Nepal Earthquake Notes – 2 – Response

Our experiences their experiences

phresponse
(This photo was taken from the Canterbury Public Health Response Document)

In 2011 February 22nd, Christchurch was struck with a 6.4 earthquake at about 12.51 PM in the afternoon. The epicentre of the earthquake was around a place known as Lyttleton. The city centre was badly affected, many buildings collapsed and particularly in the Eastern suburbs of Christchurch, the devastation was remarkable as hundreds of houses were immediately destroyed or were rendered useless for living. People were displaced and were accommodated in several shelters across the city and a massive restoration operation was launched. Immediately following the earthquake, the death tally stood at 185. Following the initial earthquake, the city suffered about 12,000 more aftershocks over the next three years. The citizens battled the aftershocks as they rebuilt the city. Four years later, Christchurch is again coming back to her former glory and plans are afoot for the renvewal of the city. But in the rebuild and reconstruction of the city of Christchurch hangs a tale that can have important lessons for everyone around the world.

In 2015 April 25th, Nepal, in Kathmandu suffered the result of a similar earthquake of much larger intensity 7.9 Richter scale epicentre located at Lamjang in the Kathmandu Valley and not far from Everest. This also led to massive damage, about 1900 lives lost in the first 24 hours itself, and massive losses of property. Several villages disappeared, and there were avalanches from Mount Everest and other mountains that added to the woe. At the time of writing this, rescue operations are underway and several aftershocks have already taken place.

At the time of writing this, a massive recovery operation is taking place, and you can learn more about the recovery operations here

I write this on the third day of the Nepal earthquake and would like to highlight some aspects of earthquake disaster management and strategies that I saw implemented in Christchurch. Some public health and disaster management measures certainly helped people of Christchurch and led to far fewer deaths and destructions that would otherwise occur. In no particular order,

  1. Immediately after the earthquake, the public health department issued warnings about boiling drinking water and restriction of the “flushing the toilet”. Which meant, the advisories were about conservation of water and keeping in mind that it was possible that the drinking water might be contaminated. It turns out that these two activities alone led to really less load of people with stomach related diseases that would otherwise occur.
  2. The city government formed a crisis management team and the mayor oversaw the operations. The control room effectively managed hundreds of visitors and worker bees who turned up to set up search and rescue operations that led to the recovery of bodies and clearing of people who were trapped in the debris.
  3. Several volunteer organisations set up shelters that allowed people to camp out and provided food, shelter, and clothing.
  4. In addition to medical services, several additional services such as mental health services and care were pressed into action.
  5. A thorough evaluation of every building was undertaken, and each building in each residential zone was “sticker”-ed, or colour coded so that the status of the building would be known.
  6. Fresh water was provided to the affected neighbourhoods
  7. Recovery operations were televised and tally of the deceased and recovered were made available to people.

A good description of the steps are available with the Wikipedia entry

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Whose safety first?

Guy defusing a landmine

Whose life? Whose safety?

The picture above shows an official of a bomb disposal squad attempting to defuse a landmine that was booby trapped in a forest area of the West Bengal state of India. It was unfortunate that he died in the attempt as the landmine blew up on his face (for a detailed account and picture of how it all happened, read the page here:

http://www.telegraphindia.com/1060922/asp/frontpage/story_6779024.asp).

Why was he doing what was he doing? Why was he prying open a potential live bomb with hammer and chisel with no safety equipment worn on him? It’s very unfortunate that our police forces are supposed to tackle issues like defusing live bombs and chase terrorists and people with guns, but more often than not, occupational safety issues are ignored.

It’s surprising that there is very little literature out there that addresses the issues of occupational safety for security personnel and police forces. I searched the Pubmed with the following keywords: “Occupational Health”[MeSH] AND “Police”[MeSH] to capture as much literature as I could. Here are the search results. I could retrieve about 53 articles, but none of them dealt with issues related to occupational hazards of police officials who disposed bombs, etc, or safety awareness among police officials, or intervention research to improve safety consciousness. No primary study, no secondary data analysis that could fit a systematic review. There may have been some research tucked somewhere, but at least Pubmed database did not archive any that could be retrieved by their generic keywords.

As police forces, particularly in countries like india, need to tackle problems of defusing bombs, and terrorist plots, there is a need for systematic training of these personnel in occupational hazards and safety awareness. This also needs to be reflected in research people do.

Journalists, particularly those who cover war and terror is the other very vulnerable group. In the blast that occured in West Bengal on the 21st September, 2006, several journalists got severly injured.

It’s sad, almost to the point of callousness that police officials and journalists paid so scant attention to their occupational hazards even as they deal with dangerous stuff day in and day out. There was clear lack of awareness; how do you explain the near Darwin award nomination style attempt to defuse a bomb with just chisel and hammers? The accidents and deaths yesterday were stark reminders of what could happen if you ignore safety.

There is an urgent need to set up studies on occupational safety and their awareness among security forces, police officials, and journalists. There is also a need for organizing regular training programs and training manuals for these occupational groups.

Anyone listening?

Real time disease surveillance

This afternoon I met with the chief of the National Institute of Cholera and Enteric Diseases center. We discussed development of a syndromic surveillance using cell phones and computers. We discussed about RODS, an open source implementation of syndromic surveillance using computer based communications. RODS is truly amazing, here is a short history of the project: [RODS Project Website]