Module: Public Health Disaster Planning for Districts Organization: East Africa HEALTH Alliance, 2009-2012 Author(s): Dr. Roy William Mayega (MakSPH) (Lead Author), Dr. Christoper Orach-Garimoi (MakSPH), Dr. Simon Mamuya (Muhimbili Univ. SPH), Dr. Joseph Chuwa (MoH, Tanzania), Dr. Tabu Simiyu (Moi Univ. SPH), Mr. Mike Renny Wafula (OPM, Uganda), Dr. G. Kabagambe (LIPHEA) Resource Title: Session 1.4: Vulnerability Analysis License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution 3.0 License: http://creativecommons.org/licenses/by/3.0/. Disclaimer: Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Background: Remember the formula: Disaster Risk = [Hazard X Vulnerability]/ [Capacity] In the previous sessions, we looked at the first part of this equation i.e., the Hazard Analysis. We saw that it has two multiplicative components: 1. The Probability of Occurrence of the disaster 2. The Potential Impact of the Disaster However, the Disaster Risk Equation is incomplete if we do not consider vulnerability. If a disaster occurs and it meets a very vulnerable community, the effects of even a low hazard disaster are likely to be magnified. In this session, we shall conduct a vulnerability analysis to complete this equation. PART A: Vulnerability Analysis: Vulnerability of Critical Infrastructure The effects of a disaster are likely to be more magnified if the population or infrastructure is more vulnerable. We therefore need to consider the vulnerability of: 1. Critical Infrastructure 1 2. The Population In the first part of these exercises, we shall focus on determining a score for the vulnerability of critical infrastructure in the district to the 3 top priority hazards that you identified in the previous session. Exercise: 1. Each team will examine the public health infrastructure in the district 2. Using the top three hazards (as identified in the previous exercise on Hazard Analysis), each team will complete an infrastructure vulnerability estimate for the critical infrastructure using Table One below 3. Use the following criteria: 0 = Not Vulnerable 1= Somewhat Vulnerable 2= Moderately Vulnerable 3= Very Vulnerable Important Hint! Vulnerability of infrastructure should be viewed in a broad way. In the simplest way, it could mean that buildings and roads are vulnerable. On the other hand, it could mean that health units could be over-whelmed; drugs may run out because of the disaster; in the case of some epidemics, health workers (the human resources) may panic and run away from the health units, resulting in a break down of service delivery. Therefore, each of the 3 priority hazards should be studied carefully for the infrastructure items indicated Table One: Vulnerability of Critical Infrastructure to the 3 Top Priority Hazards Asset Vulnerability Priority Hazard Number 1 Priority Hazard Number 2 Priority Hazard Number 3 1. Building Structures 2. Electrical Power 3. Water Supply 4. Sanitation systems 5. Medical Equipment 6. Medical Supplies 7. Human Resources 8. Communications 9. Environmental Control 10. Roads Sub-Total Score 2 Divide sub-total by 10; Mean Infrastructure Vulnerability Score: Question: For which of the 3 Top Priority Hazards is your infrastructure most vulnerable? Part B: Vulnerability Analysis: Vulnerability of the Population Exercise: Using the three top hazards (as identified in the Hazard Analysis) each team will complete a Population Vulnerability Estimate for the community using table Two Below, according to the following criteria: 0 = Not Vulnerable 1= Somewhat Vulnerable 2= Moderately Vulnerable 3= Very Vulnerable Hint: In order to score the items below, you need to ask your self two questions: 1. Do we have this situation in our district? 2. If yes, to what extent does this make us vulnerable to each of the 3 priority hazards Example: 1. Do we have food insecurity in this district? Yes 2. If Yes, to what extent does it make us vulnerable to the 3 top Hazards in this district Priority Hazard Number 1 (Epidemics): Score 1 Priority Hazard Number 2 (Drought): Score 3 Priority Hazard Number 3 (Fire): Score 0 Use Table Two below to score each of the 20 factors for the 3 priority hazards After that, compute the mean population vulnerability score for the population 3 Table Two: Vulnerability of the Population to the 3 Top Priority Hazards Population Vulnerability Priority Hazard Number 1 Priority Hazard Number 2 Priority Hazard Number 3 1. Poor people 2. Children and women 3. People with Disabilities 4. Lack of information 5. Lack of experience 6. Inadequate healthcare 7. Geographically isolated areas 8. Inadequate social organization 9. Malnourished people 10.Inappropriate development policies 11. Food insecurity 12. Societal stratification 13. Poor water and food quality 14. Limited district-level resources 15. Political perceptions 16. Graft/corruption 17. Lack of social order 18. High burden of illness 19. Inadequate disaster preparedness 20. Socio-cultural practices Sub-Total Score Divide sub-total by 20; Mean Infrastructure Vulnerability Score 4 Part C: Summary of Vulnerability Scores You have computed two types of mean vulnerability scores for the three top priority hazards in your district: A mean vulnerability score for critical infrastructure and one for the population. Now add these up for each of the disasters and find the overall mean vulnerability score for both infrastructure and the population. Use Table 3 for this computation. Table 3: Summary of Vulnerability Ranking Vulnerability Category Mean Score for Priority Hazard 1 Mean Score for Priority Hazard 2 Mean Score for Priority Hazard 3 Infrastructure (C) Population (D) Average Vulnerability Score (C+D)/2 = (E) Question: Based on the total vulnerability scores for infrastructure and the communities, to which of the 3 top priority hazards is your district more vulnerable in case it occurred? Part D: Completing the Disaster Risk Equation Now transfer the Hazard Priority Score for each of the 3 priority hazards that you computed in the previous session into the table below: Insert the average vulnerability score (combining both infrastructure and people) to the 3 priority hazards 5 The multiply them to obtain the Disaster Risk for the 3 priority hazards in your district Use Table Four below Table Four: Product of Hazard and Vulnerability Hazard Hazard Average Priority Score Vulnerability (C) Score (E) Disaster Risk (C X E) Questions: Based on both Hazard and Vulnerability combined, does the ranking of your top 3 priority hazards in your district change? If so, what is the new order of importance of the 3 top hazards? Conclusion of the Exercises We have just completed the Equation: Disaster Risk = [Hazard X Vulnerability]/[Capacity] We have just conducted what we call the ‘Hazard Vulnerability Capacity Analysis’ (HVCA) for our districts Significance: It tell us: 1. The priority hazards to focus on and plan for in the districts 2. Whether vulnerability changes the effects of disasters Extension Activity 1.4 Please refer to the additional notes attached for further information in the implications of this analysis 6