Evac - Health Consideration

Guideline
Department of Health, NSW

73 Miller Street North Sydney NSW 2060
Locked Mail Bag 961 North Sydney NSW 2059
Telephone (02) 9391 9000 Fax (02) 9391 9101
http://www.health.nsw.gov.au/policies/
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Major Evacuation Centres: Public Health Considerations

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Document Number GL2011_011
Publication date 26-Aug-2011
Functional Sub group Population Health - Disaster management
Summary This document provides guidance regarding public health matters that
may be considered in the establishment and monitoring of a major
evacuation centre. The State Emergency Operations Controller is
ultimately responsible for the activation of a major evacuation centre in
the event that local resources are not equipped to manage the
accommodation requirements following a decision to evacuate a
population. Activation of a major evacuation centre will require multi
agency consultation and response. This document is a guideline that
considers the physical requirements, health protection and health
promotion amongst evacuees.
Author Branch Office of the Chief Health Officer
Branch contact Darrin Eade 9391 9085
Applies to Local Health Districts, Government Medical Officers, Public Health Units
Audience Public Health Units, Government Medical Officers, NSW Ambulance
Service
Distributed to Public Health System, Government Medical Officers, NSW Ambulance
Service, NSW Department of Health
Review date 26-Aug-2016
Policy Manual Not applicable
File No. H11/15070-15
Status Active
Director-General
GUIDELINE SUMMARY
MAJOR EVACUATION CENTRES: PUBLIC HEALTH

CONSIDERATIONS
PURPOSE
The primary purpose of Major Evacuation Centres: Public Health Considerations is to
provide guidance to NSW public health services regarding matters that may need to be
considered in the establishment and monitoring of a major evacuation centre. It
considers evacuation centre physical requirements and health protection and health
promotion amongst evacuees.
KEY PRINCIPLES
The impact of some emergencies may exceed the capability of existing evacuation
centre arrangements. The number of people presenting at the centre, the size of the
facility required and the length of time it will need to operate may instigate the
establishment of a major evacuation centre.
Planning for a major evacuation centre needs to address many public health concerns.
These include the physical amenities and space required for well-being, minimising the
risk of communicable disease outbreaks and the need to promote the health of
evacuees to prevent the acute exacerbation of chronic diseases.
The State Emergency Operations Controller is ultimately responsible for the activation
of a major evacuation centre in the event that local resources are not equipped to
manage the accommodation requirements following a decision to evacuate a
population. Activation of a major evacuation centre will require multi-agency
consultation and response.
USE OF THE GUIDELINE

Preparing for and responding to a public health emergency is a whole-of-health
responsibility. This document provides guidance regarding public health matters that
may need to be considered in the establishment and monitoring of a major evacuation
centre.
However, as in any emergency situation, there may be factors which cannot be
covered by a single set of guidelines. This document should be used as a guide for
consideration rather than a mandatory directive. It does not replace the need for the
application of expert judgement to each individual situation.
This guideline should also be read in conjunction with NSW emergency management
plans:
The NSW State Disaster Plan (Displan) details emergency preparedness, response
and recovery arrangements for New South Wales to ensure the coordinated
GL2011_011
Issue date: August 2011
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Major Evacuation Centres: Public Health

Considerations
Guideline
response to emergencies by all agencies having responsibilities and functions in

emergencies.
In addition to the Displan, there are sub plans, which address specific hazards and
supporting plans, which outline arrangements for groups of agencies which may be
acting in a supporting role. These plans are available at:
http://emergency.nsw.gov.au/content.php/475.html
Healthplan is the supporting plan that provides for five major contributing health
service components which constitutes the whole of health response and outlines
their agreed roles and functions. Healthplan is available at:
http://emergency.nsw.gov.au/content.php/562.html
REVISION HISTORY
Version
August 2011
(GL2011_011)
Approved by
Deputy Director-General
Population Health and Chief
Health Officer
Amendment notes
New guideline.
ATTACHMENTS
1. Major Evacuation Centres: Public Health Considerations
GL2011_011
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MAJOR EVACUATION CENTRES:

Public Health Considerations
Guideline

GL2011_011

Considerations
Guideline
CONTENTS
1. Introduction ............................................................................................................. 1
1.1 Who uses emergency centres? ........................................................................... 2
2. Health information systems.................................................................................... 2
2.1 The importance of disaster victim registration (DVR) ........................................... 2
2.2 Health surveillance .............................................................................................. 2
3. Physical amenities .................................................................................................. 3
3.1 Location ............................................................................................................... 3
3.2 Areas required ..................................................................................................... 3
3.3 Physical space and air circulation ........................................................................ 4
3.4 Safety, privacy, rights and responsibilities ........................................................... 4
3.5 Water requirements ............................................................................................. 5
3.6 Personal hygiene ................................................................................................. 6
3.7 Mud/disinfecting area .......................................................................................... 6
3.8 Toilets.................................................................................................................. 6
3.9 Cleaning of living areas ....................................................................................... 7
3.10 Recreation area ................................................................................................. 7
3.11 Smoking ............................................................................................................ 8
3.12 Laundry (where available) ................................................................................. 8
3.13 Garbage (solid waste management) .................................................................. 8
4. Food safety .............................................................................................................. 9
4.1 Eating areas and kitchen hygiene ........................................................................ 9
4.2 Serving food ........................................................................................................ 9
4.3 People with special dietary needs and allergies...................................................10
5. Pets and public health .......................................................................................... 10
6. Control of communicable diseases ..................................................................... 12
6.1 Vaccinations ...................................................................................................... 12
6.2 General infection control for evacuation centres ................................................ 13
6.3 Management of people with infectious diseases in evacuation centres.............. 13
6.4 Standard Precautions (summary): ..................................................................... 14
6.5 Sick bays/special temporary accommodation centres ...................................... 15
6.6 Outbreak control ................................................................................................ 15
7. Control of non-communicable diseases/chronic illness management ............. 16
7.1 Injury ................................................................................................................. 16
7.2 Chronic diseases ............................................................................................... 16
7.3 Reproductive health........................................................................................... 16
8. Hygiene promotion................................................................................................ 17
8.1 Hand hygiene .................................................................................................... 17
9. Returning home information ................................................................................ 17
10. APPENDICIES ...................................................................................................... 18
Appendix one - Hand hygiene ................................................................................ 18
Appendix two - Sample health promotion materials ................................................. 19
Appendix three - Environmental health assessment form for centres ...................... 29
Appendix four - References .................................................................................... 31
Appendix five - Additional resources..........................................................................32
GL2011_011
Contents page

Considerations
Guideline
1. Introduction
Planning for a major evacuation centre needs to address many public health concerns.
These include the physical amenities and space required for well-being, minimising of
the risk of communicable disease outbreaks and the need to promote the health of
evacuees to prevent the acute exacerbation of chronic diseases.
The NSW State Disaster Plan (Displan) details emergency preparedness, response
and recovery arrangements for New South Wales to ensure the coordinated response
to emergencies by all agencies which have responsibilities and functions in
emergencies.
In addition to the Displan, there are sub plans, which address specific hazards and
supporting plans, which outline arrangements for agencies which may act in a
supporting role. These plans are available at
http://emergency.nsw.gov.au/content.php/475.html .
The State Emergency Operations Controller is ultimately responsible for the activation
of a major evacuation centre in the event that local resources are not equipped to
manage the accommodation requirements following a decision to evacuate a
population. Activation of a major evacuation centre will require multi agency
consultation and response.
This document provides guidance regarding public health matters that may need to be
considered in the establishment and monitoring of a major evacuation centre. It will not
consider provision of medical or mental health services, although these too will have a
significant impact on the health of the evacuee population.
This guideline should not be seen as a stringent set of rules to be applied without the
expert input and discretion of the managing professionals. In any emergency situation
there may be factors which cannot be covered by a single set of guidelines, therefore,
this document should be used as a guide, rather than a mandatory directive to be
followed. It does not replace the need for the application of expert judgement to each
individual situation.
Resources on the practical aspects of planning for a major evacuation centre are listed
in appendix five. Useful guidance is available from the Sphere Projects Humanitarian
Charter and Minimum Standards in Disaster Response i, as adopted by the World
Health Organisation, from Emergency Management Australia ii, from Emergency
Preparedness Canada iii and also from the United States Centres for Disease Control
and Prevention resources iv.
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Guideline
1.1 Who uses emergency centres?

Experience from Hurricane Katrina, where a large urban population was evacuated
from New Orleans in the US, shows that it is likely the most vulnerable groups that
require accommodation in emergency centres are those that have poor social
supports, have nowhere else to go or who cannot afford to obtain temporary
accommodation. Many of these people have chronic health problems such as
diabetes, cardiac disease or mental illnessv.
2. Health information systems

2.1 The importance of disaster victim registration (DVR)
In order to provide appropriate care it is important to understand who the vulnerable
groups are upon entry to the evacuation centre. This includes screening people for
possible communicable diseases (see section 6, page 12) and for chronic diseases
that require regular medication or therapy (e.g. epilepsy, diabetes, congestive
cardiac failure).
The Red Cross, in conjunction with the NSW Police, registers people affected by
emergencies and disasters in NSW and manages subsequent enquiries through the
National Registration and Inquiry System (NRIS). The NRIS is a computer based
filing and retrieval system that allows for self registration and contains a public
search function. The NRIS provides basic information regarding a persons safety
and whereabouts and has limited capacity to register health information.
Consideration should be given to how health information will be maintained,
including how to locate individuals within the evacuation centre (e.g. an evacuation
centre address). This will be important for follow-up of those with health conditions
that require monitoring. Data from NRIS may be able to be imported or extracted
and re-entered into other surveillance tools such as NCIMS or NetEpi.
2.2 Health surveillance

A standardised health information system (HIS) should be implemented to routinely
collect relevant data on demographics, mortality, morbidity and syndromic
surveillance from the evacuees. Age and sex data should be sought to assist in the
identification of groups at special risk. A dedicated team should be identified to
organise and supervise this system. The HIS may be based in either NCIMS or
NetEpi, or may require another data capture tool.
A regular epidemiological report should be generated and shared with all relevant
agencies, decision-makers and the community. The frequency of the report will vary
with the emergency and the stage of the emergency. Responsibility for the
production of the epidemiological report is to be determined at the time of the
emergency.
Confidentiality of the data stored should be ensured and reporting performed in a
non-disclosive fashion.
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Considerations
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The HIS should include a component to ensure the timely detection of and response
to infectious disease outbreaks.
Supplementary data from other relevant sources (e.g. police, welfare services) may
be used to assist in the interpretation of surveillance data and to guide decision
making.
3. Physical amenities
Selection of an evacuation centre site and management of the centre is the
responsibility of other agencies. The information below provides guidance for public
health services if they are asked to provide advice as to the adequacy of planned
facilities.
3.1 Location
Where possible and safe, evacuees should be accommodated near to their homes.
If the nature of the emergency is such that the evacuation site is likely to be affected
(e.g. power, water and/or sanitation failures) then it is preferable to move people to a
site of safety.
Any building should be structurally sound and have sufficient fire and emergency
exits. Ensure that gas, electricity, water and sewerage systems have been checked
by the relevant authorities.
The facility will likely be caring for those with limited physical mobility including
those in wheelchairs, those using mobility aids and those with very young children in
prams. This should be considered when planning an evacuation site.
3.2 Areas required

The centre may require:
Administration/staff area
Registration area
Mud/disinfecting area (to prevent mud and debris being tracked into the building this
will simplify cleaning and also reduce the risk of falls on wet floors)
Sleeping area (including addresses within the sleeping area so that evacuees can be
easily located for follow-up of social or medical issues)
Eating area
Shower and toilet facilities
Kitchen/food preparation area
Handwashing stations
Rubbish collection area
Clinic area
Isolation area for potentially infectious people
Laundry
Recreation areas (e.g. play area)
Crche
Special purpose areas (e.g. depending on the population, a prayer area)
Pet holding area
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3.3 Physical space and air circulation

Living areas should be well ventilated with a reasonable supply of fresh air available.
People should have sufficient covered living space providing thermal comfort, fresh
air and protection from the climate ensuring their privacy, safety and health and
enabling essential household and livelihood activities to be undertaken. A covered
floor area in excess of 3.5m2 per person will often be required to meet these
considerations. vi
The floor-to-ceiling height is also a key factor, with greater height being preferable in
hot and humid climates to aid air circulation, while a lower height is preferable in cold
climates to minimise the internal volume that requires heating. The internal floor-toceiling height should be a minimum of two metres at the highest point. vi
There should be no smoking in the centre and cooking should only occur in the food
preparation area.
The ambient temperature of the building should ideally be 15-19oC. High
temperatures may lead to heat stress, lower temperatures may leave vulnerable
persons prone to hypothermia
3.4 Safety, privacy, rights and responsibilities

Where possible, families should be accommodated together. Well-planned access
routes through the evacuation centre should be highlighted. Materials to screen
personal space and opportunities for internal subdivision within the evacuation
centre should be provided.vi Individual spaces can aid the provision of adequate
privacy and safety.
People seeking or receiving assistance in an evacuation centre and those who
provide that care have the right to be treated with respect. All care will be provided
in a manner that shows courtesy and consideration for a persons culture, religious
beliefs, sexual orientation, issues arising from a disability and right to privacy vii.
All health professionals delivering healthcare services within NSW Health must be
made aware of the detailed rights and responsibilities outlined in PD2011_022 Your
Health Rights and Responsibilities policy directive available from the NSW Health
website: http://www.health.nsw.gov.au/policies/pd/2011/PD2011_022.html
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Considerations
Guideline
3.5 Water requirements

The quantities of water needed for domestic use may vary according to the climate,
the sanitation facilities available, people's normal habits, their religious and cultural
practices, the food they cook, the clothes they wear, and so on. The following table
advises basic survival water needs:
Reference: The Sphere Project (2011) Humanitarian Charter and Minimum Standards in Disaster
Response.
In an absolute emergency 7L per person per day of water should be provided.

Ideally at least 15L per person per day should be supplied for drinking, cooking and
personal hygiene requirements. The very young and the elderly are most at risk of
dehydration. The allocated amount may need to be increased in hot conditions or
where heavy work is being carried out.
People should have to queue for no more than 15 minutes to access water and it
should take no more than three minutes to fill a 20L container. Excessive queuing
time suggests that there is inadequate water availability.
Consider the number of people per tap and the water flow a rough guide is 250
people per tap when the water flow is 7.5L/min. vi
Steps should be taken to minimise post-water delivery contamination (e.g. containers
dedicated to water collection should be provided for family groups). People in the
centre should be provided with information regarding any water quality concerns.
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3.6 Personal hygiene

Good personal hygiene should be promoted throughout the centre. Hand hygiene
and good respiratory etiquette (covering coughs and sneezes) should be promoted
with education materials and distribution of equipment (e.g. alcohol-based hand
cleanser, tissues, and rubbish bins) if possible. Separate handwashing stations
should be set up near toilet and meal areas and there should be systems in place to
ensure high compliance (e.g. staff member monitoring station to ensure that people
wash their hands before lining up in queue to collect meal).
A ratio of one shower per 50 people is suggested if the weather is temperate and
one shower per 30 people in hot weather.
A supply of personal hygiene products should be available to evacuees and
additional items essential for ensuring personal hygiene, dignity and well-being must
be accessible (e.g. incontinence pads, feminine hygiene products). Each individual
should have access to a supply of soap and laundry soap.
Caretakers of infants and children under two years should have access to at least
three disposable nappies per day with the ability to replenish (or 12 washable
nappies if access to new stocks is likely to be an issue and appropriate laundry
facilities are available).
3.7 Mud/disinfecting area

Often evacuees may come from an area that has been contaminated (e.g. by
sewage) or is muddy or dusty. In order to maintain the cleanliness of the facility and
reduce the chance of introduction of disease an area at the entrance to the facility
should be put aside for cleaning mud from shoes and clothes.
3.8 Toilets
Ideally there should be a maximum of 20 people for each available toilet. In the
initial phases of the emergency a figure of 50 people per toilet may be used until
additional facilities are available. Use of toilets could be arranged by households
and/or segregated by sex. The allocation of toilets may depend on the
demographics of the evacuees (e.g. predominantly male vs. predominantly female).
A regular cleaning roster should be established and maintained. Toilet facilities
should include provision for the disposal of womens sanitary products (e.g. bins with
tight fitting lids).
Toilets should be sited in such a way as to minimise threats to users (particularly
children and females). This includes appropriate lighting, or provision of torches to
those in the evacuation centre.
There should be one wash basin per 10 people. Soap, water and hand towels
should be available in the toilets for hand washing. Posters promoting hand washing
should be available in the toilet block.
Refuse bins with tight fitting lids should be located in the toilet block.
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Considerations
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Facilities for changing infants and for the safe disposal of childrens used nappies
should be established, including hand washing facilities next to the changing
station/s.
3.9 Cleaning of living areas

Rosters of personnel (either volunteers or evacuees) should be developed and
systematic cleaning undertaken. Cleaning materials should be made available to all
residents and residents encouraged to keep the evacuation centre clean and tidy.
Any cleaning materials should be safely stored in a designated, secure cupboard.
All floors should be swept, electrostatically mopped or vacuumed daily. Sleeping
areas must be kept neat and tidy to facilitate cleaning activities. People should not
eat in the sleeping area to facilitate ease of cleaning and reduce the attraction of
ants, flies and cockroaches.
Keeping surfaces and items clean helps to reduce the spread of infections amongst
people living or working at the evacuation centre. Surfaces should be cleaned with a
household detergent when visibly dirty and on a regular schedule. Kitchens and
bathrooms should be cleaned at least daily and as necessary (e.g. after use). Bed
frames, mattresses and pillows should be cleaned and their coverings laundered
between occupants. Other furniture should be cleaned weekly and as needed.
Spills should be cleaned up immediately.
Sanitise (i.e. reduce microbial contamination to safer levels) high-risk surfaces using
a household disinfectant or a mixture of 1 teaspoon of household bleach in 1 litre of
clean water (mixed fresh daily). Household bleach and detergents are dangerous
and should be stored securely away from children. Where needed, disinfectant
solutions should be made up as required and then discarded by being flushed with
copious amounts of water down the sink (down a dedicated sink for cleaners if
available). It is preferable to wear disposable gloves whilst performing cleaning
activities. If using bleach, gloves, apron and a face shield should be worn.
Cleaning of high-risk surfaces is particularly important. High-risk surfaces include:
food preparation surfaces
surfaces used for nappy changing
surfaces soiled with body fluid (e.g. vomitus, blood, faeces).
Because of the potentially high ratio of residents to toilets, temporary evacuation
centres have a particular need for frequent and supervised cleaning and
maintenance of toilet facilities. Designated centre personnel should ensure that
surfaces are wiped down with disinfectant at least hourly whilst the premises are
occupied, and that basic supplies such as hand soap, paper towels, and toilet paper
are maintained in each toilet block.
3.10 Recreation area

A safe, secure recreation area should be put aside for children and adults. Children
and adults will need an area for physical activity such as sport and games. Children
may also require an indoor area for more passive activities.
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3.11 Smoking
There is no legal obligation to provide designated smoking areas. However, if it is
decided such areas are to be provided they should be:
located outdoors, clearly designated and well-ventilated with no possibility that

the resultant smoke will contaminate indoor areas
located away from cross traffic and where people may be congregated
provided with ash bins. viii
Should it be decided to establish a designated smoking area, advice should be

sought from WorkCover NSW.
WorkCover Authority of NSW Ph: 13 10 50
Website: www.workcover.nsw.gov.au
3.12 Laundry (where available)

Laundry should be processed off-site as far as possible, or undertaken in an area
separate to personal hygiene facilities.
If laundry facilities are provided there should be one wash stand per 100 people.
Garments heavily soiled with faeces should be handled carefully, wearing gloves,
and placed in a plastic bag for disposal. If faeces can easily be removed using toilet
paper, the garment may be laundered by washing in a washing machine using
normal temperature settings and laundry detergent. There is no need to disinfect the
tubs of washers or tumblers of dryers if cycles are run until they are completed.
Any donated clothing must be washed and screened for appropriateness before
distribution. All affected people should have access to sufficient changes of clothing
to ensure their thermal comfort, dignity, health and well-being. This will require at
least two sets of essential items, particularly underclothes, to enable laundering.vi
3.13 Garbage (solid waste management)

Local council is responsible for waste management in an emergency, however public
health services may be asked for advice.
Waste disposal, including disposal of regulated clinical waste such as needles and
syringes, should comply with local requirements. Facilities should be provided for
the proper disposal of needles and syringes used for medications. Containers
designed for sharp waste disposal should be placed where needles and syringes are
used. Sharps containers must be AS/NZS compliant. Many people who use
needles and syringes may be reluctant to disclose their need publicly, hence all
evacuation centres facilities (e.g. toilet blocks, clinic areas) should have some
capacity for the safe disposal of needles and syringes.
Garbage receptacles should be lined with plastic bags that can be securely tied shut.
Garbage bags should not be overfilled, nor should they be compressed by hand to
expel excess air.
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Garbage should be placed in an area separated from the living spaces, preferably in
garbage bins. Garbage bins should have tight fitting lids to discourage vermin.
Waste pick-ups should be frequently scheduled - daily, if possible. If daily pick-ups
are not occurring, ensure the garbage is stored in a shady location in secure bins.
There should be at least one 100L bin per 40 people. The bin should have a tight
fitting lid and be changed every 2 days.
There should be 2.5 garbage collectors for litter control per 1000 residents.
4. Food safety
4.1 Eating areas and kitchen hygiene
Food should not be consumed in sleeping areas. When people bring their own hot
food into the evacuation centre they should be encouraged to consume it entirely or
to throw out the left-overs. The eating area should be swept after each use and
washed daily.
If a kitchen is accessible, and is being used, some kitchen hygiene rules apply:
sponges and scourers should be washed daily or discarded and replaced

daily
when storing and preparing food, do not let raw meat juices drip onto other
foods
keep raw and cooked food separate. It is preferable to have separate utensils
for raw and cooked foods, especially cutting boards. If this is not possible,
ensure that they are cleaned and sanitised between being used for raw foods
and cooked foods
food supplies should be kept in containers with tight fitting lids
keep benches, kitchen equipment and tableware clean
wash hands with soap and running water thoroughly before starting to prepare
or eat any food, even a snack
do not handle food for others if you are sick with symptoms of gastroenteritis
(e.g. vomiting, diarrhoea) or for 48 hours after you completely recover
if a food that is meant to be refrigerated is left out of the fridge for 2 hours or
more, avoid eating it
cook and reheat foods until they are steaming hot
4.2 Serving food

Where possible, food should be prepared off-site in a dedicated food preparation
facility where food preparation standards are observed. It is preferable that an
Environmental Health Officer from the local council would have inspected the food
preparation area prior to its use to ensure it meets the appropriate standards. A
separate eating area should be made available to assist in keeping the evacuation
centre clean.
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Considerations
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Further information regarding the serving and storage of food are available in the
publication Safe Food Australia, published by the Food Standards Australia and New
Zealand (FSANZ). The NSW Food Authority, part of the Agricultural Services
Functional Area has resources available on-line that may be helpful at
http://www.foodauthority.nsw.gov.au/ .
4.3 People with special dietary needs and allergies

It is likely that some of the evacuee population will have special dietary needs due to
health or cultural requirements (e.g. a low salt diet, a diabetic diet). These needs
should be taken into account when planning for catering for the evacuation centre
and alternatives provided where possible.
It is also important to identify any allergies that may exist within the evacuee
population and take measures to ensure these individuals are not fed any food
containing those allergens, and that the potential for cross contact during food
preparation and serving is minimised.
5. Pets and public health

The Agricultural Services Functional Area is responsible for the management of
animals in an emergency. There is a risk to public health if people refuse to
evacuate because of concern for a pets welfare and public health services should
be prepared to provide advice.
Whilst having a pet nearby may provide a source of comfort for those who have been
evacuated, pets may pose a risk to public health through transmission of disease,
risk of injury and loss of amenity (noise and smell). The appropriateness of housing
pets in public evacuation centres should be carefully considered. However,
assistance animals as defined in the NSW Companion Animals Act 1998 should be
allowed if required.
Sometimes separate areas can be established for pets. If this is done, then these
areas should be staffed with animal care personnel who have been trained in the
handling of animals as well as appropriate approaches to infection control. Animal
evacuation centres or foster homes may be good alternatives.
If there is no alternative to having pets in the evacuation centre, the following
guidelines, developed by the Centres for Disease Control and Prevention, may help
reduce risk of injury or disease:
if a pet is kept at a human evacuation centre, it should not be allowed to freely

roam the facility and should be kept under control at all times, either via
caging or a leash. This is for the animals safety, as well as the safety of the
people in the evacuation centre.
animals must be kept out of food preparation areas.
dogs and cats should be treated for intestinal parasites while staying at the
human centre. This is particularly important when the pet is younger than 6
months old.
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Guideline
dogs and cats should be treated with medications to kill fleas and ticks. Care
should be taken to administer treatments that are safe for that particular
species of animal (i.e. not all treatments that are safe for dogs are safe for
cats).
furred or feathered pets should be housed in areas separate from people with
allergies or asthma triggered by fur, feathers, or dander.
cats should be kept in a cage with a litter box that is cleaned frequently (at
least once every 24 hours). Pregnant women or immunocompromised people
should not have contact with used litter.
dogs should be walked regularly on a leash outside the centre to allow them
to urinate and defecate in designated areas. Any faeces should be
immediately collected and disposed of.
anyone bitten by an animal should speak with a healthcare provider to discuss

associated concerns (e.g. tissue trauma, infection). Bites and scratches
should be thoroughly cleaned with soap and water.
people caring for pets in evacuation centres should practice good hygiene by
cleaning up after their pets (e.g. disposal of faeces) and frequently washing
their hands.
children younger than 5 years old should not handle reptiles without adult
supervision, and should always wash their hands after doing so. Hand
washing should be monitored by an adult.
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6. Control of communicable diseases

Any evacuation centre can provide a focus for the ready communication of infectious
diseases. Good infection control, plans for effective sanitation, careful attention to
food handling and storage and plans for the isolation of people with infectious
disease can mitigate the risk of a large-scale infectious disease outbreak.
Evacuation centres may have limited capacity for providing sanitary and food
preparation facilities. Bathing and laundry resources are also likely to be limited.
People should be discouraged from preparing food or laundry on-site as this may
lead to unsanitary conditions.
The centre staff should ensure that appropriate hygiene and cleaning facilities are
available. They should be are aware of the procedures required to manage a person
with a potentially infectious disease. Public health services may need to provide
advice or basic training of this topic.
Posters should be developed emphasising the importance of hand hygiene and safe
food handling and what people should do if they become ill. These posters should
be placed in prominent positions in the evacuation centre.
In areas that have been flood-affected there is an increased chance of wound
contamination. Residents should be encouraged to clean wounds appropriately.
Where puncture or other contaminated wounds have occurred people should have
their tetanus vaccination status assessed and be immunised if their vaccination is
not up to date or unknown.
Numbers of mosquitoes can increase significantly following floods in warmer months.
Control measures should ensure that water holes or containers capable of holding
water are regularly checked for evidence of mosquito breeding.
Where mosquitoes are present, evacuees and staff should be provided with an
adequate insect repellent containing DEET or picaridin and given instructions
regarding effective use (e.g. re-application in hot weather) and advised to wear loose
fitting clothing and footwear. Mosquito netting may be required in some situations
(e.g. if entrances to accommodation areas cannot be effectively screened with
mesh).
6.1 Vaccinations
The organisation of a vaccination campaign requires good management ability and
technical knowledge. Responsibilities for each component of the vaccination
program need to be explicitly assigned to agencies and persons by the health
coordination agency. NSW Public Health Units are experienced in setting up
vaccination clinics and managing the need for vaccination.
There is no predefined list of vaccines for any single emergency and vaccination
programs should consider each person individually, in the context of the presenting
situation. Routine vaccines should be considered first. If possible, all evacuees
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should be up-to-date with current standard vaccine recommendations. Further

vaccines should be considered according to the presenting risk.
It is also important to document vaccines appropriately, not only in the clinics record
but also in a suitable record that can be carried by the evacuee.
Full vaccination recommendations are available on the Immunise Australia Program
website at http://www.immunise.health.gov.au/ or phone 1800 671 811.
6.2 General infection control for evacuation centres

Use of appropriate infection control measures by all staff/volunteers and evacuees
can reduce the spread of infectious diseases.
Encourage good personal hygiene practices by adopting the following:
covering coughs with tissues, disposing of tissues in the garbage after one
use
washing hands or using alcohol-based hand cleanser after coughing, after
going to the toilet and before eating
providing tissues and rubbish bins in evacuation centre living areas.
preparing food hygienically.
not sharing eating utensils or drinking containers
not sharing personal care items such as combs, razors, toothbrushes, or
towels
having sharps disposal containers available.
6.3 Management of people with infectious diseases in evacuation

centres
The arrival of people who may have symptomatic infections, and/or unrecognised or
incubating infectious diseases, combined with potential for crowding and limited
sanitary infrastructure, increases the risk of infections spreading among residents
and between residents and staff. This is particularly true of respiratory infections and
diarrhoeal diseases. Before entering an evacuation centre, all residents should be
requested to report the following conditions:
fever
cough (new or changed)
vomiting
diarrhoea
rash.
People with any of the above conditions should be admitted to the evacuation centre
only after appropriate medical evaluation and care. Evacuation centre staff should
be actively and regularly asking residents of the centre about the presence of above
syndromes in order to identify illness. Residents of the centre should be instructed
to report any of the above conditions to the centre staff, who should consult health
authorities in a timely fashion.
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Evacuation centre staff with any of the above symptoms should not work in the
centre, but should seek medical evaluation by their own GP where available for
assessment and clearance prior to returning to work.
If a communicable disease is identified in a person already residing at the centre, the
ill individual(s) should be separated from other residents or transferred to a special
accommodation centre or sick bay (see section 6.5). A separate area or room to
house potentially infectious people should be identified in advance. If several people
with similar symptoms are identified, they may be housed together in one area.
However, beds should be separated by at least 2m and preferably screened. A
dedicated toilet facility should be identified and reserved for use of the ill individuals
only.
More than one separate area may be needed if more than one illness is identified in
the population, for example, an area for people with diarrhoea and another area for
people with a cough and fever. Such separate areas will need to have extra health
staff dedicated to monitoring people housed there and ensuring that the area is kept
clean and appropriately supplied.
Each evacuation centre should have a clear plan for transferring individuals with
potentially infectious diseases from the centre to an appropriate sick bay, either
within the centre or nearby. The sick bay should ideally be a room where the sick
person can be isolated. Ill individuals with respiratory symptoms should wear a
surgical mask if in close proximity to others while awaiting evaluation or transfer. A
waiting area should be designated that is separate from the main centre living areas,
but which can be closely monitored by centre staff. A system for identifying and
notifying the receiving sick bay must be in place.
Centre staff working with people who have symptoms of illness should use Standard
Precautions (defined in section 6.4) for any interactions that require potential
contact with body fluids, and should place particular emphasis on hand hygiene.
The use of Standard Precautions aims to protect residents and staff from exposure
to recognised and unrecognised sources of infection.
6.4 Standard Precautions (summary):

During the care of any ill individual, personnel should:
wear gloves if hand contact with blood, body fluids, respiratory secretions
or potentially contaminated surfaces is expected
wear a disposable gown if clothes might become soiled with a patients
blood, body fluids or respiratory secretions
change gloves and gowns after each patient encounter and wash hands or
use alcohol-based hand cleanser immediately after removing gloves
wash hands or use alcohol-based hand cleanser before and after touching
a patient, after touching the patients environment, or after touching the
patients respiratory secretions, whether or not gloves are worn
when hands are visibly dirty or contaminated with respiratory secretions,
wash hands with soap (either plain or antimicrobial) and water
cover any cuts or sores prior to patient care
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6.5
wear a mask and protective eye wear if there is a risk of splash of bodily
fluids.
Sick bays/special temporary accommodation centres
There will be circumstances where a person becomes unwell and does not require
hospital-level care, but does require a separate room because of the nature of the
disease or because of the potential to infect others. Public health services should be
prepared to make recommendations for the appropriate placement of affected
people, noting that people in this situation only need the level of care that family or
friends would usually provide.
It is strongly recommended that such facilities are planned for and that centre staff,
some with health care experience (e.g. registered nurses) who are willing to care for
sick people are identified.
A clear referral pathway to hospital care (if required) and for reporting disease
outbreaks should be made available during the accommodation planning.
Provision should be made to accommodate at least up to 2% of people in this
fashion. This is an estimate based on the prevalence of infectious diseases during
the winter period in the population. However, in a closed environment the
prevalence is likely to be higher and greater space may be required should an
outbreak occur.
6.6 Outbreak control

Sampling materials and transport media for the infectious agents most likely to cause
a sudden outbreak should be available on-site. If rapid tests are available (e.g. for
influenza in influenza season) they should also be stored locally.
When a communicable disease outbreak is suspected amongst the residents, public
health staff designated as responsible for the site or the public health controller (if
there are no on-site staff) should be immediately informed.
Case definitions and thresholds for notification should be developed and the health
care clinics providing care for those in the centre informed of the notification protocol.
If a source is suspected that source must be controlled (e.g. toilet facilities, food
preparation area, ventilation).
Susceptible groups (e.g. those who are unimmunised or who have incomplete
immunisation, the very young, and the very old) may need particular protection. This
may be in the form of vaccination or chemoprophylaxis, where this is available. A
record of those receiving interventions should be kept.
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7. Control of non-communicable diseases/chronic illness

management
7.
Injury
The HIS should identify any injuries related to the evacuation centre and injury
prevention programs implemented to minimise the risk of injury in evacuees.
7.2 Chronic diseases

Many people with chronic diseases may have acute exacerbations or significantly
worsen if regular care is not provided. Consideration should be given to the
continuous needs of those with health conditions that require intensive treatment in
the home (e.g. peritoneal dialysis, access to continuous positive airway pressure
devices).
The displaced population should be encouraged to continue to undertake their
routine chronic disease management through appropriate education campaigns.
Appropriate essential medications should be available on-site.
Sharps disposal should be made available in private areas. Persons requiring the
use of sharps in their disease management should be made aware of appropriate
sharps disposal in the centre.
Exacerbations of chronic diseases should be carefully monitored for in the HIS and
steps taken to manage any increase in presentations over that expected.
7.3 Reproductive health

Pregnant women will require continuing antenatal care. Collecting information
regarding the number of women who may be pregnant in the centre will be
important. If a large-scale vaccination campaign is to be conducted, it is important to
identify pregnant women who should not undergo vaccination.
In the aftermath of Hurricane Katrina it was recognised that in addition to the health
care needs of women who are already pregnant, health care needs of women who
wish to avoid an unintended pregnancy are also important. Women may not have
access to their preferred contraceptive method, hence health planning should
consider strategies for providing access to contraception, including methods
requiring a prescription ix.
If infants are born in the centre then connection to usual health services for the
mother and baby should be prioritised. This includes the newborn screening
program.
Steps should be taken to prevent and manage the consequences of gender-based
violence with assistance from partner agencies as appropriate. The number of
incidents of gender-based violence should be carefully monitored.
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8. Hygiene promotion
A hygiene promotion campaign should be established within the centre. This is
something that should be included in the evacuee induction.
8.1 Hand hygiene

It is important for residents to wash their hands regularly and to dry them with a
paper towel to avoid illness. Staff and residents should wash their hands with soap
and running water for at least 10 seconds, after using the toilet and before handling
food. Alcohol-based hand cleanser is an effective addition to hand washing and a
reasonable temporary substitute when soap and clean water are not readily
available.
Evacuation centres are likely to have limited availability of and/or accessibility to
sinks for hand washing. Thus, additional attention should be paid to positioning
alcohol-based hand cleanser dispensers in convenient locations such as the
entrance to the facility, throughout the living areas (depending on the size of the
venue), at the beginning of food service lines and in toilet facilities. Ensure that all
arriving residents are instructed on their use and availability.
Hand hygiene messages are provided in Appendix one. A sample poster is also
provided for information.
9. Returning home information

When it is time for people to return home after a cyclone, flood, or other natural
disaster, public health services should be prepared to provide information and
guidance in order to reduce the probability of illness, disease or injury to individuals
and families from hazards resulting from the disaster x .
The criteria for evacuees returning home may include:
the incident is under control and not expected to escalate
residential premises are considered safe by the relevant authorities or if
considered unsafe, evacuees are transferred to longer-term accommodation
information has been provided to evacuees on the current situation and
actions to take regarding recovery from the incident (e.g. clean up information,
safety precautions, utilities supply)
Information and advice about whom to contact if any ill health effects develop
(e.g. Healthdirect, General Practitioner, local hospital).
Specific assistance and advice may be required for people with existing illness or
injuries prior to returning home, such as:
adequate prescription medication supply and storage facility (e.g. insulin and
refrigeration)
specific medical equipment (e.g. blood glucose monitor, oxygen cylinders,
bandages)
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10. APPENDICES
Appendix one - Hand hygiene
It is best to perform handwashing with soap and running water but, when water isnt readily available,
you can use alcohol-based hand cleanser made for cleaning hands. Below are some tips for washing
your hands with soap and water and with alcohol-based hand cleanser.
When should you wash your hands or use an alcohol hand gel?
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Before eating food or handling food for others

After handling uncooked foods, particularly raw meat, poultry, or fish*
After going to the toilet
On entry to any food preparation or consumption area
After changing a nappy or cleaning up a child who has gone to the bathroom
Before and after tending to someone who is sick
Before and after treating a cut or wound
After blowing your nose, coughing, or sneezing
After handling an animal or animal waste
After handling garbage
*Food handlers should wash hands with soap and water before beginning work, and before returning
to work from any toilet visit or break. Alcohol-based hand cleanser should not be substituted for food
handlers.
Note: NSW Health has a range of posters and factsheets regarding handwashing, infection control
and cough etiquette available for downloading and printing on the website
www.health.nsw.gov.au
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Appendix two - Sample health promotion materials

from the Centre Disease Control and Prevention
available at: http://emergency.cdc.gov/disasters/evaccenters.asp
Guidelines for Evacuation Centre Play Areas
Children with symptoms of contagious diseases, such as vomiting, diarrhoea, fever, cough, draining skin
sores, rash should not be allowed in common play areas until they are no longer considered infectious, as per
medical advice.
Children and parents should wash their hands with soap and water or clean their hands with antiseptic hand
gel before entering and when leaving the common play area.
Toys used in play areas should be made of smooth solid surfaces that can be easily cleaned and disinfected.
Avoid toys with small pieces and crevices and those made of fabric fur.
Donations of stuffed animals or other toys that cannot be cleaned and disinfected should be accepted only if
they are new and then should be distributed to individual children to keep and not kept in common play areas
to be shared.
Toys should be cleaned and disinfected at least three times a day. In addition, they should be cleaned
immediately if they are soiled with vomit, stool, or other body fluids.
How to clean and disinfect toys
Clean off visible dirt with soap and water.
Spray the toys with disinfectant and allow the disinfectant to remain in contact with the toy for one minute, then
wipe off.
Toys that are likely to be mouthed by infants and toddlers should be rinsed with clean tap water after they are
disinfected.
These simple precautions can keep
our guests from getting infections.
Recommendations from the US Center for Disease Control and Prevention
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Please help protect the health of your

baby and others by keeping this station
clean!
1) Place clean paper towels on station surface.
2) Set your baby on the towels, then remove soiled
clothing and nappy.
3) Clean your baby and throw soiled wipes, nappy and
used paper towels into garbage bin. Placed soiled
clothing into a plastic bag.
4) Clean your hands with wipes and throw these into
garbage bin.
5) Put a fresh nappy and clothes on your baby.
6) Remove baby from station area and wash his/her
hands.
7) Clean soiled areas of station with wipes and throw
these into garbage bin.
8) Spray station surface with disinfectant solution and
allow to air dry.
9) Wash your hands thoroughly with soap and water, or
use a waterless hand gel.
Recommendations from the US Center for Disease Control and Prevention
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WASH YOUR HANDS

After a disaster, staying clean can be hard to do. You may not
have running water. But staying clean helps you stay healthy.
Things you can do to stay clean and healthy

Wash your hands with soap and clean water. If you dont have
soap and water, you can use alcohol-based hand cleaners.
Wash your hands many times each day.
Times to wash your hands are
Before
Making food
Touching a sick person
Touching a cut, sore or wound
After
Using the bathroom

Blowing your nose, coughing or
sneezing
Touching things that may carry
germs, like:
- Nappies or a child who has
used the toilet
- Food that is not cooked (raw
food)
- Animals or animal waste
- Garbage, garbage bins
- Things touched by flood water
- A sick person
- Cuts, sores and wounds
Recommendations from the Centres for Disease Control and Prevention
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Hand Hygiene Cards
Developed 9/8/05 by the US Center for Disease Control and Prevention:

www.bt.cdc.gov/disasters/hurricanes/handwashing.asp
To be passed out with alcohol-based hand cleanser in the evacuation centre
Suggested printing front/back on 4 x 6 cards
Clean Hands Save Lives
When should you wash your hands?
Keeping hands clean is one of the most important steps we

can take to avoid getting sick and spreading germs to others.
It is best to wash your hands with soap and clean running
water for 20 seconds.
Before preparing food
After going to the bathroom
After changing nappies or cleaning up a child who
However, if soap and clean running water are not available,

use an alcohol-based hand cleanser to clean your hands.
Alcohol-based hand cleansers significantly reduce the number
of germs on skin and are fast acting.
When using an alcohol-based hand cleanser:
Apply cleanser to the palm of one hand

Rub hands together
Rub the product over all surfaces of hands and
fingers until hands are dry.
has gone to the bathroom
Before and after tending to someone who is sick
After blowing your nose, coughing or sneezing
After handling an animal or animal waste
After handling garbage
Before and after treating a cut or wound

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Fact Sheet
Recommendations for Persons Undergoing Blood Glucose Monitoring in Evacuation Centres for the Prevention of
Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus Transmission
Regular monitoring of blood glucose levels through the use of fingerstick devices and portable glucose meters is an
important component of routine diabetes care. Adherence to Standard Precautions, as well as specific infection control
recommendations targeting diabetic care procedures in group residence settings is needed to prevent the transmission of
hepatitis B virus, hepatitis C virus, and human immunodeficiency virus.
The following recommendations can prevent diabetics and other evacuation centre residents from acquiring infections with
bloodborne pathogens.
Diabetes Care Procedures and Techniques
Prepare medications such as insulin in a centralised medication area; multiple-dose insulin vials should be
assigned to individual residents and labelled appropriately
Never reuse needles, syringes or lancets
Ensure a separate fingerstick blood sampling device is available for each affected resident. Consider selecting
single-use lancets that permanently retract upon puncture
Dispose of used fingerstick devices and lancets at the point of use in an approved sharps container
Environmental surfaces such as glucose meters should be decontaminated regularly and any time that
contamination with blood or body fluids occurs or is suspected
Ideally a separate glucose monitoring device should be assigned to each individual resident with insulindependent diabetes. If a glucose meter that has been used for one resident must be reused for another resident,
the device must be cleaned and disinfected with 1:10 dilution household bleach and clean water
Do not carry supplies and medications in pockets
Because of possible inadvertent contamination, unused supplies and medications taken to a residents bedside
during fingerstick monitoring or insulin administration should not be used for another resident.
Hand Hygiene and Gloves
Wear gloves during fingerstick glucose monitoring, administration of insulin, and during any other procedure that
involves potential exposure to blood or body fluids
Change gloves between resident contacts. Change gloves that have touched potentially blood-contaminated
objects or fingerstick wounds before touching clean surfaces
Remove and discard gloves in appropriate receptacles after every procedure that involves potential exposure to
blood or body fluids, including fingerstick blood sampling
Perform hand hygiene (i.e. hand washing with soap and water or use an alcohol-based hand cleanser)
immediately after removal of gloves and before touching other medical supplies intended for use on other
residents.
Other Considerations
Review regularly the individual residents schedules for fingerstick blood glucose sampling and insulin
administration and reduce the number of percutaneous procedures to the minimum necessary for appropriate
medical management of diabetes and its complications
Assure that adequate staffing levels are maintained to perform all scheduled diabetes care procedures, including
fingerstick blood glucose monitoring
Consider the diagnosis of acute viral hepatitis infection in residents who develop an illness that includes hepatic
dysfunction or elevated aminotransaminase levels (AST or ALT).
Recommendations from the US Center for Disease Control and Prevention. If more information is required, please
see http://www.cdc.gov/ncidod/diseases/hepatitis/mmwr.htm#diabetes .
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State Logo
ENVIRONMENTAL HEALTH ASSESSMENT FORM FOR CENTRES

For Rapid Assessment of Centre Conditions during Disasters
I. ASSESSING AGENCY DATA

Agency /Organization Name
90Immediate Needs Identified: Yes No
2Assessor Name/Title
3Phone:
4Email or Other Contact:
II. FACILITY TYPE, NAME AND CENSUS DATA

5Centre Type Community/Recovery Special Needs Other _________________6ARC Facility Yes No Unk/NA 7ARC Code ____
8Date Centre Opened __ __ /__ __/__ __ (mm/dd/yr) 9Date Assessed __ __ /__ __/__ __ (mm/dd/yr) 10Time Assessed __ __ : __ __
11Reason for Assessment Preoperational Initial Routine Other
12Location Name and Description
13Street Address
14City / County
15State
20Phone
16Zip Code
17Latitude/Longitude
19Facility Type School Arena/Convention centre Other
18Facility Contact / Title

21Fax
22E-mail or Other Contact
23Current Census _________ 24Estimated Capacity ___________25Number of Residents _________26Number of Staff / Volunteers ________
III. FACILITY
27Structural damage
Yes No Unk/NA
28Security / law enforcement available

29Water system operational
30Hot water available
31HVAC system operational
32Adequate ventilation
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
33Adequate space per person

34Free of injury /occupational hazards
35Free of pest / vector issues
36Acceptable level of cleanliness
37Electrical grid system operational
38Generator in use, 39 If yes, Type
40Indoor temperature _________ degrees C
IV. FOOD
41Preparation on site
42Served on site
43Safe food source
44Adequate supply
45Appropriate storage
46Appropriate temperatures
47Hand-washing facilities available
48Safe food handling
49Dishwashing facilities available
50Clean kitchen area
V. DRINKING WATER AND ICE
51Adequate water supply
52Adequate ice supply
53Safe water source
54Safe ice source
VI. HEALTH / MEDICAL
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
VIII. SOLID WASTE GENERATED

66Adequate number of collection
receptacles
67Appropriate separation
68Appropriate disposal
69Appropriate storage
70Timely removal
71Types
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Yes No Unk/NA
Solid Hazardous Medical
Unk/NA
IX. CHILDCARE AREA

72Clean nappy changing facilities
Yes No Unk/NA
73Hand-washing facilities available
Yes No Unk/NA
74Adequate toy hygiene
Yes No Unk/NA
75Safe toys
Yes No Unk/NA
76Clean food/bottle preparation area
Yes No Unk/NA
77Adequate child/caregiver ratio
Yes No Unk/NA
Yes No Unk/NA
X. SLEEPING AREA
79Adequate number of cots/beds/mats
Yes No Unk/NA
80Adequate supply of bedding
Yes No Unk/NA
81Bedding changed regularly
Yes No Unk/NA
82Adequate spacing
Yes No Unk/NA
Yes No Unk/NA
XI. COMPANION ANIMALS
84Companion animals present
Yes No Unk/NA
85Animal care available
Yes No Unk/NA
86Designated animal area
Yes No Unk/NA
Yes No Unk/NA
XII. OTHER CONSIDERATIONS
88Handicap accessibility
Yes No Unk/NA
89Designated smoking areas
Yes No Unk/NA
COMMENTS (List Critical Needs on Immediate Needs Sheet)
55Reported outbreaks, unusual illness / injuries

Yes No Unk/NA
56Medical care services on site
Yes No Unk/NA
57Counseling services available
Yes No Unk/NA
VII. SANITATION
58Adequate laundry services
Yes No Unk/NA
59Adequate number of toilets
Yes No Unk/NA
60Adequate number of showers
Yes No Unk/NA
61Adequate number of hand-washing stations
Yes No Unk/NA
62Hand-washing supplies available
Yes No Unk/NA
63Toilet supplies available
Yes No Unk/NA
Yes No Unk/NA
65Sewage system type Community On site Portable Unk/NA
XIV. IMMEDIATE NEEDS SHEET
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Item #
Description
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Appendix four - References

i
The Sphere Project (2004). Humanitarian Charter and Minimum Standards in

Disaster Response. Accessed 7 April 2011 online at http://www.sphereproject.org
ii
Emergency Management Australia (2005). Evacuation Planning. Accessed 7 April

2011 online at
http://www.ema.gov.au/agd/EMA/rwpattach.nsf/VAP/(A80860EC13A61F5BA8C1121
176F6CC3C)~AEM_11_EvacPlan.pdf/$file/AEM_11_EvacPlan.pdf
iii
Hanna J (1996). Draft Guidelines for the planning and operation of emergency
reception centres and shelters. Emergency Preparedness Canada, August 1996
iv
Center for Disease Control and Prevention (CDC) (2011). Information for Disaster
Evacuation Centers. Accessed 7 April 2011 online at
http://www.bt.cdc.gov/disasters/evaccenters.asp
v
M Brodie et al. (2006). Experiences of Hurricane Katrina Evacuees in Houston

Shelters: Implications for Future Planning Am J Public Health. 2006;96:
doi:10.2105/AJPH.2005.084475
vi
The Sphere Project (2011). Humanitarian Charter and Minimum Standards in

Disaster Response. Accessed 20 July 2011 online at http://www.sphereproject.org
vii
NSW Department of Health (2011) Your Rights and Responsibilities PD2011_022.

Accessed 1 July 2011 online at
http://www.health.nsw.gov.au/policies/pd/2011/PD2011_022.html
viii
Cancer Council NSW (2011). Smoking in the workplace. Accessed 7 April 2011 at
http://www.cancercouncil.com.au/editorial.asp?pageid=394
ix
Callaghan W.M. et al. (2007). Health concerns of women and infants in times of
natural disasters: Lessons learned from Hurricane Katrina. Maternal Child Health
J.11(4):307-311
x
Centre for Disease Control and Prevention (CDC) (2005) Clean up after a natural
disaster. Accessed 13 April 2011 online at
http://www.bt.cdc.gov/disasters/hurricanes/educationalmaterials.asp#cleanup
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Appendix five - Additional resources

Australian Government Attorney-Generals Department Emergency Management in
Australia available at http://www.ema.gov.au/
Canadian Centre for Emergency Preparedness available at http://www.ccep.ca/
Health Protection Agency (UK) available at http://www.hpa.org.uk/
New South Wales Department of Health website available at
http://www.health.nsw.gov.au/
New South Wales Government Emergency Management New South Wales
available at http://www.emergency.nsw.gov.au/home.html
The Sphere Project Humanitarian Charter and Minimum Standards in Disaster
Response available at http://www.sphereproject.org/
United States of America Centre for Disease Control (CDC) available at
http://emergency.cdc.gov/disasters/evaccenters.asp
World Health Organisation (WHO) available at http://www.who.int/en/
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Evac - Health Consideration

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Guideline

Department of Health, NSW

Major Evacuation Centres: Public Health Considerations

MAJOR EVACUATION CENTRES: PUBLIC HEALTH

USE OF THE GUIDELINE

Issue date: August 2011

Major Evacuation Centres: Public Health

response to emergencies by all agencies having responsibilities and functions in

Issue date: August 2011

MAJOR EVACUATION CENTRES:

Issue date: August 2011

Major Evacuation Centres: Public Health

Issue date: August 2011

Major Evacuation Centres: Public Health

Issue date: August 2011

Major Evacuation Centres: Public Health

1.1 Who uses emergency centres?

2. Health information systems

2.2 Health surveillance

Issue date: August 2011

Major Evacuation Centres: Public Health

3.2 Areas required

Issue date: August 2011

Major Evacuation Centres: Public Health

3.3 Physical space and air circulation

3.4 Safety, privacy, rights and responsibilities

Issue date: August 2011

Major Evacuation Centres: Public Health

3.5 Water requirements

In an absolute emergency 7L per person per day of water should be provided.

Issue date: August 2011

Major Evacuation Centres: Public Health

3.6 Personal hygiene

3.7 Mud/disinfecting area

Issue date: August 2011

Major Evacuation Centres: Public Health

3.9 Cleaning of living areas

3.10 Recreation area

Issue date: August 2011

Major Evacuation Centres: Public Health

located outdoors, clearly designated and well-ventilated with no possibility that

Should it be decided to establish a designated smoking area, advice should be

3.12 Laundry (where available)

3.13 Garbage (solid waste management)

Issue date: August 2011

Major Evacuation Centres: Public Health

sponges and scourers should be washed daily or discarded and replaced

4.2 Serving food

Issue date: August 2011

Major Evacuation Centres: Public Health

4.3 People with special dietary needs and allergies

5. Pets and public health

if a pet is kept at a human evacuation centre, it should not be allowed to freely

animals must be kept out of food preparation areas.

Issue date: August 2011

Major Evacuation Centres: Public Health

anyone bitten by an animal should speak with a healthcare provider to discuss

Issue date: August 2011

Major Evacuation Centres: Public Health

6. Control of communicable diseases

Issue date: August 2011

Major Evacuation Centres: Public Health