Emergencies, Disasters, and Crises – A Revisit

Posted on July 12, 2012

Food for thought during the Disaster Consciousness Month:

Emergencies, Disasters, and Crises

What do emergencies, disasters, and crises have in common? Simply, that something bad has happened or is happening. When something bad and/or unexpected happens, it may be called an emergency, a disaster, or a crisis depending on the magnitude of the event and the current phase of the event.

No universal consensus up to now.

Majority agree “emergencies” is less in magnitude compared to “disasters” and “crises.”

Some would use “disasters” and “crises” interchangeably.  Some would say “crises” has greater magnitude than “disasters.”

In August 2011, I wrote the following blog:

Emergency vs Disaster vs Crisis

by Reynaldo O Joson on Friday, August 26, 2011 at 7:57am

On the first day of our Training Course on Hospital and Health Facility Emergency Exercises in Hanoi, Vietnam, August 23, 2011, in the first module entitled Emergency Preparedness and Emergency Response Plan handled by another facilitator, the perennial question of what is the difference between and among the various terms being used, particularly, “emergency,” “disaster,” and “crisis” cropped up.

Time again and again, since 2007 when I started being part of the pool of facilitators of World Health Organization (WHO), Western Pacific Region (WPRO), conducting courses on emergency and disaster preparedness in hospitals, I encountered this non-universal agreement or definition,  NOT to say confusion, of the abovementioned terms.

My recommendation has been to come out with an operational definition by a hospital, communicate it to the staff, and stick to it.  Of course, to come out with the operational definition, some benchmarking will have to be done , such as looking at how WHO would use it, how the country’s ministry or department of health would use it, etc.  Other factors to consider would be coming out with terms that are easy to recall and usual perceptions of the people in the community.

Personally, from my experience, in the hospital setting, I would recommend the following:

1. To limit to the use of two terms, “emergency” and “disaster,” and not to include “crisis” anymore.  Crisis is more akin to the word “disaster” if splitting hairs will be done.  For operations management purposes, the use of “emergency” and “disaster” will be enough to cover and designate two different situations that we commonly encounter in practice where the continuum goes from emergency to disaster (see below).
2. To use “emergency” to mean anything threatening that one must act and manage it right away and the threat is still manageable with the resources on hand. If an urgent action is not taken, an unwanted consequence, such as a disaster event, may happen.
3. To use “disaster” to mean an emergency that overwhelms the person or a group of persons in managing and controlling it.  The overwhelming can be in terms of psychosocial impact, tarnished reputation, destruction of property, injuries to or diseases or deaths of human beings, scarcity of resources, financial loss, and other ill-consequences of significant magnitude.

The abovementioned generic concepts of “emergency” and “disaster” are applicable in any situation in the hospital, i.e., in terms of structure, activity, and people.  In a hospital setting, emergency and disaster situations can occur in association with the physical structure of the hospital (such as collapse of the hospital building); in association with any activity being done in the hospital, particularly medical services (such as wrong diagnosis and treatment) and support services in patient care (such as breakdown of the hospital information and billing system); and in association with the people (patients, visitors, and staff) situated inside the hospital at any one time (such as sudden cardiopulmonary arrest).

Advice: Just use the words ”emergency” and “disaster” in emergency and disaster preparedness and management program of a hospital and agree on an operational definition for each for purposes of differentiation.