In disaster situations the incidence of common childhood illnesses increases due to the breakdown of the entire system leading to inadequate water supply, poor sanitation, overcrowding malnutrition etc. Though generally health workers are the ones to provide primary care, in times such as these the experts too, have to function at this level.

Preparedness

Standardization of the procedures used for disease prevention and treatment is particularly important in an emergency. Such procedures should be recorded and all health personnel should be familiar with them. The range of drugs used in camps or in health facilities for the affected population should be limited to the minimum needed for the management of common diseases. Similarly, medical equipment should be simple, sturdy, and easily replaceable. Such provisos can be executed at the time of need only if the planners have done their homework in times of peace and calm.

The aims and objectives during preparedness are:

1. To train the health workers to identify and manage the following common childhood illnesses in disaster situation. This list may have to be revised keeping the local conditions and epidemiology in mind.

   Acute Respiratory Illnesses	Poliomyelitis (Acute Flaccid Paralysis)
   Conjunctivitis	Scabies
   Diarrheal Diseases	Snake Bites
   Hepatitis	Tetanus
   Malaria	Tuberculosis
   Measles	Typhoid Fever
   Meningitis	Whooping cough
   Pediculosis	Worm Infestation

2. To identify indications for further referral for hospital care: eg. a single case of cholera, measles and meningitis should alert the authorities for further action. Similarly for hepatitis, typhoid, mumps etc.
3. To identify problems, which are the early indicators of epidemics.
4. To be familiar with disease surveillance methodology and program ie, reporting to local/district health authorities and also zero-reporting.

Rescue Phase

Common illnesses are usually not of major importance and hence tend to take a back seat during this phase giving way to more pressing concerns of survival like food, water, shelter, injuries (major and minor), sanitation etc.

Recovery Phase

1. The health care workers will have to provide primary health services under the constraint of prevalent situation.
2. The administrators will have to look after the resetting of the health delivery system and resolve the underlying problems.
3. In the first few weeks and months the health workers will be over whelmed by the overload of the work and may have to focus attention on the diseases likely to cause greater mortality e.g. diarrheas, pneumonias, malaria, measles and malnutrition
4. Immunization to be undertaken as per the guidelines in the Chapter on Immunization
5. Prevention and treatment of important illnesses as detailed in the Annexure1
6. Surveillance and reporting system of the diseases as detailed in the Annexure 2

Rehabilitation Phase

Health delivery services to be restored to normal as far as possible. The nutritional status and indices should reflect the path of recovery i.e. no evidence of malnutrition. The underlying factors to be taken care of Environmental issues of water, sanitation and overcrowding.

Annexure 1

Annexure 2

Brief description of some Common Illnesses