Chapter 2 REVIEW RELATED LITERATURE The review of the literature for this study focuses on emergency management in Iligan

City. The chapter begins with an introduction about environmental disasters specific to flood and earthquake, a definition of emergency management, the essential interventions, followed by several studies and researches conducted in the past. An environmental disaster is defined as an environmental emergency or ecologic disruption of severity and magnitude resulting in deaths, injuries, illness and/or property damage that cannot be effectively managed but the application of routine procedures or resources and that result in need of additional assistance. (Veenema, 2007) Floods and earthquakes are the deadliest accounting for more than half of the total casualties (Duque, 2005) thus emergency management is essential. Emergency management, as defined by Dr. Wayne Blanchard of FEMAs Emergency Management Higher Education Project is the managerial function charged with creating the framework within which communities reduce vulnerability to hazards and cope with disasters. While, disaster management is a discipline that involves preparing for disaster before it occurs, disaster response (e.g. emergency evacuation, quarantine, mass decontamination, etc.), as well as supporting, and rebuilding society after natural or human-made disasters have occurred. In general, any Emergency management is the continuous process by which all individuals, groups, and communities manage hazards in an effort to avoid or ameliorate the impact of disasters resulting from the hazards. (Kumar, 2011) Emergency management must be: Comprehensive emergency managers consider and take into account all hazards, all phases, all stakeholders and all impacts relevant to disasters. Progressive emergency managers anticipate future disasters and take preventive and preparatory measures to build disaster-resistant and disaster-resilient communities.

 Risk-driven emergency managers use sound risk management principles (hazard identification, risk analysis, and impact analysis) in assigning priorities and resources. Integrated emergency managers ensure unity of effort among all levels of government and all elements of a community. Collaborative emergency managers create and sustain broad and sincere relationships among individuals and organizations to encourage trust, advocate a team atmosphere, build consensus, and facilitate communication. Coordinated emergency managers synchronize the activities of all relevant stakeholders to achieve a common purpose. Flexible emergency managers use creative and innovative approaches in solving disaster challenges. Professional emergency managers value a science and knowledge-based approach based on education, training, experience, ethical practice, public stewardship and continuous improvement.(Principles of emergency Management, September 2007) One of the most important public health tasks in the immediate aftermath of a disaster is to conduct a rapid and comprehensive assessment of population health requirements. (Connolly, 2005) The initial data collection as part of the rapid assessment should include the following: 1. Assessment of the current circumstances and quality of life of victims-location, demographic data, routes of access and modes of transportation, communication systems, availability of basic services( water, electricity, communications, sanitation facilities, housing and shelters), and availability of food. 2. The scope of the damage- determine the number of deaths, the number of persons injured, the number who have disappeared, the number displaced and their location, the status and capacity of health care facilities, urgent needs, and human and material resources in the immediate area (Farmer et.al, 2004) The role of the Public health nurse Public health nurses working at the local levels are expert in population health care and routinely conduct disease surveillance, implement programs in health promotion, and are knowledgeable in healthy standards for food, water and sanitation.(Atkins et.al, 2005) All responding nurses will be empowered to exercise leadership and discerning judgment in the following:

 Assessing the affected community for the presence (or absence) of the basic fundamentals for healthclean water, safe food, sanitation and shelter. Reestablishing the sanitary barriers that protect communities from environmental hazards Detecting changes in the integrity of the environment and organizing activities designed to eliminate or mitigate existing health hazards. Planning for continuous maintenance and monitoring of facilities basic to health regarding proper waste removal, adequate water and food supplies, shelter and personal safety. Responding aggressively to evidence of the transmission of disease to ameliorate the spread of an epidemic throughout the population. Respecting and empowering affected individuals by giving them decisionmaking rights regarding all pertinent public health issues. (Veenema, 2007) The National Disaster Risk Reduction and Management Council According to Mindanews released last February 2012, this is the agency of the Philippines assigned in dealing with disasters or emergencies for the welfare of the people. Formerly known as National Disaster Coordinating Council, it was renamed, reorganized and expanded in 2010. It is directed under the Office of Civil Defense under the Department of National Defense. Flood According to Veenema (2007) Flood results from prolonged rainfall for several days the River or a stream then overflow and flood surrounding areas. A flash flood from a broken dam or levee or after intense rainfall of 1 inch (or more) per hour often catches people unprepared. Morbidity during and after a storm itself results from drowning, electrocution, lacerations, or punctures from flying debris, and blunt trauma or bone fractures from falling trees or other objects. Heart attacks and stress-related disorders can arise during the storm or its aftermath. Gastrointestinal, respiratory, vector-borne disease as well as accidental pediatric poisoning can all occur during the period immediately after a storm.(Veenema, 2007) The health impacts of flooding include infectious disease morbidity exacerbated by crowded living conditions and compromised personal hygiene, contamination of water

sources, disruption of sewage service, and solid waste collection, and increased vector populations. Water borne diseases namely enterotoxigenic eschirichia coli, Shigella, hepatitis A, leptospirosis, giardasis are significant hazards as do other vector-borne disease and skin disorders. Floods are classified by WHO among sudden onset phenomena, although different types may occur with different speeds: Flash floods; River floods ( mostly seasonal); Coastal floods, associated with tropical cyclones, tsunami, storm surges.

Flood management Since 1991, ISO has administered the National Flood Insurance Programs (NFIP) Community Rating System (CRS). The CRS is a voluntary incentive program that assesses a communitys ability to mitigate flood damage. Their activities include

public information advising people about the flood hazard and ways to reduce flood damage mapping and regulations includes programs that provide increased protection to new development flood damage reduction activities that reduce the flood risk to existing development flood preparedness activities such as flood warning and dam safety programs

The Philippine flood scenario

According to PAGASAs gathered statistics from 1948 to 2004, an average of 20 storms and/or typhoons enter the Philippine area of responsibility per year. The Philippines belong to the typhoon belt, which makes it an easy target for storms and typhoons. This then results to floods on some areas of the Philippines.

Following Typhoons Ondoy and Pepeng, the Philippines enacted the Republic Act No. 10121 (Disaster Risk Reduction and Management Act) and Strategic National Action Plan for Disaster Risk Reduction containing the countrys framework for disaster risk reduction and management. The government, with World Bank support, is also set to complete the preparation of the Metro Manila Flood Management Master Plan early this year.The Philippines has drawn up a comprehensive framework for dealing with natural disasters and has done great strides in addressing the risk of floods. This guidebook is a great contribution to efforts at making sure that peoples vulnerabilities to calamities are reduced significantly, said World Bank Country Director for the Philippines Motoo Konishi. The guidebook was produced with the financial support of the Global Facility for Disaster Reduction and Recovery (GFDRR). Partners include the Japan International Cooperation Agency (JICA).Since Philippines is vulnerable to a variety of natural hazards, such as typhoons, periodic droughts, Earthquakes, and floods. US Aid has conducted some program updates regarding emergency management: PROGRAM UPDATE PHILIPPINES Mindanao Emergency Response Network (MERN): Implemented by Save the Children/Philippines (SCF/P), this program uses MERNs 40 participating local and international non-governmental organizations (NGOs) to work collectively in preparedness and relief activities, has created small stockpiles of locally procured relief items for emergencies, livelihood recovery for returning displaced persons, and provides small grants to MERN members for humanitarian assistance. Initiated in March 2003, funding for this program will continue until June 2007. Additionally, USAID/OFDA provided $100,000 to SCF/P in FY 2006 for community-based disaster preparedness in Southern Leyte Province. USAID/OFDA funding for this project totals $1.1 million since March 2003. PROGRAM UPDATE REGIONAL PROGRAMS Climate Forecast Applications (CFA): Since 1998, USAID/OFDA has supported the Asian Disaster Preparedness Centers (ADPC) activities to promote understanding of and preparation for extreme climate events. The current five-year project (FY 2003-FY 2008) seeks to strengthen the capability of Asian countries, including the Philippines, to manage and reduce the

impacts of climate fluctuations through targeted demonstration projects and community participation. The CFA program also mobilizes communities to utilize climate forecast data for agriculture, water resource management, and other sectors sensitive to climate variability. In FY 2006, including Philippines and Indonesia, USAID/OFDA contributed $325,000, and total project funding to date is approximately $2.3 million. Program for Enhanced Emergency Response (PEER), Phase II: This five-year activity includes training programs for medical first responders, collapsed structure search and rescue, and mass casualty training for hospitals. Initiated in March 2003 and implemented by the National Society of Earthquake Technology (Nepal), the program will continue through March 2008. USAID/OFDAs FY 2006 contribution to PEER was $1.5 million for 6 countries. Total project funding amounts to more than $9.4 million since FY 1998. Program for Hydro-Meteorological Risk Mitigation in Asian Cities (PROMISE): USAID/OFDA is supporting ADPC's efforts to increase community preparedness and capacity for managing hydrometeorological disasters, with an initial pilot project in Dagupan City, a low-lying coastal delta area of Luzon Province vulnerable to flooding. In FY 2006, USAID/OFDA provided $500,000 to PROMISE to 5 countries, including Philippines.

Iligan city flood scenario

Recently, last December 17, 2011 Iligan city- unused to storms was devastated by floodwaters raged by Typhoon Sendong. (GMA NEWS, December 17, 2011) The impact of Tropical Storm Sendong has been dubbed by local officials to be the worst to have hit the City of Iligan. Out of 330,000 total population, 5,521 families (27, 605 individuals) have been affected. Of these, an estimated 15,000 individuals are in 16 Evacuation Centers. The local officials cited that as of 19 December, there have been 279 registered deaths, of which around 50-60 of dead bodies have no claimants. The City Government conducted mass burial of unclaimed cadavers on 19 of December. To date, around 447 persons are still reported missing. There are 1,635 homes that are totally damaged and 1,632 homes are partially damaged. Three schools have been washed out by flashfloods. It has affected so many of our constituents

that even those who are expected to help are also victims," Iligan Citys mayor Lawrence Cruz stated. At least 24 barangays were affected which include Bayug, Bayug island, Mahayahay, Tambacan, Tubod, Tipanoy, Abuno, Palao, Ubaldo Laya, Pugaan, Rugongon, Tibanga, Santiago, Hinaplanon proper, Sta. Filomena, Luinab, Upper Hinaplanon, San Roque, Mandulog, Digkilaan, Mainit, San Miguel, Villa Verde, Bagong Silang, Sto. Rosario, Kalilangan, and Panorogangan. (Singcolinquisitor, December 2011) Priority public health concerns identified include: (1) water, sanitation and hygiene, (2) health surveillance and prevention of potential disease outbreaks; and (3) mental health and psychosocial support services. PNA Disaster Preparedness Committee coordinated with the World Health Organization Office of the Representative in the Philippines and Department of HealthHealth Emergency Management Staff to organize a field mission to Cagayan de Oro. The Committee ascertained the need for nurses to help in promoting proper water, sanitation and hygiene and providing psychosocial support services to families in evacuation centers and in affected communities in Cagayan de Oro and Iligan City. A group of resource persons were identified who can help in the field mission to train nurses and prepare them for deployment to needed areas. These resource persons are from the University of the Philippine Open University and University of the Philippines Manila College of Nursing (Phil. Nurses Association, 2012) The UP Padayon team spent three days assessing the extent of damage and the relief measures specifically in the towns of Santiago, Hinaplanon Upper Hinaplanon in Iligan City. The team was divided into four sub teams the Health team, Community Health and Water Sanitation team, Forensics team, and Geohazard team.(Manila bulletin, January 2012) Aside from food, water and clothing, officials of Iligan City are asking donors for anti-tetanus medicines after noting several cases of the condition in the city's flood-affected areas.(GMA news, December 2011) According to Medline (2012) Tetanus is a serious illness caused by tetanus bacteria. The bacteria live in soil, saliva, dust and manure. The bacteria usually enter the body through a deep cut, like those you might get from cutting yourself with a knife or stepping on a nail. Another dreading communicable disease is Leptospirosis. At least 24 people have died of leptospirosis in areas hit by Tropical Storm Sendong (Washi), the National Disaster Risk Reduction

and Management Council reported Monday.In its 8 a.m. update, the NDRRMC said at least 377 leptospirosis cases had been recorded in hospitals in Region X as of Sunday.The NDRRMC said that of the 377 cases, 258 were in Cagayan de Oro City and 119 in Iligan City.Of these, eight died in Cagayan de Oro and 16 died in Iligan, the NDRRMC said. The two cities are the hardest-hit areas.(GmA news, January 2012) The US National Institutes of Health's Medline Plus website defines leptospirosis as a rare and severe bacterial infection that occurs when people are exposed to certain environments. It said leptospirosis is caused by exposure to several types of the Leptospira bacteria, which can be found in fresh water that has been contaminated by animal urine, and occurs in warmer climates. Health officials said during the distribution of medicines, evacuees were also told to take doses of the antibiotics doxycycline. Jun Galvan, information officer of the Department of Health in Northern Mindanao, said the antibiotics were handed out in anticipation of flood-borne diseases as people wade in floodwaters to search for missing relatives or retrieve belongings. As more patients crowd hospitals, Dr. David Mendoza, head of the Regional Epidemiology Surveillance and Disaster Response Unit, said health officials were certain that many evacuees failed to heed the advice of health officials to take the antibiotic before they wade in the floods. (Inquirer news, January 2012) As early as December 13, 2011, three (3) days prior to the entry of TS Sendong in the Philippine Area of Responsibility (PAR), NDRRMC OPCEN was already activated and raised to Blue Alert Status. The Duty Alert System was immediately implemented involving the NDRRMC OpCen staff (Teams A and B who rendered duty round the clock on a rotation basis. On December 14 the center was ugraded into an emergency operations center under Red Alert Status wherein NDRRMC member agencies rendered duty at OPCEN on rotation basis to establish close coordination among member agencies in terms 7 of preparing for TS Sendongs expected landfall in the mainland. (NDRRMC, Feb. 2012)

Earthquake
One of the most frightening and destructive phenomena of nature is a severe earthquake and its terrible aftereffects. An earthquake is the sudden, rapid shaking of the earth, caused by the breaking and shifting of subterranean rock as it releases strain that has accumulated over a long time.(FEMA,2011)

One of the most common disasters in Iligan City is earthquake occurrences. As taken from the recently updated website-earthquaketrack.com, Iligan has had 37 earthquakes in the past year, and has experienced the highest magnitude of 7.9 in the year 1976. Earthquakes are caused by a sudden shift / movement deep under ground in the
Earth's tectonic plates. On the surface, we see this as the shaking of the ground, causing damage to poorly built structures.( ProjectShum Production,2006)

Philippine earthquake scenario Since The Philippine archipelago belongs to the Pacific ring of fire, about 87 erthquakes occurred various parts of the country in January this year.(Zambo Times, 2012) As taken Alexander Villafanias aticle in yahoo last March 2011, the worst earthquake in the Philippines was the Luzon earthquake that happened in July 16, 1990. It had caused 1,621 deaths and P15 billion worth damage and followed by the Mindoro earthquake on November 15, 1994 with the intensity of 7.1. The second strongest earthquake since the 1990 Luzon earthquake was the Moro Gulf, Mindanao earthquake with a magnitude of 7.6 which occurred last July 23, 2010.(Villafania, 2011) The latest earthquake was in Luzon with the magnitude of 6.1 on June 16, 2012(USGS, 2012) Iligan City Earthquake Scenario The latest earthquake had a moderate magnitude of 5.2 in the Ritcher scale Last March 5, 2012 according to Bernama from Malaysian news. The biggest magnitude happened about 36 years ago according to the websiteearthquaketrack.com. The magnitude of 7.9 was recorded in Sultan Kudarat and one of the greatky affected was its nearby city, Iligan. No recent catastrophic earthquakes has hit the city of Iligan but the disaster management council has observed some mitigation measures like the fire drills conducted.

Related Studies Since there are no studies that tackle about disaster management in Iligan city, the related studies about disaster management in the Philippines are taken up instead. According to a paper by Lourdes C. Masing-the Director of the Philippine National Red Cross in 2009 the vulnerability of the Philippines against disasters has been imminent and therefore requires the participation of people or volunteers for disaster management since the organization under government cannot do it alone. She also stressed the importance of preparedness than reconstruction and rehabilitation. Summary The studies conducted in Albay had produced significant results, as stated by (Evasco & Alejandro, 1996) the government should intensify training programs on disaster management to ensure that the personnel would acquire the necessary skills needed in the implementation of disaster management programs. Another case study presented by Manuel Quezon III in 2001 pressed the concerns about logistics, communication and transportation. It notes that lacks of necessary equipment and effective communication and transportation systems greatly affect and limit disaster management operations in the country based on the famous 1990 tragedies such as the mayon volcano eruption and the Payatas Tragedy and In the study by the World Bank looking at the Comprehensive Disaster Risk Management for Asia and the Pacific Region, particularly for the Philippines has identified issues on the development of a national framework for a comprehensive disaster risk management. http://www.mrsc.org/subjects/pubsafe/emergency/ps-flood.aspx http://www.health.ny.gov/environmental/emergency/flood/ http://www.osha.gov/SLTC/emergencypreparedness/guides/earthquakes.html