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According to Forgione (2008) calamities are classified into two distinct categories they are natural disasters, which consists earthquake, floods and hurricanes; and manmade disasters, such as terrorism and industrial catastrophes. The complexity, location or time of the next disaster cannot be predicted by anyone, however, manmade disasters, especially the people those who involving in terrorism, medical providers consider this as the most challenging disaster threat due to the unpredictability of the exploit and the number of casualties involved. A mass casualty exploit is considered as an event that gives abundant casualties to disturb the normal capacity of the function of the affected community. The diversity and severity of injuries, additionally to the number of victims, is an important factor in deciding whether the mass casualty incident will overload the medical and public health infrastructures of that locality. There is a folk story that all calamities are different but the common thing after each and every disaster is the basic medical and public health problems which is shared commonly by all the disasters where their etiology is not considered. Triage is considered as the most major task in the scenario of the disaster response. Disaster triage is different when compared to the standard medical triage in that standard triage gives many benefits for the patient, whereas disaster triage provides the greatest good for large number of patients.
According to Katez et al (2017) the prevention and preparedness of emergency situations at the local level with the city and country authorities, tribal leaders and governors who are responsible for any disaster. Officials of over emergency management functions are classically entrusted by the state and regional government. The responsibilities for biological threats rest with emergency response agencies, private and public medical institutions, state and regional public health care departments that usually have shortage in clear funding mechanisms for sustained readiness activities, with no scarcity of competing priorities. It has been assumed by the federal planning guidance that state and local officials will lead the beginning response to a disaster or urgency, with federal measures coming into play only under certain conditions.
According to Haigh and Amaratunga (2010) a sequence of disasters that gradually increased the degree of unpredictability faced by the challenged emergency arrangements and policy makers. The roots and cause of these calamities have been extensive, but they have strengthened the necessity to proactively determine disaster risk and increase a community’s flexibility as a part of the withstanding development criteria. The results outlined here serve to underline and support the growing identification that those responsible for the built environment have a important role to be played in effective disaster planning. It is also appeared to be highly advisable for the built environment discipline to be able to grant an increasing resilience through a methodology that is inter disciplinary in nature. The term built environment came into existence and was used in the 1990s and although comparatively new, it attempts to describe in one integrated and holistic concept, the outcome of human activities. Tasks considered to be central to their work involves the ” design, planning maintenance management and monitoring of the aesthetic and functional layouts of built environments” and ” developing and discovering apt solutions about the standard and use of the built domain in rural, suburban and urban areas.
According to Fernandez et al (2002) the potential of a disaster victim to respond to, prepare for, and recover from a disaster depends on a variety of the factors that usually are beyond the individual’s rapid control. The longevity and severity of the event, the efficiency of the warning systems, the sufferer’s health status, and their access to resources are some of the factors affecting an individual’s response and recovery capacity. The sufferers, who are socially isolated and house-bound or who have damaged adaptability may meet each other halfway in their potentiality to respond to and recover from disasters. Individuals depend upon regular medication, nursing care and the provision of care and food from volunteer agencies also may be unsafe. The limitations which exist previously such as impaired mobility can present major disadvantages during calamities. In sudden-onset disasters such as earthquakes and flood the elderly physically may be impotent to protect themselves or quickly vacate a building.
According to Shi (2012) in the different political and economic systems the government plays in various roles in managing public problems and affairs. But in the case of such public affairs as disaster risk management of the government, the government acts an important role with capitalist market federal and economic system. Everyone is equal in the eyes of law a government must take responsibility for the welfare of the people in its disaster risk management. As this is an age of scientific development, the government is in an enforcement to play a leading role in disaster management; this duty is part of the power afforded to the overall system, the policy making and implementation methodology, and legislation covering integrated disaster risk management. As a country with many natural calamities and serious disaster situations, has paid attention to its legislation relating to the management of different natural disasters. Under the organization of the legislative affairs office of the state council, several regulations regarding integrated disaster risk management has adopted by the standing committee of the National People’s congress. A complete set of laws and regulations have been established especially in the case of the disaster relief and emergency management, which represents the leading role played by governments at different levels. The people’s governments at the country level shall be accountable for answering to emergencies that occur within their own administrative areas; the people’s government at the next higher level, which the people’s governments of the administrative areas said are subordinate to, shall assume responsibility, or the people’s governments at the next higher level of the respective people’s governments of the said administrative areas shall jointly assume accountability.
According to Atlay and Green (2006) calamities are large intractable problems that test the ability of nations and communities to protect their infrastructure and populations effectively, to reduce both property loss and human and to quickly recover. The genuine randomness of impacts and effects and originality of incidents demand dynamic, effective, cost efficient solutions and real-time, thus making the topic very apt for OR/MS research. While humanities and social sciences literature are enjoying unlimited articles on natural disaster management, the OR/MS community is yet to produce a critical mass. Emergency response efforts consists of two different stages; pre-event and post-event response. Pre-event tasks involve predicting and analyzing potential dangers and developing necessary action plans for vacating. Post-event response starts while the disaster still in progress. At this stage the issues are said to be allocating, coordinating, managing and locating means. An effective emergency reaction plan should integrate both of these stages within its objective. Additionally they include separating pre and post-loss intensions may lead to suboptimal solutions to the overall problem.
According to Welzel et al (2010) the population is gradually increasing, which allows for a greater effect after small and large events alike. Additionally medical systems suffer from everyday messing and lack of potentiality for even small increases in population of the patients and also the type of the patients. To increase the volume of the patients in long term crisis, there may a short term increase in demand for surge. The EDs become the target of the patients, when the primary medical care or health care and outpatient systems are not doing their work efficiently. There are many actions to be taken to manage the disaster risk. Alternative health care centres can be opened, elective number of surgeries can be cancelled, stable Ed patients and inpatients can be discharged, off duty or standby staff can be called to manage the catastrophic surge. A clear plan must be taken to define who has the power to take an initial step on such a disaster for a system to work effectively. Additionally, the trigger points which activate these costly measures are specified.
According to Manastireanu (2010) International Strategy for Disaster Reduction defines the disaster as an incident with a larger serious damage to the lives, material, environmental and economic losses beyond the potentiality of the disaster victims to manage with its own resources. The study of the post disaster requirements regarding the common care of politraumatism and for the intensive care is the basis for developments of the infrastructure in the pre disaster stage. This will permit to be interested further on the impossibility faced by all sufferers, especially children and women. The recognition and evaluation of risks during the pre-disaster stage enables the preparedness of the response to the possible effects of the disaster, to create positive conditions for efficiency and to ignore both an undervaluation and over evaluation if it is possible. The preparedness programs should include the training of members of regional communities in providing medical care which should be more appropriate and accurate and also sustainable. The national emergency management must be able to identify the authority lines at national and local level, databases of national experts of different fields of medicine can be consulted on specific issues; procedures and formal bond to coordinate efforts with other countries and local officials within the country. Undoubtedly the ability to manage with a situation is dependent on the existing infrastructure and on how effective the intensive care systems of preexisting politraumatism care in affected areas can be efficiently organize and can manage with the problem.
According to Campbell and Abrahams (2011) the increase in the number of disaster and sufferers or victims of the disaster are linked with the threats from the change of climate which has drawn national and international attention to the risks developed by the disasters and the way to get rid of the situation. The participants of various international and national communities are more aware of the importance of preventive measures before the disasters occur through disaster risk reduction (DRR), involving the emergency preparedness measures, through the disaster recovery and response. The international community have put an effort to deploy a new and developed approach to disaster recovery, disaster risk reduction and recovery and also emergency preparedness. Improved health emergency may occur by one of the possible method that is Primary Health Care (PHC) strategy (Health Emergency Management or HEM). Improved strategy for health emergency management in general had recent developments in many aspects. The objective of humanitarian reforms at developing international response to calamities are more stable and anticipatable which has given rise to cluster approach, which includes the Global Health related clusters such as recovering in the early stage, protection, water and food, hygiene and sanitation.
According to The National Academies Of Press (2007) in addition to afford to an overall lagging of bed space in the regional healthcare centres during the mass casualty or natural disaster forces the organization to repay the inpatients due to the scarcity of bed space. This is considered as a major disadvantage or threat to the medical centre of the affected region. Emergency patients fight for beds, services and staff with the other patients who are scheduled for elective admission, and also with the patients who are admitted for surgical and therapeutic procedures. When there are limited resources such as beds and staffs elective admissions usually prevail because they pay better and promote loyalty among admitting surgeon or physicians. Emergency admissions typically generate less income for the hospital, and may also lead to spend the hospital money. Since the patients sustaining in the hospital previously are unlikely to leave the hospital, whereas the elective admission are said to go to another hospital. At the end hospitals earn a good sum financially from increased population of patients, there is a restrain to hold unoccupied beds open for emergency admissions. The emergency patients routinely undergo number of complex diagnostic and screening services because of the enhanced standards of care and improvement in the medical technology. This ensures retaining the patient’s life with good health.
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