FLOODING – Frequently Asked Questions What is flood and how it is classified? Floods are defined as the overflow of areas that are not normally submerged with water or a stream that has broken its normal confines or has accumulated due to lack of drainage. What are different types of flooding? River flooding: River flooding occurs when heavy rains or rapid snowmelt cause rivers to rise. Coastal flooding: Coastal flooding may occur due to tidal surges and flash flooding. Flash Floods: Flash floods usually result from intense storms dropping large amounts of rain within a brief period. Dam Failure: Dam failures are potentially the worst flood events. When a dam fails, a gigantic quantity of water is suddenly let loose downstream, destroying anything in its path. Can flood be forecasted? Yes, with scientific development, flood forecasting is made much in advance. What are the Public Health risks related to flood? The health problems relating to flood can be either due to direct impact on human population, direct impact on existing 1 infrastructure or the resultant effects due to combination of these factors. What are the hazards of flooding? Urban Areas Rural Areas Massive amounts of erosion can be accomplished by flood waters. Such erosion can undermine bridge structures, levees, and buildings causing their collapse. Flooding of farmland usually results in crop loss. Livestock, pets, and other animals are often carried away and drown. Water entering human built structures cause water damage. Even with minor flooding of homes, furniture is ruined, floors and walls are damaged, and anything that comes in contact with the water is likely to be damaged or lost. Flooding of automobiles usually results in damage that cannot easily be repaired. Transportation systems may be disrupted, resulting in shortages of food and clean-up supplies. Food grains stored at home or in go-downs get wet and start rotting. In under developed countries food shortages often lead to starvation Gas and electrical service may be disrupted. Water supply pipes/ system get damaged and wells get inundated creating shortage of drinking water. The affected communities living in temporary shelters/ resettlements have limited or no access to safe drinking water, food etc. In addition, prevailing unhygienic sanitary conditions make it conducive for spread of food and waterborne diseases. Hazards Common to both rural and urban areas: 2 Humans that get caught in the high velocity flood waters are often drowned by the water. Floodwaters can concentrate garbage, debris, and toxic pollutants that can cause the secondary effects of health hazards. Drinking water supplies may become polluted, especially if sewerage treatment plants are flooded. This may result in disease and other health effects. Cooking fuel gets spoiled/wet making it difficult to cook food and also drinking water contamination poses many water/food borne diseases. Washing away of property, pet animals and crops result in to severe economic losses and mental stress. Hypothermia may also be a problem, particularly in children, if trapped in floodwaters for lengthy periods. There may also be an increased risk of respiratory tract infections due to exposure (loss of shelter, exposure to flood waters and rain). Effects on mental health include Post Traumatic Stress Disorder; excessive grief, sleep disorders; exaggeration of existing illness; death wish & suicidal ideation. Reproductive Health - Pregnant mothers and newborns become vulnerable and require additional care. What are the diseases related with flooding? Floods can potentially increase the transmission of the following communicable diseases: 3 Water-borne diseases, such as typhoid fever, cholera, leptospirosis and hepatitis A Vector-borne diseases, such as malaria, dengue and dengue haemorrhagic fever, yellow fever, and West Nile Fever Food-borne diseases. Types of ailments 1) Respiratory diseases 2) Injuries (not very common) 3) Water-borne diseases (diarrhoeal diseases/cholera, gastroenteritis, dysentery etc.), Infective Hepatitis, Poliomyelitis. 4) Malaria / Filaria 5) Skin diseases / Eye Diseases 6) Snake / Insects bite Due to Adverse condition of living Collapse of houses/standing structure Non-availability or inadequate availability of drinking water due to: Flooding of wells, which cause pollution to the water Breakdown of piped water supply Inaccessibility of available water sources because of damages caused by flood. Unsanitary conditions in villages / evacuation camps due to: accumulation water, lack of excreta disposal; blockage / disruption of normal drain; slush with increase in breeding space for flies; overcrowding at temporary shelters. Dumping of compound dry-waste Dumping of animal excreta Dumping of carcasses Increase in mosquito breeding space Lack of personal hygiene and overcrowding Water entering into their shelters 4 What preventive measures should be undertaken following flood? Water-borne diseases are one of the most common phenomena during flood. Diarrhoeal diseases are one of earlier manifestations but diseases like typhoid, infective hepatitis and poliomyelitis are usually seen after about a fortnight. Therefore consumption of safe drinking water, maintenance of good personal hygiene and sanitary arrangement is the key measures. Which are the water-borne diseases associated with flooding? The major risk factor for outbreaks associated with flooding is the contamination of drinking-water facilities. There is an increased risk of infection of water-borne diseases contracted through direct contact with polluted waters, such as wound infections, dermatitis, conjunctivitis, and ear, nose and throat infections. The only epidemic-prone infection which can be transmitted directly from contaminated water is leptospirosis. Transmission occurs through contact of the skin and mucous membranes with water, damp soil or vegetation (such as sugarcane) or mud contaminated with rodent urine. Which are the vector-borne diseases associated with flooding? Floods may indirectly lead to an increase in vector-borne diseases through the expansion in the number and range of vector habitats. Standing water caused by heavy rainfall or overflow of rivers can act as breeding sites for mosquitoes, and therefore enhance the 5 potential for exposure of the disaster-affected population and emergency workers to infections such as dengue, malaria etc. Which are the food-borne diseases associated with flooding? Food in affected areas may become contaminated and consequently be at risk for outbreaks of food-borne disease, including diarrhoea, dysentery, cholera, hepatitis A, and typhoid fever. Poor sanitation, including lack of safe water and toilet facilities and lack of suitable conditions to prepare food have led to mass outbreaks of food-borne disease. What measures can be taken towards water safety? For point-of-use or household water treatment, the most practical forms of free chlorine are liquid sodium hypochlorite, solid calcium hypochlorite and bleaching powder (chloride of lime; a mixture of calcium hydroxide, calcium chloride and calcium hypochlorite). The amount of chlorine needed depends mainly on the concentration of organic matter (impurities that consume some chlorine) in the water and has to be determined for each situation. After 30 minutes, the residual concentration of active chlorine in the water should be between 0.2-0.5 mg/l, which can be determined using a special test kit. In case of damages to centralized (community) system of water treatment, household water treatment methods like boiling, filtration (with cloth or sand or ceramic candle), settlement, 6 chlorination or permanganate, solar disinfection etc can be adopted. Drinking water should be stored of in clean, covered and narrow mouthed containers. Use only tap or ladle to draw water if stored in a wide-mouthed container. What measures can be taken to ensure food safety? Avoid raw and uncooked food unless it can be peeled or shelled. Cook food thoroughly and eat it while still hot. Cooked food should not be stored for a long time. Keep the food covered and reheat it thoroughly before consuming Keep the cooking utensils and kitchen area clean and wash hands before handling food. How can vector-borne diseases be prevented? Insecticide treated mosquito nets (ITN) are suitable if nets were previously used by the population, and if living in structures that allow mosquito nets to be supported or hung. Indoor spraying of residual insecticide ("house spraying") has been the method of control most often used. Insecticides: implementation of preventive measures such as indoor residual spraying, or the retreatment/distribution of Insecticide Treated Nets (ITNs) in areas where their use is well-known. 7 DOs & DON'Ts After the flood, “DO”: Do enhance drying out of buildings by carefully removing mud, standing water, and water-logged furnishings and debris. Do remove residual moisture gradually by allowing structures to dry naturally. Open doors and windows. Do document the damage for insurance purposes by taking notes or photographs. Do BEFORE removing items from water, prepare a clean, dry, well-ventilated temporary area for sorting and storing your objects. Wet objects should be moved only once because they are fragile, so setting aside such an area is vital. Do wear rubber gloves, and, if possible, a face mask, when handling items. Do provide support for damaged objects when moving them, such as a cart, or a flat, sturdy surface. Do call an expert if in doubt about how to salvage any materials. After the flood, “DON'T” Don't remove standing water in a basement too fast. If the pressure is relieved too quickly it may put undue stress on the walls. Don't dry buildings with mechanical dehumidifiers, which may draw out moisture too quickly and cause additional damage. Allow structures to dry naturally. 8 Don't scrub or brush mud and other deposits from materials. This may cause further damage. Don't let water-damaged papers remain in wet boxes--remove water-damaged papers from wet boxes then air dry or freeze dry. Don't open any books or albums that were completely submerged. (Wet paper is very weak and will tear.) Don't keep objects in dark, hot, stagnant air with high humidity-these conditions encourage mold. Don't try to separate bundles of saturated paper. Water Borne Diseases DO’s Drink water from a safe source or water that has been disinfected (boiled or chlorinated). Store water in narrow mouthed container with lid/cover and use ladle or tap to draw water Cook food or reheat it thoroughly and eat it while it is still hot. Keep food items covered. Wash hands before preparing or eating food and after defecation. Increase fluid intake in case of diarrhoea. Use ORS solution or home available fluids as soon as diarrhoea starts. Refer the diarrhoea case to a health facility in case of following: Child is irritable, restless or lethargic or unconscious. Eating or drinking poorly. 9 Child has marked thirst. Child has fever or blood in stool. DON'Ts Don't drink water from unsafe sources. Don't eat uncooked food unless it is peeled or shelled. Don't eat cut fruits. Don't defecate indiscriminately. Vector Borne Diseases DO's Use insecticide treated bed nets (ITBN) or insect repellents while sleeping to keep away mosquitoes. Wear cloths that cover arms and legs. Keep patients protected from mosquito bite in acute phase. Empty water containers at least once a week. Cover and seal septic tanks and soak-away pits. Remove water from coolers and other places where water has remained stagnant. All fever cases to be given presumptive treatment for malaria. DON'Ts Don't allow water to stagnate. Do not allow discarded items to accumulate such as tyres, tubes, empty coconut shells, household items and objects where water may collect. 10 Discourage children from wearing shorts and half sleeved cloths. Food-borne diseases KEEP FOOD AT SAFE TEMPERATURES (prevent growth of microorganisms) Eat cooked food immediately and do not leave cooked food at room temperature longer than 2 hours Keep cooked food steaming hot (more than 60°C) prior to serving Cooked and perishable food that cannot be kept refrigerated (below 5°C) should be discarded COOK THOROUGHLY (kill dangerous microorganisms) Cook food thoroughly, especially meat, poultry, eggs and seafood until it is steaming hot throughout For cooked meat and poultry to be safe their juices must run clear and no parts of the meat should be red or pink Bring foods like soups and stews to boiling and continue to boil for at least 15 minutes to make sure all parts of the food has reached at least 70°C. While cooked food should generally be eaten immediately, if necessary thoroughly reheat cooked food until it is steaming hot throughout. 11 ANNEXURE – 1 FLOOD PREPAREDNESS What you should know? 80% of flood deaths occur in vehicles, and most happen when drivers make a single, fatal mistake trying to navigate through floodwaters. Just 6 inches of rapidly moving floodwater can knock a person down. A mere 2 feet of water can float a large vehicle even a bus. One-third of flooded roads and bridges are so damaged by water that any vehicle trying to cross stands only a 50% chance of making it to the other side. Know your neighborhood flood history If it has been raining hard for several hours, or steadily raining for several days, be alert to the possibility of a flood. Floods can take several hours to days to develop. A flood WATCH means a flood is possible in your area. A flood WARNING means flooding is already occurring or will occur soon in your area Flash floods can take only a few minutes to a few hours to develop. A flash flood WATCH means flash flooding is possible in your area. A flash flood WARNING means a flash flood is occurring or will occur very soon. When a flood WARNING is issued, Listen to local radio and TV stations for information and advice. If told to evacuate, do so as soon as possible. When a flash flood WATCH is issued— be alert to signs of flash flooding and be ready to evacuate on a moment’s notice. 12 When a flash flood WARNING is issued— or if you think it has already started, evacuate immediately. You may have only seconds to escape. Act quickly! Stay alert for changing weather conditions Listen to local radio or TV for flood information. Get out of areas subject to flooding like low spots, canyons, and areas downstream from dams Consider purchasing flood insurance Do not attempt to cross water that is above your knees Do not drive over a flooded road Abandon a stalled vehicle and immediately move to higher ground Move to higher ground away from rivers, streams, creeks, and storm drains. Do not drive around barricades - they are there for your safety. If your car stalls in rapidly rising waters, abandon it immediately and climb to higher ground. Remember, it does not have to be raining for a flash flood to occur. Some of the most dangerous floods originate many miles away. What to do before the flood? When you receive a Flood Watch: A Watch is issued when flooding is possible within the watch area. When a flood watch is issued, you should be aware of potential flood hazards. Everyone in a Watch area should be ready to respond and act quickly. Have an evacuation plan in place BEFORE flooding occurs. Flooded roads may cut off your escape route. Head for higher ground before the water becomes too deep. Remember – just six inches of rapidly flowing water can knock you off your feet. 13 Know your flood risk and the elevation above which flooding occurs. Do streams or rivers near you flood easily? If so, be prepared to move to a safe place. Know your evacuation routes. Develop an evacuation plan. Everyone in your family should know where to go if they have to leave. Discuss flood plans with your family. Everyone should know what to do in case all family members are not together. Discussing flood plans ahead of time helps reduce fear and anxiety and lets everyone know how to respond. Determine if the roads you normally travel to reach your home or job will be flooded during a storm. If so, look for alternative routes to use during flooding. Keep a battery-powered portable radio, emergency cooking equipment, and flashlights in working order with extra batteries. Have a professional install check-valve in plumbing to prevent flood waters from backing up into the drains of your home. Keep your automobile fueled; if electric power is cut off, gas stations may not be able to operate pumps for days. Store drinking water in food-grade containers. Water service may be interrupted. Keep a stock of food requiring little cooking and no refrigeration; electric power may be interrupted. Keep first-aid supplies and prescription medicines on hand. What to do during the flood? If advised to evacuate, do so immediately! Families should use only one vehicle to avoid getting separated and reduce traffic jams. Move to a safe area before access is cut off by flood water. Continue listening to radio or television for information concerning the flooding. Don’t drive if you don't have to. 14 Get out of areas subject to flooding. This includes dips, low spots, canyons, washes, etc. Do not attempt to cross flowing streams. Never try to walk, swim, drive, or play in flood water. You may not be able to see how fast the flood water is moving or see holes or submerged debris. Do not camp or park your vehicle along streams and washes, particularly during threatening conditions. Be especially cautious at night when it is harder to recognize flood dangers. Do not attempt to drive through a flooded road. The depth of water is not always obvious. The road bed may be washed out under the water, and you could be stranded or trapped. Do not drive around a barricade. Barricades are there for your protection. Turn around and go another way! If the vehicle stalls, leave it immediately and move to higher ground. Rapidly rising water may engulf the vehicle and its occupants, sweeping them away. Vehicles can be swept away by as little as two feet of water. Children should NEVER play around high water, storm drains, viaducts, or arroyos. It is very easy to be swept away by fastmoving water. If you come upon a flowing stream where water is above your ankles, STOP! Turn around and go another way. Climb to higher ground. If it is moving swiftly, even water six inches deep can knock you off your feet. Many people are swept away wading through flood waters, resulting in injury or death. What to do in case of a flash flood? There may be no time for a warning to be issued. You may have only seconds to escape. It could be a life-and-death decision for you and your family. If you suspect a flash flood is about to 15 happen immediately climb to higher ground. Avoid walking through any swiftly-moving floodwaters. Even water that is 6 inches deep can sweep you off your feet. If you are in a car and come to a flooded area, turn around and go another way. If your car stalls, abandon it immediately and climb to higher ground. Many deaths have resulted from attempts to move stalled vehicles. What to do for evacuation? Expect the need to evacuate and prepare for it. When a flood watch is issued, you should: Fill your vehicle’s gas tank and make sure the emergency kit for your car is ready. If no vehicle is available, make arrangements with friends or family for transportation. Fill your clean water containers. Review your emergency plans and supplies, checking to see if any items are missing. Tune in the radio or television for weather updates. Listen for disaster sirens and warning signals. Put livestock and family pets in a safe area. Due to food and sanitation requirements, emergency shelters cannot accept animals. Adjust the thermostat on refrigerators and freezers to the coolest possible temperature. What to do if you are ordered to evacuate? You should never ignore an evacuation order. Authorities will direct you to leave if you are in a low-lying area, or within the greatest potential path of the rising waters. If a flood warning is issued for your area or you are directed by authorities to evacuate the area: Take only essential items with you. 16 If you have time, turn off the gas, electricity, and water. Disconnect appliances to prevent electrical shock when power is restored. Follow the designated evacuation routes and expect heavy traffic. Do not attempt to drive or walk across creeks or flooded roads. What to do if you are ordered not to evacuate? Monitor the radio or television for weather updates. Prepare to evacuate to a shelter or to a neighbor's home if your home is damaged, or if you are instructed to do so by emergency personnel. What You Can Do After the Flood? Get necessary medical care at the nearest hospital. Do not visit disaster areas. Your presence might hamper rescue and other emergency operations. If the power is out, use flashlights, not candles. Use flashlights, not lanterns, torches, or matches, to examine buildings. Flammables may be inside. Report broken utility lines to appropriate authorities. Boil drinking water before using. Wells should be pumped out and the water tested for purity before drinking. If in doubt, call your local public health authority. If fresh or canned food has come in contact with flood waters, throw it out. Take steps to reduce your risk of future floods. Make sure to follow local building codes and ordinances when rebuilding, and use flood-resistant materials and techniques to protect yourself and your property from future flood damage. Your emergency supplies kit to Include: 17 At least a 3-day water supply (Five liters per person per day) Food that won't spoil One change of clothing and footwear per person One blanket or sleeping bag per person First aid kit and manual Essential medicines Contact lenses, extra eyeglasses and dentures Baby supplies such as formula, bottles, diapers, powdered milk and medications Feminine supplies and personal hygiene items Special items for infant, elderly, and disabled family members Mess kit or paper cups and plates and plastic utensils Battery operated radio and extra batteries Flashlight with extra batteries Cash or traveler's checks, change Extra set of car keys Soap, liquid detergent Cash and credit card Entertainment--book and games Utility knife and can opener Map of area Remember to keep important family documents in a waterproof, portable container you can grab quickly in case of evacuation. Insurance policies, wills, contracts, deeds, stocks and bonds Passports, social security cards, immunization records Bank account numbers Credit card account numbers and companies 18 Inventory of valuable household goods, important telephone numbers Family records (birth, marriage, death certificates) 19 ANNEXURE – 2 Effects of flooding on health 20