Floods can cause many challenging issues for public health with both immediate and long-term implications. Drowning, contagious infections, and post-traumatic stress disorder are some health scares associated with flooding. Floods constitute the most frequent catastrophic risk factor, significantly increasing death and morbidity globally. The location, terrain, population makeup, and infrastructure determine how floods affect the local human population (Paterson, Wright, & Harris, 2018). Healthcare incident management takes a risk-based approach comparable to the efforts invested in dealing with natural emergencies like floods. Floods require the deployment of comprehensive or complex emergency management, including preparedness, recovery, response, and overall readiness. Like many other medical emergencies, flood management employs an integrative, people-focused strategy (World Health Organization, 2019). This research paper focuses on the fundamental principles of healthcare management as applied to incident management during floods, including triaging, handling vulnerable groups, and interagency cooperation.
Floods and the fundamental principles of healthcare incident management
The stabilization of the disaster scene, protection and preservation of life, and protection and preservation of property are the three fundamental principles of emergency management. Healthcare professionals comprehend the first principle instinctively and conceptually (Cooper, 2010). They also understand that the third principle is crucial to the first since they cannot carry out life-saving procedures without the necessary facilities, tools, and resources. The second principle, nevertheless, might be less apparent because an organized crisis response can only take place within the framework of a stable workplace, which is challenging to accomplish in the moments immediately after a catastrophic event when chaos is the norm, even in a remarkably intricate workplace like medical facilities that are highly self-regulated. So, to organize the chaos associated with emergencies such as floods, an emergency management system is required.
In flood events, the incident command structure should be defined by the three fundamental tactics—unity of command, the span of control, and clarity of text—that must underpin all incident orders. Open communication among all individuals participating in the emergency response is crucial because of unity of command. To maintain the strength of the hierarchy of command, these people nevertheless follow official commands and submit regular reports to a designated superior (Cooper, 2010). The concept of span of control states that no line manager can efficiently coordinate the work of a particular number of subordinate employees in a high-stress setting.
Clear communication is vital to guarantee that everyone participating in the relief efforts is aware of the strategic framework of the incident response blueprint and the Special Techniques used to counter the tragedy (Cooper, 2010). The clarity of text alludes to the principle that all written and verbal correspondence must be conveyed in the most straightforward and concise, basic vocabulary conceivable, seeking to avoid using phrases or colloquialisms that are likely beyond the comprehension of many emergency personnel.
Floods fit well into these principles since they call for the emergency operations strategy, which includes emergency triaging, to be implemented and activated at the hospital. The facility’s command center must be activated to guarantee the safety of both patients and personnel during floods. It deploys the entire hospital staff and generates a demand for more medical specialists. Even healthcare executives skilled in deciphering complicated organizational charts and clinicians used to diagnosing and treating complex medical issues may find it challenging to comprehend the incident command system used during emergencies like floods (Cooper, 2010). The fundamentals of incident command, nonetheless, are the same since everyone involved in the catastrophe response is accountable for their immediate responsibilities, communicating with others, and, most importantly, their protection and safety. In a nutshell, in the event of floods, there will be various efforts geared toward these principles – to protect human life, to stabilize the situation, and to protect property.
Issues would make triaging victims a challenge during floods.
Accurate and quick triage is the cornerstone of effective performance in accidents and emergencies. During emergencies like floods, triage becomes challenging for various reasons related to the immediate impact of the floods or emergencies. For instance, triaging implies that nurses and other healthcare workers can correctly offer early assessment procedures to the affected people. However, amidst the chaos caused by the floods, affected individuals may not be able to access the services of a nurse due to broken or unusable infrastructural systems such as roads and bridges. The lack of reliable infrastructure delays the affected people’s access to facilities and healthcare professionals for immediate evaluation and assistance.
Another primary cause of challenges in triaging during floods could be poor communication. As explained under the fundamental principles of healthcare incident response, precise and reliable communication is a core component of emergency operations. However, floods can adversely affect communication, as they may affect the power supply that supports the communication networks (Jha, Bloch & Lamond, 2012). It becomes challenging to connect the people needing help with the triage nurses and other healthcare professionals on the response teams, in addition to communication affected by the floods. Studies have proven time, and again that hierarchical structures slow down communication, which would ultimately affect other parts of the response efforts, including triaging.
Ultimately, it is a matter of common knowledge that hospitals receive numbers beyond what their capacity can ordinarily handle during floods and other emergencies of the same magnitude. With a more than ordinary population visiting a healthcare facility, the resources will become overwhelmed, and the human resources trend in triage may not be sufficient to serve the victims effectively and in a timely fashion (Mort et al., 2018). In a nutshell, those factors that pose severe challenges to the dredging process are directly associated with the immediate impact of the disaster.
Types Of Injuries Most Likely to Occur
More people die from floodwaters than any other calamity. A hospital needs to be prepared to treat patients who have spent much time outside before they can be saved (Paterson, Wright, & Harris, 2018). Puncture wounds, hypothermia, and trauma from falling objects are just a handful of the wounds a hospital may treat during a flood. The primary injuries include:
- (i) Vector-borne illnesses could include hemorrhagic illness, dengue, yellow fever, and malaria.
- (ii) Waterborne illnesses
- infected wounds.
- (iv) Orthopedic injury and hypothermia are two common types of injuries resulting from flooding.
- (v) West Nile virus transmission by mosquitoes After a flood subsides and stagnated rainwater is present, fever frequently occurs (Bartholdson & von Schreeb, 2018).
Issues that may uniquely affect the vulnerable populations
Children and the elderly are among the most vulnerable groups in any community. Floods may negatively impact older people’s health in several ways. The spread of infectious diseases and mental illnesses, made worse by the devastation of facilities, houses, and livelihoods, are two of the longer-term effects of flooding on health, in addition to the instant harm and death, they cause. According to a meta-analytic assessment, older people were 2.11 times more likely than younger ones to exhibit manifestations of PTSD and 1.73 times more likely to suffer adjustment problems after being subjected to catastrophic events (Bukvic et al., 2018). Many areas with more significant senior populations have additional characteristics that significantly influence this age group’s susceptibility, including aging housing stock, disability, and household earnings, which frequently vary across rural and urban surroundings. Children’s wellbeing is impacted by several variables, such as the loss of important personal and household belongings, social ties, intimately familiar environments, and schooling; feelings of sheer terror, stress, economic hardship, separation, unequal treatment, breakdown, mental anguish, and insecurity; a lack of sleep and recreation; diminishment in diet, living quarters, and housing quality; and a complete absence of flood educational opportunities for students and staff as a whole (Mort et al., 2018).
Public Health issues that may ensue and mitigation strategies
In terms of public health, flooding can have either direct or indirect consequences. Communities’ direct responses to flooding might be categorized as immediate, intermediate, or late. Floods have acute negative implications on health that manifest immediately or within days (Okaka, & Odhiambo, 2018). At this time, there is a great deal of anxiety about mortality from injury and drowning in floodwaters. The likelihood of drowning is typically based on the possibility of either a storm surge or a flood with a slow beginning. People lose their lives by drowning in their cars and houses or being swept away by floods. Severe hypothermia is another acute condition that may develop.
The initial impacts are those that appear within ten days of the disaster. At this point, there is a severe danger of infection from secondary infections and cuts and bruises. Antifungal therapy may not be necessary if proper wound care, extraction of foreign objects, and removal of damaged tissue material are performed (Okaka & Odhiambo, 2018). Typhoid, cholera, and viral gastroenteritis are all possible in places with low sanitation and hygiene standards. Hepatitis A and E, for example, could happen.
Depending on the region, the likelihood of vector-borne diseases like dengue fever and malaria increases the longer the flood waters remain in place. Mortality can result from a lack of accessibility to medical care services and medications to treat noncommunicable illnesses like hypertension and heart problems (Yu et al., 2020). Mental health illnesses like post-traumatic stress are among the other issues that are frequently disregarded. The damage to the transportation infrastructure that makes it harder for the disaster response to reach the flooded areas and assist impacted populations might indirectly impact health. In addition, the destruction of agriculture and food stores increases the risk of famine and hunger in the populace.
Compared to the acute health effects of floods, psychological issues, which can develop later, are frequently disregarded and not as thoroughly explored. It is currently known that experiencing a flooding catastrophe can influence people immediately following the occurrence and occasionally for years to come. Some typical psychological health issues that develop during a flooding disaster include anxiety, panic, post-traumatic stress disorder (PTSD), hallucinations, and sleeplessness.
Another potential health effect of flood catastrophes is malnutrition or malnourishment, and there is evidence to support it. Victims frequently lack access to a regular food supply and have been reported to eat very little during or after flooding (World Health Organization, 2019). Flooding can also seriously impact food production, including agriculture. This may affect the availability and caliber of food, resulting in undernourishment and malnutrition.
How interagency cooperation and local collaboration can be effectively utilized
It takes a network of affiliated institutions and entities to safeguard and advance public health. While government healthcare agencies are ultimately responsible for preserving the public’s health, interagency collaboration with communities and cooperative stakeholders is crucial for a quick and successful reaction to public health disasters and emergencies (Baskin et al., 2021). These organizations include many that may not be considered a component of the general health system, including local health departments (LHDs) and some that are typically thought of as such.
Collaboration across entities is characterized as a procedure whereby organizations accept risks, duties, and incentives to exchange information, modify actions, work collaboratively, and improve one another’s capabilities for mutual advantage and a common goal (Baskin et al., 2021). Associated agencies value collaboration for a variety of reasons. As operations and initiatives may be integrated and finances can be consolidated, combined projects can give partnering agencies results that may not have been possible independently.
These results may improve advocacy and capacity, increase awareness and recognition, offer a more systematic approach, and provide more possibilities for new projects. Collaborative efforts may also prevent agencies from working in duplicate. Successful collaborations foster teamwork, a feeling of ownership, and a setting that offers all the tools necessary for success.
Supportive relationships rely on each participating party’s involvement to achieve the partnership’s objectives and capitalize on each participant’s assets. The effectiveness of cooperation is improved when all parties involved are conscious of each other’s capabilities and areas of specialization (Nkwunonwo, Whitworth & Baily, 2020). This enhances the efficacy of combined effort. Partner organizations must trust one another for continued cooperative efforts to be successful because reliable, dependable partners carry out their commitments, have common purposes and objectives, and are ready to be transparent and straightforward. Effective partnerships, which comprise routine, continuing, open discussions, teamwork, and planning, require trust and practical talks.
Emergency preparedness initiatives may start with collaborations between LHDs and other affiliate organizations. Numerous school systems now have health-related initiatives in place, such as campaigns to promote a healthy lifestyle, promote quitting smoking, and in some cases, raise awareness of STDs and illnesses (Bell et al., 2018). Developing collaborative preparedness measures for LHDs and school systems might benefit from building upon current partnerships and activities. Collaborations on preparation projects might take the form of co-writing plans, carrying out emergency drills and rehearsals, and equipping schools to serve as shelters or distribution points in times of need.
Pre-and Post-incident Pitfalls
People should be warned not to consume stormwater runoff after it has passed, nor should they use it to clean their dishes, brush their teeth, or prepare foodstuff. Affected individuals should wait until city officials have deemed it acceptable to return home following the evacuation (Yu et al., 2020). To determine whether their water is suitable for drinking and showering, everyone should abide by the local authorities’ water advisory notices. Furthermore, consumers must only consume and cook with purified, hot, or bottled water during a water warning. Traveling through flooded regions and stagnant water should be avoided as it might be problematic.
Floods pose a severe public health threat because they affect communities in diverse ways that ultimately impact their wellbeing and quality of life. This paper has reviewed some of the ways in which floods impact health directly. One significant health risk in the event of a flood is illnesses and epidemics. Waterborne infections, or those brought on by ingesting or coming into touch with polluted water, are one possible type of these. Diarrhea, cholera, scarlet fever, and leptospirosis are a few examples. The paper has effectively described some of the considerations unique to floods when assessed from the public health perspective.
Bell, J. E., Brown, C. L., Conlon, K., Herring, S., Kunkel, K. E., Lawrimore, J., … & Uejio, C. (2018). Changes in extreme events and the potential impacts on human health. Journal of the Air & Waste Management Association, 68(4), 265-287.
Cooper, A. (2010). Healthcare Incident Management Systems. Health care emergency management: principles and practice. Sudbury, MA: Jones & Bartlett Learning, 21-45.
Nkwunonwo, U. C., Whitworth, M., & Baily, B. (2020). A review of the current status of flood modeling for urban flood risk management in developing countries. Scientific African, 4(4), 785-792.
Paterson, D. L., Wright, H., & Harris, P. N. (2018). Health risks of flood disasters. Clinical Infectious Diseases, 67(9), 1450-1454.
Okaka, F. O., & Odhiambo, B. (2018). Relationship between flooding and outbreak of infectious diseases in Kenya: a review of the literature. Journal of environmental and public health, 4(5).
Bartholdson, S., & von Schreeb, J. (2018). Natural disasters and injuries: what does a surgeon need to know? Current trauma reports, 4(2), 103-108.
World Health Organization. (2019). Health emergency and disaster risk management framework.
Baskin, C. R., Barry, M., Cohen, R. E., Condren, C., Crosley, S., Dickhans, C. D., … & Schmidt, S. (2021). All Hands-on Deck: Local Public Health Agencies Leveraging the Incident Command System During Crises. Health security, 19(4), 364-369.
Yu, D., Yin, J., Wilby, R. L., Lane, S. N., Aerts, J. C., Lin, N., … & Xu, S. (2020). Disruption of emergency response to vulnerable populations during floods. Nature Sustainability, 3(9), 728-736.
Bukvic, A., Gohlke, J., Borate, A., & Suggs, J. (2018). Aging in flood-prone coastal areas: Discerning the health and wellbeing risk for older residents. International Journal of Environmental Research and Public Health, 15(12), 2900.
Mort, M., Walker, M., Williams, A. L., & Bingley, A. (2018). Displacement: critical insights from flood-affected children. Health & Place, 52, 148-154.
Jha A. K. Bloch R. & Lamond J. (2012). Cities and flooding: a guide to integrated urban flood risk management for the 21st century: a summary for Vietnamese policymakers. World Bank.