Family and Disaster Preparedness

When disaster strikes it will greatly impact the family life. The impact itself will take from in the separation of the family members, disability, death, relationship tension, reduced of coping mechanism, and family conflict. According to the north Carolina Cooperative Extension, think and plan before a disaster usually helps family members react wisely to the emergency. Familes should work together to identity and collect the resources which are needed to meet basic needs during and after disaster. When people feel prepared, they cope better.

Big number of corpse from disaster and the risk of communicable desease

Death due to natural disaster is generally caused by dull trauma. Big number of corpse within short period in disaster area can cause fear of epidemic, however there is not any proof yet declaring that those corpse increase the risk of post-disater epidemic. When death occurs immediately after disaster, the human corpse does not cause epidemic. The infection sources are usually from the survivor than those who died due to disaster. Death due to communicable disease, pathogen organism could not survive in a dead body except on some cases that needs special treatment such as death due to cholera or dengue.

How does individual respond to a disaster

1. Immediate individual response ( 24 hours ) Following disater :

• Tense, worried, panic
• Glued, absent-minded, shocked, do not believe it
• Happy or euphoria,
• Tired, confused
• Anxious, crying, isolated, withdrawal
• Feel guilty

2. First until third week post disaster

• Worried, alert, sensitive, easily angry, difficult to sleep
• worried, very sad
• Re-experiencing the event
• Sad
• Remaining positive reactions: expect or think about future, involved activities for help and relief

3. More than three weeks after the disaster
Reaction shown can be permanent and it is indicated with :

• Tired
• Feel Panic
• Continuous sadness, pessimistic and unrealistic thinking
• Do not conduct activities, isolated and withdrawal
• Anxiety which is indicated with physical signs such as palpitations, dizzy, tired, queasy, headache, etc.

4. Response after disaster within the period of more than three weeks

• Some survivors can get acute mental disorder. This may occur from few weeks to several months following the disaster
• Form or disorder includes : acute reaction to stress, sorrow and grieve, diagnosed mental disorder, adaptation disorder
  

Post disaster activity includes recovery

Post disaster activity includes recovery, rehabilitation and reconstruntion.

Activity on post disaster stages aims the recovery process of the effected community by re-functioning the facilities and infrastructures as it was. At this stage we must consider that rehabilitation and reconstruction should fulfill the disaster principles; physical rehabilitation is a must but psychological rehabilitation such as fear, trauma or depression has to be handled also.

Besides that, disaster will effect cruelly the most vulnerable groups like children, women, the elderly and people with physical limitations who need particular attention. Disaster will also give tremendous impact on the health of effected areas. Number of communicable diseases may increase, particularly infectious disease caused by water and soil. In addition, increasing cases of mental illness can be observed. therefore, the comprehensive and sustainable approaches are needed to cope with physical health ( free from physical illness ) and mental health.

Living in vulnerable areas should give us some pressure that we should prepare for such disasters as well as possible. Good and sustainable planning also will make us think rationally in facing disaster situation. This thinking enables to minimize victims and other possible impacts. The community and government need to fully aware that we live in prone area, therefore disaster may srike anytime, suddenly. Disaster mitigation or risk reduction and its anticipative actions are absolute to live side by side with disasters. It also takes strong political will of government to prioritize disaster mitigation program by conducting risk assessment, early warning and preparedness to face disaster and other socialization activities to the community.

Deseases relate to population density

Measles, the increasing risk of measles case on post-disaster depends on the measles immunisation coverage of the inhabitants, especially to children under age 15. A dense living environment condition such as refuge area may enable the spread of measles. To prevent the epidemic not to occur it take higher measles immunisation coverage. After the tsunami, 35 measles cases were found in North Aceh and continued sporadic cases all over Aceh area although mass immunisation campaign had been conducted.

Meningitis, caused by Neisseria meningitidis and spread from human to human, especially in a dense living environment. Many cases and deaths caused by meningitis as reported occurred to refugees in Aceh after tsunami; however accurate prophylaxis antibiotic treatment may hamper the spread.

Acute Respiratory Infection ( ARI ) is a disease that often causes high number of sickness and death to refugees, especially children under age 5. Poor acces to health service and insufficient availability of antibiotic can increase the mortality risk caused by ARI. The risk factor to refugees may also increase due to the circumstances; they generally saty in a dense living environment, contaminated by smoke and dust, sleep in a same room and have bad nutrition. As reported that SARS is the major case and cause the highest death toll to refugees after tsunami in Aceh.

Deseases relate to water

Diarrhoea, may occur due to contaminated water supply and is often reported after flood disaster and in the refuge area. One example is when flood disaster occurred in Bangladesh in 2004. Diarrhoea epidemic was found for more than 17,000 cases at that time. Same thing also happened in West Bengal in 1998 where cholera epidemic caused more than 16,000 cases. The risk of diarrhoea epidemic on post-disaster is higher in developing countries than in developed ones. In Aceh province, Indonesia, rapid health assessment was conducted for inhabitants in the city. 85% of inhabitants who drunk water from unprotected wells suffered diarrhoea in the last two weeks.

Hepatitis A and E, can spread through faecaloral spreading, and relate to poor access to safe water supply and sanitation. Hepatitis A is generally endemic in developing countries. Children are often contaminated yet they may from their immune at young age. So, in area like this, the risk becomes lower. In endemic area, hepatitis E epidemic often occurs after heavy rain or flood. This desease is not generally serious and may heal itself, but for pregnant women the mortality level can increase to 15%. After the tsunami in December 2004 in Aceh, hepatitis A and E cases were found, but fortunately the epidemic did not occur.

Leptospirosis, is a zoonosis desease that can spread through skin contact and mucous membrane with water, humid area or mud that had been contaminated by rat's urine. Flood can help the spreading of this organism and cause epidemic like in Taiwan in 2001.