Spreading awareness about rural outreach program

 Flood

Floods are the most common natural disaster in India. Several states have been affected over the years by heavy floods. Recent examples include 2015 Gujarat floods and 2018-19 Kerala floods.

Warning systems:Initially, Emergency time functions are activated by SEOC and DEOC. All necessary forces are pre-positioned as per the direction of the state incident commander. And the defence wing along with the central force is ready to move into any location in the state.

Flood Preparedness

If each one of us is better involved in the process of preparedness, creation of awareness and the working of skilled emergency response teams, we can reduce loss of life and minimize human suffering.

BEFORE FLOODING OCCURS

Identify the nearest shelter and know the route. Prepare an emergency kit which includes:

First aid kit with extra medication for snakebite and diarrhoea

Strong ropes for tying things

Radio, torch and spare batteries

Stocks of fresh water, dry food, salt and sugar, kerosene, candles and matchboxes

Water-proof bags

Umbrellas and bamboo sticks(for protection from snakes)

If in rural areas, identify areas which are higher than your surroundings or build an earthen mound to locate cattle etc in the event of a flood

WHEN FLOODING APPEARS LIKELY

Tune in to radio or Tv for warnings and advice

Keep vigil about warnings from local authorities

Keep the emergency kit ready

IF YOU NEED TO EVACUATE

Inform volunteers or DMT the address of the place you are moving to.

Raise furniture, clothes, appliances onto beds or tables

Turn off power

Put sandbags in the toilet bowl or cover all drains to prevent sewage back-flow

Lock your house and take the route to nearest shelter

Do not get into water of unknown depth and current

DURING FLOODS

Drink boiled water

Don’t eat heavy meals

Use raw tea, rice water, tender coconut water etc during diarrhoea

Do not let children remain on empty stomach

Use bleaching powder and lime to disinfect surroundings

Avoid entering floodwaters

Do not eat food that got wet in floodwaters

Use halogen tablets to purify water before drinking it

Be careful of snakes

Man made disasters:Disasters that are caused by human beings are called man-made disasters. Examples are nuclear bombs, transportation accidents etc.

The most serious threats occur due to nuclear, biological and chemical warfare which are collectively known as WMD or Weapons of Mass Destruction.

Nuclear Weapons:

Nuclear weapons are the most dangerous weapons on earth. One can destroy a whole city, potentially killing millions, and jeopardizing the natural environment and lives of future generations through its long-term catastrophic effects. The dangers from such weapons arise from their very existence. Although nuclear weapons have only been used twice in warfare—in the bombings of Hiroshima and Nagasaki in 1945—about 13,400 reportedly remain in our world today and there have been over 2,000 nuclear tests conducted to date. Disarmament is the best protection against such dangers, but achieving this goal has been a tremendously difficult challenge.

Biological Weapons

Biological weapons disseminate disease-causing organisms or toxins to harm or kill humans, animals or plants. They can be deadly and highly contagious. Diseases caused by such weapons would not confine themselves to national borders and could spread rapidly around the world. The consequences of the deliberate release of biological agents or toxins by state or non-state actors could be dramatic. In addition to the tragic loss of lives, such events could cause food shortages, environmental catastrophes, devastating economic loss, and widespread illness, fear and mistrust among the public.

Chemical Weapons

The modern use of chemical weapons began with World War I, when both sides to the conflict used poisonous gas to inflict agonizing suffering and to cause significant battlefield casualties. Such weapons basically consisted of well known commercial chemicals put into standard munitions such as grenades and artillery shells. Chlorine, phosgene (a choking agent) and mustard gas (which inflicts painful burns on the skin) were among the chemicals used. The results were indiscriminate and often devastating. Nearly 100,000 deaths resulted. Since World War I, chemical weapons have caused more than one million casualties globally.

Petrochemical Transportation Accidents

Warning Systems

Emergency Response Vehicles of Oil Companies are under the control of State Emergency Operations Centre.

Standard Operating Procedure

1.Revenue department will Evacuate 500 metre radius and ensure compliance of all procedures by concerned departments along with informing SEOC for availing the services of the Emergency Response Vehicle of Indian Oil Corporation.

2.Fire & Rescue Services Will Avoid ‘Boiling Liquid Expanding Vapor Explosion (BLEVE)’ by continuous cooling with water and foam till the fuel is removed by the Emergency Response Vehicle or until the containment gets exhausted.

3.Police will ensure that no public shall be permitted within 500 m radius and stop all transport from and leading to the site within this radius. They will ensure that no vehicle shall enter the 100 m radius of the site other than Fire Force vehicles and the Emergency Response Vehicle of the petroleum companies and no one other than Fire & Rescue Service Personal and the experts of oil companies shall be permitted within the 50 m radius of the event site.

4.The electricity board will disconnect electricity to the panchayats falling within the 500 m radius and BSNL along with other private mobile telephone companies will switch off mobile towers within 500 m radius of the event.

5.Oil Companies will honor the directions issued by SEOC immediately for operational deployment of ERVs and they shall specifically designate officers not below the rank of General Managers to liaison with SEOC for operational deployment of the ERVs. The Oil PSUs shall ensure that ERVs have permanent mobile numbers issued and the numbers shall be intimated formally to SEOC such that SEOC can track the movement of the ERV during emergency deployment and ensure smooth movement through traffic control and Police escort.

Cyclones:Cyclones account for 30% of the total occurrences of disasters in India. It is defined as a region of low atmospheric pressure surrounded by high atmospheric pressure resulting in swirling atmospheric disturbance and accompanied by powerful winds. The Odissa super-cyclone in 1999 had a wind speed of 260-300 km/hr and killed thousands.

EOCs are required to disseminate warning to all the line departments & activate the emergency time functions.

All control rooms should function 24 hours.

Navy, Coast Guard and other central forces should be ready to move into any location.

BSNL should sent early warning SMS to public as per the information from EOC. Police should deploy emergency communication systems

Hospitals, CHCs and PHCs in the districts predicted to be affected by the cyclone should function at full strength 24 hours as per requirements by making necessary human resource arrangements from district level. Medical teams should be kept ready for field level disaster management. Ensure control measures for epidemic prevention. Adequate quantities of medicines, bleaching powder, chlorine tablets and trained manpower have to be ensured.

Relief camps should start functioning and relocation of the vulnerable population should be given priority.(particularly those living in kutcha houses and low lying areas) to the relief camps and other safe locations

The electricity board and public works department should be ready with emergency repair teams for deployment. Make necessary arrangements for drinking water distribution.

Police should stop vehicular traffic other than that of emergency services via roads prone to inundation. Collect and intimate the details of mainland fishermen to EOC, if stranded.

Declare holiday for all educational institutions

All mass gatherings and social events to be stopped

Adequate lifeguard, rescue boats, life lines/buoys to be positioned near the beaches.

Fisheries - Keep record/data of fishing boat /number of fishermen venturing to sea for fishing in particular islands. Advise fishermen to not venture into sea

Relief camps

Introduction

Setting up and managing camps is one of the most challenging tasks when a disaster occurs. They are indispensable and require proper planning and execution. The process is dynamic in nature. The camps need to be constructed such that the physical, emotional, cultural and social well-being of the camp inhabitants are ensured.

Relief camps are usually considered temporary, with an aim to provide basic necessities in an efficient manner. The site of construction, climatic changes etc will affect the stability and maintenance of the camps.

In this level, we look at the general guidelines of constructing a camp during a disaster as well as the setting up of an FLTC.

Standard Operating Procedure for Relief Camps

Location

The site should not be vulnerable to natural disasters like landslides, earthquakes etc

Preferably accessible by motor vehicles

Shelter

Inhabitants should be protected from adverse effects of the climate

Sufficient warmth, air, security and privacy must be maintained

General administration of the camp

A camp officer should co-ordinate and supervise the day-to-day activities in the camp

Any government officer can be asked to assist depending upon the requirements in the camp.

Management of the camp

Treat every inhabitant of the camp with dignity and respect

Make effective arrangement for distribution of food and aid to the people in the camp

Special care should be taken to ensure that vulnerable people like disabled, elderly, pregnant women and children get adequate aid and supply of food and other facilities.

Voluntary Organizations and leading citizens may be encouraged and involve in management of relief camp

Basic Facilities

Lighting Arrangement and Generator Set

Water Facilities

Sanitation

Food and clothing

Medical Facilities & Psycho-social Support

Briefly, these are the following steps involved in Setting up a FLTC:-

Identifying a suitable building

Procurement of goods

Setting up of Doffing & donning areas

Creating partition and Laying of beds

Prepping of washrooms, drinking water facility, recreational area

Setting up of the nursing station

Demarking and sealing isolation area

Setting up of Administrative area

Identifying the staff and training them

These steps are to be dealt with in-depth in the coming chapters.

A First-Line Treatment Centre(FLTC) is a facility where the most mildly symptomatic or asymptomatic COVID patients are treated. 70-80% of COVID patients are asymptomatic and only exhibit mild symptoms.

All such patients will be admitted into the FLTCs so that hospitals may be reserved for the most critically ill. FLTCs are not hospitals in the strict sense but only makeshift healthcare centres.

FLTCs are usually created as and when the need arises for such a facility within the Panchayat. A suitable Community Hall or any building is identified and the same is converted into a FLTC for a definite time period.

The following steps must be followed to set up the physical infrastructure required to create an FLTC:

Demarcate the isolation area as per the facility layout

Identify separate entry and exit points for patients and staff

Place the furniture and fittings as per the facility layout.

Set up enclosed Doffing and Donning areas

Set up an administrative office. The office must have a computer, a printer and one smart phone.

Set up a room for medical staff and non-medical staff each and a store room

Arrange for charging points both inside the isolation area for the patients and at the officer space outside the isolation area

Internet connectivity through Wi-Fi must be enabled both for the patients as well as staff

Drinking water must be made available in the isolation area

The electric lines and plumbing must be checked

Place signages to clearly establish a circulation flow for patients staff as well as stock

Place one smart phone permanently within the isolation area and the other smart phone in the administrative office outside the isolation area. This will be the primary mode of communication between the staff within the isolation area and the administrator stationed outside.

Seal the isolation area securely.

The building identified to be converted into a FLTC must have the following facilities:-

The Facility must be spacious enough to accommodate large numbers of patients easily.

It must be airy and naturally lit.

It must be a closed building so that the isolation area can be easily sealed.

The building must be ideally located away from hospitals and schools to protect the sick, elderly and children from any possible spread of the infection.

The building must be located within a short distance from a Taluk Hospital so that support can be sent from the Taluk Hospital in case of any medical emergency.

The facility must have separate entry and exit for patients and staff.

The proposed isolation area must have a partition to house Male and Female Patients separately (If the facility is open for both men and women)

There must be an adequate number of washrooms with at least one washroom per 4 patients.

There must be a dining area and a recreational area within the isolation area

There must be room outside the isolation area to set up the administrative office, area for staff and to set up a storeroom.

There must be a secure storeroom to store the medical supplies and other necessary items.

There must be an ambulance bay and waiting area outside the building

There must be enough space to create Donning (putting on of PPE kits) and Doffing (Putting off PPE kits) areas for nurses and doctors.

A.RECEPTION AREA:

Most patients who reach the First Line treatment centers are Covid 19 cases who have mild symptoms. With minimum but efficient use of PPE, triage the patient into stable & unstable.

All patients should sanitize their hands & wear masks before entry.

If a patient is a direct entry case and not referred through the Telehealth Helpline Unit, then a screening questionnaire needs to be applied for initial categorization and admission to FLTC.

B.COVID CARE AREA

The isolation area should have 3 entry/exit points:

STAFF ENTRY

STAFF EXIT

PATIENT ENTRY/EXIT

The area is completely sealed shut at all other places to ensure that no unauthorised entry or exit takes place.

C. ISOLATION AREA:The isolation patient area should have

1.Nurse Station

2.Sample Collection Area

3.Utility Area (Dining Area and Recreational Area)

4.Cots should be kept at least 2-3 m apart

5.Separate personal properties to be given to each patient

D. DONNING AREA

This is for the staff to wear personal protective equipment (PPE). This space should have

One table and stool

Hand washing area

Disinfectant dispenser(preferably with Lysol, in 10% *dilution)

Hand sanitizer dispenser (containing 60-80% Isopropyl alcohol)

Micropore tape dispenser

Hanging Mirror (for checking proper positioning of PPE )

E. DOFFING AREA :This is for the staff to safely remove PPE to safely dispose of them later.

Stool

Laundry Bins

Disinfectant spraying units

Hand washing area

Wash rooms (For staff to take bath after doffing. Each wash room to be disinfected after every use.)

IMPORTANT POINTS

Ideally there must be CCTV cameras in the patient isolation area

A separate phone (ideally a smart phone with internet service) must be kept in the isolation unit to enable communication with the outside world

Inflow and outflow of patients

A clear circulation flow for patients must be set on the ground. The patients will be taken in the ambulance straight till the entry into the isolation area. If the FLTC also has a triage facility, then to the Triage Area.

Once the patient enters the isolation area, the door must be secured to avoid any unauthorised entry or exit

Inflow and outflow of Staff

Staff must enter the facility through the staff entry close to the administrative area. They must then wear PPE Suits in the Donning area before entering the Isolation area. While exiting the isolation area, they must first doff within the doffing area, bath in the washroom and exit through the separate staff exit only.

Flow of stock and consumables

The inventory management component of the CARE system is used in managing inventory within a FLTC. A secure Store room is identified to store all the durables.

The flow of goods must also be clearly laid out. The goods must be dropped off close to the store room near the reception area. The same must be transported to the store room. As per need this stock must be drawn while recording the same in the inventory management tool.If such goods need to be taken into the isolation area, the same must be done by a staff donning the PPE suit. The channel of entry and exit will be the ones marked for staff.

Data management within an FLTC:

Data Management may be done through any hospital/patient management software.

For instance, FLTC's in Ernakulam district of Kerala uses CARE as patient management tool. The data of each patient is recorded in the system at the time of admission. Subsequently, each consultation or daily round detail is also added into the system for the record.

Any Sample testing that takes place in a FLTC is also routed through the CARE system.

If the patient is shifted from the facility to another hospital or another healthcare facility, the patient details are transferred to the new facility through the internet using the CARE System.

The administrator of the facility is in-charge of entering data into the CARE system. This person must be trained in the use of the CARE system for the management of patients, sample and inventory. The training material to using CARE system is available at Care System 101

A FLTC with 25 beds must have the following staff:-

1 Doctor on call available 24 hours

6 Nurses ( 2 nurses working in 8 hrs shifts)

6 Cleaning Staff (2 Staff working in 8 hrs shifts)

3 Data Entry personnel ( 1 Staff working in 8 hrs shifts)

1 Administrative head (Nodal person)

1 Information Officer (the contact person for families of the patients).

The number of staff may be increased or decreased depending on the capacity of the facility.

HOW CAN YOU CONTRIBUTE?

"How can an individual contribute to the society or community?" is a question that can be best answered by oneself.

Every individual can contribute in various ways by innovating or finding solutions to fill the lacuna or sufficiency of the existing systems at the grass-root level of a community.

This process can only be started once there is a clear idea of the existing system that has been functioning to solve the problems and obstacles that have popped up in the past and present scenarios.

You can contribute in three ways.

Cooperate with courtesy and patience with healthcare workers in the smooth working of the public health system. Always cooperate with law enforcement officials and other public servants.

Communicate to your family and friends how our public governance system works. May this knowledge and awareness flow from you to many others.

Contribute your time and efforts by engaging with your local community to find unique solutions for the unique problems that your community faces. Engage with your locale panchayat/ ward level team to see where you can step in and contribute. Put your skills and knowledge to use within your own community.

Depending on your interest and skill sets there are umpteen number of ways in which you can contribute to making the system better and more efficient.

Every individual will definitely have a role or way in which they can contribute to this fight. Let us look at some examples of how people from various walks of life have contributed.

Software Engineer - There are multiple software engineers who have built systems to track or integrate multiple processes in the healthcare system/ambulance network to improve the efficiency of the existing system. Especially in the backdrop of COVID we have seen many software engineers come forward with smart and intuitive tools to revolutionise field like healthcare, law enforcement, communication etc.

Farmers - Many farmers have started giving advice to homemakers and youngsters about the basic steps and knowledge required to cultivate vegetables at home. Thereby promoting the concept of self-sufficiency. Today, micro-farms are trending and people have started farming in their own homes. Any farmer can contribute towards imparting knowledge of farming into the general population and may even get into supplying seeds, biofertilizers or any service relating to farming.

Artists - Creative illustrations have been made to improve public health awareness campaigns. Art plays a major role in influencing the public. Moreover, art as an activity also supports mental health. Therefore as an artist, you may be able to contribute by creating meaningful art spreading positive messages or important information among the public. You may even choose to contribute by spending a little time every day to teach children art.

The problems faced by our community are many-folds. Problems like poverty, unemployment, food insecurity etc are increasing because of the socio-economic impact caused by the Pandemic.

Our country already has a system to solve issues faced by the community. Just like any other system, this system is also far from perfect. It is upon us civilians to supplement the efforts of the state and work towards increasing the efficiency of the governmental projects.

There are various existing government programs for poverty alleviation, generating employment for the unemployed etc. A few of these programs are listed below:-

Ashraya:

In this scheme, families which are the weakest financially in a Panchayat or Municipality is identified. A clear criterion is set to identify the most deprived. Income, health, assets, etc. are factors.

The objective of the scheme is to elevate them till they do not require the support and integrate them to the mainstream society. The scheme requires every Grama Panchayat to prepare separate micro-projects for each destitute household identified. These micro-projects are then integrated with the annual plans of the Grama Panchayats. This program is implemented through Kudumbashree. Kudumbashree updates the Ashraya List every year. Eligible families are identified by NHGs, verified by ADS, followed by eligibility checking at the CDS and finally approved by the Grama Panchayat Committee.

Multi-year projects are considered under this scheme. Three-year duration initially, extendable through projects for continued support to the needy.

The Panchayat must see to it that the benefit of any project or scheme must first fall upon this population. If there is a scheme by the Water authority, it must be made sure that the people under Ashraya have a priority. The same goes for any scheme under health, education etc.This project has been financed by central, State government support, contributions by District and Block Panchayats, and plan funds of the respective Grama Panchayats. Attempts to mobilize financial and other support from agencies and individuals may also be helpful. The existing schemes which are considered under the project are:

Land for house construction for the homeless by Grama Panchayat

House under Indira Awas Yojana (IAY)

Electrification through Rajiv Gandhi Grameen Vidyutikaran Yojana

Drinking water through the special scheme of Kerala Water Authority (KWA) covering BPL families etc.

How can you contribute?

Students can contribute their time, effort and resources to support the implementation of this scheme so that the intended benefits reach the beneficiaries. You may work with the Panchayat, firstly by understanding how this scheme has been implemented so far. The students may also identify people who deserve to be beneficiaries of this scheme.

Employment Guarantee:

This has been one of the flagship schemes and includes programs under NREGA. Every ward has at least 10-50 people who participate in the scheme. It is not only the poorest section of the society, women from the middle-class are also seen to be participating. Even 85-year-old people participate. Anyone can work depending on their ability. This ensures them a minimum pay.

The objective of the Act is to enhance livelihood security in rural areas by providing at least 100 days of guaranteed wage employment in a financial year to every household whose adult members volunteer to do unskilled manual work. They may apply for registration in writing or orally to the local Gram Panchayat. The Gram Panchayat after due verification will issue a Job Card which is free of cost.

A Job Cardholder may submit a written application for employment to the Gram Panchayat, stating the time and duration for which work is sought. The minimum days of employment have to be at least fourteen. In case, work is provided beyond 5 km, extra wages of 10% are payable to meet additional transportation and living expenses.

Wages are to be paid according to the Minimum Wages Act 1948 for agricultural labourers in the State unless the Centre notifies a wage rate which will not be less than Rs. 60 per day. Equal wages will be provided to both men and women. Permissible works predominantly include water and soil conservation, afforestation and land development works.

This scheme is sponsored by the central government. The central government provides the majority of the funds and the state contributes a small portion. The scheme has played a significant role in poverty alleviation in the past decades.

The funds flow through the Panchayats. The primary intention of the central government is only to disburse the funds to the unemployed population and if the workforce is made use of more efficiently, this could lead to more development of the community. There is scope for innovation to make the scheme more effective.

How can you contribute

Students may choose to research on the impact of the Project in their panchayat. The impact is of two-fold. Firstly, the aspect of poverty alleviation and secondly, the impact of work carried out by the beneficiaries of the scheme. Find ways by which the quality of work done through the scheme may be increased so that the whole community may benefit from it.

You may also choose to increase awareness about this scheme among the poor and unemployed.