Anything that disrupts natural state of affairs is a disaster. Asian Disaster Preparedness Center (ADPC) defines disaster as a sudden or gradually occurring event triggered by human action or by natural causes. UNDR considers an event as a disaster, which occurs in a certain place and time, putting the community in serious danger and destroying the social infrastructure. Generally, we understand disaster as a natural or human-induced event that deeply disrupts life and normal social environment and inflicts great loss of life and property. Disaster can be of two types: natural disaster and human induced.

Natural disasters include tornado, cyclone, flood, earthquake, tidal surge, tsunami, drought, epidemic, volcanic eruption, arsenic contamination, cold wave, conflagration, etc.

Human induced disasters could be war, famine, food-crisis, political turmoil, border conflict, displacement, industrial/technological accident, nuclear, chemical and gas contamination, environmental degradation, fire, terrorism, etc.

Geographic location and climatic conditions have made natural disasters common in Bangladesh. Tornado, flood, drought, and river erosion are taking place every now and then. Besides, Bangladesh suffers occasional earthquakes, being within the earthquake zone. The massive earthquake of 1897 is still an active memory. Such earthquakes change the topography. Geologists and historians are of the opinion that the present course of the Brahmaputra River and the highlands of Modhupur Gor are effects of such earthquakes. A moderate earthquake shook Chittagong and adjoining areas in 1997. During July-August 1999, Moheshkhali and adjacent areas suffered four jolts. These tremors caused both human and material losses.

Complete elimination or prevention of natural disasters is beyond human abilities. However, preparedness, including awareness would substantively reduce the impact of disasters. The old belief that collecting and distributing relief material to the victims after the disaster is only possible action has changed. The present concept of disaster management emphasizes preparedness before the disaster and rehabilitation -- not just relief -- after the disaster. Bangladesh has adopted the same principles and changed the Ministry of Relief in to the Ministry of Disaster Management, Relief and Rehabilitation.

The government, in cooperation with UNDP and UNICEF, has established the Bureau of Disaster Management to build mass disaster awareness. As it is not possible for any individual, department, ministry, or organization to tackle a disaster single-handedly, the government has formed the National Disaster Management Council combining all relevant ministries, departments, and organizations, including the representatives of NGOs. The council is the highest body on disaster management and the Prime Minister chairs the council. Moreover, the disaster management committee chaired by the minister for DMRR is responsible for implementation of the government's national policies. District, upazila, and union disaster management committees chaired by the deputy commissioner, upazila nirbahi officer, and the chairman respectively are active in the field level. The MoDMRR formulated and published a standing order for disaster management.

Disaster and the health are closely interrelated. Disasters affect the health systems most. One hundred and thirty-four countries adopted the Alma Ata declaration: "Health for all by the year 2000" in 1978. The declaration perhaps materialized in developed countries, but in our country it is yet to materialize. According to WHO: "Health is a state of physical, mental, and social well-being, not merely the absence of disease or infirmity." In our country, we give more emphasis on primary health care because a notable number of people in our country are illiterate and unaware. Illiteracy and unawareness breed misconception.

Science has developed a lot, yet, in the 21st century, amidst scientific progress, people in our country still practice quack medication. Nonetheless, people nowadays are somewhat conscious about health. Literate and illiterate people are equally active to vaccinate infants against the six deadly diseases. Besides, managing family size and thereby improving mother and child health status is becoming common. Health service providers from both public and private sectors are extending all out support in this regard.

Now is the time to think about the post-disaster situation. More than two lakhs people died in seven countries on December 26, 2004 due to tsunami catastrophe. Lakhs of people were injured, millions of dollars of property was destroyed. Indonesia is the worst affected among the seven countries. The total climatic condition of Indonesia is said to have changed. Several days passed before the cadavers could be found and removed, causing severe pestilence. Rescue workers from all over the world rushed to Indonesia to help the victims. The loss cost by quake is severe. If any moderate

scale quake takes place in our country thousands will die, loss of wealth will be in the crores. Most of the buildings of Bangladesh are 2 to 5 storied and most of them are constructed without complying with the rules and regulations of building code. A 9.0 force tremor would destroy 63 percent of houses in Dhaka. On the other hand, flood and drought are regular happenings. Flood devastates houses and croplands. Diarrhoea, dysentery, jaundice, influenza, and skin diseases are prevalent in post-flood period.

From the very beginning of human life, people are facing flood, drought, torrential rainfall, earthquake, frostbite, and volcanic eruption. Nobody has control over these menaces. However, in some cases we can minimize the loss by taking preventive measures. For example, we can avoid loss of life and property from earthquake if we follow the national building code. On the other hand, to minimize disaster we have to create mass awareness. Disaster Management Bureau is primarily engaged in mass awareness campaign to reduce losses from cyclone, tidal surge, flood, and drought. Gradually the bureau is addressing other disasters such as arsenic contamination. Recently the bureau organized the second national seminar on earthquake. Experts from Nepal and India participated in the seminar together with the Bangladeshi experts and administrators. It has also undertaken training schemes for earthquake. Most recently, ADPC and BRAC organized training on Earthquake Vulnerability Reduction (EVR-3) to promote mass awareness. Participants and resource persons from Bangladesh, India, Nepal, Sri Lanka, Thailand, and the US attended the international training.

A group of smart physicians, nurses, and volunteers are needed to tackle the post-disaster health situation. The most important task in post-disaster situation is to secure the brain and medulla oblongata of the victim. Therefore, the first duty in a post-disaster situation is to secure the scene from unwanted crowd and protect the brain and medulla oblongata with cervical collar. Securing emergency medical service or medical first responders and attending other injuries would follow afterwards.

The Acting-Principal of the Bangladesh Fire Service and Civil Defense Training Complex at Mirpur, Mr. M. A Salam, informed that lately, for the first time, five graduation courses of international standard were conducted in Bangladesh. Seventeen fire-fighters successfully completed these internationally accepted courses. Experts from India, Indonesia, Nepal, Philippines, and the US were the trainers and instructors for the courses. The course titles were: Medical First Responder (MFR) and Collapsed Structure Search and Rescue (CSSR). The successful graduates are qualified to conduct the training all over the country. Cooperation from government, private organizations, and generous individuals will foster the process.

Bangladesh abounds with curious people. Curious people always crowd accident-scene and often hamper the activities of the service providers. Fire service or such other agencies face great difficulty in managing the crowd. Presence of TV camera leads the people to compete for appearance on the camera. Of course, there are exceptions. Few days back, when the WASA bhavan caught fire, one rickshaw puller Mostofa set a rare example of bravery. If we all can demonstrate such serving mentality, rescuing the victims from accidents would become easier. Meanwhile, a tornado struck Rangpur and Gaibhandha killing and injuring people. The injured were in precarious condition. Food, water, medicine, treatment, nursing -- everything was in short supply. Now is the time to prepare for the present and impending disasters.

Dr. Mustafa Abdur Rahim is Director of Samajic Shyastha Kendra.