There is a paucity of reliable data on the healthcare needs over time after sudden onset disasters (SOD). There also are no widely acknowledged definitions and data on deployment, use, staffing, and management of foreign field hospitals (FFH) after such disasters. Further, the efficiency, relevance, timing and cost-effectiveness of FFHs in the aftermath of SODs have been questioned. This was again highlighted after the 2010 Haiti earthquake, when the situation, to a large extent, was chaotic, uncoordinated, and care was not adapted to needs. These shortcomings create severe difficulties with respect to studying the real impact of medical aid after a SOD and optimizing the international medical relief efforts to be applied afterward. This article aims to present a health system approach to the deployment of FFHs after a SOD, here applied to an earthquake. By reviewing the literature and drawing on field experiences from SODs, a conceptual framework was developed that capture the essential dimensions in such a model, including: (1) classification standardization of levels of care in FFH (1–4); (2) time-phases after the event (1–5); and (3) the need for health care based on the assumed burden of disease and, hence, need for medical care in relation to the socio-economic context. The model currently is being tested on a number of international experts in the field. By using this framework, the authors hope to create: (1) a common platform for research within this area; and (2) a tool for international actors that will facilitate a development toward an international coordination body in the future. As such, the framework hopefully will offer an opening to a structural approach to the above mentioned difficulties, support international actors in their SOD preparations and deployments, and put them in a better position to optimize the resources available to the targeted population.

In the past two decades, Mumbai has witnessed several mass-casualty incidents. Somehow, it seems that the city has missed some important lessons from these events. Mumbai has no formal structure for emergency medical services (EMS). Although EMS may seem to be a much-desired necessity, scholars have raised questions on the practicality and feasibility of having such a system in Mumbai. Factors such as population congestion, traffic volume, and lack of coordination among existing hospitals, the success of such a system in a city like Mumbai is jeopardized. In spite of having similar challenges in some other regions of the country, EMS systems (e.g., in Gujarat) have achieved substantial success. This paper deals with the planning and organization of EMS in Mumbai. It evaluates the performances of the existing EMS systems in other Indian cities. The paper also discusses the advantages of having such a system, particularly during the events such as disasters, accidents, acts of terrorism, etc. The paper also discusses the possible consequences of the absence of EMS, such as delayed ambulance dispatch, improper distribution of patients, overcrowding at certain hospitals thereby leading to poor triage, and several similar problems that can worsen a crisis. It studies the potential challenges for the establishment of such a system in Mumbai, and suggests a model for an effective EMS system for the city.

Logistics has always been an important factor in humanitarian aid operations, to the extent that logistics efforts account for 80% of disaster relief. They often have to be carried out in an environment with destabilized infrastructures ranging from a lack of electricity supplies to limited transport infrastructure. Furthermore, since most natural disasters are unpredictable, the demand for goods in these disasters is also unpredictable. Thus it is evident that humanitarian logistics is challenging as it has to be more flexible, and has to function under severe constraints. In India, humanitarian logistics remains a neglected field ins disaster management, the cost of which is paid by loss of human lives and property. In recent Kosi Flood the total population of 33,45,545 people living in 993 villages of 412 panchayats of 35 blocks of 5 districts were affected. A total of 3, 40,742 houses were damaged and 7, 12,140 animals were affected. A total of 239 humans and 1232 animal's lives were lost (Department of Planning and Development, Government of Bihar). The Paper analyses, Madhepura district government's mechanisms of managing logistics while responding to Kosi floods 2008. It evaluates the efficiency of these mechanisms with respect to its outreach to flood affected people. It review and analyses the strengths and weaknesses of the adopted distribution network design for relief management with reference to strategic locations of the relief camps, during the first month of the kosi floods in 2008. It suggests ways to improve disaster logistics at district level in Bihar. The study looks into the possibilities of adopting newer approaches in the field of logistics that could be implemented with greater efficiency under similar conditions. The logistics in the devastating floods at the district level in a developing country has key learning lessons for similar resource poor environments.

Liberia's 14 year civil war destroyed domestic agricultural production, veterinary and agricultural education, extension services and domestic food security. These losses severely limited domestic food production, and basic hygiene and sanitation: potable water, abattoirs, cold chain and food storage were greatly diminished. The average Liberian life expectancy fell from 45.8 in 1990 to 41.8 years presently. The population birth and death rate are two of the highest globally with a resulting population growth rate, of 2.7% per annum; this growth rate requires an immediate and concerted focus on domestic food production to alleviate nutritional inadequacy and hunger, trade imbalances and loss of foreign exchange credits. Food supply nationally is presumed adequate because of importation, though domestic production is inadequate. Unequal distribution precludes food security for all Liberians. Value chain augmentation, enhancing food availability across all sectors of Liberian society and ensuring distribution of a safe food supply needs critical development. Infant mortality remains one of the highest in the world (approximately 160/1000 births), much of which is attributed to food insecurity, food contamination and lack of uniformly available potable water. Recreation of Liberia's public health and food security requires redevelopment of disease monitoring and laboratory diagnostic capability to re-establish safe food production and handling practices across all sectors. This will allow determination of endemic disease burden for the principal livestock species: poultry, sheep, goats, cattle and swine. Creation of a national disease surveillance/monitoring system allows for targeted disease intervention, ensuring vaccination for correct serotypes and most critically prevalent diseases. Creation of community level training and support will target intervention of local diseases, but also allow for national prioritization of diseases. Targeting which are most prevalent or most likely to cause production limiting effects will require periodic surveillance, targeted vaccination, and chemotherapeutic intervention and evaluation of therapeutic success.

Animal production is an important component to economic stability and food security in developing country. Economic development programs have targeted agriculture in developing country as a means of decreasing poverty and empowering vulnerable populations throughout much of the developing world. Disasters due to natural and man-made hazards that impact animal agriculture have a disproportionate impact on the rural poor and vulnerable populations affecting the economic well being and health of the greater population. Protection of livelihoods dependent on animal agriculture is important to consider in community resilience and humanitarian assistance activities that range from capacity building through response and recovery. In order to meet the challenges of the next generation of global health threats, policy, research, and practice must adopt a new cross-cutting approach that targets the human-animal-ecologic interface taking into account political, socioeconomic, and cultural factors.

Disasters cause destruction, but also bring opportunities for development. A lack of this perspective in disaster management leads to planning and managerial follies. The reconstruction and rehabilitation program from the Latur earthquake (Maharashtra, India) should be used as a starting point. Leh, the largest district of India, was hit by a cloudburst and subsequent flashfloods on 05–07 August 2010. The monetary value of the total damages is estimated to be approximately Rs 225 crores. A total of 87% of the affected infrastructure required complete reconstruction. The rest received partial damages. This paper uses field data collected on development needs in 112 villages over a span of five years (just preceding the disaster) and data for damage assessment from the 42 affected villages collected immediately after the disaster. The paper does a careful assessment of the damages in the flashflood, analyses the pre-existing developmental requirements of all the villages in the district, and explores the possibilities of integrating post-disaster reconstruction with the pre-existing developmental requirements. In India, post-disaster reconstruction quite often is an elaboration of short-term, makeshift arrangements, thereby giving rise to obvious developmental concerns. Merits and demerits of this strategy will be discussed. This research examines the financial implications of integrating reconstruction projects with development programs. It also looks into the sustainability of development, and how can this serve as a strategy in making communities more resilient to future disasters.

Veterinary education provides a solid clinical and public health background that is applicable to several international development and humanitarian assistance sectors; however key skills and experiences that are required to be an effective Global Veterinary Medicine practitioner are not covered. In response to the US Department of Defense adopting Stability Operations as a core mission, the US Army Veterinary Corps has developed a Veterinary Stability Operations Practitioner Course intended to prepare Veterinary Corps officers to function effectively if tasked to conduct or support Stability Operations. The Veterinary Stability Operations Practitioner Course is a two part workshop series that provides a global veterinary perspective including knowledge, skills and experience necessary for Veterinarian to function in an international developing setting. Skills in assessment methodologies, program planning and evaluation are core to each workshop. Knowledge is based on production, market, and disease surveillance systems in the developing world. The intent is for the attendee after completing the course series to view their operational environment differently by understanding the social and cultural context that influences local population decisions and behaviors.

Building Resilient Extended-Care Facilities During Natural Disasters – Lessons Learned from the 2007 Tulsa, Oklahoma Ice Storm. In the last decade, increasing importance has been placed on building resiliency into critical healthcare systems. This has meant shifting the paradigm from focusing on response to one of preparedness. In 2007, an ice storm as part of a series of winter storms occurred in the south central United States causing extensive power outages, in Tulsa, Oklahoma, for a period of up to 3 weeks. Five of the six tertiary care hospitals in Tulsa suffered power outages, phone system failures or oxygen and/or suctioning system failures. Local water treatment plants were without power for 48 hours. During this time, multiple extended-care (nursing home) patients were discharged to homes or transferred to hospitals because the nursing homes were not prepared to cope with an extended power outage. This paper is a retrospective analysis and discussion of lessons learned with respect to the vulnerability of these extended-care healthcare systems and the public health response during natural disasters.

The watersheds are the home for our key natural resources and have been one of the basic elements in land use management systems throughout the hydraulic civilization of our country. “Badulla River” is one of the main watersheds in Sri Lanka extend about 1400sq.km consisting five sub catchments high steep lands. It mainly represents tea estates and agricultural lands with a weak land use pattern due to poor maintenance and unsuitable human involvements. This has contributed to reduce the rain water infiltration in to the soil increasing a huge amount of runoff water drainage. Situation has resulted frequent floods even in a small precipitation causing widespread damages to community. Hence, an initial project was started on surface water management, soil conservation and livelihoods development to control the frequent floods highlighting the urgent actions for an optimal land use management with support of field experts. Improved surface water drainage and soil conservation are the main options that might lead to mitigate the flash floods. Efforts were sharpened by integrating GIS Mapping for such initiation to enhance the effectiveness of the design. Results achieved could address many issues in relation to flood protection, habitat management, water protection and water quality management. Food risk generally related to the specific characters in a particular catchments and this model project proved that such issues can effectively be addressed through a joint program properly designed.

Natural disaster like cyclone, tidal bore, flood, tornado etc. is a common phenomenon in Bangladesh. Tropical cyclones associated with tidal surges occur at the rate of 1.3 a year in the coastal districts, cyclone in 1970 and 1991 claimed over 500,000 and 138,000 lives respectively in the coastal districts and offshore islands. The vulnerability is so miserable that they have to go and settle in the newly accreted land in Bay of Bengal and its surrounding areas which is occasionally hit by tidal bore or devastating cyclone. The main susceptibility comes from weak social and economic structures of the country. Housing quality, preexisting poor health and nutritional status, social welfare infrastructure, and economic resilience determine the magnitude of a disaster's effect and its long term consequences. In recent years, improved early warning systems and preparedness measures have helped reduce mortality, but no significant change in morbidity. However the effective disaster preparedness systems and capabilities for post-disaster emergency phase usually provides through volunteer contributions and local authority at the neighborhood level. The government's relief team, NGOs and foreign teams took couple of days to few weeks to start operation properly after devastating disasters like Sidr in 2007. However the basic survival and emergency assistance like clothes, shelter, food and medicine which saved thousand of lives were managed by community people themselves. Active participation of local communities, those have rich experience of coping with natural disaster both in preparedness and emergencies are essential for successful disaster reduction policy and practice, also putting value on our traditional social and cultural bondage. So strategies for disaster preparedness should be focused at family and community levels, support to community-based low-cost technology, promotion and development of human resources and integration disaster management components into development policies and empower the people to face the challenges of disasters.

Disasters tend to exacerbate and bring to surface the socio-economic, political, environmental vulnerabilities of the different sections of a community and thus, are seen as opportunities for reduction of vulnerability. In a post-disaster recovery program, organizations often come together in an effort to create safe conditions, reduce pressures and address root causes. These programs, at times, may further strengthen the existing vulnerabilities, thereby making some groups of the community better off than the others. Vulnerability is a dynamic process and no individual is completely vulnerable or resilient. Root causes, dynamic pressures and unsafe conditions also change with time and depends on the context of analysis. This study examines changes in vulnerability after intervention by organizations using a case study of one of the villages affected by the 2001 Gujarat Earthquake. The case study of the village gives an insight into the intra-societal vulnerabilities and how these vulnerabilities change with time. The study is qualitative in nature and has used purposive sampling technique to collect data. Data analysis was done using inductive coding methods. The study is of practical significance for the local authorities to understand peoples' perception of their vulnerabilities and ways to decrease them. It also adds to the body of knowledge by understanding vulnerability and resilience as social processes and offer lessons for future recovery processes.