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Nadia Rohmatul Laili

Why we must learn about
• Indonesia is one of the vulnerable group
 Many islands
 Tectonic slices
 Active volcanoes
 Complexity and diversity in culture, tradition,
ideology, ethnicity, religion, politics, and
• Frequently happen
• Disaster preparedness is yet optimized
• Hazards are the potential threats that may
occur during a given time period in a given
place. Hazard is define as potential threats to
involve human life, natures, and properties
caused by natural and/or man made behavior.
• Vulnerabilities are identified points of
weakness that an organization may have for a
spesific hazard.
• Climatological hazards, eg: floods, abration
• Geological hazards, eg: volcanoes, earth quake, landslides
• Industrial & technological hazards
• Man Made, eg: conflicts, war
• Physical vulnerability, eg: infrastructure, public facilities
• Social vulnerability, eg: sex, religion, culture, poverty
• Economic vulnerability, eg: low level income
• Environmental vulnerabilty, eg: water, air, land
• Institutional vulnerabilty, eg: policy, disaster management
WHO, 2002
How can this happen??



A disaster occurs when hazards and vulnerability meet

• A disaster is an occurrence disrupting the
normal conditions of existence and causing a
level of suffering that exceeds the capacity of
adjustment of the affected community (WHO/
EHA 2002)
• Disaster are events that inflict significant
damage to life or property and that
substantially overwhelm the local
community’s resources (Powers, 2010)
Type of Disaster
Natural Men Made
• Tsunami • Social Conflicts
• Earth Quake • Terorism
• Volcanoes • Mass Transportation
• Flood Accidents
• Landslides • Industrial accidents
• CBNRE (Chemical,
biological, Nuclear,
Radiological, and Explosion)
• Physical & psychological impact
• Environmental damage
• Damage to infrastructure
• Disruption of public services
• Loss properties
• Social economic impact
Does disaster need
• The adaptation of professional nursing
knowledge, skills and attitude in recognizing
and meeting the nursing, health and
emotional needs of disaster victims
• Disaster nursing provides care, advocacy, and
promotion of health within the context of a
The Goal of Disaster Nursing
Ensuring the Highest achievable level of care is
delivered through identifying, advocating, and
caring for all impacted populations throughout
all phase of disaster event, including active
participation in all levels of disaster planning
and preparedness
Characteristics of Disaster Nursing
• Caring for the community during disaster
- must be aware of the potential hindrances
- modification necessary to provide care
- coordinating care with otherr agencies &
- overseeing the transfer of patients t hospital
- assigning supplemetal heathcare workers
• Personal impact
- lack of communication
- increased physical demand
- working long shifts
- should develop coping strategies and
support network
• Adverse conditions
- structural damage
- must be aware of potential hazard
• Lack of recognition
- nurses often is not understood by others
• Critical thinking
• Adaptibility
• Leadership
- coordinate and organize efforts during all
stages of disaster
Nursing in the Phase of Disaster
• Mitigation initiatives
• Hazard-vulnerabiliy assessment
• Identified risks
• Training and practice
Nursing in the Phase of Disaster
Relief Response
• Recognize the impact on health care
• Coordination
• Involve in assesing community needs
• Providing care
Nursing in the Phase of Disaster
• Rebuilding the healthcare system
• Public health surveillance
• Establishing temporary clinics
• Guiding immunization programs
• Ensuring that the ongoing health and survival
needs of the community are met
• Providing psychological care
• Undang Undang Dasar 1945
• Undang-Undang Nomor 24 Tahun 2007 tentang
Penanggulangan Bencana
• Peraturan Pemerintah Nomor 21 Tahun 2008 tentang
Penyelenggaraan Penanggulangan Bencana
• Peraturan Pemerintah Nomor 22 Tahun 2008 tentang
Pendanaa dan Pengelolaan Bantuan Bencana
• Peraturan Presiden Nomor 8 Tahun 2008 tentang Badan
Nasional Penanggulangan Bencana
• Peraturan Menteri dalam Negeri Nomor 46 Tahun 2008
Tentang Pedoman Organisasi dan Tata Kerja BPBD
Disaster Ethics
• Nurses need to understand their professional
codes of ethics, not only in their countries, but
also in the countries in which they may work
• Nurses need to be aware of the cross-cultural
issues related to religion, gender, and
particular cultural practice that either can
diminish or enhance their contribution to the
individuals and communities in need during
and after disasters
The ethics of clinical dilemmas should be
analyzed in relation to four topics:
1. Medical indication
2. Patient preferences
3. Quality of life
4. Social, economic, legal, and administrative
contextual features
• Respect of autonomy  respecting in adult
individual right
• Beneficience  doing good
• Non-maleficence  not causing harm, reduce
the risk of harm
• Justice  equitable distribution of goods and
The Challenge to Ethical Practice
during Disaster
• Prioritizing the allocation of resources
• Duty to care
• Alteration in practice standards
Ethical Decision-Making
Values: Need regular drills
1. Reasonable and exercise
2. Open and transparent
Ethics must
3. Inclusive
become an
4. Responsive essential
5. Accountable component of
training in all