The private sector: crossing over the fence

Until recently, many private sector disaster management initiatives were developed to minimize property damage and losses. In most cases, disaster management was simply equated with security measures; it was unclear whether these security measures were implemented merely to satisfy national laws or to comply with the demands of insurance companies.

Today, the private sector is rethinking its role and obligations. Whereas managing the effects of technological accidents was once considered the sole responsibility of the government, attitudes began to change following large-scale calamities such as Bhopal, the 1984 gas explosion in Mexico City or recent airplane crashes. This shift in attitudes may be partially due to a company's concern over jeopardizing their reputation or trademark. But it is also the result of the private sector's willingness to play a greater part in disaster management.

Contingency Planning

Some industries now admit that in spite of the precautions they have taken, accidents can and will continue to happen. As a result, they have stepped up contingency planning. Planning for the unexpected, and sharing this information with others, will avoid some commonly observed problems. For example, the best prepared industries have disaster plans for their plants, but these are neither commonplace nor fully implemented. Consequently, security personnel may be able to quickly intervene and manage a routine emergency situation, but they are unable to handle those accidents that, because of the magnitude or the origin of the event, exceed their capacity to respond. In other industries, disaster plans provide for physicians to treat job-related injuries caused by dangerous substances used in factories. But these same physicians have no plan to cope with or treat a large number of people with more complicated injuries such as burns.

Contingency planning is part of the job of airport managers and the airlines' station managers. As part of the disaster plan, airports that do have ambulances check them to ensure that they are in working order. But how often is the airport's capacity to transport a large number of victims checked? Most airports also have medical arrangements in place to treat injured or sick travellers. But they rarely have plans or well-trained personnel to handle large-scale accidents. Unless there are both plans and people prepared to deal with mass casualties, a large number of lives will be lost. Responders must be trained and plans tested down to the last detail if plans are to be useful.

Private Industry and Disaster Planning

Although disasters and accidents will continue to plague the Region, close collaboration among local governments, community groups and the private will broaden the scope of and improve disaster plans, thereby mitigating their effects. The private sector can:

· "cross over the fence" into the surrounding community to coordinate and prepare integrated disaster plans. Unfortunately, the private sector has not crossed the fence often enough. This is partly because, with the exception of some major urban areas, many communities themselves are still ill-prepared.

· develop a local plan, assess capabilities, and recognize limitations. Then look externally and take expertise from outside the fence to compliment what is needed.

· plan and make arrangements for external support in pre-identified specialized areas.

· negotiate agreements with appropriate regional and international responders.

The Next Steps

Prior to the April Hurricane Conference in Miami, the International Disaster Advisory Committee of the Office of U.S. Foreign Disaster Assistance (OFDA) brought together public and private sector representatives that operate in the Caribbean to discuss opportunities for governmental, non-governmental and private sector collaboration. Most of the discussion focused on the response to foreign disasters and major accidents. It appears that some airports and airlines have taken measures to - improve contingency planning, but these plans are too narrowly focused and are seldom tested. The International Civil Aviation Organization (ICAO) has guidelines, but it lacks the authority to enforce them. PAHO has developed a mass casualty simulation exercise to assist in organizing and testing emergency plans, but lacks the resources to disseminate it. Could collaboration with the private sector result in an integrated exercise? Within the framework of the International Decade for Natural Disaster Reduction, the time may be right to plan and carry out activities.

To increase the private sector's role even further as an active participant in the disaster management process, they must gain a better understanding of the relationship between security measures and disaster response plans; of the need to integrate community and industrial disaster plans so that they mutually reinforce one and other; and of the importance of collaborating more closely with the public sector in disaster response and international assistance. There are many signs of private industry's willingness to cooperate. Their sound contribution to disaster management will be welcome.

An airport contingency plan would not have prevented this plane from parking in the trees. But had there been mass casualties, well-trained personnel would have saved lives.(Photo: Carlos Gaggero/PAHO)

News from PAHO/WHO

New Slide Series

Inappropriate international assistance, deteriorating sanitary conditions, temporary shelters - much has been written about these visible challenges to managing disasters. But there are other issues that, although unpleasant to discuss, require attention and training.

One of these is managing a large number of dead in the aftermath of disasters. The staff of the Mexican Society of Emergency and Disaster Medicine has prepared for PAHO a new 28-slide set entitled Manejo de Cadáveres. It covers the basic techniques of collecting and handling bodies, selecting a site for the morgue, and techniques for identifying corpses.

Manejo de Cadáveres is available in Spanish only. Readers who wish to obtain copies are asked to send a brief outline of the activities in which they plan to use this slide set. Direct inquiries to the Editor of this Newsletter.

. . . and the U.N.

UNDP/UNDRO Meet at First Regional Training Course

The United Nations Development Program (UNDP) and the Office of the U.N. Disaster Relief Coordinator (UNDRO) held the first phase of their global Disaster Management Training Program in May in Bogota, Colombia. (See Issue No. 43 for background information on the Program.) The target of this regional workshop was UNDP staff from selected disaster-prone countries in the Americas. Representatives from sister U.N. agencies also attended. UNDP's Deputy Resident Representatives and National Officers who have been assigned responsibility for disaster prevention activities discussed and developed strategies for incorporating disaster prevention aspects into UNDP project planning. The UNDP Resident Representative serves as UNDRO's in-country representative and as such heads the

U.N. response to disasters. In this context, the group discussed UNDP's role in the different phases of disasters and the role of the U.N. and its specialized agencies in coordinating the postdisaster response. The Latin American regional workshop will be followed by 10 country-level workshops during 1991 and 1992. PAHO organized this first regional workshop, with the support of the Organization of American States and Colombia's National Disaster Prevention Office A Caribbean regional workshop, organized by the OAS, is scheduled for November 1991. More information will appear in the next issue of this Newsletter.

IDNDR Newsletter

The Secretariat of the International Decade for Natural Disaster Reduction has published the first issue of its bimonthly newsletter Stop Disasters. Disseminating information on an international scale is critical to the success of the Decade and this newsletter will pro vice a credible information link for all IDNDR partners. The newsletter is published in English, Spanish, French and Italian by the Osservatorio Vesuviano in Naples, Italy as their contribution to the Decade. Readers may request copies from IDNDR Secretariat, Palais des Nations, CH-1211, Geneva 10, Switzerland.

PAHO Disaster Adviser Moves to Barbados as PCDPPP Closes The Pan Caribbean Disaster Preparedness and Prevention Project, based in Antigua since 1981, ended its activities on 31 March. PAHO has transferred its Subregional Disaster Office to its Caribbean Program Coordination office in Barbados. Readers may direct future correspondence to Dr. Jean Luc Poncelet, Disaster Preparedness Adviser, Pan American Health Organization, P.O. Box 508, Bridgetown, Barbados, telephone: (809) 436-6448 or 426-3860; fax: (809) 436-6447. The Red Cross component of PCDPPP has relocated to Jamaica. Correspondence may be addressed to Caribbean Regional Officer, League of Red Cross and Red Crescent Societies, c/o Jamaican Red Cross, 76 Arnold Road, Kingston 5, Jamaica.

Other organizations

Disaster Center in Mexico

CENAPRED is the National Disaster Prevention Center, established in Mexico City by the governments of Mexico and Japan. Similar to CISMID, the Center for Seismic Engineering and Mitigation of Disasters in Lima, which was established under a bilateral arrangement between Peru and Japan, CENAPRED supports research and development studies on disaster prevention and mitigation. The Center also maintains a library and databases of materials for use by national disaster agencies and professionals. Professional and technical training and the dissemination of information on preparedness and prevention to the disaster community and the general population are important functions of CENAPRED. For information about CENAPRED's activities write Centro Nacional de Prevención de Desastres, Providencia 1229, Colonia del Valle, Mexico, D.F., Mexico

Colombian Red Cross Materials

The Valle Chapter of the Colombian Red Cross, in collaboration with other agencies from the Cali area, has published a community-level guide for disaster preparedness and prevention. The well-illustrated guide was prepared to train community leaders to develop an integrated security plan in which both governmental and non-governmental organizations responsible for the city's safety participate. The Guide contains easy-to-understand language and helpful checklists. Available in Spanish only. Write Sra. Olga Lucia Garces de Franco, Jefe, Departamento de Socorro, Cruz Roja Valle, Apartado Aereo 6829, Cali, Colombia.

Research on Search and Rescue

The National Science Foundation has awarded a three-year grant to a team of researchers from Texas A&M University's School of Architecture to examine destruction, casualties, search and rescue and emergency medical response during disasters. The researchers will use an integrated approach to consider the human ecological context of disasters - including their physical, organic and social dimensions. We will look for more information on the results of this study.

Upcoming meetings and courses

Meetings

September

8-11 Emergency Planning '91 will be held at Lancaster University and deal with the development and improvement of planning and response to disasters. Write Emergency Planning '91, Conference Office, Bowland College, Lancaster University, Bailrigg, Lancaster, LA1 4YT U.K.

October

2-4 The International Symposium on Acute Renal Failure will hold a session on disaster assistance for acute renal failure (which, in major sudden-impact disasters, has resulted from being crushed or trapped in collapsed structures). For more information contact Office of Continuing Medical Education, CB#7000, University of North Carolina, Chapel Hill, North Carolina 27599 U.S.A. phone (919) 962-2188.

Courses

Harvard University's School of Public Health is offering a one-week course on Planning for Nuclear Emergencies. The course will run from 10-14 June, and although some of the information provided is in the context of the U.S. Government, it will cover standards and guides for emergency response, training and notification, and protective action guides. For a complete course description write Mary F. McPeak, Office of Continuing Education, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, telephone: 617432-3515.

The Center for Seismic Engineering and Mitigation of Disasters (CISMID) in Lima, Peru will hold a three-week cow from 19 June - 12 July (in Spanish) on urban planning for disasters. Participants will include civil engineers, architects and planners. Professionals interested in applying for the course may obtain further information from CISMID, Casilla Postal 2812, Lima 100, Peru.

Oxford Polytechnic is offering five one-week training courses on the various phases of disaster management, including emergency preparedness, rehabilitation and mitigation planning, and on developing training skills. For course outline and schedules write Dr. Yasemin Aysan, Oxford Polytechnic, School of Architecture, Gipsy Lane, Headington, Oxford OX3 0PB U.K.

Member countries

Caribbean: Health Disasters Coordinators Meet

Health Disaster Coordinators from the Caribbean countries met in St. Lucia in March. The Health Coordinators discussed national health agreements within the context of a Caribbean response mechanism now that the Pan Caribbean Disaster Preparedness and Prevention Project has terminated. They also placed emphasis on the need to prepare prepackaged public health information that would be available for rapid dissemination before, during and after disasters. The participants also endorsed two important documents: the

Guidelines on the Role of Women in Disaster Management (which they will present at the annual meeting of National Disaster Coordinators) and the Approach to the development of Health Sector District Disaster Management Plans in the Caribbean (a methodology, tested in three countries, for developing community disaster plans.) Both of these documents are available from the Editor of this Newsletter.

Barbados: New Base for Disaster Response Agency

Caribbean Heads of Government have selected Barbados as the head quarters for Caribbean Disaster Response Agency, which will be created to coordinate an intra-Caribbean response to difficult post-disaster situations. More information will appear in future issues of this newsletter.

Cholera Epidemic in South America Emergency health managers in several countries in South America are facing a new challenge, added to the natural and manmade disasters that already threaten their countries. The confirmation of a few cases of cholera in Peru in late January, has now turned into a mayor epidemic. In Peru alone, more than 177,000 people were affected nationwide by mid-May. Thirteen hundred have died from cholera. The emergency situation is also seriously affecting Ecuador which reports almost 7,000 cases. Colombia, Chile and Brazil have been affected to a lesser degree, reporting 210, 38, and 6 cases respectively. PAHO has prepared the following information documents (in Spanish only): Pautas para el Control del Cólera - Medidas Preventivas en el Sector Ambiental para Enfrentar la Amenaza and Reglas de Oro de la OMS para la Preparación Higiénica de los Alimentos. Copies are available from the Editor of this Newsletter. In addition, the Organization has prepared a special issue of its Epidemiological Bulletin on cholera. Single issues are available from the Editor.

Cholera is spread by contaminated food and water.

Severe dehydration can lead to death if it is not quickly treated.

Health promoters educate the public about control measures.

World health day

Argentina: Promotional material was distributed to the press, universities and health sector institutions.

Bolivia: WHD was amply publicized in both print and broadcast media. In La Paz, 34 schools participated in the Children's Art Contest.

Chile: High-level government officials witnessed the formation of Chile's IDNDR Committee. The Civil Defense sponsored school evacuation programs and WHD posters were posted in subway stations.

Colombia: The President of Colombia awarded the Jorge Bejarano Medal to Beatriz Velez, Health Disaster Coordinator of the Ministry of Health and Camilo Cardenas, Director of Colombia's National Disaster Office. Teleconferences were broadcast, for health professionals on disaster prevention and rehabilitation and for the general public on family disaster prevention.

Costa Rica: Print and audiovisual material was distributed at a three-day health fair. A press conference and school evacuation drills were held.

Ecuador: Two official ceremonies marked WHD; the Director's message was televised and part of the WHD video aired on the nationally-televised program Siete Dias.

El Salvador: The Director's video message was distributed and WHD was observed at a national course on emergency plans for schools and local health services.

Guatemala: Several drills tested school evacuation plans and mass casualty management. Non-governmental organizations and the press participated in workshops and Guatemalan youth contributed to the Children's Art contest.

Honduras: The Red Cross helped with the Children's Art Contest. The WHD message was broadcast on radio and TV and health personnel were offered air time to talk about disasters.

Mexico: 600 persons attended a celebration in the capital and most states also held celebrations. Public information material on disasters was widely distributed.

Nicaragua: The WHD message was televised nationally and several national organizations helped sponsor the Children's Art contest.

Panama: The Ministry of Health held local level seminars and cultural programs in the country's 12 regions. The Ministry of Education coordinated the Children's Art Contest and universities held a science week with disaster prevention as the theme.

Paraguay: Prizes were awarded to the winners of the nationally-sponsored children's art contest. The Ministry of Public Health appointed a Commission to raise public awareness of the need for preparedness.

Peru: WHD was celebrated in the Medical College of Peru and was written about in the press.

Trinidad and Tobago: A major effort to sensitize the country on the need for preparedness was launched. A special Sunday newspaper supplement was published and the electronic media mentioned WHD in broadcasts. The Ministry of Education held promotional and educational activities in eight counties.

Uruguay: A press conference was held to disseminate the PAHO Director's WHD message; this was later televised.

Venezuela: WHD material was distributed throughout the country and the message by the Minister of Health and Welfare was published in major newspapers.

Colombian Disaster Program Receives the Macedo Award At World Health Day celebrations in Washington, D.C., the American Association for World Health (AAWH) bestowed the Macedo Award on the disaster preparedness program of the Ministry of Health of Colombia. Several indicators reveal a country's level of health-sector disaster preparedness. The commitment of the Government of Colombia to preparedness is evident through its technical program in the Ministry which has set goals for emergency health preparedness and is responsible for ongoing pre-disaster planning and coordination. Colombia has not only recognized disaster preparedness formally, but also legally, as an integral function of the Ministry. This will ensure continuity despite changes of administration. The Colombian health sector pro gram has worked with many sectors - environmental health services, schools, the private sector, the mass media, and non-governmental organizations - to train local health services and first responders and thus ensured a good overall national response. Colombia has also been at the forefront of including disaster preparedness in the post-graduate curriculum of its schools of public health, medicine, nursing and engineering, thus helping to ensure that the country's next generation of professionals will support preparedness activities. AAWH presents the Macedo Award, named after the Director of PAHO, each year to an individual or agency that has shown recognized achievement in the field chosen for that year's World Health Day.

Review of publications

The books referred to below have been abstracted from review copies received from the publisher by the Editor of this Newsletter. Except where noted otherwise, none of the books are available from PAHO. The publisher and the list price (when available) are included at the end of the abstracts for readers who are interested in purchasing the books.

The Things We Give: A Critical Look at Donations In-Kind. S. Faulkner et al. Henry Dunant Institute, 1989, 93 pp. (English)

As its title implies, this book takes a critical and constructive look at post-disaster donations that are channelled through the International Red Cross and Red Crescent Movement. The book is the work of seven authors who approach the subject from the perspectives of recipients of aid, donors, a coordinating body, and an independent observer. They provide an account of the problems surrounding donations in kind and express a variety of opinions on what should be done to improve the situation.

- Henry Dunant Institute, 114 rue de Lausanne, 1202 Geneva, Switzerland.

Personal Services: Psychosocial Planning for Disasters. Health and Welfare Canada, 1990, 100 pp. Bibliography (English, French)

The information offered in this manual is based on current knowledge and practice derived from research and case reports, the practical experiences of human service workers and the personal experiences of disaster victims. The manual describes the impact of disasters on people - their physical and emotional reactions, their recovery problems and needs - and suggests effective response activities and services. It also covers some of the planning and intervention responses necessary to effectively deliver psychological and social services following disasters.

- Single copies available free of charge from Director, Emergency Services, Health and Welfare Canada, Jeanne Mance Building, Ottawa, Ont. K1A 0L3 Canada.

Disaster Preparedness: A Handbook for Trainers. Council for Advancement of People's Actions and Rural Technology (CAPART). 1990, 200 PP. (English)

This manual was written by PREPARE, a non-profit voluntary organization active in community disaster preparedness in India. Because of the importance of traditional practices and the initiative of the community in emergency situations, the handbook is designed for trainers working in community-level disaster preparedness. It makes extensive use of pictures, with minimum text, to provide reference material for community training. It may provide a model for agencies in the Americas who wish to develop similar publications.

- US$15. PREPARE, 364 North Main Road, Anna Nagar, West Extn, Madras 600101, India.

Slides on Geological Hazards The U.S. National Geophysical Data Center has 17 slide programs available on geologic hazards worldwide. The programs range from general (earthquake damage) to more specific (earthquake damage to schools). Also included are programs on landslides, volcanoes and tsunamis. Each 20-slide program is accompanied by a description of the effects of the hazards, dates and locations. These slide sets are suitable for presentations to both technical and non-technical audiences and cost US$25.00 each. For a list of available programs write to National Geophysical Data Center, 325 Broadway, E/GC4, Dept. 839, Boulder, Colorado 80303, U.S.A.

Research Opportunities Disaster research in the health sector is often the "poor relative", underfunded and assigned to a low priority by disaster managers and health scientists. However, several important sources of support may be available to scientists in Latin America and the Caribbean. The European Community periodically launches appeals for proposals and projects. Scientists and researchers from Latin America or the Caribbean may submit proposals for scientific research projects on disaster prevention, reduction, or preparedness that are relevant to the health sector. These proposals should be jointly executed or implemented with European institutions. To be placed on the mailing list or receive forms, express your interest through the EEC delegate in your country or directly to the attention of Dr. Marc de Bruycker, Commission of the European Communities, Directorate General XII-G-4, Science and Technology for Development Division, Rue de la Loi 200, B-1049, Brussels, Belgium, fax 236-3308. In addition, certain European universities in countries such as the Netherlands are interested in Jointly developing research studies and disseminating the findings. Readers who would like more information may contact the Editor of this Newsletter. University Partnerships in the Americas The arrangement known as "sister" cities, municipalities or countries has provided learning experiences for all partners. Now, universities in selected European countries have expressed interest in establishing twinning arrangements, whereby university personnel, fellows or materials are exchanged to support courses and curricula in disaster medicine. Universities in the Americas who are interested in finding out more about these opportunities should write to the Editor of this Newsletter and include a brief description of the university's disaster medicine curriculum and activities.

Selected bibliography

The articles listed in this section are of interest to health professionals and other e responsible for various aspects of disaster relief and preparedness programs. They have been reproduced and recently added to the collection of articles available from the Editor of this Newsletter. A complete list of reprints is available upon request. Please quote the reference code listed to the left of the publication title when requesting articles

D.14 Risk factors for tornado injuries. Millicent Eidson, et al. International Journal of Epidemiology, 19(4):1051-1056, 1990.

D.19 Public concern about chemicals in the environment: Regional differences based on threat potential. Holly L. Howe, Ph.D. Public Health Reports, 9(2):186-195, 1990.

D.20 Improving the care of patients with major trauma in the accident and emergency department. R. B. Fisher, Christine H. Dearden. British Medical Journal, 300:1560-1563, 1990.

E.2 Prevention of excess mortality in refugee and displaced populations in developing countries. Michael J. Toole, M.D. et al. JAMA, 263(24):3296-3302, 1990.

E.14 Los invencibles maremotos. Michael J. Mooney. Américas, 42(4):25-28, 1990.

E.19 War-related changes in health and health services in Nicaragua. Richard M. Garfield. Soc. Sci. Med. 28(7):669-676, 1989.

Requests for articles should be directed to: Pan American Health Organization Emergency Preparedness and Disaster Relief Coordination Program 525 Twenty-third Street, N.W. Washington, D.C. 20037, U.S.A.

Disaster Preparedness in the Americas is the Newsletter of the Emergency Preparedness and Disaster Relief Coordination Program of the Pan American Health Organization, Regional Office for the Americas of the World Health Organization. The reported events, activities and programs do not imply endorsement by PAHO/WHO. nor do the statements made necessarily represent the policy of the Organization. The publication of this Newsletter has been made possible through the financial support of the Canadian International Development Agency (CIDA). Correspondence and inquiries should be addressed to: The Editor Disaster Preparedness in the Americas Pan American Health Organization 525 Twenty-third Street, N.W. Washington, D.C. 20037, U.S.A.