3. Medico-tactical characteristic of natural disasters.

1. Flood

There are such natural phenomena as the floods, or catastrophic flooding of the settlements on the vast territories. They influence greatly upon the public health services’ tactics activity and the employment of medical forces and means. First of all, territory scales of flooding and the fact that the great amount of the population becomes homeless and is deprived of drinking water and food products is of great importance in the given case. The people are also exposed to influence of cold water, wind and others of the meteorological factors.

The floods can be caused: by a heavy falling of precipitations or intensive melting of snow, by the joint action of flood waters and ice blockings, by hurricane wind, underwater earthquake (seaquake).

Floods can be predicted: to determine time, character, its expected sizes and to organize the preventive measures in proper time, to create favourable conditions for realization the conducting-salvaging and urgent breakdown-restoring works.

The other kind of flood is sill - suddenly formed stone-muddy stream caused by a sharp rising of the water level in the mountain rivers. It contains solid materials (10-75 % of its volume) and moves at a speed of more than 10 m/s. Volumes of the mudflow can reach hundreds of thousands - millions м³, and sizes of the placing mountain rocks - up to 3-4 м in a diameter and weight up to 100-200 tons. Having large weight and speed of movement, they destroy buildings, constructions, roads and all another on a way of a movement.

So, heavy prolonged shower in January, 1982 has caused landslips in Peruvian Andes, which have carried away lifes of 5000 men. In Bangladesh ,1975, 30 thousand men were lost. Annually in the world at average occur up to 30 floods, thus the perished persons make about 6000, wounded-15000, lost - about 30 mln., homeless persons - about 3,5 mln.

On the rivers of Ukraine the cascade of hydroschemes (about 2000 dams) was created. At their destruction in a zone of flooding can appear a few hundreds of the populated areas. Only within the limits of Kiev the zone of flooding can make 42 square km., where about 400 000 people lives. In Odessa the most dangerous area for catastrophic flooding is Peresyp (the dam of Khadzhibeysky estuary).

When there is a danger of flood, the actions of the appropriate committees and commissions should be the following:

- To announce an alarm in a zone of crisis;

- If the situation requires, to begin realization of evacuation measures according to the plan;

- To determine areas, where the help is necessary;

- To determine, who from the population requires the help and to render it;

- To maintain communication with medical services.

On a case of flood there should be a plan of joined actions of Civil Defense services, MD, militia and medical formations, thus it is important to represent clearly, what can happen, where and when.

The efficiency of rendering of the medical help to victims and of the use of forces and means of public health services considerably raises at allocation on flooded territory of four zones of catastrophic flooding depending on speed of waterflow, height of the flood wave and distance of the settlement from the water-development projects as well as from the dangerous phenomena (of a typhoon, tsunami, rather rough sea, high water etc.)

The first zone of catastrophic flooding. It sides directly with the water-development project or the beginning of the natural phenomenon, it

Stretches for 6-12 km, height of a wave can reach several meters. The wave is characterized by a heavy water flood with the current rate of 30 and more km/hour. Time of passage of a wave - 30 minutes.

The second one is the zone of rapid current of 15-20 km / hour. It stretches on 15-20 km. Time of passage of a wave is 50-60 minutes.

The third zone is the zone of average current with speed of 10-15 km/hours and extent till 30-50 km. Time of passage of a wave is 2-3 hours.

The fourth is the zone of weak current (overflowing). The speed of current can reach 6-10 km/hour. Its length will depend on the configuration of terrain and can make 30-70 km from the water-development project or the place of the beginning of the natural phenomenon.

The size and structure of losses will change depending on density of the population in a zone of flooding, timeliness of the notification, distance of the settlement from a place of flood origin and location of medical establishments, height of a flooding wave and time of its passage, temperature of water and air, time of day and other features. The characteristic of possible size of losses on zones of flooding in day time and night time is submitted in table 4 (in % from the population).

For rendering the urgent medical help the emergency pre-medical care teams are formed on the basis of municipal, central, regional, local hospitals as well as on the basis of polyclinic establishments and medical aid posts in the first place. Medical-nurse teams of the emergency medical care are formed in peace time on the basis of municipal, central, regional and interregional treatment-and-preventive establishments on the basis of the decision of territorial bodies of public health services for work in the focus independently and for strengthening of the ambulance teams, which also take part in rendering the medical help to injured in extreme situations.

The rendering of the emergency medical help at once in large territory to isolated groups of the population causes the work of the mentioned teams by not great powers on the wider area, sometimes on significant distance of one team from another. In some cases, being placed on crafts (boats, motor boats), medical sisters and the doctors of brigades will be compelled to work independently. All persons participating in rescue on water, should be supplied with saving means (belts, ring life buoys etc.).

The rendering of the first medical help to the suffered population includes first of all, warming (shelter from a cold), realization of artificial lung ventilation, indirect massage of heart, and also bandages at traumas, temporary immobilization of fractures.

The first aid is limited by the measures directed on maintenance of vital functions of the organism.

For organization of sanitary-hygienic and antiepidemiological measures in zones of catastrophic flooding, the groups of epidemiological reconnaissance and brigades of the emergency sanitary-preventive help, which are created on base of sanitary-epidemiological stations of a different level are directed.