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NATURAL DISASTERS AND HEALTH PRMOTION Natural disasters are tragic incidents originating from atmospheric, geologic and

hydrologic changes. In recent decades, millions of people have been killed by natural disasters, resulting in economic damages. Natural and complex disasters dramatically increase the mortality and morbidity due to communicable diseases. The major causes of communicable disease in disasters are categorized into four sections: Infections due to contaminated food and water, respiratory infections, vector and insect-borne diseases, and infections due to wounds and injuries. With appropriate intervention, high morbidity and mortality resulting from communicable diseases can be avoided to a great deal. Nurses have unique skills for all aspects of disaster to include assessment, priority setting, collaboration, and addressing of both preventive and acute care needs, thus disaster management includes four phases: prevention (or mitigation), preparedness, response, and recovery.

Prevention (Mitigation) All-hazards mitigation (prevention) is an emergency management term for reducing risks to people and property from natural hazards before they occur. This phase entails public health nurses to be involved with organizing and participating in mass prophylaxis and vaccination campaigns to prevent, treat, or contain a disease (CDC, 2009). Primary prevention in health promotion is an early anticipation to keep diseases from occurring, and protecting oneself from injuries and accidents i.e. keeping people healthy and preventing diseases from taking place. Thus it belongs to this disaster phase. Since mitigation also entails lessening the severity of an

adverse effect, secondary prevention (i.e. the early efforts at detecting and preventing a disease from spreading) belong to this category. Preparedness: This phase for the public health nurse nurses entails identifying and educating these vulnerable populations about what impact the disaster might have on them, including helping them set up a personal preparedness plan. In addition to high-risk individuals in neighborhoods, locations of concern e.g schools, college campuses, residential centers, prisons, and high-rise buildings should be identified (Langan and James, 2005). The nature of primary prevention as described earlier qualifies it also belong to this category.

Response phase: Response phase competencies include conducting a rapid needs assessment, outbreak investigation and surveillance, public health triage, risk communication, and technical skills such as mass dispensing. Recovery competencies include participating in after-action processes, contributing to disaster plan modifications, and coordinating efforts to address the psychosocial and public health impact of the event.

Epidemiological issues for instance include detecting disease outbreak, determining the cause, identifying factors that place people at risk, implementing measures to control the outbreak, and informing the medical and public communities about treatments, health consequences, and preventive measures ( Rotz et al, 2000 ). Thus secondary health prevention is the primary relevant means of health promotion for this stage because it basically seeks to stall or slow down the progress or advancement of an already detected or diagnosed health risk or illness.

Recovery phase: Recovery is about returning to the new normal, a community balance of infrastructure and social welfare that is near the level that it would have had if the event had not occurred (Leonard and Howitt, 2010). The recovery phase is often the hardest part of a disaster. It involves ongoing work beyond the preparedness and the rush to response. Part of the role of the nurses in this phase of disaster is the unintentional injuries associated with post-disaster cleanup creates opportunities for unintentional injury and hazards, including those occurring from falls, contact with live wires, accidents with cutting devices, heart attacks from overexertion and stress, and auto accidents resulting from road conditions and missing traffic controls (e.g., stoplights). Also referrals of advanced or critical health conditions to health professionals or specialist hospitals like mental clinic, orthopedic hospital e.t.c. is expected to continue throughout the recovery phase and as long as the need exists. The role of the nurse in case finding and referral remains critical during this phase. Considering that the fundamental nature of tertiary prevention is to provide guidance to patients with complex or long-term health issues such as fractures, putting rehabilitation programs and patient support groups in place, it belong to this category.

Potential agencies to work with in emergencies include agencies like

The United Nations and its organizations i.e. its Office for the Coordination of Humanitarian Affairs (OCHA) in collaboration with the Inter-Agency Standing Committee (IASC) are responsible for bringing together national and international humanitarian providers to ensure a coherent response to emergencies. It also advocates for people in need, promotes preparedness and prevention and facilitates sustainable solutions.

The International Federation of Red Cross and Red Crescent Societies i.e. The International Federations mission is to improve the lives of vulnerable people by mobilizing the power of humanity.

The International Committee of the Red Cross i.e. It is mandated by the international community to be the guardian and promoter of international humanitarian law, working around the world to provide assistance to people affected by violence.

International non-governmental agencies i.e. they target poor women because, equip them with the proper resources, prevent the spread of HIV, increase their access to clean water and sanitation because women have the power to help whole families and entire communities escape poverty.

National organizations e.g. USAID, easily harness government allocated resources for natural dissasters.

REFERENCES Centers for Disease Control and Prevention : Strategic National Stockpile (SNS) , Atlanta , 2009 a , CDC . Available at http://www. bt.cdc.gov/stockpile/. Accessed February 5, 2010. Langan J C , James D C , editors: Preparing nurses for disaster management , Upper Saddle River, NJ , 2005 , Pearson Prentice Hall . Leonard H B , Howitt A M : Acting in time against disasters: a comprehensive risk-management framework . In Howard K , Michael U , editors: Learning from catastrophes: strategies for reaction and response , Upper Saddle River, NJ , 2010 , Wharton School Publishing.