AEHO Duty on flood

Assistant of Environmental Health Officer duty on flood

Before the flood

• Providing "Bilik Gerakan Banjir" in term of room and equipment.
• Visit and evaluating area for temporary evacuation place for flood's victim
• Evaluating high risk area based on history and experience in order to prevent any outbreak or diseases

During the flood

• Contact and follows the order of Commander Operation Disaster at State level
• Making sure the preparation in any level standby and ready to move when the time needs
• Monitoring the temporary evacuation for flood victims.
• Monitoring infectious diseases especially water-bourne and food-bourne diseases
• Monitoring the condition of the flood and public health needed within the situation of the flood.

After the flood

• Receive reports and monitor the situation in the region was hit by floods in terms of an increased incidence of infectious diseases, especially water-borne diseases
• Taking preventive measures of infectious diseases with safe drinking water supply and sanitation, sanitary food preparation, health advice and other related issues.
• Improving health advice and education to the public regarding control measures to prevent infectious diseases, especially in the area that has been flooded.
• Provides the latest report on the situation with flooding affecting public health action is taken, the weaknesses that have been identified and recommendations made for future action
• Estimate and advise the type of assistance that should be given to rehabilitate infrastructure of public health services such as safe water supply, sanitation, sewage disposal in sanitary and other facilities related
• Improving health advice and education to the public regarding control measures to prevent infectious diseases, especially in the area that has been hit by floods
• Advising the public that water storage area does not become mosquito breeding and the potential for the spread of dengue fever

Arahan 20

Arahan MKN No. 20 : Dasar dan Mekanisme Pengurusan Bencana Negara.

1.    Bilakah Arahan ini diwujudkan?

Arahan ini mula diwujudkan pada 11 Mei 1997 oleh Majlis Keselamatan Negara (MKN), Jabatan Perdana Menteri (JPM) ekoran daripada tragedi keruntuhan Pangsapuri Highland Towers di Hulu Klang, Selangor pada 11 Disember 1993. Bagi memperkemas dan memperluaskan skop pengurusan Bencana yang semakin rumit dan kompleks, Arahan ini telah disemak semula pada 30 Mac 2012 bagi menerangkan peranan pihak-pihak yang berkaitan supaya ianya lebih menyeluruh dan bersepadu.

2.    Apakah tujuan Arahan diwujudkan?

Arahan ini disediakan bertujuan untuk menggariskan dasar dan mekanisme pengurusan bencana secara menyeluruh termasuk peranan dan tanggungjawab Agensi Kerajaan, badan berkanun, pihak swasta dan badan-badan sukarela meliputi peringkat sebelum, semasa dan selepas berlaku sesuatu bencana supaya pengemblengan sumber dapat disepadukan bagi mengelakkan pembaziran, konflik serta pertindihan peranan.

3.    Mengapa skop dasar dan mekanisme Arahan ini hanya bertumpu kepada pengurusan bencana di darat?

Penumpuan ini adalah kerana kekerapan tinggi kejadian bencana di darat dan penyelarasan tindakbalas agensi-agensi pengurusan bencana di darat adalah penting. Walau bagaimanapun Arahan ini juga telah memperjelaskan peranan dan tanggungjawab Agensi Peneraju bagi kejadian bencana maritim dan udara. Agensi Penguatkuasaan Maritim Malaysia (APMM) telah dipertanggungjawabkan bagi mengurus kejadian bencana di laut manakala Jabatan Penerbangan Awam (DCA) akan mengendalikan bencana udara dengan kedua-duanya menggunakan Manual Mencari dan Menyelamat (SAR) Kebangsaan Jilid IV sebagai rujukan.

4.    Jenis kejadian bencana apakah yang termasuk di bawah Arahan ini?

Terdapat 11 jenis bencana yang akan diurus di bawah Arahan ini iaitu

a.    bencana alam (banjir, ribut/taufan, gempa bumi, tsunami, ombak besar, kemarau dan tanah runtuh);

b.    bencana industri (letupan, kebakaran, pencemaran, kebocoran bahan berbahaya di kilang/loji/depot yang memproses, mengeluar dan menyimpan bahan ini);

c.    kemalangan melibatkan pengangkutan/penyaluran/pemindahan bahan berbahaya);

d.    keruntuhan bangunan/struktur khas;

e.    kemalangan udara (yang berlaku di kawasan berpendudukan tinggi);

f.     pelanggaran/gelinciran keretapi/lain-lain sistem pengangkutan rel yang melibatkan jumlah mangsa/kemusnahan harta benda yang besar;

g.    kebakaran (melibatkan kawasan yang luas termasuklah kebakaran bangunan tinggi/struktur khas yang mempunyai ramai orang);

h.    empangan/takungan air pecah;

i.      kemalangan kimia, biologi, radiologi dan nuklear;

j.      kejadian jerebu;

k.    penularan wabak penyakit berjangkit yang tidak terkawal/pandemik; dan

l.      lain-lain kejadian Bencana yang akan diisytihar/ditetapkan Kerajaan.

Kejadian yang tidak tersenarai di atas akan ditakrifkan sebagai Kejadian Bukan Bencana dan tidak tertakluk di bawah Arahan ini.

5.    Bagaimana Arahan ini membantu pengurusan bencana?

Arahan ini menerangkan mekanisme pengurusan bencana mengikut tiga (3) tahap iaitu Tahap I (peringkat Daerah), Tahap II (peringkat Negeri) dan Tahap III (peringkat Pusat). Penerangan setiap tahap ini adalah seperti berikut:

Tahap I	Tahap II	Tahap III
Peringkat Bencana	Daerah	Negeri	Pusat
Nama Jawatankuasa Pengurusan Bencana	Jawatankuasa Pengurusan Bencana Daerah (JPBD)	Jawatankuasa Pengurusan Bencana Negeri (JPBN)	Jawatankuasa Pengurusan Bencana Pusat (JPBP)
Jenis Bencana	Kejadian kecil, setempat, terkawal dan tiada potensi untuk merebak	Kejadian serius dan merebak ke dua (2) daerah dan lebih	Bencana lebih kompleks di dua (2) buah negeri dan lebih serta mengambil masa lama
Sumber	Dapat dilaksana menggunakan sumber setempat	Bantuan aset, kewangan dan sumber di peringkat Negeri serta bantuan yang terhad dari peringkat Pusat	Penggemblingan aset, kewangan dan sumber yang lebih besar atau melalui bantuan dari luar negara
Pengerusi Jawatankuasa	Pegawai Daerah	YB Setiausaha Kerajaan Negeri	YB Menteri yang dilantik oleh YAB Perdana Menteri
Komander Operasi Bencana	Ketua Polis Daerah	Ketua Polis Negeri	Pengarah Keselamatan Dalam Negeri dan Ketenteraman Awam, PDRM
Timbalan Komander Operasi Bencana	Pegawai Bomba Daerah	Pengarah Bomba dan Penyelamat Negeri	Timbalan Ketua Pengarah (Operasi) JBPM
Komander Kawalan Hadapan	Dilantik oleh Komander Operasi Bencana mengikut kepakaran dalam menasihat tindakan mengikut jenis bencana

6.    Bagaimana perintah dan kawalan dilaksana?

Bagi tujuan perintah dan kawalan, kawasan bencana akan dibahagikan kepada tiga (3) zon iaitu:

a.    Zon Merah

Zon ini meliputi suatu kawasan yang ditetapkan oleh Komander Operasi Bencana bagi menjalankan operasi mencari dan menyelamat oleh Agensi Penyelamat dan pasukan-pasukan khas yang mempunyai kepakaran tertentu sahaja. Kebenaran masuk ke dalam zon ini perlu terlebih dahulu mendapat kebenaran daripada Komander Operasi Bencana dengan nasihat Komander Kawalan Hadapan.

b.    Zon Kuning

Zon ini adalah kawasan di luar tempat kejadian yang ditetapkan oleh Komander Operasi Bencana untuk menempatkan pos-pos Agensi Penyelamat dan pasukan-pasukan khas yang mempunyai kepakaran tertentu. Penempatan pos-pos dan akses masuk ke zon ini perlu terlebih dahulu mendapat kebenaran daripada Komander Operasi Bencana.

c.    Zon Hijau

Zon ini adalah kawasan di luar Zon Kuning yang menempatkan pos-pos dan petugas-petugas Agensi Bantuan dan Pemulihan serta badan-badan sukarela. Zon ini juga menempatkan Pusat Pengurusan Media, Pusat Keluarga Mangsa, Pusat Kaunseling, Tempat Bekalan Makanan, Tempat Rehat dan Tempat Mayat. Lain-lain fungsi zon ini akan diputuskan oleh Komander Operasi Bencana.

7.    Bagaimana operasi mencari dan menyelamat diselaras?

Bagi melicinkan tugas, Komander Operasi Bencana akan melantik Komander Kawalan Hadapan (Forward Commander) untuk mengetuai semua operasi mencari dan menyelamat di tempat kejadian. Komander Kawalan Hadapan ini hendaklah terdiri daripada mana-mana Komander pasukan Agensi Penyelamat. Tugas Komander Kawalan Hadapan adalah untuk menilai dan melaporkan situasi Bencana kepada Komander Operasi Bencana.

8.    Adakah Arahan ini akan mengehadkan pihak media untuk menjalankan tugas?

Pihak media masih dibenarkan untuk mendapatkan maklumat dan berita berkenaan kejadian bencana. Satu kawasan yang dikenali sebagai Pusat Pengurusan Media yang diwujudkan di Zon Hijau. Pusat yang diselaras oleh Jabatan Penerangan ini akan memudahkan pihak media untuk mendapatkan maklumat melalui sesi sidang media yang akan disampaikan oleh Pegawai yang berkelayakan. Prosedur ini diwujudkan supaya hanya fakta penting disampaikan kepada orang awam bagi mengelak berlakunya kekeliruan yang tidak diingini.

9.    Bagaimanakah prosedur jika terdapat pihak-pihak merancang untuk memohon atau menghantar bantuan kemanusiaan terutama sekali dari/ke luar negara?

Mana-mana pihak yang merancang untuk memohon bantuan kemanusiaan dari luar negara atau menghantar bantuan kemanusiaan ke luar negara hendaklah terlebih dahulu merujuk kepada MKN. Berdasarkan Arahan ini, MKN sebagai Agensi Peneraju Utama pengurusan bencana Negara bertanggungjawab untuk menyelaras pelaksanaan bantuan kemanusiaan supaya pelaksanaannya selari dengan keputusan dasar Kerajaan serta instrumen antarabangsa seperti perjanjian, memorandum persefahaman, deklarasi dan sebagainya yang telah dimetrai Kerajaan dengan pihak antarabangsa.

10.  Apakah peranan yang boleh dimainkan Agensi Kerajaan, badan berkanun, pihak swasta dan badan sukarela dalam mencapai matlamat pengurusan bencana secara berkesan?

Setiap pihak boleh bekerjasama untuk melaksanakan setiap perkara yang telah digariskan di dalam Arahan ini. Kerjasama yang boleh dijalinkan adalah seperti membantu melaksanakan program-program kesedaran dan kependidikan awan berkaitan pengurusan bencana, membantu menyalurkan bantuan dari segi penggunaan logistik pada waktu yang diperlukan, menyalurkan sumbangan kewangan kepada Kumpulan Wang Amanah Bantuan Bencana Negara (KWABBN) serta menggembleng tenaga dalam usaha-usaha pengurangan risiko bencana.

Prevention

Tubercolisis

• BCG
• The TB vaccine called Bacillus Calmette-Guerin (BCG) was first developed in the 1920s
• It is one of the most widely used of all current vaccines, and it reaches more than 80% of all new born children and infants in countries where it is part of the national childhood immunization program, However, it is also one of the most variable vaccines in routine use
• The BCG vaccine has been shown to provide children with excellent protection against the disseminated forms of TB, however protection against pulmonary TB in adults is variable. Since most transmission originates from adult cases of pulmonary TB, and it is generally used to protect children, rather than to interrupt transmission among adults
• The BCG vaccine will often result in the person vaccinated having a positive result to a TB skin test

Hand Mouth Food Disease

• Wash hands often with soap and water, especially after changing diapers and using the toilet
• Cleaning and disinfecting frequently touched surfaces and soiled items, including toys
• Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease
• Using mouthwashes or sprays that numb mouth pain
• Isolate contagious people because disease is highly contagious, people with the illness should limit their exposure to others while they have active signs and symptoms. Keep children with HMFD out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.
• Encourage your child to drink plenty of fluids

Leprosy 

• The Bacillus Calmette-Guerin(BCG) vaccine offers a variable amount of protection against leprosy in addition to tuberculosis It appears to be 26 to 41% effective (based on controlled trials) and about 60% effective based on observational studies with two doses possibly working better than one.Development of a more effective vaccine is ongoing as of 2011

Measles

Measles
Measles or as known as Rubeola is a childhood infection caused by a virus. Measles can be serious and even fatal for infant.

Symptoms
Measles signs and symptoms usually appear 10 to 14 days after the exposure to the virus. Symptoms such as

• Fever
• Dry cough
• Runny nose
• Sore throat
• Skin rash
• Diarrhea
• Dehydration

The incubation period of measles is 10 to 14 days after infected

Causes

The cause of measles is a virus that replicates in the nose and throat of an infected child or adult.

When someone with measles coughs, sneezes or talks, infected droplets spray into the air, where other people can inhale them. The infected droplets may also land on a surface, where they remain active and contagious for several hours.

You can contract the virus by putting your fingers in your mouth or nose or rubbing your eyes after touching the infected surface

Risk Factors

Being unvaccinated - If you haven't received the vaccine for measles, you're much more likely to develop the disease.

Traveling - If you travel to developing countries, where measles is more common, you're at higher risk of catching the disease.

Having a vitamin A deficiency - If you don't have enough vitamin A in your diet, you're more likely to contract measles and to have more-severe symptoms.

Infants

Unvaccinated pregnant mother

Prevention

If someone in your household has measles, take these precautions to protect vulnerable family and friends:

• Isolation - Because measles is highly contagious from about four days before to four days after the rash breaks out, people with measles shouldn't return to activities in which they interact with other people during this period
• Away from the infected person
• Vaccinate- Anyone who at risk of getting the measles who has not been fully vaccinated receives the measles vaccine as soon as possible

Tuberculosis

Tuberculosis
Tuberculosis or as known as TB is a serious infectious disease that main affects lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air through coughs and sneezes.


Symptoms
Few common symptoms of TB

• Coughing
• Coughing up blood
• Chest pain
• Pain wih breath
• Unintentional weight loss
• Fatigue
• Fever
• Night sweats
• Chills
• Loss of appetite

Person at risk

• People with HIV/AIDS
• Drug users
• Those in contact with infected individuals
• Health care workers who treat people with TB

Causes

Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.

Although tuberculosis is contagious, it's not easy to catch. You're much more likely to get tuberculosis from someone you live with or work with than from a stranger. Most people with active TB who've had appropriate drug treatment for at least two weeks are no longer contagious.

Control and Prevention

Stay home - Don't go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.

Ventilate the room - Tuberculosis germs spread more easily in small closed spaces where air doesn't move. If it's not too cold outdoors, open the windows and use a fan to blow indoor air outside.

Cover your mouth -  Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.

Wear a mask - Wearing a surgical mask when you're around other people during the first three weeks of treatment may help lessen the risk of transmission.

Chikungunya
Chikungunya is a disease transmitted to humans by infected mosquitoes. Chikungunya also shares some clinical signs with dengue and can be misdiagnosed where dengue is common. The infection caused by Chikungunya virus is was first described in East Africa in 1952. The virus is transmitted by mosquitoes and belongs to the family Togaviridae in the genus Alphavirus.

Mode Of Transmission
Humans are infected when Aedes aegypti and albopictus mosquitoes, containing Chikungunya virus, bite humans and the viruses are trasmitted during the bloodmeal. The viruses then multiply in humans and can then be picked up by other uninfected mosquitoes when they bite infected humans.

Chikungunya virus infection is not considered to be contagious because there is no direct human to human transfer of Chikungunya viruses, so infected individuals cannot directly transfer the virus to another human because the virus has to pass through a mosquito first. However, outbreaks can occur in populations where a number of both mosquitoes and humans are infected with the virus.

Symptoms
Usually the symptoms will develop within 3 to 7 days after a bite by an infected mosquito. The most common symptoms are fever and join pain or the individual may develop such headache, muscle pain, join swelling or rash.

The symptoms are similar to dengue fever that is also spread by same mosquitoes.


Some rare complications include:-

• Eye problems
• Inflammation of the heart, liver, brain, skin, kidneys and nerves.

Prevention

No vaccince exists to prevent chikungunya virus infection or disease. Prevent chikungunya virus infection by avoiding mosquito bites and mosquitoes that spread the chikungunya virus bite mostly during daytime. 

• Use air conditioning or window and door screens to keep mosquitoes outside. Or sleep under a mosquito bed net.
• Help reduce the number of mosquitoes outside your home by emptying standing water from containers such as flowerpots or buckets.
• Wear long-sleeved shirts and long pants.
• 
  

Rabies
Rabies is a zoonotic disease caused by virus Lyssavirus. Rabies virus is endemic virus on all continent except Antarctica. Every year more than 15 million people worldwide receive post exposure vaccination to prevent rabies.

How its spread
Rabies is a viral illness spread via the saliva of an infected animal. This occurs usually through biting a human or another animal. Transmission can also occur through saliva touching an open wound or touching mucous membranes.

After being bitten by a rabid animal, the virus is deposited in the muscle and subcutaneous tissue. For most of the incubation period (1 to 3 months). The virus then travels via peripheral nerves to the brain and from there, again via peripheral nerves, to nearly all parts of the body.

Symptoms
Symptoms can occur as fast as within the first week of infection. Normally the early symptoms are very general such as weakness, fever and headaches.


The disease can take 2 forms:-

• Paralytic rabies - Patient's muscles slowly get paralyzed starting at the site of the bite. Ends with coma and death
• Furious rabies - Classics symptoms such as anxiety or confusion, encephalitis causing hallucinations or confusion orcoma, hypersallivation or having difficulty in swallowing

Person at risk

• Person always contact with rabid animals
• Person who have a nature with animals or veterinars

Prevention

• Frequently keep vaccine rabies up to date for pets
• Frequently have a medical care and take vaccine for immunization
• Animal control to remove the infected animals
• Beware of stray animals
• Vaccinate pets and keep them away from wild and outdoor animals