Revelation of 5.12 Quake, Sichuan, China

Part 4a Short-term response after the quake

Supercourse China 超级课程 ·中国

http://www.SuperCourse.cn/

2008-6-6

Outline

Response of ordinary people4.1.Personal sanitation problem

4.2.Post-disaster self psychological adjustment

Short-time response of professional agencies4.3.Secondary disasters control4.4.Medical treatment and transport for the wounded4.5.Public health and infectious disease control4.6.Victims settlement4.7.Post-disaster psychological assistance

Response of ordinary people

4.1 Personal sanitation problem

4.2 Post-disaster self psychological adjustment

4.1Personal sanitation problem• Sanitation of drinking water

– Water is necessary in daily life and it will cause epidemics if there are bacteria in the water

• It is important to remind the victims not to drink raw water but the boiled water.

• Management of the external environment– Poor sanitation condition of the external environment

proliferation of mosquito outbreak of the epidemic such as haemophilus influenzae type B meningitis So it is necessary to sanitize and carry out disinsection

• And we should make a hard effort into the development of national sanitation movement and the prevalence and education of health knowledge

信息来源：中国政府网，卫生部

4.1Personal sanitation problem

• Deal with the epidemic situation as soon as possible after discover of the cases

-The victims should be reminded to keep an eye on their health condition and report to the medical staff when feeling uncomfortable.

4.2 Post-disaster self psychological adjustment

国家 CDC

国家 CDC

Short-time response of professional agencies

4.3 Secondary disasters control

4.4 Medical treatment and transport for the wounded

4.5 Public health and infectious disease control

4.6 Victims settlement

4.7 Post-disaster psychological assistance

According WHO:

1) Treating The Injured

2) Communicable Disease Surveillance & Control

3) Ensuring Safe Water And Food Supply

4) Immediate & Long-term Mental Health & Psychosocial Support

5) Reconstruction Of Health Care System In The Affected Areas

Public Health Priorities

4.3 Secondary disasters control

• The Wenchuan earthquke probably cause other secondary disasters

• such as the threaten resulting from dams ：• The biggest earth and stone work-dam is moved 30cm

because of the earthquake• About 400 injured dams are likely to endanger the

people living downstream• And the formation of natural dams and lakes is also

another threaten.

The response of the Ministry of Land and Resources after this

quake • The response of the Ministry of Land and Resources

after this quake • Starting the preplanned emergency response scheme for

super geological disaster, organizing geologists to the disaster area, establishing the check of the most important hidden troubles and guiding the evading and prevention and treatment of geological disaster.

• Assembling 7 aircrafts to carry out the aviatic photography, arranging 6 high resolution radar-remote sensing satellites to get the remote sensing pictures of the disaster area after the quake. These measurements had offered 19,000 pieces of relief maps for disaster relief and 22,000 special maps on analysis of disaster situation and rescue situation till May 25th

Ministry of Land and Resources

The response of the Ministry of Land and Resources after this

quake • Paying a close attention to the weather condition and

forecasting the happening of geological disasters, ruling out the hidden troubles in the area where the water conservancy facilities, roads and railways, power supply circuit and the communication facilities stand. And 386 places of great threaten and 34 barrier lake were discovered.

• Offering the mapping ensurence for the reconstruction. Establishing the emergence-response check, resuming the mining work, programming the land for reconstruction and revising the plans of prevention and treatment for earthquake properly. And ensuring the land for reconstruction after earthquake, starting the green channel for the approval of the land, practising special land-supply policy and enhancing the effort for reclaiming of the destroyed plowland.

Ministry of Land and Resources

Lake Formation & Flood Threat

• Creating natural dams by moved down rocks into rivers

• Formation of 21 lakes throughout the basin

Dangers due to earthquake-created dams:– Upstream floods

– Instability of the piles of rubble

– Bursting the dam by another quake

– Downstream floods by cascade of water

– Evacuation of thousands of people from Beichuan

4.4 Medical treatment and transport for the wounded

The arrangement of transportation of the injured after this earthquake

• 10015 injures had been transported to 20 provinces (district or city) by May 31st, contributed with:

-21 appropriative trains -99 charter flights -10,000 over ambulances -5000 over medical staff -20 provinces -And more than 340 level-

three hospitals.

Ministry of Health

• Large scale migration of inhabitants

• Large scale scale influx of relief workers & material

Indian Examples: BHUJ Eathquake

• International NGOs : 55• National /Local NGOs : 26• Government Bodies : 8• Donor Governments :18• Inter Governmental Organisations :8• Red Cross and Red Cresent :6• Total Organisations (2 weeks) :125

Relief Agencies at work

• Immediate 48-72 hrs Relief and Rescue provided by Indian Army Teams and the Indian Army Hospital

• 12000 surgical operations performed in makeshift Military Hospital within first 60 hrs of the Disaster

4.5 Public health and infectious disease control

ANTICIPATED PUBLIC HEALTH PROBLEMS IN DISASTERS

1 Disruption of Water supply and Sanitation

2 Large scale migration

3 Overcrowding due to emergency housing situations with poor personal hygiene

4 Mass feeding without adequate food handling, storage and sanitary facilities

5 Disposal of Dead Bodies and Caracas

6 Rodent and Stray dog/animal problems

7 Relaxation of sterilization precautions and emergency use of unscreened blood

8 Psycho-social and Mental health problems

COMMUNICABLE DISEASES HAVING DISASTER IMPLICATIONS (HAVING POTENTIAL FOR OUTBREAK)

1.Amoebiasis

2.Camplyobacter Enteristis

3.Chicken Pox

4.Cholera

5.Coccidiomycosis

6. Dengue fever

7.Diptheria

8.E. Coli Diarrhoea

9.Food Poisoning

10.Rotavirus Enteritis

11.Hepatitis A, B & E

12.Hanta Virus Disease

13.Influenzae

14. Leptospirosis

15. Malaria

16. Measles

17. Meningitis

18. Pertusis

19. Plague

20. Pnuemococcal Pneumonias

21. Rabies

22. Relapsing Fever

23. Salmonellosis

24. Scabies

25. Typhoid Fever

• Situation Assessment

• Public Health Measures– Water Borne disease– Air Borne infections– Vector borne diseases– Biomedical wastes– Disease Surveillance – Dead Bodies and Animal Caracas Disposal– Disinfecting of Rescue Sites and Teams– Mental Health

Public Health Measures

• Situation Assessment

• Public Health Measures– Water Borne disease– Air Borne infections– Vector borne diseases– Biomedical wastes– Disease Surveillance – Dead Bodies and Animal Caracas Disposal– Disinfecting of Rescue Sites and Teams– Mental Health

Public Health Measures

CLIMATIC CONDITIONS PREVAILING IN BHUJ IN FIRST WEEK OF FEB 2001

Max Min

Day Time 330 C 220 C Avg Temp 210CNight Time 190 C 090 C

RH 72 61

Rainfall Nil Gujarat State has experienced Drought Conditionssince 1998

Water Borne disease• Threat potential

– Breakdown of distributed piped water supplies and water requirement being met from alternate sources

– Drinking water available only from 4 to 5 deep bore wells scattered over the whole town and nearby villages in the Public Health Engineering Department.

– Drinking water is highly salty and at places turbid (due to earthquake).

– The water is collected by water truck/water bowsers/tankers and distributed manually

• Intervention– The bore well water is collected in sump.

– Flocculation and sedimentation in the sump was carried using Alum for a period of atleast 4 hours

– It is followed by super chlorinating at 2 ppm with liquid chlorine and/or bleaching powder with a contact period of minimum 20 minutes

– All water bowsers/tankers leaving the water point were checked for free chlorine levels and due records were kept.

Water Borne disease

Water Borne disease•Outcome– 70 to 75 percent of population was getting chlorinated water supply.

– A 8000 litre desalination plant received as gift from USAID was installed for exclusive issue of drinking water.

–There were no cases of Gastro Intestinal diseases among population in 3 week post disaster period.

–A close monitoring has been instituted combined with disease surveillance

• Threat potential

– All pers and families living in tentage and makeshift

arrangements

– Inadequate supplies of tentage resulting in

overcrowding by a factor of 80 to 100 percent.

– Sharp and high difference in max and min temp

(max daytime temp of 34 to 36 degrees centrigade

while min night temp was 8 degrees centigrade)

– Season ideal for Chicken pox, measles and

meningitis outbreaks

– Potential of outbreak of Bubonic plague was kept in

mind in view of earthquake disaster

Air Borne disease

• Intervention– Health education campaign was undertaken to ensure

that there was minimal over crowding in tentage accommodation. A minimum distance of 3 feet was advocated

– To adopt a head-foot alternate bed positions

– Adequate ventilation of tentage and exposure to sun during daytime was adovacated

– Provision of adequate warm clothing

– Field and Hospital based Passive Disease surveillance

– Active surveillance by random interviews was carried out in select areas of high density. Every day, a new area was visited. Health advice was given.

Air Borne disease

• Outcome– There were 4 cases (all adult males) of chicken

pox reported between 7 to 8 Feb in military areas and 31 cases among civil population in samkhayali village near Bachao. Of these, 28 were children under 12 years of age and 3 adults

– Outbreak control measures included segregation and symptomatic treatment of the affected individuals

– All cases recovered and no secondary outbreak of communicable diseases was reported in military and civil areas till 3 weeks after last case

Air Borne disease

• Threat perception– No piped distribution of water supply

leading to places with water point collection

– Inadequate disposal of liquid and solid wastes leading to fly nuisance

– Inadequate disposal of Bio Medical waste

Vector Borne disease

• Intervention– Spraying operations using 0.1 % NUVAN (Dicholorvos)

solution in the areas where solid waste were disposed

– Daily sprinkle of Lime Slaked powder over and around the Deep Trench/Shallow Trench latrines used for excreta disposal in temperory shelters put up for living

– ‘Smoking’ of the Deep trench latrines to prevent and fly breeding

– Spray water collection pockets with anti larval measures - Baytex 1000 Conc and/or Baytex granules or Abate (Temephos 0.5%)

– Space spraying of tentage accommodation with Baygon and /or Malathion 50 % EC (in 0.5 % solution)

Vector Borne disease

• Large quantity of Biomedical waste was generated in the areas in military hospital and other places in whole of district of Bhuj following disaster.

• No incineration facilities are available except in the military hospital where rudimentary and sufficient facilities are available only for routine workload

• The waste was segregated into open pits at a distance from the hospital and burnt in the beehive incinerator over a period of 7days

• Other non biodegradable waste like plastics, IV Sets, were disposed by deep burial in open ground

• Biological medical waste generated in other areas including animal dead was strewn all around in Bhuj district and posed a potential public health problem

Bio Medical Waste

Disease Surveillance• Active Disease

surveillance in 10 relief centres were established in and around Talukas of Bhuj district - Khavda, Anjar, Baccaho (2 centers), Samkhyali, Ratanpol, Modvadar, Dhori, Dharan and Mandvi.

• Passive Disease surveillance launched in consultation with WHO Teams and the State Health authorities