Networking emergency teams in Jerusalem

With the recent upsurge in terrorism, more and more attention is being directed at examining the effectiveness and efficiency of emergency teams. These teams tend to focus on their areas of expertise without necessarily communicating, cooperating or coordinating their operations. Research suggests that improved interpersonal communication and coordination enhances the overall work of each emergency team, and that their combined effort is far in excess of the sum of their individual endeavours. This paper outlines attempts made in Jerusalem to improve the performance of emergency teams and to help the helpers by holding training workshops, setting up a forum of co‐workers and encouraging dialogue among various emergency teams in the city. A planned intervention programme was designed to enable informal networking between team leaders. The programme had an impact on team workers and resulted in a more coordinated and effective service delivery during emergencies.     

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.     

Disease Surveillance and Control After a Flood: Khartoum, Sudan, 1988

Following a flood in Khartoum, Sudan, emergency disease surveillance was implemented to monitor the health status of the population. Simple, symptom-oriented case definitions for diarrheal disease, measles, respiratory disease, malaria, and jaundice were included on the report form used to collect daily counts of outpatients in a sample of both temporary and permanent clinics located in areas of the city most affected by the flood. Data collected from major teaching hospitals allowed comparison of pre- and post-disaster levels of morbidity and mortality. In addition, special surveys collected information unobtainable from health facilities. Sentinel clinic surveillance data indicated that diarrheal disease accounted for the greatest number of clinic visits, while malaria was the second most common reason for seeking medical attention. Malaria blood smear surveys showed that the parasitemia prevalence ranged from 11% to 19% in the general population and from 21% to 46% among febrile clinic patients. Hospital admission data demonstrated an increase in morbidity from diarrhea and malaria in August 1988, when compared to previous months and August of the previous year, although it is uncertain whether this increase was due to the flood. Nutrition surveys demonstrated that 23% of young children were moderately or severely undernourished, with substantial variation by area of the city. No major outbreaks of communicable disease were detected in the 4 weeks after the flood. Disease surveillance provided data useful in identifying public health problems, setting priorities, targeting interventions and controlling rumors. Disease control measures taken by the Ministry of Health included provision of potable water, standardization of medical care, and distribution of immunizations, oral rehydration salts, and vitamin supplements to children.     

Pollution by halogenated aromatic compounds at Trissino: A case study of groundwater contamination and rehabilitation

An investigation is presented on industrial contamination by benzotrifluoride percolation into ground water used for drinking water, in a populated area of 20 km² at Trissino, north Italy, due to improper chemical waste disposal. Hydrogeological features of the situation are reported, as well as the emergency action taken, such as the surveys made and their analytical results. The epidemiology of the emergency is examined and rehabilitation measures are presented and discussed. Fortunately no major ecological or social disaster occurred, In part thanks to the speed and efficiency with which the affair was handled. It is notable that the authorities kept the public duly informed and thus retained their confidence.     

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.     

Mortality and morbidity in refugee camps in eastern Sudan: 1985-90

Civil war has disrupted life in Ethiopia since the 1960s and many people have sought refuge in Eastern Sudan, particularly during the famine emergency of 1984–85. UNHCR has provided the main financial support for the refugee programme, but began scaling down operations in 1990. Nearly 300,000 refugees still live in camps and benefit from food and health programmes. Health services are co-ordinated by the Sudanese Refugee Health Unit which operates a centralised health and nutrition surveillance system with the co-operation of the NGOs responsible for health care in the camps. A revision of the monthly reporting system and the establishment of a computer database in 1990 provided an opportunity to review the situation in the camps over the five years since the emergency. Child death rates for example, appear to have been reduced to levels below those expected in rural Africa. Patterns of mortality, morbidity, and nutritional status are outlined here and point to the general effectiveness of the health care programme. The surveillance system can, however, be used to identify those camps which have persistent problems, while monthly comparisons with the situation in previous years can provide early warning of deteriorating conditions.     

Evaluation of a population mobility,mortality, and birth surveillance system in South Kivu,Democratic Republic of the Congo

Prospective, community-based surveillance systems for measuring birth, death, and population movement rates may have advantages over the ‘gold-standard’ retrospective household survey in humanitarian contexts. A community-based, monthly surveillance system was established in South Kivu, Democratic Republic of the Congo, in partnership with a local implementing partner and the national ministry of health. Data were collected on the occurrence of births, deaths, arrivals, and departures over the course of one year, and a retrospective survey was conducted at the end of the period to validate the information. Discrepancies between the two approaches were resolved by a third visit to the households with discordant records. The study found that the surveillance system was superior in terms of its specificity and sensitivity in measuring crude mortality and birth rates as compared to the survey, demonstrating the method's potential to measure accurately important population-level health metrics in an insecure setting in a timely, community-acceptable manner.     

The use of cluster sampling to determine aid needs in Grozny, Chechnya in 1995

War broke out in Chechnya in November 1994 following a three-year economic blockade. It caused widespread destruction in the capital Grozny. In April 1995 Medical Relief International--or Merlin, a British medical non-governmental organisation (NGO)--began a programme to provide medical supplies, support health centres, control communicable disease and promote preventive health-care in Grozny. In July 1995 the agency undertook a city-wide needs assessment using a modification of the cluster sampling technique developed by the Expanded Programme on Immunisation. This showed that most people had enough drinking-water, food and fuel but that provision of medical care was inadequate. The survey allowed Merlin to redirect resources earmarked for a clean water programme towards health education and improving primary health-care services. It also showed that rapid assessment by a statistically satisfactory method is both possible and useful in such a situation.     

从人员疏散的角度研究公路隧道的横通道间距

隧道的横通道作为人员疏散的安全地带,其间距的设置在人员安全疏散中是至关重要的。以雪峰山隧道为工程实例,从人员安全疏散的观点出发,阐述了一种计算横通道间距的方法,并简述了方法的应用。首先根据特长隧道火灾特点,模拟分析特长隧道四种不同火灾场景下的典型自然疏散过程,并运用火灾模拟软件FDS4.0计算四种火灾场景在不同横通道间距情况下的危险时间,然后与相应的包含人员疏散行为特征的疏散时间相比较,得出该隧道最适宜的横通道间距为270m,并分析其经济性。其方法和结论可为特长隧道消防系统的设计、紧急疏散方案和引导指挥体系的建立提供理论依据。     

The urban poor in Dhaka City: their struggles and coping strategies during the floods of 1998

Bangladesh experienced one of the worst floods in recorded history in 1998. This paper focuses on the needs and coping strategies of the urban poor in Dhaka City, which had been very badly affected. The city's roads were completely under water, and most areas were water-logged with drainage and sewage systems blocked. Rising water levels compelled many slum dwellers to move to temporary shelters and relief camps. Women and children were the worst affected. The lack of sanitation facilities and privacy forced women and children to defecate in their own homes. There was an acute scarcity of safe drinking-water, and food prices rose dramatically. Diarrhoea, fever and colds were the most common illnesses affecting the poor. The floods left many of them unemployed, and in some families, the result was increased tension and incidents of domestic violence. In some areas, members felt pressured to repay micro-credit loans. Most NGOs, however, suspended loan repayments. During this period, a committee was set up to co-ordinate and work towards addressing some of the main post-flood problems.     

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.     

Restoring sanitation services after an earthquake: field experience in Bam, Iran

A powerful earthquake hit the city of Bam in southeast Iran on 26 December 2003. In its aftermath, a number of international relief agencies, including Oxfam, assisted in providing emergency sanitation services. Oxfam's programme consisted of constructing and repairing toilets and showers in villages located outside of the city. In contrast with other organisations, Oxfam opted for brick-work structures, using local materials and human resources rather than prefabricated cubicles. The choice illustrates the dilemmas faced by agencies involved in emergency sanitation: responding to needs in a manner consistent with international standards and offering assistance in a timely fashion while involving beneficiaries. Following a preliminary survey, Oxfam concluded that the provision of showers and latrines, in addition to utilisation of local materials and human resources, was essential for ensuring well-being, empowerment and dignity among members of the affected population, thereby maximising the benefits.     

重大自然灾害后遗体处置应急预案研究

重大自然灾害发生后一般都会伴随着大量人员的遇难,及时妥善处置灾后众多遇难者遗体,是许多国家面临的棘手问题。借鉴我国唐山7.8级地震和汶川8.0级地震中遗体应急处置的经验与教训,从遗体的搜集、存放、运输、消毒、防腐、保存、火化、掩埋等方面,探索遗体处理应急预案的程序与内容,从而提高政府应对重大自然灾害后大量遗体的应急处置能力,全面保障灾区群众的身心健康。     

Cholera in Sudan: An account of an epidemic in a refugee camp in eastern Sudan, May-June 1985

In 1985 cholera has been a serious problem in the horn of Africa, particularly affecting the many famine victims and refugees in that region. In this paper the history of cholera in Africa is briefly summarized, as is the background to the current refugee situation in eastern Sudan. A cholera epidemic involving 1,175 cases in two adjacent refugee camps in eastern Sudan is described. In this epidemic there were thirteen inpatient deaths and thirty-eight known home deaths from cholera. The management of the epidemic is described in detail. Overall an average of 8 1. of intravenous fluid was used per case, a higher figure than was anticipated, probably because of the unexpected degree of vomiting and the shortage of trained nursing staff.
The relationship between cholera and malnutrition is explored and hypochlorhydria is suggested as the main reason for the increased susceptibility to cholera among malnourished populations. It was observed that severely malnourished adults and children appeared to nave less severe diarrhoea with their cholera, presumably because of reduced mucosal surface area and poor enterocyte function. Finally possible means of aborting cholera epidemics are discussed.     

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.     

美国的灾害应急管理及其对我国相关工作的启示

在介绍美国灾害应急管理体系的基础上，结合中国实际，对美国气象灾害应急管理工作进行了分析，并借鉴其成功经验，提出了建立和完善中国气象灾害应急机制的一些措施。认为广泛吸纳国际社会在灾害应急管理方面的成功模式和经验，形成具有中国特色的现代化气象灾害应急管理机制，从而进一步加快中国气象灾害管理体系的建设，是科学应对气象灾害，减少人民生命财产损失，实现国家安全和经济社会可持续发展的一个重要举措。     

Addressing challenges for future strategic‐level emergency management: reframing,networking, and capacity‐building

The mounting frequency and intensity of natural hazards, alongside growing interdependencies between social‐technical and ecological systems, are placing increased pressure on emergency management. This is particularly true at the strategic level of emergency management, which involves planning for and managing non‐routine, high‐consequence events. Drawing on the literature, a survey, and interviews and workshops with Australia's senior emergency managers, this paper presents an analysis of five core challenges that these pressures are creating for strategic‐level emergency management. It argues that emphasising ‘emergency management’ as a primary adaptation strategy is a retrograde step that ignores the importance of addressing socio‐political drivers of vulnerabilities. Three key suggestions are presented that could assist the country's strategic‐level emergency management in tackling these challenges: (i) reframe emergency management as a component of disaster risk reduction rather than them being one and the same; (ii) adopt a network governance approach; and (iii) further develop the capacities of strategic‐level emergency managers.     

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.     

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.     

面向突发灾害事件的应急效能评估方法

通常在面临突发灾害情况下,难以迅速确定最佳救援方案,其中的重要原因是缺乏有效的决策支持。为此,提出了突发事件应急效能的概念,并建立了一个基于效用聚合的突发事件应急预案的效能评估方法。最后,以一个大地震灾害的想定为例,应用提出的应急灾害效能评估方法,对多个应急预案进行了评估,评估结果合理可行。