Chennai needs connected efforts from all, to bring it back to normal- by Dr Manoj Kumar Gupta
The city of Chennai and its suburbs are going through series of crisis. This disaster catalyzes new or exacerbates existent disparities in health by disrupting the continuity of care and leaves behind the vestige of a fragmented primary and...
The city of Chennai and its suburbs are going through series of crisis. This disaster catalyzes new or exacerbates existent disparities in health by disrupting the continuity of care and leaves behind the vestige of a fragmented primary and mental health infrastructure with more susceptible population to the deleterious effects of the disaster. It calls for massive coordination of local agency, hospitals, doctors, paramedical staff and volunteers.
Both physical and psychological processing of the disaster can be evident for several years after the disaster itself. A significant amount of stress due to the death of loved ones and loss of jobs, material goods and livelihoods can be particularly traumatic to affect the psychological health, which sometimes does not show up immediately.
Fighting the pathogenic surplus:Disaster gives way towards distorting physical health by change in population structure due to displacement as well as change in the agents that create disease. It also causes changes in environment by creating new breeding places for disease causing agents thereby introducing new diseases in the populations. Floods particularly can potentially increase the transmission of water-borne diseases (typhoid fever, cholera, leptospirosis, hepatitis A etc.) and vector-borne diseases (malaria, dengue and dengue haemorrhagic fever etc.). On top of that dysfunction of health facilities due to physical damage to the hospitals and health buildings and loss of medical equipment and medicines along with damage to infrastructure such as roads and bridges, keeping people from being able to connect to health services they need,creates a devastating situation to handle.
In addition, periods of high stress, overcrowding in temporary relief situations, and challenges related to hygiene could increase the chance of sexually transmitted diseases and gender-based violence.
Deployment of Heath managers:The damage inflicted by a disaster can be minimized by providing efficient health managers at the site. Health managers have certain skills and abilities like decisiveness, flexibility, problem solving, innovation and creativity, planning and organizing personnel, managing teams and team building, strategic planning, decision making etc,in order to manage these catastrophes. Those health manages can help in mitigating the situation by identifying community resources applicable to the physical, social, and psychosocial effects of a disaster.
These health managers can also identify groups who are most at risk from disasters (i.e., children, older adults, and homeless, chronically ill, homebound, physically or mentally disabled). Health managers can very well manage the crowd at health facilities by triage and other methods.
Disaster Management education: Experts need to transfer their knowledge on epidemiological assessments and data analysis to limit the morbidity and mortality following the disaster to the local citizens in the best possible for their understanding and implementation. By communicating with government officials about the public health effects of potential disasters and provide expert assistance during and after disasters they can help in assuring that health services continue post impact, including acute, continuity of care, primary care and emergency care. Health managers can also help in cooperating and collaborating with other partners and health and human service professionals to ensure that primary health, public health, and mental health issues are adequately addressed in disaster planning and intervention outcome are rigorously evaluated. They can also assist in developing and advocating public policies designed to reduce the public healthimpact of potential disasters.
Here are a few tips for all the stake holders who can help the city to manage any disease outbreak.
Recommendations for the large hospitals
• Deploy more people at entry level/front office to minimize the documentation work time
• Stronger first-aid and emergency ward units with larger man-power to reduce the waiting time
• Provide basic medicines and ensure adequate supply
• Screen for common diseases
• Do all the required steps to prevent the outbreak or epidemics
• Follow the Simple Triage And Rapid Treatment (START) protocol
• Shifting patients who are in the intensive care units and new born babies to the top floors
• Train volunteers on handling antibacterial chemicals that have to be sprayed to reduce bacterial build up
• Train volunteers on assisting citizens to identify symptoms of potential communicable diseases which have high chances of spreading after any disaster
• Share instruction list of do’s and don’t with volunteers groups through pamphlets, emails, WhatsApp messages and social media platforms
• Create helplines for volunteers to reach out to for crucial information
• Provide mobile health care units with your staff (doctors and nurses)
Recommendations for the smaller clinics and the individual doctors
• Re-establishing and improving the delivery of primary health care
• Assist larger hospitals or government setups through mobile health care units with your staff (doctors and nurses)
• Screen for common diseases and provide necessary information
• Provide medicines to people for common diseases in the mobile health care units and in their clinics
• Assist volunteers to handle patients in terms of first aid through training camps at clinics
• Provide information to assist individuals or families to create an emergency plan, discuss the plan with family members, and practice the plan.
• Monitoring of change in infectious agent through development of antibiotic resistant in patients
• Display of disease data in the clinic (if possible)
• Proper and immediate feedback to all concerned who are in a position to take action in case of any outbreak warning signals/ Trigger events
Recommendations for the Para medical staffs and the Volunteer groups
• Should be ready with transport facilities to evacuate patients, use personal vehicles if possible
• Create groups to help locality wise
• Volunteer groups should look for a group leader with medical background to avoid any mistakes
• Stay dry and fit to avoid carrying any diseases (use necessary personal protection measures)
• Take necessary measures to maintain environmental sanitation and education on hygiene and hand washing
• Public health responders should set up a rapid disease risk assessment within the first week of the disaster in order to identify disaster impacts and health needs
*Dr Manoj Kumar Gupta, MD (Community Medicine), MIPHA, MIJPSM, is Associate Professor & Dean Research Coordinator, Indian Institute of Healthcare Management and Research Bangalore (IIHMR)
Date:
Thursday, December 17, 2015