The Public Safety Risk Management Framework The basis for designing EHA training courses in WPRO health The GreekTemple ModelofSociety education art andculture security livelihoods environment governance Sustainable Human Development health, education, governance, livelihoods, environment (security) Public Safety individuals populations Emergency Risk Management + Management Hazard Prevention and Vulnerability Reduction + Mitigation + Emergency Preparedness Emergency Relief (readiness) + (response and recovery) Reconstruction and Disaster Emergencies Non Disaster Emergencies Rehabilitation for example Earthquakes Epidemics Hazards Risks loss of control Emergencies nationallevel of authority local War / Complex Disaster Non-disaster Personal Injury Emergencies emergencies emergencies Mass Casualty Pollution Epidemics Refugees Local flooding Events Industrial Accidents Transport Accidents Civil strife Urban Fires Indicators for monitoring risk reduction General impact of Prevalence of disasters = Hazard specific mortality + Hazard specific morbidity disasters hazard prevalence injuries, disability, disease events/province/year mortality rate flood mortality rate flood injury rate affected/province/year fatality rate flood fatality rate flood disability rate lethality rate flood lethality rate flood disease rate hazard conversion rate deaths/100000 population/year flood deaths/100000 population/year flood cases/100000 population/year disasters/total hazard events/year deaths/100000 affected/year flood deaths/100000 affected/year flood cases/100000 affected/year flood disasters/total floods/year deaths/disaster event deaths/flood event cases/flood event report EXCESS cases evaluate as 10 year rolling averages Other indicators economic data social data agricultural data education data Emergency Prevention and Vulnerability Reduction Community Risk + + Preparedness = Mitigation Programme Programme Management Programme safer communities Risks are the potential outcomes from the exposure of communities to hazards Public safety risk is: How do we assess proportional to Risk ? hazard X vulnerabilities readiness Determinants: quality hazard is a determinant of the TYPES of risks (death, disease etc) quantity vulnerabilities/readiness are determinants of HOW MUCH risk (risk modifiers) vulnerability determines pre-impact risks readiness determines post impact risks Goal the goal of a community risk management programme is to enhance public safety in communities Outcome Public safety risks are reduced by: reducing exposure to hazards (hazard mitigation/prevention) AND reducing vulnerabilities in communities (of people, property, services, livelihoods, environment) AND increasing readiness of responders Public Safety Emergency Management Risk Management Personal Injury Hazard Reduction Non-disaster Emergencies + Vulnerability Reduction Disaster Emergencies Emergency Preparedness National Security safer communities Public Safety Risk Management Public Safety Emergency Management Risk Management Relief Emergency Hazard Reduction Reconstruction Preparedness Vulnerability Reduction Rehabilitation Readiness to Respond safer communities Public Safety Risk Management Public Safety Risk Management + Emergency Management Hazard Reduction Damage Assessment and Needs Analysis Vulnerability Reduction Epidemiology and Reporting Emergency Preparedness Mass Casualty Management Hospital Planning Curative Care Shelter and Security Water and Sanitation Control of Communicable Disease Food and Nutrition Reproductive Health Psychosocial Needs Medical Supplies and Logistics Media and Public Information Recovery and Rehabilitation safer communities Disaster Management is: 80% generic 15% specific 5% unique to all disasters to the hazard to the event 1. Organisation EOC earthquake time coordination large numbers of trapped and injured place communications large numbers of homeless and displaced weather transport large numbers of dead and missing logistics and supplies geography information and media dead, injured and missing staff climate reporting and surveillance damaged critical infrastruture/resources (hospitals, vehicles) loss of water, gas, electricity, phone, transport, fuel networks security 2. Response loss of road, sea, air, rail infrastructutre / access search and rescue politics evacuation long period of SAR, victim extraction economy mass casualty management high demand for FA, stretchers, triage, medical transport governance management of dead and missing high demand for beds, surgery, blood products, referral security wound infections, amputations, tetanus, dust inhalation emergency management capacity temporary shelter, clothing and utensils high demand for orthotics, prosthetics, disability, dental logistics capacity emergency water, sanitation and energy demand for specialised spinal and head injury care disposal of inappropriate donations emergency food supplies high demand for temporary shelter, food, utensils, stoves, emergency public and environmental health water, energy, clothing, tents, blankets leadership emergency engineering and public works high demand for psychosocial support of victims and staff solidarity management of donated supplies/foreign teams morale 3. Recovery few outbreaks of communicable diseases corruption lifelines variable demand for medicines and equipment crime curative and public health care (acute/chronic injury care - high, infectious disease - low, looting education potentially unstable chronic disease - medium) agriculture compensation claims trade and commerce contamination of water, air and soil insurance claims toxic chemical, sewerage and gas leaks/spills 4. Rehabilitation and Reconstruction urban fires, explosions ownership disputes people contaminated, infested and unsafe foods property disputes property increased vector breeding services livelihoods loss of livelihoods, markets, distribution networks environment THIS IS WHAT WE PLAN FOR …. Definitions of Types of Emergencies hazards + community risks (consequences) type of emergency natural hazards hydro metereological death mass casualty event storms people injury (mental and physical) epidemic floods disease (mental and physical) extreme temperatures drought ++ geological secondary hazards (fire, disease) earthquakes displacement slides services loss of property volcano infrastructure loss of income disaster other natural environment breakdown in security forest fires livelihoods damage to infrastructure technological hazards breakdown in essential services industrial accidents transport accidents ++ structural failures urban fires biological hazards diseases of epidemic potential social environment breakdown in social, economic infestations economic environment and political structures complex emergency societal hazards political environment famine civil strife war terrorism community hazard x vulnerability / readiness = Community Risks risk quality risk quantity risk quantity indicators: indicators: indicators: indicators: natural hazards people: laws, policy, guidelines, procedures probability of: biological hazards: access to health care authority, resources, plans death technological hazards measles vaccination knowledge, skills, attitudes injury (mental and physical) societal hazards under 5 nutrition multisectoral, all hazards disease (mental and physical) 1. probability of occurrence under 5 mortality legislation 2. scale: magnitude, intensity access to clean water national and sectoral policy loss of lifelines ie 3. area, spread, duration access to sanitation administrative procedures (shelter, water, food, energy) biological hazards: adequate housing response and recovery plans population displacements season, infectivity, latency employment/income preparedness plans loss of property transmission, resistance, etc female literacy technical guidelines loss of income earthquakes property: management structure floods/storms health infrastructure institutional arrangements secondary hazards famine vehicles information systems breakdown in security diseases of epidemic potential medical equipment/supplies warning systems damage to infrastructure events/crowds services: human resources breakdown in services intoxification curative care services material resources environmental contamination infestations ambulance services financial resources etc transport accidents public health services simulations and training structural failures health information system education industrial accidents livelihoods: public information pollution formal community participation Monitor and evaluate by following refugees informal research hazard specific rates and trends: war environment: publications events/year terrorism natural/built/urban/rural private sector role cases and deaths/100000/year water/soil/air quality cases and deaths/1000 affected/year vector habitats cases and deaths/event/year forestry, agriculture EXCESS injuries; disease; disability Prevention and Emergency Vulnerability Community Risk Mitigation + + Preparedness = Reduction Programme Management Programme Programme Health Needs in an Emergency Time-frame General Needs Health Sector Responsibilities first search and rescue safe extraction, resuscitation and first aid 24 evacuation / shelter triage and transport system hours food primary medical care water detoxification /decontamination public information system acute medical and surgical care (first line and referral) ency coordination, communication, logistics and reporting systems (including injury and disability registers) end of security