Steps for the Earthquake Safety

Step 1: Secure your space by identifying hazards and securing moveable items. 

Step 2: Plan to be safe by creating a disaster plan and deciding how you will communicate in an emergency. 

Step 3: Organize disaster supplies in convenient locations. 

Step 4: Minimize financial hardship by organizing important documents, strengthening your property, and considering insurance.

Step 5: Drop, Cover and Hold On when the earth shakes. 

Step 6: Improve safety after earthquakes by evacuating if necessary, helping the injured, and preventing further injuries or damage. 

Step 7: Reconnect and Restore daily life by reconnecting with others, repairing damage, and rebuilding community

References:

1. https://www.earthquakecountry.org/library/Seven_Steps_Flyers_English.pdf
2. https://www.cdc.gov/cpr/documents/BeReady_Earthquakes.pdf

What to do during an earthquake?

Past experiences in earthquakes may give you a false sense of safety like .....you didn't do anything, or you ran outside, yet you survived with no injuries.....Or perhaps you got under your desk and others thought you overreacted.

But mostly you may have never experienced the kind of strong earthquake shaking that is possible in much larger earthquakes: sudden and intense back and forth motions of several feet per second that will cause the floor or the ground to jerk sideways out from under you, and every unsecured object around you may topple, fall, or become airborne, potentially causing severe injuries. 

That is why you must learn to protect yourself immediately after the first jolt... don't wait to see if the earthquake shaking will be strong!

1. If you are INDOORS -- STAY THERE! DO NOT run outside or to other rooms during an earthquake.

2. DO NOT stand in a doorway. You are safer under a table.

3. If you are IN BED, hold on and stay there, protecting your head with a pillow. You are less likely to be injured staying where you are. 

4. In MOST situations, you will reduce your chance of injury if you: Get under a desk or table and hang on to it (Drop, Cover, and Hold on!) or move into a hallway or against an inside wall.

5. If possible before shaking intensifies, quickly move away from glass, hanging objects, bookcases, china cabinets, or other large furniture that could fall. 

6. Watch for falling objects, such as bricks from fireplaces and chimneys, light fixtures, wall hangings, high shelves, and cabinets with doors that could swing open.

7. DO NOT use the elevators. The electricity may go out, and the sprinkler systems may come on.

8.STAY CLEAR of windows, fireplaces, and heavy furniture or appliances. 

9. If you are in the kitchen, quickly turn off the stove and take cover at the first sign of shaking.

10. GET OUT of the kitchen, which is a dangerous place (things can fall on you). 

11. DON'T run downstairs or rush outside while the building is shaking or while there is a danger of falling and hurting yourself or being hit by falling glass or debris.

12.If you are OUTSIDE -- get into the OPEN, away from buildings, power lines, chimneys, and anything else that might fall on you.

13. If you are DRIVING -- stop, but carefully. Move your car as far out of traffic as possible. 

14. DO NOT stop on or under a bridge or overpass or under trees, light posts, power lines, or signs. 

15. STAY INSIDE your car until the shaking stops. 

16. When you RESUME driving, watch for breaks in the pavement, fallen rocks, and bumps in the road at bridge approaches.

17. If you are in a MOUNTAINOUS AREA -- watch out for falling rock, landslides, trees, and other debris that could be loosened by quakes.

18. If you are trapped, stay calm. Try to get someone’s attention by tapping on hard or metal parts of the structure. Doing so may increase your chances of being rescued.

Special circumstances:

References:

1. https://www.usgs.gov/faqs/what-should-i-do-during-earthquake?qt-news_science_products=0#qt-news_science_products
2. https://www.shakeout.org/dropcoverholdon/
3. https://www.ready.gov/earthquakes
4. https://www.cdc.gov/disasters/earthquakes/during.html
5. https://www.earthquakecountry.org/step5/
6. https://www.nationalgeographic.com/environment/natural-disasters/earthquake-safety-tips/
7. https://www.cdc.gov/cpr/documents/BeReady_Earthquakes.pdf photo credit
8. https://www.fema.gov/sites/default/files/2020-07/fema_earthquakes_p-1078-protect-yourself-during-earthquakes_20171130.pdf
9. https://www.earthquakecountry.org/library/Earthquake_Protective_Action_Postcard_English.pdf photo credit
10. https://www.fema.gov/sites/default/files/2020-07/fema_earthquakes_p-1078-protect-yourself-during-earthquakes_20171130.pdf photo credit

Drowning: Prevention needed to save lives

What is drowning?

Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid with outcomes that are classified as death, morbidity, and no morbidity.

What is the problem statement?

• Worldwide, drowning is the 3rd leading cause of unintentional injury death (7% of all injury-related deaths)
• Around 320 000 drowning deaths occur annually.
• Children, males, and individuals with increased access to water are at high risk of drowning.
• > 90% of drowning deaths occur in low- and middle-income countries.
• China & India together contribute 43% of the total drowning deaths in the world.

What are the risk factors?

• Age: Highest drowning rates are among children 1–4 years, followed by children 5–9 years. Drowning is one of the top 5 causes of death for people aged 1–14 years for 48 of 85 countries with data meeting inclusion criteria.
• Gender: Males are at risk of drowning, with twice the overall mortality rate of females due to increased exposure to water and riskier behavior such as swimming alone, drinking alcohol before swimming alone and boating.
• Access to water: Individuals with occupations such as commercial fishing or fishing for subsistence, using small boats and children who live near open water sources, such as ditches, ponds, irrigation channels, or pools are especially at risk.
• Flood disasters: Risk of drowning increases with floods particularly in low- and middle-income countries where people live in flood-prone areas and the ability to warn, evacuate, or protect communities from floods is weak or only just developing.
• Traveling on water: Journeys on overcrowded, unsafe vessels lacking safety equipment or are operated by personnel untrained in dealing with transport incidents or navigation or under the influence of alcohol or drugs are also a risk.
• Other risk factors: Infants left unsupervised or alone with another child around water, alcohol use near or in the water, medical conditions such as epilepsy & tourists unfamiliar with local water risks and features.

How to prevent drowning?

We can prevent drowning by the following methods:

• Installing barriers (e.g. covering wells, using doorway barriers and playpens, fencing swimming pools, etc.) to control access to water hazards, or removing water hazards entirely greatly reduces water hazard exposure and risk.
• Supervised child care for pre-school children.
• Teaching school-age children basic swimming, water safety, and safe rescue skills.
• Setting and enforcing safe boating, shipping, and ferry regulations.
• Building resilience to flooding and managing flood risks through better disaster preparedness planning, land use planning, and early warning systems.
• Developing a national water safety strategy to raise awareness of safety around water, build consensus around solutions, provide strategic direction, and a framework to guide multisectoral action and allow for monitoring and evaluation of efforts.
• Creating and maintaining safe water zones for recreation.
• Covering of wells or open cisterns.
• Emptying buckets & baths, and storing them upside down.

 Reference:

1. https://www.who.int/news-room/fact-sheets/detail/drowning
2. https://www.who.int/health-topics/drowning#tab=tab_1
3. file:///C:/Users/Dr%20PREETI%20USHA/Downloads/9789241511933-eng%20(1).pdf photo credit
4. file:///C:/Users/Dr%20PREETI%20USHA/Downloads/9789241564786_eng.pdf photo credit
5. https://www.who.int/violence_injury_prevention/global_report_drowning/WHO_Infographic_A4_1PAGE_ToWeb_REV1.pdf photo credit

Road traffic accidents: It's not just happen, it's caused

What is a road traffic accident (RTA)?

Any injury due to crashes originating from, terminating with, or involving a vehicle partially or fully on a public road.

What is the problem statement?

According to WHO, around 1.35 million people die each year as a result of road traffic crashes in the world. 

• More than half of all road traffic deaths are among pedestrians, cyclists, and motorcyclists. 
• 93% of the world's fatalities on the roads occur in low- and middle-income countries, even though these countries have approximately 60% of the world's vehicles. 
• Road traffic injuries are the leading cause of death for children and young adults aged 5-29 years. 
• Around 1.54 lake people die annually in India (NCRB-2019) in road traffic accidents.

What are the causes of RTA?

• Rapid urbanization
• Motorization
• Lack of appropriate road engineering
• Poor awareness levels
• Nonexistent injury prevention programs, and 
• Poor enforcement of traffic laws has exacerbated the situation.

Who are at risk?

• People with low socioeconomic status: Around 90% of road traffic deaths occur in low- and middle-income countries highest in the African region. Even within high-income countries, people from lower socioeconomic backgrounds are more likely to be involved in road traffic crashes.
• Younger age:  Children and young adults aged 5-29 years are more vulnerable
• Male sex: Males are more likely to be involved in road traffic crashes than females. 
• People with certain medical conditions: Sudden illness, heart attack, impaired vision, fatigue, etc.
• People with certain psychosocial factors: Lack of experience, risk-taking, impulsiveness, detective judgment, delay in decisions, aggressiveness, poor perception, family dysfunction, Heightened emotional tension, etc.
• People without body protection: Helmets, safety belts, and child restraints. 
• People who drive under the influence of alcohol and other psychoactive substances

What are the risk factors?

Environmental:

• Defective narrow roads
• The defective layout of cross-roads and speed breakers
• Poor lightening
• Lack of familiarity
• Bad weather
• Mixed traffic (slow & fast-moving, pedestrians and animals)
• Traveling in groups
• Inadequate enforcement of existing laws
• Inadequate post-crash care centers

Relating to vehicles:

• Excessive speed-Directly related both to the likelihood of a crash occurring and to the severity of the consequences of the crash.
• Old & poorly maintained vehicles- Safe vehicles play a critical role in averting crashes and reducing the likelihood of serious injury.
• The large number of 2 or 3 wheelers
• Overloaded vehicles
• Low driving standards
• Distracted driving: Drivers using mobile phones are approximately 4 times more likely to be involved in a crash.
• Use of stolen vehicles

What should be done to reduce RTA?

Accidents don't just happen; they are caused and it can be prevented. Governments need to take action in a holistic manner which requires involvement from multiple sectors such as transport, police, health, education, and actions that address the safety of roads, vehicles, and road users. 

• Data collection: All accidents should be reported and investigated properly to know the risk factors, circumstances & chain of events leading to accidents.
• Road safety education: It should begin from the school children & all drivers should be trained in safe driving & proper maintenance of vehicles. 
• Promotion of safety measures: Seat belts, safety helmets, door locks, proper vehicle design, use of laminated high-penetration resistance windscreen glass, etc.
• Avoidance of alcohol & other drugs: As it impairs the driving ability & increases the risk of RTA. Strict laws should be enforced.
• Designing safer infrastructure: Incorporating road safety features into land-use and transport planning for all types of vehicles with taking pedestrians into consideration.
• Improving post-crash care for victims: Planning, organization & management of trauma treatment and emergency care services at every hospital or PHC.
• Setting and enforcing laws: To eliminate related to key risks & causative factors like improvement of roads, the imposition of speed limits, marking of dander points, safety measures, drunken driving, etc.
• Rehabilitation centers: Medical, social & occupational rehabilitation to prevent, reduce, or compensate disability & thereby handicap.
• Accident research/ accidentology: For new & better methods to prevent accidents.

References:

1. https://www.nhp.gov.in/road-traffic-accidents_pg
2. https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries
3. https://ncrb.gov.in/sites/default/files/Chapter-1A-Traffic-Accidents_2019.pdf
4. Park, K., 2019. Park's Textbook Of Preventive And Social Medicine. 25th ed. Jabalpur: M/s Banarsidas Bhanot Publishers, p.1000.
5. https://www.who.int/health-topics/road-safety#tab=tab_3
6. https://www.who.int/docs/default-source/infographics-pdf/road-safety/10-strategies-for-keeping-kids-safe-on-the-road-en.pdf?sfvrsn=968cba78_2 photo credit
7. https://www.who.int/violence_injury_prevention/road_safety_status/2018/1.35-million.jpg?ua=1 photo credit
8. https://www.who.int/violence_injury_prevention/road_safety_status/2018/1st-cause.jpg?ua=1 photo credit
9. https://www.who.int/violence_injury_prevention/road_safety_status/2018/8th-leading-cause.jpg?ua=1 photo credit
10. https://www.who.int/violence_injury_prevention/road_safety_status/2018/54-percent-deaths.jpg?ua=1 photo credit
11. https://www.who.int/violence_injury_prevention/road_safety_status/2018/Low-income-countries.jpg?ua=1 photo credit