Disaster: PerspectivesSource: EK Noji, The Public Health Consequences of Disaster

Disaster: PerspectivesA disaster is a result of a vast ecological breakdown in the relation between humans and their environment, a serious or sudden event on such a scale that the stricken community needs extraordinary efforts to cope with it, often with outside help or international aidSource: EK Noji, The Public Health Consequences of Disaster

Disaster: PerspectivesPublic Health View

Disasters are definedby what they do to people...

Source: EK Noji, The Public Health Consequences of Disaster

Disaster: PerspectivesMajor Categories of Disasters

-Natural Disasters-Human-generated Disasters

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

Disaster: PerspectivesNatural Disasters-Arise from forces of nature-Two subcategories:Sudden impact or acute onsetSlow or chronic onsetSources: CDC & EK Noji, The Public Health Consequences of Disaster

Disaster: PerspectivesSudden Impact or Acute Onset DisastersGeological or climatic hazards Hurricanes/typhoonsTornadoes EarthquakesVolcanoes FloodsTsunamis Temperature extremesWildfires LandslidesAvalanchesEpidemicsFood, water, vector-borne diseasesPerson-to-person transmission diseasesSources: CDC & EK Noji, The Public Health Consequences of Disaster

Disaster: PerspectivesSlow or Chronic Onset DisastersDroughtFamineEnvironmental degradationChronic exposure to toxic substancesDesertificationDeforestationPest infestationSources: CDC & EK Noji, The Public Health Consequences of Disaster

Disaster: Perspectives

Disaster: Perspectives

Disaster: Perspectives

Disaster: Perspectives

Disaster: Perspectives2002 DEEP Center Classification-Natural disasters-Non-intentional human-generated disasters-Terrorist-perpetrated disasters-Complex disasters-Natural-technological disasters (NA-TECHS)

Disaster: PerspectivesHuman-Generated DisastersIndustrial/technologicalTransportation (vehicular)DeforestationMaterial shortagesComplex emergencies

Source: EK Noji, The Public Health Consequences of Disaster

Disaster: PerspectivesComplex Emergencies-Wars and civil strife-Armed aggression-Insurgency-Other actions resulting in displaced persons and refugees

Source: EK Noji, The Public Health Consequences of Disaster

Disaster: PerspectivesTerrorist-perpetrated Disasters-Biological-Nuclear-Incendiary-Chemical-Explosive

The Disaster Cycle

Disaster CycleSudden impact natural disasterscan be considered as a continuous time sequenceof five phases:Inter-disasterPre-disasterImpactEmergencyReconstructionSource: EK Noji, Sivertson KT. Injury prevention in natural disasters: a theoretical framework. Disasters 1987;11:290-296.

Interdisaster PhasePlanning disaster prevention/preparedness/mitigation Identifying risksIdentifying vulnerabilitiesCreating a resource inventoryConducting professional trainingConducting community education

Synonym: Non-disaster Phase

Disaster Cycle

Predisaster PhaseIssuing timely warningsImplementing protective actionsUndertaking emergency management activitiesEvacuating population as necessary

Synonym: Warning PhaseDisaster Cycle

Impact PhaseDestructionInjuriesDeathsmay occur during impactDisaster Cycle

Disaster CycleEmergency PhaseImplementing life-saving actions-search and rescue-first aid-emergency medical assistanceRestoring emergency communicationsRestoring emergency transportationImplementing public health surveillanceEvacuating vulnerable areas

Synonyms: Relief Phase, Isolation Phase

Disaster CycleEmergency PhaseNote: The immediate post-impact period is the isolation phase where most urgent rescue tasks are accomplished by the survivors using local resources

Synonyms: Relief Phase, Isolation Phase

Reconstruction PhaseRestoring pre-disaster conditionsReestablishing health servicesReconstructing & repairing damaged facilitiesReflecting and debriefing on lessons learned

Synonym: Rehabilitation PhaseDisaster Cycle

Disaster Severity

Disaster SeverityA Decade of Natural Disasters1 million thunderstorms100,000 floodsTens of thousands of landslides, earthquakes, wildfires & tornadoesSeveral thousand hurricanes, tropical cyclones, tsunamis & volcanoes

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

A Decade of Natural Disasters (1980s)Floods 39,000 deathsTropical cyclones 14,000 deathsHurricanes 1,000 deathsEarthquakes 54,000 deathsOther disasters1,012,000 deathsTOTAL1,120,000 deaths

Sources: CDC & EK Noji, The Public Health Consequences of DisasterDisaster Severity

Factors Contributing to Disaster Severity-Human vulnerability due to poverty & social inequality-Environmental degradation-Rapid population growth especially among the poor

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

Disaster Severity

Influence of PovertyPersons in poverty:-Live in poor housing unable to withstand seismic activity-Live in poor housing susceptible to landslides-Inhabit coastal areas and flood plains vulnerable to hurricanes, storm surges, flooding, and tidal waves-Live near hazardous industrial sites-Do not receive education on life-saving actions during disasters-Do not receive warning of impending disasters

Sources: CDC & EK Noji, The Public Health Consequences of DisasterDisaster Severity

Influence of Poverty-Low-income countries:3,000 deaths per disaster-High-income countries:500 deaths per disaster

Sources: CDC & EK Noji, The Public Health Consequences of DisasterDisaster Severity

Influence of Population Growth- Urban dwellers:1920: 100 million1980: 1 billion2000: 2 billion

2000: 20 cities with >10 million people

Sources: CDC & EK Noji, The Public Health Consequences of DisasterDisaster Severity

Capabilities of Developed NationsThat Mitigate Disaster Effects-Ability to forecast severe storms-Ability to enforce strict building codes-Ability to use communication networks to broadcast alerts and warnings-Ability to provide emergency medical services-Ability to engage in contingency planning

Sources: CDC & EK Noji, The Public Health Consequences of DisasterDisaster Severity

Disasters: The Public Health Impact

Disasters: The Public Health ImpactMortality & MorbidityDisasters cause deaths, injuries, and illnessesDisasters may overwhelm medical resources and health services

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

Disasters: The Public Health ImpactHealth Care InfrastructureDisasters may destroy hospitals Disasters may disrupt routine health servicesDisasters may disrupt preventive activitiesConsequence: long-term increases in morbidity and mortalitySources: CDC & EK Noji, The Public Health Consequences of Disaster

Environment & PopulationDisasters may increase potential for communicable diseasesDisasters may exacerbate environmental hazardsConsequences: increases in morbidity and premature death, decreased quality of lifeSources: CDC & EK Noji, The Public Health Consequences of Disaster

Disasters: The Public Health Impact

Psychological and Social BehaviorDisasters may cause generalized panic or paralyzing traumaDisasters may provoke increases in anxiety, depression and neurosesDisasters may lead to post-traumatic stress disorder (PTSD) at epidemic levels

Sources: CDC & EK Noji, The Public Health Consequences of Disaster

Disasters: The Public Health Impact

Food SupplyDisasters may disrupt the food supplyDisasters leading to food shortages may cause specific micronutrient deficiencies Disasters may provoke severe nutritional consequences including famine and starvationSources: CDC & EK Noji, The Public Health Consequences of Disaster

Disasters: The Public Health Impact

Population DisplacementDisasters may cause large spontaneous or organized population movementsPopulation movement may increase morbidity and mortalityPopulation movement may precipitate epidemics of communicable diseases in both displaced and host communitiesCrowding of populations and overlay of refugee and host populations may lead to injuries and violenceSources: CDC & EK Noji, The Public Health Consequences of DisasterDisasters: The Public Health Impact

Kondisi IndonesiaGeografis Indonesia rawan bencana Bencana alam (Natural Disaster) Karena ulah manusia (Man-Made Disaster) Kedaruratan Kompleks (Complex Disaster)Selalu akibatkan masalah kesehatan ujung tombak

Peta Lempeng Bumi di IndonesiaKerawanan Gempa

Peta Tingkat Kerawanan Bencana Tsunami di Indonesia

Peta Rawan Gempa Bumi di Indonesia

Peta Daerah Gunung Api di Indonesia

Gunung Berapi129 gunung berapi aktif: Jawa ( 21 gunung ) Sumatra ( 21 gunung api ) Bali ( 2 gunung api ) Nusa Tenggara ( 20 gunung api ) Laut banda ( 9 gunung api ) Sulawesi Utara ( 6 gunung api ) Kepulauan Sangihe ( 5 gunung api ) Halmahera ( 5 gunung api )

Peta Rawan Tanah Longsor di Indonesia

Peta Rawan Banjir di Indonesia

Peta Rawan Konflik di Indonesia

Bencana & Korban Massal di Indonesia 1980 2004 :Gunung Galunggung, 1980Food Poisening Jakarta Barat, 1981Kebakaran Tanjung Priok, 1981Gas Tanjung Priok, 1982Gempa Jawa Barat, 1983Fire Htl Jakarta, 1985Bouraq Krawang, 1985KLL Jalan Tol, 1985Banjir RS Atmajaya, 1986Evac RS Fatmawati Ledakan Mesiu), 1987Kecelakaan Kereta Api Bintaro, 1987Isolasi RS Koja (Huru-hara Tg Priok), 1987Food Poisening Pabrik Jakarta, 1988

Bencana & Korban Massal di Indonesia 1980 2004 :Gempa Flores, 1991Riot Jakarta, 1992Banjir Jakarta, 1991&1992Tsunami Lombok, 1993Gempa Liwa, 1993Gn Merapi Jogya, 1995Gempa Kerinci, 1995Riot PDI-P Jakarta, 1996Gempa& Tsunami Biak Gempa Sulawesi Selatan, 1997Riot Etnik Pontianak, 1997Gempa Bengkulu, 1997Riot Etnik Sampit, 2001

Bencana & Korban Massal di Indonesia 1980 2004 :Pengungsi di Madura, Poso, NTB, NTT, Papua, Jawa Barat, Jawa Tengah, Maluku, Maluku Utara, Sulawesi Utara, 2001Kekeringan di Sampang, 2001Gunung Papandayan, 2002Kecelakaan Kereta Api Brebes, 2002Tnh Longsor Jawa Timur, 2002Banjir Sumatera Utara, 2002Banjir Sumatera Utara, 2002Banjir Pekalongan & Semarang, 2002Riot Agama Ambon, 1999 - 2002Riot Agama Palu, 1999 - 2002Riot Papua, 1999 - 2002Bom Teroris (32x) & Riot Jakarta, 1998 - 2002

Banjir 3 Minggu Jakarta 2002Nunukan Displaced Migrant Worker 2002Bom Teroris Bali 2002Bom Teroris Htl Marriott Jkt 2003Ledakan Pabrik Kimia Gresik 2004Gempa Karang Asem Bali 2004Gempa Nabire 2x 2004Gempa Aceh 2004Gempa Palu 2005Kelaparan NTT 2005Sampah Longsor Bandung2005Gempa Nias 2005 Bencana & Korban Massal di Indonesia 1980 2004 :

Bencana Alam & Manusia

Masyarakat panikTerganggunya pelayanan umum bagi wargaKerusakan sarana dan prasaranaKegiatan sosial tergangguKegiatan sehari-hari lumpuh Kerusakan kehidupanKegiatan ekonomi Lumpuh Pengungsian penduduk. Cedera tubuhAngka kesakitan > Kematian >Efek Psikologis Post Trauma Stress Bencana & Korban Massal di Indonesia 1980 2004 :

Bencana Bisa Terjadi Kapan Saja, di mana Saja, dan Bisa Menimpa Siapa Saja.