welfare of the people of Bermuda. Disaster prone countries are increasingly adopting measures for the mitigation and prevention of disasters. As public awareness of disasters increases, there is a demand for better management practices. The goal of disaster management is to prevent or to minimise death, injury, suffering and destruction. Many people and many organisations are involved in this effort: government and local agencies, private relief organisations, and police departments, medical and nursing staff, engineers, meteorologists, geologists, sociologists, volunteers etc. Because disaster management is an interdisciplinary task, all persons involved must understand their respective role and responsibility.

Disaster: is an occurrence that causes suffering or creates human needs that victims cannot alleviate without assistance. These situations include: hurricanes, storms, earthquakes, droughts, explosions, collapsed buildings, fires, transportation wrecks and volcano eruptions.

Disasters are commonly divided according to their causes into two distinct categories: NATURAL DISASTERS MAN-MADE DISASTERS Some natural disasters are hurricanes, floods, tidal waves, volcanic eruptions, landslides and earthquakes.

Some man-made disasters are fires, explosions, pollution, power failure, exposure to radiation, nuclear fallout, aircraft accidents and oil spills.

Impact of disasters vary and can be divided into the following categories: IMPACT ON THE NATION Increase in unemployment -- loss of revenue due to disruption.

Decrease in manpower due to injury or death.

Disruption of normal services which may include all transportation, communication systems, damaged facilities -- shift in priorities in relation to health care.

Psychological effects on the nation may be negative or positive -- Negative effects include continued dependency on other nations -- positive effects may be technical cooperation among developing countries, unification of forces without the nation in the rehabilitative new relationships with other nations -- thus serving as a vehicle for change.

IMPACT ON THE COMMUNITY Interruption of electrical services due to disconnected wires, uprooted or dislodged poles.

Destroyed vehicles, road blocks, erosion of roads, landslides.

No air communications, blocked and/or damaged runways.

Destroyed boats, damage to harbours/docks.

Radio, television, newspaper, telecommunication, telephone meteorological station, and air communication may be disrupted causing limited or no dispersion of information nationally or internationally.

Complete or partial damage to buildings and homes causing dislodgement, dislocation and loss of personal property.

Possible shortage of water, food and supplies.

PSYCHOLOGICAL EFFECTS ON THE COMMUNITY Effects may include feelings of helplessness depending on the severity of the disaster. Community members may react by showing signs of depression, fear, anxiety, hyperactivity and psychosomatic disorders.

IMPACT ON THE PEOPLE Injuries may vary in type and severity depending on the nature of the disaster. The number of deaths is in relationship to level of preparedness, time and type of disaster.

Loss of home and possessions may include crops, live stock, and personal affects leading to economic problems and psychological trauma which may manifest itself in anxiety, fear, aggression and grieving.

Health care workers and families may themselves be victims and this may led to a shift in priorities regarding health care delivery.

Buildings affected where services are normally delivered -- such as clinics, hospitals, pharmacies and laboratories providing services to the community may be partially or totally destroyed.

A shortage of blood may occur depending on the number and severity of injured victims. There may be a reduction in the number of donors.

Damage of laboratory equipment and lack of personnel will further compound the problems. Storage areas for medications and supplies may be damaged, and there may be an insufficient quota to serve the number of victims requiring services; including insufficient medical personnel to prescribe medications.

Cumulative stress and exhaustion on the Health Team.

Health manpower may be limited leading to long hours of health care delivery to a large number of victims, excluding provision for periods of rest.

Conflict of loyalties between family and profession may be present.

Normal health care problems continue.

Victims may be present with chronic medical conditions such as diabetes mellitus, and hypertension. Provisions must be made for continued treatment of these medical problems.

As you are aware disasters can be damaging -- be prepared! Jacqueline Lightbourne Chief Nursing Officer -- Department of Health.