Strengthening Public Health Capacities in Disasters

Context: Living with the pandemic months together has had a desensitizing effect on the collective psyche which visible in our disaster management framework in writing off many pressing public health issues. 

Disaster Management Framework in India:

• Disaster Management (DM) Act, 2005:laid an institutional framework for managing disasters across the country; a systematic scheme for prevention, mitigation, and responding to disasters of all kinds.
• During Pandemic: The DM Act was used to further a range of measures, from imposing lockdowns to price control of masks and medical services.

Issues with our disaster management framework:

• Reactive Approach: The management of disaster is often reactive in nature and under-emphasizes the public health angle.

• Over-reliance on private healthcare during health emergencies: Private sector is incapable of supporting disaster management related to Health because of the following reasons:

• Weak regulation and poor organization: which gets compromised during disasters.
• Larger share private hospitals as small enterprises: This restricts many private hospitals from getting themselves included under the public insurance criteria set by the government.
• Parking Lot Conundrum: which relates to the fact that disaster preparedness does not make a strong “business case” for hospitals, which prefer to invest in more profitable areas.
• Fails to identify progressive events: which nevertheless cause substantial damage, often more than sudden catastrophes, as disasters. For, E.g. it neglects tuberculosis and recurrent dengue outbreaks.
• Pervasive policy gaps: While the DM Act does require States and hospitals to have emergency plans, medical preparedness is de facto a matter of policy.

Way Forward: Development should not remain oblivious to the possibility of disaster imposed pressures

• Integrate disaster management with primary care: for ensuring low cost and coordinated healthcare response for, E.g. linking National Health Mission (NHM) with DM Act.
• Ensure legal mandate to strengthen public sector capacities via disaster legislation, including capacity building of staff and strengthening the health system at grass root levels.

Conclusion: Making primary health care central to disaster management can be a significant step towards building a health system and community that is resilient to disasters.