Part 2: The Operational Framework Longitudinal Components Transectional Components (BSFs) Dependence

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Part 2The Operational FrameworkLongitudinal
ComponentsTransectional Components
(BSFs)Dependence
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Operational Framework

• Longitudinal Phases
• describe a disaster
• Transectional Structure (snapshots)
• describe a society
• Administrative structures

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Operational Framework

• The first two portions of the operational
  framework deal with describing the
• Disaster
• Society(s) affected by the disaster
• The disaster is described with Longitudinal
• The society is described with Transectional

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Operational Framework
Society A Society B
Disaster X Disaster X in Society A Disaster X in Society B
Disaster Y Disaster Y in Society A Disaster Y in Society B
Transectional
Longitudinal
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Longitudinal Phases of a Disaster

• Progressive and chronological
• Focus on properties rather than absolute time
• Overlap between phases

event
damage
response
recovery
event
damage
response
recovery
time
event
damage
response
recovery
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Longitudinal Phasesa clinical example

• Consider two different patients who require an
  admission to the hospital
• Although the people are different and their
  diseases may be different, a comparison between
  their respective clinical courses can be made

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Patient A
Baseline health status
Clot to brain
Neuron death
Unable to speak or use right hand
Anticoagulationrehab
Speech returns
Pre-event
Event
Damage
Change in Function
Response
Recovery
time
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Patient B
Baseline health status
Gallstone blocks cystic duct
Inflammation GB
Pain, N/V,jaundice
cholecystectomy
recovery
Pre-event
Event
Damage
Change in Function
Response
Recovery
time
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Disaster A
Pre-event status tertiary care hosp
Earthquake
Tertiary care hosp collapse
40 HC provider loss, no OR, 50 in patient bed
loss
Field hosp, volunteer HC providers
recovery
Pre-event
Event
Damage
Change in Function
Response
Recovery
time
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Longitudinal Phases
Pre-event
Event
Damage
Change in Function
Response
Recovery
time
Pre-event
Event
Damage
Change in Function
Response
Recovery
time
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Longitudinal Phases
Society A Society B
Disaster A Pre-event
Event
Damage
Change in Function
Response
Recovery
Disaster B Pre-event
Event
Damage
Change in Function
Response
Recovery

• Compare a phase of any disaster in any society to
  the same phase in a different disaster or
  society
• damage from a hurricane in Florida to damage
  from a bomb in Madrid
• response to a chemical release in India to
  response to a famine in Sudan

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Transectional Structure of Society(The Basic
Societal Functions)

• A method for organizing society into functional
  components
• Provides generic and reproducible descriptors of
  society

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Structure vs. function

• The BSFs are functional divisions of society
• There are structural components of each BSF

structure
function
function
structure
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Transectional Structurea clinical example

• The longitudinal clinical course does not provide
  an adequate description of the patient
• Clinicians describe patients based on organ
  systems
• Nervous Hematological
• Cardiovascular Immune
• Pulmonary Endocrine
• GI Musculoskeletal
• Renal Integument

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Structure vs. function

• The organ systems are functional divisions of an
  organism e.g., the GI system
• There are structural components of each organ
  system e.g., liver, intestine, etc.

structure
function
function
structure
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Transectional Snapshots
Pre-event
Event
Damage
Change in Function
Response
Recovery
time
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2
Assessment
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Transectional snapshot of a patient A

• Assessment 1 Pre-event
• Poorly controlled hypertension
• 30 pack-year smoking history
• Physical exam notable for right carotid bruit
• Mild renal insufficiency with creatinine 1.8
• Etc. through each organ system

• Assessment 2 Change in Function
• Right hemiparesis and garbled speech
• Imaging reveals left cerebral hemisphere ischemic
  changes
• Serum creatinine 2.7
• Etc. through each organ system

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Transectional Structure of Society

• People can be organized by functional organ
  systems
• Societies can be organized into functional
  components called Basic Societal Functions

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Basic Societal Functions

• Public Health
• Medical Care
• Logistics and Transport
• Security
• Energy
• Water and sanitation
• Economy

• Education
• Public Works and Engineering
• Food and Nutrition
• Shelter and Clothing
• Communications
• Environmental Services

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Transectional snapshots of BSF A and BSF B
Graphical representation of chronological changes
of the functional status of two Basic Societal
Functions.
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Transectional Structure

• Compare medical care in Florida in the response
  after a hurricane to medical care in Honduras in
  the response after a hurricane

Society A Society B
Medical care Security Medical care Security
Disaster A Pre-event
Event
Response
Disaster B Pre-event
Event
Response
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Sub-functions of the GI system
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Components of the BSFs
Nesting of components that comprise a basic
societal function
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Interrelationships between BSFs

• No BSF can function in isolation
• Medical care relies on
• Energy to run lights, machines, and refrigeration
• Education to train personnel
• Transport to bring supplies
• Transport, in turn, relies on
• Public works and infrastructure
• Energy to supply fuel

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Dependency and Interdependency
BSF A is dependent on subfunction A.
Both BSF A and BSF B are dependent on Subfunction
A. Therefore, BSF A and BSF B are interdependent.
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Dependence and Interdependence

• Although subfunction A is required by two BSFs,
  it is assigned to only one BSF
• Any subfunction or component that is required by
  more than one BSF is an area of vulnerability for
  society

vulnerable
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Priorities

• When setting priorities
• Keep in mind dependencies