Effective Public Health Response in Disasters.

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The most important lesson I learnt from this review is about myths and realities public health emergency situations. Disaster responses are often planned on limited personal experiences, anecdotes, logical frameworks, perceptions and beliefs. Many commonly held beliefs are often at variance with ground realities observed during the course of various disasters and the actual responses to it. For example; indiscriminate mass vaccination is wasteful. Instead targeting of specific groups may be useful. But many people tend to believe that mass vaccination is required in times of disasters and public health emergencies. Similarly, spraying streets and rubble with large quantities of disinfectant and does nothing whatsoever for public health. But people may believe that streets, rubble etc. should be sprayed with disinfectant to stop spread of disease. Disaster response planners often belief that casualties will be brought by ambulances and distributed among hospitals appropriately. In reality, Most casualties arrive by a variety means such as private cars, taxis, police, and are transported to the closest or most familiar hospitals. The risk for outbreaks of infectious disease is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to influence the risk for communicable diseases and death in the affected population.

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