RAPID DAMAGE ASSESSMENT AND NEEDS ANALYSIS FORM-2

Note: This must be submitted not later than 3 weeks after disaster and will answer the questions "What are the gaps and issues?"
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    I. General Situation Before Disaster

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    II. General Situation After Disaster

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    III. Characteristics of Disaster Zone

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    IV. Accessibility to Affected Municipalities and Disaster Zones

    IV-A. To the municipal/city center

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    IV-B. Routes to affected zones

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    V. Electricity, Communication and Fuel in Disaster Zones

    Electricity

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    Telephone/fax

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    Mobile Phones

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    Radio Stations

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    Television

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    Radio Communication

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    Fuel Distribution

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    VI. Heath

    VI-A. Availability of Personnel, Medicines and Medical Supplies and Others

    Medical Personnel

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    Medicines

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    Medical Supplies

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    Health Establishments in the Disaster Zone

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    Disposal of Corpses

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    VII. WASH

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    Estimated dwellings/shelters with water (%)

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    Alternative sources of water supply

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    Water Sources

    Wells

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    Rivers/streams

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    Storage Infrastructure

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    Aqueduct

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    Spring

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    Others

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    Sanitation System

    Latrines

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    Sewer System

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    Septic Tanks

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    Waste Disposal System

    Solid Waste

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    Discharge of grey/black liquids

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    Rubbish disposal

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    Main Sanitation needs

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    VIII. Food and Nutrition

    Food Sources

    Main source of food for displaced families

    Self-production

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    Purchase

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    Donation/food aid

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    Exchange/Trade

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    Collection

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    Means for Affected families to Prepare Food

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    Food Reserves

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    Food Interventions

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    Main Needs in Food and Nutrition

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    IX. Shelter

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    Main Neesd in Shelters

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    X. Livelihood

    Impact on Livelihood Sectors

    Activity/Sector

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    Cattle Raising

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    Fishing

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    Industrial

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    Commerce

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    Manual Labor

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    Skilled Labor

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    Others

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    Main Needs in Livelihood

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    XI. Protection

    Situation of Children

    Orphans

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    Separated from Parents

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    Main barriers for the fulfillment of basic protection principles and actions

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    Main Needs in Protection

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    XII. Education

    Impact on Schools

    No. of Classrooms

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    Furnishings Affected (est %)

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    Materials Affected (est %)

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    No. of Students Affected

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    Main Needs in Eduction

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    XIII. Organization and Coordination

    Provincial Clusters

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    PDCC

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    CDCC

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    MDCC

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    BDCC

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    Others

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    Information Flow (Check if existing)

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