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

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Lesson 4 - Phase two: Measures taken during the disaster and in the aftermath

Study Guide

In this lesson the importance of advance planning is evident. It provides detailed information on how to carry out the Environmental Health Emergency Operations Plan during the warning period, as the disaster occurs, and in the immediate postdisaster emergency period. Finally, during the consolidation period, recovery measures begin.

Learning Objectives

List the three time frames within phase two: during and immediately following a natural disaster.

Understand the principal objectives that should be met during each time frame.

Know ways to assure safe food, potable water, facilities for sanitation and hygiene, adequate shelter, and vector control during and immediately following a disaster.

Be aware of the necessity of keeping the population fully informed during this period.

Know the measures to be taken during the period of consolidation, as steps toward recovery begin.

Learning Activities

Read pages 23-35 in the manual.

Read pages 47-50 in the manual (Annex 2), particularly if you will be involved in provision of safe drinking water.

Scan pages 51-55. This will be useful for detailed planning of environmental health measures during the immediate postdisaster emergency period.


Complete the Self-Assessment Test.


Lesson 4 - Self Assessment Test

Multiple Choice

Circle the correct answer(s):

1. Activities taken during the emergency warning period include:

a. testing of water for the presence of Escherichia coli andunsafe concentrations of nitrate
b. providing safe, adequate shelter to stricken populations
c. dusting of displaced persons to protect against spread of typhus
d. mobilizing emergency personnel and informing threatened population of what to do
e. preparing lists of needed assistance and submitting them to relief agencies

2. Food spoilage is commonly the result of:

a. overcrowding
b. power outage
c. shortages of environmental personnel
d. interruption of vector control activities

3. During the immediate postdisaster emergency period, ways to determine which areas merit greater attention include: (select two)

a. sending out questionnaires to all stricken areas for distribution to and response from each household or displaced person
b. conducting epidemiologic surveys of the incidence of disease
c. checking population movements within or near stricken sites
d. determining remaining stocks of all perishable foodstuffs
e. surveying the availability of water, food, shelter, and waste disposal in stricken areas
f. calculating the reserve capacities of retail and wholesale food outlets

4. The most essential item that disaster-stricken populations must be provided with is:

a. nonperishable food
b. medicine
c. fuel
d. drinking water
e. adequate waste disposal
f. shelter material

5. Latrine requirements in disaster operations include:

a. 1 seat/20 persons in tent camps
b. 1 seat/35 women in temporary building shelters
c. 1 bore-holed trench/10 persons
d. 1 shallow trench/200 persons
e. none of the above

6. Large volumes of water that will be hauled to camps or to consumers in affected areas should be:

a. cooled
b. stored
c. aerated
d. strained
e. disinfected
f. heated

7. A____ is essential to the sanitary maintenance of latrines.

a. sufficient supply of cleaning agents
b. health education program in latrine Usage and upkeep
c. survey of latrine construction projects
d. sufficient quantity of water
e. system of monitoring for the presence of nitrates

8. Overturning receptacles can prevent:

a. damage to materials from constructing temporary shelters
b. proper functioning of a refuse collection system
c. proliferation of disease-carrying insects
d. accumulation of foul-tasting water

9. In general, displaced persons should be encouraged and assisted to:

a. evacuate to temporary resettlement camps
b. stay with family, friends, or in nearby public buildings
c. construct permanent settlements as far away as possible from the stricken area
d. apply to aid organizations for tents and sleeping bags
e. move to the nearest urban center

10. Tablets can be used to disinfect water following which guideline(s):

a. the eight milligrams of elemental iodine released by the most common iodine tablet can treat 10 liters of water in one minute.

b. water should be strained through layers of cloth or allowed to settle before disinfectant tablets are added

c. 160 milligram Halazone tablets can disinfect 40 liters of turbid water

d. all of the above

11. In relief operations. which of the following water requirements is incorrect:

a. 50 liters/person in field hospitals
b. 35 liters/person in washing installations
c. 25 liters/person in mass feeding centers
d. 5 liters/person in temporary camps
e. all of the above

12. Overcrowding can lead to disease principally because:

a. accessibility to medical care is severely curtailed
b. maintaining standards of personal hygiene becomes more difficult
c. water supplies are likely to become contaminated
d. lack of privacy, introduction of unfamiliar food, and mental stress all lead to a breakdown in the body's immune system
e. people generally take their pets and domestic livestock with them

13. In camps for displaced persons, it is important that residents be made aware of:

a. the camp's sanitation regulations
b. where to locate alternate sources of drinking water
c. names and titles of authorities to contact
d. how to disinfect their own water
e. timetables for returning to their homes

14. Emergency environmental health control measures are carried out:

a. during phase one of a disaster
b. as soon as a warning is received
c. after the rescue and accommodations of displaced persons
d. only by qualified environmental health specialists
e. in response to requests from officials in the stricken area

15. Water located near sewage outfalls, chemical plants, solid waste disposal fields and abandoned mines

a. should be boiled
b. should be disinfected before using
c. should be tested for the presence of E. colli and high concentrations of nitrates
d. should never be used
e. should not be used unless determined safe by a knowledgeable environmental health specialist
f. should be used only as a last resort

16. After mains, reservoirs, and wells have been repaired, they should be:

a. put back into service immediately
b. inspected by a qualified environmental health specialist
c. cleaned and disinfected
d. monitored daily for chlorine residuals

17.Match water requirements in different settings with the appropriate volumes:

___Minimum daily water capacity in temporary settlements and camps

___Daily consumption of water in field hospitals

___Minimum daily amount of water needed during evacuation in the tropics

a. 3 liters/person
b. 6 liters/person
c. 15 liters/person
d. 40-60 liters/person

18. Tank trucks are used for transporting

a. solid waste
b. drinking water
c. emergency personnel
d. equipment and supplies
e. gasoline
f. milk

19. Final disposal of solid waste in tent camps should be by:

a. waterproof and insectproof solid waste disposal containers
b. transport
c. incineration
d. treatment at a sewage treatment plant
e. burial
f. a or b
g. c or e
h. d or e

20. Covering food and water containers and removing all debris and garbage protects against:

a. pets and domestic livestock
b. contact with insecticides
c. fire hazard
d. disease vectors
e. spoilage

21. The first concern of decision makers during emergency periods is:

a. chemical contamination of food and water supplies
b. salt water contamination of food and water supplies
c. chlorine contamination of food and water supplies
d. heavy metal contamination of food and water supplies
e. microbial contamination of food and water supplies
f. vector contamination of food and water supplies

22. Precautions regarding the use of Halazone tablets in water disinfection include:

a. dosages for turbid and clear water are identical
b. before consumption, water should always stand one hour following disinfection
c. tablets come in two strengths with different tablet-to-water ratios
d. all of the above


Indicate T or F:

___23. All food should be inspected and analyzed in the immediate aftermath of a disaster.

___24. Priority should be given to the consumption of non-perishable food.

___25. When people are informed of what services are available, where to go and whom to contact, it improves the effectiveness of environmental health activities.

Answer Key

1. d

9. b

17. c,d,b

2. b

10. b

18. b

3. c,e

11. d

19. g

4. d

12. b

20. d

5. e

13. a

21. e

6. e

14. b

22. c

7. b

15. e

23. F

8. c

16. c

24. F

25. T

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