Hospital Response to Natural Disasters : form Tsunami to Hurricane Katrina
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1 Hospital Response to Natural Disasters : form Tsunami to Hurricane Katrina Dr. WL Cheung Director Professional services & Operations Hospital Authority
2 The Affected Tsunami Areas 2004
3 Tsunami 2004
4 Tsunami 2004
5 Our Medical Team
6 Lessons from Tsunami 2004 Hospital system damaged Thousands of severe traumatic injuries & soft tissue infections patients Inadequate medical professionals or equipments for extensive wound debridement, orthopaedics or amputation mobile medical programs & temporary field hospitals needed NEJM 352;5 Feb 3, 2005
7 Hurricane Katrina 2005
8 Hurricane Katrina 2005
9 Hurricane Katrina 2005
10 Lessons from Katrina 2005 Poor pre-crisis planning Insufficient priority to critical public health issues & basic human needs Communications break-down Safety & security system failure Most vulnerable populations neglected
11 Nature & Human Disasters 1. Disasters of Natural Origin Sudden - Earthquakes, tsunami Less sudden : Hurricane 2. Disasters of Human Origin Industrial Accidents ( e.g. chemical, biological etc ) Transportation Accidents ( e.g. plane crash ) Wars & Terrorist Attacks Complex Emergencies ( e.g. civil strife )
12 Hong Kong Place of Luck & Fortune
13 Typhoon Rose 1971
14 Typhoon Rose 1971
15 Typhoon Rose 1971
16 Typhoon Rose 1971
17 Landslide 1972
18 Major Isolated Accidents
19 WTO MC6 2005
20 Arts of War Not on the likelihood of the enemy s s not coming, but on our readiness to receive him; Not on the chances of his not attacking, but rather on the fact we have made our position steadfast
21 Healthcare Managers Should Prepare for Disasters 1. Turbo-charge your imagination 2. Scenarios planning 3. Think in probabilities, impact and cost 4. Cultivating a need for preparedness 5. Create a culture to face reality
22 500 occurrences Windstorm Flood
23 Risk Assessment Great population density. Geographic Characteristics Hills, Island & Peninsula, Slopes, reclamation land along harbor Not in earthquake zone Heavy rainfall & typhoon High rise building supplied with life-lines lines Heavy & modern traffic International city High dependence on external support
24 When Mega Disaster Strikes..
25 Prevention Recovery Contingency Planning Preparedness Response 1
26 Disaster Management Communication obtain information from various sources Co-ordination ordination liaise with other involved agencies Control deploy and utilise resource Command take charge of the appropriate response 2
27 Major Impacts of Mega Disaster Facilities Destruction Lifelines Disruptions Traffic & Transport Disruptions Communication Breakdown Mass Injuries & Deaths Healthcare System Disruption 3
28 Major Impacts of Mega Disaster Facilities Destruction Lifelines Disruptions Traffic & Transport Disruptions Communication Breakdown Mass Injuries & Deaths Healthcare System Disruption 3
29 Major Impacts of Mega Disaster Facilities Destruction Lifelines Disruptions Traffic & Transport Disruptions Communication Breakdown Mass Injuries & Deaths Healthcare System Disruption 3
30 Major Impacts of Mega Disaster Facilities Destruction Lifelines Disruptions Traffic & Transport Disruptions Communication Breakdown Mass Injuries & Deaths Healthcare System Disruption 3
31 Major Impacts of Mega Disaster Facilities Destruction Lifelines Disruptions Traffic & Transport Disruptions Communication Breakdown Mass Injuries & Deaths Healthcare System Disruption 3
32 Major Impacts of Mega Disaster Facilities Destruction Lifelines Disruptions Traffic & Transport Disruptions Communication Breakdown Mass Injuries & Deaths Healthcare System Disruption 3
33 Major Impacts of Mega Disaster Facilities Destruction Lifelines Disruptions Traffic & Transport Disruptions Communication Breakdown Mass Injuries & Deaths Healthcare System Disruption 3
34 Healthcare System Disruption Mission Critical Functions
35 Healthcare System Disruption Mission Critical Persons
36 Health Impacts 1. Deaths when the disaster strikes 2. Survival of the immediate threat but deaths from injuries induced by the event 3. Death due to diseases due to destruction of the public health infrastructure 4. Mental & Psychological Trauma Mortality Time
37 Disaster Responses I Search & Rescue Shelter & Evacuation Medical Relief Multi-agency Collaboration Volunteer Coordination Outside Assistance Coordination
38 Search & Rescue Extrication Incident Site Triage Emergency Medical Team Accident & Emergency Care
39 Shelter & Evacuation Temporary shelters Community halls, schools and other premises Basic Needs for Health Clean water & sanitation Food Shelter and clothing Health services Information
40 Medical Relief Assess capability & functionality Support current systems that function Designate clear roles and functions Consider patient evacuation Triage & referral networking Build temporary facilities & clinics
41 Medical Relief Community Health Centers Triage & Treatment Infectious Diseases & Chronic Diseases Psychological Support
42 Disaster Responses Search & Rescue Shelter & Evacuation Medical Relief Multi-agency Collaboration Volunteer Coordination Outside Assistance Coordination
43 Multi-agency Collaboration
44 Voluntary Agencies
45 National & International Assistance ( Day 4-7 ) ( Day 2-3 ) ( Day 1 ) HONG KONG SAR HONG KONG SAR Hong Kong MAINLAND MAINLAND CHINA CHINA CHINA INTERNATIONAL COMMUNITY INTERNATIONAL COMMUNITY
46 The Right Place & Time
47 The Right Things The nature of donations Should be required Should not be available locally
48 Disaster Responses II Resource Deployment Coordination Communication Media Information & Media Logistics
49 Disaster Responses II Resource Deployment Coordination Communication Media Information & Media Logistics
50 Media
51 Information Platform 1. Measure crude mortality rates, causes of mortality, nature of health problems 2. General condition of the population with regard to the supply of basic needs 3. Condition of the environment in terms of weather, water supply and drainage, transmissible diseases outbreak etc 4. Morbidity of the affected or vulnerable population esp. on Chronic Diseases & PTSS
52 Logistics First What can I do to help?.lacking an assigned role, many found themselves sitting on their hands, doing nothing for which they had been trained. First priorities are security and safety for the population water, sanitation, food and shelter Vaccination against measles ( <15 years old ) Curative care etc
53 Disaster Occurs Health Needs
54 Disaster Occurs Field Operations Health Needs
55 Disaster Occurs Hospital Hospital damage damage assessment assessment Field Operations Health Needs
56 Disaster Occurs Field Operations Hospital Hospital damage damage assessment assessment Hospital Evacuation if required Health Needs
57 Disaster Occurs Field Operations Hospital Hospital damage damage assessment assessment Hospital Evacuation if required Health Needs Role Role Delineation Delineation of of Healthcare Healthcare Facilities Facilities based based on on capacity capacity & & capability capability
58 Disaster Occurs Field Operations Hospital Hospital damage damage assessment assessment Hospital Evacuation if required Health Needs Short, intermediate & Long Term Needs Role Role Delineation Delineation of of Healthcare Healthcare Facilities Facilities based based on on capacity capacity & & capability capability
59 Disaster Occurs Field Operations Hospital Hospital damage damage assessment assessment Hospital Evacuation if required Health Needs Short, intermediate & Long Term Needs Role Role Delineation Delineation of of Healthcare Healthcare Facilities Facilities based based on on capacity capacity & & capability capability Central Central co-ordination co-ordination of of Medical Medical logistics logistics With With NGO NGO and and HKSAR HKSAR
60 Disaster Occurs Field Operations Hospital Hospital damage damage assessment assessment Hospital Evacuation if required CHINA & International Help Health Needs Short, intermediate & Long Term Needs Role Role Delineation Delineation of of Healthcare Healthcare Facilities Facilities based based on on capacity capacity & & capability capability Central Central co-ordination co-ordination of of Medical Medical logistics logistics With With NGO NGO and and HKSAR HKSAR
61 Prevention Prediction & intervention Population evacuation Health related disasters Drive for higher Safety Planning and drilling
62 Learning & Sharing No incident is the same No quick manual for disaster management Must research, share & learn from each other
63 Thank you!
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