Disasters can strike anytime and anywhere. Whether it be man-made or the result of the forces of nature, a disaster occurs anytime destruction overwhelms a region’s ability to cope and recover from it. However, it has been estimated that although only 11% of disasters affect the populations of the least-developed countries, they sustain 53% of all casualties (1). In other words, vulnerable populations are unequally affected by global hazards. Many of the factors that play into this are consistent with the themes we’ve discussed in class such as poor infrastructure for healthcare delivery, disparities in access to resources, low levels of education and other factors like climate change.
A U.N. human development report on climate change cited that in the four years between 2000 and 2004, 1 in 1,500 people living in an OECD country were affected by a climate disaster. In contrast, 1 in 19 people living in the developing world were affected (2). When natural disasters strike, the effects are widespread and long-lasting. In the short-term there is often chaos, confusion and tragedy as people try to save their families from fire, floods and hurricanes. The focus for responders is usually to evacuate people to safety and treat critical injuries. However, even if we could do that effectively, prompt rescue and treatment does not mitigate the long-term effects on health and economy. Not only could houses, businesses, hospitals and government buildings be destroyed in a disaster, but the neighboring communities of a disaster area must find ways to support a rapid influx of people and their resources are often overwhelmed.
This affects people for years as they struggle to find housing, jobs and security.
We must think broadly about cultural and social issues that all play a role, even among factors that aren’t obviously related. For example, the report cited a study that found gender bias affected the ability of women to recover from a disaster. When a cyclone and flood hit Bangladesh in 1991, the death rate among women was five times higher and for those who did survive, legal restrictions on land and property ownership limited their capacity to rebuild their lives without a husband or father to provide for them (2).
The coordination and efficacy of the global response to disasters is often painfully unhelpful. The Social Issue Report found two main barriers exist: insufficient coordination among actors (including local governments, aid governments, military, U.N. forces, NGOs) and limited involvement of the affected government in response. Although technology has allowed us to better predict when and where some types of disasters will occur, for the most part this has not yet led to prevention of destruction. Until we are able to control external factors like wind and rain (which may never happen), we must work to mitigate vulnerability and advocate for the rights of those at most risk of being affected.
- Jauregui, C., Sholk, J., Radday, A., & Stanzler, C. (2011). International disaster response. Social Issue Report, Boston: MA.
- United Nations Development Programme. (2007). Fighting climate change: Human solidarity in a divided world. Human Development Report 2007/2008. New York: NY
In the aftermath of a disaster media will often focus on lost lives, damaged homes, hindered businesses, and brave heroes. While these issues and others often saturate the news for a short period of time, the attention to these communities is often and rapid and fleeting as the disaster itself. Building are often rebuilt, financial aid is often collected, and heroes are often awarded, but beyond all of this rebuilding often lingers a more transparent problem, mental health (1,2). These events are associated with numerous mental health outcomes including depression, anxiety, and post traumatic stress disorder. Research also shows that these mental health problems are often associated with physical health issues such as illness (1). As mentioned in the blog, there are large discrepancies between healthcare systems in developed and developing countries. Mental health surveillance and treatment is no different. Developing countries, the poor, and minority populations often have less detection and treatment of mental health problems. It is critical, even in developed countries, that governments, NGOs and other disaster relief organizations look beyond rebuilding the community and also focus on rebuilding the minds of the community (1). Psychological First Aid (PFA) is one method that attempts to facilitate acquisitions of essential resources while reducing physiological arousal and guiding survivors to additional resources. Emotional venting is not a key goal of this method but is permitted if the subject desires it. This method does seem counterintuitive to many common mental health methods, but provides a means of support while respecting the individuals privacy (2).
ReplyDelete1. Warheit, G J. 1985 A Prepositional paradigm for estimating the impact of disasters on mental health
2. Veehuis, Phillip E. Mental Health and Disasters. JAMA 2010; 304(12): 1387-1388
Kelly, I completely agree with your opinion of working to mitigate vulnerability and advocating for the rights of those most at risk of being affected by disasters. We see examples of this in the news on a continual basis. Whether the disaster be natural or man-made, it can still have the same impact on the lives of individuals. I worked with the local chapter of the American Red Cross last summer which sparked a personal interest of mine in public health, mental health. Stuart makes a great point about the focus on mental health in developing countries, but I feel it is just as necessary in the developed world also. I believe there needs to be a greater focus on the mental health of individuals as they recover from such disasters. As we know, sometimes these disasters cannot be anticipated. They may catch people “off-guard” and their lives change in an instant. They have to learn to cope with loss of life, loss of personal belongings (homes, clothing), and potentially relocating to build a new future. I would like to see more efforts in following up with disaster affected individuals to help alleviate the pressure and PTSD that typically occurs. Most resources are targeted towards the physical environment and rebuilding, but mental health is just as important to rebuild.
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