DISASTER

NURSING
DISASTER
■W H O : Any occurrence that causes
damage, ecological disruption, loss
of human life and deterioration of
health and health services on a
scale sufficient to warrant an
extraordinary response from
outside the affected community.
■P A H O : An overwhelming
ecological disruption which
exceeds the capacity of a
community to adjust and
consequently requires
assistance from outside.
■W. Nick Carter : It is an event,
natural or manmade, sudden or
progressive, which impacts with
such severity that the affected
community has to respond by
taking exceptional measures.
■In simple words…… It is a
catastrophe, a calamity or a
cataclysm which results in
loss of life and property.
■ Health care providers characterize
disasters by what they do to people—
the consequences on health and health
services
■ A medical disaster is a catastrophic
event that results in causalities that
overwhelm the health care resources
in that community (Al-Madhari & Zeller,
1997)
■Noji (1997) describes disasters
quite simply, as “events that
require extraordinary efforts
beyond those needed to
respond to everyday
emergencies”
 CLASSIFICATION
DISASTE
R

NATURA MANMA
L DE
■ The World Health Organization defines
natural disaster as the “result of an
ecological disruption or threat that
exceeds the adjustment capacity of the
affected community”
■ Natural disasters include earthquakes,
floods, tornadoes, hurricanes, volcanic
eruptions, ice storms, tsunamis, and
other geologic or meteorological
phenomena
■ Meteorological Disasters : cause by
extreme weather various kind of storms,
cold spells, drought, heat waves
■ Typological Disaster :
avalanches(snow),landslides, floods
■ Telluric and Tectonic Disasters :
earthquakes, tsunamis, volcanic eruptions
■ Biological Disaster : insect swarms,
epidemics of communicable diseases
■ Man-made disasters are those in which the
principal direct causes are identifiable
human actions, deliberate or otherwise
(Noji, 1996).
■ Man-made disasters include biological and
biochemical terrorism, chemical spills,
radiological (nuclear) events, fire,
explosions, transportation accidents,
armed conflicts, and acts of war
■Human-generated disasters can be
further divided into three broad
categories:
(a) complex emergencies,
(b) technologic disasters,
(c) disasters that are not caused by
natural hazards but occur in
human settlements.
■ Complex emergencies involve situations
where populations suffer significant casualties
as a result of war, civil strife, or other political
conflict. Some disasters are the result of a
combination of forces such as drought, famine,
disease, and political unrest that displace
millions of people from their homes.
■ E.g. These humanitarian disasters can be epic in
proportion, such as civilians fleeing the Iraq
war or refugees displaced by the conflict in
Darfur.
■Technologic disasters, large
numbers of people, property, community
infrastructure, and economic welfare are
directly and adversely affected by major
industrial accidents; unplanned release of
nuclear energy; and fires or explosions
from hazardous substances such as fuel,
chemicals, or nuclear materials
■ a natural disaster, or phenomenon,
may trigger a secondary disaster, the
result of weaknesses in the human
environment. An example of this is a
chemical plant explosion following an
earthquake. Such combinations, or
synergistic disasters, are commonly
referred to as NA-TECHs (Natural and
Technological Disasters)
■Disasters are frequently
categorized based on their
– onset,
– impact,
– and duration
For example,
earthquakes and tornadoes are rapid-
onset events—short durations but with a
sudden impact on communities.
Hurricanes and volcanic eruptions have a
sudden impact on a community; however,
frequently advance warnings are issued
enabling planners to implement
evacuation and early response plans
For example,
droughts and famines have a more gradual
onset or chronic genesis (the so-called creeping
disasters) and generally have a prolonged
impact
A bioterrorism attack may be sudden and
unanticipated and have a sudden and
prolonged impact on a community.
Factors that influence the impact of a
disaster on a community include
 the nature of the event,
time of day or year,
 health
age characteristics of the population
affected,
the availability of resources
Further classification of
terms in the field of
disaster science
distinguishes between
hazards and disasters.
Hazards present the possibility
of the occurrence of a disaster
caused by natural phenomena
(e.g., hurricane, earthquake),
failure of man-made sources of
energy (e.g., nuclear power
plant), or by human activity (e.g.,
war).
HEALTH EFFECTS OF DISASTERS
■ Disasters may cause premature deaths, illnesses,
and injuries in the affected community, generally
exceeding the capacity of the local health care
system.
■ Disasters may destroy the local health care
infrastructure, which will therefore be unable to
respond to the emergency. Disruption of routine
health care services and prevention initiatives
may lead to long-term consequences in health
outcomes in terms of increased morbidity and
mortality.
■ Disasters
may create environmental
imbalances, increasing the risk of
communicable diseases and environmental
hazards
■ Disasters may affect the psychological,
emotional, and social well-being of the
population in the affected community. Depending
on the specific nature of the disaster, responses
may range from fear, anxiety, and depression to
widespread panic and terror
■ Disasters may cause shortages of food and
cause severe nutritional deficiencies.
■ Disasters may cause large population
movements (refugees) creating a burden on
other health care systems and communities.
Displaced populations and their host
communities are at increased risk for
communicable diseases and the health
consequences of crowded living conditions
THE DISASTER CONTINUUM
■The life cycle of a disaster is
generally referred to as the
disaster continuum, or
emergency management cycle.
three major phases
preimpact (before),
 impact (during),
and postimpact (after),
The five basic phases of a disaster
management program
preparedness,
mitigation,
 response,
recovery, and
evaluation
Preparedness refers to the proactive
planning efforts designed to structure the
disaster response prior to its occurrence.
Disaster planning encompasses evaluating
potential vulnerabilities (assessment of
risk) and the propensity for a disaster to
occur. Warning (also known as forecasting)
refers to monitoring events to look for
indicators that predict the location, timing,
and magnitude of future disasters.
Mitigation includes measures taken to
reduce the harmful effects of a disaster
by attempting to limit its impact on
human health, community function, and
economic infrastructure. These are all
steps that are taken to lessen the
impact of a disaster should one occur
and can be considered as prevention
measures.
Prevention refers to a broad range
of activities, such as attempts to
prevent a disaster from occurring,
and any actions taken to prevent
further disease, disability, or loss of
life.
The response phase is the actual
implementation of the disaster plan.
Disaster response, or emergency
management, is the organization of
activities used to address the event.
Traditionally, the emergency management
field has organized its activities in sectors,
such as fire, police, hazardous materials
management (hazmat), and emergency
medical services.
 The response phase focuses primarily on
emergency relief: saving lives, providing
first aid, minimizing and restoring
damaged systems such as
communications and transportation, and
providing care and basic life
requirements to victims (food, water, and
shelter)
Recovery actions focus on stabilizing and
returning the community (or an
organization) to normal (its preimpact
status). This can range from rebuilding
damaged buildings and repairing
infrastructure, to relocating populations
and instituting mental health interventions.
Rehabilitation and reconstruction involve
numerous activities to counter the long-
term effects of the disaster on the
community and future development.
Evaluation is the phase of disaster
planning and response that often receives
the least attention. After a disaster, it is
essential that evaluations be conducted to
determine what worked, what did not
work, and what specific problems, issues,
and challenges were identified. Future
disaster planning needs to be based on
empirical evidence derived from previous
disasters
Evaluation is the phase of disaster
planning and response that often receives
the least attention. After a disaster, it is
essential that evaluations be conducted to
determine what worked, what did not
work, and what specific problems, issues,
and challenges were identified. Future
disaster planning needs to be based on
empirical evidence derived from previous
disasters
Disaster Overview in the Philippines
■ Hazards
The Philippines has an increased vulnerability to natural
hazards, which are attributed to the nation’s geographic
position in Southeast Asia within the “Ring of Fire”
between two tectonic plates (Eurasian and Pacific). The
Philippines is most vulnerable to typhoons; however,
volcanoes, floods, landslides, earthquakes, droughts and
tsunamis also pose serious risks. The nation’s natural
hazards are due to contributing weather and
environmental factors
■ Natural Hazards The Philippines experiences natural
hazards such as typhoons, earthquakes, floods,
volcanic eruptions, landslides, and fires.
■ Typhoons are both the most common and most
destructive natural disasters in the Philippines.
Historically, the Philippines have been vulnerable to
extreme weather.
– Typhoon Haiyan (Yolanda) resulted in more than
6,300 lost lives, over four million displaced citizens,
and US$2 billion in damages in 2013.
– Annually, an average of twenty tropical cyclones
enters the waters surrounding the Philippines
Volcanoes
 The Philippines is also unique for its high level of
exposure to volcanic hazards. Located on the ‘Pacific
Ring of Fire’, the country lies at the intersection of two
tectonic plates - the Eurasian and the Pacific. These
plates move continually, causing both volcanic events
and earthquakes.
■ The country is home to roughly 300 volcanoes, of which
22 are classified as active and five are classified as
highly active: Taal, Mayon, Bulusan, Kanlaon and
Hibok-Hibok
Earthquakes
■ The Philippines’ earthquake risk is similar to that of its volcanic
risk. The root cause of both hazards is the same – the tectonic
plate boundary. The country has an average of roughly 20
earthquakes each day, but most of the daily earthquakes
measure 4.5 or less, and do not cause infrastructure damage or
loss of life.
Floods
Monsoon rains can be very damaging to the many low-lying,
marginally developed areas in the Philippines. Total annual
rainfall is expected in the Philippines ranging from 1 meter (3.28
feet) to 4 meters (13.12 feet). However, unusually strong monsoon
seasons have recently been exacerbated by increased urban
development, which impedes the traditional drainage channels
and creates flooding hazards in urban areas
Tsunamis
■ There is an elevated risk of tsunamis in the Philippines due to it
being an island nation with significant seismic activity. The
coastlines are at the highest risk of tsunami impacts and most
of the coastal areas have endured minimal impacts of a
tsunami
Landslides
■ Landslides often initiated by other significant weather events,
are a major hazard in the country. Most of the nation’s
regions, with the exception of the Palawan regions, are highly
susceptible to landslides. Landslides are commonly generated
by a volcanic eruptions, earthquakes, and typhoons or
increased monsoon rainfall
Droughts
■ The islands of the Philippines endure weather conditions
related to El Niño, including prolonged drought conditions from
postponements in seasonal monsoon precipitation.
Recent History of Natural Disasters
■ Mayon Volcano Eruption - Jan 2018 On 15 January 2018, two lava
collapse events occurred in the Mayon Volcano (located in
Albay provice 300 km southeast of Manila), producing rockfall
and ashfall in 29 villages of Camalig and Guinobatan. Lava
flow, rockfall events and short pyroclastic flows were also
observed the following day.
■ Tropical Cyclone Tembin - December 2017 Several provinces on
the island of Mindanao were affected by Tropical Storm
Tembin (known locally as Vinta), which made landfall on 22
December 2017.
■ Tropical Storm Kai-Tak - December 2017 On 16 December 2017,
Tropical Storm Kaitak (known locally as Urduja) made landfall
over San Policarpio, Eastern Samar province.
■ Earthquakes - July 2017 On 6 July 2017, a 6.5-magnitude
earthquake struck the Philippines. The earthquake had a depth
of 6.49 kilometers; it had an epicenter located three kilometers
north-northeast of Masarayao, Leyte
■ Earthquakes – February - March 2017 On 10 February 2017, a 6.7-
magnitude earthquake with a depth of ten kilometers and an
epicenter located near Surigao City caused loss of lives and
damage to properties in the Caraga region, particularly in
Surigao del Norte province
■ Floods and Landslides-January 2017 On 16 January 2017, over
63,000 people were displaced due to flash floods in northern
Mindanao and the Visayas with an estimated 48,000 people
inside 115 evacuation centers.9
Country Risks
■ Pollution Pollution is a major concern in the Philippines. This is
because only an estimated 10 percent of the sewage generated
in the country is properly treated or disposed of. The
remainder, approximately 90 percent, of raw sewage is
naturally disposed of and eventually ends up in the ocean due
to precipitation, surface runoff, flooding, and coastal erosion.
■ Overfishing and Destructive Fishing -The Philippines has seen
an increase in overfishing and destructive fishing practices. The
Asian Development Bank (ADB) has estimated that there is a 90
percent decline in the number of marine life that can be fished
in some regions.
Deforestation . Philippine forests remain vulnerable to poor
agricultural practices, and increased urbanization, unlawful
logging, and forest fires. Prolonged forest degradation has
resulted in severe soil erosion
Increased Coastal Development Coral reefs, mangrove and
seagrass have been damaged, increasing the nation’s
vulnerability to coastal disasters and reducing sustainable
marine life within the region. As coastal populations have
increased, so has excavation, dredging, and coastal
transformation to accommodate coastal development practices.
Country Risk Profile
 Risk involves exposure to hazards, vulnerability, as
well as lack of coping capacity is important factors in
Disaster Risk Management.
 Figure 2 shows INFORM’s risk profile for Philippines.
 INFORM is a global, objective, and transparent tool for
understanding the risk of humanitarian crises. INFORM is a
composite indicator, developed by the Joint Research Center,
combining indicators into three dimensions of risk: hazards
(events that could occur) and exposure to them, vulnerability
(the susceptibility of communities to those hazards) and the
lack of coping capacity (lack of resources that can alleviate the
impact)
INFORM gives each country a risk score of 1-10 (1
being the lowest and 10 the highest) for each of
the dimensions, categories, and components of
risk, as well as an overall risk score. The higher
the score the more vulnerable a country is. The
purpose of
The Philippines has a 2018 Hazard and Exposure
risk of 7.8/10; a Vulnerability score of 4.2/10; and a
Lack of Coping Capacity score of 4.2/10. Physical
exposures to tropical cyclones are the highest
THE DISASTER PLANNING
■The disaster-planning continuum is broad
in scope and must address collaboration
across agencies and organizations, advance
preparations, as well as needs assessments,
event management, and recovery efforts.
Individuals and organizations
responsible for disaster plans should
consider all possible eventualities—
from the sanitation needs of crowds at
mass gatherings, to the psychosocial
needs of vulnerable populations, to
evacuation procedures for buildings
and geographic areas— when
designing a detailed response
TYPES OF DISASTER PLANNING
1. agent-specific approach focus
their preparedness activities on
the most likely threats to occur
based on their geographic
location
2. The all-hazards approach is a
conceptual model for disaster
preparedness that incorporates
disaster management components
that are consistent across all major
types of disaster events to maximize
resources, expenditures, and
planning efforts.
issues and challenges can be effectively addressed in core
preparedness activities and include the following:

1. Communication problems.
2. Triage, transportation, and
evacuation problems.
3. Leadership issues.
4. The management, security of, and
distribution of resources at the
disaster site.
5. Advance warning systems and the
effectiveness of warning messages.
6. Coordination of search and rescue efforts.
7. Media issues.
8. Effective triage of patients (prioritization for
care and transport of patients).
9. Distribution of patients to hospitals in an
equitable fashion.
10. Patient identification and tracking
11. Damage or destruction of the health care
infrastructure.
12. Management of volunteers, donations, and
other large numbers of resources.
13. Organized improvisational response to the
disruption of major systems.
14. Finally, encountering overall resistance (apathy)
to planning efforts. Auf der Heide states, “Interest
in disaster preparedness is proportional to the
recency and magnitude of the last disaster” (1989).
11. Damage or destruction of the health care
infrastructure.
12. Management of volunteers, donations, and
other large numbers of resources.
13. Organized improvisational response to the
disruption of major systems.
14. Finally, encountering overall resistance (apathy)
to planning efforts. Auf der Heide states, “Interest
in disaster preparedness is proportional to the
recency and magnitude of the last disaster” (1989).
11. Damage or destruction of the health care
infrastructure.
12. Management of volunteers, donations, and
other large numbers of resources.
13. Organized improvisational response to the
disruption of major systems.
14. Finally, encountering overall resistance (apathy)
to planning efforts. Auf der Heide states, “Interest
in disaster preparedness is proportional to the
recency and magnitude of the last disaster” (1989).
11. Damage or destruction of the health care
infrastructure.
12. Management of volunteers, donations, and
other large numbers of resources.
13. Organized improvisational response to the
disruption of major systems.
14. Finally, encountering overall resistance (apathy)
to planning efforts. Auf der Heide states, “Interest
in disaster preparedness is proportional to the
recency and magnitude of the last disaster” (1989).
Methods for Data Collection for Disaster
Planning
1. HAZARD IDENTIFICATION AND
MAPPING
Hazard identification is used to
determine which events are most likely
to affect a community and to make
decisions about who or what to protect
as the basis of establishing measures
for prevention, mitigation, and
Historical data and data from other
sources are collected to identify
previous and potential hazards.
Data are then mapped using aerial
photography, satellite imagery,
remote sensing, and geographic
information systems
2. VULNERABILITY ANALYSIS is used to
determine who is most likely to be affected,
the property most likely to be damaged or
destroyed, and the capacity of the community
to deal with the effects of the disaster. Data
are collected regarding the susceptibility of
individuals, property, and the environment to
potential hazards in order to develop
prevention strategies. A separate
vulnerability analysis should be conducted
for each identified hazard.
3. RISK ASSESSMENT uses the results of the
hazard identification and vulnerability
analysis to determine the probability of a
specified outcome from a given hazard that
affects a community with known
vulnerabilities and coping mechanisms (risk
equals hazard times vulnerability). The
probability may be presented as a numerical
range (i.e., 30% to 40% probability) or in
relative terms (i.e., low, moderate, or high
risk).
Major objectives of risk assessment
include:
■ Determining a community’s risk of adverse
health effects due to a specified disaster (i.e.,
traumatic deaths and injuries following an
earthquake)
■ Identifying the major hazards facing the
community and their sources (i.e.,
earthquakes, floods, industrial accidents)
 ■ Identifying those sections of the community
most likely to be affected by a particular
hazard (i.e., individuals living in or near flood
plains)
■ Determining existing measures and
resources that reduce the impact of a given
hazard (i.e., building codes and regulations
for earthquake mitigation)
■ Determining areas that require
strengthening to prevent or mitigate the
effects of the hazard
Hazard Analysis
CAPACITY TO RESPOND
Resource identification is an essential feature
of disaster planning. A community’s capacity
to withstand a disaster is directly related to
the type and scope of resources available,
the presence of adequate communication
systems, the structural integrity of its
buildings and utilities (e.g., water, electricity),
and the size and sophistication of its health
care system
Resources include both human and physical elements,
such as organizations with specialized personnel and
equipment.
Disaster preparedness should include assembling lists of
health care facilities; medical, nursing, and emergency
responder groups; public works and other civic
departments; and volunteer agencies, along with phone
numbers and key contact personnel for each. Hospitals,
clinics, physician offices, mental health facilities, nursing
homes, and home care agencies must all have the
capacity to ensure continuity of patient care despite
damage to utilities, communication systems, or their
CORE PREPAREDNESS ACTIVITIES
1) Theoretical foundation for disaster planning. Disaster plans
are “constructed” in much the same way as one builds a
house.
2) Disaster planning is only as effective as the assumptions upon
which it is based
3) Core preparedness activities must go beyond the routine
4) Community needs assessment.
5) Identify leadership and command post
6) The first 24–48 hours: design of the local response. A plan for
the mobilization of local authorities, personnel, facilities,
equipment, and supplies for the initial postimpact 48-hour
period is composed of the next level of the foundation of the
disaster response.
7)Identification and accommodation of
vulnerable populations.
8) State and federal assistance.
9. Identification of training and educational
needs, resources, and personal protective
equipment (PPE).
10) Plan for the early conduct of damage
assessment.
Guha-Sapir (1991) developed a template, or tool, from disaster
epidemiology that includes useful indicators for a rapid needs
assessment after earthquakes and which can be used to estimate
the following factors:
■ Overall magnitude of the effect of the disaster (geographical
extent, number of individuals affected, estimated duration).
■ Effect on measurable health outcomes (deaths, illnesses,
injuries).
■ Integrity of the health care delivery system.
■ Specific health care needs of survivors.
■ Disruption of services vital to the public’s health (water, power,
sanitation).
■ Extent of response to the disaster by local authorities.
 EVALUATION OF A DISASTER
PLAN
An essential step in disaster planning
and preparedness is the evaluation of
the disaster response plan for its
effectiveness and completeness by key
personnel involved in the response.
SITUATIONS SUGGESTIVE OF AN
INCREASED NEED FOR PLANNING
Disasters Within Hospitals
“external” events, dealing specifically with the
management of large volumes of patients
arriving from an emergency that has occurred
somewhere other than in the hospital
.“Internal” disasters refer to incidents that disrupt
the everyday, routine services of the medical
facility and may or may not occur simultaneously
with an external event.
the phases of a hospital’s internal disaster
response plan generally include the identification
of a command post and the following three phases
1) Alert phase, during which staff remain at their
regular positions, service provision is
uninterrupted, and faculty and staff await
further instructions from their supervisors.
2) Response phase, during which designated staff
report to supervisors or the command post for
instructions, the response plan is activated, and
nonessential services are suspended.
3) Expanded response phase, when additional
personnel are required, off-duty staff are called in, and
existing staff may be reassigned based on patient
needs
Internal disaster plans must address all potential
scenarios, including:
■ loss of power, including auxiliary power;
■ loss of medical gases;
■ loss of water and/or water pressure;
■ loss of compressed air and vacuum (suction);
■ loss of telecommunications systems;
■ loss of information technology systems;
■ threats to the safety of patients and staff (violence,
terrorism, and bombs);
■ toxic exposures involving fumes, chemicals, or
radiation;
■ immediate evacuation of all patients and personnel.
Bioterrorism/Communicable Disease
 At what point does outbreak management become
disaster management? The investigation and
management of any communicable disease outbreak
requires three steps:
(a) recognition that a potential outbreak is occurring;
(b) investigation of the source, mode of transmission,
and risk factors for infection; and
(c) implementation of appropriate control measures
 If outbreak management
exceeds or threatens to exceed
the capability and resources of
the institution, then a disaster
management model may be
useful
Hazardous Materials Disaster
Planning
Gasoline and liquid petroleum gas are
the most common hazardous materials,
but other potential hazards include
chlorine, ammonia, and explosives.
Situations involving relocation of
nuclear waste materials also pose a
considerable risk to the communities
involved
Hazardous Materials Disaster
Planning
Gasoline and liquid petroleum gas are
the most common hazardous materials,
but other potential hazards include
chlorine, ammonia, and explosives.
Situations involving relocation of
nuclear waste materials also pose a
considerable risk to the communities
involved
Material safety data sheets
standardize the method of
communicating relevant information
about each material—including its
toxicity, flammability, and known
acute and chronic health effects— and
can be used as part of the hazard
identification process
PROFESSIONAL NURSING MANDATE
According to the American Nurses Association
(ANA), “the aim of nursing actions is to assist
patients, families and communities to improve,
correct or adjust to physical, emotional,
psychosocial, spiritual, cultural, and
environmental conditions for which they seek
help” and definitions of nursing have evolved to
acknowledge six essential features of
professional nursing:
■ Provision of a caring relationship that
facilitates health and healing.
■ Attention to the range of human
experiences and responses to health and
illness within the physical and social
environments.
■ Integration of objective data with
knowledge gained from an appreciation of
the patient or group’s subjective experience.
■ Application of scientific knowledge to the
processes of diagnosis and treatment
through the use of judgment and critical
thinking.
■ Advancement of professional nursing
knowledge through scholarly inquiry.
■ Influence on social and public policy to
promote social justice.
EMERGENCY HEALTH
SERVICES
EHS COMPONENTS
The EHS system is a complex
combination of various providers and
facilities that provide three basic medical
functions: evacuation, stabilization, and
redistribution
EHS COMPONENTS
The EHS system is a complex
combination of various providers and
facilities that provide three basic
medical functions: evacuation,
stabilization, and redistribution.
the emergency medical services (EMS)
system, emergency departments (ED), and
alternate sources of emergency care.
The EMS system
traditionally includes all services from the
receipt of emergency requests for
assistance to the transport of patients to
EDs.
In most circumstances, EMS dispatchers
receive the call for assistance and, in
response, send appropriate resources to
the patient.
EMS providers range from first
responder to emergency
medical technician-paramedic
and provide care that can be
divided roughly into two levels
—basic life support (BLS) and
advanced life support (ALS).
EMS providers range from first
responder to emergency
medical technician-paramedic
and provide care that can be
divided roughly into two levels
—basic life support (BLS) and
advanced life support (ALS).
BLS providers can provide
extrication, immobilization, and
bleeding control, while assisting a
patient in taking their own
medication (nitroglycerin, for
example) or administering oxygen
ALS providers can perform a
number of skills, including
intubation, needle thoracostomy,
defibrillation, and cardiac pacing,
while administering a wide variety
of pharmacotherapy, including
advanced cardiac life support
medications.
The Medical Priority Dispatch System
(MPDS) is an example of a commonly used
triage system specifically designed to
abstract caller information through a
question-driven protocol and direct
appropriate resources based on that
information.
Through the protocol-driven triage process,
dispatchers determine the level and rapidity of
response required
EDs receive undifferentiated, unscheduled
patients and can evaluate and provide initial
management of disease.
Beyond this, EDs have differing capabilities in
terms of diagnostic tools and treatment
capabilities
 the hospital’s ED and inpatient capabilities may
range from providing basic care to
administering specialized, advanced
interventions such as trauma, stroke, and
cardiac care.
EDs receive undifferentiated, unscheduled
patients and can evaluate and provide initial
management of disease.
Beyond this, EDs have differing capabilities in
terms of diagnostic tools and treatment
capabilities
 the hospital’s ED and inpatient capabilities may
range from providing basic care to
administering specialized, advanced
interventions such as trauma, stroke, and
cardiac care.
satellite EDs are preexisting health care
facilities that can be activated in the event
of a disaster to provide emergency care.
These sites could include schools, arenas,
stadiums, jails, or fairgrounds. Depending
on the resources invested, satellite EDs can
provide a level of service ranging from
simple first aid to advanced life support
care, including radiographic and surgical
capabilities.
Alternate sources of emergency care
Many communities have urgent care centers
established to provide care for minor illnesses
and injuries.
Some are equipped to perform laboratory
testing and radiographs, infuse intravenous
medications, or provide more advanced
therapies.
Physician offices are also an alternate source of
emergency care. Some integrated physician
practices already evaluate and care for acutely
ill patients on-site.
 MAJOR EHS CONCEPTS ASSOCIATED WITH
DISASTERS
Emergency Health Services typically differentiates
between a mass casualty incident (MCI) and a disaster
 Any influx of patients from a single incident that
exceeds the capacity of the EHS system can be
considered an MCI
 In turn, EHS will typically refer to a disaster as a
natural or man-made phenomenon that results in the
destruction or dysfunction of the available response
infrastructure to meet the community’s need for
health care
Thus in the case of a hurricane or power
outage, only a few injured people may require
medical care; however, because the health
system infrastructure may have been
destroyed, the disaster may clearly require
outside assistance to meet the health care
demands of the community. This type of disaster
is sometimes referred to as a “paralytic”
disaster because it has the potential to eliminate
the EHS’s ability to respond to any call for
services, let alone extra demands for care
resulting from the event.
The Joint Commission on
Accreditation of Healthcare
Organizations also defines a third
level of crisis—a catastrophe.
A catastrophe is considered a
disaster in which the community
and hospital are overwhelmed and
isolated for 3 or more days
The Joint Commission on
Accreditation of Healthcare
Organizations also defines a third
level of crisis—a catastrophe.
A catastrophe is considered a
disaster in which the community
and hospital are overwhelmed and
isolated for 3 or more days
All disasters have a time component.
For most, the time line is very short.
With an explosion, a shooting, or a
tornado, the damage will occur during
a brief period and recovery will follow.
However, the impact from this type of
event can endure, even beyond 3
months.
. In contrast, a biological attack, infectious
epidemic, or flood may cause damage over
a longer period, with new patients
appearing continuously. For a routinely
overwhelmed EHS system, the premise that
most disasters cannot be planned is
extremely important for preplanning.
. In contrast, a biological attack, infectious
epidemic, or flood may cause damage over
a longer period, with new patients
appearing continuously. For a routinely
overwhelmed EHS system, the premise that
most disasters cannot be planned is
extremely important for preplanning.
ICN FRAMEWORK OF DISASTER
NURSING COMPETENCIES
 
 “Competence” is a frequently used word that is
defined inconsistently in the literature (Fleming
and Holmes, 2005). In the health professions,
“competence” is used to describe the
knowledge that enables a practitioner to
perform activities consistently in a safe manner.
It is the major determinant of performance.
There is general agreement in nursing that
“competence” reflects the following:
|knowledge, understanding and
judgment; |
a range of skills cognitive, technical or
psychomotor and interpersonal;
a range of personal attributes and
attitudes”
The ICN defines competence as “a
level of performance demonstrating
the effective application of
knowledge, skill and judgment”.
Need for Competencies in Disaster
Nursing
Nurses must be able to work
internationally, in a variety of settings
with nurses and health care providers
from all parts of the world. To assure a
global nursing workforce ready to
respond in the event of a disaster,
competencies are essential.
Competencies:
 facilitate deployment of nurses globally;
 create consistency in the care given;
 facilitate communication;
 build confidence;
 facilitate a more professional approach;
 promote shared aims;
 allow for a unified approach;
 enhance the ability of nurses to work effectively within the
organizational structure;
 assist nurses to function successfully as members of the multidisciplinary
team.
 The ICN Framework of the Disaster Nursing
Competencies
 The ICN Disaster Nursing Competencies were
developed after an analysis of existing competency
frameworks in the area of public health, mental
health, health care workers, emergency managers,
nursing and disaster nursing
 The focus of the ICN Disaster Nursing Competencies is
the generalist nurse. All nurses are expected to be
able to demonstrate these competencies.
Competencies related to specialty nursing such as
emergency nursing, paediatric nursing and public
health nursing were not specifically incorporated into
 The “disaster management continuum” was selected
as the organization structure for several reasons:
 it is a process recognized throughout the world;
 nursing roles are integrated throughout it;
 it provides a consistent way to organize the competences;
and
 it enhances the ability to develop educational curriculum
that integrates the disaster management continuum with the
competencies
The competencies were organized under four areas:
 mitigation/prevention competencies;
 preparedness competencies;
 response competencies; and
 recovery/rehabilitation competencies.
Within the four areas, 10 domains were identified:
(1) risk reduction, disease prevention and health promotion;
(2) policy development and planning;
(3) ethical practice, legal practice and accountability;
(4) communication and information sharing;
(5) education and preparedness;
(6) care of the community;
(7) care of individuals and families;
(8) psychological care; (9)
(9) care of vulnerable populations; and
(10)long-term recovery of individuals, families and communities.
Numbering of the competencies is only for the ease of
Within the four areas, 10 domains were identified:
(1) risk reduction, disease prevention and health promotion;
(2) policy development and planning;
(3) ethical practice, legal practice and accountability;
(4) communication and information sharing;
(5) education and preparedness;
(6) care of the community;
(7) care of individuals and families;
(8) psychological care; (9)
(9) care of vulnerable populations; and
(10)long-term recovery of individuals, families and communities.
Numbering of the competencies is only for the ease of
 DISASTER
MANAGEMENT
The purpose of disaster management
in any health care facility is to maintain
a safe environment and continue to
provide essential services to the
patients during times of disaster.
Disaster management includes
preparedness/risk assessment,
prevention, mitigation, response,
recovery, and evaluation activities
The most important aspect of disaster
management is planning in advance
Cuny (1998) describes three types of advanced
planning activities:
(1) Strategic planning—These are planning
activities that focus on preparing the
organization for any type of threat. This is
commonly referred to as the all hazards
approach.
- is done to prepare the hospital for any type of
emergency or disaster.
(2) Contingency planning—These are planning
activities related to a site-specific threat that
may occur at any time. An example of this in
the hospital setting would be planning
activities for a facility that is in close
proximity to a nuclear power plant or an
airport.
-done after a risk assessment has been
completed and the vulnerabilities of the
organization are identified
(3) Forward planning—These are planning
activities for a known imminent disaster; for
example, a pending snowstorm, hurricane or
major rock concert.
-is performed in response to an
anticipated disaster or event. It focuses
on plans for activation of the existing
strategic and possibly the contingency
plans
(3) Forward planning—These are planning
activities for a known imminent disaster; for
example, a pending snowstorm, hurricane or
major rock concert.
-is performed in response to an
anticipated disaster or event. It focuses
on plans for activation of the existing
strategic and possibly the contingency
plans
Considerations Related to Internal
Versus External Disasters
■ Internal Disaster - occurs when there is an event
within the facility that poses a threat to disrupt the
environment of care. Such events are commonly
related to the physical plant (e.g., loss of utilities or
fire), but can arise from availability of personnel (e.g.,
a labor strike).
– Regardless of the cause, the management goal is
to maintain a safe environment for the patients,
continue to provide essential services, ameliorate
the problem, and restore normal services.
■ External Disaster - becomes a problem
for a facility when the consequences of
the event create a demand for services
that tax or exceed the usual available
resources (e.g., arrival of a large
number of trauma patients or victims
of a chemical HAZMAT incident).
■ Goolsby and Kulkarni (2006) further
classify disasters according to the
magnitude of the disaster in relation to
the ability of the agency or community
to respond.
– Disasters are classified by the
following levels:
■ Level I: If the organization, agency, or
community is able to contain the event and
respond effectively utilizing its own resources.
■ Level II: If the disaster requires assistance
from external sources, but these can be
obtained from nearby agencies.
■ Level III: If the disaster is of a magnitude that
exceeds the capacity of the local community
or region and requires assistance from state-
level or even federal assets
 Considerations Related to Levels of
Disasters
Level I
The agency must assure that each of its own
employees are competent in basic emergency
preparedness, and there is adequate surge
capacity within its own organization to be
prepared to respond to routine emergencies,
some of which can be expected, such as power
outages, weather events, or other limited
events.
Level II
The agency must assure that it has
adequate linkages with other
organizations and agencies in the
surrounding community so when
needed, required local support and
assets can be readily procured.
Level III
The agency must assure that it has
adequate linkages with state- and
federal-level organizations, have the
ability to know when to request a
higher level of assistance, and know
the communication chain of command
for requesting state and or federal
assets.
For any type of disaster, whether it be a
Level I, II, or III or internal, external, or
combined internal/external, is to have a
solid plan in place for the most likely
events, establish relationships with public
agencies (e.g., EMS, fire and police
departments), utility companies
(telecommunications, electric, and water),
and enter into mutual aid agreements with
similar types of facilities (e.g., the hospital in
the next community).
For any type of disaster, whether it be a
Level I, II, or III or internal, external, or
combined internal/external, is to have a
solid plan in place for the most likely
events, establish relationships with public
agencies (e.g., EMS, fire and police
departments), utility companies
(telecommunications, electric, and water),
and enter into mutual aid agreements with
similar types of facilities (e.g., the hospital in
the next community).
 DISASTER MANAGEMENT
PROGRAMS
There are five basic phases to a
disaster management program
(Kim & Proctor, 2002), and each
phase has specific activities
associated with it.
Preparedness/Risk Assessment:
Evaluate the facility’s vulnerabilities or propensity
for disasters.
Issues to consider include:
 weather patterns;
 geographic location;
 expectations related to public events and
gatherings;
 age, condition, and location of the facility;
 and industries in close proximity to the hospital
(e.g., nuclear power plant or chemical factory)
Mitigation:
These are steps that are taken to lessen the
impact of a disaster should one occur and can
be considered as prevention measures.
 Examples of mitigation activities include
installing and maintaining backup generator
power to mitigate the effects of a power
failure or cross training staff to perform
other tasks to maintain services during a
staffing crisis that is due to a weather
emergency.
Response:
The response phase is the actual
implementation of the disaster plan. The
best response plans use an incident
command system, are relatively simple, are
routinely practiced, and are modified when
improvements are needed.
Response activities need to be continually
monitored and adjusted to the changing
situation
Recovery:
Once the incident is over, the
organization and staff need to
recover.
Recovery is usually easier if, during
the response, some of the staff have
been assigned to maintain essential
services while others were assigned to
the disaster response.
Evaluation:
Often this phase of disaster planning and
response receives the least attention. After a
disaster, employees and the community are
anxious to return to usual operations. It is
essential that a formal evaluation be done to
determine what went well (what really
worked) and what problems were identified.
A specific individual should be charged with
the evaluation and follow-through activities.
 PHASES OF DISASTER
MANAGEMENT
Risk Assessment
The disaster manager needs to
consider what types of disasters
are most likely to be encountered
by the organization
The best disaster management plans are
developed for an all hazards approach and
then have specific appendices for the events
that are most likely to occur in the area
The disaster manager needs to also perform a
risk assessment in the area of staffing.
Depending on the nature and extent of the
disaster and the demographics of the workforce,
there may be variation in the employee’s ability
and/or willingness to report to work
Mitigation
Mitigation lessens the severity and impact of the
disaster through appropriate planning and
practice. The best ways to mitigate the results of
a disaster are to perform a thorough hazard
vulnerability risk assessment and be sure that
your plan includes provisions for each of the
likely events; develop a plan that maintains the
least variation from normal routines as possible;
and develop backup plans in the event the first
response actions are not successful.
 Not all disasters can be
prevented. But mitigation
activities can lessen the
degree of the impact of the
disaster
NON-STUCTURAL

■FORMULATION AND IMPLEMENTATION OF POLICIES

■IDENTIFYING HIGH RISK ZONES
■LAYING VARIOUS SAFETY CODE OF CONDUCT e.g.
construction rules in high seismic zone

STUCTURAL

■ESTABLISHMENT OF MONITORING SYSTEM e.g. P.T.W.S. (

Pacific Tsunami Warning Center)
■CONSTRUCTION OF DISASTER SHELTERS
ESSENTIAL ELEMENTS FOR HOSPITAL DISASTER MANAGEMENT
The essential elements for any disaster management system
include the following:
■ An appropriate infrastructure to support the disaster response,
which includes maintaining services for preexisting patients as
well as the new arrivals.
■ An appropriately trained staff who are competent to perform
their disaster response functional roles and able and willing to
report to work during any sort of disaster.
■ A clearly defined, executable, practiced emergency response
plan.
■ A strong foundation of preexisting relationships with
partnering organizations and agencies that can be called on to
provide mutual aid and support when needed.
 PREPAREDNESS
■MAKING VIABLE DISASTER PLAN TO
RESPOND RAPIDLY AND EFFECTIVELY

■ASSEMBLING ADEQUATE RESOURCES

■COLLECTING STOCKS OF CONSUMABLE

ITEMS

■TRAINING OF PERSONNEL
 DISASTER PLANNING PRINCIPLES
 IT SHOULD BE A CONTINUOUS PROCESS.
 IT SHOULD HAVE THE ABILITY TO FORESEE ADVERSE
SITUATIONS.
 IT MUST EVOKE PROPER RESPONSE.
 IT MUST BE BASED ON VALID KNOLEDGE.
 IT SHOULD SERVE AS AN EDUCATIONAL ACTIVITY.
 IT MUST BE REALISTIC AND ADAPTABLE.
 IT MST USE EXISTING STRUCTURE INSTEAD OF CREATING NEW
ONE.
 IT MUST BE CLEARLY WRITTEN.
 IT MUST BE TESTED.
 IT SHOULD BE HARMONISED AT EACH LEVEL WITH THE
HIGHER LEVEL.
ESSENTIAL ELEMENTS FOR HOSPITAL DISASTER MANAGEMENT
The essential elements for any disaster management system
include the following:
■ An appropriate infrastructure to support the disaster response,
which includes maintaining services for preexisting patients as
well as the new arrivals.
■ An appropriately trained staff who are competent to perform
their disaster response functional roles and able and willing to
report to work during any sort of disaster.
■ A clearly defined, executable, practiced emergency response
plan.
■ A strong foundation of preexisting relationships with
partnering organizations and agencies that can be called on to
provide mutual aid and support when needed.
Response
It is at this point that the disaster manager
must change leadership styles.
During disaster response, group decision
making/consensus style management is
replaced with structured and focused
direction style.
Staff who have been involved in the
planning process will recognize the need for
this style of leadership and will cooperate.
Response
It is at this point that the disaster manager
must change leadership styles.
During disaster response, group decision
making/consensus style management is
replaced with structured and focused
direction style.
Staff who have been involved in the
planning process will recognize the need for
this style of leadership and will cooperate.
 RESPONSE
TO SAVE LIFE AND PROTECT PROPERTY
■MEASURES TAKEN IMMEDIATELY PRIOR TO AND
FOLLOWING DISASTER
■PROPER AND TIMELY WARNING USING MEDIA,
ROVING LOUDSPEAKERS etc.
■DEPLOYMENT OF SKILLED PERSONS
■RESCUE WORK
■MEDICAL CARE
■DRINKING WATER SUPPLY
■RESTORE ALL SORTS OF COMMUNICATION
The best disaster management plans are
developed for an all hazards approach and
then have specific appendices for the events
that are most likely to occur in the area
The disaster manager needs to also perform a
risk assessment in the area of staffing.
Depending on the nature and extent of the
disaster and the demographics of the workforce,
there may be variation in the employee’s ability
and/or willingness to report to work
HOSPITAL INCIDENT COMMAND SYSTEM
(HICS)
HICS is an emergency management
system that is comprised of specific
disaster response functional role
positions within a hierarchical
organization chart
Key Features of Incident Command and HICS
Predictable, responsibility-oriented chain of
command:
 In the HICS system there is ONE incident
commander. This individual has overall
responsibility for the management of the
incident, and employees know who reports
to them and to whom they report. Direction,
requests for resources and all information
flow in a prescribed fashion up or down the
chain of command.
Use of common nomenclature:
 All agencies utilizing ICS use the same
titles and functional roles for the
command staff positions. Use of common
terminology assists different agencies
with communicating with each other.
Unified command structure:
 This allows all agencies involved in the
response to coordinate efforts by establishing
a unified set of incident objectives and
strategies.
Incident Action Plan (IAP):
 This is a plan that is developed when multiple
agencies are involved in the disaster response.
It ensures that all agencies are working
toward the same goal. It is what is developed
when the unified command structure is used.
Unity of command:
 Each person reports to only one individual.
Manageable span of control:
 Each manager controls a defined amount of resources,
which is limited to what can realistically be managed. The
ideal range is 5–7 people per supervisor; however where
tasks are relatively simple, the personnel possess a high
level of expertise or the management team is in close
proximity to those being supervised, this number of persons
supervised can be higher than 7.
Use of JAS:
 Job action sheets define for the staff what their
specific functional role is during the disaster
response. They also facilitate improved
documentation for better financial recovery after the
event.
 HICS Structure
 HICS achieves command and control during disaster response
through its chain of command, incident action plans, defined
functional roles for each individual, and extensive use of
incident response tracking forms.
 At the top of the organization tree are the command positions:
Incident Commander, Safety, Liaison, and Public Information
Officers.
 Under the command positions are the staff positions that
include the section chiefs and their reporting staff.
 As the disaster response evolves, sections are activated or
deactivated.
 The only position that is always required for incident command
is the Incident Commander
Specific HICS Functional Roles Although
 HICS has many different functional
roles, the roles on the top of the
organization tree will be similar across
a variety of types of organizations. The
positions at the base of the tree are
more generic to the hospital setting
Command Positions
 These are the positions at the top of the ICS
organizational tree. They are the same in
HICS as well as ICS for the uniformed
services.
Incident Commander (IC)
 The mission of the IC is to organize and
direct the operations of the incident. The
highest-ranking executive in the
organization appoints the IC, and from that
point the IC directs the disaster response.
  The IC immediately appoints the other required
command staff (e.g., safety, liaison, and public
information officers) and activates the required
sections (planning, operations, logistics, and
finance)
Safety and Security Officer:
 The mission of the safety officer is to ensure for the
safety of the staff, facility, and the environment during
the disaster operation. The safety officer has the final
authority to make decisions as they relate to safety
and hazardous conditions. With the threat of
bioterrorism and chemical warfare, the role of the
safety officer has taken on added importance.
Liaison Officer:
 It function as a contact for external
agencies.
 The liaison officer serves as a conduit for
these agencies and serves to prevent the
IC from becoming overloaded with
information and requests.
Public Information Officer:
 is responsible for providing information to the
news media. Disaster managers must be
aware that the news media can make or
break the public’s perception of the hospital’s
response to a disaster. When the media are
handled appropriately, they can be an asset
to the disaster response. The public
information officer is key to this process, and
this position should be activated for any
response that has the potential to involve the
media
Medical/Technical Specialists:
 These positions provide guidance on a variety of
special situations. Positions may include specialists in
biological and infectious diseases, legal affairs,
chemical, radiological, risk management,
medical staff, pediatric care, clinic
administration, hospital administration, and
medical ethics.
Medical/Technical Specialists:
 These positions provide guidance on a variety of
special situations. Positions may include specialists in
biological and infectious diseases, legal affairs,
chemical, radiological, risk management,
medical staff, pediatric care, clinic
administration, hospital administration, and
medical ethics.
 Staff Positions
The lower portion of the ICS tree contains the staff positions. Staff
positions all fall under one of four sections and are headed by a chief.
■ Planning Section Chief:
 collect and distribute information within the organization
that is required for planning and the development of an
IAP(incident action plan). The planning section chief
assures that the appropriate reports are being generated,
and that the facility IAP is communicated to the other
section chiefs. This position also directs the planning
activities for staffing and manages the labor resource
pools.
Logistics Section Chief:
 ensure that all resources and support
required by the other sections are readily
available.
 Responsibilities include maintenance of the
environment and procurement of supplies,
equipment, and food. Logistics ensures that
the operations staff can focus on delivering
services.
Finance/Administrative Section Chief:
 to monitor the utilization of assets and
authorize the acquisition of resources
essential for the emergency response.
This position is also frequently charged
with ensuring that human resources
policy and procedure consultation is
available to the IC
 RECOVERY
 During the recovery phase the disaster is over,
and the facility attempts to return to usual
operations.
 Plans should be in place to provide critical
incident stress debriefing for those staff members
who may have been exposed to traumatic
experiences or worked for protracted periods of
time and may be simply exhausted. It is during
the recovery phase that a tally is made of the
resources expended during the disaster response
 EVALUATION AND FOLLOW-THROUGH
 Every time an organization engages in a
disaster response an evaluation needs to be
done. It is best if one person is designated to
coordinate this effort. It should be performed in
a formal way and include not only staff, but
also those agencies that the health facility
interfaced with during the response
 PHILIPPINE
ORGANIZATIONAL
STRUCTURE
 The National Disaster Risk
Reduction and Management
Council (NDRRMC) is the central
body for coordinating disaster
management and response.
 focal point body responsible for coordinating
preparedness, response, prevention and
mitigation, and rehabilitation and recovery.
 Lead Government Agencies in Disaster Response
The Department of Social Welfare and Development
(DSWD), through the Disaster Response Assistance and
Management Bureau,
is the lead agency for disaster response.
 It is responsible for planning, coordinating, and leading
immediate disaster relief efforts, as well as ongoing
monitoring.
The DSWD leads the NDRRMC’s disaster response pillar
and provides technical assistance and resource
augmentation, camp coordination and management
activities, and food and non-food items to the affected
population.
The Office of Civil Defense (OCD)
is the executive arm and secretariat of
the NDRRMC. The primary role of the
OCD is to administer the national civil
defense and disaster risk reduction
and management programs.
The OCD also provides guidance on
strategic approaches and measures to
reduce vulnerabilities and risk
The Office of Civil Defense (OCD)
is the executive arm and secretariat of
the NDRRMC. The primary role of the
OCD is to administer the national civil
defense and disaster risk reduction
and management programs.
The OCD also provides guidance on
strategic approaches and measures to
reduce vulnerabilities and risk
International Federation of Red Cross and Red
Crescent Societies
is a humanitarian organization which provides
assistance and promotes humanitarian activities by
National Societies, with a view to preventing and
alleviating human suffering.
It was founded in 1919, and includes 190 Red Cross
and Red Crescent National Societies. The IFRC
carries out relief operations to assist victims of
disasters, and combines this with development
work to strengthen the capacities of its member
National Societies.
The Philippine Red Cross (PRC)
 is a voluntary, independent and autonomous non-
governmental society auxiliary to the government authorities
in the humanitarian field.
 The PRC exists to assist the Philippine government in
discharging the obligations provided in the Geneva
Conventions and the statutes of the International Red Cross
and Red Crescent Movement.
 It is a permanent member of the national and local Disaster
Risk Reduction and Management (DRRM) councils of the
Philippines. Keys roles and responsibilities of the PRC in
disaster management are established under national
legislative and policy frameworks, such as the Philippines
Red Cross Act 2009 and the Philippines Disaster Risk Reduction
and Management Act 2010
 The PRC’s recognized functions include organizing (in liaison
with public authorities) emergency relief operations,
establishing and maintaining national and international relief
efforts in response to natural or man-made disasters during
times of peace and armed conflict, and meet emergency
needs and alleviate suffering.
 The PRC is responsible for Disaster Management Services
(DMS). They deliver humanitarian assistance to populations
affected by natural hazards or human-induced emergencies.
 They have a wide network of skilled and well-trained staff
and volunteers. The PRC has six major services, which include
disaster management, health, welfare, blood, volunteer
service, and Red Cross youth
 DMS implements its mandate to save lives, minimize
human suffering, and reduce loss of properties, by
implementing preparedness, risk reduction, and
management programs for at-risk communities;
ensuring timely and effective relief assistance; and
conducting recovery programs
USAID
 The U.S. Agency for International Development (USAID)’s Office of
U.S. Foreign Disaster Assistance (OFDA) has robust disaster risk
reduction programs that build the capacity of local communities in the
Philippines, government agencies and nongovernmental organizations to
prepare for and respond to the range of natural disasters. USAID/OFDA
has responded to 50 disasters in the Philippines since 1990.
Policies, Framework, and Plans for
Disaster Management
Guiding Policy
Philippine Disaster Risk Reduction and Management Act (DRRM
Act 2010 or Republic Act No. 10121) The Philippine National Disaster
Risk Reduction and Management Act 2010 (DRRM Act 2010)
established a multi-level disaster risk management system. The
Act establishes the NDRRMC as the peak policy-making body for
coordination, integration, supervision, monitoring and evaluation.
The Office of Civil Defense (OCD) is tasked with administering the
national civil defense and disaster risk reduction and
management program
The DRRM Act 2010 is accompanied by a set of
“Implementing Rules and Regulations” that
lists the powers and functions of the National,
Regional and Local Disaster Risk Reduction
and Management Councils (DRRMCs), as well
as provisions for installing Local Disaster Risk
Reduction and Management Offices
(LDRRMOs) in every barangay
Key Plans
National Disaster Risk Reduction and
Management Plan 2011-2028 (NDRRP) outlines
key planning aspects such as timelines, lead
agencies, outcomes and activities according
to four thematic areas: (1) disaster prevention
and mitigation, (2) disaster preparedness, (3)
disaster response and (4) disaster
rehabilitation and recovery
 The NDRRMP fulfills the requirement of RA No.
10121 of 2010, which provides the legal basis for
policies, plans and programs to deal with
disasters. The NDRRP also outlines provisions for
developing and implementing disaster risk
reduction plans at the regional, provincial, city,
municipal and barangay levels.
Strengthening Disaster Risk Reduction in the Philippines:
 Strategic National Action Plan (SNAP) 2009-2019 The plan
attempts to strengthen disaster risk reduction and outlines 18
priority programs and projects based on 150 strategic actions.
The plan includes a four-point plan of action for preparedness
including upgrading the forecasting capability of warning
agencies; intensification of public information and education
campaign on disaster preparedness; enhancing capacity building
of local chief executives and disaster coordinating councils; and
strengthening mechanisms for government and private sector
partnerships.
National Disaster Response Plan for Hydrometeorological Hazards
(2014)
 This disaster response plan outlines the processes and
mechanisms for national, regional and local disaster response,
focusing on hydrometeorological hazards including typhoons,
tropical storms and flooding. The plan outlines the role of the
AFP, who directs the Search, Rescue and Retrieval (SRR)
cluster. AFP is also a member of the Camp Coordination and
Camp Management (CCCM) cluster and the Logistics cluster.
National Disaster Response Plan for Earthquake and
Tsunami
This is the National Government’s action plan in
providing response assistance for managing earthquakes
and tsunamis. The plan aims to ensure the timely,
effective and coordinated response by the National
Government by providing support assistance to disaster
affected areas. All local government units are mandated
to prepare and render disaster response within their
boundaries
Armed Forces Humanitarian Assistance and Disaster
Response Plan (OPLAN Tulong – Bayanihan) (2016)
This plan outlines core functions and operational
processes and systems to be used by the AFP in
Humanitarian Assistance and Disaster Relief
(HADR) operations
Metro Manila Earthquake Contingency Plan (Oplan Metro Yakal
Plus)
This plan is the Metro Manila Disaster Risk Reduction
Management Council’s (MMDRRMC) response tool based on
the 7.2 Magnitude movement of the West Valley Fault (WVF)
with Intensity VIII ground shaking disaster scenario. It aims to
prepare for earthquake disaster preparedness response of the
MMDRRMC and its partners by defining roles and
responsibilities that are carried out before, during, and after a
strong earthquake. Response operations, standard operating
procedures and command structure follow the provisions of the
National Disaster Response Plan for Earthquakes and Tsunami
and Incident Command System
CBRN National Action Plan The Philippines has a national
Chemical, Biological, Radiological, and Nuclear (CBRN)
Action Plan.
This plan unifies the capacity of the country and
establishes priority actions for enhancing capabilities to
predict, prevent, prepare for, and perform mitigating
activities on CBRN incidents and disasters. The plan also
sets plans for conducting post-action activities.
Operational Guidelines on Philippine International
Humanitarian Assistance Cluster (draft, 2016)
These operational guidelines for the Philippines
International Humanitarian Assistance Cluster
(PIHAC) contain provisions for the cluster to
manage incoming international humanitarian
assistance. It draws upon the IDRL Guidelines is
currently under development
 Education and Training
The Office of Civil Defense (OCD)
coordinates training and capacity
building. It is the implementing arm of
the NDRRMC. The OCD creates,
supervises and monitors the
implementation of National DRRM and
Civil Defense training policies, plans and
programs. Their specific functions include:
Formulate Civil Defense Career
Development Training Program for OCD
Organic Personnel and other DRRM
professionals;
Develop and establish a comprehensive
monitoring system to ensure the effective
implementation of DRRM and Civil Defense
Training;
Evaluate the training conducted to
determine the effectiveness of the program;
 Conduct research for the development of courses
on Civil Defense and DRRM;
 Formulate the training needs assessment system
on Civil Defense and DRRM to determine other
training requirements of OCD personnel and the
general public;
 Coordinate with the network of local and
foreign DRRM, Civil Defense and Climate Change
institutions for training opportunities,
partnerships and cooperation; and
Supervise the implementation of
national DRRM training policies,
plans and programs
 Disaster Management Communications
The Philippine government and aid agencies
learned from Typhoon Haiyan and have
focused on disaster risk reduction and
preparedness, which emphasizes the
importance of Early Warning Systems (EWS),
clear evacuation points, pre-positioned aid, and
education on safer locations to build and plant.
Since Typhoon Haiyan, the communication of
early warnings in the Philippines has improved
significantly.
Early Warning Systems
The Government of the Philippines lists three
services for disaster information, mitigation, and
management:
• The Climate Experiment Project:
this is a software that calculates the percent
chance of rain (PCOR) or probability of rain
using infrared and water vapor satellite image
data, and Doppler Radar data in combination
with statistical evaluation of historical rainfall;
Nationwide Operational Assessment of Hazards
(NOAH):
 is a service that aims to increase awareness for
disaster risk and involves preparedness and
reducing the catastrophic impacts of extreme
hazard events;
 NOAH can mitigate disasters such as floods,
typhoons, and landslides by providing information
about bad weather through their website and free
mobile phone application. The application provides
information on rainfall in real-time on water levels,
rainfall, and humidity in 200 areas in the Philippines
Philippine Geoportal:
 advocates the use of standard multi-
scale base maps that serve as tools for
strategic planning, decision making,
situational analysis and other common
requirements.
o The government has installed sensors, rain
gauges, and weather monitoring systems in
various areas. In addition, people can
access Tweets sent out via Twitter via cell
phones from the Philippines weather
bureau, or the Philippine Atmospheric,
Geophysical and Astronomical Services
(PAGASA).
o Approximately 80 percent of the households in the
country have a mobile phone which makes early
warning alerts via text a viable option.168 Photo 10
shows one Filipino resident with a cell phone who is
able to receive early warning alerts
o Flood-prone towns receive flood early warning
devices from the Department of Science and
Technology (DOST). The devices are composed of
an electric siren, LED beacon controller box, and
solar panel. They alert residents in low-lying
areas of impending floods or flash floods and
allow residents to evacuate to safer areas
Responsible for monitoring and forecasting EWS.
 The DOST is the chair on Disaster Preparedness and Mitigation
of the Regional Disaster Risk Reduction and Management
Council. DOST also brings EWS Information, Education and
Communication (IEC) forums into Philippine provinces
 The Philippine Atmospheric, Geophysical, and Astronomical
Services Administration (PAGASA) provide tropical cyclone
warnings, flood bulletins and advisories, and various weather
forecasts.
 The Philippine Institute of Volcanology and Seismology
(PHIVOLCS) is a service institute of the DOST and is
responsible for the mitigation of disasters that may arise from
volcanic eruptions, earthquakes, and tsunamis.
Military Role in Disaster Relief
The Armed Forces of the Philippines (AFP) has
an integral role in disaster response in the
Philippines. The components of the AFP include
the Philippine Army, Philippine Navy, Philippine
Air Force and the Philippine Marine Corps.
The AFP has the following key functions in disaster
response:
• Conduct Search, Rescue and Retrieval (SRR) Operations;
• Conduct evacuations of affected communities;
• Provide assistance in the transportation of relief goods
and rescue and medical teams;
• Provide resource and personnel support to NDRRMC,
clusters and other agencies;
• Assist the police in restoring and maintaining
peace and order;
• Assist in the restoration of government functions;
and
• Respond to requests for assistance from Local
Government Units (LGUs) and cluster members
through DRRMCs or the OCD.
• Assist the police in restoring and maintaining
peace and order;
• Assist in the restoration of government functions;
and
• Respond to requests for assistance from Local
Government Units (LGUs) and cluster members
through DRRMCs or the OCD.