Transcript davos forum
Evaluating the Processes of Learning from Environmental Disasters David Alexander Global Risk Forum - Davos (CH) What are lessons? + The process of disaster risk reduction (DRR) Analysis Past events • utilised Disaster • adopted risk • learned reduced Lessons - • • • • registered archived forgotten ignored Vulnerability maintained. Knowledge is power* Knowledge is enlightenment *Ipsa scientia potestas est Dichotomies in knowledge • individual and social knowledge • traditional and affective knowledge (Weber) • facts and values (Simon) • optimising and satisficing (Simon) • objective knowledge of bureaucracies and cultural knowledge of clans (Ouchi) • objective and tacit knowledge (Polanyi) • incremental and radical learning (March) • enduring and perishable information. DIKW pyramid Wisdom: ability to take decisions on the basis of principles, experience and knowledge Knowledge: understanding of how things function (or should function) Information: description of physical and social situations Data: basic facts and statistics COMMUNICATION • • • • Unexpected event New circumstance Error New practice Experience Change and innovation Lesson to be learned Recognition and comprehension Lesson learned Improved safety Sources of lessons on disaster • general and specific lessons from major events • lessons from monitoring drills and exercises • cumulative experience of particular phenomena, practices or problems • lessons that arise from particular situations • lessons from human error and technical faults. UK HM Inspectorate of Railways (Board of Trade/Royal Engineers. 1840) (since 2005 HSE Rail Accident Investigation Branch) • Rigorous, impartial, independent investigation of accidents • Recommendations for changes in rail safety were non-binding • Railway industry strongly resisted changes (e.g. better signalling, continuous brakes, electrical rather than gas lighting) • Trains without continuous braking survived in the UK into the 1970s • Crucial improvements resisted c. 60 years. Why are lessons not learned? • cost considerations • indifference or corruption • opposition from particular interests • accidental or wilful ignorance • political expediency • cultural rejection of DRR. There is a common tendency to blame organisational failures on human error rather than systemic inadequacies. "Details are still sketchy, but we think the name of the bird sucked into the jet's engines was Harold Meeker" unreinforced completely reinforced Cost of retrofitting a building Cost per life saved Number of casualties completely reinforced largely unreinforced Cost of retrofitting a building Lack of incentive to "learn lessons" A basis of theory Knowledge of hazards and their impacts Disaster Risk Reduction Knowledge of community vulnerability DRR Knowledge of coping capacity and resilience Natural systems: function Organisational systems: management Hazard Resilience Social systems: behaviour Vulnerability Technical systems: malfunction Hazards and risks: disaster preparedness Governance: democratic participation in decision making Livelihoods: diversity and security RESILIENCE: managing risks adapting to change securing resources Uncertain future: long-term trends climate change capacity to adapt Risk-expenditure cycle Large disaster Increased risk Reduced expenditure Return of complacency No disaster Deaths, injuries, hardship, damage, disruption Review Increased expenditure Reduced risk Sadly, this is a good metaphor for current disaster risk reduction.... MAJOR DISASTER RISKS (e.g. floods, drought, landslides, heatwaves) EMERGING RISKS (e.g. climate change, pandemics) SUSTAINABILITY OF DISASTER RISK REDUCTION GENERAL SUSTAINABILITY (e.g. lifestyles, economic activities, environment) DAILY RISKS (e.g. food security, poverty) In times of peace Planning, warning and preparedness Fusion with sustainability agenda Enhanced structural protection Organised non-structural protection In times of crisis Indeterminacy Climate change Collateral vulnerability Cascading effects Interaction between risks Secondary disasters "Fat-tailed" distributions of impacts Probability And what about the cultural acceptability or unacceptability of lessons....? National Regional Peer group culture Family culture Value system Work culture culture culture Personal culture Technology as a source of risk reduction Benign Malignant Ceaseless development of technology Technology as an inadvertent source of risk Technology as a deliberate source of risk Cultural filter Risk management practices Optimisation Technology Response Message Perception Plan Culture Social factors The creation of a culture of civil protection HABIT MASS EDUCATION PROGRAMME CULTURE SOCIAL CAPITAL Augmentation INSTRUMENTS OF DISSEMINATION • mass media • targeted campaign • social networks • internet Individual vs organisational learning Disaster Risk Policy Assessment Risk assessment • hazard • vulnerability Policy assessment • exposure • costs Expected • benefits losses • consequences Policy adoption Perception Risk management Risk assessment Disaster threat Risk Organisational communication learning Knowledge Risk analysis Adaptation A classification of organisational learning Narrow learning, inhibited innovation Professional model Bureaucratic model Professional Machine bureaucracy bureaucracy embrained encoded Superficial learning, limited innovation embodied embedded Dynamic Operating learning, adhocracy radical innovation Occupational community model Cumulative learning incremental Organisational innovation community model 'J-form' organisation Source: Lam (2000) Environmental context Latent organisational context Active context Active (members' organisational tools) context Practical experience Knowledge After: Argote and Spektor (2011) Evidence-based practice: the systematic use of lessons learned. Enduring knowledge:• fundamental concepts and procedures • consensus knowledge • information that reinforces, sustains and maintains existing practices "Perishable" knowledge:• poorly collected and conserved 'transient' information • fruit of an organization's adaptation to rapid and profound change. Ambulance Evidence-based practice and maladaptive behaviour, Genova flash floods, November 2011 We tend to prepare for the last disaster, not the next one. Preparation for nuclear war was a prime example of how lessons were not learned. • the post-nuclear world...? • collapse of life-support systems • persistence of radiation • Hiroshima and Nagasaki no guide to modern nuclear war • preparations were preposterous Can we learn from this example? • • • • Lessons of GEJET:complex emergent verified by future history not yet accepted by all decision-makers or publics Public interest Sustainable lessons Personal or private interests LESSONS LESSONS ...LEARNED? ...LEARNED? Uncertainty, unpredictability Cultural acceptability Incentives to learn Thank you for your attention! [email protected] emergency-planning.blogspot.com www.slideshare.com/dealexander