There are five essential phases in the management of disasters: – planning, prevention, preparation (mitigation), respond and recovery. They are closely linked. Focus of action of each of these phases is placed between different periods in relation of disaster events:

•- Pre-event phase – planning and prevention

•- Event - early detection and incident command

•- Post even phase - mitigate of consequences, early response and recovery

Planning: on the basis of demographics, mortality and morbidity data, information about health system and epidemiological investigation and needs assessment analysis, all hazard and specific hazard plans should be developed.

Prevention: this describes those activities that can be implemented following the risk assessment to stop the designated major disaster/incident from occurring (or minimising its likelihood) – these are examples of hazard reduction programmes.

Risk reduction methods are based on the principles of acceptance, avoidance, and mitigation. Some examples of hazard reduction plans are remediation of contaminated land before building on or building barriers to reduce a flooding risk.

Mitigation: this describes those activities, whose implementation as soon as there is advance warning of an imminent threat will minimise the impact of the incident. Activities include both forecasting and implementing the precautionary measures.

It involves both organisations and individuals who are involved in the response, recovery and post-incident audit phases.

Mitigation is based on vulnerability reduction programmes. Vulnerability reduction describes those activities whose implementation is designed to minimise the consequences of a hazard event. This is achieved by lowering the vulnerability to hazards and /or reducing the number of elements at risk. Some examples of vulnerability reduction plans are designing earthquake proof buildings or heat wave watch scheme.

Response: this describes those activities whose implementation in the immediate aftermath of a major disaster/ incident will provide health and social care (to casualties/ those affected by the incident), and will rehabilitate or reconstruct the physical structures of the community. Essential elements of the response include equitable access to adequate safe water, hygienic sanitation, and food and shelter, and protection of affected populations from ill-health and violation. Responses should give priority to the most vulnerable people: women (especially when pregnant), young children, older people and persons who are disabled or chronically ill.

It includes how the emergency preparedness and response plan is activated (including Alert and Standby). There are many different emergency plans, some of them being:

•-generic (all hazards) or specific;

•-single agency or multi-agency;

•-local, regional or national;

•-business continuity plans.

Response activities include many different actions as follows:

•-Development of specific incident algorithm

•-Command and control

•-Safety (self, scene and survivors)

•-Communication

•-Scene assessment

•-Triage

•-Treatment

•-Transport