IMPACT OF DISASTERS ON HEALTH CARE SYSTEM OR APPROACH

It is true that natural as well as man made disasters impinge on human existence without warning regardless of how diligent meteorological stations are, internationally. Also, Central Intelligence Agencies are always predicting impending situations, but this can be merely speculations even when scientific evidence supports them. Predictions, do not always accurately determine time and place of attacks and it can entail ongoing tedious investigation processes. In the presence of such uncertainties social service structures concerned with disaster awareness and intervention should always be alert to such eventualities that plague the universe manifesting as earthquakes, tornadoes, flooding, hurricanes, fires, bombings, shooting and a very expansive list of occurrences from time to time These experiences bring to the forefront of any society public servants in the capacity of law enforcement and health personnel who are the first in arriving at the scene. Also, at this time those affected begin to evaluate the system to know whether it is adequately providing the service it has promised. Therefore, health systems comprising nurses and public health officials primarily, must be equipped with appropriate knowledge regarding chain of command, communication protocol, available resources for intervening; theoretical models of intervention and tools to assess whether the system is working or corrupt.

HEALTH CARE SYSTEM EVALUATION AND PRESENTATION

IMPACT OF DISASTERS ON HEALTH CARE SYSTEM OR APPROACH

Introduction
The impact of disasters on health care systems or approach cannot be easily estimated physically or emotionally. The task of maintaining equilibrium or restoring it if disrupted when the unexpected occurs requires that health care systems be adequately equipped with strategies and techniques to intervene at the right time as well as appropriate technology and skills (Baker & Chapman, 2005). Precisely, it is a costly venture. Hence, twenty first century disaster approaches must link national goals with people’s priority (Porter, 2001).
Health care systems with isolated disaster plans and approaches which are not people oriented are useless. Disruption in infrastructure, social structure, physiological and psychological structures occur. Again, Nurses and Public health officers are unusually found in the fore front of natural; terrorists or chemical attacks on the environment (Haddow et.al, 2008)
It is rather disheartening too when health care systemic approaches are antiquated offering palliative remedies to the suffering public in the face of imminent death. Professionals add to the disaster if they panic. Accordingly, the Disaster Preparedness white paper for Community and Public Health Nurses requires that nurses be resources that are organized and adapt a multi-sector approach; operate on the foundation of professional ethics; act as leaders in developing and implementing interventions; value the protocols established by state entities through which they function and demonstrate expertise being role models when intervening during a disaster (Kuntz et. al, 2008).
Within these guidelines the author will establish parameters through evaluation whereby health care systems around the world can operate embracing a context of relevance; not ridicule and be efficient respondents in a disaster. This researcher will explain the impact of disaster on Health care Systems and public health personnel by describing the Chain of Command in a time of natural or man made disaster; relate the efficacy of Health Care governance in disaster; provide theoretical models of Health Care governance in disaster and unravel implications regarding application of the theoretical models mentioned.

Disaster Chain of Command

Incident Commander/ Health Care Designee

(Green, 2002)
Internationally, provisions outlined in a chain of command assist health care systems to respond based on a definite systemic approach. It instructs Community Health nurses from whom or where instructions are received to whom service intervention should be targeted in responsible execution of duties. However, countries modify these links while adapting principles for their individual locations and social structure.
The foregoing diagrammatic representation indicates a general chain of command that is applicable to health care systems around the world. The incident commander heads the team of operations. Usually it is the Health Officer or someone designated to function within that capacity (Green, 2002)
Next in line are two major descending ladders depicted by Public Information, Safety and Liaison officers. These officers together correlate information which is passed down the administrative ladder to supporting health care staff within health care system disaster net work. Their interactions further join four levels of executors within the chains. They are operations; planning and intelligence; logistics and Financial administration (Green, 2002).
The applicability of this model in itself can be considered a theoretical approach to both being prepared as well as creating a people oriented design of response to a disaster under any circumstances. When the chain of command operations are utilized in lower level scenarios community health nurses execute decisions passed from a State Public Health Director’s level through to the Senior Public Health Nurse; Environmental Specialists and other Public Health Professionals such as Paramedics, Fire fighters and Social Environmentalists (Green, 2002).

Efficacy of Health Care Governance in Disaster

Green (2002) continues to deliberate on the chain of command model to suggest that health care systems internationally can facilitate efficacy of governance by establishing the 5S protocol of implenetation without creating further disaster (Green, 2002). The chart below describes the suggested strategies.
S

Means

Action
Safety
Is the means safe for me to be there
If it is then go to the next S. If not get out or take actions to make it safe
Size-up
Conduct a size up as you approach the incident
How big is the incident in area, size of threat, and number of people?
Send
Send for help
Contact dispatch, your agency. Request additional help
Set-Up
Set up incident command
Assume the command and begin assigning tasks in relation to available resources
Start
Start emergency procedures
Start taking emergency actions to control incident/s

5 S protocol (Green, 2002)

It must be understood that responding to disaster in an emergency is a health care system intervention. Efficacy means preparation of health care professionals. Nurses ought to be prepared through advanced training and information dissemination from events of previous catastrophes like the Japan earth quake and nuclear explosion as well the Haiti dilemma. Efficiency would also mean that clinical research should be conducted with updated recommends informing society and social planners in being better prepared by making relevant adjustments utilizing findings to inform education programs for health care professionals in the future (Flory et. al, 2008).
This entails a national revision of nursing education curricula to include all categories of nurses across the country. The focus ought to be directed towards understanding contextual factors; considering cultural influences; planning ahead and utilizing networks (Flory et. al, 2008).
Precisely, efficacy of healthcare governance also means appropriate evaluation and utilization of resources in a people oriented approach to resolving situations which arise from time to time in a disaster. Always there are a number of resources available within communities. They ought to be accessible at that particular geographic location to assist in addressing disaster issues.
Essentially, community health nursing networks prove a vital resource in disseminating information. Public health clinics ought to be equipped with medical supplies to respond to injuries such as cuts, fractures, burns; fainting and unconsciousness among other critical emergencies. Ambulance services; paramedics and support systems such as law enforcement and fire fighters add to the gamut of resources which are built into the network of disaster preparedness.
Consequently reports have been that, in 2003 the Health Resources and Service Administration funded a Bioterrorism Training and Development Curriculum Program which informs health care systems regarding how to recognize, assess and utilize resources in the community (Kuntz et. al, 2008). Conclusively, these are the impacts of disasters on health care system efficacy to the population as a whole.

Discussion of theoretical models in Health Care Governance for Disaster

Two relevant theoretical models mentioned in this exposition relates to the Chain of Command and 5 S protocol. These are assumptions developed by Professor Green (2002) that provide a framework to guide health care system interventionists into appropriately responding to the concerns of masses during a disaster.
The chain or command is a basic guide which incorporates a number of correlating devices to supplement implementation. These include a single command post; unified command; incident action plans, standardization and span of control. Green (2002) advocates this typology is a public health model. Its applications are precise especially, when the 5S protocol is inculcated into its execution (Green, 2002).
Alternative theoretical models in Health Care Governance for Disaster turn attention to shared governance. Mary Anthony (2004) advocates that shared governance utilized in healthcare systems are very cost efficient being perspectives burrowed from organizational, management, and sociological theories (Anthony, 2004). A major strength is its ability to garner cooperation from adjacent disciplines in the execution of tasks, especially, in disaster situations. Self managing work teams is also very beneficial adaptations which is absent in other theoretical assumptions of governance (Allan et. al, 2004).
Then, disaster management theories in themselves offer assumptions through which healthcare systems are guided into action. These theories tend to force health care systems to analyze potential threats and develop contingency plans to protect vulnerable populations (Erickson, 2006).

Implication regarding application of Models

Regardless of how fascinating a theory may appear on paper always it is the application in a real world situation that determines benefits to the structures for which it was intended. In the previous segment of this discussion four theories were highlighted. They are Chain of Command; 5S protocol; Shared Governance and Disaster Management (Erickson et.al, 2003)
Implications regarding application of any of these models depend on their appropriateness for the particular society. Technologically developed societies can implement sophisticated typologies which allow for applications of a disaster management plan. Less developed may opt for shared governance while simpler yet social structures may tend to adopt Chain of Command incorporating the 5 S protocol. Each one is useful based on needs of health the care system to which it is to be applied.

Conclusion

The foregoing ‘to the point’ exposition presenting a Health Care System evaluation regarding the impact of disaster and approaches taken to address issues faced by populations, it was revealed that the impact of disasters on health care systems or approach cannot be easily estimated physically or emotionally.
Also, the writer emphasized that internationally, provisions outlined in a chain of command assist health care systems to respond based on a definite systemic approach. It instructs Community Health nurses from whom or where instructions are received to whom service intervention should be targeted in responsible execution of duties.
Protocols guide health care systems towards appropriate intervention while utilizing people oriented designed service delivery models. Precisely, responding to disaster in an emergency is a health care system intervention. Careful application of theoretical models that meet specific society determines efficacy of health care systems during disasters.

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