Friday, October 28, 2011

Snow removel and exercise. Community Participation. Whole Community Approach

SNOW EMERGENCIES. “ONE BLOCK AT A TIME.”

Many individuals treat snow emergencies as just an inconvenience or interruption to normal individual and community routines. But, snow emergencies have physical & mental health, financial and economic impacts on a community.

Treating snow emergencies with the same planning requirements, and preparedness as earthquakes, tornadoes, flooding, and man-made disasters will contribute to decreasing health effects, and the financial and economic impacts.

Communities can plan block traffic parking patterns, and block snow removal plans that can greatly increase the movement of neighbors and emergency personnel. Planning with public safety and transportation departments on snow removal plans have to be considered long before these events occur.

A weekend snow emergency exercise with neighbors can provide assurance that each neighbor knows what will be the procedures for parking, snow shoveling, and assistance to those that are unable to remove even small amounts of snow due to physical limitation.

Contact your local public safety, transportation, or other authority for snow removel on public roads and residential areas. Communities with home owner or other residential associations have snow removal plans. Contact them for snow removal patterns in your area.

Thursday, October 27, 2011

Recovery from Disasters. Secondary Effects. Sanitation.

http://new.paho.org/disasters/index.php?option=com_content&task=view&id=543&Itemid=904

Cholera in Disaster Situations

Cholera is an intestinal infection caused by toxigenic Vibrio cholerae, group O-1 or O-139. Natural and man-made disasters which produce overcrowding, a scarcity of safe drinking water, improper elimination of human waste, and the contamination of food during or after its preparation are risk factors for the spread of the disease.

Description

In areas where cholera has not been confirmed, a suspected case is defined as severe dehydration or death from acute watery diarrhea in a patient over 5 years of age.

In areas where an epidemic is under way, a suspected case of cholera is defined as acute watery diarrhea, with or without vomiting, in a patient over 5 years of age.

A confirmed case of cholera is defined as the laboratory-confirmed presence of V. cholerae 01 in any patient with diarrhea. Once the presence of the disease has been confirmed, it is unnecessary to examine specimens from all cases or contacts. Monitoring should include ongoing laboratory confirmation of a small proportion of cases.

It is important to adopt this definition. However, for clinical management of cases of acute watery diarrhea in an area in which an epidemic is under way, cholera should be suspected in all cases in patients aged 2 or older. It should be noted that in Central America, cholera primarily strikes adults, with 80% of the recorded cases representing individuals 5 years of age or older, while 80% of diarrheal diseases from other causes occur in children under 5.

There are more than 60 serogroups of Vibrio cholerae, but only the O1 serogroup causes cholera. V. cholerae occurs as two biotypes: classical and El Tor. Each biotype has two serotypes: Ogawa and Inaba. The El Tor biotype (first isolated in Egypt in 1905) is responsible for almost all the recent outbreaks of the disease, producing a greater proportion of asymptomatic infections than the classical biotype and surviving longer in the environment. This biotype can live in association with certain aquatic plants and animals, which makes water an important reservoir of the infection.

History of Cholera in the Region

The second cholera pandemic spanned the period 1826 to 1837. This was the first pandemic that ravaged England and Western Europe, causing thousands of deaths in early 1830. The epidemic spread to Canada, the United States, and Mexico in continental North America, to Guyana in South America, and to Cuba.

In January 1991 Vibrio cholerae 01 reached a town on the coast of Peru, trumpeting the arrival of the seventh cholera pandemic in Latin America. By the year 2000 the epidemic had spread to 21 of the 35 countries of the Region of the Americas, with Canada, Uruguay, and the Caribbean remaining free of the disease.

Moreover, in 1999 Argentina, Bolivia, Chile, Costa Rica, French Guiana, Guyana, Paraguay, Panama, and Suriname did not report cases of the disease.

In the 19th and early 20th century cholera was a predominantly urban phenomenon with high case-fatality rates (30-50%). In contrast, the Latin American epidemic of the 1990s was rural, with lower case-fatality rates (around 2%). The disease is also becoming endemic, and an incipient seasonal epidemiological model can be observed.

Risks for the Traveler

People who follow the usual tourist itineraries and observe food safety recommendations face practically no risk when visiting countries that have reported cases of cholera.

The 10 Most Frequently Asked Questions

Q. When we speak of cholera we often refer to it as a pandemic. What is a "pandemic"?
A pandemic is a disease that strikes the majority of the population in a large region, emerges simultaneously in different parts of the world, and is a long-term phenomenon.

Q. Is cholera as widespread and serious now as it used to be?
No. In the 19th century cholera was found in major cities, causing high case-fatality rates (30%-50%), while today the infection is often mild, self-limiting, or subclinical and is found in rural areas, with relatively low case-fatality rates (2%).

Q. What led to the changes in the model of the disease?
The following factors can be mentioned: (a) El Tor, a biotype of V. cholerae in circulation, which produces a greater proportion of asymptomatic cases than the classical biotype; (b) greater access to safe drinking water; (c) better excreta disposal systems; (d) health education, and (e) primary health care.

Q. Is it possible to contract V. cholerae through person-to-person contact?
It is possible, but this type of transmission is very rare.

Q. What are the main steps in managing a suspected case of cholera?
The main steps are: assess for dehydration, rehydrate with a solution of oral rehydration salts, observe the patient, replace missing fluids, administer oral antibiotics only to patients with serious dehydration, and feed the patient.

Q. Do we need a health system with a high level of complexity to treat cholera?
Fluids and simple electrolyte replacement therapy produce excellent results in the majority of cases. Serious cases may require antibiotics (doxycycline or tetracycline for adults; trimethoprim sulfamethoxazole for children). These interventions can be carried out at the primary level.

Q. Are travel and trade restrictions recommended in outbreaks of cholera?
No. Travel and trade restrictions between countries or between different areas of a country do not prevent the spread of cholera. Not only are they ineffective, they lead to the suppression of information on outbreaks of the disease. WHO modified its International Health Regulations in 1973 so that travelers would no longer be required to show a certificate of vaccination against cholera.

Q. Are vaccinations recommended for cholera control?
No. The traditional vaccine against cholera (based on whole, killed cells) is characterized by low levels of efficacy and high reactogenicity. Therefore, it is not recommended for the control of epidemics. The new vaccines might be considered, but with these, there is a rapid loss of protection, giving people a false sense of security. Resources should be channeled to the most useful control methods.

Q. How do we protect young children against cholera?
In infants under 6 months, breast-feeding protects against the disease. Careful preparation of formula and food with safe drinking water should protect infants who are not breast-fed.

Q. Is it mandatory to report cholera outbreaks?
Yes. The diseases listed as reportable by the International Health Regulations are cholera, yellow fever, and the plague. WHO publishes the data on cholera outbreaks in the Weekly Epidemiological Record; the CDC publishes its semiweekly "Health Information for International Travel" to inform the public about where cholera and yellow fever have been reported.

What to Do at the Institutional and Community Level

Adopt long-term policies to ensure that all populations have access to adequate systems for excreta disposal and the provision of safe drinking water;

Offer basic health services through primary health care systems. The majority of cholera cases respond well to simple therapies; Prescribe antibiotics only for cholera cases showing signs of severe dehydration;
Monitor the susceptibility of V. cholerae to antibiotics;
Maintain specificity in reports, employing the case definitions developed by PAHO/WHO;
Update the epidemiological profile of areas with cholera or considered at risk for the disease;
Offer periodic training to physicians and paramedical personnel for the clinical management of patients with acute diarrhea;
Maintain a stock of essential emergency supplies, especially oral rehydration salts (ORS) and solution and appropriate antibiotics.
Maintain a buffer stock of drugs at appropriate points in the drug administration system;
Emphasize safe disposal of human excreta through health education;
Construct sanitary systems for human waste disposal, suited to the local conditions.
Promote community production of chlorine so that it can supply itself.

What to Do at the Personal Level

Drink only safe water (tap water, boiled for a minute or more, or water that has been disinfected with chlorine or iodine tablets);
Avoid raw food (except fruits or vegetables that can be peeled);
Cook food until hot both inside and out and eat while still hot;
Carefully wash and dry kitchen or serving utensils;
Wash hands carefully with soap after using the toilet and before preparing or eating food or feeding children;
In emergencies, while a better latrine is being constructed, a simple pit (0.3m x 0.3 m x 0.5 m) can be dug at least 30 meters from the well or other source of drinking water. Latrines should be located below the level of the water source. Avoid swampy ground.

What Not to Do

Do not eat mollusks, shellfish, or other fish or seafood from polluted waters, unless they are cooked thoroughly;
Do not eat raw vegetables;
Do not wash kitchen utensils or eat with water known to be contaminated;
Do not bathe in water known to be contaminated;
Do not mix raw food with cooked food;
Do not drink milk that has not been pasteurized, unless it has been boiled adequately;
Do not eat ice cream or use ice, unless it is from a safe source;
Do not take antibiotics, unless prescribed by a health worker;
Do not issue a quarantine in an effort to control the spread of cholera.

Contact

Dr. Marlo Libel
Phone: (202) 974-3129
Email: libelmar@paho.org

Wednesday, October 26, 2011

REENTRY PROGRAM for Ex-Offenders & Disasters. ‘Whole Community Approach’

REENTRY PROGRAM for Ex-Offenders & Disasters. ‘Whole Community Approach’

“Thinking outside the box.”

· Can ex-offenders be utilized in all phases of the emergency management process for communities in recovering from disasters (natural, and man-made)?

· Could the FEMI EMI community based online courses be used in the release\parole process, then be supplemented by direct Community Emergency Response Team (CERT) training upon release so that these individuals are a vital resource welcomed back into the community?

· Is this an under utilized resource for community recovery?

In developing your community programs utilize all available resources for planning and long-term recovery. The whole community approach encompasses using all members of your community for recovery, and providing assistance. Senior citizens, the disabled, individuals, families, and businesses in your area must be included in your efforts.

For grant and funding opportunities take into consideration long-term part-time positions using these individuals.

Comments?

Disasters and Domestic Violence

http://www.ptsd.va.gov/professional/pages/disasters-domestic-violence.asp

Disasters and Domestic Violence

Fran H. Norris, PhD

Prevalence and impact of domestic violence in the wake of disasters

Two questions require attention when considering the implications of domestic violence for postdisaster recovery.

The first question is whether domestic violence increases in prevalence after disasters. There are only minimal data that are relevant to this question. Mechanic et al. (1) undertook the most comprehensive examination of intimate violence in the aftermath of a disaster after the 1993 Mid-western flood. A representative sample of 205 women who were either married or cohabitating with men and who were highly exposed to this disaster acknowledged considerable levels of domestic violence and abuse. Over the 9-month period after flood onset, 14% reported at least one act of physical aggression from their partners, 26% reported emotional abuse, 70% verbal abuse, and 86% partner anger. Whether these rates of physical aggression are greater than normal is not known because studies of domestic violence from previous years and under normal conditions have showed the existence of rates of violence as low as 1% and as high as 12%.

A few studies have produced evidence that supports the above. Police reports of domestic violence increased by 46% following the eruption of the Mt. St. Helens volcano (2). One year after Hurricane Hugo, marital stress was more prevalent among individuals who had been severely exposed to the hurricane (e.g., life threat, injury) than among individuals who had been less severely exposed or not exposed at all (3).

Within 6 months after Hurricane Andrew, 22% of adult residents of the stricken area acknowledged having a new conflict with someone in their household (4). In a study of people directly exposed to the bombing of the Murrah Federal Building in Oklahoma City, 17% of noninjured persons and 42% of persons whose injuries required hospitalization reported troubled interpersonal relationships (5).

The second question is whether domestic violence, regardless of the reasons how or why it occurs, influences women's postdisaster recovery. An important finding from Mechanic et al.'s (2001) study was that the presence of domestic violence strongly influenced women's postdisaster mental health. Thirty-nine percent of women who experienced postflood partner abuse developed postflood PTSD compared to 17% of women who did not experience postflood abuse. Fifty-seven percent of women who experienced postflood partner abuse developed postflood major depression compared to 28% of nonabused women. Similarly, Norris and Uhl (3) found that as marital stress increased, so too did psychological symptoms such as depression and anxiety. Likewise, Norris et al. (4) found that 6 and 30 months after Hurricane Andrew, new conflicts and other socially disruptive events were among the strongest predictors of psychological symptoms.

These findings take on additional significance when it is remembered that not only are women generally at greater risk than men for developing postdisaster psychological problems, but women who are married or cohabitating with men may be at even greater risk than single women (6,7). In contrast, married status is often a protective factor for men (8,9). It also has been found that the severity of married women's symptoms increases with the severity of their husbands' distress, even after similarities in their exposure have been taken into account (7).

In summary, although the research regarding the interplay of disaster and domestic violence is not extensive and little of it has been derived from studies of incidents of mass violence, the available evidence does suggest that services related to domestic violence should be integrated into other mental-health services for disaster-stricken families.

Screening for women's safety may be especially important. Helping men find appropriate ways to manage/direct their anger will benefit them and their wives. It will also help their children, as children are highly sensitive to postdisaster conflict and irritability in the family (7,10).

Summary of empirical findings

Although there is little conclusive evidence that domestic violence increases after major disasters, research suggests that its postdisaster prevalence may be substantial.
In the most relevant study, 14% of women experienced at least one act of postflood physical aggression and 26% reported postflood emotional abuse over a 9-month period.
One study reported a 46% increase in police reports of domestic violence after a disaster.
Other studies show that substantial percentages of disaster victims experience marital stress, new conflicts, and troubled interpersonal relationships.
There is more-conclusive evidence that domestic violence harms women's abilities to recover from disasters.
In the most relevant study, 39% of abused women developed postdisaster PTSD compared to 17% of other women, and 57% of abused women developed postdisaster depression, compared to 28% of other women.
Marital stress and conflicts are highly predictive of postdisaster symptoms.
In light of the fact that, in general, married women are a high-risk group for developing postdisaster psychological problems, it seems advisable to integrate violence-related screenings and services into programs for women, men, and families.

References

Mechanic, M., Griffin, M., & Resick, P. (2001). The effects of intimate partner abuse on women's psychological adjustment to a major disaster. Manuscript submitted for publication.
Adams, P. R., & Adams, G. R. (1984). Mount Saint Helen's ashfall . American Psychologist, 39, 252-260.
Norris, F. H., & Uhl, G. A. (1993). Chronic stress as a mediator of acute stress: The case of Hurricane Hugo. Journal of Applied Social Psychology, 23, 1263-1284.
Norris, F. H., Perilla, J. L., Riad, J. K., Kaniasty, K., & Lavizzo, E. A. (1999). Stability and change in stress, resources, and psychological distress following natural disaster: Findings from Hurricane Andrew. Anxiety, Stress, and Coping, 12, 363-396.
Shariat, S., Mallonee, S., Kruger, E., Farmer, K., & North, C. (1999). A prospective study of long-term health outcomes among Oklahoma City bombing survivors. Journal of the Oklahoma State Medical Association, 92, 178-186.
Brooks, N., & McKinlay, W. (1992). Mental health consequences of the Lockerbie disaster. Journal of Traumatic Stress, 5, 527-543.
Gleser, G. C., Green, B. L., & Winget, C. N. (1981). Prolonged psychological effects of disaster: A study of Buffalo Creek. New York: Academic Press.
Fullerton, C.S., Ursano, R.J., Tzu-Cheg, K., & Bharitya, V. R. (1999). Disaster-related bereavement: Acute symptoms and subsequent depression. Aviation, Space, and Environmental Medicine, 70, 902-909.
Ursano, R. J., Fullerton, C. S., Kao, T. C., & Bhartiya, V. R. (1995). Longitudinal assessment of posttraumatic stress disorder and depression after exposure to traumatic death. Journal of Nervous and Mental Disease, 183, 36-42.
Wasserstein, S. B., & LaGreca, A. (1998). Hurricane Andrew: Parent conflict as a moderator of children's adjustment. Hispanic Journal of Behavioral Science, 20, 212-224.

Date Created: 01/01/2007 See last Reviewed/Updated Date below.

Scholarship Opportunity. Entering College for the First Time.

http://www.gmsp.org/publicweb/AboutUs.aspx

The Gates Millennium ScholarS Program

For students entering college for the first time in the fall 2012, the GMS 2012 Scholarship Application online process is now open. The deadline for all submissions is Wednesday, January 11, 2012 at 11:59 p.m. EST.
GMS will select 1,000 talented students each year to receive a good-through-graduation scholarship to use at any college or university of their choice. We provide Gates Millennium Scholars with personal and professional development through our leadership programs along with academic support throughout their college career.

Our program is more than a scholarship—it’s an opportunity to change your life! Just ask Deonte Bridges how much the GMS scholarship means to him.

If you are willing to serve as a nominator or recommender for deserving students, you can make a difference in their lives.

The goal of GMS is to promote academic excellence and to provide an opportunity for outstanding minority students with significant financial need to reach their highest potential by:

Reducing financial barriers for African American, American Indian/Alaska Native, Asian Pacific Islander American and Hispanic American students with high academic and leadership promise who have significant financial need;
Increasing the representation of these target groups in the disciplines of computer science, education, engineering, library science, mathematics, public health and the sciences, where these groups are severely underrepresented;
Developing a diversified cadre of future leaders for America by facilitating successful completion of bachelor's, master's and doctoral degrees; and
Providing seamless support from undergraduate through doctoral programs, for students selected as Gates Millennium Scholars entering target disciplines.

The Gates Millennium Scholars (GMS) Program, established in 1999, was initially funded by a $1 billion grant from the Bill & Melinda Gates Foundation.
The GMS Scholarship Award Provides:

Support for the cost of education by covering unmet need and self-help aid;

Renewable awards for Gates Millennium Scholars maintaining satisfactory academic progress;

Graduate school funding for continuing Gates Millennium Scholars in the areas of computer science, education, engineering, library science, mathematics, public health or science;

Leadership development programs with distinctive personal, academic and professional growth opportunities.

Program Accomplishment:

Funding more than 15,000 Gates Millennium Scholars since the inception of the program

Obtained a 79.9% graduation rate in five years*

Supported Gates Millennium Scholars enrolled in more than 1,500 colleges and universities

Supported Gates Millennium Scholars representing 50 states and five outlying areas

Graduated over 7,000 Gates Millennium Scholars since the program's inception

Five year retention rate of 87.7%*

*Reflects cohorts 1 through 4

Administration:

UNCF—the United Negro College Fund—administers the Gates Millennium Scholars Program (GMS). To reach, coordinate and support the constituent groups, UNCF has partnered with the American Indian Graduate Center Scholars, the Hispanic Scholarship Fund, and the Asian & Pacific Islander American Scholarship Fund to assist in implementing the program.

The GMS Advisory Council has seven members: six members from higher education and one member representing the Bill & Melinda Gates Foundation. Advisory Council members include:

Youlonda Copeland-Morgan, Associate Vice President for Enrollment Management, Financial Aid Service, Syracuse University
Carmen D. Lopez, Executive Director, College Horizons Inc.
Dr. Raymund Paredes, Commissioner of Higher Education, Texas Higher Education Coordinating Board
Margaret Daniels Tyler, Senior Program Officer, Education, Bill & Melinda Gates Foundation

The GMS program is more than just a scholarship. The GMS program offers Gates Millennium Scholars with ACademic Empowerment (ACE) services to encourage academic excellence; mentoring services for academic and personal development; and an online resource center that provides internship, fellowship and scholarship information.