( By A Study Guide (Pan American Health Organization (PAHO) )

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Lesson 3 - Phase one: Predisaster health measures

Study Guide

This lesson begins the detailed presentation of how to prepare for a sudden natural disaster that could disrupt environmental health services. The information is presented in both Chapter 2 and Annex 1 of the manual. Since this gives a fragmented and sometimes confusing presentation, it is suggested that you read through the material once, and then go back and study it in detail in the sequence presented in the table at the right.

Learning Objectives

Recognize the critical importance of detailed advance planning for effective management of environmental health services and resources in the event of a sudden natural disaster.

Know the elements that go into developing an environmental health emergency operations plan.

List the effects of natural disaster that are most likely to occur and create high health risks in certain areas.

Know the protective measures that can be taken to minimize the effects listed in Objective 3.

Explore ways to educate environmental health personnel and the public to prepare for and respond effectively to a natural disaster.

Learning Activities

Read pages 13-15 in the manual.

Read pages 43-46 in the manual (Annex 1).

Read pages 15-21 in the manual.

Study the material in detail, in the sequence given in the table at the right. The page references are to Scientific Publication No. 430.

Plan for Emergency Environmental Health Operations

Prior to a disaster - Phase One


1. Assessing extent of damage likely


Vulnerability Analysis


disaster: type, characteristics, potential effect on each component of service

During a disaster - Phase Two

2. Estimating resources likely to remain after disaster


Identifying organizational resources


emergency staffs and teams

advisory committee

channels of liaison

coordination agreements


Inventorying supplies and equipment


3. Calculating needs of affected communities


Determining margin of safety between service requirements and capacities vs minimum estimated need


4. Matching community needs with remaining resources

Following a disaster - Phase Three

5. Setting a timetable for addressing specific needs


specifying recovery measures


6. Determining the best program for using resources


allocating resources


7. Assigning specific tasks


Routine Measures to Protect Environmental Health

1. Civil engineering structural damage


2. Contamination of food and water supplies


3. Power outage


4. Transportation failure


5. Protecting personnel


6. Improving capabilities


Emergency Education & Information Program


Complete the Self-Assessment Test.

Lesson 3 - Self assessment test

Multiple Choice

Circle the correct answer(s):

1. Predisaster environmental health measures are intended to reduce or eliminate environmental health hazard by:

a. developing evacuation strategies, coordinating transport and distribution of emergency supplies, and developing a public education program

b. developing an emergency operations plan, establishing an immunization program, and adopting routine measures to protect lifeline services

c. developing a public education program, conducting epidemiologic surveys, and coordinating transport and stockpiling of emergency relief supplies

d. developing an emergency operations action plan, adopting routine measures to protect lifeline services, and developing a public education program

e. assigning key military personnel to special emergency relief teams, organizing an emergency administration, and developing an emergency operations action plan

2. To ensure safe delivery of water in the event of equipment failure at a water treatment plant, it may be expedient to:

a. provide for bypass facilities to a point where raw water can be chlorinated
b. conduct education campaigns to warn the public of possible contamination of water supplies
c. monitor raw water on a more frequent basis prior to and during a disaster
d. install auxiliary pipelines for delivery from the plant to private households
e. all of the above

3. Preventive strategies in disaster management should focus on which environmental health impact area(s):

a. power outage
b. building structural damage
c. food and water contamination
d. water pipeline damage
e. a, c and d only
f. all of the above

4. Delivery of enough water and food to stricken areas is likely to depend largely upon:

a. national and international cooperation in stockpiling and distributing relief supplies
b. inspection and analysis of food and water supplies conducted by trained technicians
c. financing efforts organized on a national scale to purchase necessary goods and treatment units
d. protective and emergency measures taken to keep vital transportation routes open
e. willingness of local people to eat and drink products that taste different than what they are used to

5. To be effective, a public education program should:

a. persuade people to rely on government assistance
b. persuade people to go immediately to centralized relocation camps in the event of a disaster
c. inform people of emergency phone numbers to use in obtaining emergency information during and after a disaster
d. inform people of what to expect and appropriate emergency steps to take
e. enable communities to be totally self-reliant

6. Programs to educate environmental health services staff about emergency measures should be conducted:

a. once it is known that a disaster is imminent
b. at least once a year
c. only for essential emergency personnel
d. on a voluntary sign-up basis
e. at least twice a year

7. To be able to plan effectively for protecting lifeline services and facilities before, during, and after a disaster, one should consider: (select two)

a. a community's ability to pay for training programs and emergency drills
b. the number of environmental health personnel in urban centers and their proximities to other disaster prone areas
c. effects on environmental health services common to all disasters and effects associated with a specific disaster type unique to a particular area
d. risk of disease in areas prone to disaster
e. baseline environmental health levels

8. The primary cause of food or water contamination after a disaster is:

a. damage to civil engineering structures
b. interruption of inspection and monitoring activities
c. large-scale looting of public and private facilities
d. personnel shortages
e. difficulty in maintaining standards of personal hygiene

9. One way to reduce the chemical strength of contaminants in water is to:

a. provide for a reservoir storage capacity of 1 to 2 times normal capacity
b. add sufficient quantities of water from a protected source to the contaminated supply
c. identify alternative sources of safe water
d. dilute the supply with floodwaters

10. A margin of safety for a particular service is achieved when:

a. the estimated capacity of that service after a disaster has occurred exceeds the minimum need for it in the population

b. manpower and resources allocated to that service prior to a disaster exceed the estimated requirements

c. multiple copies of maps, personnel and supplies lists, and descriptions of emergency procedures have been made

d. advanced preparations have been made to reinforce structures or provide for alternative sources

e. mutual aid agreements are drawn up among related services and shelter is guaranteed to essential environmental health personnel

11. Water treatment processes and equipment may shut down because of:

a. power outage
b. transportation failure
c. lack of field test kits
d. sudden reductions in water supply levels
e. contamination of water supplies

12. The first step in developing an environmental health emergency operations plan is to:

a. adopt routine measures to protect environmental health services
b. list all organizations that will participate in emergency activities and assign individual members to emergency teams
c. develop an emergency education and information program
d. inventory stockpiles of all equipment, supplies, and other materials necessary for the emergency
e. estimate the margin of safety between the capacities of services to meet requirements and the minimum estimated need for a service in the population

13. All relief workers should receive:

a. appropriate technical aids
b. appropriate antibiotics
c. first aid kits
d. copies of the emergency operations action plan
e. appropriate vaccinations


Indicate T or F:

___14. The principal objective of predisaster preventive environmental health measures is to eliminate or reduce hazards after a disaster event.

___15. Power outages are a common occurrence only during the initial impact of a disaster.

___16. In planning for power outages, on-site standby generators are always preferable to portable generators.

___17. Damage to reservoir retaining walls can cause serious injury or death to nearby individuals.

Answer Key

1. d

10. a

2. a

11. a

3. f

12. b

4. d

13. e

5. d

14. T

6. b

15. F

7. c,d

16. F

8. a

17. T

9. b

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