NCM 0120: Disaster Nursing | Lecture

MODULE 1: EPIDEMIOLOGIC RESPONSE TO DISASTER

2nd Semester | A.Y. 2022 – 2023

Transcribed by: Patricia O. Loanzon | BSN 4D

INTRODUCTION  Disasters can occur as a result of natural dangers

Effective disaster management is concerned with the like extreme weather or human-related acts like
efficient and effective organization and coordination of bombings.
resources and information in the case of a disaster. (http://www.ifrc.org/en/what-we-do/disaster-management/about-
disasters/definition-of-hazard)
Epidemiological strategies have been used to respond to
the public health consequences of catastrophes since DISASTER – any occurrence that causes damage,
the 1960s. Epidemiologists assess the impact of a ecological disruption, loss of human life, deterioration of
disaster on human health, offer ways to control an health and health services on a scale, sufficient to
outbreak within a disaster situation, and provide support warrant an extraordinary response from outside the
for reducing the impact of future disasters with the affected area.
cooperation of the disaster management team (Centers
for Disease Control and Prevention (CDC). Disaster Occurrence either natural or manmade that causes
Preparedness and Response: Complete Course. human suffering and creates human needs that victims
Facilitator guide). cannot alleviate without assistance.

Nurses play an important role in the accomplishment of MAIN FEATURES OF A DISASTER

these objectives. To be a member of the disaster 1. Unpredictability – increase predictability, increase
management team, you must be able to recognize the effect
various types of catastrophes, as well as their effects. 2. unfamiliarity
3. speed
LESSON 1: THE DEFINITION OF DISASTER AND ITS 4. urgency
PUBLIC HEALTH IMPLICATIONS 5. uncertainty
As society has grown and gotten more complicated, so 6. threat – humans are possible victim
have its vulnerabilities to numerous dangers and ----------------------------------------------------------------------------
disasters. You may be requested to respond to these DISATER RISK REDUCTION INCLUDES:
natural and human-caused disasters as a member of the  reducing exposure to hazards
health-care team. In this course, you will learn about  lessening vulnerability of people and property
different sorts of disasters, their potential effects on  wise management of land and the environment
human civilization, and factors that can amplify or  improving preparedness for adverse events
exacerbate negative health outcomes.
RISK HAZARD DISASTER
 Probability of  Precursor of  Predictable,
disaster disaster, complication
 The chance unpredictabl of hazard
high or low, e, inevitable  An event
that any  A that
hazard will dangerous completely
actually situation causes
cause that poses a damage to
somebody threat or human
harm. = may life/society
probability develop into and
that a person a disaster. property.
may be hurt  A condition  “The hazard
 Einstein or situation is realized.”
(1988) which has (Whittow,197
defines risk the potential 9) = already
DEFINITION OF A DISASTER as the to create took place;
A disaster is a serious disruption of the functioning of probability of harm to hazard
society, causing widespread human, material or an event people, which
environmental losses that exceeds the local capacity multiplied by property, or already
to respond, and calls for external assistance. the the happened
 The United Nations Department of Humanitarian Affairs, the World consequenc environment.  “A disaster
Health Organization and Gunn’s multilingual Dictionary of Disasters
Medicine and International Relief
es if the ” (IPENZ, generally
event 1983) results from
When is an event a disaster? occurs.  A hazard the
 At least 20% of the population are affected in the  (Hazard + may lead to interaction,
need of emergency assistance Vulnerability a disaster in time and
 At least 20% of the means of livelihood are + Exposure) when it space,
destroyed / Capacity interacts with between the
 Major roads and bridges are destroyed and  Chance that vulnerable physical
impassable for at least a week, disrupting flow of someone will human. exposure to
transport and commerce be harmed  Anything a hazardous
 Widespread destruction of fish ponds, crops, by the that can process and
poultry, and livestock and agricultural products hazard cause harm a vulnerable
 Epidemics human
population.”
(Smith, 1996)
 Remember!!!! DISASTER IS NOT SYNONYMOUS
with RISK and HAZARD. Example: Living in an island that is very prone for
 Natural or man-made disasters can be categorized tsunami. One person is living in a building that is sturdy.
according to their speed of onset (sudden or Another family is living in a building which is in poor
slow), scale (small, moderate, or major). quality.
 Both of them is faced with the hazard of tsunami

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 NCM 0120: Disaster Nursing | Lecture
MODULE 1: EPIDEMIOLOGIC RESPONSE TO DISASTER
2nd Semester | A.Y. 2022 – 2023

Transcribed by: Patricia O. Loanzon | BSN 4D

 The risks are different. There is a lower risk for  Resistance: Lack of proper measures - ↑
the sturdy building compared to a poor quality vulnerability
building.  Resilience: Economic limitations ↑ vulnerability
 Increased vulnerability
CAPACITY VULNERABILITY
The combination of all The condition determined DISASTER RISK
the strengths and by physical, social, Risk: (Hazard + Vulnerability + Exposure) / Capacity
resources available within economic and *higher risk if ↑ hazard, vulnerability, exposure
a community, society or environmental factors or *the higher the capacity → the lower the risk for disaster
organization that can processes, which increase (indirectly proportional)
reduce the level of risk, or the susceptibility of a
the effects of a disaster. community to the impact
 tantamount capability of hazards. (UN ISDR
 the higher the 2002)
capacity → the lower  the more vulnerable
the vulnerability the person or the
community → the
Capacity may include: higher the risks for
 physical, institutional, hazard
social or economic
means Exposure + resistance +
 as well as skilled resilience
personal or collective  Exposure = at risk
attributes such as property and
'leadership' and population
'management.' (more exposure →
more vulnerable)
Capacity may also be **directly proportional
described as capability. to vulnerability
(UN ISDR 2002)  Resistance =
measures taken…
(more resistant →
less vulnerable)
**indirectly ↓ Disaster Risk
proportional to
vulnerability ↓ (Hazard + Exposure + Vulnerability) - ↑ Capacity
 Resilience = ability Monitor Increased Measures
to recover… and community to reduce
(more resilience → forecast awareness vulnerability
hazards
less vulnerable)
**indirectly
proportional to DISASTER CLASSIFICATION BASIS
vulnerability Onset Scale Source Involvement
(magnitude)
Rapid Level 1 Natural Internal
Vulnerability Example Slow Level 2 Manmade External
Level 3 Combined

TYPES OF DISASTERS: SPEED OF ONSET

(sudden or slow)
Sudden or rapid onset Slow onset disasters
disasters
 Shock is caused by  Slow-moving
these disasters that are disasters/moving
triggered by the phenomena
abrupt onset of  A disaster that prevails
events. = causes for many days,
shock months or even
 These calamities may years
have a short-term or
long-term impact.
 The majority of the
'natural' disasters
happen without
notice, especially in
the case of
earthquakes
Examples: Examples:
 Cyclones, hurricanes,  Drought, Climate
and typhoons, volcanic change, environmental
eruptions, Floods can deterioration, and
The darker the color, the higher (Southern area) the risk strike quickly (yet the desertification, famine,
for cyclones. conditions that lead to pest infection
 Exposure: Higher exposure (dark) - ↑ flooding are fairly
vulnerability predictable)
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 NCM 0120: Disaster Nursing | Lecture
MODULE 1: EPIDEMIOLOGIC RESPONSE TO DISASTER
2nd Semester | A.Y. 2022 – 2023

Transcribed by: Patricia O. Loanzon | BSN 4D

water component), specific type of man-

TYPES OF DISASTERS: SCALE avalanche – mass made disaster: a
(MINOR, MODERATE OR MAJOR) movement which combination of civil
 Level I disaster – considered a minor disaster. happens on areas with strife and conflict that
These involves minimal level of damage snow, subsidence leads to a mass
 Level II disaster (meso) – considered a moderate (sinkhole/depression) exodus of people and
disaster. The local and community resources have to the events that follow,
be mobilized to manage this situation - 2. Climatological such as disease and
= community can still able to manage the effects of disasters -events property destruction.
the disaster on their own caused by long-lived
Ex: Stampede (can be I or II) processes in the 2. Technologic
 Level III disaster (macro) – considered a massive spectrum from intra- emergencies - large
disaster- this involves a massive level of damage seasonal to multi- number of people,
with severe impact. decadal climate property, community
= community will usually need the help from external variability = climate infrastructure, and
resources or other sources changes economic welfare are
Ex: Mt. Pinatubo, Typhoon Ondoy directly and adversely
e.g heatwave, extreme affected by major
THE HIGHER THE LEVEL, THE HIGHER THE winter, wildfire, industrial accident,
MAGNITUDE. drought unplanned release of
nuclear energy and
TYPES OF DISASTERS: SOURCE 3. Meteorological fires or explosions
(NATURAL VS MAN-GENERATED) disasters -events from hazardous
Natural Disasters Man-made/ human- caused by short-lived substances such as
generated processes in the fuel, chemicals, or
 caused by natural or  secondary to human spectrum from minutes nuclear materials. =
environmental forces errors or fault to days disasters or
functioning of catastrophic events
technological process e.g storm, cyclone wherein there is
 resulted from human community
actions or 4. Hydrological infrastructure and
technological failures, disasters - events economic welfare
deliberate or caused by deviations damages which is
otherwise in the normal water caused by a major
 results of human cycle and/or overflow industrial event →
intent, error, or as a of bodies of water may be severe that
result of failed caused by wind will lead to complex
systems setup emergencies
 For example, human
activities (e.g., e.g. flood, coastal Also possible are
agricultural or other flood/ storm surge, combined natural–
practices) that result mass movement (wet) manmade disasters,
in deforestation have as would occur if an
led to landslides and 5. Biological disasters - earthquake destroyed
drought. Similarly, the are events caused by a nuclear power plant.
the exposure of living (Zibulewsky J. Defining
settlement of disaster: the emergency
communities in flood organisms to germs department perspective. Proc
zones or close to and toxic substances Bayl Univ Med Cent). = can
beaches and coastal not deliberate = no overlap
areas has increased human extension of
the human effect of exposing someone (an 3. Terrorism - defined
floods and tsunamis. accident) as an act that is
Natural disasters are Categories: violent or
classified into five 1. Complex e.g. infectious dangerous to
subgroups, namely: emergencies - diseases, insect human life, with the
geophysical, conditions where infestations, animal intent of furthering
climatological, populations suffer stampede political or social
meteorological, significant casualties objectives. =
hydrological, and as a result of war, civil intentional but if is
biological disasters strife, or other political unintentional, it is
conflict. = there is a considered biological
1. Geophysical combination of disaster (natural)
disasters political wars,
(Geological) - events conflicts, etc. which Bioterrorism is the
originating from the would lead to deliberate release of
solid earth destruction of human viruses, bacteria, or
life and properties other germs (also
e.g. earthquake, known as “agents”)
volcano eruption, After the fall of the used to cause illness
landslide, mass Soviet Union, the or death in people,
movement (dry), World Health animals, or plants. =
avalanche, subsidence Organization coined “Bio” means alive or
downslope of any the term "complex living
material (dry – soil, humanitarian
rocks, etc.; if wet – w/ disaster" to describe a 4. Transitional Human

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 NCM 0120: Disaster Nursing | Lecture
MODULE 1: EPIDEMIOLOGIC RESPONSE TO DISASTER
2nd Semester | A.Y. 2022 – 2023

Transcribed by: Patricia O. Loanzon | BSN 4D

Shelter - any of a patients of a

range of shelter chemical spill
options that help COVID-19 Pandemic
people affected by
conflict or natural QUESTION: The 2001 anthrax attacks, also known as
disasters who have Amerithrax (a combination of "America" and "anthrax"),
lost or abandoned took place in the United States over several weeks
their housing beginning on September 18, 2001, one week after the
(temporary shelters) September 11 terrorist attacks, and involved letters
until they can return containing anthrax spores being mailed to several news
to or recover media offices as well as Democratic Senators Tom
acceptable Daschle and Patrick Leahy, killing five people and
permanent infecting 17 others. This example of disaster is an
accommodation. example of what kind of disaster?
Disasters are most a. Natural disaster
often associated with b. Technological disaster
outbreaks, c. Complex emergency
epidemics, and d. Human-induced disaster = since there is intent
pandemics. = → Bioterrorism
brought about by poor
water or poor EFFECTS OF DISASTERS
sanitation It is vital to remember that a natural or human-caused
Source: Compendium of Philippine Environment Statistics 2016 disaster only becomes a disaster when it grows to a
https://www.mchenrycountyil.gov
size that exceeds local capabilities to handle the
After the fall of the Soviet Union, the World Health problem and necessitates outside aid. As we have
Organization coined the term "complex humanitarian seen, a danger can lead to disaster in a vulnerable
disaster" to describe a specific type of man-made group or community.
disaster: a combination of civil strife and conflict that
leads to a mass exodus of people and the events that SOCIAL VULNERABILITIES connected with poverty,
follow, such as disease and property destruction. health and nutritional status, access to health
services, and environmental conditions are all
Complex emergencies are marked by widespread variables that contribute to susceptibility. Another key
violence and loss of life, population displacement, factor that can influence the scale of a disaster's
widespread damage to societies and economies, the potential consequences is the community's
need for large-scale, multi-faceted humanitarian preparedness and mitigation efforts.
assistance, (society can no longer mobilize their own *Mitigation – community is doing something to decrease
resources; need external help), political and military or reduce.
constraints impeding or preventing humanitarian
assistance, and significant security risks for FACTORS AFFECTING MAGNITUDE
humanitarian relief workers in some areas. → lots of OF THE DISASTER
factors and events – either natural or human-generated  Nature and severity of disaster
calamities – that cause secondary disasters/significant  Characteristic of population – total number of
casualty condition
 Living conditions of the community -
Also possible are combined natural–man-made characteristics of the house
disasters, as would occur if an earthquake destroyed a  Level of preparedness
nuclear power plant.  Health infrastructure of the community
(Zibulewsky J. Defining disaster: the emergency department perspective. Proc
(Bayl Univ Med Cent). 2001;14(2):144-149.
doi:10.1080/08998280.2001.11927751) The effects of disasters can be classified into three
major categories, according to the CDC (Public Health
TYPES OF DISASTERS: Surveillance for Disaster-related Mortality. Full-day
Internal Disasters External Disasters Training: Colorado Department of Health and
 Occurs when there is  Becomes a problem Environment Disaster Epidemiology Training; October
an event within the for a facility when the 24, 2012; Denver CO). Infrastructure damage, human
facility that poses a consequences of the impact, and environmental hazards are the three
threat to disrupt the event that creates a major categories. These categories are frequently
environment of care demand for services linked. Regardless of how a disaster's impacts are
defined, the end outcome is a severe disruption of
 Emergency situations that exceed the
usual available society's functioning, resulting in widespread human,
in which only
resources = material, or environmental losses that surpass local
patients, visitors and
hospitals would try to capacity to respond and necessitate outside aid.
staff within the
hospital are injured build tents outside
the hospital because Infrastructure Human Impact Environmental
they can no longer Damage Hazard
address the needs of  Damage  Injury or  Technologic
the increased may occur death are al
number of patients to houses, the most malfunctions
 Emergency business immediate may release
situations that centers, effects of hazardous
involve the whole hospitals, disasters on materials
community and human into the
Examples: Examples: transportati health. community.
 loss of utilities or fire  arrival of large on services.  Morbidity  For example,
in the hospital number of trauma  Example: rates for a toxic
Access to variety of chemicals
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 NCM 0120: Disaster Nursing | Lecture
MODULE 1: EPIDEMIOLOGIC RESPONSE TO DISASTER
2nd Semester | A.Y. 2022 – 2023

Transcribed by: Patricia O. Loanzon | BSN 4D

health illnesses can release Chemical or biologic contaminants such as asbestos

services may and be possibly released from massive structural collapse or
 The local increase dispersed by dust clouds during a natural or human induced disaster
health (directly or strong are categorized mainly as:
infrastructur secondary – winds, a. Infrastructure damage
e may be PE) seismic b. Human impact
destroyed,  Damage to motion, or c. Environmental hazards
which can infrastructur rapidly d. All of the above
disrupt the e can lead moving
DISASTER-RELATED HEALTH EFFECTS AND
delivery of to food and water
PUBLIC HEALTH IMPLICATIONS
routine water disasters
The magnitude or severity of the public health effects of
health shortages resulting in
a certain disaster may be influenced by the following:
services to and massive
nature and extent of the disaster itself, population
an affected inadequate structural
density, underlying health and nutritional conditions of
population sanitation, collapse or
the affected population, level of preparedness, and the
 Roads may all of which dust clouds
pre-existing health infrastructure.
be accelerate can cause
impassable the spread the release
The effects may be classified as direct or indirect health
or of infectious of chemical
effects.
damaged, diseases or biologic
hindering  Loss of contaminant
s such as DIRECT HEALTH INDIRECT HEALTH
relief loved ones,
asbestos or EFFECTS EFFECTS
efforts, social
mycotic  Caused by the  Caused by
limiting support
(fungal) disaster’s actual, unsafe/unhealthy
access to networks, or
agents. physical forces conditions that
needed displacemen
medical t can result  Flooded or  typically occur during develop due to the
supplies in psycho- damaged the event effects of the disaster
and care, social sewers or or events that occur
affecting the problems. latrines may from anticipating the
disaster
distribution  Proper force people
of food manageme to use  Some indirect health
throughout nt of dead alternative effects may not
the country, bodies also methods for appear until several
and becomes a disposing weeks/months/days
increasing challenge human following a disaster
the risk of and every waste, while other indirect
injuries as a effort should potentially health effects may
result of be taken to introducing occur immediately
motor identify the additional after, or even prior to,
vehicle bodies and environment the disaster
accidents. assist with al hazards  One of the public
final into a health concerns
disposal in community. following a disaster is
accordance  Increase in the potential for the
with vector spread of
surviving populations, communicable
family such as diseases or new
member mosquitoes illness outbreaks.
wishes and or rodents *after
the religious can pose a Examples: Examples:
and cultural risk to  drowning during a  Carbon monoxide
norms of the human tsunami poisoning is an
community. health, as  injury caused by indirect health effect
can stray flying debris/ that typically occurs
animals structural collapse during power outages
displaced by during a hurricane  worsening of a
the disaster  suffocation on the chronic disease =
Source: Centers for Disease Control and Prevention (CDC). Disaster release of gas tank/ poor accessibility to
Preparedness and Response: Complete Course. Facilitator guide, first edition.
Atlanta (GA): CDC gas leak, poisoning medications (no
access)
QUESTION: On September 11, 2001, the World Trade  waterborne or vector-
Center (WTC) twin towers in New York City collapsed, borne diseases =
transforming most of the buildings' massive masses into flood
dense dust clouds that accumulated on the streets and  disease outbreaks
within buildings throughout Lower Manhattan. About 80–  mental health
90 percent of the settled WTC Dust was a highly alkaline concerns = insomnia,
mixture of crushed concrete, gypsum, and synthetic anxiety
vitreous fibers (SVFs) that was easily resuspended by
physical disturbance and low-velocity air currents, with MAN-MADE DISASTERS (NUCLEAR EXPLOSION)
particle sizes ranging from 2.5 m upward. High amounts PENNYSYLVIA, 1979 AND RUSSI 1986
of coarse and supercoarse WTC Dust were breathed  Human mortality
and deposited in the conductive airways in the head and  People still living in contaminated areas (soil,
lungs, then swallowed, irritating the respiratory and ground, water, air, food)
gastroesophageal epithelia physically and chemically.

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 NCM 0120: Disaster Nursing | Lecture
MODULE 1: EPIDEMIOLOGIC RESPONSE TO DISASTER
2nd Semester | A.Y. 2022 – 2023

Transcribed by: Patricia O. Loanzon | BSN 4D

 Emergency workers suffered acute radiation  This is largely due to the location and geographical
sickness context as the risk involving coastal hazards such
 Birth defects, miscarriages, and still births as typhoons, storm surges and rising sea levels is
 2000, thyroid cancer in children and adolescents high.
 Suicide and violent deaths among firemen,  Also, as the islands are located within the “Ring of
policemen, and recovery workers Fire” between the Eurasian and Pacific tectonic
plates, earthquakes and volcanoes are posing
QUESTION: What is not a typical example of an indirect serious risks to the safety of the populace.
health effect?  Flooding, landslides, droughts and tsunamis further
a. Exacerbation of chronic disease contribute to the exposure to natural hazards (CFE-
b. Waterborne disease DM, 2018). Of these, hydro-meteorological events
c. Drowning = direct effect of the force of disaster including typhoons and floods, accounted for over
d. Disease outbreak 80% of the natural disasters in the country
during the last half-century (Jha, 2018).
LESSON 2: THE PHILIPPINE
DISASTER AND RISK PROFILE
This section of the module gives an overview of the
Philippines' current disaster profile and risk
reduction efforts under the Sendai Framework's four
priorities (Disaster Risk Reduction in the Philippines: Status Report 2019,
Bangkok, Thailand, United Nations Office for Disaster Risk Reduction (UNDRR),
Regional Office for Asia and the Pacific).

*Read Philippines Disaster Management Reference

Handbook pages 19-26

THE PHILIPPINE DISASTER AND RISK PROFILE

The following is a summary of natural disasters in the
Philippines in recent years:
1. Tropical Storm Kompasu (Maring) - October
2021
2. Floods and Landslides - July 2021
3. Taal Volcano - July 2021 and January 2020
4. Typhoon Surigae (Bising) – April 2021
5. Typhoon Vamco (Ulysses) - November 2020
6. Typhoon Goni (Rolly) - November 2020
7. Typhoon Molave (Quinta) - October 2020
8. Typhoon Vongfong (Ambo) - May 2020
9. Typhoon Phanfone (Ursula) - December 2019
10. Earthquake – December, October 2019 -
Mindanao

 On the average, geophysical, hydrological, and

meteorological disasters had the highest
percentages relative to the total number of natural
disasters, at 40 percent; 27 percent; and 24
percent, respectively. Meanwhile, biological
disasters had the least average of two percent.
This map shows the seismic, volcanic and tropical storm  Earthquakes - it lies along the Pacific Ring of Fire,
risk in the country. (area on the Asia and the Pacific which is prone to
*Philippines - Pacific Ring of Fire and Typhoon Belt earthquakes due to the number of volcanoes in its
*Least Prone (earthquake) – Palawan vicinity), the country have frequent seismic and
*More Prone (typhoon) – East side volcanic activities; very big statistic of earthquakes of
smaller magnitude occur very regularly due to the
BACKGROUND meeting of major tectonic plates in the region
 In terms of disaster risk, the Philippines ranked  Tectonic earthquakes – are produced by
third among all of the countries with the highest sudden movement along faults and plate
risks worldwide according to the World Risk Report boundaries. Type of earthquakes we are careful
2018, with an index value of 25.14% (World Economic of (“Big Earthquake”) in the country.
Forum, 2018). Something that we have to focus and  Earthquakes induced by rising lava or magma
work with; one of the reasons why we have to be beneath active volcanoes is called volcanic
prepared at all times. earthquakes.
 At least 60% of the country’s total land area is  ***The more earthquake prone regions are
exposed to multiple hazards, and 74% of the eastern Mindanao, Leyte, and Samar
population is susceptible to their impact (GFDRR,  Liquefaction is a significant concern in central
2017). Approximately 85.2% of the sources of the
Luzon, especially in the provinces of
country’s production have been reported to Pangasinan, Tarlac, and some areas in Metro
susceptible to disasters……. Manila.

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 NCM 0120: Disaster Nursing | Lecture
MODULE 1: EPIDEMIOLOGIC RESPONSE TO DISASTER
2nd Semester | A.Y. 2022 – 2023

Transcribed by: Patricia O. Loanzon | BSN 4D

 Tectonic earthquakes are produced by sudden

movement along faults and plate boundaries QUESTION: In Philippines, most disasters are classified
 Volcanic eruptions - There are 53 active as:
volcanoes (out of the 300+ total) in the a. Natural
archipelago. b. Technological-generated
MEMORIZE MO DAPAT SIGURO TO?!?!?! c. Biological
Most active volcanoes are the Mt. Mayon d. Hydro-meteorological
(Bicol), Mt. Kanlaon (Negros), Mt. Taal
(Batangas), Mt. Pinatubo (Zambales), etc. - As nurses, we are the most numbered member of the
(MKTP) healthcare team, which makes us instrumental and
essential in times of disasters.
The volcanoes of the Philippines rank as the
most deadly and costly in the world. About LESSON 3: THE ROLE OF DISASTER NURSING IN
13% of the country’s historic eruptions have DISASTER PREPAREDNESS AND RESPONSE
caused fatalities, most notably at Taal and
Mayon, and 22% of its eruptions caused Critical Thinking Triage, trauma, life support,
significant damage. Since the establishment of Problem solving skills mental health, infection
PHILVOLCS, the negative impact of the Communication skills control
eruptions, including damage, has been
significantly reduced. Disaster epidemiology entailed assessing the needs
of affected people and providing fast and reliable health
 Flooding - torrential rain can result in flooding in information to decision makers, as well as identifying
overflowing rivers, saturated soil, low-lying areas risk factors and improving disaster prevention and
and poor drainage. The most number of mitigation methods in the future. Disaster epidemiology
deaths and economic losses come from this is critical to the development of disaster
type of hazard. preparedness and management principles in a variety
 ”Pacific typhoon belt” of sectors, including Disaster Nursing.
 These events account for 80% of
disaster deaths, 90% of affected people, Nurses have been at the vanguard of disaster nursing
and 92% of economic damage for well over a century, dating back to Florence
 Torrential rain can result in flooding in Nightingale in the 1800s. Since then, nurses have
overwhelming rivers reacted to countless tragedies across the country and
 Monsoon rains can bring damaging beyond the world. Nurses are uniquely suited to
floods to low-lying, marginally developed respond to the diverse and specific demands
areas. Stronger monsoon seasons imposed by disasters because of their critical thinking,
combined with increasing urban problem-solving, and communication skills. Nurses'
development exacerbates flood risks, as strong clinical competence and decision-making
drainage channels are insufficient or capacity enable them to provide a wide spectrum of
impeded. treatment (e.g., triage, trauma, life support, mental
 The Philippines is also very susceptible health, and infection control) during all phases of
to sea level rise along the coast, disaster response, from mitigation through recovery.
contributing to flood risks. Repeated Military nurses, in particular, have contributed greatly to
flooding is a problem for the metro what is known about disaster nursing since the 1920s as
Manila area, which houses about 13 a result of their diverse domestic and international
million people and contributes experiences.
approximately 35% to the national
economy. The Manila area experiences Disaster nursing can be defined as “the adaptation of
perennial floods during rainy seasons as professional nursing knowledge, skills and attitude
it is located in a river delta by the ocean. in recognizing and meeting the nursing, health and
emotional needs of disaster victims.” It does not only
 Typhoon - In average, about 20 typhoons involve events during the disaster, but also during before
occur annually, with the months of June to and after the disaster
November averaging approximately 3 typhoon
strikes per month. The overall goal of disaster nursing is to achieve the
 The Philippines is the country most exposed to best possible level of health for the people and the
tropical storms in the world. The Philippines community involved in the disaster.
straddles the typhoon belt, an area in the
western Pacific Ocean where nearly one-third OTHER GOALS OF DISASTER NURSING
of the world’s tropical cyclones form. ARE THE FOLLOWING:
 Approximately 22 tropical cyclones enter the To achieve the best possible level of health for the
Philippines area each year; of these storms, an people and the community involved in the disaster.
average of 6-7 annually cause significant
adamge. 1. To meet the immediate basic survival needs of
 For the ten-year period, a total of 4,426 deaths populations affected by disasters (water, food,
due to human induced incidents were recorded shelter, and security). In times of disasters, we do
with 23% (1,028 events) classified under land not only focus on the physical health but nurses
disasters, including vehicular accidents and train can be shelter managers, assigned in food & water
mishaps, and another 23% (1,027) as maritime- sanitation to help meet basic needs. Nurses in the
related disasters. (Compendium of Philippine Environment hospital or community report of the distribution
Statistics 2016) teams of the food & water of the affected victims.
 Human-generated disasters that are 2. To identify the potential for a secondary
uncommon also happen, such as vehicular disaster. As nurses, we have to anticipate of the
accidents, bombings, and stampedes. But, possible effects of a disaster (direct & indirect
majority of the disasters in the Philippines are health effects). A good nurse who practices the
classified as natural disasters. principles of disaster nursing can anticipate the

7
 NCM 0120: Disaster Nursing | Lecture
MODULE 1: EPIDEMIOLOGIC RESPONSE TO DISASTER
2nd Semester | A.Y. 2022 – 2023

Transcribed by: Patricia O. Loanzon | BSN 4D

possibility of having indirect health effects of a 7. Leadership in coordinating patient triage, care,
disaster (e.g., during a typhoid outbreak: effect on and transport during times of crisis. Very evident!
emotional and mental health especially if there Nurses in times of disasters will serve as leaders in
were deaths, high demands/shortages for evacuation centers, shelters, or facilities.
resources with IV fluids, antibiotics) Leadership is a very important factor in increasing
3. To appraise both risks and resources in the the capacity of the community to recover
environment. Check on the available resources meaningfully and timely.
(e.g., are there other secondary sources of water 8. The teaching, supervision, and utilization of
such as water stations) auxiliary medical personnel and volunteers. s.
4. To correct inequalities in access to health care or During times of disasters, the nurses guiding other
appropriate resources. The nurse is an equalizer health personnel doing health education does not
who helps in allocating the resources. stop. If you are a nurse in the community, you are
5. To empower survivors to participate in and expected to do health education among barangay
advocate for their own health and well-being. health workers or volunteers in order to cascade
During an outbreak phenomenon, you can important teachings.
empower survivors by providing health 9. Provision of understanding, compassion, and
teachings such as proper handwashing emotional support to all victims and their family.
techniques, proper food handling, and storage of Just like in Trauma Nursing, we do not only deal
water. with the physical aspect but also with the
6. To respect cultural, lingual, and religious emotional, spiritual and psychological aspect of the
diversity in individuals and families and to apply patient. As much as possible, we need to show
this principle in all health promotion activities. understanding and compassion because there are
Disaster Nursing in relation to Cultural Nursing. We times when these are only what we can offer.
have to respect the cultural and religious belief of
people. (e.g., If you have an indigenous patient or KEY POINTS!
a group of family who believes in tying a red cord  A disaster is a major disturbance of society’s
tightly around the abdomen of a child will help in functioning that results in widespread human,
easing relief, you have to first acknowledge or ask material, or environmental losses that surpass
about the reason, then you should compromise local capacity to respond and so demands
and state that they can do it as long as they do not outside aid.
tie it too tightly or slightly make it loose to prevent  The effects of disasters can be classified into
interfering with respirations.) three major categories: infrastructure damage,
7. To promote the highest achievable quality of life for human impact, and environmental hazards.
survivors. Involves rehabilitative efforts, debriefing, Health impact may be direct or indirect.
psychological support, and etc.  Disaster nursing can be defined as “the
adaptation of professional nursing knowledge,
PRINCIPLES OF DISASTER NURSING skills, and attitude in recognizing and meeting
The basic principles of nursing during special (events) the nursing, health and emotional needs of
circumstances and disaster conditions include: disaster victims.” The overall goal of disaster
1. Rapid assessment of the situation and of nursing nursing is to achieve the best possible level of
care needs. Disasters are usually emergency health.
situations so we must perform our assessment
rapidly.
2. Triage and initiation of life-saving measures first.
Prioritizing patients who need the most help.
ABC!?
3. The selected use of essential nursing
interventions and the elimination of nonessential
nursing activities. When you do your history and
PE, you have your primary survey and short history
first before doing a whole evaluation and complete
history.
4. Adaptation of necessary nursing skills to disaster
and other emergency situations. The nurse must
use imagination and resourcefulness in dealing
with a lack of supplies, equipment, and personnel.
Nurses are very creative and can adapt to different
situations. (e.g., Patient has fever and the hospital
does not have a hypothermia blanket, you can
submerge the IV tubing in a kidney basin with ice
so that the fluid going into the body is cool to
reduce high temperature; You can use blankets or
plywood boards to transport patient during
emergencies)
5. Evaluation of the environment and the
mitigation or removal of any health hazards.
Safety is the priority. As a nurse, you are not only
concerned with the patient but you look into the
general picture and reduce the environmental
hazards as much as we can.
6. Prevention of further injury or illness. Part of the
principles or activities in Disaster Nursing is to
identify risks, who are at risk and identify resources
to prevent secondary or indirect health effects.