DISASTER AND DISASTER NURSING (7TH SEMESTER)

D-DESTRUCTION
I- INCIDENTS
S-SUFFERINGS
A-ADMINISTRATIVE, FINANCIAL FAILURES
S-SENTIMENTS
T-TRAGEDIES
E-ERUPTION OF COMMUNICABLE DISEASES
R-RESEARCH PROGRAMME AND ITS IMPLEMENTATION
The word ‘Disaster’ is derived from the French word ‘Desastre’.
This is formed by 2 words ‘Des’= bad and ‘Astre’= planet- A sudden incident or natural catastrophe that causes great damage or loss of life.
TYPES:
A. ON BASIS OF ORIGIN- natural (meterological, topographical, telluric and teutonic, biological) and man made (technological, accident, civil,warfare)
B. ON BASIS OF NATURE- geological, water and climate hazards, environmental hazards, chemical and industrial hazards, accident
C. ON BASIS OF INTENSITY- fast and slow
factors- poverty, overpopulation, urbanization, warfare and strike,enviromental degradation, lack of knowledge and awareness.
Disaster magnitude refers to the scale and severity of a disaster’s impact. It can be measured in various ways :
scale of impact
Intensity
economic loss
Measured on a logarithmic scale.
LOCAL DISASTER :
Refers to an event occurring in a specific geographical area causes significant harm to people, property and the environment.
Ex- floods, earthquakes, cyclones, landslide (Natural)
Industrial accidents, fires, building collapse ( Man made)
REGIONAL DISASTER :
These are catastrophic events that effect a larger geographical area but limited to one region of country. These disasters have a broader impact than local.
Ex- Tsunami – 2004 Indian Ocean Tsunami, Fanni- in Odisha and neighboring states(Natural)
Nuclear accident, fires, Industrial Disaster- Bhopal Gas Tragedy ( Man made)
NATIONAL DISASTER :
Refers to a large-scale event affecting an entire nation. These disasters cause widespread loss of life, property damage and economic disruption.
Ex- war, economic depression, severe stock market crash.
GLOBAL DISASTER :
A large-scale event that affects multiple countries. Its have widespread impacts on human lives, economics, ecosystems and global stability. Often require coordination with international for response and recovery.
Ex- pandemics (COVID-19, Spanish Flu), climate changes (Natural)
Global Conflicts (World War I & II), Economic Crisis ( 2008 financial Crisis) (Man Made)
DISASTER MANAGEMENT CYCLE:
mitigation, preparedness, response, recovery

1. MISS RAJOSI K. DISASTER MANAGEMENT (Acc. VII Sem.)

2. D-DESTRUCTION I- INCIDENTS S-SUFFERINGS A-ADMINISTRATIVE, FINANCIAL FAILURES S-SENTIMENTS T-TRAGEDIES E-ERUPTION OF COMMUNICABLE DISEASES R-RESEARCH PROGRAMME AND ITS IMPLEMENTATION The word ‘Disaster’ is derived from the French word ‘ Desastre ’. This is formed by 2 words ‘Des’= bad and ‘Astre’= planet- A sudden incident or natural catastrophe that causes great damage or loss of life. INTRODUCTION

3. “A serious disruption to the functioning of a community, which causes human, material, economic and environmental losses beyond a community's ability to cope.” – UNDRR (United Nations Office For Disaster Risk Reduction)

4. Examples of 2025 : India experienced a series of significant natural disasters that resulted in substantial loss of life, displacement, and economic impact. Notable events include:

5. TYPES OF DISASTER ON THE BASIS OF ORIGIN :

6. TYPES EXAMPLES Meteorological Storms (Cyclones, typhoons, hurricanes, tornados, hailstorms, snowstorms), cold spells, heat waves and droughts. Topographical landslides, avalanches, mudflows and floods. Telluric and Teutonic Earthquakes, volcanic eruptions and tsunamis Biological communicable disease, epidemics and insect swarms (locusts). Technological A mishap at a nuclear power station, a leak at a chemical plant Accidents transportation, structural collapse, explosions and fires Civil disasters riots and demonstrations. Warfare bombardment, blockade and siege

7. B. ON THE BASIS OF NATURE : TYPES EXAMPLES Geological Hazards Earthquake, Tsunami, Volcanic eruption, Landslide, Dam burst, Mine Fire. Water & Climatic Hazards Tropical Cyclone, Tornado and Hurricane, Floods, Drought, Hailstorm, Cloudburst, Landslide, Heat & Cold wave, Snow Avalanche Environmental Hazards Environmental pollutions, Deforestation, Desertification, Pest Infection. Chemical, Industrial and Nuclear Accidents Chemical disasters, Industrial disasters, Oil spills/Fires, Nuclear. Accident Train accidents, air crash, bomb blasts, Forest fires, Building collapse, Electric Accidents, Festival related disaster, mine flooding.

8. C. ON THE BASIS OF INTENSITY : TYPES EXAMPLES Fast intensity Earthquake, flood, tsunami Slow intensity Drought

9. POVERTY 01 POPULATION GROWTH 02 RAPID URBANIZATION 03 ENVIRONMENTAL DEGRADATION 04 LACK OF AWARENESS & INFORMATION 05 WAR AND CIVIL STRIFES 06 FACTORS AFFECTING DISASTER

10. POVERTY: Poverty is a significant factor that causes disasters and increases vulnerability to them. Poor people often live in hazard-exposed areas with low-quality housing that is more susceptible to damage. They lack financial resources, insurance, social protection, and adequate access to services, which limits their ability to prepare for, cope with, and recover from disasters. POPULATION GROWTH: As population density rises, especially in urban areas, more people and infrastructure are concentrated in hazard-prone zones, such as coastal regions or floodplains. This density leads to congestion, limited escape routes, and strain on infrastructure, which amplifies the impact of disasters. Rapid population growth often outpaces the development of adequate infrastructure and services, resulting in poorly planned settlements and informal housing in risky locations. More people in a small space mean that when disaster strikes, many get affected at once, and it’s harder to get help or escape quickly. Rapid population growth can also strain resources like clean water and roads, making it tougher to prepare for emergencies or recover after a disaster

11. RAPID URBANIZATION Increased population density in cities concentrates people and assets in small areas, raising the potential human and economic losses if a disaster occurs. Alteration of natural landscapes, including deforestation and destruction of wetlands, reduces natural protection against hazards like floods and storm surges. Lack of adequate infrastructure and services (drainage, sanitation, emergency response) increases vulnerabilities and reduces capacity to cope with disasters. Poorly planned and unregulated urban growth pushes marginalized communities to live in high-risk areas such as steep slopes, floodplains, and coastal zones. Expansion of impervious surfaces (concrete, asphalt) leads to poor water drainage, causing urban flooding even during normal rainfall.

12. ENVIRONMENTAL DEGRADATION Environmental degradation is a key factor causing disasters because it weakens nature's ability to protect people from hazards. When natural areas like forests, wetlands, and mangroves are destroyed, it increases the chance of floods, landslides, and storm damage. For example, cutting down trees on slopes makes landslides more likely, and removing coastal mangroves allows storm surges to cause more damage. Overuse of natural resources and pollution reduces the health of ecosystems that regulate water and soil, making areas more vulnerable to droughts and floods. Environmental damage also worsens climate change, which increases the frequency and intensity of natural hazards.

13. LACK OF AWARENESS AND INFORMATION Lack of awareness and information is a major factor causing disasters because when people do not know about the risks they face or how to prepare for disasters, they are less likely to take protective actions. Many people do not prepare emergency supplies, make evacuation plans, or pay attention to warnings simply because they are unaware of the dangers or do not understand the importance of preparation.

14. MAGNITUDE OF DISASTER Disaster magnitude refers to the scale and severity of a disaster’s impact. It can be measured in various ways : scale of impact Intensity economic loss Measured on a logarithmic scale.

15. LOCAL DISASTER : Refers to an event occurring in a specific geographical area causes significant harm to people, property and the environment. Ex- floods, earthquakes, cyclones, landslide (Natural) Industrial accidents, fires, building collapse ( Man made) REGIONAL DISASTER : These are catastrophic events that effect a larger geographical area but limited to one region of country. These disasters have a broader impact than local. Ex- Tsunami – 2004 Indian Ocean Tsunami, Fanni - in Odisha and neighboring states(Natural) Nuclear accident, fires, Industrial Disaster- Bhopal Gas Tragedy ( Man made) NATIONAL DISASTER : Refers to a large-scale event affecting an entire nation. These disasters cause widespread loss of life, property damage and economic disruption. Ex- war, economic depression, severe stock market crash. GLOBAL DISASTER : A large-scale event that affects multiple countries. Its have widespread impacts on human lives, economics, ecosystems and global stability. Often require coordination with international for response and recovery. Ex- pandemics (COVID-19, Spanish Flu), climate changes (Natural) Global Conflicts (World War I & II), Economic Crisis ( 2008 financial Crisis) (Man Made)

16. FLOODS Assessed by the volume of water, area inundated, and water flow levels. CYCLONE Categorized by wind speeds on the Saffir-Simpson scale. EXAMPLES OF MEASURING MAGNITUDE EARTHQUAKE Measured using the Richter scale or Moment Magnitude Scale (Mw). PANDEMIC Determined by the spread of the disease, mortality rates, and global health impacts.

17. COMMON PROBLEMS DURING DISASTER

18. Injuries and Fatalities Trauma from debris, burns, or structural collapses Disease Outbreaks Cholera, typhoid, and respiratory infections due to poor sanitation and overcrowding Mental Health Issues Anxiety, depression, and post-traumatic stress disorder (PTSD) are prevalent. Disruption of Health Services Limited access to medical care due to damaged facilities and infrastructure. A. HEALTH RELATED ISSUES :

19. Contaminated Water Supply Risk of waterborne diseases. Poor Sanitation Lack of toilets or improper waste disposal Limited Access to Hygiene Supplies Shortages of soap, clean water, and feminine hygiene products. B. Water, Sanitation, and Hygiene (WASH) Problems: C. Food and Nutrition Challenge : Food Shortages Due to disrupted supply chains and damaged agricultural fields. Malnutrition Disruption of food stock and public distribution system Spoiled Food Due to lack of refrigeration or contamination.

20. Overcrowding in Shelters Increases the risk of disease transmission. Homelessness Destruction of homes leads to displacement. D. Shelter and Housing Problems: E. Communication and Transportation Breakdown: Loss of Connectivity Damage to communication networks and infrastructure. Blocked Roads Hinders rescue operations and delivery of aid.

21. Loss of Livelihoods Destruction of businesses, farms, and job Rising Prices Inflation of basic commodities due to scarcity. Cost of Rehabilitation High expenses for rebuilding and recovery. F. Economical challenges: G. Environmental Problems: Land Degradation Soil erosion and deforestation Pollution Contamination of water, air, and soil Loss of Biodiversity Destruction of habitats for flora and fauna

22. COMMUNICATION BREAKDOWN Implant redundant communication system is essential to ensure that communication remain intact during disaster. Ex- satellite phone, two way radios. METHODS TO OVERCOME

23. Resource shortage Establishing communication with suppliers for rapid procurement during emergencies. Coordinate with national and international aid organisations for additional resources and support. Setting up distribution centres for managing and allocating resources effectively.

24. Infrastructure Damage Prioritizing infrastructure repair and restoration based on critical needs is essential. Temporary solutions, such as mobile clinics and portable water treatment units and Develop alternative routes and temporary infrastructure. ( Sibir , health camp) Health & safety risks Setting up emergency medical services and a triage system. Establishing quarantine measures and improving sanitation. Providing mental health support and counselling services in coping with trauma and stress. Ensuring medical facilities are adequately stocked and staffed is also important for effective response.

25. Public confusion and panic Providing timely, accurate and clear information through official channels help to reduce confusion and panic. Engaging community leaders and volunteers to assist with information dissemination and crowd control can help manage public reactions and maintain order. Educating the public in advance through awareness campaigns and preparedness drills can help them respond more effectively. Economic disruption Collaborating with economic development agencies to plan and implement recovery strategies ensures a more coordinated and effective approach to rebuilding local economy.

26. Environmental impact Conducting environmental impact assessments and cleanup operations is essential for addressing contamination and restoring affected areas. Implementing mitigation measures such as reforestation and habitat restoration. Promoting environmental awareness and conservation practices

27. NEEDS OF PERSONS AFFECTED IN DISASTER

28. DISASTER MANAGEMENT CYCLE MITIGATION PREPAREDNESS RESPONSE RECOVERY 1 2 3 4

29. Mitigation is defined as sustained action for lessening the impact of a disaster, the effort to reduce loss of lives and destruction of properties from disaster. Mitigation activities actually eliminate or reduce the probability of disaster occurrence or reduce the effects of unavoidable disasters through proactive measures taken before an emergency occurs. Shaping of public policies and plans that either modify the causes of disasters or mitigate their effects on people, property and infrastructure. Ex: Clearing space around buildings to create a defensible space against fires. Securing furniture to floors and wells to help prevent damage during earthquakes. Relocating structures to less disaster-prone areas. Public safety measures such as continual maintenance of roadways and dams. MITIGATION

30. Disaster preparedness refers to measures taken to prepare for and reduce the effects of disasters. Proactive measures taken to ensure appropriate system, procedures and resources are prepared for responding effectively to disaster victims. Effective preparedness reduces max. number of lives, vulnerability and enhance resilience and coordination during action. Ex: Japan, a highly prone to natural disasters like earthquake, tsunamis. Japanese government has implemented extensive preparedness measures like strict building codes designs to ensure structure can withstand seismic activity. Covers a wide range of activities: Individual, family and community preparedness: knowing what to do before, during and after disaster. Preserve food, equipements, water, medicines Public awareness activities ( meeting, media coverage, distributing leaflet, posters) PREPAREDNESS

31. Emergency preparedness is the proactive process of planning and organizing to ensure an effective response to unforeseen emergencies and disasters. This involves: Developing strategies Training personnels Establishing systems Arrange the resources to mitigate the impact of emergencies and facilities a swift recovery. GOAL : To minimize harm to people, property and operations by anticipating potential risks and implementing measures to address them before they occur. EMERRGENCY PREPAREDNESS

32. RISK ASSESSMENT EMERGENCY PLANNING Identify potential hazards and vulnerabilities specific to community, organization or region. This helps in understanding the types of emergencies that could occur and their potential impact. Create comprehensive plans that outline how to respond to various types of emergencies. These includes: Developing evacuation routes Establishing communication channels Assigning roles and responsibilities to personnel. Components of emergency preparedness

33. TRAINING & DRILLS RESOURCE MANAGEMENT Conducting regular training sessions and simulation exercises to prepare individuals and teams for emergency situations. It helps in familiarizing everyone with the procedures and improving their capabilities. Ensuring that necessary resources (first aid, emergency kits, communication tools) are readily available. Coordinating with local agencies and organizations for additional support if needed. PUBLIC AWARENESS Educating the community or organization about potential risks and emergency procedures. Awareness campaign helps to increase knowledge on activities during disaster.

34. RESPONSE 03

35. Response phase is the actual implementation of disaster planning in the immediate aftermath of a disaster. Focusing on saving lives and protecting community assets. The response phase includes the mobilization of the necessary emergency services and first responders in disaster areas. Humanitarian organizations should be present for: Evacuation Search and rescue First aid and medical assistance Relief delivery Psycho-social counselling Triage is a process which places the right patient in the right place at the right time to receive the right level of care. Triage is categorized by different color coding: Red- most urgent, first priority (having life threatening injuries, hypoxia, shock, burns, chest wounds, head injuries) Yellow- urgent, second priority (multiple fractures, spine injuries). Appears stable enough to withstand up to 2 hours. Green- not severe, third priority (simple fracture, minor burn, sprain ). Patients can wait for more than 2 hrs. for treatment. Black- dead/expectant Triage helps to bring order in a chaotic scene and identifies those who are in greatest need by using resources in an effective manner.

36. PSYCHOSOCIAL FIRST AID STRATEGIES Psychosocial First Aid (PSFA) is an immediate intervention in the aftermath of any disaster. It can be administered within the first few days of the disaster to three weeks by any person with a minimum or no education. It is practical help provided on a humanitarian basis in a supportive manner to the affected person/family/community. After any disaster, it is also important to observe that along with the physical (e.g., fractures, injuries, malnutrition, etc.) psychological (e.g., shock, sadness, fear, anger, etc.) consequences, social (property loss, loss of job, risk of migration, increase in crime rates) Consequences also affect the lives of the people. The physical, psychological, and social consequences are interlinked.

37. After the disaster recovery: rehabilitation, reconstruction Disaster recovery has 3 distinct but interrelated meanings. Goal is restoration of normal community activities Phase starts after recovery phase and ends when community has returned to its normal routine. Process by which community achieves goals of returning to normal routines. Recovery measures both short and long term include: Rebuilding and strengthening of damaged structures Relocation of safe places Income generating projects Recovery: going back to normal

38. BASIC DISASTER SUPPLES KIT

39. A basic disaster supplies kit is a vital component of emergency preparedness designed to ensure that individuals and families can maange their basic needs during and after a disaster.

40. CATEGORY QUANTITY Bottle water , purification tablet 1 gallon / person/day for 3 days Food Canned foods Dry foods Energy bars For 3 days/ person First aid kit 1 kit includes bandages, antiseptic sol. And ointments, scissors, syringes, cotton, essential medicines Flash light 1-2 Radio 1 Hygienic items Soap / sanitizer Toothbrush / toothpaste Feminine products (sanitary napkin, diapers) 1 bottle 1 set As needed Clothing and bedding 1 / person

41. CATEGORY QUANTITY Documents ( ID, insurance, work profile, medical records, financial information) In waterproof container Cash Small amount Multi tools 1 set Special needs items (baby formula food, baby food, pet food, medications if needed) As needed Emergency contacts 1 copy Phone charger , portable charger 1-2 units Plastic bags Several units

42. Disaster response including emergency relief measures and life saving techniques A. IMMEDIATE RESPONSE AND ASSESSMENT The initial phase focuses on immediate relief efforts and rapid assessment of the situation. Primary objectives during this phase are to ensure the safety of survivors, assess the extent of damages and identify urgent needs. This involves evaluating the damage to infrastructure, estimating the number of casualties and identifying areas in need of urgent assistance. The information gathered during the assessment guides the allocation of resources and prioritizes response efforts. For instance, if a major earthquake has stuck a city, the assessment would focus on identifying collapsed buildings, trapped individuals and areas with significant structural damage.

43. B. EMERGENCY RELIEF MEASURES Emergency relief measures are essential for addressing the immediate needs of affected populations. These measures typically include the provision of basic necessities such as food, water, shelter and medical care. The distribution of these resources must be carefully managed to ensure equitable access and to prevent overcrowding and panic. C. LIFE-SAVING TECHNIQUES Severe life-saving techniques- basic first aid (CPR, Bandaging), search and rescue operations, psychosocial counselling, infection control and disease prevention are fundamental to effective disaster response. These techniques focus on stabilizing and treating injured individuals, preventing further harm and improving survival chances. D. COMMUNICATION AND COORDINATION Effective disaster response relies on coordination among various agencies, organizations and levels of government. Establishing clear communication channels and command structures ensures that resources are efficiently allocated and efforts are well coordinated. Emergency Operation Centers (EOC) and Incident Command System (ICS) are commonly used to manage and streamline response activities. E. LONG TERM RECOVERY While immediate response and relief are critical, long-term recovery is essential for restoring normalcy and rebuilding affected communities. This involves addressing long-term needs such as repairing infrastructure, providing financial assistance and supporting economic recovery. Recovery efforts should be planned with a focus on resilience, ensuring that communities are better prepared for future disasters.

44. TEAM COORDINATOR To impart and transmit the disaster prediction warning, received from various centres of local, state or central government to the common man or general public. To prepare the common man through the medium of IEC, for disaster management and its mitigation. To work as an active member of a disaster management team . To coordinate between different departments and organisations involved in disaster management. To lead a disaster health team member. ROLE OF COMMUNITY HEALTH NURSE IN DISASTER MANAGEMENT COMMUNICATOR

45. HEALTH CARE PROVIDER To search and protect disaster afflicted people. To get relief materials like food packets, clothes, blankets, tents etc. from government and non-government organizations. To distribute relief material among afflicted people. To make efforts to restore water and electricity supply and other public utility systems in affected areas, as soon as possible. To assist in protecting the safe remains of belongings or properties of afflicted people. To help in shifting and transporting the injured and afflicted people to health centres, hospitals, etc. To follow the 'triage' system of setting priorities for medical care to disaster victims. To provide nursing care to afflicted people on the basis of standing order or self-discretion. To help in restoring the normal function of health organisations in affected areas. impart nursing services in hospitals and health institutions of affected areas. RESCUER

46. HEALTH EDUCATOR & COUNSELLOR DAMAGE ASSESOR To provide health information to affected communities about individual health safety. To provide health education regarding safety from water pollution, air pollution, proper disposal of garbage, proper use of toilets and safety from vector-borne diseases. To give advice to afflicted people to solve mental and physical health problems. To console those people who have lost their near and dear ones. To assist estate evaluators in immediate and detailed evaluation of property damages. To inform insurance agents, surveyors about disabled or crippled citizens. To prepare the reports of damages being done to health organisations or institutions, while delivering services.

47. REHABILITATOR To assist in re-establishing the housing facilities and other basic amenities in affecting areas. To take an active part in social, physical and occupational rehabilitation of affected people. To help in promoting a healthy environment in the affected area.

48. FUNCTIONS OF COMMUNITY HEALTH NURSE In disaster preparedness To facilitate preparation with community- The nurse can help initiate updating disaster plans, provide educational programmes & material regarding disasters specific to areas. To provide updated record of vulnerable populations within community - The nurse should be involved in educating these populations about what impact the disaster can have on them. Nurse leads a preparedness effort - Nurses can help recruit others within the organisation that will help when a response is required. It is wise to involve people in these efforts who demonstrate flexibility, decisiveness, stamina, endurance and emotional stability.

49. Nurse plays multiple roles in community - Nurses might be involved in many roles. As a community advocate, the nurse should always seek to keep a safe environment. She must assess and report environmental hazards.   Nurses should have an understanding of community resources - What community resources will be available after a disaster strikes and how the community will work together. A community wide disaster plan will guide the nurse in understanding what should occur before, during and after the response and his or her role in the plan. Disaster Nurse must be involved in community organisation - Nurses with an in-depth understanding of disaster management can be involved in any number of community organisations, such as the American Red Cross, Ambulance Corps etc.  

50. FUNCTIONS OF COMMUNITY HEALTH NURSE In disaster response Nurses must be involved in community assessment, case finding and referring, prevention, health education and surveillance. Once rescue workers begin to arrive at the scene, immediate plans for triage should begin. Nurses working as members of an assessment team have the responsibility of giving accurate feedback to relief managers to facilitate rapid rescue and recovery. Nurses involved in on- ongoing surveillance use the following methods to gather information: interviews, observation, physical examination, health and illness screening surveys, records etc.

51. TRIAGE In disaster management, triage is the rapid sorting of patients by severity of injury to maximise survival and optimize limited resources, often using colour -coded tags (red, yellow, green, black) to categorise immediate, delayed, minor, and deceased injuries, respectively. How Triage Works: Sorting: Patients are quickly grouped and assessed based on their condition. Categorization: Patients are assigned a colour -coded tag indicating their priority for treatment. Red (Immediate): Life-threatening injuries that require immediate attention. Yellow (Delayed): Serious injuries that are not immediately life-threatening but need care within a short timeframe. Green (Minor): Minor injuries that can be treated later. Black (Expectant/Deceased): Patients with mortal injuries or who have already died and are not prioritized for treatment. c. Interventions: Rapid life-saving interventions, such as opening an airway, can be performed during the assessment phase.

52. Common Triage START Method (Simple Triage and Rapid Treatment): A widely used system that assesses respiration, pulse, and mental status to categorize patients in mass casualty incidents. The goal is to identify who needs immediate medical help, who can wait and who is deceased so that limited resources are used effectively. SALT Method (Sort, Assess, Life-Saving Interventions, Treatment/Transport): A newer, more flexible method that begins with a group sort, then assesses individuals for life-saving interventions before moving to treatment and transport.

53. FUNCTIONS OF COMMUNITY HEALTH NURSE In disaster recovery Successful Recovery Preparation - Flexibility is an important component of successful recovery preparation. Community clean-up efforts can incur a host of physical and psychological problems. Ex.- Physical stress of moving heavy objects can cause back injury, severe fatigue and even death from heart attacks. Health teaching - Nurses must remain vigilant in teaching proper hygiene and making sure immunization records are up to date. Psychological support - Acute and chronic illness can be exacerbated by prolonged effects of disaster. The psychological stress of clean-up and moving can bring about feelings of severe hopelessness, depression and grip.

54.   Referrals to hospital as needed Stress can lead to suicide and domestic abuse. Although most people recover from disasters, mental distress may persist in vulnerable populations. Referrals to mental health professionals should continue as long as the need exists.   Remain alert for environmental health Nurses must also remain alert for environmental health hazards during the recovery phase of a disaster. Home visits may lead the nurse to uncover situations such as lack of water supply or lack of electricity.

55. THANK YOU !!!