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

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Lesson 5 - Phase three: Rehabilitation measures

Study Guide

This final lesson deals primarily with short-term rehabilitation measures that should be started as soon as possible, such as restoration of lifeline environmental health services and restoration of essential surveillance activities. It also outlines the process for evaluating how well the emergency operations action plan worked.

Learning Objectives

Understand the factors involved in planning for systematic restoration of environmental health services.

List the six lifeline services that should receive the highest priority in short-term rehabilitation.

Understand the purpose and application of technical health surveys in the rehabilitation phase.

Consider when to take environmental health surveys, their order of importance, and basic parameters used for determining disease risk.

Understand the importance of evaluating the emergency operations action plan, and consider the types of questions that should be posed and to whom a final report should be sent.

Learning Activities

Read pages 37-40 in the manual.


Complete the Self-Assessment Test.


Lesson 5 - Self-Assessment Test

Multiple Choice

Circle the correct answer(s):

1. What is the primary role of a national committee?

a. to mobilize and coordinate military and civil defense personnel in carrying out emergency relief efforts
b. to receive and distribute relief supplies obtained from national and international agencies
c. to plan, monitor, and coordinate the reconstruction and restoration of all lifeline services
d. to make policy changes at the national level for rechanneling appropriations into priority areas
e. to review and evaluate the emergency operations action plan so that strengths and weaknesses of the plan observed under disaster conditions can be recognized and improvements incorporated in preparedness planning for future disaster occurrences

2. Technical surveys are performed to:

a. train environmental specialists
b. let the people know that something is being done
c. assist officials in determining areas of priority intervention
d. test the usefulness of equipment and supplies
e. determine the incidence of disease

3. Environmental health surveillance activities are aimed principally at:

a. determining whether or not there is any increased risk of disease.
b. evaluating the emergency operations action plan
c. gathering information about specific equipment and supplies needed
d. contacting and reassuring victims that order will be restored
e. taking epidemiologic surveys of the incidence of disease

4. If water is found to contain E. coli and dramatically increased levels of chloride, this may indicate:

a. contamination of water by insect vectors
b. contamination of water by human waste
c. presence of a chlorine residual
d. a possible laxative effect on a consumer
e. high salt levels, rendering the water unfit to drink but acceptable as an ingredient in food

5. Besides testing the quality of the food itself, inspections should be made to determine the cleanliness of:

a. premises where food is handled and prepared
b. washing facilities
c. food storage facilities
d. facilities for sanitary excrete disposal
e. all of the above
f. none of the above

6. It is especially critical that settlements for displaced persons, hospitals, and schools be surveyed for:

a. food handling and preparation activities
b. children who have been separated from their parents
c. incidence of malaria and yellow fever
d. adequacy of clothing provisions
e. adequacy of solid and liquid waste handling systems

7. In order to better coordinate routine activities and improve emergency response as part of a future disaster preparedness plan, it is first necessary to:

a. create a national committee of all local and government service agencies
b. conduct technical and environmental health surveys
c. evaluate the emergency operations action plan as it was carried out before, during, and after a disaster
d. map all areas that were in greatest need of outside disaster relief
e. develop separate subplans for water supply service, solid waste service, and so forth

8. Environmental health surveys should begin:

a. as soon as water, food, and sanitation services have been restored
b. as soon as technical surveys have been initiated
c. throughout all phases of a disaster
d. as soon as electricity, transportation, and communications services are in operation
e. during the immediate postdisaster emergency period

9. Short-term rehabilitation measures are undertaken to achieve three primary objectives: (select three)

a. make emergency information available to the public
b. prepare lists of needed assistance and submit them to relief agencies
c. restore lifeline services
d. locate sites for tent camps
e. restore environmental health surveillance activities
f. conduct technical surveys
g. return hospitals, schools and churches back to a normal state
h. evaluate the emergency operations plan once it has been implemented

10. Phosphatase determination kits check for:

a. high levels of totally dissolved solids in drinking water supplies
b. deterioration in food quality
c. presence of disease vectors in food
d. presence of chlorine residual
e. milk quality
f. contamination of food or water with human waste

11. Chlorine residuals should be tested:

a. only where water is suspected of contamination by human or chemical waste
b. on a short-term basis
c. between the disaster occurrence period and the consolidation period
d. immediately after the disaster and on a routine basis thereafter
e. only until routine testing for E. coli and nitrates has been instituted


Indicate T or F:

___12. Only water used in the preparation of food should be tested for microbial and chemical contaminants.

___13. Supplies and parts should be ordered from local sources only if they cannot be obtained from international relief agencies.

___14. Some rehabilitation measures must be taken during the emergency and immediate post emergency periods.

___15. Latrines should be inspected by qualified environmental health personnel during and after their construction.

___16. Heating fuel, communication, and electricity are not of primary concern during short-term rehabilitation.

Answer Key

1. c

7. c

12. F

2. c

8. a

13. F

3. a

9. c,e,h

14. T

4. b

10. e

15. T

5. e

11. d

16. F

6. e

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