🌊 Urban Flooding in Ahmedabad, Gujarat

from docx import Document
from docx.shared import Pt, Inches, RGBColor, Cm
from docx.enum.text import WD_ALIGN_PARAGRAPH
from docx.enum.table import WD_TABLE_ALIGNMENT, WD_ALIGN_VERTICAL
from docx.oxml.ns import qn
from docx.oxml import OxmlElement
import copy

doc = Document()

# ── Page margins ──────────────────────────────────────────────────────────────
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# ── Default body style ────────────────────────────────────────────────────────
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# ══════════════════════════════════════════════════════════════════════════════
#  COVER / HEADER
# ══════════════════════════════════════════════════════════════════════════════
p = doc.add_paragraph()
p.alignment = WD_ALIGN_PARAGRAPH.CENTER
run = p.add_run("3rd YEAR POSTGRADUATE WRITE-UP")
run.font.name = "Arial"
run.font.size = Pt(10)
run.font.color.rgb = RGBColor(120, 120, 120)

title = doc.add_heading("", level=0)
title.alignment = WD_ALIGN_PARAGRAPH.CENTER
run = title.add_run("Urban Flooding in Ahmedabad, Gujarat")
run.font.name = "Arial"
run.font.color.rgb = RGBColor(31, 97, 141)

sub = doc.add_paragraph()
sub.alignment = WD_ALIGN_PARAGRAPH.CENTER
run = sub.add_run("Public Health Management — Role of District Health Officer")
run.font.name = "Arial"
run.font.size = Pt(13)
run.font.bold = True
run.font.color.rgb = RGBColor(52, 73, 94)

date_p = doc.add_paragraph()
date_p.alignment = WD_ALIGN_PARAGRAPH.CENTER
run = date_p.add_run("Date: 24th July 2026  |  Subject: Community Medicine / Preventive & Social Medicine")
run.font.name = "Arial"
run.font.size = Pt(10)
run.font.italic = True
run.font.color.rgb = RGBColor(150, 150, 150)

doc.add_paragraph()

# Disaster cycle image (small, centred)
add_image_centred(doc, "/tmp/workspace/flood-writeup/disaster_cycle.png",
                  width_inches=3.5,
                  caption="Fig. 1 — Disaster Management Cycle (Source: Park's Textbook of Preventive & Social Medicine)")

doc.add_page_break()

# ══════════════════════════════════════════════════════════════════════════════
#  INTRODUCTION
# ══════════════════════════════════════════════════════════════════════════════
add_coloured_heading(doc, "INTRODUCTION", level=1)
add_body(doc,
    "Urban flooding following heavy monsoon rainfall in Ahmedabad represents a complex public health emergency. "
    "As the District Health Officer (DHO), I function within the legal framework of the Disaster Management Act, 2005, "
    "under the District Disaster Management Authority (DDMA) — headed by the District Magistrate/Collector. "
    "The DDMA operates under the guidance of the NDMA (National) and GSDMA — Gujarat State Disaster Management Authority. "
    "The DHO serves as the nodal health officer for all health-sector activities in this framework."
)

# ══════════════════════════════════════════════════════════════════════════════
#  SECTION 1 — PUBLIC HEALTH IMPACT
# ══════════════════════════════════════════════════════════════════════════════
doc.add_page_break()
add_section_box(doc, "1. PUBLIC HEALTH IMPACT OF FLOODS", color_rgb=(192, 57, 43))
doc.add_paragraph()

add_image_centred(doc, "/tmp/workspace/flood-writeup/flood_impact.png",
                  width_inches=6.2,
                  caption="Flowchart 1 — Public Health Impact of Urban Floods")

add_coloured_heading(doc, "A. Direct / Immediate Health Impacts", level=2, r=192, g=57, b=43)
add_simple_table(doc,
    ["Impact", "Examples"],
    [
        ["Deaths", "Drowning (most common), electrocution"],
        ["Injuries", "Trauma from debris, fractures, lacerations, snake bites"],
        ["Hypothermia", "Prolonged water exposure — highest risk in children & elderly"],
    ],
    col_widths=[2.5, 4.0]
)

add_coloured_heading(doc, "B. Waterborne & Foodborne Diseases (Most Significant Post-Flood Threat)", level=2, r=192, g=57, b=43)
for item in [
    "Cholera — explosive outbreaks in flooded urban slums; El Tor biotype",
    "Typhoid & Paratyphoid Fever — contaminated water/food",
    "Hepatitis A & E — feco-oral; Hepatitis E especially dangerous in pregnancy",
    "Acute Diarrhoeal Diseases (ADD) — major cause of post-flood morbidity",
    "Leptospirosis — zoonotic; enters through skin abrasions from rat-urine contaminated floodwater",
    "Bacillary & Amoebic Dysentery",
]:
    add_bullet(doc, item)

add_coloured_heading(doc, "C. Vector-Borne Diseases (Delayed — 2–4 weeks post-flood)", level=2, r=192, g=57, b=43)
for item in [
    "Malaria (P. vivax dominant in Gujarat) — Anopheles mosquito",
    "Dengue & Chikungunya — Aedes aegypti breeding in stored/stagnant water",
    "Japanese Encephalitis — Culex mosquito; peri-urban areas",
    "Filariasis — Culex quinquefasciatus in urban drains",
]:
    add_bullet(doc, item)

add_coloured_heading(doc, "D. Other Impacts", level=2, r=192, g=57, b=43)
for item in [
    "Skin & Wound Infections — cellulitis, tinea; scabies outbreaks in crowded relief camps",
    "Respiratory Illnesses — ARI, pneumonia from overcrowding and dampness",
    "NCD Aggravation — missed antihypertensives, antidiabetics, anticonvulsants, ARVs",
    "Mental Health — PTSD, acute stress disorder, depression, grief reactions, suicidal ideation",
    "Disruption of health infrastructure — PHCs, CHCs, hospitals inundated",
    "Food insecurity & malnutrition — crop damage, market disruption",
]:
    add_bullet(doc, item)

add_coloured_heading(doc, "Vulnerable Priority Groups", level=2, r=192, g=57, b=43)
add_body(doc,
    "Children <5 years  |  Pregnant & lactating women  |  Elderly (>60 years)  |  "
    "Persons with disabilities  |  Urban poor / slum dwellers  |  Patients on long-term medications",
    bold=True
)

# ══════════════════════════════════════════════════════════════════════════════
#  SECTION 2 — 4 PHASES
# ══════════════════════════════════════════════════════════════════════════════
doc.add_page_break()
add_section_box(doc, "2. ROLE OF DISTRICT HEALTH ADMINISTRATION — 4 PHASES", color_rgb=(31, 97, 141))
doc.add_paragraph()

add_image_centred(doc, "/tmp/workspace/flood-writeup/dho_phases.png",
                  width_inches=6.2,
                  caption="Flowchart 2 — DHO Role Across 4 Phases of Disaster Management")

# Phase 1
add_coloured_heading(doc, "PHASE 1: PREVENTION (Pre-Disaster)", level=2, r=39, g=174, b=96)
for item in [
    "Health hazard vulnerability mapping — identify flood-prone wards, slum clusters",
    "Flood-proofing of PHCs, CHCs, district hospitals — locate on higher ground",
    "Safe water supply protection — coordinate with municipal body",
    "Immunization drives — Hepatitis A, Typhoid before monsoon season",
    "IEC (Information, Education, Communication) — pre-monsoon health awareness campaigns",
    "Maintain disease baseline data for each ward (IDSP)",
]:
    add_bullet(doc, item)

# Phase 2
add_coloured_heading(doc, "PHASE 2: PREPAREDNESS (Pre-Disaster)", level=2, r=41, g=128, b=185)
for item in [
    "District Health Action Plan (DHAP) for floods — prepare and update annually with DDMA",
    "Pre-position health supplies: ORS, chlorine/halazone tablets, IV fluids, RDT kits, antibiotics, antivenoms",
    "Constitute and train Rapid Response Teams (RRT): 1 doctor + 1 paramedic + 1 lab technician",
    "Equip Mobile Medical Units (MMUs) — fuel, stock, check",
    "Early Warning System linkage with IMD and GSDMA",
    "Mock drills / tabletop exercises to test response mechanisms",
    "Train ASHAs, ANMs, Medical Officers in flood-specific protocols",
    "Designate and equip flood relief camps with health posts",
    "Establish flood-proof communication (satellite phones, HAM radio)",
    "Hospital Disaster Plans: nominate nodal officer; stock resuscitation equipment; contingency bed plans",
]:
    add_bullet(doc, item)

# Phase 3
add_coloured_heading(doc, "PHASE 3: RESPONSE (During & Immediately After Flood)", level=2, r=192, g=57, b=43)
for item in [
    "Activate District Emergency Operations Centre (DEOC) — 24×7 staffing",
    "Deploy Mobile Medical Teams to flood-affected areas and relief camps",
    "Triage — classify injured by severity & survival likelihood (maximum benefit to maximum people)",
    "Rapid Health Assessment (RHA) — within 24–48 hrs: mortality, morbidity, service disruption",
    "Disease surveillance: daily IDSP S/P/L forms; lower alert threshold; activate IHIP",
    "Water quality testing — chlorination (residual chlorine 0.5 mg/L at point of use)",
    "Environmental sanitation — 1 toilet per 20 persons; safe disposal of dead bodies/carcasses",
    "Vector control — fogging, larviciding, bed-net distribution",
    "Safe food supply — inspect relief camp food; condemn contaminated items",
    "Mass casualty management — coordinate surge capacity with district hospital",
    "Psychosocial first-aid — trained counsellors at relief camps",
]:
    add_bullet(doc, item)

# Phase 4
add_coloured_heading(doc, "PHASE 4: RECOVERY / REHABILITATION (Post-Flood)", level=2, r=142, g=68, b=173)
for item in [
    "Gradual restoration of health services — PHCs, sub-centres repaired and reopened",
    "Active outbreak surveillance — continued IDSP reporting for 8–12 weeks post-flood",
    "Outbreak investigation — deploy RRT; implement control measures",
    "Safe water declaration — test all sources before declaring safe",
    "Nutritional rehabilitation — SAM/MAM survey and management (especially children)",
    "Mental health support — long-term PTSD counselling, grief support programmes",
    "Damage and loss assessment — report to state for reconstruction funding",
    "Lessons-learned review — document gaps to improve next disaster plan",
]:
    add_bullet(doc, item)

# ══════════════════════════════════════════════════════════════════════════════
#  SECTION 3 — NATIONAL HEALTH PROGRAMMES
# ══════════════════════════════════════════════════════════════════════════════
doc.add_page_break()
add_section_box(doc, "3. ROLE OF NATIONAL HEALTH PROGRAMMES IN FLOOD MANAGEMENT", color_rgb=(30, 132, 73))
doc.add_paragraph()

add_image_centred(doc, "/tmp/workspace/flood-writeup/national_programs.png",
                  width_inches=6.2,
                  caption="Flowchart 3 — National Health Programmes Activated During Flood Response")

programmes = [
    ("IDSP — Integrated Disease Surveillance Programme (Most Critical)", [
        "Real-time outbreak detection via IHIP (Integrated Health Information Platform)",
        "Daily S forms (syndromic), P forms (presumptive), L forms (lab-confirmed)",
        "Rapid Response Team (RRT) dispatch for outbreak investigation",
        "DHO action: ensure daily reporting from ALL health facilities and relief camps",
    ]),
    ("NVBDCP — National Vector Borne Disease Control Programme", [
        "Malaria: Mass Blood Surveys, RDT testing, ACT/CQ treatment, IRS (DDT/Malathion), LLIN distribution",
        "Dengue/Chikungunya: source reduction drives, Temephos larviciding, pyrethroid fogging",
        "Anti-larval operations in all stagnant floodwater pools",
    ]),
    ("NHM — National Health Mission", [
        "Mobile Medical Units (MMUs) deployed to marooned/inaccessible areas",
        "ASHAs and ANMs: household visits, ORS distribution, chlorine tablets, referral",
        "Janani Suraksha Yojana — ensure institutional delivery for pregnant women in camps",
        "Free drugs and diagnostics (JSSK / Free Drug Scheme) continue at relief camps",
    ]),
    ("RNTCP / NTP — National TB Programme", [
        "Identify TB patients in affected areas; arrange uninterrupted DOTS supply at camps",
        "Missed treatment → drug resistance; highest priority continuity",
        "Coordinate with private practitioners for treatment records",
    ]),
    ("NLEP — National Leprosy Eradication Programme", [
        "Ensure MDT (Multi Drug Therapy) continuation for leprosy patients",
        "Wound care surveillance and management in post-flood camps",
    ]),
    ("NMHP — National Mental Health Programme", [
        "Psychological First Aid (PFA) immediately post-flood",
        "Screen for PTSD, depression, acute stress at relief camps",
        "Train ASHAs in basic psychological support",
    ]),
    ("NPCDCS — Non-Communicable Diseases Programme", [
        "Continuity of antihypertensives, antidiabetics, anticoagulants for displaced patients",
        "BP and blood glucose monitoring camps in affected areas",
    ]),
    ("Jal Jeevan Mission — National Drinking Water Programme", [
        "Emergency water quality testing across all sources",
        "Rapid repair of broken pipelines; community-level chlorination",
    ]),
]

for prog_name, bullets in programmes:
    add_coloured_heading(doc, prog_name, level=2, r=30, g=132, b=73)
    for b in bullets:
        add_bullet(doc, b)

# ══════════════════════════════════════════════════════════════════════════════
#  SECTION 4 — INTERSECTORAL / COMMUNITY / RISK COMM
# ══════════════════════════════════════════════════════════════════════════════
doc.add_page_break()
add_section_box(doc, "4. INTERSECTORAL COORDINATION, COMMUNITY PARTICIPATION & RISK COMMUNICATION", color_rgb=(125, 60, 152))
doc.add_paragraph()

add_image_centred(doc, "/tmp/workspace/flood-writeup/intersectoral.png",
                  width_inches=6.2,
                  caption="Flowchart 4 — Intersectoral Coordination, Community Participation & Risk Communication")

# 4A
add_coloured_heading(doc, "A. Intersectoral Coordination", level=2, r=41, g=128, b=185)
add_body(doc,
    "Disaster preparedness is an on-going multisectoral activity forming an integral part of the national "
    "disaster management system (Park's PSM). The DHO does not act in isolation — all health actions must be "
    "synchronised with the Incident Command System (ICS) under the DDMA."
)
add_simple_table(doc,
    ["Department / Agency", "Role in Flood Response"],
    [
        ["Ahmedabad Municipal Corporation (AMC)", "Drainage, water supply safety, solid waste, shelter in schools"],
        ["Gujarat Power Corp (GETCO/DGVCL)", "Electricity shut-off in flooded areas to prevent electrocution"],
        ["Public Works Dept (PWD)", "Road clearance, bridge safety assessment"],
        ["Police / Home Department", "Crowd control, law and order at relief camps"],
        ["NDRF / SDRF", "Search, rescue, body recovery"],
        ["Revenue Department (Collector)", "Relief fund disbursement, camp management"],
        ["Department of Education", "Schools as shelter / relief camps"],
        ["Women & Child Development", "AWW for nutrition surveillance; identify pregnant women"],
        ["Animal Husbandry", "Dead carcass disposal; zoonotic disease (leptospirosis) control"],
        ["Agriculture Department", "Food security, crop loss assessment"],
        ["NGOs / Red Cross", "Relief distribution, psychosocial support, manpower"],
        ["Private Hospitals / Medical Colleges", "Surge capacity; specialist services"],
        ["IMD (Met Department)", "Real-time weather forecasts and early warnings"],
    ],
    col_widths=[2.8, 3.7]
)

# 4B
add_coloured_heading(doc, "B. Community Participation", level=2, r=39, g=174, b=96)
add_body(doc,
    "\"The community is the first responder of any kind of disaster and public health emergency.\" "
    "— NIDM Journal of Disaster & Development, 2022"
)
for item in [
    "ASHAs — household surveys, ORS distribution, referral, birth/death reporting",
    "ANMs — skilled birth attendants at relief camps; immunization; ANC follow-up",
    "Anganwadi Workers (AWW) — nutritional surveillance; identify SAM/MAM children",
    "Aapda Mitra Volunteers — NDMA-trained community first responders",
    "Self-Help Groups (SHGs) — food preparation, distribution, psychosocial support for women",
    "Community and religious leaders — communicate health messages; mobilise community; counter misinformation",
    "Ward-level Health Committees (NHM) — activated for camp monitoring",
]:
    add_bullet(doc, item)

# 4C
add_coloured_heading(doc, "C. Risk Communication", level=2, r=192, g=57, b=43)
add_body(doc,
    "Effective risk communication is one of the 8 core capacities under IHR 2005 and "
    "\"an essential requirement for prompt medical response\" (NDMA Flood Guidelines)."
)
add_coloured_heading(doc, "Principles:", level=3, r=100, g=100, b=100)
for item in [
    "Early warning — communicate before the disaster escalates",
    "Accurate — based on verified data; avoid rumour",
    "Clear and simple — use local language (Gujarati); avoid jargon",
    "Actionable — tell people exactly what to do",
    "Two-way — enable community feedback",
    "Consistent — one official spokesperson (DHO/DDMA)",
    "Credible — use trusted voices (doctors, religious leaders, elected representatives)",
]:
    add_bullet(doc, item)

add_coloured_heading(doc, "Communication Channels:", level=3, r=100, g=100, b=100)
add_simple_table(doc,
    ["Channel", "Message Type"],
    [
        ["Press Conference (Official)", "Case counts, boil-water advisory, evacuation zones"],
        ["Doordarshan / All India Radio", "Community messages, do's and don'ts"],
        ["SMS alerts (NDMA Common Alert Protocol)", "Evacuation warnings, emergency numbers"],
        ["WhatsApp / Social media", "Health tips; counter misinformation"],
        ["Helplines: 1070 (Flood) / 104 (Health)", "Queries, emergency referral"],
        ["ASHAs / ANMs door-to-door", "Camp-level direct messaging"],
        ["Loudspeaker / Miking in areas", "Real-time local instructions"],
    ],
    col_widths=[3.0, 3.5]
)

# ══════════════════════════════════════════════════════════════════════════════
#  SUMMARY TABLE
# ══════════════════════════════════════════════════════════════════════════════
doc.add_page_break()
add_section_box(doc, "QUICK SUMMARY — DHO AT A GLANCE", color_rgb=(52, 73, 94))
doc.add_paragraph()
add_simple_table(doc,
    ["Dimension", "Key Action"],
    [
        ["Legal framework", "DM Act 2005 — NDMA > GSDMA > DDMA"],
        ["Main health threats", "Waterborne diseases > Vector-borne diseases > Trauma"],
        ["Top priority disease", "Diarrhoea / Cholera — safe water is the #1 intervention"],
        ["First action at disaster", "Rapid Health Assessment + Activate DEOC"],
        ["Surveillance system", "IDSP — daily S/P/L forms; IHIP platform"],
        ["Key national programme", "IDSP (surveillance), NVBDCP (vectors), NHM (delivery)"],
        ["Communication principle", "Early, accurate, actionable, consistent"],
        ["Vulnerable priority", "Children, pregnant women, elderly, disabled, urban poor"],
        ["Legal tools", "Epidemic Diseases Act 1897 + DM Act 2005"],
    ],
    col_widths=[2.8, 3.7]
)

# ══════════════════════════════════════════════════════════════════════════════
#  FOOTER / REFERENCES
# ══════════════════════════════════════════════════════════════════════════════
doc.add_paragraph()
add_coloured_heading(doc, "REFERENCES", level=2, r=100, g=100, b=100)
for ref in [
    "Park K. Park's Textbook of Preventive and Social Medicine. 26th ed. M/S Banarsidas Bhanot Publishers; 2023.",
    "NDMA. National Disaster Management Guidelines — Management of Floods. New Delhi: NDMA, Govt. of India.",
    "NIHFW. Training Course on Management of Public Health Emergencies for District Health Officers. New Delhi: NIHFW.",
    "Sharma R, Thapa R, Parkash S, et al. Public Health Emergency and Disaster Management. Disaster & Development. 2022;11(1).",
    "NDMA. Annual Report 2024–25. New Delhi: National Disaster Management Authority.",
    "Disaster Management Act, 2005. Ministry of Home Affairs, Govt. of India.",
    "International Health Regulations (IHR), 2005. World Health Organization.",
]:
    add_bullet(doc, ref)

# ── Save ──────────────────────────────────────────────────────────────────────
out = "/tmp/workspace/flood-writeup/Flood_Disaster_Public_Health_DHO_Writeup.docx"
doc.save(out)
print(f"Saved: {out}")