Saturday, November 27, 2010

Pathophysiology of Disaster

            On Tuesday afternoon, Indonesia has raised the alert level at one of its dozen of volcanoes, Mount Bromo to “beware,” the highest alert level before an eruption. I am lucky enough to have visited Mount Bromo on my first year study here. I still remember that the entire top of the mountain has been blown off and the crater inside constantly belches white sulphurous smoke. The view is really breathtaking. Mount Bromo is 275 km east of Mount Merapi, which in the past month has unleashed a series of powerful eruptions leaving more than 300 people dead. The volcano's initial blast occurred less than 24 hours after a tsunami swept through the remote Mentawai islands, killing at least 428 people.


MOunt Bromo shoots ashes into the sky


MOunt Bromo Behind Me

               Indonesia is situated along the Pacific Ring of Fire that leaves it vulnerable to earthquakes and gives it more active volcanoes than any other country. Not only in Indonesia, a disaster happens somewhere in the world almost daily. In the lecture, conceptual framework of disaster, Dr Hendro Wartatmo said that the word disaster is broadly defined. The UU Republik Indonesia no 24 Tentang Penanggulangan Bencana states that a disaster is an occurence which can be induced by natural, non-natural or manmade forces that negatively affect life and causes loss of life or injury, environmental degradation, property damage or psychological impact to the community.

              At the beginning of the lecture, Dr Hendro showed us a scenario about Mount Merapi eruption. Later, the scenario is split into sentences. We were asked to match some terms of disaster pathophysiology with the sentences. All of the terms were not new to us but it is not easy to match them as they have similar meaning one to another. Below is the pathophysiology of disaster with the terms.

Hazard à Event à Impact à Damage


             A disaster happens starting with the hazards. Hazard is something contains energy or to be accurate, a potentially physical event, phenomenon or human activity which can bring destructive effect to a given area or community. There are natural hazards (geological, biological, etc.) as well as human-induced hazards (environmental degradation and technological hazards). Risks come in between hazard and event. Risk is defined as the probability of harmful consequences, or expected losses resulting from interactions between natural or human-induced hazards & vulnerable conditions.
Conventionally, risk is expressed by the notation:
                                          Risk  = Hazards x Vulnerability.
To describe disaster risk reduction, the concept of capacity which refers to a combination of all the strengths and resources available within a community that can reduce the level of risk or the effects of a disaster is included. Below is the modified notation.
   Risk =     Hazard x Vulnerability              
Capacity
Event comes after hazard or risk. Event is the realization of hazards which is followed by the impact. The term impact indicates the  contact between an event and society. Unavoidably, the impact of an event would lead to damage. For instance, damage may refer to a change of social functions within a community. 

                According to WHO, a disaster happens when “a sudden ecological phenomenon of sufficient magnitude to require external assistance ".  To differentiate between event and disaster, the keyword is that disaster calls for external aids in order to restore the pre-disaster living condition or to return to normal operations of the community while the event needs no external helps. When a disaster strikes, its destructive effects would overwhelm the ability to meet the demand for health care, as The American College of Emergency Physicians (ACEP) has pointed out. For this reason, a proper disaster management which involves pre-disaster planning, organizing, controlling, feedback and corrective action must be carried out.

References:
1) Lecture Note : by Dr Hendro Wartatmo
    Conceptual Framework of Disaster & Disaster Management   

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