gizi fk ub -...

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GIZI FK UB

Malang, 24 01 2014

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Bencana : Peristiwa atau rangkaian peristiwa yang

mengancam dan mengganggu kehidupan dan

penghidupan masyarakat yang disebabkan

oleh faktor alam dan atau faktor manusia

sehingga mengakibatkan timbulnya korban

jiwa, kerusakan lingkungan, kerugian harta

benda dan dampak psikologis

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PASCA BENCANA

PRA BENCANA

4 Apa yg anda ketahui

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MANAJEMEN BENCANA ( Disaster Management )

Seluruh kegiatan yang

meliputi aspek

perencanaa dan

penanggulangan bencana,

pada sebelum, saat dan

sesudah terjadi bencana

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Jenis Bencana

6 RESIKO

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8 Vul, mitig

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Kerentanan (vulnerability)

Kerentaan merupakan suatu kondisi dari

suatu komunitas atau masyarakat yang

mengarah atau menyebabkan

ketidakmampuan dalam menghadapi

ancaman bahaya.

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Mitigasi (mitigation)

Mitigasi adalah serangkaian upaya untuk

mengurangi risiko bencana, baik melalui

pembangunan fisik maupun penyadaran dan

peningkatan kemampuan menghadapi

ancaman bencana.

( Hyogo Framework for Action 2005 – 2015 )

RS

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Hyogo Framework for Action

2005-2015

Mekanisme terpadu pengurangan resiko

bencana

Pengurangan risiko bencana sebagai bagian

terpadu dari proses pembangunan dan

bukan sebagai tujuan itu sendiri.

( Kerangka Kerja Aksi Hyogo )

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IRB

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13 ( INDEKS RAWAN BENCANA INDONESIA, BNPB 2011 )


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Rekapitulasi Bencana Tahun 2010

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UU

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UU Bencana No 24 th 2007

PERATURAN KEPALA BNPB NOMOR 7 TAHUN 2008 TENTANG PEDOMAN

TATA CARA

PEMBERIAN BANTUAN PEMENUHAN KEBUTUHAN

DASAR

STANDAR MINIMAL PENANGGULANGAN MASALAH

KESEHATAN AKIBAT BENCANA DAN PENANGANAN

PENGUNGSI

(KM Kes no: 1357/Menkes/SK/XII/2001 )

Keppres untuk pencairan cepat dana anggaran darurat ( JuBir Presiden 25/11/2011 )

IDP

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Handbook for Emergencies.

( The Emergency Preparedness and Response Section UNHCR Headquarters )

Pengungsi

PRIO

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Emergency Social Services

Emergency clothing service

Emergency lodging Service

Emergency Food Service

Registration and Inquiry Service

Personal Services

Reception Centre Service

( Terpal Plastik. Oxfam International © 2007 )

( Emergency Food Service: Planning for Disasters )

© Her Majesty the Queen in Right of Canada (2007))

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Meeting Urgent Needs

Responsibilities


© Her Majesty the Queen in Right of Canada (2007))

Sina

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23 Kabanjahe, IDP G Sinabung

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EFS

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Meeting Urgent Needs

Responsibilities

respon


© Her Majesty the Queen in Right of Canada (2007)

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Responsibilities

Sufficient amount of food

Meet high risk group

Appropriate food services

Food requirement ( quantities, hot/cold )

Religious/cultural requirements

Food safety



ORG

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Operational Guidelines

Sanitation Guidelines

Safe Procedure Essential

Personal Hygiene

Precaution Against Food Contamination

Operational Procedure at Warehouses

Improvised Refrigerator

ref



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Improvised Refrigeration Above Ground



bnpb

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Bantuan Dasar

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BAB II PENGERTIAN DAN PRINSIP

A Pengertian

2. Bantuan dalam hal ini adalah bantuan kemanusiaan yg terdiri dr penampungan sementara, bantuan pangan, sandang, air bersih dan sanitasi, serta pelayanan kesehatan

B Prinsip.

1. Cepat dan tepat

2. Prioritas : diutamakan kepada kelompok rentan

( BNPB No 7 th 2008 , Pedoman Tata Cara Pemberian Bantuan Pemenuhan

Kebutuhan Dasar )

air

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Water / Air

Harus cukup

Bersih, jernih

Aman

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Bantuan Air Bersih

Standar Minimal Bantuan : a. Bantuan air bersih diberikan sejumlah 7 liter pada tiga

hari pertama, selanjutnya 15 liter per orang per hari. b. . . . . . .

c. . . . . . .

(PERATURAN KEPALA BNPB NOMOR 7 TAHUN 2008 TENTANG

PEDOMAN TATA CARA PEMBERIAN BANTUAN PEMENUHAN KEBUTUHAN DASAR)

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The Sphere Project

Copyright © The Sphere Project 2004

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Environmental health in emergencies: technical notes on water and sanitation,

Kathmandu: WHO, 2007.

Minimum water quantity needed

CT

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Food Safety

handen

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SL CYH

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WASH HANDS WHEN VISIBLY SOILED ! OTHERWISE, USE HANDRUB !

( Hand Hygiene, Technical Reference Manual. WHO 2009 )

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39 ( Hand Hygiene, Technical Reference Manual. WHO 2009 )

40 ( Hand Hygiene, Technical Reference Manual. WHO 2009 )

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42 (LES BONNES PRATIQUES D’HYGIÈNE DANS LA PRÉPARATION ET LA VENTE DES ALIMENTS DE RUE EN AFRIQUE )

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5fs

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Five keys to food safety

1. keep clean

2. separate raw and cooked

3. cook all foods thoroughly

4. keep food at safe temperatures

5. use safe water and raw materials.

( Five keys to safer food manual, WHO 2006 )

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Food Worker Top 10

1 Only work when you are healthy.

2 Wash your hands often and well.

3 Don’t touch ready-to-eat food with bare hands.

4 Keep food hot or cold.

5 Cook food to proper temperatures.

6 Cool hot food as quickly as possible.

7 Keep raw meat away from other food.

8 Wash, rinse, sanitize, air dry – always follow the 4 steps

in order.

9 Keep food preparation areas and utensils clean and

sanitized.

10 Ask questions if you have them

( Food Safety is Everybody’s Businnes )

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1. jaundice

2. diarrhoea

3. vomiting

4. fever

5. sore throat with fever

6. visibly infected skin lesions (boils, cuts, etc.)

7. discharges from the ear, eye or nose

( Codex Alimentarius - Food Hygiene )

Only work when you are healthy

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FOOD SAFETY GUIDELINES

1. DO NOT ACCEPT food or water from unapproved or unknown sources.

2. If the water system is contaminated, use bottled water.

3. Provide handwashing soap and paper towels at toilet facilities.

4. Prepare only the quantity of food sufficient for immediate use. Leftovers must be

avoided if refrigeration is inadequate.

5. Cool all perishable foods rapidly. Use shallow pots and pans to divide hot foods.

6. Observe temperature controls for potentially hazardous foods-keep it hot 140 °F or

above and cold, 41°F or below.

7. Keep hand contact to a minimum when preparing foods.

8. Use single-service eating and drinking utensils.

9. Keep food preparation surfaces clean, and avoid contact between raw and

ready-to-eat foods.

( EMERGENCY SHELTERS AND MASS FEEDING CENTERS, County of San Diego )

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Golden rules for safe food preparation

1. Cook raw foods thoroughly.

2. Eat cooked food immediately. *

3. Prepare food for only one meal. *

4. Avoid contact between raw foods and cooked foods.

5. Choose foods processed for safety.

6. Wash hands repeatedly. *

7. Keep all food preparation premises meticulously clean.

8. Use safe water.

9. Be cautious with foods purchased outside. *

10. Breast-feed infants and young children. *

Source: World Health Organization (1991d)

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( Hand hygiene technical reference manual )

© World Health Organization 2009

makan

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Makanan

Waktu banjir Jkt, reporter TV tanya pada petugas : makanan apa yang dibutuhkan ?

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Makanan

Berapa kalori

Pengerjaan mudah

Kemasan mudah

Ragam menu

Penghidangan

Pengawasan mutu

Peralatan

Pembersihan

kalori

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Kalori

SK

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BNPB no 7 Th 2008

Bantuan Pangan Standar Minimal Bantuan :

a. Bahan makanan berupa beras 400 gram per

orang per hari atau

b. Makanan yang disediakan dapur umum berupa

makanan siap saji sebanyak 2 kali makan ( ? ) dalam sehari.

c. Besarnya bantuan makanan (poin a dan b)

setara dengan 2.100 kilo kalori

KM Kes no: 1357/Menkes/SK/XII/2001 :

2100 kcal,

40gr lemak

50 gr protein / hari.

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2,100 kcals per person per day

10-12% of total energy provided by protein

17% of total energy provided by fat

adequate micronutrient intake through fresh or

fortified foods.

Humanitarian Charter and Minimum Standards

Minimum Standards in Food Security, Nutrition and Food Aid. SPHERE

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57 Humanitarian Charter and Minimum Standards


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Humanitarian Charter and Minimum Standards


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60 surv

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Kegiatan

1. Melakukan penapisan (screening) bila prevalensi gizi kurang

balita 10–14.9% atau 5–9.0% yang disertai dengan factor pemburuk.

2. Menyelenggarakan pemberian makanan tambahan sesuaidengan jenis

intervensi yang telah ditetapkan pada tahap 1 fase II

(PMT darurat/Ransum, PMT darurat terbatas serta PMT terapi).

3. Melakukan penyuluhan baik perorangan atau kelompok dengan materi

penyuluhan sesuai dengan butir b.

4. Memantau perkembangan status gizi melalui surveilans.

5. Melakukan modifikasi/perbaikan intervensi sesuai dengan perubahan

tingkat kedaruratan :

Tahap Tanggap Darurat , hari ke 20

( KM Kes no: 1357/Menkes/SK/XII/2001 )

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5. Melakukan modifikasi/perbaikan intervensi sesuai dengan perubahan

tingkat kedaruratan :

a. Jika prevalensi gizi kurang > 15% atau 10–14% dengan factor pemburuk, diberikan paket pangan

dengan standar minimal per orang perhari (ransum), dan diberikan PMT darurat untuk balita,

ibu hamil ibu meneteki dan lansia serta PMT terapi bagi penderita gizi buruk.

Ketentuan kecukupan gizi pada PMT darurat sama seperti standar ransum.

b. Jika prevalensi gizi kurang 10–14.9% atau 5–9.9% dengan factor pemburuk

diberikan PMT darurat terbatas pada balita, ibu hamil, ibu meneteki dan lansia

yang kurang gizi serta PMT terapi kepada penderita gizi buruk.

c. Jika prevalensi gizi kurang < 10% tanpa factor pemburuk atau < 5% dengan

factor pemburuk maka dilakukan penganan penderita gizi kurang melalui

pelayanan kesehatan setempat.

( KM Kes no: 1357/Menkes/SK/XII/2001 ) do

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Pengerjaan

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Food core temperatures should be held at the correct temperature for a minimum of 15-

seconds:

75ºC for poultry and reheated foods

68ºC for minced meats (beef, pork, and other meat or fish)

63ºC for fish, pork, beef and eggs

Cooking the correct temp

Pengerjaan / Preparation

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Hot holding

DZ

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Cold holding

dz

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The Danger Zone

cool

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stove

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CDC

May 2013

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Ground beef cooking temperature

Eight in ten managers said their workers do not always

take a final temperature of hamburgers with a thermometer.

Many managers said their workers always or often check

if hamburgers are ready in ways other than using a thermometer.

They check the color of the hamburger, how it looks, and how it feels.

About one in ten hamburgers were undercooked

(cooked to less than 155°F).

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Cross contamination

In many restaurants, workers were seen preparing raw ground beef

in a way that could lead to cross contamination.

Workers :

• Did not wash their hands in between touching raw ground beef and

touching other foods (six in ten restaurants).

• Used the same utensil on raw ground beef and other foods without

washing in between (one in three restaurants).

• Used the same utensil on raw ground beef and cooked ground beef

(without washing in between) (four in ten restaurants).

• Wiped their hands on cloths/aprons after touching raw ground beef

(four in ten restaurants).

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Pengawasan

Mutu

wash

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Cleaning and

Sanitizing

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clean

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Cleaning and Sanitizing

Cleaning : pakai sabun

Sanitizing : pakai chemical

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Washing Dishes by Hand

CLEAN and SANITIZE the sink

SCRAPE leftover food into the garbage

WASH dishes in hot, soapy water in the first sink

RINSE dishes with clean, hot water in the second sink

SANITIZE by soaking the dishes in the third sink filled with warm water and an approved sanitizer

AIR DRY all dishes and utensils instead of using a towel

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3 Compartment Sink

SANITIZE

(1) 100mg/L chlorine solutions at a minimum temperature of 24ºC

(2) clean water at a minimum temperature of 77ºC

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Manual Pot And Oversized Utensil Washing

2 Compartment Sink

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A sanitizing solution can be made of 1 teaspoon of

household bleach mixed with 1 gallon of clean warm water.

This provides the required 50 parts per million (ppm) chlorine needed for sanitizing.

kalori

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Four separate sinks should be set up –

• one for handwashing

• one for washing food preparation utensils and dishes

• one for sanitizing utensils

• one for preparing foods

( EMERGENCY SHELTERS AND MASS FEEDING CENTERS, County of San Diego )

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(LES BONNES PRATIQUES D’HYGIÈNE DANS LA PRÉPARATION ET LA VENTE DES ALIMENTS DE RUE EN AFRIQUE )

buku

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resep

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Resep2 Menu

2100 kcl, 400 gr beras, 40 gr lemak,

50 gr protein / hari

Sehat

Mudah persiapan dan penyajiannya

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[email protected]

081 334 663 808

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[email protected]

081 334 663 808

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mailto:[email protected]

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Bagaimana kl tidak ada air

AIR

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Dlm jumlh besar chlorination

Dlm jumlh kecil :

Boiling

PAC

PUR

SODIS

Water Treatment

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Kejernihan air

Jernih ( < 30 NTU )

Keruh ( > 30 NTU )

Sample Turbidities (Howard, 2001)

www.cee.mtu.edu/sustainable_engineering

( nephelometric turbidity units )

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CHLORINATION

Preparation 1 L of 1% chlorine stock solution

A 1% solution contains 10 g of chlorine per litre = 10000mg/l or 10000ppm (parts per million).

1 tablespoon = 4 teaspoons

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Jumlah kecil , air jernih

Boiling

PUR

PAC

SODIS

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Boiling

Sampai mendidh

Dipengaruhi ketinggian lokasi

Harus ada tungku / kompor dan bahan bakar

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Jumlah kecil air keruh

Jumlah air 10 liter

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Penjernih Air Cepat ( PAC )

Alumunium Sulfat ( Tawas )

Poly Aluminium Chloride

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Alumunium Sulfat

( Tawas )

1. Air keruh dlm ember 20 liter

2. Tuangkan Tawas ½ sendok teh ( digerus )

aduk pelan2

3. Diamkan kira 10-20 menit sp terbentuk

endapan, isap air jernihnya

4. Air jernih bisa di didihkan , Chlorine atau

Sodis

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Solar water disinfection

Copyright © by SANDEC (Water & Sanitation in Developing Countries) at

EAWAG (Swiss Federal Institute for Environmental Science and Technology)

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Solar water disinfection

Prinsip

UV dari matahari mempengaruhi metabolisme dan merusak sel

UV bereaksi dengan oxygen yang terlarut dalam air membentuk

oxygen free radicals dan hydrogen peroxides yang bisa

membunuh kuman

Jika temperatur air meningkat diatas 50 derajat C maka efek

disinfeksi nya lebih cepat 3 kali

Oksigen, CO2 berkurang, Fe teroksidasi dan mengendap

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UV-C light ranges in wavelength from 200–280 nanometers (nm) but operates most effectively as a

germicidal light at a frequency of 253.7 nm.

UVC-Germ Blaster's UV-C light penetrates the cell walls of the microorganism, damaging its

genetic structure by separating the bonds in the DNA strand.

The damaged bonds in the DNA prohibit future reproduction and ultimately destroys the

microorganism.

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Chlorine and Alternative Disinfectants Guidance Manual

Prepared by: Earth Tech (Canada) Inc. 850 Pembina Highway Winnipeg,

Manitoba R3M 2M7 March 2005

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Tata Cara SODIS

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Factors reducing the efficiency

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Factors reducing the efficiency



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Minimum daily requirements:

Minimum survival allocation: 7 litres per person per day. This should be increased

to 20 litres per person as soon as possible.

Communal needs and a spare capacity for possible new arrivals should be added.

Health centres: 40-60 litres per patient per day.

Feeding centres: 20-30 litres per patient per day.

Schools: 3 litres/pupil/day.

Mosque: 2 to 5 litres/person/day.

Hand washing at communal latrines and Offices: 1 to 2 litres/user/day for hand

washing, and 2 to 8 litres/cubicle/day for cleaning.

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1. Wash dishes in the first sink containing hot soapy water

2. Rinse dishes in the second sink containing hot water

3. Air dry all dishes and utensils

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