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Saturday, July 28, 2012

NATURAL DISASTERS AND THE ROLE OF ENVIRONMENTAL HEALTH PRACTITIONERS

By Ibaniba Briggs-Iti
A paper delivered during the 41st Annual National Conference/Scientific Workshop f Environmental Health Officers Association of Nigeria [EHOAN] in Yenagoa, Bayelsa State, March, 2008


Health care service delivery is a major factor in the sustenance and development of any nation.
States and the international community as a whole recognize this situation and see it as a challenge to harness all necessary available machinery within their jurisdictions to meet this need.

The United Nations for instance states as one o its objectives to co-operate in solving economic, social, cultural and humanitarian global problems. Consequently the Economic and Social Council which is one of the organs of the organization has established well over fifteen agencies and organizations as a functional response to meeting the needs of peoples of the world. Amongst these specialist organizations are WHO, UNESCO, UNICEF, UNDP, UNFPA, UNHCR, UNFDAC, FAO, UNEP, UNDLP etc that specifically cater for the health needs of the people.

Back home in Nigeria, the Federal Ministry of Health which is the highest body responsible for provision of health services set for itself laudable objectives and about “2 1 point” responsibility which generally encompass provision o material and human resources, coordinating and supervising health programme, participating in inter-sectoral and inter-ministerial collaborations, making of health laws and policies amongst others to meet the health needs of Nigerians.
The federal government has also established several agencies and parastatals to support and complement the functions of FMOH. Some of the agencies so established are NAFDAC, NPHCDA, NHIS, NPI, SON, PAFA, NACA, NDLEA.

Private voluntary organizations, international governmental and other non governmental organizations have also emerged to join the league of organizations established to promote health. USAID, CIDA, ICRC, NRCS, PPFN, Rotary International, WCC, Rochas Okorocha’s Foundation, Kanu Nwankwo Health Foundation are examples.

Health care service delivery generally includes provision of institutional, facilities and man-power resources.

In the aspect of provision of human resources or manpower, the health sector has a chain of professionals in its service. They include Medical Practitioners, Nurses, Pharmacist, Laboratory Scientists, Environmental Health Practitioners and Community Health Practitioners etc.

Each of these professional groups has their specific roles to play in the achievement of the holistic goal of the health sector.

The Environmental Health Officer (EFIO) or practitioner is one of the oldest personnel in the health sector. His emergence dates back to the colonial era and has faced dangers in course of passing through the various stages of metamorphosis to the present day professional that he is.

The modern EHO is educated with diversities of knowledge and skills, is controversial and the envy of other sister professional groups in the sector.
The Environmental Health Officers (Registered) Act of 2000 provides for the registration and practice of persons if the profession. With the governing council created by the law of 2000 and the Environmental Health Officers Association of Nigeria (EHlOAN) which is set to co-ordinate and regulates the activities of members, the today 13110 is set on the path of expertise and relevance.
To be able to keep with the pace, EHOAN is organizing this programme tagged “BAYELSA 2008”, which is the 4 in the series, and the purpose is to sensitize and energize members of the profession. This year’s theme is “Environmental Health Practice in Nigeria: Challenges and Prospects”.

It should be noted that indeed there are challenges and prospects facing the professional group. How these challenges threaten the relevance of the group and how this would be tackled should be a concern for all as well as the ability of it to appropriate the prospects that stand before all.

It is believed that at the end of this conference and workshop, fresh achievable strategies would emerge to this effect.
Six papers have at been earmarked to be delivered:
• Water Sanitation as a Key Strategy Towards Achieving the Goals of International Year of Sanitation (IYS).
• Food Sanitation and its Implications on Environmental Health Practice in Nigeria.
• Natural Disasters and the Role of Environmental Health Practitioners.
• Malaria Prevention Through Environmental Sanitation: A key Strategy for the Achievement of Millennium Development Goals.
• The Essentials o Effective Waste Management as A Tool For The Enhancement of International Year of Sanitation (IYS) in Nigeria.
• Implementation of National Environmental Sanitation Policy: The Journey so far.

This paper titled “National Disasters and the Role of Environmental Health Practitioners will examine the role of EHOS in the management of natural disasters and objectives are as follows:
a. To explain types Natural disasters
b. To identify organizations and agencies involved in managing natural disasters.
c. To explain the composition and functions of disaster response teams.
d. To analyze the role of the EHO in management of natural disasters in Nigeria.
By way justifying the need of this paper, it is worthy to note that it is on record that millions of people die as a result of natural disaster.

Tangiwai volcanic eruption disaster for example killed about 23,000 people in Armen Columbia in 1985, the 2005 Kashmir earthquake caused 79,000 lives in Parkistan.

Disaster incidences have been increasing astronomically over time, in the 1980’s there were only about 100 recorded hydrological disasters per year but the number has risen to over 300 a year since 2000 (source: World Disaster Report 2006).

It is therefore expedient that the management of such situations be tackled seriously. [ the El 10 can be relevant in this business of disaster management is one of the targets of this conference.


MEANING AND TYPES OF NATURAL DISASTERS
Natural Disaster has been defined as the consequence of a natural hazard (e.g. volcanic eruption, earthquake and landslide) which moves from potential into au active phase and as a result affects human activities causing financial, structural and human losses.
Human vulnerability element is incorporated into the definition in some cases stating thereby that disasters occur when hazards meet vulnerability.

Natural Hazard is a situation which has the potential to create an event that has an effect oil people. Natural hazards result from natural processes in the environment and some natural hazards are related e.g earthquakes can result in tsunamis; drought can lead directly to famines and diseases.

The National Emergency Management Agency (NEMA) Act (1999) defines natural or other disasters as including any disaster ansing from crisis, epidemic, drought, flood, earthquake, storm, train, roads, aircraft, oil spillage or other accident and mass deportation or repatriation of Nigerians from any other country.

Natural hazards may be classified into the Following:
• Geological
(Ava kinche, Earthquake, Lahars, Landslide, Mudliows, Sinkholes, Volcanic eruptions).
• Hydrological
(Flood, Limnic eruption, mealstrom, seiche tsunami).
• Climate
(Blizzard, drought, hailstorm, Heat wave, hurricanes, tropical cyclones, typhoons, Ice storm, tornado).
• Fire (wild fire)
• Health and disease
• Space
(Solar flare, impact event)

Types of Natural Disasters
• Avalanche
This occurs when large snow mass slides down a mountain slide into a slope. In an avalanche, lots of’ material or mixtures of different types fall or slide rapidly under the force of gravity.
• Earthquake
This occurs as a result of sudden release of’ stored energy that radiates seismic waves. At the earth’s surface, earthquake may manifest themselves by shaking or displacement of’ the ground. Many earthquakes occur each day but are not large enough to cause to- significant damage.
 The. 2004 Indian Ocean earthquake which is the second largest earthquake recorded in history claimed about 229,000 people.
 2O0 Kashmir earthquake caused 79,000 lives in Pakistan
• Lahar
Lahar is a type of natural disaster closely related to a volcanic eruption and involves a large amount of material including mud, rock and ash sliding down the side of the volcano at a rapid pace. These flows can destroy entire towns in seconds and kill thousands of people.
 Tangiwai disaster killed about 23,000 people in Armen Columbia in l98


• Landslides/Mud Flows
A Landslide is a disaster closely related to an avalanche but instead of occurring with snow, it occurs involving actual elements of the ground including rocks, trees, parts of houses and any thing else which may happen to be swept up. Landslides can be caused by generally instability in the surrounding land.
Mudslidcs or mud flows are a special case of’ landslides in which heavy rainfall causes loose soil on steep terrain to collapse and slide downwards. This usually OCCWS after periods of heavy rain.
• Sink holes
It is a localized depression in the surface topography usually caused by the collapse of a subterranean structure such as a cave. Although rare, large sinkholes that develop suddenly in populated areas can lead to collapse of buildings and other structures.
• Volcanic Eruption
A volcanic eruption is the point in which a volcano is active and releases its power; the erupt ions comes in many forms. They range from daily small erupt R)I is which occur in places like Kilanea in Hawali or extremely infrequent super volcanic eruption.
According to Toba catastrophe theory, 70 — 75 year thousand years ago a super volcanic event in lake Toba reduced the human population to 10,000 or even 1,000 breeding pairs, creating a bottle neck in human evolution.
Flood
Flooding occurs as a result of prolong rainfall including thunderstorms, rapid inciting of large amount of snow or rivers which swell from excess precipitation upstream and cause widespread damage to areas downstream or less frequently the bursting of man — made dams or levees.
 The Huange Ho River Flood in China in 1931 caused between 800,000 and 4,000,000 deaths.
 Yangtze River floods in China in 1978 rendered 14 million people covered much of the country for three weeks resulting in thousands of death leaving the country devastated for years afterwards.
 Tropical/storm Allison in Houston Texas in 2001 was devastating
 Hurricane Katrina in New Orleans in 2005 left most of the city under water.
Limnic Eruption
It is also referred to as a “Lake overturn”. A limnic eruption is a rare type of natural disaster in which CO2 suddenly erupts from deep lake water, posing the threat of suffocating wildlife, live stock and human such an eruption may also cause tsunamis in the lake as the rising CO2 displaces waters. Scientist believes landslides, volcanic activity or explosions can trigger such an eruption.
 1984 limnic eruption in Lake Monou in Cameroon causing the death of 37 nearby resident
Tsunami
It is a wave of water caused by the displacement of a body of water. The world is Japanese meaning harbor and wave. Tsunami can be caused by undersea earthquakes.
Blizzard
It is a severe winter storm condition characterized by low temperature strong winds and heavy blowing snow.
Drought
It is an abnormally dry period when there is not enough water to support agriculture, Urban or environment. Water needs. Extended drought can result in deaths by starvation or diseases and can result in wildfires
 Between 1900-1941 China experienced several cases of droughts killing millions of people.
 Since 2006, Western Australia, New South Wales, Victoria and Queens land have been under drought conditions for five to ten years.
Hailstorm
A Hailstorm is a natural disaster where a thousandstornm produces numerous hailstorms which damage the location in which they fall. Hailstorm can be especially devastating to farm fields, running crops and damaging equipment.
• Hailstorm in Munich Germany on August 31, 1986 fell thousands of trees causing millions of dollars in insurance claims
Hurricane, Tropical Cyclones and Typhoon
Hurricane, Tropical Cyclones and typhoon are different names for the same phenomenon. A cyclonic storm system forms over the oceans. It is caused by evaporated water that comes off the ocean and becomes a storm. The carioles effect causes the storm to spin and a hurricane is declared when the spinning mass of storms attains a wind greater than 74 mph.
Hurricane is used for these phenomenon in the Atlantic and Eastern Pacific Oceans, tropical cyclone in the India, Typhoon in the Western pacific.
• 1970 Bhola cyclone is recorded as the deadliest hurricane
• 2005 Hurricane Katrina which devasted the Gulf Coast of the U.S.
Tornado
A Tornado is a natural disaster resulting from thunderstorm. Tornados are violet rotating colomns of air which can blow at speeds between 50 and 300 mph and possibility higher. Tornadoes can occur one at a time or can occur in large tornado outbreaks along sequel lines or other large areas of thunderstorm development. Waster spouts are tornadoes occurring over tropical waters in high rain conditions.
Wild fire
It is an uncontrolled fire burning in wild land areas. Common causes include lightening and drought but wild fires may also be started by human negligence or arson. They can be a threat to those in rural areas and also wild life.
Epidemics
An outbreak of a contractible disease that spreads at a rapid rate through human population.
A pandemic is an epidemic whose spread is global. There have been many epidemics throughout history.
• The 1918 Spanish Flu pandemic killings an estimated 50 million people worldwide
• The 1957-1958 Asian flu pandemic which killed an estimated one million people.
• The 1968-1968 Hong Kong Flu pandemic
• The 2002-2003 SARS pandemic
• The AID epidemic beginning in 1959
• Others are Malaria, Ebola bemorrhage fever, Cholera, Menningitis, Yellow Fever etc.
Impact Event
It is a natural disaster in which an extraterrestrial piece of rock or other material collides with the earth. The exact consequences of a direct earth impact would vary greatly with size of the colliding object, although in cases of medium to large impacts short term climate charge and a general failure of agriculture.
Famine
A social and economic crises that commonly accompanied by wide spread malnutrition starvation, epidemic disease and increase mortality although some famine occur by natural factors, it can and often is a result of economic or military policy that deprives people of food that they require to survive Famines often hit areas like sub-Sahara African and Asia.
Common natural disasters in Nigeria are flooding, erosion and drought. Although natural disasters are situations caused by natural factors some underlying factors have been identified by some experts as being responsible especially in the hydrological disasters. For instance unplanned urbanization in flood prone region increase the likelihood that their towns and villages will be affected by flash floods and coastal floods.
Large areas covered with cement prevents runoff water to get absorbed by the soil thereby causing floods.

ORGANIZATIONS INVOLVED IN MANAGEMENT OF NATURAL DISASTERS
Disaster management is a global issue. States and non governmental agencies efforts towards this direction are laudable. Programmes and activities have been earmarked to ensure disaster relief and reduce the consequential risks. Some of the organizations and bodies involved in management of natural disaster may be stated as follows
National Level
In Nigeria apart from the direct efforts of the Ministries of Health and Environment, there are established several other bodies which engage in disaster management. Some of them include:
National Emergency Management Agency (NEMA)
This is the foremost agency saddled with the responsibility of managing emergencies. The agency has a governing council made up of the following:
• The Vice President (Who is the chairman)
• The secretary to Government of the Federation
• Representatives from the Federal Ministries of Aviation, Foreign Affairs, Health, Internal Affairs, Transport, Water Resources, Works and Housing
• One representative each of the armed forces, the Nigerian Police, the Nigerian Red Cross societies, such voluntary organization as may be determined from time to time.
The functions of the agency are as follows:
• To formulate policy on all activities relating to disaster management in Nigeria and coordinate the plans and programme for efficient and effective response to disasters at national level.
• Co-ordinate and promote research activities relating to disaster management at the national level
• Monitor the state of preparedness of the organizations or agencies which may contribute to disaster management in Nigeria.
• Collate data from relevant agencies so as to enhance forecasting, planning and field operation of disaster management.
• Educate and inform the public on disaster prevention and control measures.
• Coordinate and facilitate the provision of necessary resources for search and rescue and other types of disaster curtailment activities in response to disasters distress calls.
• Coordinate the activities of all voluntary organizations engaged in emergency relief operation in any part of the federation.
• Receive financial and technical aid from international and nongovernmental management in Nigeria.
• Collect emergency relief supply from local and foreign sources and from international and non governmental agencies
• Liaise with state emergency management committees established under section and monitor where necessary the distribution of relief materials to disaster victims.
• Process relief assistance to such countries as may be determined from time to time.
• Liaise with the UN Disaster Reduction organization or such other international bodies for the reduction of natural and other disaster
• Prepare the annual budget for disaster management in Nigeria
• Perform such other functions which in the opinion of the agency are its objectives in the act.
The Nigerian Red Cross Society (NRSC)
NRCS is a non governmental organization directly linked to the International Committee of the Red Cross (ICRC).
It is an independent humanitarian relief and development organization whose mission is to prevent and alleviate human suffering and is guided in its work by the seven fundamental principles of the movement tagged “The Vienna Proclamation of 1965”. The principles include; Humanity, Impartiality, Neutrality, Independence, Voluntary Service, United and Universally.
Activities of NRCS include:
• Recruitment and training of personnel for rendering of first aid, disaster relief and home nursing.
• Dissemination of information on the ICRC activities and international humanitarian law to target groups such as Red Cross volunteers, the military, the police, teachers and media.
• Family training activities
• Planning and implementing disaster preparedness and response
• Render community services in the areas of
 Health education
 Blood donation
 Primary Health care services
 First aid training and services
 Vacation programme
 Environment project such as construction of latrine.
INTERNATIONAL LEVEL
International agencies involved in natural disaster management include:
a. International Committee of the Red Cross (ICRC)
This organization is made up of the following:
 The international committee of the Red Cross
 International Federation of Red Cross and Red Crescent societies
 National Red Cross and Red Crescent societies totaling about 160.
The functions of ICRC include
 Assist victims of disasters by providing medical care, setting up hospitals and rehabilitation centre.
 Provide appropriate aids as needed such as food, shelter, and clothing
 Run central tracing agency
 Promote assistance to war disabled
 Initiate and promote international humanitarian law ‘
 Carryout studies and research on humanitarian work
 Reunite families split by war
 Visit military prisoners and other detainees
 Arbitrate between warring parties in armed conflict
 Prohibit in human or degrading treatment e.g. hostage taking, torture, summary executions, deportations etc
 Active in conflict resolution, armed and non armed conflict and internal disturbances and tension.
b. Medicines Sans Frontier (MSF)
 Provides health and to victims of wars and natural disasters
c. United Nations Development Programme (UNDP)
 Fights poverty and diseases and advocates for environmental protection.
d. United Nations High Commissioner for Refugees (UNCHCR)
e. World Bank.
f. United Nations Environmental Programme (UNEP).
g. World Health Organization (WHO).
WHO is active in emergency and humanitarian actions.
Others include:
 USAID
 Medicine Sans Frontier (MSF) (provides health aid victims of war and natural disasters. Provides aids in chronic emergencies)
 World Food Programme (WFP)
 UNICEF
 CARE USA
 Catholic Relief Services (CRS)
 Food and agriculture organization (FAO) etc.

COMPOSITION AND FUNCTIONS OF EMERGENCY RESPONSE TEAM.
Composition
A comprehensive emergency response team may be composed of the following:
a. Health Team
 Medical doctors
 Nurse
 Drug dispenser
 Health Educator
 Nutritionist
 Medical records officer
 Environmental Health Officer etc.
b. Environmental management team
 Environmental Health officer
 Civil and other Engineers.
c. Social welfare team
d. Information team
e. Fires control/service team
f. Representative of organizations
g. Security team (Civil Defence Corps/Police).
Functions of Emergency Management team
Functions of emergency response team may be summarized thus.
 Assessment of disaster zone and cases
 Evacuation of victims to temporary settlement
 Render Health services to the needy
 Provision of relief materials such as food, water, clothing drugs to victims
 Provision of Environmental and general sanitation
 Refer serious health cases to hospitals
 Provision of security and safety of victims
 Publicities/report emergency situations
 Seek financial aids for victims.
ROLES OF ENVIRONMENTAL HEALTH PRACTITIONERS IN DISASTER MANAGEMENT
It is difficult to stand before professionals like you and give instructions on what should be done during emergencies. However a reminder of what is normally done is an easier task to accomplish.
It is therefore intended in this part of the paper to highlight what is already known by all, and this will be done with a persuasive note to all the endeavour to take actions in order to maintain the image brushing ad relevance that the professional group requires at this time.
The role of the Environmental Health Officer in disaster management is to carry out environment process, most particularly to note are:
• The Evacuation stage
• The settlement stage
• The Treatment stage
• The clean up stage
• The provision of supplies stage.
In each of these stage, the EHO is expected to:
• Make observations/carryout inspections
• Detect nuisances
• Abate the nuisances
• Prevent the reoccurrence of nuisances.
The specific environmental health actions to be taken by the EHO are as follows:
• Inspect and determine the suitability of means of transportation.
• Ensure that means are not overcrowded or pose health hazards
• Ensure sanitary waste disposal for victims in transit
• Give health education to victims.
Settlement Stage
• Carryout site/facility inspection before arrival of victims
• Ensure provision of waste disposal facilities
• Ensure adequate waster/electricity supply
• Ensure provision for storage and preservation of food
• Give health education to victims
• Carryout disinfections and disinfestations.
Treatment stage
• Ensure that hospital/medical wastes are sanitarily disposed off
• Carryout disinfection of materials.
Clean up stage
• Zone area for proper cleaning
• Determine appropriate cleanup methods
• Supervise clean up exercise
• Ensure sanitary disposal of waste generated
• Coordinate personnel to be used for the exercise
• Ensure that dead bodies are appropriately disposed.

Provision of Supplies Stage
• Ensure safety of supplies
• Ensure storage and preservation of supplies
• Ensure fair distribution of supplies.
The EHO is expected to play his role in the management of disasters and his ability to take quick and relevant actions in what makes the difference.

CONCLUSION
Quick response to emergency situations save life and reduce mobility rates of victims. It is important therefore that the EHO understands the emergency situation and identify areas that pertain to him and take appropriate actions. In this way he becomes relevance and contributes his best whenever and wherever the call comes.

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