Importance of mitigation

Mitigation is a crucial component of disaster management, serving as a proactive approach to

reducing the impacts of disasters on communities and infrastructure. Here's why mitigation is
important:

1. Risk Reduction: Mitigation aims to identify, assess, and reduce risks before disasters occur.
By implementing measures such as building codes, land-use planning, and infrastructure
improvements, communities can lower their vulnerability to various hazards.

2. Cost Savings: Investing in mitigation can result in significant cost savings in the long run.
While upfront costs may be incurred for implementing mitigation measures, they are often
much lower than the expenses associated with disaster response, recovery, and rebuilding
efforts.

3. Protecting Lives: Mitigation measures help protect human lives by minimizing exposure to
hazards. This can include constructing storm shelters, implementing early warning systems,
and educating the public about evacuation routes and safety protocols.

4. Preserving Infrastructure: Disasters can cause extensive damage to critical infrastructure

such as roads, bridges, utilities, and communication networks. Mitigation efforts focus on
strengthening infrastructure to make it more resilient to natural hazards, ensuring continuity
of essential services during and after disasters.

5. Safeguarding the Environment: Mitigation strategies often consider environmental concerns,

aiming to minimize the impact of human activities on ecosystems and natural resources.
Sustainable land-use planning and ecosystem restoration initiatives can help mitigate the
environmental consequences of disasters.

6. Community Resilience: Mitigation fosters community resilience by empowering individuals

and organizations to better withstand and recover from disasters. It promotes collaboration
among government agencies, businesses, nonprofits, and residents, fostering a sense of
shared responsibility for disaster preparedness and response.

7. Long-Term Planning: Mitigation encourages long-term planning and foresight, rather than
reactive responses to emergencies. By integrating mitigation into development policies and
practices, communities can create more sustainable and resilient environments for future
generations.

Overall, mitigation plays a vital role in disaster management by reducing risks, protecting lives and
property, and enhancing the resilience of communities in the face of natural and human-induced
hazards.

Strategies for mitigation

A. Pre disaster planning

1. Risk assessment-
Risk assessment is a fundamental process in disaster management aimed at understanding
and evaluating potential hazards, vulnerabilities, and the likelihood of adverse
consequences. Here's how risk assessment is conducted in the context of disaster
management:
  Identifying Hazards: The first step in risk assessment is to identify and characterize
potential hazards that could lead to disasters. Hazards can be natural (e.g.,
earthquakes, floods, hurricanes, wildfires) or human-induced (e.g., industrial
accidents, terrorist attacks, technological failures). Comprehensive hazard
identification involves analyzing historical data, scientific research, and local
knowledge.

 Assessing Vulnerabilities: Once hazards are identified, the next step is to assess the
vulnerabilities of communities, infrastructure, and natural systems to these hazards.
Vulnerability assessment involves analyzing factors such as population density, land
use patterns, building codes, socioeconomic conditions, environmental degradation,
and access to resources. Vulnerability mapping and modeling techniques may be
used to quantify and visualize vulnerabilities spatially.

 Estimating Potential Impacts: Risk assessment involves estimating the potential

impacts of hazards on people, property, the environment, and the economy. This
includes evaluating the likelihood and severity of various scenarios based on factors
such as hazard intensity, exposure, and susceptibility. Impact assessment may
consider direct physical damage, casualties, displacement, disruption of services,
economic losses, environmental degradation, and social consequences.

 Determining Risk Levels: Risk assessment combines hazard information, vulnerability

analysis, and impact estimation to determine the overall level of risk posed by
different hazards. Risks may be categorized based on severity (e.g., low, moderate,
high), likelihood (e.g., rare, occasional, frequent), and spatial distribution (e.g.,
localized, regional, widespread). Risk matrices or risk scoring systems can help
prioritize risks for further action.

 Identifying Risk Reduction Measures: Based on the results of risk assessment,

strategies and measures can be identified to reduce or mitigate the identified risks.
This may include structural measures (e.g., building retrofits, flood defenses), non-
structural measures (e.g., land-use planning, early warning systems), policy
interventions (e.g., regulations, incentives), and community-based initiatives (e.g.,
awareness campaigns, capacity building).

 Monitoring and Review: Risk assessment is an iterative process that requires ongoing
monitoring, review, and adaptation. As conditions change and new information
becomes available, it's essential to update risk assessments to reflect evolving
hazards, vulnerabilities, and risk reduction measures. Regular reviews help ensure
that disaster management strategies remain effective and responsive to emerging
challenges.
2. Emergency Response plans
Define roles, responsibilities, and procedures for various stakeholders involved in emergency
response. This includes delineating the chain of command, establishing incident command
structures, and outlining decision-making processes.
Develop standard operating procedures (SOPs) for key tasks such as evacuation, sheltering,
search and rescue, medical triage, communication, logistics, and resource allocation.
3. Staff training and drills-
 (a) Planning
The planning process shall broadly involve:
1. Formation of a sub-team (within the HDMC) who shall draft the plan.
2. Development of the plan and sub-plans; guidelines, standard operating procedures
etc.
3. Allocation of resources to execute the plans; and
4. Defining and allocating roles/responsibilities to be performed by hospital staff in
the event of activation of the plan.
The main objective of the Hospital Disaster Management Plan shall be to optimally prepare
the staff, institutional resources and structures of the hospital for effective performance in
different disaster situations. The HDMP shall be a written document and copies of the same
shall be made available to all staff in the hospital. It shall have comprehensive actionable
plans for disaster Preparedness, Response and Recovery corresponding to the Pre Disaster
Phase, Disaster Phase and Post Disaster Phase respectively. All hospitals shall have an HDMP
detailing but not limited to:

(1) Hazard Vulnerability Analysis (HVA) for the hospital/health facility

(2) Hospital Incident Response System
(3) Individual Roles and Responsibilities
(4) Hospital Capacity and Capability Analysis
(5) Hospital-Community Coordination, and
(6) Hospital Command Centre

(b) Training

 All hospital staff shall be regularly oriented to the Hospital Disaster Management Plan
(especially each time the plan is updated or modified). Hospital staff who will implement the
HDMP shall be trained every alternate month.
 All HIRS position holders (including their 2nd and 3rd line back-ups) shall learn the SOPs and
Job Action Sheets (JASs). They shall be trained as Master Trainers with a clear understanding
of the training outcomes regarding examinations. Practice evaluations shall be documented
for inspection.
 Specialized need-based training to perform specific functions during the disaster shall be
planned and executed for different hospital staff categories. The training will follow the skills
matrix appended in Annexures 2, 3, and 4.
 Regular Training and capacity-building provisions shall enhance the staff's capacity and
competency in providing critical clinical services during emergencies.

(c) Drills

Every hospital/healthcare facility shall conduct periodic drills and rehearsals to test the response
capabilities to emergencies in real-time, which will serve as opportunities for practical learning for
the hospital staff. There are several types of hospital drills, which include computer simulations,
tabletop exercises, and operationalized drills involving specific emergency scenarios.

(1) Table Top Exercises

A Table Top Exercise is a paper drill intended to demonstrate the working and communication
relationships of functions within the disaster management organizational plan and HIRS. The exercise
is intended primarily for the administrators, managers and personnel who could be placed into an
officer's position upon activation of the disaster management plan.

All hospitals shall carry out a tabletop exercise every quarter with the whole HIRS team. Proceedings
of the exercise shall be documented for inspection.

(2) Partial evacuation/Non-evacuation Drills & Mass Casualty Incident (MCI) Response Drills

Hospital evacuation may become necessary if a disaster damages the hospital. Such situations need
to be foreseen, and proper planning has to go into how to evacuate and which areas of the hospitals
need to be evacuated first in case of an internal disaster. All hospitals shall do an ICU evacuation drill
& ward evacuation drill once a year.

The function of the MCI drill is to check the system's resilience in terms of capacity and capability
when faced with an extraordinary surge of patients in the Emergency Room after an external
disaster. All hospitals shall carry out an MCI drill once a year.

Third-party evaluators shall evaluate all drills using a validated drill evaluation tool & documented.
The learning from the hot wash after the drill shall be documented for inspection, and the HDMP
shall be revised accordingly within seven working days of completion of the drill.

To ensure proper planning, training, and drills, every hospital shall:

i. Ensure that a Hazard- Vulnerability Assessment (HVA) of the hospital and a hospital

capability analysis precedes the development of the Hospital Disaster Management Plan

ii. Meticulously plan for each of the critical functions of hospital disaster preparedness and response

iii. Develop standards/protocols/guidelines for all aspects of hospital disaster preparedness and
response

iv. Allocate adequate resources for the smooth execution of the Hospital Disaster Management Plan

v. Regularly conduct training for the hospital staff involved in hospital disaster preparedness and
response

vi. Test the Hospital Disaster Management Plan by undertaking simulation exercises

vii. Conduct periodic Disaster Drills/exercises to improve the disaster preparedness and the response
capability of the hospital

viii. Regularly update and revise the Hospital Disaster Management Plan to meet the changing and
emerging scenarios.