Disasters are usually measured by the number of deaths, injuries and damage to property that they cause. But, do these measures truly express the magnitude of damage to people’s health and quality of life?
In 2011, the earthquake that struck the Pacific coast of Tōhoku, with a magnitude of 9.0 (Mw), was the largest to ever hit Japan and the fourth most powerful in recorded history. Strong national building codes protected most of the buildings in Japan from this devastating earthquake and saved many lives as a result, but the people affected by that disaster still suffer from chronic illnesses, mental problems, loss of family and exposure to nuclear power plant accidents—most notably Fukushima, which continues to pose contamination risks due to the severe infrastructure damage it incurred during the earthquake. The public health situation of a community is a key factor in measuring their resilience against disasters, and accordingly, the strengthening of mental and physical health must be made a priority when looking to curb the risks posed such disasters in the future.
On the other side, the process of rebuilding after a disaster is just as important as the capacity and resilience building processes that happen prior to a disaster. Health professionals have an important role to play in facilitating mutual, cooperative relationships with non-health professionals as they work together to help rebuild communities. Specialists, such as those involved in disaster medicine, need to forge partnerships with general health providers to create a unified approach to community resilience and rebuilding programs. The role the health professional plays is not only important in the acute response to injuries caused by disasters, but also in preparedness work, which is crucial to later making an efficient response to any disaster.
In Japan, for example, nation-wide disaster medical response systems have saved many lives. With the Tōhoku earthquake in 2011, systems such as disaster-base hospitals, disaster medical assistant teams (DMAT), staging care units (SCU), wide-area transportation systems, emergency medical information systems (EMIS) and disaster medical-public health coordinators worked efficiently in the immediate aftermath of the earthquake, saving countless lives and limiting the impact of the disaster.
Despite these efforts, however, the medical and public health needs of the affected people exceeded the relief capacities in place at the time and, indeed, for several months after the event. Mental health problems including post-traumatic stress disorder (PTSD), depression and alcoholism are still huge problems in those affected, and it will take years to find solutions to these issues. Medical and public health preparedness should be emphasized and prioritized in order to build resilience to disasters in the form of long-running, systematized global health programs.
During the International Symposium for Disaster Medicine and Public Health Management that took place last May, scientists and experts in disaster medicine and public health reached a consensus that health concerns should be imperative in the formulation of disaster risk reduction interventions. Prioritization of the people’s mental and physical health in the process of disaster risk reduction should be in included in frameworks and policy at all levels. Preparation for people who need special assistance, such as those with disabilities, children and women, elderly people, people with chronic illnesses, foreigners and travelers, cannot be made without their own participation in the process of disaster risk reduction planning.
To achieve the above, education and training of general health-care providers and the continued development of the field of disaster medicine and public health are the only methods that will lead to long-lasting implementation.
All of this has been in the spotlight at the 3rd World Conference for Disaster Risk Reduction taking place in Sendai, Japan earlier this month. The Hyogo Framework for Action (HFA), endorsed by the UN General Assembly in 2005 to make the world more disaster resilient, will be revised in Sendai to reflect the post-2015 development agenda and give greater emphasis to the health of those vulnerable to the risk of natural disasters. The original HFA did not do enough to influence the design of existing national social protection mechanisms, particularly with regard to health programs and education schemes, which are crucial to building resilience to disasters. The new framework HFA framework under discussion in Sendai is meant to cover the next 20-30 years and will be expanded to include such important areas of social protection, like heath and education, effectively leading to the scaling-up of disaster resilience before disasters hit.
We, as health professionals, are striving to strengthen community resilience to disasters through the improvement of physical and mental health services. To do this, health professionals must be regarded as a key stakeholder working in concert with other professionals in the field of disaster risk reduction.
Shinichi Egawa (Tohoku University)
COHRED’s take on Prof. Egawa’s excellent contribution
In this guest post, Shinichi Egawa—Division of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science (IRIDeS), Tohoku University—writes about disaster resilience as a necessary trait of ‘healthy’ societies. Governments across the globe are scaling up their combined efforts to reduce the risk of natural disasters. What role can evidenced-based health research, innovations and findings play in shaping local, regional and global Disaster Risk Reduction (DRR) responses? How can we change from ‘disaster preparedness’ to ‘increasing community resilience’? How can public, private and non-profit interactions be streamlined to increase efficiency and impact and reduce duplication? How can we optimize technology and human resource development in early warning, mitigation and post-disaster response? These and other key issues will be under the spotlight at the forthcoming Forum 2015 in Manila, Philippines, for which Prof. Egawa is part of the DRR scientific committee. COHRED firmly believes research and innovation are key to make societies healthy and thus, as Prof. Egawa maintains in his post, disaster-resilient. We therefore aim to stimulate widespread discussion on specific recommendations to strengthen national (health) research and innovation systems to make societies in low- and middle-income countries (LMICs) more resilient after natural hazards/disasters and adaptable to climate changes. Everyone interested in helping to develop the research and innovation systems of LMICs to become more disaster resilient – should be in Manila in August!
Carel IJsselmuiden (COHRED)