Impact of psychological risk factors on disaster rescue operations: the case of Italian volunteers

This paper reports on research into the characteristics of emergency rescue workers, with a focus on psychological distress. We present the results of a study of volunteers from the Italian national civil protection programme. A questionnaire was administered to 2,576 subjects from all over Italy. Most respondents were men, mostly unemployed, whose average level of education was higher than that among most Italian volunteers. Many were poorly endowed with basic skills, with large differences according to geography. Many expected to convert their volunteer activities into permanent jobs. Using this data, we employed a logistical regression model to analyse the risk of low, moderate and severe psychological distress symptoms, including anxiety and panic attacks, during rescue operations. The results indicate that some rescuers are particularly vulnerable to distress. The highest risk factors pertained to volunteers from southern Italy whose training is inadequate, who have little experience of emergency work and who play subordinate roles in small teams that lack psychological support services.     

The Response of the South Manchester Accident Rescue Team (SMART) to the Armenian Earthquake and Lockerbie Air Disaster: A Report to the Prime Minister's Office

The delay in receiving authorisation for the despatch of SMART significantly reduced our overall effectiveness. The majority of injured survivors were extracted during this time and our special expertise could have saved a significant number of lives. The episode has provided SMART with unique experience for a British medical team and this knowledge should not be wasted. In contrast to other major western countries the British response was fragmented. We have no central stockpile of equipment and no official response team. The British who responded were independent of each other even when from the same service. The quality of the individual British teams was as good as any and often better. However, the ability of other nations to coordinate their response centrally and draw from a pool of workers already used to working together, improved both their efficiency and effectiveness. There are great difficulties in communication during any disaster and these increase with the scale of the disaster. Incoming rescue workers were given false or misleading information and rumour was widespread. Even when few people were found alive rescue workers expressed a strong need for a medical presence in case they discovered an injured person or they them selves became ill or injured. We were told repeatedly by experienced rescuers that we were the first team of British senior doctors they had met at the front line of a disaster and they were extremely pleased to see us. Transport was a major problem both in terms of vehicles and local knowledge. It was not thought to be within the remit of a medical team to make provision for food and shelter and this was confirmed in Moscow prior to departure for Yerevan. In retrospect this was a mistake and reduced the time we could stay at the front line. If we had not equipped ourselves with special clothing we could not have gone to the front line. A medical team must be part of larger team of rescue workers. Within this unit there will be provision for food, shelter, transport and communication as well as medical and surgical equipment.     

地震灾区救援力量优化调配模型

从救援对象的确定、救援队伍的需求和救援力量的调配三个方面,较为全面的讨论了地震灾区如何根据灾害情况和救援资源的分布,科学合理地开展救援力量的优化调配,以达到快速营救受困人员的目的。根据受灾情况确定对救援队伍的实际需求是分配救援力量的前提,从对象的确定和需求经验关系的给出两方面,讨论了如何根据地震破坏和灾区实际情况确定灾区对救灾力量,尤其是专业救援队伍的具体需求。队伍的优化调配是运筹学中运输问题的求解,基于现有线性优化算法,在地理信息平台上,建立了队伍优化分配的模型和软件。采用汶川地震的实际数据进行了实例计算和分析,给出了今后在救灾过程中科学调配救援力量的可参考样本。     

Epidemiological assessment of food aid in the Bosnian conflict, 1994-97

Surveys in emergency settings are important for the accountability of food aid. Four household surveys conducted between 1994 and 1997 measured the performance of the Bosnia food aid programme, covering a random sample of clusters in Bosnia and Herzegovina and the Republica Srpska. The team calculated coverage, exclusion and inclusion errors, programme misses, and under-supply. Despite intended universal coverage from 1994-96, 15, 19, and 31 per cent, respectively, did not receive food across the three-year time frame. Households categorised as vulnerable were somewhat more likely to receive food. Programme misses were rare, whereas under-supply fell from 30 per cent in 1994 to four per cent in 1997, as the availability of other food increased. Extrapolation suggested that 61 per cent of the food distributed did not reach households. The programme introduced priority categories for targeting in 1997, yet nearly one-half of the highest priority households did not receive food. Incomplete coverage and weak targeting were related to political constraints.     

Using evidence to improve reproductive health quality along the Thailand-Burma border

The Mae Tao Clinic, located on the Thailand-Burma border, has provided health services for illegal migrant workers in Thailand and internally displaced people from Burma since 1989. In 2001, the clinic launched a project with the primary aim of improving reproductive health services and the secondary aim of building clinic capacity in monitoring and evaluation (M&E). This paper first presents the project's methods and key results. The team used observation of antenatal care and family-planning sessions and client exit interviews at baseline and follow-up, approximately 13 months apart, to assess performance on six elements of quality of care. Findings indicated that improving programme readiness contributed to some improvement in the quality of services, though inconsistencies in findings across the methods require further research. The paper then identifies lessons learned from introducing M&E in a resource-constrained setting. One key lesson was that a participatory approach to M&E increased people's feelings of ownership of the project and motivated staff to collect and use data for programme decision-making to improve quality.     

The development of aid agency policy on the use of imported biscuits in emergency relief

During 1985 more than 5,000 tonnes of biscuits consisting of twenty-eight different brands were sent to Ethiopia and Sudan for emergency relief feeding. They were freely available to recognized agencies operating feeding programmes. Biscuits were popular with programme supervisors as few resources (fuel, staff and personnel) were required for their preparation and distribution. They were also popular with beneficiaries.
Different aspects of biscuits were examined and characteristics considered important included: nutritional composition, acceptability to beneficiaries, packaging, the biscuit dimensions, shelf-life and accompanying information (nutritional composition, ingredients and guidelines for use).
The results of a field study indicated that biscuits have a limited, but useful, role to play in the early stages of emergency relief. Based on the study, guidelines for both donors and users, on the use of food aid biscuits were developed, which emphasize their joint responsibility in minimizing the misuse of biscuits.     

基于仿真原理的地震应急志愿者规模研究

中国是个地震多发但应对能力不强的国家,汶川地震再次暴露了中国专业地震应急救援力量不足的弊端。我们应该借鉴发达国家的经验,构建应急志愿者队伍,以提高我国的地震应急能力。根据仿真原理结合人力资源规模的确定方法,设计了地震应急救援系统仿真模型,并利用该模型计算了高校志愿者队伍的人数。该研究不但有助于丰富志愿者管理理论,同时能有效利用社会资源,提升我国地震应急救援能力,因此具有一定的理论和现实意义。     

Planning environmental sanitation programmes in emergencies

Environmental sanitation programmes are vital for tackling environmental-related disease and ensuring human dignity in emergency situations. If they are to have maximum impact they must be planned in a rapid but systematic manner. An appropriate planning process comprises five key stages: rapid assessment and priority setting; outline programme design; immediate action; detailed programme design; and implementation. The assessment should be based on carefully selected data, which are analysed via comparison with suitable minimum objectives. How the intervention should be prioritised is determined through objective ranking of different environmental sanitation sector needs. Next, a programme design outline is produced to identify immediate and longer-term intervention activities and to guarantee that apposite resources are made available. Immediate action is taken to meet acute emergency needs while the detailed programme design takes shape. This entails in-depth consultation with the affected community and comprehensive planning of activities and resource requirements. Implementation can then begin, which should involve pertinent management and monitoring strategies.     

突发事件区域应急联动影响因素的实证研究

在界定突发事件区域应急联动内涵的基础上,采用Delphi法,识别出突发事件区域应急联动的9个主要影响因素,即应急联动组织机构、应急联动法律法规、应急物资协同调配、应急队伍协同调配、应急预案动态协同、应急信息实时沟通、区域地理位置、区域灾害特征和区域合作基础。同时,运用ISM技术,确定区域应急联动9个影响因素的关联性,计算和分解可达性矩阵,绘制4级递阶有向图,得出区域应急联动影响因素的内在层次性,即划分出"基础层"、"过渡层"和"直接层",为有效构建突发事件区域应急联动机制提供了理论支持与科学依据。     

Learning lessons from the 2011 Van Earthquake to enhance healthcare surge capacity in Turkey

Historically, Turkey has adopted a reactive approach to natural hazards which resulted in significant losses. However, following the 1999 Kocaeli Earthquake, a more proactive approach has been adopted. This study aims to explore the way this new approach operates on the ground. A multinational and multidisciplinary team conducted a field investigation following the 2011 Van Earthquake to identify lessons to inform healthcare emergency planning in Turkey and elsewhere. The team interviewed selected stakeholders including, healthcare emergency responders, search and rescue services, ambulance services, and health authority representatives, in addition to conducting a focus group. Data were analysed according to an open coding process and SWOT (strength, weakness, opportunity, and threat) analysis. The findings suggest that the approach succeeded in developing a single vision by consolidating official efforts in a more structured way, mobilising many governmental and non-governmental organisations, securing significant amounts of resources including physical and human, and increasing the resilience and flexibility of infrastructure to expand its capacity. However, more attention is required to the development of stronger management procedures and acquisition of further resources.     

Community‐based preparedness programmes and the 2009 Australian bushfires: policy implications derived from applying theory

The Victorian Country Fire Authority in Australia runs the Community Fireguard (CFG) programme to assist individuals and communities in preparing for fire. The objective of this qualitative research was to understand the impact of CFG groups on their members' fire preparedness and response during the 2009 Australian bushfires. Social connectedness emerged as a strong theme, leading to an analysis of data using social capital theory. The main strength of the CFG programme was that it was driven by innovative community members; however, concerns arose regarding the extent to which the programme covered all vulnerable areas, which led the research team to explore the theory of diffusion of innovation. The article concludes by stepping back from the evaluation and using both applied theories to reflect on broad options for community fire preparedness programmes in general. The exercise produced two contrasting options for principles underlying community fire preparedness programmes.     

Implementing cash for work programmes in post-tsunami Aceh: experiences and lessons learned

Cash for work (CFW) programmes are utilised in various disaster and emergency contexts and were a prominent component of the tsunami response in Aceh province, Indonesia. This paper describes Mercy Corps' CFW programme, discusses CFW implementation experiences and provides key recommendations for similar programmes in future emergencies. For the majority of CFW participants and their households, CFW was the only source of household income and 93 per cent of household incomes were attributable to it. The CFW programme empowered displaced populations to return to their communities; 91 per cent of participants indicated that CFW facilitated their return. Other reported psychosocial benefits included providing productive activities and giving communities an opportunity to work together. Mercy Corps' experience in Aceh demonstrates that cash disbursements can be safely delivered in a widespread manner in emergencies, and that when implemented on a short-term basis, can have positive impacts at the individual and community level.     

Earthquake drills and simulations in community-based training and preparedness programmes

The San Francisco, California, bay area is subject to continuous seismic risk. One particular response has been the development of community-based training programmes designed to teach residents basic emergency response skills. Citizens are taught emergency medical techniques, search and rescue, fire suppression and other fundamental response skills. Current estimates in the Bay Area place the number of programmes at more than 100. Many programmes now include an annual community drill to reinforce the training and to evaluate the programme. The study described here is based on an evaluation of an effort initiated by BayNET (Bay Area Neighborhood Emergency Training), a voluntary association of communities with community-based disaster preparedness programmes. In April 1996, BayNET asked all of its members to hold a community earthquake drill. After the drill, a mail survey was conducted of all programme managers. The survey examined the structure and administration of the programmes, training efforts and other related components. This paper describes the typology of drill formats that communities used, the role of the simulation in the city's preparedness efforts, the qualitative costs and benefits, as well as an assessment of the drill based on survey respondents.     

Container contamination as a possible source of a diarrhoea outbreak in Abou Shouk camp, Darfur province, Sudan

Diarrhoea is one of the five major causes of death in an emergency setting and one of the three main causes of death in children (Curtis and Cairncross, 2003). In June 2004, an outbreak of shigellosis was confirmed in Abou Shouk camp in the Northern Darfur province of Sudan. As water testing showed no contamination, it was assumed that post-collection contamination was happening. The decision was taken to launch a programme of mass disinfection of all water containers in order to break the contamination cycle. Diarrhoea figures from the clinics showed a fall in cases following the cleaning campaign. It is extremely difficult to obtain good and statistically rigorous data in an emergency setting, the priority being to intervene rapidly to prevent further cases of diarrhoea. However, the results do appear to indicate that the disinfection programme has had an impact on the prevalence of bloody and watery diarrhoea.     

A 'Principled' Approach to Complex Emergencies: Testing a New Aid Delivery Model in the Nuba Mountains

This paper provides an analysis of the Nuba Mountains Programme Advancing Conflict Trans-formation (NMPACT) as an example of an operational response in a complex emergency that innovatively addressed an incipient food security crisis. NMPACT is notable for having brought together an array of actors around a common principled agenda and for being the only operational programme in the Sudan to which both warring parties subscribed during the conflict. The key features of the programme are presented and the main innovative elements are reviewed, including the role of the principles of engagement and the 'political humanitarianism' of NMPACT. The paper looks at how NMPACT broke from traditional externally driven responses to food insecurity, and, drawing on lessons from Operation Lifeline Sudan, adopted an approach that focuses on capacity building, sustainable agriculture and market revitalisation, alongside conflict transformation and peace-building. The limitations of the model are also assessed, and preliminary lessons regarding its replication in other complex emergency contexts are presented.     

The social context of childcare practices and child malnutrition in Niger's recent food crisis

In 2004–05, Niger suffered a food crisis during which global attention focused on high levels of acute malnutrition among children. In response, decentralised emergency nutrition programmes were introduced into much of southern Niger. Child malnutrition, however, is a chronic problem and its links with food production and household food security are complex. This qualitative, anthropological study investigates pathways by which children are rendered vulnerable in the context of a nutritional 'emergency'. It focuses on household-level decisions that determine resource allocation and childcare practices in order to explain why practices apparently detrimental to children's health persist. Risk aversion, the need to maintain self-identity and status, and constrained decision making result in a failure to invest extra necessary resources ingrowth-faltering children. Understanding and responding to the social context of child malnutrition will help humanitarian workers to integrate their efforts more effectively with longer-term development programmes aimed at improving livelihood security.     

政府部门的应急响应能力在城市防灾减灾中的作用

城市是人口、经济密集的地区,城市自身的特点决定了抢险救灾必须快速果断,当城市发生灾害时,当地政府部门是抢险救灾的主力军,在这一过程中,政府部门对灾害的应急反应能力成了救灾、减灾成功与否的决定性因素.文章探讨了政府部门的应急响应能力的组成及其在城市防灾减灾中的重要性.政府部门的灾害应急能力主要从应急反应、应急指挥、应急救援、应急信息的发布和应急避难五个方面体现出来.     

Training Community Health Workers in refugee camps: A case study from Pakistan

In October 1983 a training programme for refugee community health workers was begun as the major part of a primary health care programme for Afghan refugees in Pakistan. The programme began with a pilot period in Badaber camp, situated near to Peshawar. The general issues involved in training auxiliary health personnel were answered by the use of a "knowledge, attitudes and practices survey" and involvement of the refugees from the beginning of the programme. The development of the training programme is discussed with reference to these issues and the constraints arising from the special circumstances of the refugees, in addition to those common to most national training programmes, are reviewed.     

优选地震救灾路径的图与模糊集算法

由于在大地震的紧急救灾期，交通网络具有明显的结构变动性，传统的最短路算法设计出的路线难以满足救灾在时间、安全性与通行质量方面的要求。为了解决这一问题，考虑了有关的因素，基于模糊评价，对交通网络图中的长度权进行了修正；并增加了2个新的约束，然后综合应用图论与模糊极值的理论方法，建立了2个以最大限度地保障运行体的完整性与缩短运行时间为主要目标的，在多权图上优选路线的算法。该算法可较好地满足紧急救灾路线优化设计的需要。     

A baseline assessment of emergency planning and preparedness in Italian universities

Besides offering teaching and research services, schools and universities also must provide for the safety and security of their employees, students, and visitors. This paper describes emergency preparedness in a sample of Italian universities. In particular it examines risk perception within a specific professional category (university safety and security officers) in a specific cultural context (Italy). In addition, it discusses the transposition and implementation in a European Union (EU) member state of EU Council Directive 89/391/EEC of 12 June 1989, on the introduction of measures to encourage improvements in the safety and health of workers. The findings highlight heterogeneous and fragmented emergency management models within the Italian university system, underlining the need for a stricter framework of standardised safety protocols and emergency management guidelines. The study also points out that enhancing emergency planning and preparedness in Italian universities entails increasing safety leadership, employee engagement and individual responsibility for safety and security; essentially, it necessitates improving the culture of risk prevention.