Cover Image
close this bookDisasters Preparedness and Mitigation - Issue No. 06 - January, 1981 (PAHO)
View the documentFood and nutrition in the wake of disaster
View the documentNews from PAHO and WHO
View the documentNotes from other agencies
View the documentMember countries
View the documentMyths and reality: Communicable disease following natural disasters
View the documentCountry disaster preparedness programs
View the documentReview of publications
View the documentSelected bibliography

Food and nutrition in the wake of disaster

Acute disasters do not always produce food shortages severe enough to alter the nutritional status of a population. To determine what kind of food relief is needed, and when, national health authorities should be familiar with the expected outcomes of the types of disasters to which their countries are prone.

if a food relief program is warranted after a disaster strikes, steps should be taken to maximize the efficient use of resources. These include assessing the food supplies accessible after disaster, gauging nutritional needs, calculating daily food rations and bulk supplies for large population groups, and monitoring the nutritional status of the affected population.

Likely Outcomes

Disasters of any type can cause the disruption of transportation and communications systems, and of routine social and economic activities. Even when food stocks exist, they may be temporarily inaccessible. if livestock, crops and stocks are lost, the short-term problem can produce a more severe, long-term crisis. When communities are evacuated and resettled, nearly all of their food supplies will have to be provided for the duration of the encampment. Hospitals and other service facilities may also need emergency food supplies.

Long and short-term effects will vary according to the type of disaster. Earthquakes generally have little direct impact on total food availability. Standing crops are unaffected and food stocks can often be salvaged, although temporary problems may be faced due to the breakdown of the transportation and marketing systems. If the earthquake strikes during a labor-intensive period such as harvest, the loss of labor from death or its diversion from agriculture may cause similar short-term scarcities.

Hurricanes, floods and sea surges affect food availability directly. Standing crops are often completely destroyed, and especially if there is no warning period, seed stores and family food stocks may also be lost.

Setting Priorities

The decision to initiate food relief should be made at the highest level. Food distribution requires transport and personnel that may be better employed in other ways, and relief supplies may depress market prices, creating hardship for small farmers. Moreover, if essentials - such as seeds and tools - needed to restart the local economy are not provided, maintaining a population by free food distribution may hinder recovery by creating a dependence of relief.

Relief efforts should be guided by the following priorities: (1) supply food immediately where there appears to be urgent need; (2) make an initial estimate of likely food needs so that steps can be taken toward procurement, transport, storage and distribution; (3) locate stocks of food and assess their fitness for consumption; (4) monitor incoming data on changing needs so that the relief program can be modified.

Immediate Relief

For very short term need - a week or so-an emergency ration averaging 1700 kcal per capita will prevent severe nutritional deterioration and mass starvation. As an immediate relief step, available food should be distributed to groups that are at high risk, or appear to be wanting, in sufficient quantity (3 or 4 kg per person) to ensure survival for one week. Food should be included automatically, for instance, in supplies sent to communities isolated by earthquake or displaced by flooding. Where fuel shortages are likely, it may be better to distribute cooked food such as boiled rice or bread.

Estimating Food Requirements


Food stocks can often be salvaged after earthquakes.

A rough estimate should be made immediately of likely bulk food item needs to facilitate the procurement of stocks, storage and transport. The estimate should consider: (1) the probable effect of the disaster on food availability; (2) the size of the population infected; (3) normal food supply and variations within the area (e.g., the percentage of the population made up of subsistence farmers, and of those who depend wholly on purchased food), and (4) the impact of seasonal factors.

When estimating the composition of daily rations, keep them simple; facilitate storage and distribution by choosing non-perishable, nonbulky foods, and allow for substition of items within food groups. The ration should be based on three groups of foods: a staple (preferably cereal); a concentrate source of energy (a fat); a concentrated source of protein (dry meat or fish). If possible, vulnerable groups should receive a food supplement in addition to the basic ration. Children under 5 years may suffer permanent damage if malnourished, and pregnant and lactating women require more nutrients than others.

Procurement

When the amount of food required exceeds immediate local availability and it has to be distributed for several months, supplies will have to be obtained from elsewhere. Procurement and shipping may require several months, so approaches to suitable agencies should be made at the earliest possible date. Apprising donors strictly of the volume of food required is not enough. A rough estimate of local transport and storage requirements should be made, and donors should be advised of national eating habits. Food not eaten will provide no nutritional benefit.

Well-meaning donors often dispatch large amounts of "baby foods" into a disaster stricken country where hygiene standards are low and gastroenteritis is highly prevalent. Improving maternal nutrition is a more effective and nutritionally safe measure. Nor should health relief coordinators allow the emergency situation to serve as an opportunity for flooding the country with infant formulas. Multivitamin preparations, another frequent request and donation, are of no demonstrated use during the acute emergency phase and should not be requested as a separate relief item.

Surveillance

Health officials should monitor the nutritional status of the affected community if it seems that food shortages will be a long-term problem, as in areas with subsistence agriculture and temporary settlements. Taking regular physical measurements of young children, who are the most sensitive to nutritional changes, is a good emergency indicator, especially if weight for height is used.

With the results of the first survey of need, preliminary estimates of long-term distribution needs can be adjusted. As soon as an area is able to return to normal consumption patterns, distribution should be phased out.

Frequently observed: Short term health effects of major natural disaster











EARTHQUAKE

HIGH WINDS

FLASH FLOOD

FLOOD

DEATHS

MANY

FEW

MANY

FEW

SEVERE INJURIES REQUIRING INTENSIVE MEDICAL CARE

OVERWHELMING

MODERATE

FEW

FEW

INCREASED RISK OF INFECTIOUS DISEASE

POTENTIAL PROBLEM IN ALL MAJOR DISASTERS rises with overcrowding and deteriorating (Probability sanitation)

FOOD SCARCITY

RARE

RARE

COMMON

COMMON


(May occur due to factors other than shortage of food)



MAJOR POPULATION MOVEMENTS

RARE

RARE

COMMON

COMMON


(May occur in heavily damaged urban areas)



News from PAHO and WHO

European Economic Community Grant

The European Economic Community, through the Commission of the European Communities, agreed to provide financial support for the Disaster Preparedness and Emergency Relief program of the Pan American Health Organization. The grant, for the amount of US $1,584,000, is to be disbursed over a period of five years. It was made for the purpose of "improving the capability of the countries of the Latin American region to respond to and minimize the effects of natural catastrophes such as earthquakes and cyclones, and to contribute to the process of development and self-support of disaster-prone countries" in Central and South America through predisaster planning and training in the health sector.

In the immediate future, the grant will be used to "establish or improve mechanisms of coordination, to provide a focal point in the health sector at the national and subregional level for handling disasters, and to prepare health service personnel to act efficiently and rationally in the aftermath of a natural disaster in their own or in neighboring countries requesting assistance."

A Group Tour

A group of health professionals composed of two nationals from Barbados and two from Jamaica toured Canada, the U.S. and the Bahamas, from November 3 to December 5. The study tour was funded by PAHO and organized by its Division of Comprehensive Health Services and the Disaster Preparedness Office. It had the objective of acquainting the health professionals with the organization of emergency services, hospital disaster planning, and the management of mass casualties in intermediate-size community hospitals.

Health Aspects and Relief Management Course

Senior health officials involved in planning and emergency provision of health services following catastrophes in disaster-prone countries met in Brussels from October 12 to 24, to take part in the "WHO Course on Health Aspects and Relief Management-Natural Disasters." The intensive course was organized by the Centre for Research on the Epidemiology of Disasters, School of Public Health, University of Louvain. It aimed to promote a systematic approach to the management of disasters and to identify deficiencies in the field. The participants underlined the importance of establishing national command centers for disaster relief coordination in the health sector.

Introductory remarks were made by the Center's Director, Prof. Michel Lechat, and Dr. S. Gunn, head of the Emergency Relief Office of the World Health Organization. Subsequent speakers discussed standardized medical and surgical treatment, hospital disaster plans, communicable disease and surveillance, famine relief and nutritional problems, refugee camps, environmental health protection and management and health planning.

From the American region, Dr. C. Moody of Jamaica discussed the levels of decision making that are involved in the development and execution of national health plans for disaster and presented a series of slides on appropriate national policies toward international relief efforts. Dr. R. Mac Donald, from Guatemala, chaired the discussions on medical and nursing care. Prof. F. Nunes, from the University of the West Indies, presented the methods that are employed in creating simulation exercises and adapting them to national contingencies. Nunes was the author of the simulation exercise, "Cariba," first introduced earlier this year to a disaster relief seminar held in Montego Bay, Jamaica. Dr. G. Malagón of Colombia and Dr. J.L. Zeballos of Bolivia participated in the discussions, contributing observations from their experiences in the field. The closing session dealt with the role that specific organizations play in international relief assistance.

For a summary of the proceedings and documents, write: Prof. M.F. Lechat, Centre for Research on the Epidemiology of Disasters, School of Public Health, EPID-UCL 30-34, Clos Chapelle-aux-Champs, 30, B-1200 Brussels, Belgium.

Resolution to Strengthen Disaster Preparedness

In its XXVII annual meeting, the Directing Council of the Pan American Health Organization approved a resolution aimed at strengthening its disaster preparedness program. It approved the program's five-year strategy, including the proposal that a multidisciplinary team, composed of PAHO staff members or consultants and supervised by the PAHO Country Representative, be made available to interested countries to provide technical cooperation in the event of an emergency. Provided that the disaster-prone country had agreed in advance to such an arrangement, as soon as a catastrophe occurred, the team would be deployed without further request, to assist in the rapid assessment of needs, the preparation of damage estimates and other tasks. in the resolution, the Directing Council also noted the need to gradually increase technical cooperation in the Region toward the management of non-natural disasters of public health importance, such as explosions, fires and chemical accidents.

The Canadian delegation requested that the program be included on the agenda because of its firm belief that "planning and preparedness will save many lives in the Region." The Jamaican delegation noted that a national office for emergency preparedness and disaster relief had been established within the Jamaican Ministry of Local Government, and stressed the need for a greater information exchange between the countries. Barbados emphasized the importance of flexibility in preparedness plans to deal with different types of disasters. The Venezuelan delegation suggested that coordination of emergency preparedness activities in the Americas might best be achieved through the establishment of subregional coordination centers. Both Venezuela and Chile offered other member countries and PAHO the cooperation of their respective national emergency offices.

The delegation of Saint Lucia, a country which was among the most severly damaged by hurricane Alien last August, stated that its government had authorized the entry of a PAHO team in the event of a major emergency to facilitate the team's speedy collaboration with the Ministry of Health.

Notes from other agencies

UNDRO Annual Report

The UN Disaster Relief Office presented its annual report to the Secretary General during the thirty-fifth session of the UN General Assembly (May 1980). The report suggests that, pending evaluation of its performance to date, UNDRO's present mandate should be revised to clarify its responsibilities and expedite its response capability in times of emergency. Now available in English, Spanish and French from UNDRO, Geneva.

CERESIS/Instituto Nacional de Prevención Sísmica

The Instituto Nacional de Prevención Sísmica of Argentina and the Centro Regional de Sismología para América del Sur (CERESIS), organized a Regional Seminar on Earthquake Prediction. Held in San Juan, Argentina, from October 18 through 24, the Seminar was jointly sponsored by UNEP, UNESCO and UNDRO. For further information write: CERESIS, Avenida Arenales 431, Apartado 3747, Lima, Perú.

U.S. National Academy of Sciences

The siting of dams, hospitals, pipelines and other expensive facilities in potential earthquake zones could possibly be avoided if "an adequate geologic and seismic data base (is) developed and used during the planning process." This conclusion was reached by a panel of the National Research Council Assembly of Mathematical and Physical Sciences' Committee on Seismology, whose report is abstracted in the August issue of News Report. The 58-page panel report, "Earthquake Research for the Safe Siting of Critical Facilities" (ISBN 0-309-0308 2-X), can be obtained for US$8.50 from: National Research Council, National Academy of Sciences, 2101 Constitution Avenue, NW., Washington, D.C. 20418.

INTERTECT

The mechanical properties of adobe, structural modification techniques and standards for adobe construction, and post-disaster reconstruction will be discussed at the International Invitational Workshop on Earthen Buildings in Seismic Areas, to be held in Albuquerque, New Mexico, from 24 to 28 May, 1981. The workshop was organized by the Appropriate Technology International, the University of New Mexico and INTERTECT and is sponsored by the National Science Foundation. It will gather a group of experts from around the world to exchange current research information and identify possible areas for the transfer of technology, within existing social and economic constraints. Interested parties based in the U.S. should write: Dr. Gerald W. May, Dean, College of Engineering, University of New Mexico, Albuquerque, New Mexico 87131. Those based outside the U.S. should contact: Mr. Frederick C. Cuny, INTERTECT, P.O. Box 10502, Dallas, Texas 75207, U.S.A., at the earliest possible date.

American College of Emergency Physicians

The American College of Emergency Physicians and the Emergency Medicine Foundation of the U.S. sponsored a conference titled "Disasters' Problems and Solutions in their Management," held in Orlando, Florida, from 28 to 30 October 1980. Topics covered included case studies of emergency operations under disaster conditions caused by airline and ground transport accidents, fires, terrorist incidents and U.S. natural disasters. The final sessions dealt with practical guidelines developed from these situations, and their application to preparedness and evacuation plans. Conference proceedings can be obtained from the editor of this newsletter. Audio cassettes can be obtained from Disaster Conference, 600 Courtland Street, Suite 420, Orlando, Florida.

University of Colorado

The University of Colorado sponsored a Natural Hazards Research Applications Workshop from 20 to 23 July 1980, in Boulder, Colorado. Participants presented papers summarizing current research activities in the areas of hurricanes, tornados, the Mt. St. Helens volcanic eruption, mental health after disasters, management issues and information systems. Along with the workshop papers, the sponsors made available a very useful inventory of the categories of information that can be obtained from U.S. government departments. The compendium, Inventory of Natural Hazards, Data Resources in the U.S. Federal Government, includes names and addresses of the person to contact in each one. Conference materials may be requested from: Natural Hazards Research and Applications Information Center, I.B.S. No. 6, Campus Box 482, Boulder, Colorado 80309, U.S.A. One-page summaries of the sessions are available from the editor of this newsletter.

To our Readers:

Disaster Preparedness in the Americas is meant to promote the exchange of news and technical information regarding regional health activities that have a bearing on the field of disasters, both natural and man-made. Our readers are professionals with a wide range of expertise and experience in many different fields, a fact that highlights the inherently multidisciplinary nature of disaster preparedness. To a large extent, the quality and currency of the,material that is published depends on what our readers consider newsworthy. Readers are requested to send announcements and/or synopses of meetings and publications, and descriptions of activities and research in their areas, well in advance. The quarterly publication schedule initiated with this issue means that the timeliness of information will be improved. Please note that each issue will go to press one month before it is dated. Any material received after that date will appear in the following issue.

Member countries

Andean Pact

Disaster experts from the Andean Region, brought together by PAHO and the Convenio Hipólito Unanue, met to develop an operational blueprint for a national program on emergency preparedness in the health sector and mutual cooperation and assistance should a disaster occur in any of the subregion's member countries. The meeting was held in Colombia during the last week of November, and was attended by experts from the ministries of health and civil defense. Following one day of presentations on the status of the respective national programs for emergency preparedness, the participants reviewed the following issues in working groups: organization of national coordination, priorities in the training and education of human resources, research, legislation and financing of disaster preparedness programs. The high level experts then recommended the creation of a technical/administrative office for disaster preparedness and relief coordination of the Andean countries. The recommendations specified the need for allocating a specific budget allotment of the ministries of health for the ongoing activities of the office and its permanent technical staff.

Honduras

Findings from the first known experimental field trial of oral rehydration therapy in emergency situations showed that its administration by trained nurse auxiliaries and mothers can mitigate the effects of dehydration caused by diarrhea. Local authorities were faced by problems of overcrowding and poor sanitation in the refugee camps constructed in Honduras to temporarily shelter thousands of people fleeing across the border from Nicaragua. Over fifty percent of health center consultations in the camps were related to acute diarrheal disease, mostly in children. A corollary effect of the utilization of ORS was to decrease health center workloads in temporary settlements to a manageable size. The results of the field trial have been compiled and will soon be published in the PAHO Bulletin.

Panama

The Ministry of Health of the Government of Panama has organized a course on medical organization for emergency situations, to be held from January 20 to 23, 1981, in Panama. The course will cover the typology and evolution of disasters, surveillance and control of disease, environmental sanitation, management of supplies and food distribution, mental health in disaster situations, intersectoral coordination, health sector planning and coordination, international coordination and hospital emergency plans. The course format will consist of primary presentations followed by small group and plenary discussions. The presentations will be supplemented by films and a simulation exercise. For further information, write: Ministry of Health, Apto. 2048, Panama 1, Panama, 1, Dr. T. Engler.

Mexico

The Mexican Public Health Society held its XXXIV Annual Meeting from 10 to 13 November in Mexico City. A Latin American program for health care in disaster situations was among the topics that were discussed under the general theme of Health for All in the Year 2000. The meeting was chaired by Dr. Ramón Alvarez Gutiérrez. For further information, write: Sociedad Mexicana de Salud Pública, Leibnitz No. 32, México 5, D.F.

Jamaica

The Ministry of Health of Jamaica had just drafted the first version of its health disaster plan when hurricane

Alien struck the island in August. The management of emergency situations was considerably improved by the existence of the plan. The experience gathered in the disaster permitted the authorities to identify a need for improvements in sections of the plan as well as the need to expand planning activities to the parish level. A national meeting of the health sector is tentatively planned for early 1981 to complete the planning process initiated in 1980.

Cuba

The Cuban Ministry of Health is planning a national course on health care administration after natural disaster to train health administrators and civil defense administrators at the provincial level. The course is tentatively scheduled for June, 1981. In addition to local heads of health and civil defense services, participants will include representatives of international agencies who have experience with natural disaster emergencies. For further information, write: Ministerio de Salud, 23 y N. Vedado, Habana, Cuba, attention: Dr. Eddy Gomez.

Caribbean

The Caribbean Disaster Preparedness Planning Group met informally on 4 December 1980, to discuss the final steps needed to set up a multidisciplinary team of experts. Under the leadership of an UNDRO project leader, the experts will be selected from the following disciplines: general preparedness, health preparedness, Red Cross relief, and first aid. In the health sector, objectives are to promote disaster planning, train health officials, educate the general public and prepare vulnerability analyses of health and related services. Initial funding has been pledged by the Eastern Caribbean Common Market (through an EEC grant), the Office of U.S. Foreign Disaster Assistance, PAHO, and the League of Red Cross Societies. The team will serve all countries/territories of the Caribbean. Subject to confirmation of funding pledges, the team - to be stationed in Antigua - is expected to be operational by March 1981.

Myths and reality: Communicable disease following natural disasters

Human corpses must be disposed of immediately to avoid epidemics.

REALITY: Unless the victims died of a highly contagious disease and persons handling them immediately after death ignore basic sanitary precautions, the health risk from corpses is negligible. Acceptable disposal of human remains should be accorded extremely high priority for social, not health, reasons.

To prevent epidemics of cholera and typhoid fever, health officials should initiate mass immunizations, as a first priority following the advent of a catastrophe.

REALITY: Cholera and typhoid epidemics rarely occur as a consequence of disasters. Immunization of selected groups, such as children under 2 years of age who are expected to be encamped for over 30 days, should be encouraged. Primary immunization with presently available vaccines, however, requires two or three injections at intervals of two to four weeks, and it confers only partial protection, which lasts a few months. Furthermore, mass efforts at vaccination in the relief phase are an extensive drain on limited manpower, communication facilities and transportation. Improvised mass vaccinations can therefore not be justified.

Drawing courtesy Radio Times Hulton Picture Library

The population of rural areas without adequate water treatment facilities is the group at highest risk of waterborne disease epidemics.

REALITY: The groups most vulnerable to waterborne diseases are populations migrating to congested areas and relief workers from other zones who have not developed immunity to the diseases endemic to the area.

The main risk to the rural populations arises more often from disruption of normal public health programs caused by the disaster or by the diversion of relief efforts to unnecessary activities.

When disaster strikes, the affected area should order stocks of intravenous fluids in anticipation of epidemics of diarrheal disease.

REALITY: No epidemics of diarrheal disease have been documented as a result of disasters. Increases have been observed, however, in temporary settlements and other areas of high population density where sanitary measures are inadequate. When properly used, oral rehydration therapy provides a much cheaper means of treating diarrhea than IV fluids. Ninety-five percent of all cases, regardless of etiology, can be treated effectively with a case-fatality rate of less than one percent, by nonphysicians with minimum training. PAHO has stockpiles of ORS in Trinidad (CAREC), Barbados and Peru.

Country disaster preparedness programs

With this issue, Disaster Preparedness in the Americas begins the publication of brief descriptions of the disaster preparedness structures of member countries. One or two countries will be covered in each issue.

Barbados

In Barbados, the Central Emergency Relief Organization is directly responsible to the Prime Minister. It consists of a coordination council, an executive committee and a secretary. The government ministries and the departments have been assigned functions in emergencies that are based on broadening their usual responsibilities. A nation-wide communications system is the responsibility of the police, which functions out of stations covering the country's 15 districts. Further information can be obtained from: Chairman CERO, Prime Minister's Office, Government Headquarters, Bridgetown, Barbados.

Chile

The Chilean National Emergency Office of the Ministry of the Interior (ONEMI), is responsible to the Ministry of the Interior and is in charge of the development of the general executive emergency plan and the regional emergency center organizations. Once the final plan has been developed, ONEMI will assume the control and coordination of the operations and will coordinate whatever national and international assistance is required. Should a disaster strike more than one national region, ONEMI will designate a Chief of Zone to take executive charge of relief operations.

The thrust of the program is to utilize what structures already exist rather than creating new ones, with the aim in mind of maximizing the utilization of, limited resources. Further information may be obtained from: Plan Nacional de Emergencia (ONEMI), Ministerio del Interior, Beaucheff 1637, Santiago, Chile.

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.

Emergency Response Guide for Dangerous Goods, Information and Emergency Center, Transport Canada. 330 pp. No ref. 1979 (English and French)

Bilingual list of dangerous goods and their potential hazard to health, ordered alphabetically and by United Nations serial number. Provides instructions for emergency handling of each of the substances listed as well as basic first aid measures that should be taken, according to type of exposure. Valuable guide for those working in emergency coordination centers and for personnel responsible for handling dangerous substances.

- US$5.00. Information and Emergency Center, Transport of Dangerous Goods Branch, Transport Canada, Place de Ville, Ottawa, Ontario KIA ON5, Canada.

Biomedical Effects of Volcanoes, Specialized Bibliography Series, National Library of Medicine, U.S. Department of Health and Human Services. 10 pp. July 1980 (English)

The July issue of the National Library of Medicine, Specialized Bibliography Series, provides an extensive and detailed bibliography of literature (primarily from the last decade) in the field of biomedical effects of volcanoes. The issue was prompted by recent interest in the field resulting from the eruption of Mt. St. Helens in Washington State, U.S.A. The articles, monographs and reports included in the bibliography deal with health effects of volcanic eruptions as well as air, soil and water pollution. A limited number of copies are available from the editor of this newsletter or from: Reference Section, Reference Services Division, National Library of Medicine, 8600 Rockville Pike, Bethesda, Maryland 20209, U.S.A.

Handbook for Mental Health Care of Disaster Victims, Raquel E. Cohen and Frederick L. Ahearn, Jr. 126 pp. Extensive bibliography. 1980 (English)

Introduces general definitions of disasters and stress, and the role of health administrators in managing mental health problems faced by victims of sudden-onset catastrophes. Discusses the stages of emotional and behavioral changes disaster victims undergo, depending on personal and social factors affecting their vulnerability to emotional upset. After examining various models that have been developed to increase administrators' understanding of behavioral transformations in the postimpact phase, proposes guidelines for the planning and implementation of mental health services after a disaster. Ends with a detailed discussion of the three main stages of victims' emotional response to disasters and the corresponding skills that are required of mental health workers. Very useful as a guide; however, as the author recognizes, variations in cultural and social support systems require that readers take the proposals with a view toward adapting them.

- US$12.95 The Johns Hopkins University Press, Baltimore, Maryland 21218, U.S.A.

Hurricanes and Coastal Storms: Awareness, Evacuation and Mitigation, Earl J. Baker, ed. 219 pp. 105 ref. 1980( English)

A compendium of papers presented at the National Conference on Hurricanes and Coastal Storms, held at Florida State University. Participants discussed recent research findings in the areas of warning and evacuation, local disaster response planning, national flood insurance programs, land use and growth management, coastal construction and postdisaster hazard mitigation. Reference points and statistical data are based on U.S. hurricane experience. The overall methodology and the orientation of the problems examined should, however, be of interest to non-U.S. health professionals and government officials who are called upon to manage disaster preparedness and emergency relief programs.

- US$2.00. Marine Advisory Program, 6022 McCarty Hall, University of Florida, Gainewille, Florida 32611, U. S. A.

Disasters, Medical Organization, Jan de Boer and Thomas W. Bailie, eds. 110 pp. No ref. 1980 (English)

Although the title may lead readers to expect guidelines and principles in medical organization generally applicable to all countries, the chapters consist of case studies of measures and systems adopted in the Netherlands, a highly industrialized and densely populated country prone to floods and technological disasters. As a consequence, special emphasis is given to air, sea, and railroad accidents and nuclear or chemical disasters. Briefly treats legislative aspects of disaster medicine, community medicine under emergency conditions, civil defense medical services and crash teams and disaster organization in specific industries and infrastructures. little attempt was made to direct the author's conclusions and recommendations to situations and countries in which human and material resources are critically short. The chapters on triage, surgical treatment, anesthesia and analgesia and radiation may be useful to health services as aids for the preparation of simplified norms and guidelines for the treatment of mass casualties.

- US$13.00 Pergamon Press, Inc., Maxwell House, Fairview Park, Elmsford, New York 10523, U.S.A.

Selected bibliography

The publications listed in this section are articles of interest to health professionals and others 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 available reprints will be circulated to our readers periodically. When making requests, please quote the reference code listed to the left of the publication title.

J.4

Major Disasters: The Patient with Multiple Injuries, R.F. Evans, Br. J. Hosp. Med, 329-332, October 1979

K.4

Major Disasters: Disaster Planning in Hospitals, D.J. Williams, Br. J. Hosp. Med., 308-317, October 1979

E.10

Injuries from the Wichita Fails Tornado: Implications for Prevention, R. I. Glass, Science, Vol. 207, 15 Feb. 1980

I.1

Non-natural Disasters - An Epidemiological Review, Boris Velimirovic, Disasters Vol. 4 No. 2: 237-246, Pergamon Press Ltd., 1980.

I.2/E

Medical Care and Natural Disasters, Michel F. Lechat, UNDRO News, September 1980.

I.3

Aspectos Epidemiológicos para la Planeación de la Atención en Casos de Desastre, J.A. Florez Trujillo, Ministerio de Salud Pública, Antioquia, Colombia, 1980

I.4

Coping with Children's Reactions to Earthquakes and Other Disasters, Gordon et al. San Fernando Valley Clinic, 1-16,1979.

I.5

Biomedical Effects of Volcanoes, U.S. National Library of Medicine Specialized Bibliography Series, July 1980.

K.10

An Emergency Medical System Approach to Disaster Planning, L. M. Jacobs et al, Journal of Trauma, Vol. 19(3), 157-162, 1979.

NOTE: New phone number of the Emergency Preparedness Office: (202)861-6925.

Disaster Preparedness in the Americas is the newsletter of the Emergency Preparedness and Disaster Relief Coordination Office of the Pan American Health Organization, Regional Office of the World Health Organization for the Americas. 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 financial support from the Canadian International Development Agency and the Office of U.S. Foreign Disaster Assistance.

Correspondence and inquiries should be addressed to:

The Editor
Disaster Preparedness in the Americas
Pan American Health Organization,
525 23rd Street, N.W.
Washington, D.C. 20037, U.S.A.

STOP PRESS

In recognition of the value of the scientific contributions it has made to public health, the World Health Organization has designated the Centre for Research on Epidemiology of Disasters in Brussels, Belgium, WHO Collaborating Center. The Centre is headed by Prof. Michel F. Lechat. For further information on the Centre and its activities, write:

Prof. M.F. Lechat
EPID-UCL 30-34
Clos Chapelle-aux-Champs, 30
B-1200 Brussels, Belgium