To be used in conjunction with
Pan American Health Organization
Scientific Publication No. 430

PAN AMERICAN HEALTH ORGANIZATION
Pan American Sanitary Bureau, Regional Office of the
WORLD HEALTH ORGANIZATION
525 Twenty-third Street, N.W.
Washington, D.C. 20037, U.S.A.

Disaster
Management Center
UNIVERSITY OF WISCONSIN-EXTENSION
Engineering and Applied Science
432 North Lake Street
Madison, Wisconsin 53706

608-262-2061 Telex No: 265452

Answer key - Environmental health management

1. b		13. e,f,b	25. d	37. c
2. f		14. d	26. f	38. b
3. d		15. c	27. a	39. a
4. c,f		16. b	28. d	40. a
5. d		17. d	29. c and d	41. a
6. c		18. d	30. b	42. b
7. a		19. a	31. a	43. e
8. b,a,d,c		20. c	32. f	44. d
9. d		21. e	33. b,c,d	45. T
10. b		22. a	34. f	46. T
11. a		23. d	35. f	47. F
12. 1-c		24. b	36. b
	2-d
	4-a
	5-e
	6-b

Disaster Development Problem - Hurricane

Note: Page numbers cited refer to Pan American Health Organization Scientific Publication No. 430, Environmental Health Management after Natural Disasters.

(A-1) Correct answer:

Provide safe drinking water.

Drinking water, the most essential item provided to disaster-stricken populations, is both indispensible to the support of life and a major vehicle of disease transmission. Thus, although provision of adequate amounts of water for drinking purposes is of utmost importance after a disaster, it is simultaneously necessary to ensure the safety of the water used for drinking in affected sites.

(A-2) Correct Rankings:

1. Assure drinking water for victims and relief workers in hospitals and treatment centers.

Adequate drinking water should first be made accessible to victims and relief workers in essential locations, such as hospitals and treatment centers.

A major factor in the decision-making process is the risk to health involved, which is evident. If there are inadequate supplies at any essential locations, water is available in storage tanks at the desalinization plant, and it is probable that manpower and vehicles could be provided to transport it to the hospitals and treatment centers in need.

2. Repair the pumping station.

Repair and restoration of public water supplies should also be undertaken immediately.

Another major factor in decision making is the technical feasibility of an action. In this case it is not yet known if the pumping station can be immediately repaired.

3. Assess the need for drinking water in all communities affected by the disaster.

After victims and essential relief workers have an assured supply of water, the needs of populations in peripheral areas of urban centers and in densely settled rural areas and scattered rural sites should tee met.

In the immediate post-disaster emergency period, it is necessary to determine which areas merit greater attention because of multiple risk factors for disease and other health problems. At this point in the decision-making process, there is insufficient information on need and risk to take appropriate action.

4. Request mobile water purification plants from relief agencies.

In most cases mobile units are not essential and are a low priority in requests for aid. It is usually worthwhile to use mobile water purification plants during natural disaster emergencies if they are available locally. However, they produce limited quantities of water. They are also expensive and require considerable upkeep and servicing whether or not they are in use.

(A-3) Correct options:

As soon as rescue work has started, accommodating displaced persons under conditions that will not lead to deterioration of public health and the environment should be considered.

Three of the four options could be correct during the immediate post-disaster period, depending on the circumstances and the amount of time that has passed since the hurricane struck.

1. Encourage people to stay with other family members or friends.

Encouraging and assisting people to stay with family and friends will reduce the number of displaced persons who require shelter.

2. Use existing public buildings such as schools, meeting halls, and churches.

In some cases, public shelter has to be provided temporarily until more permanent locations can be planned. Existing public buildings such as schools, meeting halls, churches and hotels are often chosen as temporary shelters because they can be converted easily into dormitories. They are also likely to have sources of water supply and waste disposal, as well as bathing and washing facilities.

3. Encourage people to construct temporary shelter on their own property.

After the first two or three days following a disaster, more permanent shelters may become necessary. If adequate resources exist to provide materials for constructing temporary shelter on their own property, people should be encouraged and assisted to do so. Wherever they locate, however, they must have access to water, food, and a sanitary means of waste disposal.

4. Establish tent camps to provide shelter.

Accommodating displaced persons in tent camps should be considered only as a measure of last resort.

It is important to emphasize that once individuals have been located and established on a site, it is difficult to ask them to move again.

(A-4) Correct rankings:

1. Warehouses storing perishable food have not been damaged, but damaged power lines have put many refrigeration units out of operation.

Priority should be given to the consumption of uncontaminated, perishable food, particularly if the food supply originates in areas where there has been a power outage. A complete accounting of available food supplies is critical.

Since the food is known to be uncontaminated, its immediate distribution should take top priority. Any food that will be cooked is safe since pathogens will be destroyed.

2. Some food supplies may have become contaminated and it is not known if the food is safe for distribution.

The analysis of food products should be a low priority, because it is often too complex an undertaking to initiate in areas affected by the disaster.

The food should not be distributed until it has been inspected. Canned food can normally be used without hesitation.

3. Rats now have access to much of the food in storage because of damage to some warehouses.

Rodents are nearly impossible to control in the aftermath of disaster.

Since rodent control is not a possible option, the food to which they have access should not be used if there are ample alternate food sources. Contamination by rats is the most important reason for eliminating any food.

(A-5) Correct answer:

Create a national committee.

The first short-term measure to address breakdown in lifeline services is to create a national committee of representatives of all local and government service agencies and at least one environmental health specialist. The committee should assume responsibility for planning, monitoring, and coordinating all reconstruction activities.

The other two options are important steps in rehabilitation, but they should follow appointment of the national committee.

(A-6) Correct answer:

Advance planning may have helped in all of the four areas listed.

A review of the known effects of disasters on environmental health reveals that damage to civil engineering structures, contamination of food and water supplies, power outages, and transportation failure are highly probable and often are critical elements of a state of emergency.

1. Damage to civil engineering structures

Because more than half of the population depends on the desalinization plant for its water supply, this structure warrants maximum protection. In this instance, the failure was at the pumping station. Advance planning might have included: (a) emergency pumping equipment that could bypass the main pumping station (b) stockpiling of spare parts for the pumps.

2. Contamination of food and water supplies

The food supplies in temporary storage constitute an excellent source of emergency food and warrant special protective measures. In this instance, an effective, on-going rodent control program might have prevented one form of contamination. Strengthening of the warehouse structures might have prevented the contamination due to damage to the buildings.

3. Power outages

Loss of power to the refrigeration units threatened the perishable food supply in some warehouses. Emergency or portable generators might have provided a fast solution. The feasibility of underground electric cables in an area where hurricanes are a disaster threat should also be explored.

4. Transportation failure

This was not an important factor in this disaster, but it could be in the future. In the case of moving potable water from the storage tanks at the desalinization plant to hospitals and treatment centers, prior identification and assignment of personnel and vehicles would have been of value.