Impact of Natural Disasters on Health: A Case Study of Black Saturday Bushfire in Victoria

This paper examines the health impact of the Black Saturday Bushfire in Victoria and the interventions employed by nurses in rural and remote areas to promote recovery.

Running head: NURSING

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Every year, millions of people throughout the world, are affected by the man-made
and natural disasters. Forest fire, bushfire, wildfire, hurricanes, tornados, earthquakes and
heavy rainfalls cause more than 1000 casualties along with fatal injuries and loss of property
(Reid et al., 2016). The relationship between the natural disaster and human health has been
suggested for centuries. The natural disasters have significant impact on the overall lifestyle
and health related quality of life of the populations residing in the area that are prone to
natural disasters like volcanic eruption, earthquakes or forest fire. The main impact of the
natural disaster include detal, fatal injuries leading to extensive damage to human health,
damage to the water bodies, healthcare facilities, increase threat towards famine alone with
high prevalence of communicable diseases like an epidemic (Reid et al., 2016). When the
humanitarian and natural disasters crises strike, the affected communities is devastated and is
left vulnerable. The following paper will attempt to highlight the impact of health related
outcomes over the community in response to a natural disaster that was occurrence within
past 20 years in Australia. The paper will mainly focus on the Black Saturday Bushfire in
Victoria (2009). After analysis of the health impact of the bushfire, the paper will include
relevant discussion of the interventions employed by the nurses in the rural and the remote
areas affected by bushfire in order to promote fast recovery of the health. Overall the paper
will highlight the natural disasters and health outcomes while emphasizing on the importance
of nurse role in management of adverse health impact.
As Australian disaster with took place with the past 20 years and created a significant
health impact is Black Saturday bushfire in Victoria. The Black Saturday fires started on
2009, 7th of February. Approximately a total of 400 different bush fire outbreaks occurred in
Victoria that affected nearly 78 communities. The total death penalty amounted to 173 people
and with a loss of 2029 dwelling houses. A significant number of community dwelling people
experienced significant loss of their life and priced possession as a result of this bush fire.

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The main affected region of Victoria includes Beechworth, Churchill, Narre Warren,
Bendigo, Horsham, Redesdale, Bunyip, Kinglake and Upper Ferntree Gully. More than
19,000 Country fire Authority (CFA) employees were deployed for battling against the
bushfire outbreak. The Offices from the Victorian Department of Sustainable communities
were also involved in the process of recovery. The government of Australia also took
significant steps in the recovery management for the forest fire by giving a funding of $30
million. $5,000 grants are given to the people who lost their homes and $10,000 grants were
provided to the bereaved families (Australian Institute Disaster Resilience, 2019).
The wildfire lead to the development of several adverse health-related impacts along
with a destruction of vegetation and properties. Wildfires are uncontrolled fires occurring in
forests in the vegetative areas. This fire spreads rapidly and it is difficult to control. Liu,
Pereira, Uhl, Bravo and Bell (2015) are of the opinion that the apart from the significant
environmental impact of the forest fire, the health of the people residing in the areas that have
experienced a massive bushfire is also affected negatively. Cascio (2018) highlighted in their
study that smoke evolved during the outbreak of the bush fire is rich in carbon dioxide,
carbon mono-oxide, water vapour, particulate matter, organic chemicals, hydrocarbons,
nitrogen oxides and other trace elements. The composition of the wildfire smoke mainly
varies depending upon the temperature of the fire and wind condition. The main component
that is alarming smoke coming from the wild fire is the particulate matter (PM). Exposure of
PM that is generated during the wildfire is associated with adverse health effects like
wheezing, coughing, sore eyes, sore throats along with the development of the shortness of
breath. Constant exposure of thick smoke fire evolving from bush fire outbreak is also
associated with negative health outcomes like the asthma-related hospitalizations, acute and
chronic respiratory failure and negative cardiovascular health-related outcomes (Liu, Pereira,
Uhl, Bravo & Bell, 2015).

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Study conducted by Liu, Pereira, Uhl, Bravo and Bell (2015) highlighted that main
impact of the bushfire is Australia is generation of acute respiratory problems like acute
asthma among the children and the older adults. The smoke fire is filled with high
concentration of particulate matter (PM) like PM2.5 and PM10 micrometer penetrates inside
the lungs leading to the generation of the respiratory and breathing problems. Chronic
respiratory and breathing problem (COPD: Chronic Obstructive Pulmonary Disease) was
associated with decreasing the oxygen saturation while increase in respiratory rate (laboured
breathing). Apart from the respiratory problems, the smaller particles PM 2.5 microns gets
absorbed into the blood stream and thereby triggering adverse cardiovascular health effects
mainly among the older adults who are suffering from hypertension and other cardiovascular
diseases. This increased the overall cardiovascular mortality rate in Victoria Australia by 5%
after the outbreak of the bush fire (Ranse, Lenson & Aimers, 2010). Heat stress was another
significant health impact of the bush fire outbreak in the Victoria. Adeton et al. (2016) stated
that radiant heat is one of the biggest killer in the bush fire outbreak. People who are exposed
to the radiant heat of the bush fire, developed heat stress leading to the significant increase in
the body temperature, damage of skin (burning sensation over skin), dizziness, weakness and
fatigue. The children mainly have a sensitive skin and thus adverse impact over the children
was higher than the adults. Few children exacerbated symptoms like vomiting and rapid
breathing as an impact of heat stress. Additional health effects of the bush fire were itchy
skin, runny nose and irritation or redness of eyes (Doerr & Santín, 2016). Apart from the
physical health, the outbreak of the bushfire in Victoria Australia also resulted in the
development of mental health consequences and mental health consequences resulted in the
development of long term affect on health. Massive loss of property or sudden losses of the
near and dear ones are the reason behind the development of the mental health complications
like depression and anxiety (Ranse & Lenson, 2012).

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Remote and rural area nurses play an important role in the disaster management. It is
the role of the nurses working in the remote and in the rural areas to educate the public about
the consequences of the disaster along with the self-management interventions. The main role
of the nurses played in the rural or the remote areas affected by disaster include triage,
trauma-care, effective control of infection, command communication, reduction of the health
risk, long-term recovery process, health promotion policy and giving leaderships for the
effective management of health during disaster (Kulig, Edge & Smolenski, 2014).
Interventions given by the nurses for the management of the health impact of the
bushfire were diverse. The interventions that is used for the effective management of
asthmatic attack experienced by the children and the older adults is administration of the
inhalers along with the external supply of oxygen with the help of the nasal canulla. The
adults whose asthmatic exacerbations were not severe, facial masks were used in order to
prevent the entry of the PM rich air inside the lungs (Ranse, Lenson & Aimers, 2010). Teach
et al. (2015) stated that omalizumab or an inhaled corticosteroid boost helps to reduce the
severe exacerbations of the asthmatic attack during the natural disaster or air pollution
affected individuals. The paper also highlights the importance of the external supply of
oxygen in a Fowler’s position in order to increase oxygen saturation within the body (SpO2:
96 to 99%). However, since the people residing in the remote and in the rural areas lack
effective knowledge for the disease management. Health literacy might have been adopted in
order to promote long-term management of asthma in disaster-affected areas. Thornton et al.
(2016) stated that implementations of asthma counseling might serve as a guide for effective
management of chronic asthma under resource-poor settings.
Heat shock leads to increased in the body temperature of an individual and thereby
causing increased rate of breathing along with the generation of dizziness. The nursing
interventions for the effective management of the burning sensation and heat shock

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developed as a result of the constant exposure of the heated smoke coming from the wildfire
include comforting the skin with cool clothing in order to reduce the hypothermic effect of
the skin and the body (Lewis, Dirksen, Heitkemper, Bucher & Camera, 2015). The nurses
operating in the rural areas of the Vitoria during the outbreak of the bushfire was not
equipped with adequate thermal clothing due to the effective management of the heat shock
of the body. The approaches used by the nurses during that time recommendation of the cool
diet plan under the supervision of the trained dietician. This was followed by the external
supply of isotonic solution in order to maintain the fluid balance of the body and thereby
helping to reduce the stress of heart shock (Martin, 2009). Lewis, Dirksen, Heitkemper,
Bucher and Camera (2015) stated that as per the evidence-based practice in nursing, heat
shock results in the dehydration or loss of fluid balance in body. The effective interventions
for the management of heat shock as per the nursing guidelines include maintenance of the
strict balance within the body through oral and intravenous supply of fluid along with
measurement of the fluid output through sweat and urine. For the management of the burn
sensation of the skin cooling ointment was used (Martin, 2009). highlighted in their study that
as per the evidence-based practice the main cooling ointment that can be used for
management of the burning sensation of the skin is alovera gel and petroleum jelly along with
local application of silver sulphadiazine cream (Shahzad & Ahmed, 2013). However, Martin
(2009) highlighted in their report that large number of burnt related casualties in the Victoria
during 2009 after the outbreak of the fire generated a scarcity of the petroleum jelly and the
alovera gel in the healthcare centres.
Pena and Rollins (2017) stated that targeted interventions ate required to be
undertaken in order to reduce the cardiovascular disease complications among the mass who
are exposed for a prolong period of time over the polluted smoke filled air that is rich in the
particular matter. The immediate interventions that is used to reduce the risk of

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cardiovascular disease include external supply of oxygen for the purification of the oxygenate
blood along with effective management of the increased cardiac output by the use of the
antihypertensive pills. Under the Victorian set-up during 2009, there were no specific
interventions followed for the management of the cardiovascular disease threat apart from the
external supply of oxygen (Martin, 2009).
Ranse and Lenson (2012) stated that it is acknowledged that nurses who are assigned
to work under the rural and remote settings during the bush fire outbreak in Victoria 2009
acted as a psychological supporter in order to assist the depressive state of mind of the
victims of the bush fire. Proper psychological counseling helped in promoting comprehensive
health and well-being. However, Ranse and Lenson (2012) further recommended that it is
important to educate the nurses through awareness program to inform them about the realities
of working in disaster affected communities.
In remote areas there are less availability of resources and hence numerous barriers
are experienced by the rural and remote area nurses in Australia. The rural nurses working for
the disaster management in Australia during the outbreak of the bushfire experienced
significant challenges like limited physical and personal resources in the in the rural hospitals
or healthcare centres. The limited resources delayed the overall process of health recovery
and at the same time increased the burden over the existing nursing professionals.
Communication systems between the emergency responders, government and police
operating under the rural settings of Australia were unpredictable due to poor weather
condition and thereby delaying the overall health recovery management. Thus overall it can
be said that the clinical skills required in the disaster management surpassed the experience
and overall skill of the rural area nurse (Kulig, Edge & Smolenski, 2014).

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Thus from the above discussion, it can be concluded that main health impacts of the
victims of the bush fire that occurred in Victoria during 2009 is chronic obstructive
pulmonary disease, cardiovascular disease and heat shock. The exposure smoke filled air with
PM is the reason behind the development of the related consequences. The main nursing
interventions that are used by the nursing professionals for the management of the health
consequences were external supply of oxygen for management of asthmatic attack among
children and older adults and other cardiovascular complications. For the management of heat
stroke, external supply of fluid (isotonic) was provided.

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