Alternative Communication System During Disaster Case Study

If you ask a person who has been through a natural disaster, you will find out how difficult it is to establish communication immediately after. Usually power is down and landline communications are interrupted due to tower loss and other technical difficulties. Even though we live in an extremely technological era, an alternative communication system during disaster is an absolute necessity in such times. Rescue teams use these systems to get in touch with people who have been isolated and families get to find out about their loved ones.

Sometimes multiple disasters strike at the same time or at a short time difference like it happened in Virginia in 2011. People living here had to endure destructive tornadoes, the Tropical Storm Lee, Hurricane Irene and a 5.8 magnitude earthquake. It certainly seemed like God had a problem with that particular spot on Earth and people who were there know that in the minutes and days after everything calmed down it was very difficult to contact the authorities or to call their region emergency number.

We are used to be able to communicate at every given moment in time, with people who live thousands of miles away from our location which is why the need of an alternative communication system during disaster may seem obsolete and unnecessary. We often forget that our communication technology runs on power and it needs signal towers in order to reach the recipient device.

Communication is very important in our day-to-day life but it becomes crucial during and after a disaster. People need to let their loved ones know that they are safe and that all their family members are safe as well. Also, there are situations when family members get separated.

We all have to admit that earthquakes, storms, tornadoes, and all other natural disasters are frightening and extremely impressive. Mother Nature’s unleashed fury makes people panic and lose their calm and sometimes families get separated in a stampede. That’s why it is extremely important that everyone knows what to do in case this happens and how to get in touch as soon as they are safe.

How to communicate during a natural disaster?

Natural disaster preparation is very important and it has to be done in advance especially when it comes to communication. You need to prepare a communication system that will hold during disaster. For example, if you have Voice over IP (VoIP) that will definitely won’t work.

  • Make sure you know what type of landline phone service you are using. The modern ones need power to work and if there is a power loss it, obviously, won’t work. Most phone companies gave up their copper wiring and that’s why you have to make sure that your phone will work even in extreme cases. You can contact your phone company and ask them what type of landline you have.
  • If you have a battery operated phone or one that has a back-up system that works with batteries your problem is solved. If you don’t have one, ask your service provider if it can deliver one. Also make sure that the batteries are charged and keep a spare in the house for emergency cases. Check them periodically to make sure everything is in order. You wouldn’t want to find yourself in the middle of a hurricane, with a battery operated phone, and no usable batteries.
  • Make sure your cellular phone is charged and an extra battery wouldn’t hurt. In case wireless connection still works after a natural disaster, you may need to use the phone many times.
  • There are situations when the power goes off but secure Wi-Fi is still available so you can get online and read news about the disaster or send e-mails and chat with loved ones. That’s why it is important to charge your tablet and your laptop too. In case of need, you can recharge your phone battery from your laptop using an USB cable.
  • A simple radio device can save lives. So if you have one, regardless of its power source (battery, solar or hand-cranked) you must keep it close. News agencies and radio channels broadcast during a natural disaster in order to keep people informed. This way you know if the danger is over or if you should continue to stay in the shelter. Also, you can find out news about missing persons and other emergencies. One great product is the Ambient Weather WR111-B because it has NOAA specific channels. If you want to check out more models like this one, take a look at our reviews on best emergency radios.
  • If there is a natural disaster and you still get network and Internet, don’t occupy the line with voice calls unless you have an emergency. During times like this people need to call emergency services and lines become extremely crowded. If you have service and Internet send a text or an e-mail to your loved ones and leave the voice line free.
  • Try to conserve your battery phone by activating a profile that is less consuming. Dim your screen brightness and don’t stay online unless you absolutely need to. You never know for how long the power is going to be down and you don’t want to end up with a dead phone in the middle of an emergency. You can actually turn your phone off if you don’t manage to get service and there are no bars. Seeking for signal is a pretty consuming activity for your battery’s phone.
  • Make sure you’re not crowding the network. If you want to redial a number wait at least 10 seconds. Constant redialing in short periods of time may increase network congestion and this way no one gets to make a call.
  • Don’t try to call the emergency line if you don’t have an emergency. Usually, in case of disaster, authorities create special lines for non-emergencies where you can call and find out information.
  • If you have a landline at home that supports call forwarding you should consider forwarding calls to your smartphone. This way, even if you have to evacuate you can take on calls from your home.
  • In case the power is down and your smartphone just died you can charge it from your car if you have a car charger.

As you can see, a communication system during disaster is extremely important and if you are lucky enough to have a working phone don’t waste it’s battery on activities that are not important like games and watching videos.

Other types of emergency communication systems

Mobile phones, landlines, tablets, and laptops represent our main way of communication these days. If you are lucky, these devices may help you get through a natural disaster, by offering you the possibility to stay in touch with friends and family or to get in touch with authorities and rescue teams.

See also:How to Choose The Best Emergency Whistle for Your Needs

Still, there are many situations when traditional and modern communications failed all together leaving isolated people at the mercy of chance. That’s why an alternative communication system is absolutely necessary in a shelter or a place where people gather waiting to pass the natural disaster safely. If you have one at home is even better but if not, you need to know where the closest one is in case you need to get in touch with rescue teams.

The best Emergency Communication System or ECS must have the following attributes:

  • Time efficiency and speed – when a catastrophe takes place, people need to take immediate action. In order for this to happen they must be informed in time about emergencies and bad situations. That’s why a good ECS must be able to transmit clear information in a very fast manner;
  • Affordability – people would never invest their money in an expensive ECS unless they want to join a rescue team (and maybe not even then). A good communication system must be affordable for the large public in order to be useful. In an emergency situation, it’s no help to know that there is a very good, high-tech ECS on the market when you don’t own one.
  • Everyone can use it – let’s say that you made the investment and bought the latest ECS on the market but you didn’t have the time to read the manual. Now there are no instructions and you can’t figure it out how to use it. A good ECS must be intuitive and easy to use.
  • Sender and receiver – When in an emergency situation, one needs not only to send out notifications but also to receive instructions via the ECS. We know that this may seem totally outdated, given the era we live in, but some early ECS only had the ability to send out emergency notifications.

Solution #1 – using radio waves

Radio waves are transmitted based on Earth’s ionosphere which makes them the perfect candidate when it comes to communicating during the worst scenarios of natural disasters. The only disadvantage might be the fact that most of them operate on power but they also have back-up systems using batteries or solar power.

There are three types of devices one can use to contact first responders:

  1. Short-wave radio which can be used to transmit messages to anyone who has the required equipment to receive. Given the fact that this is a long rage communication system via radio waves, it can be the device that saves many lives when there’s nothing else around.
  2. Weather radio is the device you want to have around during tornado or hurricane season. This device turns on automatically when there is an emergency broadcast letting everyone know there is a bad weather alert.
  3. Two-way radio operates on a several miles range and consists of two devices capable to send and receive messages. They are quite small and very easy to use which is why first responders prefer to have them in their kit. A list of such devices can be found in our detailed article about the best walkie talkie, with the best range.

These are the main radio equipment that can help you during a difficult time such as natural disasters. It’s better to have at least one of them even if you own mobile phone. In case your phone doesn’t work, a radio will definitely save the day.

Solution #2 – public devices

As you can imagine, there are two types of ECS according to their owner: public and private. The private ones are the ones we’ve already discussed: mobile phones, radio devices, tablets, laptops and so on. They are destined to be used by one single person.

Public devices are meant to warn as many people as possible at the same time using visual and/or audio signals. Thus, we have:

  • Digital electronic sign on LEDs you find on public advertisement panels, subway notification panels, and so on;
  • Electronic signage using LCD TVs and monitors in public spaces like hospitals, bars, coffee shops, stores, and so on;
  • Giant voice systems that are usually on public buildings used to announce people in the close vicinity to take cover.

Another public alternative communication system during disaster is the media (television, newspapers, online publications, and radio broadcasting) but if you want to alert the population about an immediate danger, the systems enumerated above are more effective.

Solution #3 – satellite communication system

Catastrophic events such as hurricanes, earthquakes, floods and/or fire are usually followed by general madness and the lack of a working communication system makes things even worse.

So, when landlines and power are down and no modern or traditional system is working satellites are fine and continue their safe journey in orbiting the planet. This allows rescue teams and emergency responders to meet immediate communication needs, using satellites and satellite systems. This type of communication is used mostly by humanitarian organizations and first responders who are usually present at big, catastrophic events like Haiti.

There are a few examples that prove how fragile a terrestrial communication structure is. Communication towers usually get destroyed during these kinds of situations leaving people in the dark without any possibility of contacting the authorities and asking for help. This is what happened when:

  • Hurricane Katrina hit New Orleans;
  • A devastating earthquake hit Pakistan;
  • Japan was also hit by a powerful earthquake in 2011.

After these events and many like these, the importance of a wireless communication system that is not based on a terrestrial structure increased for local governments and authorities. This is where satellite communication entered the scene. They present a series of advantages towards terrestrial communication but the most important advantage is the fact that they work while floating around our planet where no wind, water or fire can reach them.

There are two main types of satellite communication that someone could use in case of emergency: Geostationary Satellite Systems (GEO) and Low Earth Orbit Satellites (LEO).

GEO support a full range of communication services like voice, broadband data and video and they are located at 36.000 km above our planet. They sit in a fixed position and usually are owned by a country or an organization responding to special (fixed or mobile) equipment located on Earth (antennas and mobile terminals). They are not just an alternative communication system during disaster they are also very useful at warning people about seismic activity that could transform in a catastrophic situation and floods.

Also, governments can broadcast warnings and keep the general flow of information during difficult times. At this moment, there are about 300 commercial GEOs floating above our heads, outside the terrestrial atmosphere.

LEOs are (as the name specifies) situated on the low orbits between 780 and 1500 km and they are used to deliver low speed data and voice. They are easier to contact using a mobile unit, the size of a cellular phone. The fact that terrestrial units are so easy to carry allows rescue team to use these satellites in any situation.

Satellite communication in case of natural disasters only works if local authorities, humanitarian organizations and first responders prepare in advance. They need to know the area and what type of satellite units they are going to need. There are four main types:

  1. Handheld – phone satellites that work using a mobile satellite provider. This type of device is affordable and very intuitive to use. Also they respect the first condition of a good ECS, they can send and receive messages at incredible speed.
  2. Terminals for communications on the move – a slightly bigger equipment that is usually operated from inside a car (you’ll need one to transport it). This type of device is required for extra high speed communications that require broadband data and video communication.
  3. Fixed satellite communications – big equipment that are best to be installed before the disaster strikes, in an area near the endangered zone. These devices are required for a longer period of time and they support all kinds of applications (pre-disaster analysis and environmental scanning) and data sent and received at tremendous speeds.
  4. Portable devices equipped with GPS technology – while it won’t give you the possibility to get in touch with the authorities, it will give you your precise location and make it easier for you to reach areas where you know you may get help.

Our friends from My Outdoors Life did create a great list of best satellite phones – check it out here.

Are you really prepared?

As you can see, according to the type of communication required there are some preparations that have to be done in advance, like:

  • choosing the satellite provider and applying for a submission;
  • selecting the necessary bandwidth;
  • selecting the type of device you will need;
  • installing the device and selecting the team that will work with them.

Like everything else, when it comes to a natural disaster, finding the right alternative communication system requires preparation in advance. Every person must be aware of the fact that disasters are called this way because they tend to flatten everything down in their way starting with houses, cars, trees and ending up with communication towers. If this happens you can’t rely on traditional systems to alert authorities and rescue teams – you must have an alternative.

Check out our informative article tackling emergency communications plans to get you prepared for anything.

Abstract

Background:

On August 6, 2010, in the dark of the midnight, there were flash floods due to cloud burst in Leh in Ladakh region of North India. It rained 14 inches in 2 hours, causing loss of human life and destruction. The civil hospital of Leh was badly damaged and rendered dysfunctional. Search and rescue operations were launched by the Indian Army immediately after the disaster. The injured and the dead were shifted to Army Hospital, Leh, and mass casualty management was started by the army doctors while relief work was mounted by the army and civil administration.

Objective:

The present study was done to document disaster management strategies and approaches and to assesses the impact of flash floods on human lives, health hazards, and future implications of a natural disaster.

Materials and Methods:

The approach used was both quantitative as well as qualitative. It included data collection from the primary sources of the district collectorate, interviews with the district civil administration, health officials, and army officials who organized rescue operations, restoration of communication and transport, mass casualty management, and informal discussions with local residents.

Results:

234 persons died and over 800 were reported missing. Almost half of the people who died were local residents (49.6%) and foreigners (10.2%). Age-wise analysis of the deaths shows that the majority of deaths were reported in the age group of 25–50 years, accounting for 44.4% of deaths, followed by the 11–25-year age group with 22.2% deaths. The gender analysis showed that 61.5% were males and 38.5% were females. A further analysis showed that more females died in the age groups <10 years and ≥50 years.

Conclusions:

Disaster preparedness is critical, particularly in natural disasters. The Army's immediate search, rescue, and relief operations and mass casualty management effectively and efficiently mitigated the impact of flash floods, and restored normal life.

Keywords: Disaster management, humanitarian assistance, mass casualty management

Introduction

In the midnight of August 6, 2010, Leh in Ladakh region of North India received a heavy downpour. The cloud burst occurred all of a sudden that caught everyone unawares. Within a short span of about 2 h, it recorded a rainfall of 14 inches. There were flash floods, and the Indus River and its tributaries and waterways were overflowing. As many as 234 people were killed, 800 were injured, and many went missing, perhaps washed away with the gorging rivers and waterways. There was vast destruction all around. Over 1000 houses collapsed. Men, women, and children were buried under the debris. The local communication networks and transport services were severely affected. The main telephone exchange and mobile network system (BSNL), which was the lifeline in the far-flung parts of the region, was completely destroyed. Leh airport was flooded and the runway was covered with debris, making it non-functional. Road transport was badly disrupted as roads were washed away and blocked with debris at many places. The civil medical and health facilities were also severely affected, as the lone district civil hospital was flooded and filled with debris.

Materials and Methods

The present case study is based on the authors’ own experience of managing a natural disaster caused by the flash floods. The paper presents a firsthand description of a disaster and its prompt management. The data was collected from the records of the district civil administration, the civil hospital, and the Army Hospital, Leh. The approach used was both quantitative as well as qualitative. It included data collection from the primary sources of the district collectorate, interviews with the district civil administration and army officials who organized rescue operations, restoration of communication, and transport, mass casualty management, and informal discussions with local residents.

Disaster management strategies

Three core disaster management strategies were adopted to manage the crisis. These strategies included: i) Response, rescue, and relief operations, ii) Mass casualty management, and iii) Rehabilitation.

Response, rescue, and relief operations

The initial response was carried out immediately by the Government of India. The rescue and relief work was led by the Indian Army, along with the State Government of Jammu and Kashmir, Central Reserve Police Force (CRPF), and Indo-Tibetan Border Police (ITBP). The Indian Army activated the disaster management system immediately, which is always kept in full preparedness as per the standard army protocols and procedures.

There were just two hospitals in the area: the government civil hospital (SNM Hospital) and Army Hospital. During the flash floods, the government civil hospital was flooded and rendered dysfunctional. Although the National Disaster Management Act(1) was in place, with the government civil hospital being under strain, the applicability of the act was hampered. The Army Hospital quickly responded through rescue and relief operations and mass casualty management. By dawn, massive search operations were started with the help of civil authorities and local people. The patients admitted in the civil hospital were evacuated to the Army Hospital, Leh in army helicopters.

The runway of Leh airport was cleared up within a few hours after the disaster so that speedy inflow of supplies could be carried out along with the evacuation of the casualties requiring tertiary level healthcare to the Army Command Hospital in Chandigarh. The work to make the roads operational was started soon after the disaster. The army engineers had started rebuilding the collapsed bridges by the second day. Though the main mobile network was dysfunctional, the other mobile network (Airtel) still worked with limited connectivity in the far-flung areas of the mountains. The army communication system was the main and the only channel of communication for managing and coordinating the rescue and relief operations.

Mass casualty management

All casualties were taken to the Army Hospital, Leh. Severely injured people were evacuated from distant locations by helicopters, directly landing on the helipad of the Army Hospital. In order to reinforce the medical staff, nurses were flown in from the Super Specialty Army Hospital (Research and Referral), New Delhi, to handle the flow of casualties by the third day following the disaster. National Disaster Cell kept medical teams ready in Chandigarh in case they were required. The mortuary of the government civil hospital was still functional where all the dead bodies were taken, while the injured were handled by Army Hospital, Leh.

Army Hospital, Leh converted its auditorium into a crisis expansion ward. The injured started coming in around 0200 hrs on August 6, 2010. They were given first aid and were provided with dry clothes. A majority of the patients had multiple injuries. Those who sustained fractures were evacuated to Army Command Hospital, Chandigarh, by the Army's helicopters, after first aid. Healthcare staff from the government civil hospital joined the Army Hospital, Leh to assist them. In the meanwhile, medical equipment and drugs were transferred from the flooded and damaged government civil hospital to one of the nearby buildings where they could receive the casualties. By the third day following the disaster, the operation theatre of the government civil hospital was made functional. Table 1 gives the details of the patients admitted at the Army Hospital.

Table 1

Admissions in the Army Hospital, Leh

The analysis of the data showed that majority of the people who lost their lives were mainly local residents (49.6%). Among the dead, there were 10.3% foreign nationals as well [Table 2]. The age-wise analysis of the deaths showed that the majority of deaths were reported in the age group 26–50 years, accounting for 44.4% of deaths, followed by 11–25 year group with 22.2% deaths.

Table 2

Number of deaths according to status of residence

The gender analysis showed that 61.5% were males among the dead, and 38.5% were females. A further analysis showed that more females died in <10 years and ≥50 years age group, being 62.5% and 57.1%, respectively [Table 3].

Table 3

Age and sex distribution of deaths

Victims who survived the disaster were admitted to the Army Hospital, Leh. Over 90% of them suffered traumatic injuries, with nearly half of them being major traumatic injuries. About 3% suffered from cold injuries and 6.7% as medical emergencies [Table 4].

Table 4

Distribution according to nature of casualty among the hospitalized victims

Rehabilitation

Shelter and relief

Due to flash floods, several houses were destroyed. The families were transferred to tents provided by the Indian Army and government and non-government agencies. The need for permanent shelter for these people emerged as a major task. The Prime Minister of India announced Rs. 100,000 as an ex-gratia to the next of kin of each of those killed, and relief to the injured. Another Rs. 100,000 each would be paid to the next of kin of the deceased from the Chief Minister's Relief Fund of the State Government.

Supply of essential items

The Army maintains an inventory of essential medicines and supplies in readiness as a part of routing emergency preparedness. The essential non-food items were airlifted to the affected areas. These included blankets, tents, gum boots, and clothes. Gloves and masks were provided for the persons who were working to clear the debris from the roads and near the affected buildings.

Water, sanitation, and hygiene

Public Health is seriously threatened in disasters, especially due to lack of water supply and sanitation. People having lost their homes and living in temporary shelters (tents) puts a great strain on water and sanitation facilities. The pumping station was washed away, thus disrupting water supply in the Leh Township. A large number of toilets became non-functional as they were filled with silt, as houses were built at the foothills of the Himalayan Mountains. Temporary arrangements of deep trench latrines were made while the army engineers made field flush latrines for use by the troops.

Water was stagnant and there was the risk of contamination by mud or dead bodies buried in the debris, thus making the quality of drinking water questionable. Therefore, water purification units were installed and established. The National Disaster Response Force (NDRF) airlifted a water storage system (Emergency Rescue Unit), which could provide 11,000 L of pure water. Further, super-chlorination was done at all the water points in the army establishments. To deal with fly menace in the entire area, anti-fly measures were taken up actively and intensely.

Food and nutrition

There was an impending high risk of food shortage and crisis of hunger and malnutrition. The majority of food supply came from the plains and low-lying areas in North India through the major transport routes Leh–Srinagar and Leh–Manali national highways. These routes are non-functional for most part of the winter. The local agricultural and vegetable cultivation has always been scanty due to extreme cold weather. The food supplies took a further setback due to the unpredicted heavy downpour. Food storage facilities were also flooded and washed away. Government agencies, nongovernmental organizations, and the Indian Army immediately established food supply and distribution system in the affected areas from their food stores and airlifting food supplies from other parts of the country.

Health

There was a high risk of water-borne diseases following the disaster. Many human bodies were washed away and suspected to have contaminated water bodies. There was an increased fly menace. There was an urgent need to prevent disease transmission due to contaminated drinking water sources and flies. There was also a need to rehabilitate people who suffered from crush injuries sustained during the disaster. The public health facilities, especially, the primary health centers and sub-health centers, were not adequately equipped and were poorly connected by roads to the main city of Leh. Due to difficult accessibility, it took many hours to move casualties from the far-flung areas, worsening the crisis and rescue and relief operations. The population would have a higher risk of mental health problems like post-traumatic stress disorder, deprivation, and depression. Therefore, relief and rehabilitation would include increased awareness of the symptoms of post-traumatic stress disorder and its alleviation through education on developing coping mechanisms.

Economic impact

Although it would be too early to estimate the impact on economy, the economy of the region would be severely affected due to the disaster. The scanty local vegetable and grain cultivation was destroyed by the heavy rains. Many houses were destroyed where people had invested all their savings. Tourism was the main source of income for the local people in the region. The summer season is the peak tourist season in Ladakh and that is when the natural disaster took place. A large number of people came from within India and other countries for trekking in the region. Because of the disaster, tourism was adversely affected. The disaster would have a long-term economic impact as it would take a long time to rebuild the infrastructure and also to build the confidence of the tourists.

The floods put an immense pressure and an economic burden on the local people and would also influence their health-seeking behavior and health expenditure.

Political context

The disaster became a security threat. The area has a high strategic importance, being at the line of control with China and Pakistan. The Indian Army is present in the region to defend the country's borders. The civil administration is with the Leh Autonomous Hill Development Council (LAHDC) under the state government of Jammu and Kashmir.

Conclusions

It is impossible to anticipate natural disasters such as flash floods. However, disaster preparedness plans and protocols in the civil administration and public health systems could be very helpful in rescue and relief and in reducing casualties and adverse impact on the human life and socio economic conditions.(2) However, the health systems in India lack such disaster preparedness plans and training.(3) In the present case, presence of the Indian Army that has standard disaster management plans and protocols for planning, training, and regular drills of the army personnel, logistics and supply, transport, and communication made it possible to immediately mount search, rescue, and relief operations and mass casualty management. Not only the disaster management plans were in readiness, but continuous and regular training and drills of the army personnel in rescue and relief operations, and logistics and communication, could effectively facilitate the disaster management operations.

Effective communication was crucial for effective coordination of rescue and relief operations. The Army's communication system served as an alternative communication channel as the public communication and mobile network was destroyed, and that enabled effective coordination of the disaster operations.

Emergency medical services and healthcare within few hours of the disaster was critical to minimize deaths and disabilities. Preparedness of the Army personnel, especially the medical corps, readiness of inventory of essential medicines and medical supplies, logistics and supply chain, and evacuation of patients as a part of disaster management protocols effectively launched the search, rescue, and relief operations and mass casualty reduction. Continuous and regular training and drills of army personnel, health professionals, and the community in emergency rescue and relief operations are important measures. Emergency drill is a usual practice in the army, which maintains the competence levels of the army personnel. Similar training and drill in civil administration and public health systems in emergency protocols for rescue, relief, mass casualty management, and communication would prove very useful in effective disaster management to save lives and restore health of the people.(2–4)

Lessons learnt and recommendations

Natural disasters not only cause a large-scale displacement of population and loss of life, but also result in loss of property and agricultural crops leading to severe economic burden.(3–6) In various studies,(3,4,7,8) several shortcomings have been observed in disaster response, such as, delayed response, absence of early warning systems, lack of resources for mass evacuation, inadequate coordination among government departments, lack of standard operating procedures for rescue and relief, and lack of storage of essential medicines and supplies.

The disaster management operations by the Indian Army in the natural disaster offered several lessons to learn. The key lessons were:

  • Response time is a critical attribute in effective disaster management. There was no delay in disaster response by the Indian Army. The rescue and relief operations could be started within 1 h of disaster. This was made possible as the Army had disaster and emergency preparedness plans and protocols in place; stocks of relief supplies and medicines as per standard lists were available; and periodic training and drill of the army personnel and medical corps was undertaken as a routine. The disaster response could be immediately activated.

  • There is an important lesson to be learned by the civil administration and the public health system to have disaster preparedness plans in readiness with material and designated rescue officers and workers.

  • Prompt activation of disaster management plan with proper command and coordination structure is critical. The Indian Army could effectively manage the disaster as it had standard disaster preparedness plans and training, and activated the system without any time lag. These included standard protocols for search, rescue, and evacuation and relief and rehabilitation. There are standard protocols for mass casualty management, inventory of essential medicines and medical supplies, and training of the army personnel.

  • Hospitals have always been an important link in the chain of disaster response and are assuming greater importance as advanced pre-hospital care capabilities lead to improved survival-to-hospital rate.(9) Role of hospitals in disaster preparedness, especially in mass casualty management, is important. Army Hospital, Leh emergency preparedness played a major role in casualty management and saving human lives while the civil district hospital had become dysfunctional due to damage caused by floods. The hospital was fully equipped with essential medicines and supplies, rescue and evacuation equipments, and command and communication systems.

  • Standard protocols and disaster preparedness plans need to be prepared for the civil administration and the health systems with focus on Quick Response Teams inclusive of healthcare professionals, rescue personnel, fire-fighting squads, police detachments, ambulances, emergency care drugs, and equipments.(10) These teams should be trained in a manner so that they can be activated and deployed within an hour following the disaster. “TRIAGE” has to be the basic working principle for such teams.

  • Effective communication system is of paramount importance in coordination of rescue and relief operations. In the present case study, although the main network with the widest connectivity was extensively damaged and severely disrupted, the army's communication system along with the other private mobile network tided over the crisis. It took over 10 days for reactivation of the main mobile network through satellite communication system. Thus, it is crucial to establish the alternative communication system to handle such emergencies efficiently and effectively.(2,11)

  • Disaster management is a multidisciplinary activity involving a number of departments/agencies spanning across all sectors of development.(2) The National Disaster Management Authority of India, set up under National Disaster Management Act 2005,(1) has developed disaster preparedness and emergency protocols. It would be imperative for the civil administration at the state and district levels in India to develop their disaster management plans using these protocols and guidelines.

  • Health system's readiness plays important role in prompt and effective mass casualty management.(2) Being a mountainous region, the Ladakh district has difficult access to healthcare, with only nine Primary Health Centers and 31 Health Sub-Centers.(12) There is a need for strengthening health systems with focus on health services and health facility network and capacity building. More than that, primary healthcare needs to be augmented to provide emergency healthcare so that more and more lives can be saved.(7)

  • Training is an integral part of capacity building, as trained personnel respond much better to different disasters and appreciate the need for preventive measures. Training of healthcare professionals in disaster management holds the key in successful activation and implementation of any disaster management plan. The Army has always had standard drills in all its establishments at regular intervals, which are periodically revised and updated. The civil administration and public health systems should regularly organize and conduct training of civil authorities and health professionals in order to be ready for action.(1–4)

  • Building confidence of the public to avoid panic situation is critical. Community involvement and awareness generation, particularly that of the vulnerable segments of population and women, needs to be emphasized as necessary for sustainable disaster risk reduction. Increased public awareness is necessary to ensure an organized and calm approach to disaster management. Periodic mock drills and exercise in disaster management protocols in the general population can be very useful.(1,3,4)

Footnotes

Source of Support: Nil

Conflict of Interest: None declared.

References

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