among others, meteorology services (including hydrology and seismology), national planning, public works, utilities (electricity, water, gas, sanitation), construction, food, industry, finance, communications, transportation, education, public information, relief and rehabilitation, social work, public health, Armed Forces, civil defense, police, fire departments, Red Cross Societies, private voluntary groups, etc.
Each agency in these sectors will have to develop its own specific action plan for executing the tasks assigned to it within the national plan. Its activities should be arranged under three distinct chronological stages: a) predisaster preparedness, b) action during the disaster, and c) postdisaster rehabilitation.
The national plan and its sectoral counterparts must be so designed as to be truly national in scope, embracing every level from the country's most sophisticated centers to its least complex and most elementary rural outposts.
The national health care preparedness plan for disaster management should also involve every organization and sector directly or indirectly performing health activities in the country. Specific responsibilities should be assigned in the plan to each of these subsectors, which in turn will have to develop their own equally specific programs, setting forth clear and precise objectives and targets, the sum total of which should precisely match the objectives stated in the national plan.
At the rural level, the health care preparedness plan for disaster management should be simple and consist of practical, easy-to-implement measures. The priority aspect should be training of medical and paramedical personnel in rural areas and training and motivation of communities.
The purpose of this manual is to furnish technical information necessary for the preparation of plans to enable health services to provide an effective response in the management of massive casualties following a disaster.
Based on the existing structure of each country's health system, this manual attempts to cover the fundamental features involved in the preparation and coordination of emergency plans which are consistent with the characteristics of the health infrastructure and effectively provide a prompt and adequate response to disaster-created needs in facilities ranging from humble health posts to sophisticated district, regional, or metropolitan hospitals.
The general planning objectives are to:
1) Coordinate the use of resources and make it more rational so as to avoid duplication of activities and functions.
2) Keep a current inventory of human, material, and institutional resources in the medical care area.
3) Carry out training activities for health-area personnel, volunteers, and staff of the emergency care system or the civil defense system.
4) Ensure the establishment of effective coordination and cooperation between national and regional organizations (public as well as private) in the implementation of the national disaster management plan.
5) Orient community action in disaster situations.