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Go Bag #4: Sanitation

FEMA - 24788 - Photograph by Andrea Booher taken on 10-29-2005 in LouisianaIn the fifth of this regular series I explore what you need to put in your go bag. This week: sanitation.

Much of the morbidity and mortality associated with disasters comes not from the impact of the disaster itself, but from avoidable infections associated with damaged infrastructure and poor hygiene in the aftermath of a disaster.

I will talk about first aid in a later post, but here the old adage “prevention is better than cure” is much more important.

Sanitation boils down to two things: staying clean and waste disposal.

Staying Clean

The most important thing to keep clean are you hands, most pathogens are spread by hands coming into contact with your face. In the past this meant washing with soap and water, which may be scarce or contaminated in a disaster.

Now with the advent of hand sanitiser, soap becomes less of a necessity. Some studies have even shown that it is more effective than hand washing with soap. Hand sanitiser should be the number 1 sanitation item in your Go Bag.

Make sure that you use a product that contains at least 60% alcohol for maximum effectiveness. However if your hands are covered in dirt or grime that will compromise the effectiveness of the hand sanitiser, so you will need to find a water source and use soap to clean them. It is a good idea to use hand sanitiser afterwards. To wash your hands liquid soap is a good addition to your Go Bag.

In between cleaning your hands make sure you avoid touching your face and mouth or any open wounds. Try and keep your clothes, particularly socks and underwear as clean and dry as possible.

If you need them make sure you keep a decent supply of sanitary pads in your Go Bag – these also make pretty good wound dressings.

Waste Disposal

You can’t be sure that you will be able to find a functioning toilet, the sewerage or water supply may have failed or buildings may be unsafe to enter. You may have to improvise a toilet.

The most portable are plastic bags that you can do your business in and then dispose of away from your shelter. There are a number of purpose designed products on the market such as the PeePoo bag, but any plastic bag will do in an emergency situation. Make sure you have a decent supply of these and toilet paper in your Go Bag.

Other options include lining an existing toilet with a larger plastic bag or using a bucket in a similar fashion. Keeping some bleach on hand can help disinfect and control odours.

If you end up having to shelter for a lengthier time in place without an operational sewerage system it may make better sense to dig a latrine or pit for defecation, make sure you line these with plastic though so contamination doesn’t leach into water supplies.

Evidence based disaster management and the Triangle of Life

One of the big drawcards for me to disaster management is that it is such an interdisciplinary career. It brings together expertise in economics, geography, psychology, sociology, geophysics, meteorology, climate science, technology, business management, information technology, public policy, statistics, anthropology, gender and sexuality studies, culture and ethnography, engineering, environmental science, health, education, agriculture and more.

In a field that draws on so many areas of knowledge, research is critically important. This includes research that may not immediately be identified to have an emergency management impact.

As emergency management has so much knowledge to draw on I often ask myself why there isn’t a stronger engagement between practitioners and researchers in the field.

Conferences seem to be dominated by consultants and professional speakers (often those leaders who presided over emergency management disasters). Governments and NGOs in these times of austerity are cutting budgets and emergency management organisations aren’t immune. In any budget cuts, research is often the first to go.

Part of the problem is that large parts of academia, including many emergency management trade journals are walled off behind expensive paywalls. This problem is particularly acute for those working in developing countries who don’t have alternative means of access to this knowledge. Subsidised journals like the Australian Journal of Emergency Management are extremely important, as they enable any emergency manager to access high quality research and researchers to reach a broad emergency management audience.

Yet few publications see emergency management practitioners and researchers collaborating on papers, or indeed researching areas of interest to local practitioners.

The problem extends beyond that though. Emergency management lacks the culture of critical thinking common to the sciences. This tends to lead to an over-reliance on good ideas, historical practice and ‘common-sense’ which may in reality turn out to be ineffective or worse, actually harmful.

The Triangle of Life: Where’s the evidence?

In a place like Kathmandu earthquakes are never too far away as a discussion topic. In a couple of different conversations the ‘triangle of life’ idea has come up. This concept basically states that you should seek shelter next to heavy objects in an earthquake, as this will be where the survival spots are if the building collapses. I always thought that the concept had some utility in developing countries, without the enforcement of building codes in places like the US and Japan.

The concept first surfaced in an email chain letter (and continues to do the rounds, with elements of it popping up in this recent youtube video) authored by self-proclaimed rescue expert Doug Copp. The triangle of life idea has been thoroughly refuted by every government emergency management agency and experienced NGO I’ve been able to find. Some of the advice in the email is consistent with that of most earthquake preparedness experts, however most of it and especially the triangle of life are absolute nonsense. The credibility of the author is also highly questionable.

But what does the evidence say?

The Triangle of Life has an intrinsic appeal to some urban search and rescue practitioners who focus on rescuing people from collapsed structures. (On the other hand plenty have put together excellent rebuttals). However the people that these professionals rescue are not typical survivors. Most will either not be trapped or be rescued by other survivors using hands and basic tools.

By the time heavy Urban Search and Rescue teams arrive on the scene very few survivors will be found. Those that are found by these rescuers will be in voids within the collapsed structures – aka triangles of life.

This produces a sampling bias, the people in these voids are not representative of the total population of survivors.

The only experimental evidence for triangle of life came from an exercise in Turkey, which  Copp was involved with (Unfortunately the links to all the primary source material on this exercise are broken). Dummies were placed within a structure, which was then collapsed. They found that the dummies placed in ‘duck, cover, hold’ positions were crushed and those placed in ‘triangle of life’ positions were not. Now by collapsed I mean demolished with conventional demolition techniques. Unfortunately this does not simulate how buildings fail in earthquakes, so little can be drawn from the results.

The other aspect of a controlled collapse is that the voids are much more predictable.  Now I’m not suggesting that the ‘experimenters’ deliberately placed the dummies in these locations but subconsciously the experimenter effect could have come into play.

So the only piece of evidence for this advice is seriously flawed at best. The ‘triangle of life’ is already on shaky ground.

The other problem with this concept is that as an earthquake survival strategy the triangle of life will only protect you in the event of a building collapse. Odds are a total structural collapse will very likely ruin your day, despite what the theory claims. Any survival strategy will only increase your chances of survival, not guarantee it, in the event of a building collapse.

But what about if your building doesn’t collapse?

Most of the injuries (and some of the deaths) from an earthquake are caused by non-structural items such as bookcases, shelves, cabinets and the items on them. Many injuries are also caused by people fleeing (often without shoes) and cutting themselves on broken glass and other falling debris. This is precisely what the ‘duck, cover, hold’ strategy is aimed at avoiding.

For example in the 1994 Northridge Earthquake most fatalities were caused by building collapse, most injuries by falling over and being hit by falling objects. There were about 4 times more injuries than fatalities.

Researchers in Iran calculated that for a large earthquake there the number of people in areas exposed to falling debris (and not building collapse) would be 12,000 times the number of people exposed to building collapse. (Unfortunately this is the only scholarly article that I’ve found that directly compares ‘duck, cover, hold’ with ‘triangle of life’.)

So when the shaking starts, odds are that ‘duck, cover, hold’ will be the most appropriate strategy.

But what about community education? Could ‘triangle of life’ be explained too,allowing people to choose their own strategy?

Trying to communicate anything about earthquake preparedness is difficult enough. You could take a mixed strategy, that attempted to explain where the limited applicability of the triangle of life might be useful. However, this would only end up confusing most of the target audience, who may end up doing nothing or panicking. To reach the broadest audience any disaster preparedness message needs to be simple and the advice that will be applicable to the largest number of people is ‘duck, cover, hold’.

There’s no evidence to suggest that the triangle of life is any better than chance.

Which brings me back to my initial discussion:

Many career paths into disaster management don’t provide a strong background in research methods or critical thinking skills. When you combine this with the poor engagement between researchers and disaster managers and the difficulty in accessing scholarly publications its no wonder that rumours like the triangle of life to continue to circulate, even among disaster management professionals.

Research accessibility, critical thinking skills and cross sector engagement all need to be addressed to ensure disaster management is evidence based and thus successful.

Go Bag #3: Food

GranolabarIn the fourth of this regular series I explore what you need to put in your go bag. This week: food.

Now you’ve got enough water and some shelter it’s time to turn your mind to your stomach. Whilst the average adult can survive more than a week without food they won’t be functioning too well.

Food will keep you energised, help stop you from getting sick and most importantly boost your morale.

For your go bag food needs to satisfy a few requirements:

Weight – You’re going to be lugging it around, so tinned food is out. You need to go for food that is light and in lightweight packaging.

Energy – To keep you going you’re going to want to eat small amounts often. So nutritious, energy dense food is important.

Water – You’re already using your limited supply for drinking so you don’t want to be re-hydrating food, or cooking something. By the same token foods that are very dry or salty will make you thirsty, putting further strain on your water supplies.

Shelf life – You don’t expect to be needing your go bag on a regular basis, so your food needs to last a while. At least six months is a good length (change it when you do your smoke detectors and other emergency kit maintenance). Don’t forget that there’s a difference between the various forms of labelling “best before” dates.

Taste – At the end of the day though you want food you like. This will boost your spirits and make it easier to rotate your stash so it doesn’t go stale.

All these factors limit your options pretty significantly. Think about packing Muesli/Granola bars, trail mix (aka scroggin), nuts (unsalted), some chocolate, dried fruit, some crackers and spread (in a tube or plastic container) and other pre-packed snacks. I know some folk who swear by tubes of sweetened condensed milk, but that’s not everyone’s cup of tea. Others will get some army rations/MREs, but these aren’t necessarily terribly tasty. Just make sure there’s some variety.

As for the amount there isn’t really any rule of thumb. You probably should have enough to stretch out over 2-3 days, but this may not be practical depending on what else you have in your go bag and how much weight you’re willing to carry.

Do you have a favourite food for your go bag? Leave a note in the comments and I’ll add it to the post.

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Go Bag #2: Shelter

CZ-IJ14a Tábořiště pro stany In the third of this regular series I explore what you need to put in your go bag. This week: shelter.

If your home or workplace becomes unsafe or is destroyed, and other buildings aren’t safe you’re going to need somewhere to stay. That means that you really need to think about shelter if you’re in an area prone to devastating earthquakes.

The most important thing here is climate:

How hot or cold does it get in your location, especially at night? What about rain, or snow? And if it does rain, how cold is it usually. Being wet is uncomfortable – being cold and wet can kill.

You can choose a tent or, if you’re the adventurous type, two tarpaulins and some rope will usually work nicely.

You will also need something to keep you warm. An emergency blanket, regular blanket or sleeping bag will work, also consider that you might need some insect repellent. Make sure that if you need a sleeping bag, it’s rated for the sort of weather you might be facing.

Think about your pets too. Much of the time evacuation centres won’t have the facilities to cater for them. Even though you might be safe and dry make sure you have taken their needs into account.

Go Bag #1: Water

Sparkling-bottled-water In the second of this regular series I explore what you need to put in your go bag. This week: water.

A healthy adult can last a week or more without food, but only a couple of days without water. In a disaster water supplies may be contaminated or just plain unavailable. Thus, if you put nothing else in your Go Bag ensure you have some water.

 

How Much?

Depending on size, amount of exercise and climate the average adult will need to drink 2-4 litres of water a day. You can calculate what your needs might be here. Add a little extra for sanitation, multiply it by a few days and your talking about 15 litres, per bag. One litre of water weighs one kilogram so your Go Bag could get pretty heavy if you carry all the water you need fresh.

However all these treatment methods below depend on you finding water, which may or may not be easy. I recommend you carry as much clean water in your Go Bag as you can.

Bottled Water

There’s a range of different ways to carry fresh water. You can buy it bottled or use containers (including ‘Camel-back’ type bladders). Remember to periodically change the water, particularly if you’re using your own bottles.

I prefer one litre clear plastic bottles. It means your supply is split up (in case one of the bottles breaks or is contaminated) and once you’ve finished a bottle, you can use the empty to start purifying any water you find straight away.

Purification

As you can’t carry enough water to sustain you for more than a couple of days the answer is purification. There’s a variety of methods you can use, but regardless of your choice you should always try and purify the freshest water you can find.

One pitfall of purification is that although most methods will kill all micro-organisms in the water, they generally can’t remove any chemical contamination such as pollutants.

All these methods are less effective (including the filters, which are designed for small particles including bacteria) if the water you find has lots of dirt or other matter in it. You should try and use some sort of coarse filter (or you can make an effective filter using sand, material and a funnel) to remove most of the gunk before proceeding.

Boiling

Boiling water is the tried and true method of killing germs, including viruses and parasites. However it’s dependent on having a container to boil the water in (though I have seen water boiled in a plastic bottle) and enough fuel to light a fire. Don’t depend on this method.

Filters

A mainstay of stationary disaster water purification systems there are also portable filters that will remove all micro-organisms from water (though beware, most cheaper filters won’t). The advantage of some filters is that they can also remove certain pollutants and other contamination. The disadvantage of filters is that they can be expensive, bulky, clog easily and once they’re broke are difficult or impossible to fix. If you choose to carry one in your go bag don’t forget to back it up with something else.

You can buy filters at most camping and trekking supply stores.

Chemical

The two prevailing chemical treatments are chlorine and iodine. There’s not a huge difference between the two (though there’s plenty of arguments on the interwebz about which is the superior treatment), but keep in mind that some people can be allergic to iodine. There’s a variety of different formulations out there, just follow the instructions on the container. I like chemicals cause they’re cheap, lightweight and can purify a lot of water.

Depending on where you are you can purchase these products at chemists/drugists, camping stores and supermarkets.

Alternatives

There are also UV sterilisers on the market as well as other chemical products which use silver. UV sterilisers use precious batteries and silver treatments are not widely available but depending on your situation may be worth investigating.

Alternatively if you’re out of options a clear (PET) plastic bottle filled with shaken water left out in the sun for around 6 hours should kill most microbes.

Go Bag: Are you ready to get out?

Recently I’ve finished putting together my ‘Go Bag’ and collecting together supplies for some of my friends. The threat of a major earthquake here in the Kathmandu Valley is very real. It was rated as having by far the highest risk of all megacities in a study by the Global Earthquake Safety Initiative. Having a Go Bag is the first step to being prepared for a major earthquake should it happen whilst I’m living here.

As one of the cornerstones of disaster preparedness I’ll be writing a series of articles about Go Bags and their contents.

For some localised guidance check the websites of your local, state or national governments and emergency services or your national Red Cross/Red Crescent society.

What is a Go Bag?

Alternately called a ‘Grab and Go Bag’ or a ‘Bug-Out-Bag’ (and a range of other cute names and acronyms) the Go Bag is a kit of essential supplies to carry with you if you need to evacuate in an emergency.

Why have a Go Bag?

A Go Bag is the first practical step to being prepared for a disaster, whether it’s a large earthquake a chemical spill or a house fire. But when I ask people about their Go Bag, they often respond that they have those items lying around the house.

Unfortunately that just won’t cut it in a disaster. The purpose of the Go Bag is that you can literally grab it and go. If you need to evacuate you don’t want to be digging through drawers and cupboards trying to pull together supplies, and then find you’re missing key items.

A Go Bag might not save your life, but it will sure make dealing with the emergency much easier and improve your comfort during the first 72 hours. And if you’re able to look after yourself, that means that the emergency services can use their limited supplies to look after those who are more in need.

A Go Bag is just one element of disaster preparedness. It’s also important know your risks, have a plan and a way to communicate with friends and family, prepare your property and get some training.

Go-Bag vs Emergency Kit

Many preparedness education will also tell you to have an emergency kit (also called a home survival kit, home emergency kit or household kit). An emergency kit is a larger box with additional supplies to help you survive in your home if you have to shelter in place, either inside or near your home. These kits often duplicate some items in a go bag but they go further, having supplies and equipment for at least 72 hours.

You can use your Go Bag to form the core of your emergency kit but it might be a good idea to duplicate some of the items in case you can’t find or access your Go Bag.

The #1 Item: Your Head

What’s the first thing in your Go Bag? It’s thinking about what you need to put in there.

Think about the hazards that might affect your area, the strength of infrastructure and emergency services. Research any public safety advice about evacuations. If the local emergency services don’t provide this information you’re going to need to come up with it yourself.

If you have to evacuate, where might you need to go, how long will it take you to get there and how long would you expect to be out of your house? For example if you’re a foreign national working or volunteering in a disaster prone area, you may think that you’d be flown out but it could take days or weeks, in which time you might have very little support.

Also think about your own needs, including any medical conditions or allergies and those of your family and pets too.

There’s no substitute for putting together your own Go Bag. Even if you buy one that’s ready made, it will have some items missing that you’ll need to add on your own such as documents and medications. Having said that a pre-made bag can be an easy and quick way of assembling the core items for your Go Bag. Just make sure you familiarise yourself with the contents and add what you need.

So what goes into a Go Bag? Stay tuned for the next instalment.