March 9, 2023

RELATIONSHIP BETWEEN HIV /AIDS AND OTHER STDS Sexually transmitted infection (STDs) vulnerable group of disease or infection whose predominant mode of transmission is through sexual intercourse Stds makes one more vulnerable to HIV infection e.g. gonorrhea and genital herpes thus early treatment   to   aspect of HIV infection. When one is infected by STDs he/ she depict the following symptoms Urethral discharge Virginal discharge Genital ulcers Long abdominal pain Eye  infection  in new born Swelling of scrotum Examples of STDs Gonorrhea Causative agent Neisseria gonococcus Signs Burning when passing urine Discharge of pus  through the urethra  of the virginal  or sore growth  incase of oral sex, Complication and treatment Damage of fallopian duct in female  and epididymis  in male  leading  to sterility Inflammation of joint, liver, heart and peritoneum may occur. Treatment By use of effective antibiotic as the organism is resistant to several times. Noflocin is a useful anti biotic. SYPHILIS Bacterium Treponema palladium Signs and symptoms Sore in the gelitalian and body rush After some years it damages the heart aorta and the brain leading to a condition known as paralysis of the insane. Complication and treatment Can cause re-current miscarriage, heart problems and brain damage Easily failed with infection of penicillin or cephalosporin’s   LYMPOGRANULOMA Causative agent – Chlamydia Signs and symptoms Swelling and ulceration of lymph nods in the grain Complication Narrowing of rectum and destruction of urethra Treatment Tetracyclines   TRICHOMONIASIS Causative agent- protozoa dichotomous virginals Signs and symptoms Burning in the virginal  and urethra Greenish – yellow discharge Complication and treatment Treated with fasigyn (tinidazole pessarics) or cream Candidiasis Causative agent – a fungus called Candida albicans Signs and symptoms Burning in the virginal  and the urethra White thick discharge sometimes tiredness with blood. Complication and treatment May lead to pre cancer condition of the neck and womb (cervix cancer) Treated with anti fungal passure or cream e.g. doctrimazole.   GENITAL HURPS. Causative agent Herpes simplex agent Signs and symptoms Painful vascular rushes in the genitals Complication and treatment Figia damage unborn baby eventually treating to death. Cancer of the neck of the womb no nearly the effective treatment. Acyclorin may be harmful.   HEPATITIS Causative agent Hepatitis ‘B’ virus Signs and symptoms Yellow less of eyes (juridical ) due to  liver damage Pain around right upper abdomen Lead to cancer of the liver. Complication and treatment Cancer of the liver. No treatment, vaccine, available also transmitted by blood transfusion. AIDS Causative agent HIV Signs Many different signs but dominated by weight less and opportunistic infections. Complication and treatment Much complication eventually leading to death i.e. no cure   CLAMIDIA SIS Causative agent Chlamydia trachomatis (virus) Very common in adolescence Pain when passing  urine Discharge and abdominal pain   Complication and treatment Damage to fallopian duct Inflation and sterility in both male  and female Treatment doxycycline Cause by human popilluma virus Signs and symptoms Marks around genital area Invasion of the neck of the womb. Complication and treatment Cancer of neck of the womb Treatment is very difficult burning the wart with podophiling etc Relationship between STDS and HIV AIDS Both are sexually transmitted Both don’t have cure Both require psychotherapy (counseling) for individual to cope with them. In all of them individual s experience stigmatization In both of them the victim should always be educated on ways  of avoiding  reinfection for it  will worsen  the situation Clinical staging of HIV / aids Clinically HIV/ AIDS infection has been categorized into five stages Transmission stage Primary infection Asymptomatic phase. Intermediate / asymptomatic stage Advance disease Transmission stage Transmission of HIV/ AIDS with the 1st stage without, with non of the subsequent stage can occur Basically HIV virus is transmitted through contact with body fluids e.g sexual intercourse. accounting 80% of HIV transmission  intravenous  drug use  10% unscreened  blood transfusion  accounting  5% of HIV transmission  and exposure  to contaminated  instrument accounting  1% e.g. needle  . Mother to child transmission accounting 10% of HIV transmission. Primary injection. The symptoms of injection occur normally 2-6 weeks after exposure to the virus. In 50-80% of patient the symptom are normally mild and patient might dismiss them as mild through symptoms. this might be accompanied  by swelling of the glands , sore throats  which  may persist  up to 14 days .CD4 will decline as immune  system come  into attack   from the virus  but will recover   as the immune  system  land to fight injection  through production  of antibodies. Antibodies may become detectable  10-14 days  after the onset of  symptoms  however  depending  on the sensitivity  of the test  and level  of A HIV test may still  be negative   once natural  viral  suppression  due to immune  function  occur  the level  of virus  reaches a plateau 3-6 months after the injection has taken place. Its during zero conversion  that the patient  is tightly  infectious and transmission of virus  is very likely  while  viral  level  remains  high in the body fluids. The plateau in the viral level is called viral sets. Point and may indicate this rate of viral replication e.g. disease progression is likely to be faster in those in those with high viral subsequent. ASSYMPTOMATIC PHASE During the phase  the patient remain asymptomatic  (no signs  of HIV  / aids) although  enlarged  gland  may characterize the phase  with minor complication  which the patients  ignore  as not no medical  attention . Oral lesion may be represented as ulcers and the patients may have increased sinuses and other respiratory tract. Many patients may take this normal   cause infection if they are unaware of their status and treat with over the counter medicine. SYMPTOMATIC STAGE Here cd4 count has fallen below 500 and remain above 200. Patients begin manifesting symptom of HIV / aids and may develop a risk of bacteria pneumonias or, pulmonary TB. Also during  this stage  mouth  infection  may also  show  itself  as oral  thrush an d oral leukoplakia. ADVANCED DISEASE During this stage the cd4 counts fails below 200 patients may develop a variety of opportunistic infection of which include Non –

Introductions The body has a two –part Immune system which workers together to protect it from harmful micro organism such as bacteria, fungi, viruses and parasites, it is divided in to two: Innate Immunity This is the front-line defense which equips us from before birth to deal with the various microorganisms that we are likely to meet in our normal everyday lives Innate Immunity Include: Antibodies formed by a mother and passed on to the developing fetus and through infant breasting feeding Tears containing the enzyme lysosome, to protect one eye from bacteria Saliva in the mouth, also containing the anti-bacterial lysosome Mucus and chemicals co-existing but with quite differing functions in the urethra Ureter (water tubes) and vagina When the barriers of the innate immunity are penetrated ,while blood cells leukocyte.(phagocytes or devouring cells) and other while cells (principally serotoxin or natural cell-Killing cells)surround and a number of other naturally-produced substances such as interfere and a range of blood proteins (called the complement system combine to help in the destruction process. Adaptive Immunity Adaptive Immunity is the second line of defense and is called into service when the defenses of the innate immunity are breached well beyond the capability of its response, Its defense, instead of being a  general reaction is much more  specific as it adapts to the particular organism present hence adaptive immunity is often referred to as specific immune system to identify the invading micro-organism as being foreign to any of the body’s own protein  these foreign  or devouring cells) and other  while cells (principally  serotoxin or natural cell-killing cells) surround and attempt to destroy  the  invader. At the same time a number of other naturally-produced substances such as interferon and a range of blood proteins called the complement system) combine to help in the destruction process. Adaptive Immunity Adaptive Immunity is the second line of defense and is called into service when the defenses of the innate immunity are breached well beyond the capability of it response. It defence,instead of being a general reaction is much more specific  as it adapts to the particular organism present hence adaptive immunity is often referred to as specific immunity. Body immunity is the ability  of the body o define  itself against foreign  bodies ( antigens) its commonly  associated  with the blood  cells  which  comprise  the soldier  cells  of the body. Body immunity system it’s important because it equips   as our bodies with the ability to control act foreign invaders. We have two types of immunity Innate Adaptive Innate immunity- natural ability of the body to defend itself against micro –organism and it’s always transmitted from parent to children. Example of innate immunity Lysosome –protect eyes and mouth from being infected by bacteria. hairs-in nose help trap inhaled mucus)has cilia  hairs found in trachea   and wind  pipe  when by they protect  the lungs  by ensuring  that foreign  matters  don’t affect. Skin – its layer protect the body surface, serviced by (sweat glands) sebaceous gland providing bacterial killing chemicals. acids – in stomach and intestine (HCl) which destroy harmful  micro organism  and also  permit   the present  of helpful bacteria.   ADAPTIVE IMMUNITY This is artificially  induced  attenuation  ( inoculation) this is type  of immunity  called intro service when  the inmate  immunity is destroyed  beyond  response . There are around 7 days between immune response as one part of the system takes over from the either. The response can either be cellular or hormonal based on the type of invader. Hormonal immunity response to bacteria while cellular responds to virus and parasite. Effects of HIV/ aids on the body immunity Weaken the body immunity leading to opportunistic infection. Inhibit the production of CD4 cells. Destroy immune system.   T- Killer cells termed as cytolysis t- lymphocytes. Upon entry in the body HIV moves n migrates to the lymph nodes in different parts of the body e.g. neck, groins and armpits. The lymphatic system which include the lymph nodes act as a reservoir for the virus it then moves other parts of the body where it infect and destroy white blood cells (t- lymphocyte or CD4 cells) The lymph nodes  normally trap bacteria , fungi and virus to allow  easier  destruction by the WBC they are contracted by there but as the virus  concentration  increases  there s both  breakdown  in the ability of the lymphocyte  to hold  back.   Infection and the destruction of the CD4 cells The breakdown  of the lymph  nodes  barrier allow rapid  spread  of the virus  into  the blood  stream and other parts  of the body. According to the  diamond  HIV / aids research centre  (US)  says  that infected die on average  every  two days   and that unto 100 billion new  viruses  are released  daily. When the virus   enter CD4 cell, it takes unto 30 hrs to cope with genetic material produce new enzyme and other viral component then they are assembled into new viruses.   Steps in viral replication The HIV virus first defined in the US in 1983 is classified in the family of tentrovidae within genus retrovirus. Retrovirus has RNA genome which also poses   a unique transcriptase (reverse transcriptase) Steps Attachment (fusion) HIV virus itself to human cell so as to inject its genetic materials   into the cell on the surface of the cell through molecules called receptors Using receptors the HIV cells attaches itself and fuses into the cell membrane. a process  called fusion to do this  HIV  uses GP120  to attach  itself to human  cell and GP 41 to fuse into  the human  cell.   Step 11 Transcription process After fusion with the cell, the virus transfers its instruction which reprogram the cell to produce copies of the cell. This instruction is known as RNA are similar to DNA contained by all cells of the body. An enzyme reversed transcriptase convert the single stranded HIV RNA to double stranded HIV DNA. A class of drugs known as transcriptase inhibitors Step111 Once HIV has converted itself to HIV DNA moves towards the host  

DEFINITION H-human I-immune V-virus A-acquire I-immune D-deficiency S-Syndrome   Meaning of HIV / AIDS HIV-human immune deficiency virus   called human because the virus can survive in human in body and also virus can be traced in fresh human blood. HIV survives in human blood but be transmitted by mosquitoes. Because  its immune  deficiency it incapacitate  weakness  body immunity  thus reduce  the natural ability to defend  protect  itself against diseases . it can be transmitted  from one person to another  (replicate HIV is the acronym for the human immunodeficiency virus. HIV is virus that causes the incurable acquired immunodeficiency syndrome (AIDS). Over time, HIV destroys the helper T cells of the body’s immune system, resulting in a critical deterioration of the immune system and the ability of the body to fight infection. HIV is most often a sexually transmitted virus. It is passed from one person another during sexual contact that involves vaginal, oral, or anal sex. HIV can also be passed to another person through other means, such as through contact with blood or body fluids. This can occur through such processes as blood transfusions or sharing needles contaminated with HIV. HIV can also be passed from an infected mother to her baby during pregnancy, childbirth or breastfeeding. Early infection with HIV often produces no symptoms. When there are symptoms, they can include flu-like symptoms that occur about four to eight weeks after infection. These symptoms generally go away within several weeks. There then may be no symptoms for months to years. The most serious complication of HIV infection is AIDS.  Treatments Treatment of HIV starts with prevention. Preventive measures include seeking regular medical care throughout the lifetime. Regular medical care allows a health care professional to best evaluate symptoms and the risks of catching HIV and regularly test for it as needed. These measures greatly increase your chances of catching and treating HIV in its earliest stages ORIGIN OF HIV/ AIDS No clear cause origin of aids / HIV, however there is several theories that have been propounded to help us understand among the theories include: Comment and curse Monkey meat theory Accidental emergency theory Conspiracy theory. (1) Comet and curse Viral material  arrived in the tail curse of a come passing  toward  to the earth was deposited and subsequently  infecting people nearby gods wrath sees the scripture  condemned sexual  sin such as homosexual. God sent HIV/ aids an incurable disease. The bible also talks about the disease which has no cure except define intervention. (2)  Monkey meat theory. The monkey family carries serian / immune virus (sir) similar to HIV found in human being. It’s believed that as a result of human eating monkey meat or monkey blood, sir cross to human being and mutilated itself to become HIV which was more infectious. (3) Accidental emergence During the 1970 there was an outbreak of small pox in southern African and central with sent doctors on an anti- pox campaign / vaccination. During this vaccination  its believed that the vaccine  of small  pox and polio  were accidentally mixed  and hence  to their contamination which in turn lead  to mutation of this respective  virus to HIV . (4) Conspiracy theory, During this era biological weapon have been manufactured as a weapon of mass destruction. Just like anthrax  weapon  the developing  world  believed   that HIV   was manufactured  or created  by the  developed world  as chemical  biological weapon  through which  the developing  world  could be examinee  / done a way  with so that the developed  world could have total control of the whole world . Propone for this theory argue that despite the fact that HIV was first diagnosed in developed world. It’s first diagnosed in the developed world. Its prevalence rate is quite high in the developing world    as opposed to the developed world.

INTRODUCTION TO HIV/AIDS KNEC NOTES – Click to view IMMUNITY KNEC NOTES – Click to view IMPACTS OF HIV AND AIDS ON VARIOUS SECTORS KNEC NOTES – Click to view HIV AND AIDS COUNSELING KNEC NOTES – Click to view

Meaning of Emerging trends in disaster management More than 90 per cent of natural disaster related deaths are to be found in developing countries. Disaster impact statistics show the global trend – there are now more disasters but fewer people die in proportion, even though more population is affected and economic losses are increasing, as discussed in the next section. Closely linked and influenced by changing perception, hazards and vulnerability is constantly shaped by dynamic and complex socio-economic and ecological processes. They are compounded by stresses felt within individual societies. The current aspects of physical exposure of human beings and economic assets have been partly shaped by historical patterns of settlements. Beneficial climatic and soil conditions that have spurred economic activities are in many cases also associated to hazard-prone landscapes. Both volcanic slopes and flood plains areas have historically attracted human activities. Where settlement patterns have contributed to configure risk scenarios, new forces, such as population growth and increased rural/urban migration, act as dynamic pressures contributing to changing patterns in increasing people’s exposure to hazards. The processes through which people and goods become more exposed to hazards are also socioeconomic conditioned. In particular, poverty levels and the impact of development processes, especially those associated with an increasingly globalised society, are reflecting, to some degree, current trends in socio-economic vulnerability to disasters. The pace of modern life has also introduced new forms of vulnerabilities related to technological developments. In addition to discouraging poverty levels, the emergence of virulent biological threats has revealed even greater vulnerability. Systemic ecological and localized environmental degradation is becoming highly influential as well, lowering the natural resilience to disaster impact, delaying recovery time and generally weakening the resource base on which all human activity is ultimately dependent. At the ecosystem level, phenomena like El Niño/La Niña, climate change and the potential for rising sea levels, are affecting the patterns and intensity of hydrometeorological hazards. Environmental degradation influences the effects of natural hazards, by exacerbating their impacts and limiting the natural absorptive capacity and resilience of the areas affected. Biological hazards in the forms of plant or animal contagion, extensive infestations, human disease epidemics and pandemics, continue to factor into the disasters-development scenario in new and unpredictable ways. They exert considerable socio-economic impacts on food security and human mortality, health and economic productivity, among other things. Disaster triggered by technological hazards often resulting from major accidents associated with industrialisation and forms of technological innovation, have significant socio-economic and environmental impact. Although technological hazards have been part of society for hundreds of years, the trends are showing an increasing impact. Technological advancements, specifically in the energy, transport and industrial sectors, are developing innovations with associated risks that are not always understood or heeded. The adverse effects of some technological disasters, both on society and on the environment, can considerably outlast the impacts associated with natural disasters. Trends in disaster impact While no country in the world is entirely safe, lack of capacity to limit the impact of hazards remains a major burden for developing countries, where more than 90 per cent of natural disaster related deaths are to be found. Twenty-four of the 49 least developed countries (LDCs) still face high levels of disaster risk. At least six of them have been hit by between two and eight major disasters per year in the last 15 years, with long-term consequences for human development (UNDP, 2001). These figures do not include the consequences of the many smaller and unrecorded disasters that cause significant loss at the local community level. The re-insurance giant Munich Re, a member of the ISDR Inter-agency Task Force, in its annual publication Topics for 2000, looked at the trend of economic losses and insurance costs over a 50 year period linked to what it calls “great natural catastrophes”. There were 20 of these, costing the world US$ 38 billion (at 1998 values) between 1950 and 1959. However, between 1990 and 1999, there were 82 such major disasters and the economic losses had risen to a total of US$ 535 billion. That is, disasters had multiplied fourfold but economic losses were 14 times higher. And in each decade between, both the number of great disasters and the economic loss involved had risen steadily. However, losses in 2000 and 2001 were down. These are absolute figures of economic loss, most of them to be found in developed and industrialized countries. But seen as losses by percentage of GDP, it is developing countries that lose most in relative terms, as shown in the graphic based on figures provided by MunichRe. For example, the economic losses of the United States from the 1997-98 El Niño event were estimated to US$ 1.96 billion or 0.03 per cent of GDP. The economic losses in Ecuador were US$ 2.9 billion, but this represented 14.6 per cent of GDP (ECLAC 2000). The International Federation of Red Cross and Red Crescent Societies, another ISDR Task Force member, confirms the worsening trend of human suffering and economic loss during the last decade. The total number of people each year affected by natural disaster – that is, who at least for a time either lost their homes, their crops, their animals, their livelihoods, or their health, because of the disaster – almost doubled between 1990 and 1999, by an average of 188 million people per year. This is six times more than the average of 31 million people affected annually by conflict. Comparing the last three decades, the trend shows an increase in the number of natural hazard events and of affected populations. Even though the number of disasters has more than tripled since the 1970s, the reported death toll has decreased to less than half (see grahpic page 12). This is among other factors due to improved early warning systems and increased preparedness. This statistic varies enormously depending on region and figures used. One needs to bear in mind that large disasters are rare events that defeat any statistical analysis in the short term. Perhaps

Meaning of disaster operations Perception, that much more attention has to be paid to the knowledge creation and spread in the form of the knowledge bases of best practice, have been recently set in a post disaster management field. Knowledge bases of the best practice are knowledge-obtaining tools, which allow to save a lot of time, provide information on the best post-disaster management practice in different forms (regulations, e-books, slide presentations, structural schemes, text, video and audio material, etc.). Tacit knowledge base of best practice consists of informal and unrecorded procedures, practices, and skills. Knowledge management systems are of value to the extent that it can codify “best practices” in a post-disaster management, store them, and disseminate them as needed. Tacit knowledge is highly personal, context-specific, and therefore hard to formalize and communicate. Tacit knowledge is extremely important to the post-disaster management because, once a tsunami subsequences are eliminate, professionals tend to forget it and start something new. Therefore, knowledge utilization is a key factor in effectively executing a post-disaster management. Education involves the enhancement and use of indigenous knowledge for protecting people, habitat, livelihoods, and cultural heritage from natural hazards. Educational practices can be conducted through direct learning, information technology, staff training, electronic and print media and other innovative actions to facilitate the management and transfer of knowledge and information to citizens, professionals, organizations, community stakeholders and policymakers. History teaches that inadequate disaster reduction awareness and preparation repeatedly leads to preventable loss of life and damage in all major natural disasters. Preparation through education is less costly than learning through tragedy. There is strong need for experience and knowledge sharing at different levels as well as need for knowledge networking and partnership building to support policy making and recovery planning. Knowledge is at its most effective when linked to community needs. Knowledge for implementing risk reduction activities at the individual, household, community and policy levels should be the ultimate target, keeping in mind that building a culture of safety and resilience requires time, effort, resources and continued cooperation and understanding amongst all actors. This calls for the application of knowledge and behavioral change on disaster risk promotion and information strengthening and dissemination on disaster risk and safety actions. This focuses on four themes: Education: formal, informal education; Increased Knowledge base: information management, multi-discipline, and cross sectoral cooperation, research and development; Information and public awareness: media, civil society involvement for dissemination and implementation; Community empowerment: capacity building, and community resilience by building knowledge bases. Tsunami recovery by public and private sector partnerships can benefit to (IBM Crisis Response Team, 2005): Identify Gaps: lack of service, support, and resources compared against victim, community, and government needs; Examine local available skill base – keep as much work local as possible; Identify minimal standards and best practices; Examine rebuilding issues including priorities, cost, resources, and labor; Understand the social, political, and environmental impact; Learn from prior disasters and mistakes to reduce exposures; Communicate and share information with partners on a regular basis. Knowledge sharing has to be developed in regional and national levels in disaster recovery phases. As Sri Lanka reviews its coastal zone management and development plans in the light of lessons learned from the tsunami, it would be wise as well to find out as much as possible about the manner in which other tsunami-prone and typhoon-prone countries in the Asia-Pacific region undertake coastal zone planning. Various governments have been working for some time on ecological restoration in their coastal zones. Practical knowledge on what works can be made accessible to Sri Lanka through exchange visits and study tours with these countries. Since other countries affected by the tsunami may also conclude that they need to take similar measures in their own coastal zones, sharing of relevant knowledge would increase the effectiveness of the whole regional process, with benefits for each country (UNEP, 2005). In Sri Lanka, regional knowledge sharing of development planning would be enhanced through exchange among experts and institutions that have experience of ecological reconstruction, planning and construction of sustainable urban environments, use of digital terrain mapping to guide investment in coastline defence, and in waste management. Environmental education and awareness is needed to increase public understanding of the environments where communities live, so that they can be encouraged and enabled to participate in their own development. The sharing of experience during reconstruction, which is considered as an educational process play an important role. Awareness rising on people’s participation to respond to early warning system is also of utmost importance. Therefore, the combination of high-tech knowledge with low or no-tech disaster education will be required in most cases. A world list on disaster reduction technologies (with specific relevance to implementation) might be a good database for field practitioners. Therefore the primary issues on knowledge are to identify, recognize the importance of traditional and indigenous knowledge bases, and utilize these bases effectively. In the countries affected by Asian tsunami the lack of knowledge management is apparent. Food is not reaching the affected victims, logistics is a nightmare and coordination is needed among the nations offering aid. It would be timely to proactively design such a knowledge system that could be used in any kind of disaster – natural or manmade. A sound knowledge management system would help tremendously. This knowledge system would be a coordination framework that could be put up immediately no matter where disaster strikes. Affected countries can immediately plug in local information – maps, population demographics, hospital locations and so on – into this coordination framework. The resources of countries offering aid can also be plugged into the system, and the logistics mapped out by the system, aided by observation satellites that can give visuals of altered coastlines and the extent of the damage. In the countries suffering from various natural disasters there is a conscious effort for Disaster Risk Reduction at national, provincial and sub-provincial level. Thousands of organizations are supporting the effort from last few decades. However there is a felt gap in

Meaning of Post-disaster development Post-disaster development has various approaches and different priorities in different countries. It is not surprising that there are widely divergent views and interpretations in various countries, with marked differences between countries that have a developed market economies, those with transition economies and in developing countries. Not all countries with one of theses three development levels, understand post-disaster development in the same way and so have different strategies. Successful strategies for post-disaster development should be more-or-less compatible with disaster level, economic, social, cultural, institutional, technological, technical, cultural, environmental and legal/regulatory situations in the country under consideration. A varied spectrum of strategies can be launched, while keeping in mind that the mix of influencing factors and the relative emphasis is on one or other of the factors and overall will depend on local conditions. Therefore, the best post-disaster development strategy of another country cannot just be copied. Strategies may only be adapted into a real disaster situation, economic, social, cultural, institutional, technological, technical, cultural, environmental and legal/regulatory circumstances of the existing state. There is no such thing as a single post-disaster development strategy that could be applied to all countries. The trends of post-disaster development and modeling were investigated by researchers from various countries. For example, Ruangrassamee and Saelem (2009) described effect of Tsunamis generated in the Manila Trench on the Gulf of Thailand. Scheffers et al. (2008) analysed Late Holocene tsunami traces on the Western and Southern coastlines of the Peloponnesus (Greece). Barbier (2008) presented lessons learned from the household decision to replant mangroves in Thailand. Cochard et al. (2008) reviewed the 2004 tsunami in Aceh and Southern Thailand with special emphasis on coastal ecosystems, wave hazards and vulnerability. Alongi (2008) studied mangrove forests with special emphasis on resilience, protection from tsunamis, and responses to global climate change. Morton et al. (2007) presented physical criteria for distinguishing sandy tsunami and storm deposits using modern examples. Prez-Maqueo et al. (2007) examined coastal disasters from the perspective of ecological economics. Rose (2007) analysed economic resilience to natural and man-made disasters. Altay and Green (2006) applied OR/MS research in disaster operations management. Benson and Clay (2006) analysed disasters, vulnerability and the global economy with special emphasis on implications for less-developed countries and poor populations. Galbraith and Stiles (2006) reviewed disasters and entrepreneurship. Hassan (2005) performed simplified two-dimensional numerical modelling of coastal flooding. Bates et al. (2004) analysed mitigating impacts on tourism. Alcntara-Ayala (2002) studied geomorphology, natural hazards, vulnerability and prevention of natural disasters in developing countries. Jayaraman et al. (1997) analysed management of the natural disasters from space technology inputs. It can be noticed that above researchers engaged in the analysis of a post-disaster development and modeling but did not consider the research’s object as was analyzed by the authors of the present investigation. A life cycle of a post-disaster development may be described as follows: post-disaster development life cycle, the stakeholders involved in a post-disaster development as well as the micro and macro environments, having a particular impact on it and making an integral whole. Ways of assessing post disaster development There are two essential branches of knowledge development; explicit and Tacit Explicit Explicit knowledge is widely used in information technologies. Explicit knowledge is comprised of the documents and data (for example, estimate for building costs) that are stored within the memory of computers. This information must be easily accessible, so that stakeholders could get all the necessary knowledge without disturbances.   Tacit Tacit knowledge is knowledge housed in the human brain, such as: expertise, understanding, skills, professional intuition, competence, experience, organizational culture, informal organizational communication networks, intellectual capital of an organization, ideals, traditions, values, emotions, etc. The research’s aim was to develop a Knowledge Model for assessing Post-disaster development by undertaking a complex analysis of micro and macro environment factors affecting post-disaster life cycle and to present recommendations on efficient eliminating disaster’s subsequences. The research was performed by studying the most advanced expertise in the field. A simulation was undertaken to provide insight into creating an effective micro and macro environment. The level of efficiency of the post-disaster development depends on the many micro and macro-level variable factors and all these variable factors can be optimized. The main objective of this Model is to analyze the best experiences in the field, to compare it and consequently to present particular recommendations. The word ‘model’ implies ‘a system of game rules’, which the post-disaster development could use to its best advantage. The stakeholders of the post-disaster management cannot correct or alter the micro and macro level variables, but they can go into the essence of their effect and take them into consideration in their activities. Stakeholders, by knowing the environment affecting their activities, can organize their present and future actions more successfully. Six stages of assessing post disaster development 1. Comparative description of the post-disaster development A system of criteria characterizing the efficiency of post-disaster development was determined by means of using relevant literature and experts methods; Based on a system of criteria, a description of the present state of post-disaster development is given in conceptual (textual, graphical, numerical, etc.) and quantitative forms. 2. A comparison and contrast of post disaster development Identifying the global development trends (general regularities) of the post-disaster development; Identifying post-disaster development differences between countries under analysis; Determining pluses and minuses of these differences for countries under analysis; Determining the best practice of post disaster development for countries under analysis as based on the actual conditions. Estimating the deviation between post-disaster developers’ knowledge of worldwide best practice and their practice-in-use 3. A development of some of the general recommendations as how to improve the efficiency levels for post-disaster development 4. Submission of particular recommendations for post-disaster development Each of the general recommendations proposed in the fifth stage carry several particular alternatives 5. A multiple criteria analysis of post-disaster development’s components and a selection of the most efficient version of post-disaster’s development life cycle were determined at this stage. After this stage, the received compatible and

Meaning of Disaster Response The response phase includes the mobilization of the necessary emergency services and first responders in the disaster area. This is likely to include a first wave of core emergency services, such as firefighters, police and ambulance crews. When conducted as a military operation, it is termed Disaster Relief Operation (DRO) and can be a follow-up to a Non-combatant evacuation operation (NEO). They may be supported by a number of secondary emergency services, such as specialist rescue teams. A well rehearsed emergency plan developed as part of the preparedness phase enables efficient coordination of rescue. Where required, search and rescue efforts commence at an early stage. Depending on injuries sustained by the victim, outside temperature, and victim access to air and water, the vast majority of those affected by a disaster will die within 72 hours after impact. Organizational response to any significant disaster – natural or terrorist-borne – is based on existing emergency management organizational systems and processes: the Federal Response Plan (FRP) and the Incident Command System (ICS). These systems are solidified through the principles of Unified Command (UC) and Mutual Aid (MA) There is a need for both discipline (structure, doctrine, process) and agility (creativity, improvisation, adaptability) in responding to a disaster. Combining that with the need to onboard and build a high functioning leadership team quickly to coordinate and manage efforts as they grow beyond first responders indicates the need for a leader and his or her team to craft and implement a disciplined, iterative set of response plans. This allows the team to move forward with coordinated, disciplined responses that are vaguely right and adapt to new information and changing circumstances along the way; Appropriate application of current technology can prevent much of the death, injury, and economic disruption resulting from disasters Morbidity and mortality resulting from disasters differ according to the type and location of the event. In any disaster, prevention should be directed towards reducing; Losses due to the disaster event itself Losses resulting from the Mismanagement of disaster relief.   Therefore, the public health objectives of disaster management can be stated as follows: Prevent unnecessary morbidity, mortality, and economic loss resulting directly from the disaster. Eliminate morbidity, mortality, and economic loss directly attributable to Mismanagement of disaster relief efforts. Nature and Extent of the Problem Morbidity and mortality, which result from a disaster situation, can be classified into four types: Injuries, Emotional stress, Epidemics of diseases, Increase in indigenous diseases. The relative numbers of deaths and injuries differ on the type of disaster. Injuries usually exceed deaths in explosions, typhoons, hurricanes, fires, famines, tornadoes, and epidemics. Deaths frequently exceed injuries in landslides, avalanches, volcanic eruptions, tidal waves, floods, and earthquakes. Disaster victims often exhibit emotional stress or the “disaster shock” syndrome. The syndrome consists of successive stages of shock, suggestibility, euphoria and frustration. Each of these stages may vary in extent and duration depending on other factors. Epidemics are included in the definition of disaster; however, they can also be the result of other disaster situations. Diseases, which may be associated with disasters, include specific food and/or water bone illnesses (e.g., typhoid, gastroenteritis and cholera), vector bone illnesses (e.g., plague and malaria), diseases spread by person-to-person contact (e.g., hepatitis A and shigellosis) Diseases spread by the respiratory route (e.g., measles and influenza).   The current status of environmental sanitation, disease surveillance, and preventive medicine has led to a significant reduction in the threat of epidemics following disaster. Immunization programs are rarely indicated as a specific post disaster measure. A disaster is often followed by an increase in the prevalence of diseases indigenous to the area due to the disruption of medical and other health facilities and programs. Disaster wears many faces. It can be a hurricane, a flash flood, a fire in your home, a terrorist attack or a financial crisis. Surviving and thriving during adverse events takes more than a vague idea of “doing something, going somewhere and waiting for the government to take care of me.” Surviving a disaster takes planning and preparation. Personal Preparation A disaster is any event that swamps a community’s or individual’s ability to cope and respond. During an emergency, all levels of government may be overwhelmed with managing the crisis. Government help may not reach you and your family for days. Being able to meet your basic needs for at least a week is a sensible course of action. Meeting Needs The immediate needs of you and your family are air to breathe, water to drink, a warm and secure place to stay, nutritious and easy-to-prepare food to eat, and the ability to stay in contact with others. Stocking up on face masks like the N100, storing at least one gallon of water per day per person for a week or more, having the materials and skills to repair a damaged roof, maintaining enough nonperishable canned and packaged food and the means to prepare it, and keeping your cell phone charged at all times can work wonders in making life bearable and safe until help arrives. Financial Matters Financial preparation is an area sometimes overlooked. Maintain adequate levels of insurance on your possessions and on yourself in case your family needs to continue without you. Have spare cash on hand, enough to operate for a week or more. ATMs will not work without electricity, leaving you without funds. Point-of-sale cash registers won’t work for the same reason. Make sure you have a stash of small bills and coins because store owners will be unable to give you change. Home Communications Establish a safe rallying point outside of your home where all family members can meet in case your home is uninhabitable or you can’t make it back. Call a family member or friend who lives out of state to let them know you’re all right. Local phone lines may be swamped and it is often easier to contact someone in a different state because of the way phone traffic is switched

INTRODUCTION Preparedness focuses on preparing equipment and procedures for use when a disaster occurs, i.e., planning. Preparedness measures can take many forms including the construction of shelters, installation of warning devices, creation of back-up life-line services (e.g., power, water, sewage), and rehearsing evacuation plans. Two simple measures can help prepare the individual for sitting out the event or evacuating, as necessary. For evacuation, a disaster supplies kit may be prepared and for sheltering purposes a stockpile of supplies may be created. The preparation of a survival kit such as a “72-hour kit” is often advocated by authorities. These kits may include food, medicine, flashlights, candles and money. Also, putting valuable items in safe area is also recommended. The objectives of the disaster preparedness is to ensure that appropriate systems, procedures and resources are in place to provide prompt, effective assistance to disaster victims, thus facilitating relief measures and rehabilitation services. Disaster preparedness is an ongoing, multi-sectoral activity to carry out the following activities; Evaluate the risk of the country or particular region to disasters. Adopt standards and regulations Organize communication, information and warning systems Ensure coordination and response mechanisms Adopt measures to ensure that financial and other resources are available for increased readiness and can be mobilized in disaster situations. Develop public education programs Coordinate information sessions with news media Organize disaster simulation exercises that test response mechanisms For the Health Sectors Disaster Preparedness plan to be successful, clear mechanisms for coordinating with other sectors and internationally must be in place. The Health Disaster Coordinator is in charge of preparedness activities and coordinating plans with Agencies Foreign Relations- UN, UNICEF.WHO & other international agencies NGO’s- Red Cross etc Those responsible for power, communication, Housing, water services etc Civil Protection agencies-Police, armed forces EMERGENCY PREPAREDNESS Agents, Diseases and Other Threats Natural Disasters Earthquakes, Floods, Cyclones, Typhoons, Tsunamis, Winter Bio-Terrorism Agents Anthrax, Plague, Smallpox Chemical Emergencies Ricin, Phosgene, Bromine, Sarin Radioactive Emergencies Mass Trauma Explosions, Blasts, Burns, Injuries Recent Outbreaks and Incidents Bird flu, SARS, West Nile Virus, Mad Cow Disease DISASTER MITIGATION It is virtually impossible to prevent occurrence of most Natural Disasters, but it is possible to minimize or mitigate their damage effects. Mitigation measures aim to reduce the Vulnerability of the System [ e.g. By improving & enforcing building codes etc] Disaster prevention implies complete elimination of damages from a hazard, but it is not realistic in most hazards. [e.g. relocating a population from a flood plain or from beach front] Medical Casualty could be drastically reduced by improving the Structural Quality of Houses, Schools, and Public or Private Buildings. Also ensuring the Safety of Health facilities, Public Health Services, Water Supply, Sewerage System etc. Mitigation complements the Disaster Preparedness and Disaster Response activities. A specialized Unit within the National Health Disaster Management Program should coordinate the works of experts in the field of Health, Public Policy & Public Health Hospital Administration Water Systems Engineering & Architecture Planning, Education etc The Mitigation Program will direct the following activities Identify areas exposed to Natural Hazards and determine the vulnerability of key health facilities and water systems Coordinate the work of Multi Disciplinary teams in designing and developing building codes and protect the water distribution from damages Hospitals must remain operational to attend to disaster victims Include Disaster Mitigation Measures in the planning and development of New facilities Identify priority hospitals and critical health facilities that complies with current building codes and standards Ensure that mitigation measures are taken into account in a facility’s maintenance plans Inform, sensitize and train those personnel’s who are involved in planning, administration, operation, maintenance and use of facilities about disaster mitigation Promote the inclusion of Disaster Mitigation in the curricula of Professional training institutes TECHNICAL HEALTH PROGRAMS Treatment of casualties Identification and disposal of bodies Epidemiological surveillance and disease control Basic sanitation and sanitary engineering Health management in shelters or temporary settlements Training health personnel and the public Logistical resources and support Simulation exercises / Mock Exercises EPIDEMIOLOGIC SURVEILLANCE AND DISEASE CONTROL Natural disasters may increase the risk of preventable diseases due to adverse changes in the following areas Population density Population displacement Disruption and contamination of water supply and sanitation services Disruption of public health programs Ecological changes that favor breeding of vectors Displacement of domestic and wild animals Provision of emergency food, water and shelter in disaster situation The principles of preventing and controlling communicable diseases after a disaster are to; Implement as soon as possible all public health measures to reduce the risk of disease transmission Organize a reliable disease reporting system to identify outbreaks and to promptly initiate control measures Investigate all reports of disease outbreaks rapidly. Early clarification of the situation may prevent unnecessary dispersion of scarce resources and disruption of normal progress   ENVIRONMENTAL HEALTH MANAGEMENT Post disaster environmental health measures can be divided into two priorities Ensuring that there are adequate amounts of safe drinking water, basic sanitation facilities, disposal of excreta, waste water and solid wastes and adequate shelter Providing food protection measures, establishing or continuing vector control measures, and promoting personal hygiene Water Supply Alternate water sources Mass distribution of Disinfectants Food Safety Basic Sanitation and Personal Hygiene Solid Waste Management Vector Control Burial of the Dead Public information and the Media EVALUATION In the case of disaster management, the Evaluator will be looking at the “actual” verses the “desired” on two levels, i.e. the overall outcome of disaster management efforts and the impact of each discrete category of relief efforts (Provision of food, shelter, management of communications etc) A critical step in the management of any disaster relief is the setting of objectives, which specify the intended outcome of the relief. The general objectives of the disaster management will be the elimination of unnecessary morbidity, mortality and economic loss directly and indirectly attributable to mismanagement of disaster relief. The comparison of the “actual” with “desired” is the first critical step of evaluation. If the objectives were met, those who have participated in the relief have demonstrated that they have

Meaning of disaster management WHO defines Disaster as “any occurrence that causes damage, ecological disruption, loss of human life, deterioration of health and health services, on a scale sufficient to warrant an extraordinary response from outside the affected community or area”. Disasters can be defined in different ways. A disaster is an overwhelming ecological disruption occurring on a scale sufficient to require outside assistance A disaster is an event located in time and space which produces conditions whereby the continuity of structure and process of social units becomes problematic It is an event or series of events which seriously disrupts normal activities The magnitude of the effects of the event will be viewed differently. HISTORICAL BACKGROUND OF DISASTER IN KENYA The country of Kenya has been stricken by various disasters ,Kenya’s disaster profile is dominated by droughts, fire, floods, terrorism, technological accidents, diseases and epidemics that disrupt people’s livelihoods, destroy the infrastructure, divert planned use of resources, interrupt economic activities and retard development. The Kenya government through the Ministry of State for Special Programmes has developed National Policy for Disaster Management in Kenya   and National Disaster Response Plan  to guide in the disaster risk reduction. The history of disasters in Kenya has been collected to assist in predicting and planning for the future occurrences. The historical document has covered the period of disasters  occurrence, areas covered, the kind of disaster and the estimated causalities. FOREST FIRES UPDATE AS AT 1530 HOURS 27TH MARCH 2009 This report covers fires that date back to early February 2009.  We have since then had serious fire outbreaks  in many forests all over the country.  This state is attributed to prolonged drought conditions, heavy fuel loads in the forests and inaccessibility of the forests. The fires increased in the early days of the month of March, within the Mau complex, Mt. Kenya ecosystem, Aberdare Area and the response has been gaining grounds, so far the predicted fire behavior has not been good at all, as long as the rains continued to delay. The continuing fires are in Nakuru, Koibatek, Lariak, Meru south in Chogoria and the Kipipiri forest areas.  Most of the fires in Kipipiri have been put off except 2 fires.  The district forest officers are mopping up the fires and monitoring the situation.As of today 30th March 2009, most of the forest stations have reported that the ragging fires had been put off over the weekend by the showers that were there in most parts of the country. NAIROBI, 2ND APRIL 2009 THE NAKUMATT AND MOLO FIRE TRAGEDY The Nakumatt Supermarket fire broke out at 2.45pm on 28th January 2009. The cause of the fire is yet to be established but it is alleged to have been started by an electric power surge. The Molo fire broke out on 31st January 2009 at 6.45 at a remote area known as Sachangw’an, 3 KM from Salgaa trading centre along Nakuru-Eldoret highway. It involved a Mercedes Benz truck Reg. No.KAY 030F that was carrying 50,000 litres of petrol from Kenya Pipeline Nakuru depot to Juba, Southern Sudan. The cause of the fire is not yet established but it is alleged that an irate person who had been denied access to siphon oil from the fallen tanker ignited the fire but himself was the first person to perish on the spot. The effect of the two fires was too enormous in terms of human causalities, loss of lives and property and in testing the effectiveness of the Kenyan response systems. The effects of the fire could therefore not be ignored. All over a sudden, everyone realized how vulnerable they were and several interventions followed in succession of one another, which included establishment of the Nakumatt/Molo fire Victims Fund and its Management Committee and calls politicians and leaders for having in place a Disaster Management Policy and its Operational Plan. RESPONSE When the fires broke out, the responses were timely – with all major response agencies taking part. For the Nakumatt fire, the Nairobi Fire Fighters were on the scene in 15 minutes while for Molo fire the General Service Unit personnel were on the scene even before the fire started. What followed is that these teams were ill equipped and had to seek help from other response agencies, both private and public, who either arrived too late, were equally ill equipped or were not well coordinated to effectively prevent the full cycle of the raging fires. By the time the fires had been contained, 29 people were confirmed dead and one survivor recorded in the Nakumatt fire tragedy and 373 persons recorded as victims in the Molo fire tragedy which included 130 who died on the spot and 243 who were hospitalized as either in-patients or out-patients in various hospitals in Molo and Nakuru. A significant number of the victims were airlifted to Nairobi Hospitals the same day. (See more statistics below). On 6th February 2009, His Excellency the President, Hon. Mwai Kibaki established a Fund, ‘The Nakumatt/Molo Fire Victims Fund’ and its Fund Raising and Management Committee through Kenya Zagette Notice No. 1171. The objective and purpose of establishing the Fund was to provide (a) assistance in payment of medical bills; and (b) associated humanitarian assistance, to the victims of both tragedies. The Fund consists of donations by leaders, the private sector, the public service, the civil society, development partners, members of the public and other well wishers. The Gazetted Fund Raising and Management Committee for the Fund comprise of Naushad Merali – (chairman), Peter Kahara Munga, Martin Oduor-Otieno Bethwel kiplagat; and Eddah Lisigi The Committee is based in the Ministry of State for Special Programmes. After its initial meetings the Committee co-opted other sub-Committee members to represent special interests. These include:- Daud A. Mohamed          – Permanent Secretary, Ministry of State for Special Programmes Abbas Gullet                   – Director,  Kenya Red Cross Dr. Francis Kimani          – Director, Medical Services Steve Smith              

INTRODUCTION TO DISASTER MANAGEMENT KNEC NOTES – Click to view DISASTER PREPAREDNESS KNEC NOTES – Click to view DISASTER RESPONSE KNEC NOTES – Click to view POST DISASTER DEVELOPMENT KNEC NOTES – Click to view DISASTER OPERATION KNEC NOTES – Click to view EMERGING TRENDS IN DISASTER MANAGEMENT KNEC NOTES – Click to view