DISASTER MANAGEMENT MODEL
FOR THE HEALTH SECTOR
Guideline for Program Development
Manitoba Health
Disaster Management
Version 1 Printed November 21, 2002

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Disaster Management Model for the Health Sector
© Manitoba Health
2000
Version 1
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Manitoba Health
Table of Contents
Table of Contents _______________________________________________________ 3
Introduction ___________________________________________________________ 5
Disaster Management Outcomes ___________________________________________ 6
Disaster Management Principles___________________________________________ 7
Disaster Management and Health __________________________________________ 8
Understanding Hazards, Disasters and Disaster Management __________________ 10
Hazards __________________________________________________________________ 10
Disasters __________________________________________________________________ 11
Disaster Management _______________________________________________________ 12
Integrated Disaster Management Model ____________________________________ 14
Strategic Approach _____________________________________________________ 16
Comprehensive Emergency Management ______________________________________ 16
Cooperation and Coordination _______________________________________________ 17
Technical Information and Expertise __________________________________________ 18
Hazard Assessment_____________________________________________________ 19
Risk Management______________________________________________________ 23
Mitigation ____________________________________________________________ 25
Preparedness__________________________________________________________ 29
Quality Improvement ___________________________________________________ 32
Integrated Disaster Management Model ____________________________________ 34
References____________________________________________________________ 35
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Disaster Management Model for the Health Sector
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Manitoba Health
Introduction
Manitoba Health, through its programs and its Disaster Management Branch, aims to develop
safer communities that suffer fewer deaths, physical injuries and psycho-social trauma as a
result of disasters. To achieve this the health system must be capable of providing a
coordinated response during disasters and deliver effective mitigation and preparedness
programs before an impact. The health sector has a vested interest and a key role in this
process since safer communities are healthier and the health of the population is an important
contributing factor to individual and community safety.
Manitoba Health has developed six disaster management expected outcomes that describe the
long-term desired state of disaster management in the health sector. These outcomes will be
achieved by implementing a comprehensive, integrated program based on the principles of
disaster management. A successful disaster management program will incorporate the four
main elements of hazard assessment, risk management, mitigation and preparedness. These
will be achieved as part of an overall strategic plan for disaster management and will be
included in an ongoing quality improvement cycle.
This guideline provides information about the disaster management principles and the
elements that are the basis of disaster management model for the health sector. It provides an
overview of the elements that will be useful when developing a strategic plan for a disaster
management program in the health sector. Each element begins with proposed objectives,
focused internally and externally, that may be adopted to help guide the program.
This guideline is directed at all components of the health sector. Only the scale of the
activities needs to change for the principles, outcomes and elements to be applied effectively
to an individual facility, a community-based program, a private sector component such as a
pharmacy, a Regional Health Authority, and to the province as a whole. A coordinated
program that includes all of these components will be necessary to create safer communities.
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Disaster Management Model for the Health Sector
Disaster Management Outcomes
Manitoba Health has defined a set of outcomes that a successful disaster management
program will aim to achieve. These specific disaster management outcomes contribute to
Manitoba Health’s mission to “promote, preserve and protect the health of Manitobans”.
1. Manitobans live in safer communities that suffer fewer deaths, physical injuries and
psychosocial trauma as a result of disasters.
This is the overall aim of a disaster management program. While large, disaster-scale impacts
will continue to kill and injure people it is important to recognize that these effects can be
reduced and that communities can be ready to respond and recover quickly and effectively.
2. Manitoba communities’ and individuals’ disaster vulnerability is minimized.
This outcome relates to the first phase of comprehensive emergency management: mitigation.
The factors that place people at risk and limit their ability to cope can be changed to make the
population less vulnerable to disasters, even preventing them or reducing their likelihood.
3. Manitoba communities and individuals are resilient to the impacts of disaster.
Preparing coping resources, at both individual and community levels, ensures that the
harmful effects of a disaster-scale impact are limited.
4. Manitobans receive appropriate health care services in times of disaster.
A disaster impact will drastically change the health needs of a community and the ability of
the health sector to meet those needs. It is important that the health care services are able to
respond to the community’s needs during and immediately after a disaster.
5. Manitobans receive health care services that address their changing needs resulting
from a disaster.
Disasters can change the future of individuals and whole communities. The direct effects of
injuries sustained in a disaster can require long-term rehabilitation while the indirect impacts
on the social, economic and physical environment can affect the population’s health overall.
The health sector must recognize and adapt to these changing needs.
6. Manitoba’s health care system is capable of responding to disasters in other
Canadian jurisdictions.
Disasters, by definition, are events that exceed the ability of the local community to cope
with the harmful effects and require extraordinary measures. During National Emergencies
these measures may include health care being delivered across normal boundaries.
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Manitoba Health
Disaster Management Principles
Manitoba Health is committed to comprehensive emergency management, enabling the
health sector to mitigate, prepare for, respond to, and recover from mass emergencies and
disasters. Manitoba Health, through its Disaster Management branch, has commenced an all-
hazards, all agencies program that promotes hazard reduction, emergency readiness, response
co-ordination and community recovery.
Manitoba Health has adopted the following principles that guide its efforts in disaster
management:
1. Comprehensive emergency management involves addressing hazards and disasters
through a balance of mitigation, preparedness, response, and recovery activities.
2. An integrated disaster management framework provides an objective and logical
process to achieving comprehensive emergency management through normal systems.
3. An all-hazards approach examines the full range of threats and recognizes the common
consequences of different impacts.
4. A systematic risk management approach provides a framework for determining the
appropriate risk treatment options.
5. Business continuity planning ensures that services remain available at appropriate levels
in times of internal disruption.
6. Ongoing monitoring and evaluation are necessary because communities, the threats
they face, and the systems they develop are part of a dynamic interaction.
7. Cooperation and coordination with municipal governments, provincial departments and
other relevant agencies will ensure the health sector can contribute to and support the
overall disaster management activities of the community.
8. Appropriate technical information and expertise must form the basis for disaster
management systems, decisions and actions.
The practice of disaster management is built on these fundamental principles. They are
interrelated to each other and best achieved when integrated into an organization’s normal
systems or business. Together with Manitoba Health’s broader goals, expected outcomes and
priority populations, these principles set the direction for disaster management in the health
sector.
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Disaster Management Model for the Health Sector
Disaster Management and Health
Vulnerability describes the relationship between common social and economic characteristics
of the population, individually and collectively, and their ability to cope with hazards they
face. The factors that increase an individual’s vulnerability to harm in a disaster are the same
as the factors that determine the general health of an
individual. Each of these can contribute to how a
The population health approach
disaster affects an individual and therefore lessening
currently being promoted by Health
the impacts of a disaster is dependent on improving
Canada and Manitoba Health looks
these factors (just as improving these factors will
at the fol owing factors as
improve an individual’s health).
determinants of health:
“Health” has been defined, in part, as the ability to
! Income and Social Status
cope with life’s challenges. Clearly a disaster creates
! Social Support Networks
rare and extreme challenges but an individual’s ability
! Social Environments
to cope is still the basic factor in determining how the
! Physical Environments
disaster will affect them and the “determinants of
! Healthy Child Development
health” are the basic indicators of that coping ability.
! Education Employment and
Working Conditions
Since death and injury are the primary negative
! Personal Health Practices and
impacts of a disaster it is obvious that the health sector
Coping Skills
has a direct role in disaster management1.
! Biology and Genetic Endowment
Unfortunately disaster management has tended to
! Health Services
emphasize the immediate response needs and has
! Culture
neglected the pre-event mitigation and post-event
! Gender
recovery needs of communities. The health sector has
traditionally shared this limited view of disaster
Manitoba Health 1997
management and has directed its energies toward
Health Canada 2000
reactive measures, such as mass casualty triage plans
and facility evacuation schemes.
While such response actions are very important, and deserve appropriate consideration,
disaster management is now broadening its view of how to best deal with disasters. This is
strongly signaled by the field’s growing interest in the concepts of sustainable mitigation and
“provention”. The disaster management profession is recognizing that the only way to make
a significant change to a community’s catastrophic risk profile is to influence the social,
economic and physical factors that determine the community’s exposure to those risks and its
ability or cope with actual impacts

1 “Emergency management” is the term most commonly associated with the field of dealing with extreme
harmful events. Manitoba Health refers to this as “disaster management” in order to differentiate this aspect of
its work from its responsibility for urgent or emergent health care that is often referred to as “emergency
medicine”. Other internationally recognized terms include “emergency preparedness” and, in some
jurisdictions, “civil defense”.
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Manitoba Health
In parallel to this shift in disaster management, the health sector is recognizing that better
health within a community cannot be achieved through the provision of health care alone.
The health sector is looking to models of population health and health promotion to address
the determinants of health just as disaster management has evolved from treating the harmful
agent to strengthening the community’s resilience to harm.
Disaster vulnerability has been related to the fol owing factors:
! social integration
! psychological & physiological
" ethnicity
" income
" locus of control
" life style
" gender
" age
" disability
" agility
" location
" education
" coping-style
" mobility
" status
" family type
" individual’s perception
" experience
" wealth
Britton and Walker 1991
Communities can become safer and healthier. The health sector must become an active
partner in the disaster management of communities while disaster management becomes an
integral part of a broader health program to protect, preserve and promote the health of all.
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Disaster Management Model for the Health Sector
Understanding Hazards, Disasters and Disaster Management
Hazards
It is important to understand hazards before developing strategies to deal with them. This
understanding must go beyond thinking of hazards just in terms of the extreme event or
agent. Hazards must be considered in terms of the threat and the threatened community. For
instance, a tornado, by itself, is simply an extreme weather phenomenon whereas a prairie
town that is built in an area that experiences tornadoes has a tornado hazard.
Hazards are those interactions between extreme
This leads to thinking
events and vulnerable communities not covered by
about hazards as a type of
the community’s coping resources
“interaction”. To identify
what a hazard is from this
perspective first consider
all the extreme events in
Vulnerable
the environment that could
Community
impact on the community.
Extreme
HAZARDS
Then consider how
Events
vulnerable the population
is to the effects of these
various impacts. Finally,
consider what resources
the community can apply
to cope with these impacts.
This recognizes that
hazards are the potential
Coping Resources
for a negative interaction
between extreme events
(of a natural or
technological origin) and
the vulnerable parts of
the population. Add to
this the community’s coping resources and the hazards are the remaining potential
interactions.
Different hazards have different characteristics that help explain how the interaction with the
community is likely to happen. Understanding these differences can improve planning and
better target mitigation activities.
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Document Outline

• Guideline for Program Development
• Table of Contents
• Introduction
• Disaster Management Outcomes
• Disaster Management Principles
• Disaster Management and Health
• Understanding Hazards, Disasters and Disaster Management
  • Hazards
  • Disasters
  • Disaster Management
• Integrated Disaster Management Model
• Strategic Approach
  • Comprehensive Emergency Management
  • Cooperation and Coordination
  • Technical Information and Expertise
• Hazard Assessment
• Risk Management
• Mitigation
• Preparedness
• Quality Improvement
• Integrated Disaster Management Model
• References

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