hospital response to natural disasters · hospital response to natural disasters : form tsunami to...

Hospital Response to Hospital Response to Natural Disasters :Natural Disasters :form Tsunami to Hurricane Katrinaform Tsunami to Hurricane Katrina

Dr. WL CheungDr. WL CheungDirectorDirector

Professional services & OperationsProfessional services & OperationsHospital AuthorityHospital Authority

The Affected AreasTsunami 2004Tsunami 2004

Tsunami 2004Tsunami 2004

Our Medical TeamOur Medical Team

Lessons from Tsunami 2004Lessons from Tsunami 2004Hospital system damagedHospital system damagedThousands of severe traumatic injuries & soft tissue Thousands of severe traumatic injuries & soft tissue infections patientsinfections patientsInadequate medical professionals or equipments for Inadequate medical professionals or equipments for extensive wound extensive wound debridementdebridement, , orthopaedicsorthopaedics or or amputationamputation

mobile medical programs & temporary field hospitals mobile medical programs & temporary field hospitals neededneeded

NEJM 352;5 Feb 3, 2005NEJM 352;5 Feb 3, 2005

Hurricane Katrina 2005Hurricane Katrina 2005

Lessons from Katrina 2005Lessons from Katrina 2005

Poor prePoor pre--crisis planningcrisis planningInsufficient priority to critical public health Insufficient priority to critical public health issues & basic human needsissues & basic human needsCommunications breakCommunications break--downdownSafety & security system failureSafety & security system failureMost vulnerable populations neglectedMost vulnerable populations neglected

Nature & Human DisastersNature & Human Disasters1.1. Disasters of Natural OriginDisasters of Natural Origin

Sudden Sudden -- Earthquakes, tsunamiEarthquakes, tsunamiLess sudden : HurricaneLess sudden : Hurricane

2.2. Disasters of Human OriginDisasters of Human OriginIndustrial Accidents ( e.g. chemical, biological Industrial Accidents ( e.g. chemical, biological etc )etc )Transportation Accidents ( e.g. plane crash )Transportation Accidents ( e.g. plane crash )Wars & Terrorist AttacksWars & Terrorist AttacksComplex Emergencies ( e.g. civil strife )Complex Emergencies ( e.g. civil strife )

Place of Luck & FortunePlace of Luck & Fortune

Hong KongHong Kong

Typhoon Rose 1971 Typhoon Rose 1971

Typhoon Rose 1971Typhoon Rose 1971

Landslide 1972Landslide 1972

Major Isolated AccidentsMajor Isolated Accidents

WTO MC6 2005WTO MC6 2005

Arts of WarArts of WarNot on the likelihood Not on the likelihood of the enemyof the enemy’’s not s not coming, but on our coming, but on our readiness to receive readiness to receive him; him; Not on the chances of Not on the chances of his not attacking, but his not attacking, but rather on the fact we rather on the fact we have made our have made our position steadfastposition steadfast’’

Healthcare Managers Should Healthcare Managers Should Prepare for DisastersPrepare for Disasters

1.1. TurboTurbo--charge your imaginationcharge your imagination2.2. Scenarios planningScenarios planning3.3. Think in probabilities, impact and costThink in probabilities, impact and cost4.4. Cultivating a need for preparednessCultivating a need for preparedness5.5. Create a culture to face realityCreate a culture to face reality

WindstormWindstorm

FloodFlood

500 occurrences500 occurrences

Risk AssessmentRisk AssessmentGreat population density. Great population density. Geographic CharacteristicsGeographic Characteristics

Hills, Island & Peninsula,Hills, Island & Peninsula,Slopes, reclamation land along harborSlopes, reclamation land along harborNot in earthquake zoneNot in earthquake zoneHeavy rainfall & typhoon Heavy rainfall & typhoon

High rise building supplied with lifeHigh rise building supplied with life--lineslinesHeavy & modern trafficHeavy & modern trafficInternational cityInternational cityHigh dependence on external supportHigh dependence on external support

WhenWhenMega DisasterMega Disaster

StrikesStrikes…………………………....

Preparedness

Prevention

Response

RecoveryContingency PlanningContingency Planning

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Disaster ManagementDisaster Management

CommunicationCommunication–– obtain information from various sourcesobtain information from various sources

CoCo--ordination ordination –– liaise with other involved agenciesliaise with other involved agencies

Control Control –– deploy and utilise resourcedeploy and utilise resource

Command Command –– take charge of the appropriate responsetake charge of the appropriate response

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Major Impacts of Mega DisasterMajor Impacts of Mega Disaster

Facilities DestructionFacilities DestructionLifelines DisruptionsLifelines DisruptionsTraffic & Transport DisruptionsTraffic & Transport DisruptionsCommunication BreakdownCommunication BreakdownMass Injuries & DeathsMass Injuries & DeathsHealthcare System DisruptionHealthcare System Disruption

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Healthcare System DisruptionHealthcare System Disruption

Mission Critical FunctionsMission Critical Functions

Mission Critical PersonsMission Critical Persons

Healthcare System DisruptionHealthcare System Disruption

Health ImpactsHealth Impacts1.1. Deaths when the disaster strikesDeaths when the disaster strikes

2.2. Survival of the immediate threat but deaths Survival of the immediate threat but deaths from injuries induced by the eventfrom injuries induced by the event

3.3. Death due to diseases due to destruction of Death due to diseases due to destruction of the public health infrastructurethe public health infrastructure

4.4. Mental & Psychological TraumaMental & Psychological Trauma

Mortality

Time

Disaster Responses IDisaster Responses I

Search & RescueSearch & RescueShelter & EvacuationShelter & EvacuationMedical ReliefMedical ReliefMultiMulti--agency Collaborationagency CollaborationVolunteer CoordinationVolunteer CoordinationOutside Assistance CoordinationOutside Assistance Coordination

Search & RescueSearch & Rescue

ExtricationExtricationIncident Site Incident Site TriageTriageEmergency Emergency Medical TeamMedical TeamAccident & Accident & Emergency CareEmergency Care

Shelter & EvacuationShelter & Evacuation

Temporary shelters Temporary shelters Community halls, schools Community halls, schools and other premisesand other premises

Basic Needs for HealthBasic Needs for HealthClean water & sanitationClean water & sanitationFoodFoodShelter and clothingShelter and clothingHealth servicesHealth servicesInformationInformation

Medical ReliefMedical Relief

Assess capability & Assess capability & functionalityfunctionalitySupport current systems Support current systems that functionthat functionDesignate clear roles and Designate clear roles and functionsfunctionsConsider patient evacuationConsider patient evacuationTriage & referral networkingTriage & referral networkingBuild temporary facilities & Build temporary facilities & clinicsclinics

Medical ReliefMedical Relief

Community Health Community Health CentersCentersTriage & TreatmentTriage & TreatmentInfectious Diseases & Infectious Diseases & Chronic DiseasesChronic DiseasesPsychological Psychological SupportSupport

Disaster ResponsesDisaster Responses

Search & RescueSearch & RescueShelter & EvacuationShelter & EvacuationMedical ReliefMedical ReliefMultiMulti--agency Collaborationagency CollaborationVolunteer CoordinationVolunteer CoordinationOutside Assistance CoordinationOutside Assistance Coordination

MultiMulti--agency Collaborationagency Collaboration

Voluntary AgenciesVoluntary Agencies

Hong Kong

CHINA

( Day 1 )( Day 2- 3 )( Day 4 - 7 )

HONG KONG SAR

HONG KONG SARMAINLAND CHINA

MAINLAND CHINA

National & InternationalNational & InternationalAssistanceAssistance

INTERNATIONAL COMMUNITY

INTERNATIONAL COMMUNITY

The Right Place & TimeThe Right Place & Time

““The Right ThingsThe Right Things””The nature of donationsThe nature of donations

Should be requiredShould be requiredShould not be available locallyShould not be available locally

Disaster Responses IIDisaster Responses II

Resource DeploymentResource DeploymentCoordinationCoordinationCommunicationCommunicationMediaMediaInformation & MediaInformation & MediaLogisticsLogistics

MediaMedia

Information Platform Information Platform

1.1. Measure crude mortality rates, causes of Measure crude mortality rates, causes of mortality, nature of health problemsmortality, nature of health problems

2.2. General condition of the population with regard General condition of the population with regard to the supply of basic needsto the supply of basic needs

3.3. Condition of the environment in terms of Condition of the environment in terms of weather, water supply and drainage, weather, water supply and drainage, transmissible diseases outbreak etctransmissible diseases outbreak etc

4.4. Morbidity of the affected or vulnerable Morbidity of the affected or vulnerable population esp. on Chronic Diseases & PTSSpopulation esp. on Chronic Diseases & PTSS

““Logistics FirstLogistics First””

““What can I do to helpWhat can I do to help??”……”…….lacking an .lacking an assigned role, many found themselves sitting on assigned role, many found themselves sitting on their hands, doing nothing for which they had their hands, doing nothing for which they had been trained.been trained.First priorities are First priorities are security and safetysecurity and safety for the for the populationpopulation

water, sanitation, food and shelterwater, sanitation, food and shelterVaccinationVaccination against measles ( <15 years old )against measles ( <15 years old )Curative careCurative care etcetc

DisasterOccurs

Health NeedsHealth NeedsHealth Needs

DisasterOccurs

FieldOperations


DisasterOccurs

Hospitaldamage

assessment

Hospitaldamage

assessment

FieldOperations


DisasterOccurs

Hospitaldamage

assessment

Hospitaldamage

assessmentHospital

Evacuation if required

FieldOperations


DisasterOccurs

Hospitaldamage

assessment

Hospitaldamage

assessmentHospital


FieldOperations

Role Delineation ofHealthcare Facilities

based oncapacity & capability




DisasterOccurs

Hospitaldamage

assessment

Hospitaldamage

assessmentHospital


FieldOperations





Health NeedsShort, intermediate & Long

Term Needs

Health NeedsHealth NeedsShort, intermediate & LongShort, intermediate & Long

Term NeedsTerm Needs

DisasterOccurs

Hospitaldamage

assessment

Hospitaldamage

assessmentHospital


FieldOperations





Central co-ordination of Medical logistics

With NGO and HKSAR


With NGO and HKSAR


Term Needs



DisasterOccurs

Hospitaldamage

assessment

Hospitaldamage

assessmentHospital


FieldOperations






With NGO and HKSAR


With NGO and HKSAR

CHINA &International

Help


Term Needs



PreventionPrevention

Prediction & interventionPrediction & interventionPopulation evacuationPopulation evacuationHealth related disastersHealth related disastersDrive for higher Drive for higher ““SafetySafety””

Planning and drillingPlanning and drilling

Learning & SharingLearning & Sharing

No incident is the sameNo incident is the sameNo quick manual for disaster managementNo quick manual for disaster managementMust research, share & learn from each Must research, share & learn from each otherother

Thank you !Thank you !

hospital response to natural disasters · hospital response to natural disasters : form tsunami to...

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