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DISASTER MANAGEMENT

By.
RS

INTRODUCTION
Indonesia is the largest archipelago in the world (13.667 island and islets).
The population is the fourth largest in the world , after Republic of China, India
and USA. Indonesia has some hazard (a source a danger) can disrupt people’s
life and they can cause harm to an individual property and life or health. That
means Indonesia has some disaster problems. Disaster by definition of WHO
(World Health Organization) : any occurrence that causes damage, economic
disruption, loss of human life and deteoration in health and health services on
scale sufficient to warrant an extraordinary response from outside the affected
area or community. The greatest number of disasters occur in some countries are
affected by ill health and poor economic conditions.
Unfortunately, it is virtually impossible to prevent most disasters.
Nevertheless, we can alleviate many of their worse effects by anticipating or
preempting beforehand. Our concern is now to reduce the adverse impact of
disasters on human life, thought preparedness and the utilization of appropriate
technology to bear in a timely, coordinated and effective manner, for each phase
of operation i.e. mitigation, relief, rehabilitation and reconstruction.

DISASTER AND RISK


Disaster divided in two type, natural disaster and man made disaster. Most
of natural disasters in the world occur in Asia and Pacific region such as a wind
storm or typhoon (India, Bangladesh, Philippine), a severe earthquake (Nepal
India, Indonesia), a volcanic eruption (Japan, Indonesia, Philippines), landslides,
tidal wave, tsunamis, flood (India, Burma, Pakistan, Indonesia) . Man made
disaster also occur in Asia such as aircraft accident crash, train crash, industrial
disaster and complex disaster like civil strike, terrorism (With political, socio-
economic, ethnic or religion problem).
The emergencies in disaster situation have some problem such as mass
displacement of population. Besides these occur epidemic of airborne diseases,
enteric diseases (like cholera, typhoid) and respiratory infection. The
characteristic of disaster depend on the characteristics of the cause, frequency,
duration, speed of onset, scope of impact and destruction. Disaster has a
significant impact upon the community, people and the resources required to
response. They also produce the long term problems of restoration and
rehabilitation and the deaths, injuries or disabilities.
In the disaster management must describe the disaster risk management
(risk related to hazard and vulnerability). Disaster risk management is a
systematic of management policies or procedures of risk the community and
appropriate treatments to the risk identified. There are four elements of disaster
management, a) Prevention and mitigation, b) Preparedness, c) Response, d)
Recovery. Effective disaster management requires an active partnership between
authorities and all relevant agencies (organizations) and community
preparedness. General effect of disaster has a relationship with the type of
disaster and its effect on health, the type of effect in the disaster such as the
outbreak of infectious diseases, population movement, climatic exposure effect,
destruction of food supplies and distribution, disruption of water supply, damage
of infrastructure and problem with physical or mental health.

DISASTER PATERN AND RESPONSE


The pattern of injury depends on the type of disaster. Except in
earthquake and landslides, the number of illnesses and injuries requiring medical
attention is usually low in relation to the number of deaths. In man made disaster,
the medical problems such as blast injury (blunt trauma and several internal
injuries), and crush injury, burn injuries etc. The important to treat the emergency
patient is a basic knowledge about life support (Basic life support or advance life
support).
It is phenomenon if the disaster that cannot be managed through routine
procedures and resources of government especially in a mass casualty
problems. The complex problems in disaster are unique and are rarely
encountered by daily emergencies procedures. Disaster response needs to
mobilization of greater number of personnel’s, facilities and supplies. Disaster
response is a multi-faceted operation requiring a coordinated approach,
cooperation and understanding between the all team involved. Disaster
response has several phases: 1) Activation, 2) Implementation, 3) Mitigation, 4)
recovery phase.

EMERGENCY MEDICAL SERVICE SYSTEMS (EMSS)


The successful outcome of medical care requires adequate preparedness:
planning, disciplined and coordinated behavior by all personnel, mobilization
ability, the availability of medical resources and effective communication network.
In emergency medical system services needed to care the casualty from site of
an accident or incident to definitive care, includes: the triage, onsite medical care,
initial resuscitation and treatment, medical transport and definitive care.
In managing those disasters, Indonesia also has a system like USA
(HEICS, Hospital Emergency incident command system or HOPE, Hospital
Preparedness programmed). The system in Indonesia was called “Integrated
Emergency Management System” (Sistem penanggulangan gawat darurat
terpadu / SPGDT). To guarantee the smoothness of the implementation of the
disaster management operation, the Indonesian government has develops
coordinating institution. To cope with disaster in central level, is a non-structural
institution so called The National Coordinating Board for Disaster Management
and handling displaced persons, which the chair is Vice President. The
component in that system consists of Pre-hospital system, Hospital and inter-
hospital system. The number of element are important such as , Transport
(ambulances), Personnel (Medical first responder, ambulance nurses or
paramedics etc), Communication system (two way system), medical services,
equipment and supplies, legal aspect. The important principles and disaster
management that all medical facilities must have clearly written and
disseminated policies and procedures. The important element in the emergency
plan must be written such as triage criteria, who needs to be prioritized for
immediate care, what are the function of each and every member of the
emergency team. Many of the modern principles of emergency medicine still do
not exist in the countries. The question is who the frontline of response to
disaster is and who has a critical role in the emergency medical system to
respond to a disaster or mass casualty incident. Pre hospital emergency medical
service and resources in Asian country are minimal. Integrated emergency
medical service system may assist in delivering a good quality medical care and
help improvement manage daily emergencies and disaster in our region
especially for developing country. Regional disasters or national disaster has the
same problems: distance, availability of transportation and functioning hospital or
not. Our program should have a standing cooperative arrangement in the closest
country to help on disaster situation with mass casualty problem.

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