MODULE GENERAL EMERGENCY LIFE SUPPORT 2 PROBLEM BASED LEARNING SCENARIO 2 By: Group 6A FACULTY OF MEDICINE AIRLANGGA UNIVERSITY SURABAYA 2015
MODULE GENERAL EMERGENCY LIFE SUPPORT 2
PROBLEM BASED LEARNING
SCENARIO 2
By:
Group 6A
FACULTY OF MEDICINE
AIRLANGGA UNIVERSITY
SURABAYA 2015
MODUL GENERAL EMERGENCY LIFE SUPPORT 2
PROBLEM BASED LEARNING
SCENARIO 2
TUTOR
M. Saiful Ardhi, dr
SCENARIO COMPOSER
Teguh Sylvaranto, dr., SpAnkIC
EDITOR
Prof. Dr. Nancy Margarita Rehatta, dr., SpAnKIC-KNA
COMPOSED BY
GROUP 6A
LEADER
Ilham Wildan Ahmad 011311133021
SECRETARY
Nurul Aisyah 011311133057
NOTULEN
Tioky Sutjonong 011311133067
MEMBERS
Ayu Liana Gunawan 011211133066
Ismi Ayu Putri 011311133007
Listiana Rizka Pranandari 011311133031
Odi Yoshitaka Anggarda 011311133043
Nathania 011311133100
Ni Ketut Suastini Narada 011311133114
Afi Falizia 011311133125
Moh Erwinsyah H 011311133139
CONTENTS
Cover I
Members of Group
Learning Outcome
Mahasiswa semester 5 Pendidikan Dokter Fakultas Kedokteran Unair, setelah menyelesaikan
modul ini mampu merencanakan tugas seorang dokter dalam Management Disaster bila
terjadi bencana di suatu tempat.
Learning Outcome
After completing this module, 5th semester Medical students Faculty Medicine of Airlangga
University is able to plan the duty of a doctor in Management Disaster if there’s a disaster
happened.
CHAPTER 1
1st TUTORIAL: BRAIN STORMING
1.1. Scenario
Seorang dokter puskesmas X di Kabupaten A mendapat laporan akan adanya
letusan Gunung Z didekat wilayah puskesmas. Hujan abu pekat dan pasir terjadi
beberapa hari, salah satu desa di wilayah puskesmas X tadi diperkirakan sulit dijangkau
karena jalan terhambat oleh abu gunung ditengah hujan deras yang sering terjadi di kaki
gunung tersebut. Desa tersebut merupakan daerah pertanian tanaman dataran tinggi
dengan jumlah penduduk 15.000 orang. Dalam menghadapi bencana tersebut, dokter
puskesmas X, diperintahkan kepala dinas kesehatan kabupaten untuk merencanakan
koordinasi penanganan dampak kegiatan gunung api tersebut.
A doctor of health centre X (puskesmas X) in district A received a report that there
will be an eruption of Mount Z. Dense ash and sand rain occur a couple days, one of the
village in the area of health centre X was expected to be difficult to be reached because
the roads are obstructed by the mountain ash in the middle of the heavy rains that often
happen in foot of the mountain. The village is a highland crops area with a population of
15.000 people. In order to face the disaster, doctor of health centre X, ordered by the head
of district health department to plan the coordination to handle of the impact of the
volcano.
1.2. Main Problem
Coordination in ordered to handle the impact of volcano activity in a village with 15.000
people which was predicted to be difficult to be reached because of the obstructed roads
by the ash of the volcano in the middle of heavy rain.
1.3. Keywords
1.3.1. Coordination
1.3.2. Eruption
1.3.3. Dense ash rain
1.3.4. Heavy rain
1.3.5. Sand rain
1.3.6. Obstructed roads
1.3.7. 15.000 people
1.4. Early Hypothesis
The doctor of health centre X (puskesmas X) can plan the effective coordination to handle
the impact of volcano.
1.5. Additional Information
1.5.1. Physic of the area
1. The temperature increase until 40ºC if there’s no rain
2. The distance from village to the district is 30 km
3. The road from previous village is paved with the bent of road and incline that is
a bit high with the deviation of 1200 mdpl
4. The volcano was greatly erupted 20 years ago and the villagers were been
evacuated. Lately the volcano shows no harmful activities.
5. The volcano has release ashes and sand for the last 1 week
6. BMKG released a warning about the ash rain 2 days ago
7. The rain was sometimes heavy for the last 3 days
1.5.2. The border of the village
1. North and south : forests
2. East and west : other villages with rice fields and husbandries
1.5.3. The composition of area
1. Total of village : 25
2. Total of houses : 1.200
3. Total of house holders : 2.150
4. Total of puskesmas pembantu : 1 with one nurse and one administrator
5. Total of polindes : 1 with one midwifery
6. Total of Mosque : 9
7. Total of Church : 1
8. Total of village hall : 1
1.5.4. The composition of the villagers
1. Man : 10.200 people
2. Woman : 9.800 people
3. Toddler : 1.900 people
4. Elder : 1.100 people
5. Pregnant mother : 250 people
9. Traditional market : 2
10. Total of balai desa : 30
1.5.5. The characteristic of the villagers
1. Occupation : breeder, farmer, farm worker, merchant, and civil servant
2. Education : junior high school, primary school, senior high school, and
university
3. They often defecate in rice field, toilet and river
1.6. Learning Issues One
1.6.1. What is the effort to reduce the total of victims (Mitigation)?
1.6.2. What is the meaning of management of disaster?
1.6.3. What is the impact of volcano activities to the villagers and the environment?
1.6.4. How to recruit the volunteers?
1.6.5. What is the effective communication system in management disaster?
1.6.6. What are the criteria of effective transportation in management disaster?
1.6.7. Who is the person (non-medic) that has role in management disaster?
1.7. Learning Issues Two
1.7.1. How to evacuate the victims?
1.7.2. What is the role of medical personnel in management disaster?
1.7.3. What is the logistic that is needed in a disaster situation?
1.7.4. What is the ideal characteristic of refuge?
1.7.5. What is the classification of the status of volcano?
1.7.6. How to determination the Status of disaster emergency on a national scale
and local scale?
1.8 Early Mind Mapping
signs of volcano eruption
has exploded 20 years
volcanic ash and fine sand
for about 1
vulnerability of the villagers
physical economic
social environment
analyzing impact of the eruption
2 days ago, BMKG give
warning about ash
fall
sometimes rain falls
heavily the last 3 days
count possible victims
count possible damage
Socio-economical impact
area
actions
mitigation to prevent
much damage
allertness
emergency response
restoration
Allocation and division of tasks
CHAPTER 2
2nd TUTORIAL
2.1. Answer of Learning Issues One
2.1.1. The effort to reduce the total of victims (Mitigation)
A volcanic hazard describes the physical characteristics of an eruption. While
a volcano is in eruption it will produce a variety of hazards. Near-vent volcanic
hazards tend to be very destructive, while distal hazards may cause damage to
structures or disrupt everyday life. Even when a volcano is not in eruption,
volcanic hazards such as debris avalanches or remobilized secondary lahars can
still occur.
Mitigation of volcanic hazards can be undertaken during periods of crisis,
while a volcano is in eruption. Studies of recent eruptions have led to the
identification of mitigation measures that were used successfully while an eruption
was in progress. Extensive measures have been identified for the mitigation of
problems caused by ash fall. However, there are still a number of hazards that have
few mitigation options available. For example, pyroclastic flows and surges are so
destructive that the only really viable option is to evacuate the population at risk
prior to the event.
The management and mitigation of volcanic hazards should not only occur
during crisis periods. It is also important that management of volcanic hazards is
initiated and undertaken in periods of non-crisis, prior to an eruption occurring.
Pre-planning will ensure that the mitigation measures employed in response to a
crisis are successful.
Figure 1. Volcanic hazard management during non-crisis (pre-eruption)
and crisis (during an eruption) periods (after Johnston and Houghton,
1995).
2.1.1.1. Pre-eruption: Mitigation Techniques for Non-crisis Periods
Mitigation goals are to prevent loss of life and property resulting from
volcanic eruptions. During periods when volcanoes are not active, planning and
preparation should be undertaken to ensure the effects of a volcanic eruption are
minimized. Planning is important at national, regional, local and even individual
levels. The following aspects should be considered when planning for a volcanic
eruption.
1. Land use development and regulation to prevent development in zones that are
of high risk to volcanic hazards (Johnston and Houghton, 1995).
2. Where thick ash fall is likely to occur, building codes that require roofs to have
steeper pitches could be implemented (Spence et al., 1996; Johnston, 1997a).
This is especially important for critical buildings such as hospitals, fire
stations, police stations, public buildings and schools (Johnston, 1997a).
3. Plans must be established regarding procedures during a volcanic eruption.
Plans may need to detail procedures for notifying the public about the eruption,
procedures for shutting down operations and maintenance and clean up
procedures (Federal Emergency, Management Agency, 1984; Johnston, 1997a;
1997b). Recovery planning should also be considered within the contingency
plan (Johnston, 1997a).
4. Plans and procedures need to be flexible enough to adapt to what may be
rapidly changing conditions during a volcanic eruption (Peterson, 1996;
Johnston 1997a).
5. Sample emergency ordinances should be prepared in advance (FEMA, 1984).
6. Johnston (1997a) suggests making a list of facilities that must be kept
operative, versus those that can be shut down during and after ash fall.
7. It is advisable to consider the need for stress counseling both for the general
publican emergency workers (Finnimore et al., 1995).
8. Pre-test the plan so that people know what roles they must fulfill (FEMA,
1984).
9. The 1996 Mount Ruapehu eruptions confirmed that the preparedness of a
district is based on past experiences. As a result of the 1995 eruption
experience, organizations were able to respond quickly and more effectively. It
is important to pass on information about lessons learnt from past eruption
experiences to new staff in the organizations, so that the too can use
information effectively (Neild et al,. 1998).
10. Evacuation:
Evacuation may be necessary in the event of a volcanic eruption. Near to the
source of the eruption it may be advisable to evacuate the area prior to activity
in order to save lives. It is also important to note that heavy tephra falls may cut
off transport routes after the eruptions, thus hindering any effort to evacuate
people (Johnston and Nairn, 1993). There is need to plan for the transportation,
sheltering, feeding, clothing, and medical and hygiene needs of any evacuees or
those that are stranded by an eruption. In the event of volcanic eruption there
may be a large number of displaced people that need to be cared for, and pre-
planning will mean that those people have places here they can stay (FEMA,
1984; Johnston and Nairn, 1993; Finnimore et al., 1995). Before an eruption. It
is necessary to identify resources that can be used to assist in the evacuation of
large number of residents, for example, this may include towing firms,
mechanical repair films, emergency fuel supplies and bus companies. Other
issue that should be considered include the control of traffic, and animal
transport, and welfare. The early identification of needs during a volcanic
eruption will allow ready arrangement of outside assistance when an eruption
occurs.
11. Spare Parts:
Spare parts or critical equipment that may be needed during a volcanic eruption
should be stockpiled. This may include air filters, cleaning equipment,
protective clothing, face masks and extra fire hoses (Novak et al., 1981; FEMA,
1984; Johnston, 1997a). Extra vehicles for emergency use by police and other
personnel may also be required (FEMA, 1984).
12. Education:
Education of the public about volcanic hazards and how to mitigate against the
effects of a volcanic eruption is important. Education will lessen the
physiological and physical impacts of an eruption on the public. Warnings can
be better understood if the public understands the nature of the hazard. Also,
since communications may be disrupted during and after an eruption, it is
necessary to distribute information before an event so people know what to
expect and what to do (Johnston and Nairn, 1993). The public can be educated
through newspaper articles, television, radio, the Internet, exhibits at
museums, brochures, talks by scientists to clubs and organizations and school
classes. Education about volcanic hazards aimed at school children has the
added benefit that parents become informed too, through their children
(Peterson, 1996).
13. Media:
Most people rely on the media for receiving information. Surveys by Johnston
et al., (1997) show that public knowledge and awareness of events during the
Ruapehu eruptions were derived almost entirely from the media. Effective
management of the media is required so that accurate information can be
conveyed to the public during a volcanic eruption. In a recent survey of
organizations by Paton et al. (1998), 43 percent of respondents reported that
they had suffered “media problems” during the 1995 Ruapehu eruption. These
results highlight the need for organizations to develop an effective media
response, and to provide training for media spokespersons. Paton et al. (1998)
suggest addressing this problem by including a media management component
in training programs. The increased public demand for information during a
volcanic eruption may be supplemented by distributing printed information
(Johnston, 1997b).
14. Networks:
The FEMA (1984) recommend that prior to a volcanic eruption, roles and
responsibilities of the different organizations should be defined, and a network
of authority under which individuals would work in an emergency should be
established. In the survey of organizations by Paton et al. (1998), it was found
that many respondents believed there was a “lack of clear responsibility for co-
ordination” over the duration of the 1995 Ruapehu eruptions. There is
therefore a need to establish inter-organizational networks among those
organizations that may be involved in dealing with a future volcanic eruption.
Paton et al (1998) suggest that more simulations and exercises would help
identify and resolve co-ordination problems. Another recommendation was for
groups to work together in the planning stage to develop their capability to
work as an integrated team (Paton et al., 1998). A volcanic eruption may cover
more than one local authority, and a shift in wind direction may even change
the entire area of impact. Because volcanic eruptions cover wide areas, a
nationally coordinated effort could reduce duplication. Neild et al. (in prep)
suggest that this is particularly true for providing information to the public and
media. However, concerns have been expressed over how Emergency
Management Groups would function without local knowledge if co-ordination
were controlled from an outside centre (Neild et al., in prep).
2.1.2. The Meaning of Management Disaster
Disaster management is the management of the use of existing resources to
face the threat of disaster by planning, preparation, implementation, monitoring and
evaluation at each stage of disaster management, namely pre, during and post-
disaster. Basically, disaster relief efforts include:
1. The pre-disaster phase, consisting of:
a. The situation is not a disaster, namely prevention and mitigation activities
b. Potential disaster situations, such as preparedness activities
2. The current stage of the disaster, the activities are emergency response and
recovery
3. The post-disaster phase, namely the rehabilitation and reconstruction activities
Each stage of the disaster can be described in a cycle. Each phase of the
response can not be restricted strictly. In the sense that pre-disaster efforts must
first be completed before stepping in the response phase and proceed to the next
stage, namely the recovery. This cycle must be understood that at any time, all
stages can be carried out jointly at a certain stage with different portions. For
example, the recovery phase of recovery but the main activity is prevention and
mitigation activities can also be done in anticipation of the impending disaster.
Figure 2. Cycle of Disaster Management
Various disaster relief efforts which can be done at any stage in the cycle of disasters:
1. Prevention and Mitigation
This effort aims to avoid disaster and mitigate risk characteristics. Efforts were
made, among others:
a. Development of policies, legislation, guidelines and standards
b. Manufacture of hazard maps and mapping health problems
c. Brochures / leaflets / posters
d. Disaster risk analysis
e. The establishment of disaster response team
f. Basic training in disaster
g. Building a crisis management system of community-based health
2. Preparedness
Preparedness efforts undertaken to anticipate the possibility of disaster.
Preparedness efforts carried out at the time of the disaster began to be identified
will occur. Efforts that can be done include:
a. Preparation of contingency plans
b. Simulation / rehearsal / training standby
c. Preparation of resource support
d. Preparing the information and communication system
3. Emergency Response
Health emergency response efforts undertaken to save lives and prevent
disability. Efforts are underway include:
a. Rapid assessment of health (rapid health assessment)
b. First aid and evacuation of disaster victims to health facilities
c. Fulfillment of basic needs of health
d. Protection against high-risk groups of health
4. Recovery
The recovery effort includes rehabilitation and reconstruction. Rehabilitation
efforts aimed at restoring the condition of the affected area which is too
uncertain to normal conditions better. Reconstruction efforts aimed at rebuilding
infrastructure damaged by disasters better and perfect. Efforts were made,
among others:
a. Environmental improvement and sanitation
b. Improvement of health care facilities
c. Psycho-social recovery
d. Improved health care functions
2.1.3. The impact of volcanic activity
Volcanic eruption is one of the natural disasters that often occur in Indonesia.
Volcanic eruption has highly influence for human life, both in terms of financial,
economic, social, and health.
When it erupted, the volcano generally spouting water vapor (H2O), carbon
dioxide (CO2), sulfur dioxide (SO2), hydrochloric acid (HCl), hydrofluoric acid
(HF), and volcanic ash into the atmosphere. Volcanic ash contains such as silica,
minerals and rocks. The most common elements are sulfate, chloride, sodium,
calcium, potassium, magnesium, and fluoride. There are also other elements, such
as zinc, cadmium, and lead, but in lower concentrations in this volcanic ash.
Impact of volcanic ash on health can be divided into several categories, such
as acute respiratory distress, interference with the vision, irritation of the skin, and
mechanical disruption due to volcanic ash.
1. Acute Respiratory Distress
Rrespiratory disorders is one of the most major impact of the volcanic ash.
Irritation of the nose and throat, coughing, bronchitis, shortness of breath, and
narrowing of the airways can cause death. Respiratory problems caused by the
volcanic ash would have to be quickly handled, because the respiratory system
is one of the vital things that support human life.
Fine ash particles is certainly disturbing the respiratory system, especially for
those who already have lung problems. In addition, exposure to volcanic ash
also very dangerous for infants, children, the elderly and people with chronic
lung disease such as asthma.
2. Disturbances in Vision
Besides disrupt the respiratory system, the volcanic ash also can disrupt the
visual system. Volcanic ash has a sharp grain, which can cause eye irritation.
The entry of volcanic ash into the eyes can cause eye irritation, conjunctivitis
(inflammation of the conjunctiva) and corneal abrasion (a scratch on the
cornea).
3. Irritation of the Skin
Although rare, cases of skin irritation is sometimes found along the ashfall,
particularly when the volcanic ash is acidic.
4. Mechanical Disruption
Mechanical disruption caused by the volcanic ash caused fall the roof of a house
or an accident on the highway. Roofs may collapse because heavy loads of ash,
especially if the ash is wet and buildings are not built to support heavy loads.
Roof collapse can cause people who are in the house hit so badly, even died
instantly. Injuries that can occur in the form of broken bones, bruises,
lacerations and bleeding requiring further medical procedures.
2.1.4. Volunteers Recruitment
According to Wong (2006) We have three types of volunteers in the Red Cross,
community-based volunteers, functional volunteers and professional volunteers.
Each type of volunteers has different role and characteristics. Community-based
volunteers are those come from the community and have a will to help others. They
may not have any skills or knowledge in disaster response and most of them are
untrained. Functional volunteers are those who possess special skills, such as first
aid, nursing, psychological support, disaster response and so on. If they originate
from a serving Red Cross Department, they will resume their normal volunteer
works after the disaster response while waiting for the next assignment.
Professional volunteers are those with professional qualification, such as doctor,
nurse, engineer and accountant. No matter which types of volunteers one belongs
to, they do play a role in disaster response.
2.1.4.1. Recruitment and retainment of volunteers
During disaster, we need a large number of manpower so we should have
planning in recruitment and retainment of volunteers. If we have better preparation,
we can respond to disaster effectively. Therefore, we should develop a
comprehensive volunteer management system that includes needs assessment,
recruitment, matching, training, supervision and recognition to volunteers. There
are many ways to recruit volunteers; we can do it through promotion in mass
media, website, service program, and referral from professional organizations.
Apart from recruitment, retainment of volunteers is of equal importance because it
can reduce the number of withdrawals.
To retain volunteers, we should develop a trustful working relationship with
them because it prompt us to identify suitable duty to them and show our concern
to their needs and feeling. Besides, we should develop an effective communication
channel with them so that they can grasp the most updated information of the
agency and they can know when they have to lend a helping hand. Apart from this,
we should also provide regular training and sharing to them so that they can refresh
their skill and knowledge and acquire new skills that enhance their capacity. In
addition, we should conduct debriefing session and to collect feedback through
questionnaires after the mission to improve our service. The last but not the least,
to recognize volunteers’ contribution in tangible or intangible ways is also vital to
retain volunteers.
2.1.4.2. Role in disaster management cycle
Although community-based volunteers, functional volunteers and professional
volunteers have different skills and qualifications, they can participate in any part
of the disaster management cycle, namely Disaster Response, Recovery /
Rehabilitation, Risk Reduction and Preparedness. From the view of disaster
management, collective actions are taken before, during and after any disaster
situation to predict, prevent, reduce or cope with its impact. The volunteers can
play a part in these tasks.
According to Steen (2014) some places to find volunteers are:
Colleges and universities are good sources, especially if they have training
programs for doctors, nurses, pharmacists and veterinarians — all people with
skills that are valuable in emergencies.
Churches and fraternal organizations like the Rotary or Lions clubs are also good
places to ask: They have members who know the community and are often
seeking opportunities to help others.
Ask other emergency response groups such as the American Red Cross.
Approach the private sector, since many companies match dollars for volunteer
hours to encourage community service.
Retirees are another good source — with the baby boomers leaving the workforce,
there are a lot of skilled people who may be interested in volunteer opportunities.
After developing a roster of volunteers, it’s important to train them to the job
description, perform background checks on those who may end up working in
situations where that’s necessary like a hospital, and create a database to keep track
of them.
Although we need a huge number of manpower during disaster, the influx of
volunteers may cause troubles at the scene, such as overloading of the volunteer
coordinators, volunteers are eager to help but job-matching is in vain, the scene
may need trained volunteers, but most of the volunteers are untrained, workers use
a lot of time to handle the influx of volunteers which hinder the efficiency of
disaster response. Example of things we can do tocope with this is that we can
assign jobs according to their skills and abilities, and arrange experienced
volunteers work side by side with new volunteers.
Volunteers are assets their contributions are multi-facets, such as service
implementation, management and decision-making. In order to enhance their
capacity and better prepare for disaster response, we should train up community
and also encourage people to join as professional organization volunteer such as
(Korps Suka Rela Indonesia) KSRI.
2.1.5. Effective Communication System in Management Disaster
Education information is a cheap and easy for people in disaster mitigation,
the more information, the right information, will create communication between all
stakeholders in disaster management. Communication is absolutely necessary in
order to carry out the delivery of information and coordination in disaster relief
efforts. In an emergency all communication systems can be used. The term disaster
communication has not become a popular concept in the field of communication as
well as the field of disaster. Awareness of the importance of communication in
disaster management is getting higher these days. In disaster management, accurate
information needed by the public or private organizations that have concern for the
disaster victims.
Communication in a disaster is not only needed in emergency conditions, but
it is also important at the time and pre-disaster. As it is said that communication is
the best way for the success of disaster mitigation, preparedness, response, and
recovery during a disaster situation. The ability to communicate messages about
disasters to the public, government, media and opinion leaders can reduce risks,
save lives and impact from disasters.
According Haddow and Haddow (2008: 2) there are 4 major cornerstone in
building effective disaster communication, namely:
1. Costumer Focus, namely to understand what information is needed by the
customer in this community and volunteers. Must be built mechanism which
ensures the information communication delivered with precise and accurate.
2. Leadership commitment, leadership role in emergency situation must be
committed to effective communication and be actively involved in the
communication process.
3. Situational awareness, effective communication is based on the collection,
analysis and dissemination of information related to disaster controlled.
Effective communication principles such as transparency and can be trusted to
be the key.
4. Media partnership, media such as television, newspapers, radio, and other media
is very important to convey correct information to the public. Cooperation with
the media regarding the understanding of the needs of the media with a team
trained to cooperate with the media to gain and disseminate information to the
public.
2.1.6. Criteria of Effective Transportation In Management Disaster
It has been argued that the success of an evacuation is significantly enhanced
when people and communities participate in evacuation planning. According to
this argument, com- munities are less likely to resist evacuation orders when there
is increased participation in evacuation planning because they will have had a say
in how the evacuations should be conducted. Communities may be able to identify
solutions and resources not immediately evident to the authorities or traditional
disaster responders. In particular, in order to effectively meet the needs of
particular groups within the population, it is important to communicate with each
of these groups to understand their situation, their concerns, and other
transportation and evacuation issues.
This information should then be used to devise evacuation plans that,
whenever possible, effectively reflect the different needs within the population. In
addition, engaging populations strengthens evacuation planning by making use of
local capabilities. Survivors of a disaster, who often serve as the first responders,
play a critical role in a post-disaster evacuation. A well-prepared community can
further reduce casualties. For example, in the 2004 Indian Ocean tsunami the
approximately 80,500 individuals of the Simeulue community in Indonesia,
recognizing the unusual behavior of the sea, fed to the nearby hills before the
disaster struck. Subsequently, only 7 people died, in comparison to the 163,795
casualties experienced elsewhere in Indonesia’s northern Aceh province. By
working with populations to identify and organize their own response capaci- ties,
evacuation planners can considerably enhance the overall response to a disaster.
There will be a number of people who do not have the ability or resources to
make their own way out of the danger zone. Transport arrangements should be
made for those with transport needs. To enhance transportation capacities in an
emergency it is often beneficial to establish transportation networks prior to an
emergency. In some cases, it may be better if people do not use their own
evacuation means due to the potential for traffic congestion. However, it is
important to recognize that deterring evacuation using personal vehicles may be
difficult, because it is often the method preferred by evacuees and would require
significant resources to restrict.
Persons with transportation needs may form part of the following groups:
1. Low income, do not own a vehicle;
2. Visitors to the area without access to a vehicle;
3. Language barriers;
4. Physical or medical conditions affecting mobility (visually impaired, mental
health, oxygen or other medical/mobility device dependent, etc.);
5. Able-bodied individuals who own a vehicle but choose to not self-evacuate
(based on fear or other reasons), and;
6. Other able-bodied individuals who may not be able to self-evacuate.
To identification of available transportation resources and coordination of
those limited resources is paramount to any evacuation’s success. This could
include the use of buses and mini-buses, trains, taxis and volunteer drivers, aircraft,
helicopters and boats, as well as more traditional modes of transport such as
donkeys and carts, depending on the circum- stances and resources available.
2.1.6.1. Evacuation Route
Important characteristics and factors that should be considered when selecting an
evacuation route include:
1. Shortest route to the designated destination areas
2. Capacity of proposed routes to accommodate the mode of transportation to
be used
3. Maximum roadway capacity
4. Ability to increase capacity and traffic fow using traffic control strategies
5. Availability of infrastructure to disseminate real-time conditions and
messages to evacuees en route
6. Number of potentially hazardous points, such as bridges and tunnels
7. Damage assessment of evacuation routes
As some evacuation routes may become blocked in an emergency, it is also
important to plan alternate routes or means of evacuation, in the event that
preferred routes become inaccessible.
2.1.6.2. Traffic Control Measures
In any evacuation, arrangements should be made to keep traffic moving, at
least along key routes. Traffic movements will be particularly difficult in very
built-up urban areas, and also in rural areas with poor roads. Some examples of
traffic control measures that can be used during evacuations include segregation of
pedestrian and vehicle traffic; exclusive bus routes; phased evacuation; use of
designated markings; road barriers; the use of traffic management techniques such
as “contrafow” (making the in-bound and out-bound lanes unidirectional), which
have proven to be very effective. Making provisions, such as fuel, portable
restrooms, and water, available along the route can also positively influence the
effectiveness of an evacuation.
2.1.6.3. Transportation of animals, household pets, livestock
Evacuees will often seek to bring their animals with them, and many will
ignore evacuation orders if forced to leave their pets or livestock behind. This may
be especially true if evacuees
2.1.7. Non Medic Personnel That Has Role In Management Disaster
In implementing disaster management in the region will require coordination
with the sector. Broadly speaking can described the role of cross-sector as follows:
1. Government sector, controlling development activities regional development
2. Health Sector, plan health services and medical including medications and
medical
3. Social Sector, planning needs for food, clothing, andOther basic needs for
refugees
4. Sector Public Works, regional spatial planning,site preparation and evacuation
routes, and recovery needs
5. facilities and infrastructure.
6. Transportation Sector, early detection and informationweather /
meteorological and plan thetransportation needsand communication
7. Sector Energy and Mineral Resources, planning andmitigatif control efforts in
the field of geological disasters andman-made disasters related to
disasterprevious geological
8. Sector Manpower and Transmigration, planningdeployment and transfer of
victims to areasafe disaster.
9. Financial Sector, budget preparation activity costsimplementation of disaster
management in the predisaster
10. Forestry Sector, planning and control effortsmitigatif especially forest/land
fires10. Sector Environment,planning and controlpreventive efforts, advocacy,
and early detection indisaster prevention.
11. Marine Sector planning and control effortsmitigatif in the field of tsunami and
coastal erosion.
12. Sector Research and Peendidikan High, dostudies and research as a material
for planningimplementation of disaster management in the predisaster,
emergency response, rehabilitation andreconstruction.22 Guidelines for
Preparation of Disaster Management Plan
13. TNI / police assist in SAR activities, and securityemergencies including
securing the abandoned locationbecause its inhabitants were displaced (BNPB,
2008).
2.2. Answer Learning Issues Two
2.2.1. How to Evacuate People
According to dictionary, Evacuation is to move people from a dangerous place
to somewhere safe. Tight rules goal and pace of evacuation all victims to
medication first or front and rare post is so needed to prevent overload capacity
health facility. Evacuation victims do in one direction without intersecting. From
location of disaster to first medication post,then to post rare until secondary
medication post. In In a mass disaster is may not transfer with one vehicle for one
person.
At each level of medical posts will be encountered limited resources power
including transport so need to be prepared sufficient transportation to refer the
victim to the next medical post. Every times ambulance from the field medical post
is complete refer to front the medical post, the ambulance must be immediately
returned to the field medical post. This system known as noria system which means
wheel or conveyor system management (conveyor belt management).
Figure 3. Conveyor System Management (Cited from Technical For
Healt Crisis Responses on Disaster)
Before the evacuation, health workers should do:
1. examination of the patient's condition and stability by monitoring vital
signs;
2. examination of equipment attached to the patient's body such as
infusion,pipe ventilator / oxygen, immobilization equipment and
others.
Victims should not be moved before:
1. the victims are in the most stable condition;
2. the victim has prepared adequate equipment for transport;
3. health facilities receiver has been informed and is ready to receive
victims;
4. vehicles used in conditions fit for use.
There are so many ways to carry when evacuation victims:
LIFTS AND CARRIES
ONE RESCUER
ANKLE PULL The ankle pull is the fastest method for moving a victima short distance over a smooth surface. This is not apreferred method of patient movement.
1. Grasp the victim by both ankles or pant cuffs.
2. Pull with your legs, not your back.
3. Keep your back as straight as possible.
4. Try to keep the pull as straight and in-line aspossible.
5. Keep aware that the head is unsupported andmay bounce over bumps and surfaceimperfections.
SHOULDER PULL The shoulder pull is preferred to the ankle pull. Itsupports the head of the victim. The negative is that itrequires the rescuer to bend over at the waist whilepulling.
1. Grasp the victim by the clothing under theshoulders.
2. Keep your arms on both sides of the head.
3. Support the head.
4. Try to keep the pull as straight and in-line aspossible.
BLANKET PULL This is the preferred method for dragging a victim.
1. Place the victim on the blanket by using the"logroll" or the three-person lift.
2. The victim is placed with the head approx. 2 ft.from one corner of the blanket.
3. Wrap the blanket corners around the victim.
4. Keep your back as straight as possible.
5. Use your legs, not your back.
6. Try to keep the pull as straight and in-line aspossible.
ONE-PERSON LIFT This only works with a child or a very light person.
1. Place your arms under the victim's knees andaround their back.
FIREFIGHTER CARRY This technique is for carrying a victim longer distances.It is very difficult to get the person up to this positionfrom the ground. Getting the victim into positionrequires a very strong rescuer or an assistant.
1. The victim is carried over one shoulder.
2. The rescuer's arm, on the side that the victim isbeing carried, is wrapped across the victim's legsand grasps the victim's opposite arm.
PACK-STRAP CARRY When injuries make the firefighter carry unsafe, thismethod is better for longer distances than theone-person lift.
1. Place both the victim's arms over yourshoulders.
2. Cross the victim's arms, grasping the victim'sopposite wrist.
3. Pull the arms close to your chest.
4. Squat slightly and drive your hips into the victimwhile bending slightly at the waist.
5. Balance the load on your hips and support thevictim with your legs.
TWO RESCUERS
HUMAN CRUTCH/ For the conscious victim, this carry allows the victimTWO-PERSON DRAG to swing their leg using the rescuers as a pair of
crutches. For the unconscious victim, it is a quickand easy way to move a victim out of immediatedanger.
1. Start with the victim on the ground.
2. Both rescuers stand on either side of thevictim's chest.
3. The rescuer's hand nearest the feet grabs thevictim's wrist on their side of the victim.
4. The rescuer's other hand grasps the clothing ofthe shoulder nearest them.
5. Pulling and lifting the victim's arms, therescuers bring the victim into a sitting position.
6. The conscious victim will then stand withrescuer assistance.
7. The rescuers place their hands around thevictim's waist.
8. For the unconscious victim, the rescuers willgrasp the belt or waistband of the victim'sclothing.
9. The rescuers will then squat down.
10. Place the victim's arms over their shoulders sothat they end up facing the same direction asthe victim.
11. Then, using their legs, they stand with thevictim.
12. The rescuers then move out, dragging thevictim's legs behind.
FOUR-HANDED SEAT This technique is for carrying conscious and alertvictims moderate distances. The victim must be able tostand unsupported and hold themselves upright duringtransport.
1. Position the hands as indicted in the graphic.
2. Lower the seat and allow the victim to sit.
3. Lower the seat using your legs, not your back.
4. When the victim is in place, stand using yourlegs, keeping your back straight.
TWO-HANDED SEAT This technique is for carrying a victim longer distances.This technique can support an unconscious victim.
1. Pick up the victim by having both rescuers squatdown on either side if the victim.
2. Reach under the victim's shoulders and undertheir knees.
3. Grasp the other rescuer's wrists.
4. From the squat, with good lifting technique,stand.
5. Walk in the direction that the victim is facing.
CHAIR CARRY This is a good method for carrying victims up and downstairs or through narrow or uneven areas.
NOTE: The chair used should be a sturdy one.Don't use aluminum beach chairs, resin patiochairs, swivel chairs, or lightweight folding chairs.
REMEMBER: Chairs with wheels can be used to rollthe victim, but should not be used for a carry.
1. Pick the victim up and place them or have themsit in a chair.
2. The rescuer at the head grasps the chair fromthe sides of the back, palms in.
3. The rescuer at the head then tilts the chair backonto its rear legs.
4. For short distances or stairwells, The secondrescuer should face in and grasp the chair legs.
5. For longer distances, the second rescuer shouldseparate the victim's legs, back into the chairand, on the command of the rescuer at thehead, both rescuers stand using their legs.
IMPROVISED STRETCHER This technique requires two poles/pipes strong enoughto support the victim's weight and at least two shirts.
REMEMBER: Rescuers should not give up clothingif, for any reason, this might affect their health,welfare, or reduce their effectiveness.
1. While the first rescuer is grasping the litterpoles, the second rescuer pulls the shirt off thehead of rescuer one.
2. All buttons should be buttoned with the possibleexception of the collar and cuffs.
3. The rescuers then reverse the procedure andswitch sides.
BLANKET STRETCHER This technique requires two poles and a blanket.
1. Place the blanket down on the ground.
2. Place one pole approx. 1 foot from the middle ofthe blanket.
3. Fold the short end of the blanket over the firstpole.
4. Place the second pole approx. 2 feet from thefirst (this distance may vary with victim orblanket size).
5. Fold both halves of the blanket over the secondpole.
THREE OR MORE RESCUERS
HAMMOCK CARRY Three or more rescuers get on both sides of the victim.The strongest member is on the side with the fewestrescuers.
1. Reach under the victim and grasp one wrist onthe opposite rescuer.
2. The rescuers on the ends will only be able tograsp one wrist on the opposite rescuer.
3. The rescuers with only one wrist grasped will usetheir free hands to support the victim's head andfeet/legs.
4. The rescuers will then squat and lift the victimon the command of the person nearest the head,remembering to use proper lifting techniques.
THREE-PERSON CARRY This technique is for lifting patients onto a bed orOR STRETCHER LIFT stretcher, or for transporting them short distances.
1. Each person kneels on the knee nearest thevictim's feet.
2. On the command of the person at the head, therescuers lift the victim up and rest the victim ontheir knees.
If the patient is being placed on a lowstretcher or litter basket:
On the command of the person at the head, thepatient is placed down on the litter/stretcher.
If the victim is to be placed on a highgurney/bed or to be carried:
At this point, the rescuers will rotate the victimso that the victim is facing the rescuers, restingagainst the rescuers' chests.
3. On the command of the person at the head, allthe rescuers will stand.
4. To walk, all rescuers will start out on the samefoot, walking in a line abreast.
Anticipation and Evacuation Danger Mount erupts:
1. Preparation Facing Volcano Eruption
Recognize the local area in determining a safe place to evacuate.
Create a disaster management plan.
Prepare for evacuation if necessary.
Preparing basic needs
2. If Occurred Volcanic Eruption
Avoid disaster-prone areas such as mountain slopes, valleys and
lava flow area.
In the open, protecting themselves from the ash and hot clouds.
Prepare yourself for the possibility of aftershocks.
Wear clothing that can protect the body such as: long sleeves, long
pants, hats and others.
Do not wear contact lenses.
Wear a mask or cloth to cover the mouth and nose
3. After Volcanic Eruption Occurred
Stay away from areas affected by ash
Clean the roof of the ashes. Due to its weight, can damage or tear
down the roof of the building.
Avoid driving in areas affected by ash can cause engine damage
2.2.2. The Roles of Medical Personnel In Management Disaster
Competence of medical personnel and equipment should be prepared in
accordance with the recommendation of RHA (Rapid Health Assessment). If the
recommendation is needed surgeon and anesthesia for the treatment of severe
injuries that require surgery, TRC or minimal medical assistance team should
consist of surgeons, anesthetists, general practitioners, nurses proficient surgical
and ER (Kementerian Kesehatan, 2011).
Be prepared rescuers trained to perform pre-hospital medical care well in the
field. This field medical teams have the ability to:
1. provide aid life support;
2. perform triage with either;
3. perform radio communication with the well.
In certain circumstances, difficult localization victims as victims trapped in
collapsed buildings, the liberation of the victims will require a longer time. If the
victim's condition worsens, the SAR team leader, through the Command Post may
request assistance from the medical team to stabilize the victim during the
acquisition process is done (Kementerian Kesehatan, 2011).
2.2.3. Logistic Needed In Management Disaster
Loss the sources of power on victims disaster will cause dysfunctional some
elements within the community. Conditions such as these will raise the demand for
assistance addressed to people outside the disaster area. Thus, the logistics system
becomes very important. Logistics is something that is tangible and can be used to
meet the basic needs of human life which consists clothing, food and shelter or
derivatives. Included in the logistics category are consumables such as food,
medicine, clothing and accessories, sleeping suits etc (BNPB, 2009).
According Ahyudin (2005) the variety of logistical assistance, for food and
clothing, should adjust to the culture prevailing in the disaster victims. For
example, it turns out the people in Aceh do not like sardines preserved. Food
should meet the nutritional standards, because the victims are generally inhabit
rudimentary shelter, it causing their physical state very susceptible to disease.
Therefore, the logistics of food that does not have the maximum nutritional value
can cause danger for the victim. Data show that outbreaks of illness and death
affected a lot going on continuously.
Research in the evacuation showed that child mortality is 2-3 times greater
than deaths in all age groups (Kemenkes RI, 2012). Manager of activities nutrition,
Provincial Health Office and District or City is part of a team of health problems
caused by the disaster prevention coordinated Crisis Management Center of Health
(PPKK), PPKK Regional and Sub-regional, the Provincial Health Office and
District-City and Society Organization. Handling of nutrition in disaster situations
consist of nutrient management on vulnerable groups and adults besides lactating
mothers and pregnant women. Such as feeding milk formula in infant,
micronutrient supplementation of vitamin A supplements for children, iron tablets
for pregnant and lactating mothers in addition to fresh food, iron supplementation
for pregnant women, porridge or biscuits for the elderly and others.
As for the logistical in form clothes should also suit the needs and taking into
account the dignity of the victim as a human being. In disaster specially vvolcanic
ash would lead to declining health. Drugs are needed such as eucalyptus oil, wind
starting, vitamins, and other supplements. In addition, cough medicine and
paracetamol is also needed for victims who have a fever and headache. Beside the
three types of logistics before, the victim also require other types of logistics such
as blankets, clean water, sanitary napkins and etc. As for groove of demand
logistical assistance is as follows (BNPB, 2009):
Figure 4. Groove of demand logistical assistance
Logistical assistance implemented by holding pattern involving several
institutions within the institutional system in various areas implemented in an
integrated manner: National, Province, District or city. Each one has a level of
authority:
1. National
In the case of a disaster at the district/city and province, BNPB deploying
logistical resources of the Technical Implementation Unit (UPT) regional,
institutions, businesses and communities as needed to the disaster site. If this
need is not available or not sufficient, BNPB can mobilization the assistance to
another BPBD province, or other sources both from within and outside the
country. And if there are limitations then BNPB can help through grant
assistance of ready-made patterns specifically used during emergency response.
2. Province
In the case of a disaster in the province, BPBDs deploying logistical
resources of the Institutions, Business and Communities as needed to the
disaster site. If this need is not available or not sufficient, then the provincial
government concerned may request logistical support to other nearby province.
If the province requested assistance does not have the availability of resources
logistics or insufficient, then the provincial governments affected by the disaster
can request assistance to the Central Government (BNPB). Logistic support
deployment costs are covered by provincial governments.
3. District/City
In the case of a disaster at the district/city, BPBDs District deploying
logistical resources of the institutions, Business and Communities as needed to
the disaster site. If this need is not available or not sufficient, the government
districtor city can request logistical support to the government of the District or
City nearby well in one province or another province. If it does not have the
resources available or not sufficient, then City Government affected may request
logistical support to the provincial government concerned. Deployment costs for
this equipment covered by City Government.
2.2.4. The Ideal Characteristic of a Place for Refuge
The victims of volcanic activities at anytime can be or must be evacuated for
their safety. This is some characteristics that can be used as a refuge place.
1. Select the location
When we are going to select a place for refuge at least they have to fulfill
these criteria:
a. The place for refuge or evacuated people must be safe or outside of the
affected area. In this case it must outside of volcano activities;
b. The area (luas) of the place must be adjusted with the number of people that
is evacuated;
c. The potential threat caused by unsafe buildings, the ruins, the slope of the
land, etc;
d. The potential threat in terms of security, health and the risk of natural threats
such as flood, landslides, hurricanes, etc;
e. Easy accesses to the infrastructures such as roads, bridges, river, water
supply, sanitation, lighting, telecommunication, etc.
2. The ownership of the buildings or lands and use permits
Make sure that the owner of the location permits to use their land or buildings as
a place of refuge. Try to get the permission in order to not get in trouble in the
future.
3. Infrastructures
Supporting infrastructure that is needed by the refugees is as follow:
a. Refugees need a clean water supply. The place at least close to clean water
source or water supply and any equipment that can be used by the refugees
to collect, store, and use the clean water;
b. Refugees need fine sanitation. The need bathroom and toilet that is adequate.
The location of the bathroom and toilet should be accessible and easy for
refugees to use the facility;
c. The place for refugees needs lighting at night. This help to make the refuges
feel secure and safe, especially for vulnerable people such as children,
women, and elders;
d. Refuges also need a good health care. In this case, disaster often causes a
great impact to the people health. It can be directly impact the people such as
wounds, injuries and psychological trauma as well as indirect impact to the
people such as increasing of infectious diseases, malnutrition and other
chronic diseases;
e. Security is really needed in order to keep the place secure;
f. Education is needed for the refuges if the disaster long last. Teachers are
needed to help refuges to study.
g. They need a Religious Place
h. The refuges place is dependent on social service. This service related to the
administration and management of refuge.
4. Easy accesses for the transportations
Refuges place is dependent on the easy accesses of transportation to fulfill their
need and the health care provider.
5. Telecommunication accesses
One of the important things in management disaster is communication to make
coordination. The tools can be HT, phone and etc. It’s really helpful to
coordinate in management disaster.
6. Fulfill the needs of refuges
a. Water and sanitation
Clean water is needed during the disaster. Many refuges can get sick because
of unclean water which causes infection.
b. Food and nutrition
Nutrition is one of the factors that affect the health of refuges. Therefore, the
nutrition of those people have to be fulfilled especially those for children,
elderly, pregnant and lactating mother.
c. Clothing and sleeping equipment
We need to provide clothing and sleeping equipments because the people
that are evacuated often don’t bring any of their goods such as clothes or
bed. Refuges need clothes and blankets. For baby they have special needs
such as diapers.
d. Cooking and eating equipments
If the evacuated people long last in the refuges place, preferably every
family has its own cook equipment so that they can cook their own food and
drinking water. Because the volunteers can’t keep feeding them all the time.
e. Personal hygiene
They need to maintain their personal hygiene. With this they can prevent
diseases usually caused by microorganism. Personal needs such as soal,
shampoo, toothbrush, toothpaste, and towel is important. For women there is
also a special needs such as sanitary napkins. Also diapers for baby.
2.2.5 The Classification of the Status of Volcano
There are four status for active volcanoes.
1. NORMAL status (Normal)
Meaning:
1. No symptoms magma pressure activity
2. Basic activities level
Actions:
1. Observation routine
2. Survey and investigation
2. ALERT status (Waspada)
Meaning:
1. There is a rise in activity above the normal level
2. Increased seismic activity and other volcanic events
3. Slight changes in activity caused by magma activity, tectonic and hydrothermal
Actions:
1. Extension / socialization
2. The hazard assessment
3. Checking needs
4. Implementation of limited picket
3. STANDBY status (Siaga)
Meaning:
1. All the data show that activity can immediately proceed to the eruption or lead
to
circumstances that can lead to disaster.
2. Increased intensive seismic activity.
3. If the upward trend continues, an eruption could occur within 2 weeks.
Action:
1. Socialization in regions threatened
2. Prepare emergency need
3. Daily coordination
4. Full picket
4. CAUTION Status (Awas)
Meaning:
1. Indicates volcano erupting or soon or there is a critical situation catastrophic.
2. The opening began with the eruption of ash and smoke.
3. The eruption likely to occur within 24 hours.
Actions:
1. The area endangered recommended to be emptied.
2. Coordination is done on daily
3. Full Picket
2.2.6 Determination The Status Of Disaster Emergency On A National Scale And
Local
Scale
Definition for disaster scale is a condition in a place that was devastated by a
certain type of disaster and assessed based on the number of victims, loss of property,
damage to infrastructure and facilities, coverage areas and socio-economic impacts,
which can be divided into local, regional and national levels. Disaster status divides
into disaster mild, moderate and severe according those indicators. Determination the
status of disaster emergency on a national scale carried out by the President, the scale
of the province by the governor, and district / municipality level by the Regent /
Mayor. Provisions for determination of the status and level of disaster regulated by
Presidential Regulation or known as Peraturan Presiden (PP). Also in Law No.24 /
2007 on Disaster Management, Article 7 (2) mentioned determination of the status
and level of national and local disaster loading indicator number of victims, loss of
property, damage to infrastructure, coverage of the affected area, and socio-economic
impacts posed.
In the Draft of Presidential Regulation, a local disaster (district / city) is this
disaster raises the death toll of less than 100 people, a loss of less than USD 1 billion,
the coverage area of less than 10 km2, the local government is still able to handle
based on human resources, financial resources and the government is still running .
Provincial disaster is a disaster that causes the number of victims is less than 500
people, a loss of less than Rp 1 trillion, the coverage area of more than one district /
city, the provincial government is still running. Meanwhile, the National Disaster
victims indicator of more than 500 people, the loss of more than Rp 1 trillion, its
scope several districts / cities of more than one province, and the provincial and
district government was not able to cope.
Regent / Mayor becomes primary responsibility in disaster management in
their region. Governor with all available resources to provide assistance to districts /
cities affected. Neighboring areas to provide assistance to the affected areas. Central
Government provide assistance that is not owned by the regional extremes, both
managerial, financing, logistics and equipment, and administration. So the local
government has a great responsibility because the authorities regulate the area and its
people with all the authority under existing rules.
In Indonesia, the President declared a national disaster only once, during the
tsunami in Aceh in 2004. The victims at that time is more than 200,000 people dead
and missing. Loss of more than Rp 49 trillion and district government and the
provincial government of Aceh and North Sumatra paralyzed at that time. Based on
historical records in BNPB disaster, only the tsunami disaster in 2004, which declared
the President as a national disaster. There were no other disasters that are classified as
national disasters or no determination of the President of the national disaster.
Karhutla smoke from the disaster of 1997 which affects 47.6 million people are
exposed to, 4.5 million hectares of forest were burned, and economic losses reached
Rp 57.6 trillion. Yogya earthquake in 2006 caused loss of 5,716 people died, a loss of
Rp 29 trillion, and the impact on the provinces of Yogyakarta and Central Java. West
Sumatra earthquake in 2009 caused loss of 1,117 lives, damage in 9 districts / cities,
and a loss of Rp 21 trillion. The eruption of Mount Merapi in 2010 caused fatalities
386 people were killed, four counties and 2 provinces affected, displaced 0.5 million
and a loss of Rp 3.56 trillion.
2.3. Problem Analysis
Management disaster can be divided into 3 phases, pre disaster, during disaster and
post disaster. During the pre disaster we can reduce/minimize the impact of the disaster
(mitigation). We can make a plan that is quite flexible so when the disaster gets worse
they can easily change according to the situation. We can educate the people what to
prepare during the disaster and how to survive. We can also contact/call for help from
government such as the village leaders, SAR, Police, TNI or any other government
institutions that can be helpful to management disaster. Beside government institutions,
we can also call the nearest hospital, media and recruiting volunteers.
During disaster phase, we make sure that everything on the right track and everyone
knows the job. So then we form some posts such as commando post, evacuation post,
health care post, logistic post and general kitchen post. The government institution like
SAR, TNI, etc helps to evacuate the people to the evacuation area. We can use the public
facilities like church, mosques, etc as the evacuation area as long as it big enough to fit
the people. The health care post with the medical team groups the victims use triage
(green, yellow, red and black). Also health care post helps to cure the victims. The
general kitchen post helps to feed the people in the evacuation area. The logistic team
makes sure everyone can get what they need like bed, diapers for baby, etc. Vulnerable
groups such as elderly, pregnant women and children need more attention during this
phase.
After the disaster happened, we come to the post disaster phase those we trying to
recover the place and the victims. Psychiatrists are needed to recover the mental trauma
victims. Beside that we also have to recover the environment and sanitation, improve the
health care facilities and function.
2.4. Final Hypothesis
2.5. Final Mind Mapping
2.6. Group Opinion
In this scenario, a doctor of public health center (Puskesmas) was ordered to plan a
disaster management coordination. The doctor should communicate with other institution
asking for help and also be able to plan the disaster management with existing sources.
The doctor should knows the characteristic of the disaster area. Those are include
geographical conditions, the amount and characteristic of population, how many people
which can help doctor, how many buildings can be used as an evacuation post, etc.
The doctor should communicate with other institution, such as BMKG (to know the
condition of eruption), BPBD and TNI (asking for help in management disaster), Local
Government (asking for logistic in refuge place), Public Health Office (Dinas Kesehatan)
asking for help of health services inrefuge place, medicines, mask for villagers, etc).
The first step, doctor should coordinate with the leader of village to inform that there
are going to be a volcano eruption and it harms the village. There will be an evacuation
and the leader of village should gather villagers in public area, such as mosque, church,
Polindes, Pustu, or other public facilitation. In evacuating the villagers, we should know
where the safe area is, how long the time we have until the volcano eruption, the
evacuation route, and what transportation can be used.
The next step, we should prepare the refuge place. Include the resting place (using the
public facilitation, mosque, church, etc), refuge place, we should doing a suveillance.
Finally is evaluate the disaster management.
2.7. Obstacle
- The communication in online discussion is not effective
- The answer our questions from pbl came late
- Limited synchronous literature
- In online discussion, the response of a member in a long time
- Few friends that understand to determine the management disaster to this scenario
2.8. Conclusion
In this case, as a doctor who have been given the task to plan disaster management of
mountain Z’s eruption, will need help from governnment officials and its institutions
such as BMKG, BNPD, SAR, TNI, local hospitals, and so on to provide man power,
transportation, informations regarding the mountain, security, facilities and provision for
the villagers. With the help of mass media, we can also start recruiting volunteers and
collecting donations. As an early step for Pre-disaster management, we should consult
with village chief regarding the mountain activity, the dangers, and evacuation planning.
The doctor should also learn and consult with other institutions about field data such as
geographical condition, population data, danger zones mapping, transportation routes,
and evaluate resources such as public facilities or nearby safe villages. With help from
hospital and government officials we can start bringing logistics to help villagers in need
such as protective masks and medicines to prevent unnecessary injuries. Start evacuating
the villagers to the outposts and safe places, we can use public facilities, such as mosque,
church, etc. Set up outposts if needed such as commando post, evacuation post, health
care post, logistic post and general kitchen post to fulfill the villager’s needs. Make
flexible plan for disaster phase, and pasca-disaster phase, including education to the
villagers for possible disaster outcomes just in case the disaster happens and gets worse.