Role of Pharmacist in the Management of CBRN Disasters

Rajeev Goel, Raman Chawla, Vinod Kumar, M. Silambarasan, Rakesh Kumar Sharma

Abstract: The periodicity and intensity of disaster are on the rise resulting in colossal loss of development efforts, large number of casualties and huge economic losses. Management of mass casualty incidences due to covert attacks involving Chemical, Biological, Radiological & Nuclear (CBRN) agents or man-made accidents involving them needs overall preparedness at all levels including contingency planning. At present, capacity in terms of adequate skilled manpower, material logistics and infrastructural facilities at various levels required for management and mitigation of such disasters are grossly inadequate. These deficiencies are likely to get further accentuated when vulnerable locations are specifically targeted by terrorist groups using CBRN agents. An analysis of the major disasters in the recent past reveals the salient gaps in education, training and capacity development at all levels. Awareness generation is an another important requirement at all phases of disaster management cycle.
Pharmacists can contribute in management of CBRN emergencies both directly and indirectly by strengthening the capacities and capabilities of various stakeholders in both health and non-health sectors. The play a key role in the planning and execution of pharmaceutical (drugs and medical logistics) distribution and control as well as drug therapy management of patients during disasters involving CBRN Agents. Till now pharmacy professionals have not been optimally utilised up to their capabilities in mitigating the overall impact of any mass casualty event arising out of CBRN incidents. It is imperative to impart necessary education on techniques, procedures and skill based training so that the expected roles are discharged as per spirit of requirement and they should be empowered by suitable laws to confront disaster situation involving even the CBRN agents.
Disaster means a catastrophe, mishap, calamity or grave occurrence in any area, arising from natural or human made causes or by accident or negligence which results in substantial loss of life or human suffering or damage to, and destruction of, environment, and is of such a nature or magnitude as to be beyond the coping capacity of the community of the affected area. Indian sub continent has been a theatre of all types of disasters in past two-and-a-half decades (Figure 1). About 58.6% of our landmass is susceptible to earthquakes and over 40 million hectares (8%) is prone to floods. Eight thousand kilometres of coast line is prone to cyclones and 68% of the country’s geographical area is susceptible to droughts. With the tropical climate & unstable landforms, coupled with high population density, poverty, illiteracy and lack of adequate infrastructure, India is one of the most disaster prone developing region to various natural disasters, like drought, flood, cyclone, earth quake, landslide, forest fire, hail storm, locust attack etc. Analysis of vulnerabilities with respect to natural disasters in India on a 10 point scale puts Pests and Disease outbreaks, cyclone, drought, earthquake and floods to > 8 category.


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