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Disaster preparedness in Middle America
--- Regional Plan for the Reduction of Disasters ---
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Mario Saenz Ramirez, M.D.
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The Central American Region is characterized its high biological diversity and ecosystems. It can be divided into two principal natural contexts; the high lands and the pacific coast with a volcanic origin characterized for its dry weather; and the ow Caribbean coast with a more humid weather.
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In regard with the data of the Central America Secretary of Social Integration, this region has an approximate population of 50 million, 68% of them lives in misery conditions. In the region, the percentage of poor people increased in proportion of 7% average in the period between 1980 and 1990; in the country sides. There are numerous rural families without any land, temporary workers and land owners with very small plantations for subsistency; in the city, a very large informal sector has and elevated index of unemployment and a formal sector with a very low income. Of all this case, the situation of the women head of the family and children are the most disadvantageous.
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The percentage of people with access to basic services such as drinkable water and the correct elimination of excretes and garbage in some countries, still are very poor. In El Salvador, only 48% of the population has access to drinkable water, while in Nicaragua the proportion is of 54%, in Guatemala of 64%. In these same countries, the services of environmental sanitary gets, respectively, to 58%, 27% and 59% of the population.
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The annual appraisal of deforestation is elevated. Information for the period between 1980 and 1985 indicates that Costa Rica had the highest deforestation with a 3.6% followed by El Salvador with a 3.2%, Nicaragua with a 2.7%, Honduras with a 2.3%,Guatemala with a 2.0% and Panama with less than 1%.
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Central America is a region where its exuberant and variety in nature, source of great riches, also presents an elevated potential to produce catastrophic phenomenons. Precisely, the wrong utilization of the natural environment, the difficult socioeconomic conditions of the population and planification problems of development of the governments and civil societies make suitable conditions for the magnifications of economic social and ecological repercutions, when there is a manifestation of the so called "Natural Disasters".
The Central American governments have decided to adopt an strategic framework to reduce the physical socioeconomic and environmental vulnerability and help reduce the impact of a disaster. This framework will be an important part of the region's transformation and developmentprocess for the next millennium. It will include politics of prevention and mitigation measures.
An essential part of this framework will be to develop a Central American culture of prevention and mitigation in the region's population, letting them organize and be prepare to face any kind of national or local eventuality. That suppose the full participation of the civil society in the vulnerability reductions and emergency step's work. It will also implicates to pay special attention to the most vulnerable groups and sectors of the populations, specially for its poverty and marginal levels and that will be properly incorporated in the gender aspects.
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The framework also requires that the plans and global and sectorial programs of development of our Countries, to introduce elements of prevention and mitigation required to reduce the vulnerability of the social,productive sectors, infrastructure and the environment to the local, national and regional levels.
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The Regional Plan for the Reduction of Disasters (PRRD) is the mechanism to be used by the governments of the region through its specialized institutions. They state their politics, priorities and actions of prevention and mitigation of disasters. This Regional Plan emerged as an initiative of the Center of Coordination for the Prevention of Natural Disasters in Central America (CEPREDENAC), with the purpose of establishing a Central American strategy to reduce the disaster's impact in the society and it was ratified by the highest political instance of the region and incorporates the strategic lines that were agreed in the XX Central American President's Summit, Dominican Republic and the Prime Minister of Belice,the 18th and 19th of October,1999 and captured in a final document called "Strategical Framework for the Reduction of Vulnerability and Disasters in Central America".
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This Plan consists of three parts;
1. Basic Plan: It identifies the general lineament,strategies and responsibilities
in a regional level.
2.Sectorial Strategies:Regional level, where the specialize institutions and
secretaries of the SICA establish their action plans.
3. The National Plans of Mitigation and Disaster Attention.
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Confined Space Medicine
Joseph A. Barbera, MD
Institute for Crisis, Disaster, and Risk Management
The George Washington University
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Patients trapped within confined spaces in collapsed structures are often critically injured, but may have a very prolonged period between when they are accessed by rescuers and when they are fully extricated and enroute to a hospital. Injuries such as crush syndrome and airway dust impaction may be greatly exacerbated by the rescue process. Sophisticated emergency medical care may be essential for their survival. Confined space medical care is the capability to conduct an adequate medical evaluation and institute appropriate medical therapy while the patient is still entrapped, and to provide interventions that expedite the victim's safe extrication from the confined space. This presentation will discuss the approach to confined space medical care developed through the United States national and international collapsed-structure response programs, and cite examples of the successful application of confined space medical techniques.
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I. Introduction
II. FEMA Task Force
* Mission
* Structure
* Function
III. Task Force medical team
* Mission & objectives
* Priorities
IV. Medical Team's composition & function
V. Confined Space Medicine
* Impediments
* Requirements
* Objectives
VI. Team organization for confined space operations
VII. Medical care in confined spaces
* General approach
* Specific interventions
* Coordination with rescue team
VIII. Case presentations
IX. Documentation issues
X. Retention of medical capabilities
XI. Transfer issues
XII. Medical Cache
XIII. Summary & Close