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Disaster Planning in Public Health Context

The Natural Disaster

My community in Philadelphia, PA, is vulnerable to extremely cold temperatures, floods, and strong winds or minor tornadoes but the city is not usually affected by wild fires and earthquakes. According to the City of Philadelphia (2018), the rates of flooding in Pennsylvania are the highest in the U.S. The most common causes of floods are heavy rains and warm winter temperatures resulting in the melting of snow. The areas located in the low-lying regions or near water sources are at the highest risk of flooding. The types of flooding include riverine (near natural water basins), coastal (originating from storms/hurricanes along Delaware River), and urban flash flooding (affecting underground sewers) (Ryan & Lipper, 2021). Community members can check if their property is located in the Special Flood Hazard Area and decide whether they need to register in the National Flood Insurance Program. In my community, the areas of minimal risk are mixed with floodway zones protected by coastal barrier resources.

Possible health issues that may result from flooding are water-borne diseases (cholera, typhoid fever, leptospirosis), vector-borne diseases (malaria, West Nile Fever, dengue), tetanus (from injury), and mycotoxicosis (mold poisoning). WHO (2021) suggests that water-borne diseases, diarrhea and cholera, occur when drinking water sources are compromised, while leptospirosis is the only epidemic-causing bacterial infection transmitted from contaminated water. Philadelphia is also at a regularly high risk of mosquito-borne diseases which might be increased after flooding, so the measures preventing mosquito breeding should be developed. Mold should be cleaned and prevented via moisture control, and tetanus is rare in the U.S. due to the DTaP (diphteria/tetanus/pertussis) vaccination.

The Nursing Response

The nursing response to flooding should begin with prevention via advocacy to protect the community’s infrastructure and cooperation with national/state governments to develop emergency policies at system level. Disaster preparedness requires rapid personal and professional response, so the nurse needs to have emergency supplies and a clear plan for self-care and flooding relief efforts (Stanhope & Lancaster, 2020). Community-level interventions should focus on the surveillance of the crisis, investigation of disaster-associated diseases, counseling and education for populations at risk. Emergency training and collaboration with interprofessional disaster care teams are important during the preparedness stage to coordinate actions and make sure that the community is capable of managing the disaster. The response stage should begin with the assessment of health risk, injured and victim numbers to ensure reasonable allocation of resources (community level) or request federal support (systems level) to organize shelter. The nurse should conduct epidemiologic surveillance to register the outbreaks of water-borne/vector diseases, and rapid needs assessment to address injuries and stress from ongoing hazards. Finally, during the recovery stage, the nurse needs to establish community psychosocial support and initiate community assessment for vector-borne diseases and mycotoxicosis from flood-affected buildings.

The Office of Emergency Management (OEM) introduced Emergency Operations Plan (EOP) that includes policies and procedures to protect the members of our community and their property in cases of disasters/emergences. The plan follows national and state regulations and contains general principles of disaster response as well as specific recommendations (OEM, 2015). Vulnerable populations, such as children, ethnic minorities, seniors, and people with disabilities, are indicated as requiring special assistance during an emergency. According to the planning assumptions, a disaster may happen at any moment without warning, so individuals should take measures to ensure their safety, while agencies are responsible for accessible emergency services. EOP explains response, short-term/long-term recovery, and mitigation priorities. Flood Risk Management Task Force is the committee specifically working on flood management and mitigation via community-based initiatives. Training and exercise programs are also employed to guarantee effective disaster response, and interagency cooperation is considered vital for centralized support.

The plan is effective and does not require major changes, as it complies with the guidelines by National Incident Management System (NIMS), Incident Command System (ICS), and the Commonwealth of Pennsylvania Emergency Operations Plan. EOP also includes the best practice components described by Stanhope and Lancaster (2020). However, specific algorithms or steps to take in the case of flood might be needed to improve individual response. Community-focused and flood-specific guidelines can help populations at risk practice and learn about flood-associated diseases and determine relevant skills to prepare for the disaster and define their role in the emergency response.

Is My Community Prepared for a Disaster?

The evaluation of the preparedness plan suggests that my community is ready to manage flood and disaster outcomes. Philadelphia has a high risk of floods due to its low-lying location and several major water basins, including Delaware River, affect the city. Local, state, and federal authorities contributed guidelines and resources to develop adequate disaster response in the area. The plan is based on best practices offered in the professional nursing literature and clearly describes all sections of the disaster management cycle, participating agencies, and vulnerable populations. The plan does not clarify the nursing roles or strategies for flood-specific disease treatment, but it indicates the involvement of risk management task forces and interdisciplinary teams assisting in disaster preparedness and response. Individual, public, and hazard mitigation assistance is provided by federal authorities to address the needs of local populations and community. However, individuals need a more detailed action plan with guidance on applying their skills and professional expertise for the benefit of the community during disaster preparedness/response. Overall, the plan offers direction for collaborative efforts of federal/state authorities, agencies, and individuals to ensure safety but does not list specific steps for community members to assist in disaster relief efforts.

References

City of Philadelphia. (2018). Safety & emergency preparedness. City of Philadelphia. Web.

OEM. (2015). Emergency operations plan. Web.

Ryan, J., & Lippert, J. (2021). Top 10 things you should do to prepare for flood-related issues in Philadelphia. City of Philadelphia. Web.

Stanhope, M., & Lancaster, J. (2020). Public health nursing: Population-centered health care in the community (10th ed.). Elsevier.

WHO. (2021). Flooding and communicable diseases fact sheet. WHO. Web.

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ApeGrade. 2022. "Disaster Planning in Public Health Context." September 9, 2022. https://apegrade.com/disaster-planning-in-public-health-context/.

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