ENVIRONMENTAL HEALTH MANAGEMENT PRIORITY AREAS FOR INTERVENTION. 1.Areas where health risks have increased: Areas with high population densities and luck of adequate environmetal services 2. Areas with high population densities and moderate disruption or with moderate densities with severe disruption. 3. Areas with low population density and minor disruption of services. Priority Environmental Health Services. Primary consideration should be given to services for protecting and ensuring the well being of people at high risk areas-Prevention and control of communicable diseases. Post disaster environmental health measures can be divided into two priorities. Ensuring that there are adequate amounts of safe drinking water basic sanitary 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.

The following are recommended to quickly re-establish adequate environmental health services and conditions. Obtain information about population movements in or near the stricken areas and map the location of camps for refuges, displaced persons, relief workers settlements and hospitals and other medical facilities. Carry out rapid assessments to determine the extent of damage to the public water supply and waste disposal system and food production, storage and distribution network. Determine the remaining operational capacity for delivering these basic environmental health services. Make inventory of available resources including undamaged food stocks. Human resources and readily available equipment, material and supplies Determine the stricken population immediate needs for water, basic sanitation, housing and food. Meet the needs of essential facilities as quickly as possible after the basic human consumption needs are satisfied. Hospital and other medical facilities may need increased water supplies if their is a high number of casualties. Ensure that refugees and displaced persons are properly housed and that temporary settlements and other identified high risk areas have basic environmental health services.

For the efficient use of overburdened resources, it is important to immediately and accurately access damages and identify the needs should include the following information. Type,location and extent of damage. Accessibility (communication). Remaining operational capacity Estimate of resources needed for repairs Estimated repair time

Rapid assessment will assist in identifying resources required to restore the system immediately. Human resources Need for environmental health specialist. These should be familiar with good conditions and local environmental people will be the most appropriate. Local population assists in the needed resources and services.

WATER SUPPLY. Survey of all public water supply will have to be made and their distribution system and advancing to the water resource. It is important to determine bacteriological and chemical quality of the water supplied. Bear in mind microbiological contamination. It is important to ensure that the chlorination – best means for disinfection – cheap and readily available. A minimum free residual chlorine level of 0.7mg/l is recommended in emergency situations. Chemical contamination and toxicity – second concern – potential chemical contaminants have to be identified and analyzed. If not sure – alternative water has to be found.

Alternative water resources. Deep ground water. Shallow ground water and spring water. River water. Surface water. Private water supply resources – dairies, breweries, food and beverages plants, and tourist resort – can be approached for asistance if need be.The water from whatever sourse will need too be tested for fitnes for human use.

Existing and new water resources require the following protection measures. Restrict access by people and animals – fence if posible. Ensure adequate excreta disposal at a safe distance from water source. Prohibiting bathing, washing etc. Upgrade wells – protected from contamination. Estimate the maximum yield of wells and therefore if necessary ration. In many emergency situations, water has to be trucked to disable stricken areas or camps. Water tankers – from commercial water companies, dairies etc. If locally available, mobile water purification equipment may be used in emergencies.

Mass Distribution of Disinfectants The mass distribution of tablets, powder or liquid disinfectants should be considered when: Affected persons should be experienced in their use Affected persons – trained Appropriate storage facilities are distributed Public health or community health workers – assist in ensuring proper use of disinfectants. Distribution network – in place to ensure continous supply as needed throught the emergency phase.

FOOD SAFETY Poor Hygiene – Major source of food borne illness in disaster situations. Kitchen sanitations of utmost importance. Utensils must be washed in boiled water, and personal hygiene should be monitored by individuals involved in food preparation. Food supplies – to be stored in containers that will prevent contamination by rodents or insects.Refrigiration may have to be pro ided and or improved.

BASIC SANITATION AND PERSONAL HYGIENE. Many communicable diseases – spread through faecal contaminators of drinking water and food. Therefore – need for sanitary disposal of excreta. Emergency latrines – made available displaced refugees, relief workers – places where there are no toilet facilities have been destroyed. If sanitary facilities are not available, people to bury their excreta. Personal hygiene tends to decline after natural disasters- especially in crowded areas where water is not easily available. It is therefore recommended to:

Provide basic hand washing facilities Provide washing, cleaning and bathing places Make sure adequate amounts of water available. Avoid overcrowding in sleeping quarters Launch education campaigns on personal hygiene, basic sanitation and waste management. Waste water from camps for refugees and displaced persons – proper disposal. The most common means is through soak away, seepage pit or absorption trench.

SOLID WASTE MANAGEMENT Solid waste management – special problem in emergency situations – i.e. authorities have to deal with, also debris from all sorts of things. Special care should be taken when disposing hazardous material. VECTOR CONTROL. Vector control programmes should be intensified in emergency or rehabilitation period especially in areas where vector control diseases are endemic or social concerns are: Leptospirosis, plague, malaria, typhus,bedburg,coackroches,ticks,mites,ring worms etc.

In;case of floods – mosquitoes will breed in plenty. The following are essential emergency vector control measures. Draining of water in the camps Spraying of insecticides Larviciding Mollusciciding Biological control

BURIAL OF THE DEAD Human bodies – not to contaminate streams, wells or other water sources – gastroenteritis or food poisoning syndrome to survivors. Despite the negligible health risks, dead bodies represent delicate social problems. The normal simplest burial or cremation should be used wherever possible. Before burials and cremations – bodies have to be identified and death certificates provided from registra.