**1. Introduction**

*Sunday:*

*"Well, this is a disaster" said Jojo, the 19 year old apprentice to his mentor, Raj. They were pulling in the fishing nets near the usually beautiful seaside village of Tucci, now dull and grey and partly under water. The nets were heavy with debris from the churning sea. Raj grunted a mirthless laugh. "No. This is just a hard day of work. Tomorrow will be the disaster."*

<sup>1</sup> *I went with a fictional disaster to demonstrate the principles of disaster management for a number of reasons. 1. Any current disaster would soon be overshadowed by one more recent. 2. There are many people that would have a much greater understanding than me of any historical event. 3. Any real event risks being 'foreign' to people in other places. The story of Tucci belongs to no one, and so applies to anyone. I agree with Robert Fulghum who wrote*" *…myth is more potent than history" (The storyteller's creed in All I needed to know I learned in kindergarten). JB*

*Then the old man added, "unless it stops raining, the bridge stays above water, the power line's fixed, and we have enough sandbags for everyone to keep their houses from washing away."*

*It wasn't totally exaggerated. The rain had been the worst in decades. Many homes in the low-lying village were already flooded. Those that were a little higher than the rest were already overcrowded with friends and relatives who's houses were in a foot or two of water. And the bridge, the only land access to the village, was visible only as rail posts marking a dotted line through the sea between the village and the green foothills.*

Disasters require both a potentially harmful event and a component of vulnerability [1]. If an event overwhelms local response capacity, whether by insufficient material resources or by inadequate social systems or structure, outside help is needed. This is a disaster. Thus the magnitude of an event that causes a disaster will vary by organizational capacity. Many of the natural events described elsewhere in this textbook (earthquakes, tsunamis, etc.) create disasters. An earthquake in a remote, uninhabited area might be called a natural disaster, but it is not truly a disaster if people are not severely impacted. Disasters occur at the interface of nature and civilization [2].

Emergency management is usually described in terms of planning, mitigation, response, and recovery. As we move along the spectrum of severity, from emergency to disaster, the same principles apply, with an emphasis on adaptability and collaboration. Specific to hospital disaster management, contextual issues such as triage, decontamination, and patient care are built upon a general and pervasive approach to disaster readiness. In resource-poor environments, the challenge is magnified as the impacts of natural disasters are greater, and the ability to respond and recover less. Education and training will be most effective if methods match the objectives. With all the uncertainty therein, training for disaster must include establishing relationships between organizations and allowing for flexibility in the face of events that can be predicted but never fully anticipated.

*Not every windstorm, earth-tremor, or rush of water is a catastrophe…So long as the ship rides out the storm, so long as the city resists the earth-shocks, so long as the levees hold, there is no disaster. It is the collapse of the cultural protections that constitutes the disaster proper. ([3], p. 211)*
