Health & Safety

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Contents

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Health Situation Reports

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Health

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Water - Purification

In order to drink the water, you should be prepared to treat it. There are numerous methods of water purification, described below. Please note the use of iodine, which is cheap and freely available. Recommended as a source of emergency water purification.

  • Boiling - Boiling is the most certain way of killing all microorganisms. According to the Wilderness Medical Society, water temperatures above 160° F (70° C) kill all pathogens within 30 minutes and above 185° F (85° C) within a few minutes. So in the time it takes for the water to reach the boiling point (212° F or 100° C) from 160° F (70° C), all pathogens will be killed. No need to keep the water boiling!
  • Cheapest and Easiest Drinking Water - Solar Method (SODIS) and WHO approved - Learn and Teach SODIS POTABLE WATER
  • Water - Purification - Solar Cooking
    • For water safety, maybe use solar cooking, as boiling needs a source of energy which not always will be available. Solar cooks can be built cheaply with available resources, and if done apropriately can be used to warm up water for long enough to kill most germs. Perhaps a bit tricky, but better than nothing, and maybe better than setting up fires. It depends on the location.
    • ORIGINAL SOURCE (Water Purification) and further clarification, contact: Dr Charles Johnson, Emergency Physician, email:Charles@hopeambulance.com
  • General Chemical Treatment Procedures
    • The effectiveness of all chemical treatment of water is related to the temperature, pH level, and clarity of the water. Cloudy water often requires higher concentrations of chemical to disinfect
    • If the water is cloudy or filled with large particles, strain it, using a cloth, before treatment. Large particles, if swallowed, may be purified only "on the outside"
    • Add the chemical to the water and swish it around to aid in dissolving
    • The water should sit for at least 30 minutes after adding the chemical to allow purification to occur. If using tablets, let the water sit for 30 minutes after the tablet has dissolved
    • Chemically treated water can be made to taste better by pouring it back and forth between containers, after it has been adequately treated. Other methods include adding a pinch of salt per quart or adding flavorings (e.g., syrup mix, etc.) after the chemical treatment period
    • Additional Water Help Including Bleach Method - Emergency Disinfection of Drinking Water
  • Iodine Treatment
    • Iodine is light sensitive and must always be stored in a dark bottle. Iodine has been shown to be more effect than chlorine-based treatments in inactivating cysts. Let water stand for at least 30 minutes before use. Generally, the procedure is as follows:
      • Iodine Preparations
      • Preparation Iodine => Amount/Liter
      • Iodine Topical Solution 2% = 8 drops per liter
      • Iodine Tincture 2% = 8 drops per liter
      • Lugol's Solution 5% = 4 drops per liter
      • Povidone-Iodine (Betadine®) 10% = 4 drops per liter
  • Chlorine Treatment
    • Free chlorine is the most widely and easily used, and the most affordable of the drinking water disinfectants. It is also highly effective against nearly all waterborne pathogens (except Cryptosporidium parvum oocysts and Mycobacteria species). At doses of a few mg/litre and contact times of about 30 minutes, free chlorine generally inactivates >99.99% of enteric bacteria and viruses.
    • For point-of-use or household water treatment, the most practical forms of free chlorine are liquid sodium hypochlorite, solid calcium hypochlorite and bleaching powder (chloride of lime; a mixture of calcium hydroxide, calcium chloride and calcium hypochlorite).
    • The amount of chlorine needed depends mainly on the concentration of organic matter in the water and has to be determined for each situation. After 30 minutes, the residual concentration of active chlorine in the water should be between 0.2-0.5 mg/l, which can be determined using a special test kit.
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Water - Sanitation Management in Disasters Resources

Most are PDF files with illustrations which can be downloaded and print outs given to teams for training and to teams heading for relief work in affected areas

May be helpful but written for East Coast USA

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Disease - Prevention

From Center for Disease Control - USA

  • Clean hands save lives. How to do it:

HOW TO WASH YOUR HANDS

  • Universal Precautions

Protect yourself while helping others (scroll down for information) Universal Precautions

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Sanitation in Disasters Resources

Simple summary: do not let people go to the bathroom wherever they want! Urine is relatively harmless but feces are not! Feces spread disease and must be properly disposed of.

Small groups can improvise a toilet with a five gallon bucket, a plastic bag and a bit of bleach. Avoid urination in this bucket to extend its usefulness.

Larger groups MUST designate a latrine area with porta-potties, trenches, whatever field expedients you can find PLUS handwashing facilities! The latter can be as simple as non-potable water in a hanging bucket with whatever soap can be found.

Injured, ill and sick people may have to be helped to defecate in bedpans, and the bedpans taken to the latrine area.

FAILURE TO WASH HANDS AFTER DEFECATION IS A MAJOR DISEASE OUTBREAK VECTOR.

Most are PDF files with illustrations which can be downloaded and printouts given to teams for training and to teams heading for relief work in affected areas

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Dead Bodies - Information on Handling

  • Possible risks with handling dead bodies
    • Exposure to bloodborne viruses occurs due to direct contact with non-intact skin of blood or body fluid, injury from bone fragments and needles, or exposure to the mucous membranes from splashing of blood or body fluid
    • Gastrointestinal infections are more common as dead bodies commonly leak faeces. Transmission occurs via the faeco-oral route through direct contact with the body and soiled clothes or contaminated vehicles or equipment. Dead bodies contaminating the water supply may also cause gastrointestinal infections
  • Precautions to be used by all persons working with bodies
    • Vinyl or Latex gloves should be worn
    • Masks and protective eyewear or face shields should be worn during procedures that are likely to generate droplets of blood or other body fluids to prevent exposure of mucous membranes of the mouth, nose, and eyes
    • Gowns or aprons should be worn during procedures that are likely to generate splashes of blood or other body fluids.
    • Hands and other skin surfaces should be washed immediately and thoroughly if contaminated with blood or other body fluids. Hands should be washed immediately after gloves are removed.
    • Graveyards should be at least 30m from groundwater sources used for drinking water
    • The bottom of any grave must be at least 1.5m above the water table with a 0.7m unsaturated zone. **Surface water from graveyards must not enter inhabited areas.
    • Ensure universal precautions for blood and body fluids
    • Ensure use of body bags
    • Ensure disinfection of vehicles and equipment
    • Bodies do not need to be disinfected before disposal (except in case of cholera)
    • Vaccinate workers against hepatitis B
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Disease

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Disease Surveillance

  • In disease surveillance following are important
    • a network (perhaps a hierarchy with some extra confirmation points) of trusted sources
    • case definitions (are we counting deaths, diseased, people at risk? do we count those with diarrea? do we need to define "fever"?)
    • needed data (do we need the age of the people with that disease? or just the numbers? what do we need to know?)
    • ways to communicate the data to the people who count up the numbers
    • ways to spread the information to people who can do practical things
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Tetanus

[http://www.bt.cdc.gov/disasters/hurricanes/katrina/tetanus.asp Tetanus Prevention


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Acute Kidney Failure
  • A frequent problem in land-based earthquakes is kidney failure from crush injuries and/or dehydration. The recent tsunami, by disrupting drinking water supplies, will also cause acute kidney failure due to dehydration.
    • Acute kidney failure normally requires kidney dialysis. Machines for blood-based dialysis ("hemodialysis"), or supplies for peritoneal dialysis can be quite scarce in areas devastated by the tsunami.
    • A new treatment which has been successful in pilot clinical trials in both adults and infants involves the use of an already existing medicine infused intravenously into the survivor's arm. For details: dwmoskowitz@genomed.com
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Safety

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Earthquake - Safety Tips

SAFETY TIPS BY THE MALAYSIA CIVIL DEFENCE FORCE >> The Malaysia Civil Defence Force has issued some advice on what you should do when a tremor occurs.

  • If you are indoors, do not rush for the exit as it may start a stampede; instead, take cover under the table or against interior walls.
  • Stay away from windows, shelves or fixtures that could fall and hurt you.
  • Do not use candles, matches or other naked flames as there may be gas leaks.
  • If your are outdoors, stay away from buildings and overhead electrical cables; remain in the open until the tremor stops.
  • If you are driving, stop quickly and stay in the vehicle. However avoid stopping near or under buildings, trees, bridges, overpasses or electrical cables.
  • After the tremor has stopped, do not touch damaged electrical wiring. Report any gas leaks.
  • Call the police, if anyone has been injured, then check your home for structural defects and alert the relevant authorities.
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Disaster Reduction

*Disaster Reduction Practitioner's Guide (Pdf format)
  • [ttp://www.usaid.gov./our_work/humanitarian_assistance/disaster_assistance/resources/pdf/fog_v3.pdf Field Operations Guide for Disaster Assessment and Response](Pdf format)
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Standards: Humanitarian Assistance

Sphere Handbook. Sphere Humanitarian Charter and Minimum Standards in Disaster Response sets out what people affected by disasters have a right to expect from humanitarian assistance. Launched by Red Cross and Red Crescent, it lays down minimum standards to be attained in disaster assistance in water supply and sanitation, nutrition, food aid, shelter and health services.

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Links

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NonEnglish references

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