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Week 3 Case Study

Flood Response in Gympie

The Scenario

It is February 2026, and the Mary River has broken its banks following five consecutive days of torrential rainfall across the Wide Bay–Burnett region. The town of Gympie, Queensland (population ~22,000) has been declared a disaster zone. Floodwaters have inundated the CBD, with approximately 2,400 residents evacuated to three emergency shelters: the Gympie Civic Centre, the local showgrounds, and a high school gymnasium. Road access from Brisbane is cut off, and the region is operating under Local Disaster Management Group (LDMG) coordination.

Paramedic team members Rachel and Tom have been deployed to the showgrounds evacuation centre, which is housing approximately 600 people. The shelter population includes elderly residents from a flooded aged care facility (some with dementia and mobility issues), families with young children, several people with serious chronic conditions (insulin-dependent diabetes, renal dialysis patients, COPD), and a group of backpackers who were staying at a caravan park. Power at the showgrounds is running on generators. A temporary medical station has been established, staffed by Rachel, Tom, a registered nurse, and a volunteer St John officer. The nearest hospital (Gympie General) is operational but under extreme pressure.

Over the first 24 hours at the shelter, Rachel and Tom manage the following cases: an 82-year-old woman from the aged care facility with worsening confusion and a UTI who has not received her regular medications in 36 hours; a 6-year-old boy who lacerated his foot on submerged debris during evacuation and requires wound care and tetanus assessment; a 45-year-old man experiencing a panic attack who lost his house and all possessions; a renal dialysis patient whose next scheduled session was yesterday and is now showing signs of fluid overload; and multiple presentations of gastroenteritis among shelter residents, likely from contaminated floodwater contact. Rachel must make triage and transfer decisions with limited resources and transport options.

Discussion Questions

1 Apply the PPRR framework (Prevention, Preparedness, Response, Recovery) to this flood scenario. For each phase, identify at least one action that should have been taken or should be taken now. Which phase are Rachel and Tom currently operating in?
2 Rachel has five patients requiring attention simultaneously. Using triage principles, rank the patients in order of clinical priority and justify your reasoning. Which patient(s) require emergency evacuation to hospital?
3 Identify the vulnerable populations present in this shelter. Why are these groups disproportionately affected by natural disasters? What specific health risks does each group face in the shelter environment?
4 Describe the cascading health impacts of this flood event, considering: immediate injury risk, disruption of healthcare services and medications, infectious disease risks (contaminated water, crowded shelters), and mental health impacts. How do these compound over time?
5 What injury prevention strategies could reduce harm during the response and recovery phases? Consider both individual behaviour change and systemic interventions (e.g., public messaging, environmental controls in shelters).
6 Discuss the mental health impacts of disasters. The 45-year-old man presenting with panic symptoms has lost everything. What psychological first aid principles should Rachel apply? What longer-term mental health risks exist for disaster-affected communities?

Key Concepts Applied

PPRR Framework

The four-phase disaster management cycle: Prevention, Preparedness, Response, and Recovery. Each phase requires different public health actions.

Disaster Triage

Prioritising patients when demand exceeds resources. The dialysis patient and confused elderly woman represent time-critical cases requiring transfer decisions.

Vulnerable Populations

Elderly, children, chronically ill, and people with disabilities face disproportionate disaster impacts due to reduced capacity to prepare, respond, and recover.

Cascading Health Impacts

Disasters create chains of health consequences: injury → service disruption → medication gaps → infection → mental health deterioration.

Injury Prevention

Public health strategies to reduce harm before, during, and after disaster events, from building codes to evacuation planning to shelter safety.

Psychological First Aid

Evidence-based early intervention for disaster-affected individuals: safety, calming, connectedness, self-efficacy, and hope.

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