The fourth map, consisting of prevention analysis, contains the identification, inventory, and assessment of all activities and measures in a given area to prevent hazards and their effects and provide permanent protection from their impact.  For the creation of a prevention map, structural and non-structural measures are analyzed and portrayed. 

The fifth map, a response analysis, contains the identification, inventory, and assessment of all response activities and measures in a given area to reduce social and economic damage and loses.  Measures for the criteria of a response map are analysis of search, rescue, humanitarian assistance, recovery, and reconstruction structures.  This map is emergency-oriented and shows existing disaster response structures. 

The final map, a vulnerability analysis, is assessed through the existing condition of a given area and its ability to cope and withstand to specific natural hazard events and their impact.  Measures are analysis of hazard characteristics, socioeconomic, exposure, preparedness, prevention and response variables.  Vulnerability map, also called natural hazard map, shows the degree of ability to cope with and respond to specific natural hazard events.  Vulnerability is determined through the overlay of the former maps. 

            Inside each uniform area a synthesis of values from the previous maps is given which gives an impression of the overall vulnerability of the unit.  Since each of the five indices corresponds to a specific factor, the vulnerability map shows not only the degree of vulnerability of an area, but also the reasons for tat vulnerability.  Consequently, if one desires to reduce the vulnerability of a particular area, the vulnerability map shows where changes could be introduced.               

Warning Systems

It is imperative that citizens receive a timely warning about impending hazards in order to ensure the best possible outcome.  Therefore, the development of a warning system is one of the most important functions of emergency management.  Warning systems tell populations when a hazard will occur, how long the hazard will last, what the possible impact will be, and what might be done about it.  Information issued in a warning may include predicted wind strength, expected inches of rain, road closures, and specific steps to take to prepare.  Warnings also facilitate the evacuation process and ensure that shelter locations are identified.  Different types of warning systems include sirens, media, emergency alert systems, reverse 911, intercoms, teletype writers, telephone devices, strobe lights, loudspeakers, door-to-door notification, and weather radio (ICMA, 2003).

Resource Identification

In any disaster, it is necessary that personnel, equipment, and supplies must be easily reached.  Therefore, resource lists should be developed.  Essential phone numbers, pager numbers, fax numbers, e-mail addresses, and physical addresses for key city officials, managers of city departments, utility companies, and the National Weather Service should be on hand.  The location of physicians, hazardous materials response teams, protective gear, search dogs, generators, sand bags, wrecking services, laboratories, debris removal companies, and other essential companies should also be included.  An equipment inventory list should also be developed, containing such things as fork lifts and trucks and should describe the operational status of this equipment (ICMA, 2003).  The availability of these lists and their upkeep will help reduce morbidity and mortality during a disaster.    

Although these lists are necessary, they will not always guarantee that the community has everything it needs to respond to disaster.  It is possible that a planning committee might want to apply for grants in order to acquire funding in order to fund preparedness and build emergency management potentialities.  It may also be necessary to develop mutual aid agreements such that access to specialized personnel and unique equipment might be available.  These legally binding documents are entered into by two or more jurisdictions to provide aid to each other in event of disaster (ICMA, 2003).       

Drills and training

First responders, emergency managers, and all others involved should hold regular training sessions or seek out training from state emergency management offices.  Also, the disaster plan that has been developed should ideally be exercised once a year.  This can be done one of three ways.  First, tabletop exercises are the most basic exercises in which public officials discuss disasters using paper or computer-based scenarios to practice problem solving and identify problems that might occur.  The second method uses field exercises to test a limited number of disaster functions to improve specific capabilities.  The third type of exercise is a full-scale drill which is the most comprehensive of these methods ((ICMA, 2003 and Landesman, 2001).  With each of these exercises, special attention should be payed to what might be changed to improve response.   

Public Education

Effectively educating the public is a key component to any disaster preparedness plan and has the ability to increase support for disaster policy and funding, prevent future events, and help citizens to respond to disaster in a safe manner.  Topics covered may include causes and consequences of disaster, how to protect homes, evacuation and shelter, whom to contact for assistance, other self-preservation information, basic first aid, and importance of hazard insurance.  This information can be communicated in a variety of ways including developing brochures, talking to children in schools, and enlisting the help of the mass media (ICMA, 2003).  The use of the mass media to deliver warnings to the public and to educate about avoidance of health problems after disaster can be a very effective public health tool.   

Issues in Planning for Response

Sharing Information

The sharing of information is essential, but can be complicated due to the number of people involved and the amount of equipment required.  During the impact and post-impact phases of a disaster, two-way radios may be the only reliable form of communication.  Even if ground and cellular telephone systems are still in working order, they are likely to be overloaded.  Using these radios for communication is difficult since no common frequency has been designated for these purposes.  Several different bands have been assigned public safely frequencies by the Federal Communications Commission, making it difficult for agencies to communicate on a common frequency.  Newer radios may be programmed to operate on different frequencies, but not on different bands.  While radios that operate on different bands have been produced, they are the exception (Landesman, 2001). 

Resource Management

The distribution of supplemental personnel, equipment, and supplies among multiple organizations, resource management, requires the determination of needs as well as the location of these resources.  A staging area must be set up once a security perimeter has been established where a manager will oversee personnel.  Responders and volunteers will be logged in, briefed on the situation, given an assignment, and provided with a means of communication and hardware to link them to the broader response effort (Landesman, 2001). 

Warning and Evacuation

Evacuation from areas of danger can be the most effective strategy for saving lives in a disaster situation when advance warnings are possible.  This task demands definitive communication among many agencies such as the US Weather Bureau, the sheriff’s office, and radio stations.  Threats must be detected and analyzed to determine the specific areas at risk and the nature of the risk.  Warnings must be given in such a way that those at risk will heed the notice and take appropriate measures.  Factors that improve the effectiveness of a warning include the credibility of the source of the warning, the number of warnings, the uniformity of message content across varying informants, the context of the warning, the inclusion of information that allows recipients to assess whether or not they are directly in danger, and specific information on actions that can be taken for self-protection (Landesman, 2001).      

Search and Rescue

In many disasters, casualties are initially treated in the field which influences their entry into the health care system.  Most immediate search and rescue is initiated by untrained bystanders in the area and disaster response may occur across jurisdictional boundaries or involve emergency responders from many agencies.  These characteristics can create organizational problems (Landesman, 2001).


Triage is the method of assigning priorities for treatment and transport for injured citizens.  It is important to consider the possibility of untrained personnel and bystanders who are often the first to respond and are unaware of established field triage and first aid stations.  As a result, these constructs may be bypassed by those concerned with transporting victims to the nearest hospital (Landesman 2001).  This must be considered in a successful plan.     

Casualty Distribution

The establishment of protocols for distribution of casualties between emergency medical services and area hospitals will allow for the even distribution of casualties.  This element of the plan will help prevent the closest hospitals from being inundated with patients while the resources of other hospitals are never utilized.  It will also help control transport decisions made by untrained volunteers (Landesman 2001). 

Patient Tracking

Patient tracking can be very complicated during times of disaster.  Most people evacuated from their homes are never registered by the American Red Cross, since they do not go to public shelters.  Since no single agency receives information about the location of victims from hospitals, morgues, shelters, jails, or other locations, tracking is further perplexed.  Hospital records are often incomplete since most victims arrive without the use of an ambulance.  Finally, it is possible that hospitals themselves might be damaged and evacuation might further complicate the issue of tracking where patients are located.      

Patient Care with Damaged Health Care Infrastructure

Hospitals, urgent care centers, home health care agencies, pharmacies, and dialysis centers must take appropriate measures to make sure that their facilities will not be damaged or disabled during a disaster and that backup arrangements are in place for patient care.  This includes backup supplies of power and water, secure building structures, maintaining essential equipment, surge protection and data backup, and plans for alternative sites (Landesman, 2001).

Management of Volunteers and Donations

Often, more resources than are expected, or even needed, arrive at the site of a disaster.  Large numbers of donations and unsolicited volunteers should be expected.  Also, a plan for channeling public requests for aid to a locality outside the disaster area where resources can be collected, organized, and distributed without disrupting emergency operations (Landesman, 2001).

Regardless of the level of preparedness planning that takes place, disasters will likely require some unanticipated tasks such as the organized improvisation in response to disruption of shelter, utilities, communication systems, and transportation.  Public health officials must therefore develop the capacity, procedures and training to deal with unexpected problems that might arise (Landesman 2001).    

Special Considerations

The Threat of Bioterrorism

In recent years there has been a growing concern in the public health community over the possibility of biological acts of terrorism.  This type of disaster creates a unique challenge in detection, preparation, and response (Garrett, 2001).   Absent of an explosion, there will be no immediate evidence of an attack.  Therefore, first responders will not be firefighters or police, but healthcare providers.  First indication will likely be an outbreak of uncommon illness or incidence of symptoms.  The effectiveness of medical and public health response and therefore the extent and severity of the impact on the community will be determined by the rate at which the outbreak is detected, analyzed, and understood.  Therefore, enhanced disease surveillance systems are critical (Hamburg, 2001).

Epidemiological capacity to detect and investigate outbreaks and unusual trends in infectious disease will be necessary as well as laboratory capacity to quickly collect and analyze samples.  Measures will also need to be taken to allow expedient communication of findings.  The release of biological agents may also require rapid access to substantial quantities of pharmaceutical antidotes, antibiotics, and vaccinations (Hamburg, 2001).  These considerations vary from the issues taken into account form most other potential public health disasters and increasingly require special consideration. 

After a Disaster

            The environment after a natural disaster can be unhealthy and unsafe.  Hazards that can result in injury, illness or death include (CDC, 2003):

·        Physical hazards (e.g. fire, displaced objects, unstable building structures, downed power lines, overexertion during cleanup and animals that may attack humans out of fear or because they are injured and in pain).

·        Chemical hazards (e.g. gas leaks, carbon monoxide from generators, and chemicals released from industries and other sources into food, water or the environment).

·        Disease hazards (e.g. food or water contaminated with sewage, an increase in mosquitoes that can spread disease and crowded living conditions).

·        Psychological hazards (e.g. post-traumatic stress syndrome, anxiety, depression, fear, rage).


Several factors keep people from effectively protecting themselves after a disaster including lack of knowledge about what to do or not to do, or where to acquire health and safety information; ignoring health and safety information; psychological effects of the disaster that weaken clear judgment; disaster-related disturbance of communication channels that could be used to communicate health and safety information; and interruption of social, medical, and community services.

Future of Public Health and Disaster Preparedness

            New information technologies are being used in public education and are increasingly being applied to emergency development and tutorial activities to improve emergency preparedness.  These technologies will be applied to reveal how emergency planners can more efficiently accomplish their task to educate the larger community on an assortment of issues such as the need to adopt future mitigation strategies, to respond to disaster warnings and evacuation suggestions.  Furthermore, they will be applied to establish how response and recovery information can be promptly circulated to an impacted area.  Applications will also be made available which demonstrate the advantage of technology in enhancing training activities for emergency personnel as well as offering the prospect for such instruction beyond the time and place of the original trainer.

Selected Web sites at academic institutions (Fischer, 1998)

Disaster Research Center, University of Delaware



Institute of Emergency Administration and Planning, University of North Texas





Natural Hazards Center, University of Colorado, Boulder




Social Research Group, Millersville University of Penn.




Selected Web sites of government agencies and disaster organizations (Fischer, 1998)

American Red Cross


Centers for Disease Control


Federal Emergency Management Agency


International Federation of Red Cross and Red Crescent Societies



Japan’s national Research Institute for Earth Science and Disaster Prevention



National Institutes of Health


Pan American Health Organization


Red Cross


US Federal Emergency Management Agency




US Geological Survey


US National Weather Service


Volunteers in Technical Assistance


World Health Organization



The above organizations not only provide online assistance, but also preparedness and mitigation, response and recovery information.  Furthermore, academic research centers, government agencies and disaster organizations provide a variety of information which is used to educate in several respects including:

·        What academic institutions are engaged in disaster research

·        What research topics are currently under consideration

·        Who is engaged in such research

·        What government agencies are involved in planning for and responding to disasters

·        What information is currently available from such agencies

·        What preparedness information is currently available

·        What mitigation procedures and suggestions are recommended

·        What constitutes an effective response check list

·        Disaster agent specific information (e.g. hurricane damage and flood mitigation fact


·        How to apply for FEMA assistance

·        What disaster organizations exist and the services and information they provide



            Our rethinking of disasters leads us towards a policy of long-term loss reduction, only if we accept that complete prevention is ultimately unachievable. This mitigation policy should have a risk task force that identifies problems, coordinates action with other task forces, and delivers data for the data center.  They should use standard documents to develop statistical reports to enable consistent evaluation, assessments, and reactions should be developed and used.  Periodic reviews of actions and accomplishments in vulnerability assessment should be undertaken; the task force should exchange information and knowledge between different governmental levels and social divisions.  Furthermore, evaluation of all measures and feedback to the task forces is strongly suggested.  Finally, concerning system and facilities, possible resources with respect to specified objectives, such as increasing preparedness or reducing exposure in a unit area, should be acknowledged and assessed.




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