Transcript Disasters Asia Final 1-10-14

Disasters as a Way of Life
Jennifer Leaning, M.D.,S.M.H.
FXB Professor of Health and Human Rights
Harvard School of Public Health
Harvard University
January 10, 2014
Pakistan Urban Forum—South Asia Cities
Conference
Outline
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Disaster Trends
Societal Response to Disaster
Environment and Climate Change
Forced Migration
Key Examples
Disasters as a Way of Life
World Disaster Trends
– Incidence increasing rapidly since 1970-79 1,110
• 1980-89 1,987
• 1990-99 2,742
• 2000-10 >4,500
– Costs high
• 1990s
• 2000s
• 1990s
• 2000s
• 1990s
• 2000s
200 million people affected/year
250 million people affected/year
80,000 people killed/year
>80,000 people killed/year
$60 billion cost/year
$ 90-100 billion cost/year
Disasters by Cause
Societal Response to Disaster
• Disasters reflect key structures and values of
society
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Resource availability
Environmental dependencies
Managerial competence
Technological state
Risk assessment
Problem-solving capacities
Vulnerabilities
• They strike the vulnerable disproportionately
Societal Response to Disaster
• Decision-making is central to disaster
response
• Key issues to resolve in emergency decisionmaking
• How to maintain balance between technical and ethical
issues (efficiency vs inclusiveness)
• How balance speed with comprehensiveness of
information-processing
• What must be done centrally and what best works at
the de-centralized level
• Best decision-making requires advance
planning
Societal Response to Disaster
• Individuals function within groups, so group
behavior is critical to understand
• Institutions are essential to provide
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funding for risk assessments and planning
human capital and robust training
resource mobilization
coherent direction
Societal Response to Disaster
• Definitions of disaster
– Vary with sense of proportion and value system
– “A subset of collective stress situations, arising
either from external sources (large unfavorable
changes in the environment, like floods, droughts,
accidents, attack) or from internal sources
(massive social disorganization, like riots, civil
wars, pogroms).” (Barton)
Societal Response to Disaster
• PAHO: “for operational purposes: a sudden
ecological phenomenon of sufficient magnitude to
require external assistance.”
• Other definitional dimensions:
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Scope
Speed
Duration
Social complexity
Social preparedness
Societal Response to Disaster
• Challenges
– Intensity, complexity, and scale increasing
• Population size, density of settlement
• Technology and infrastructure expansion
• Climate change
– Conceptual and managerial capacity to cope with
• Continual planning cycle
• Critical timing inputs
• Central vs. local
Societal Response to Disaster
• Classic view: Three distinct phases
– Pre-impact, impact, post-impact
– Severity often assessed in terms of duration until
recovery
• Current view:
– Phases merge into each other
– Planning and mitigation must occur iteratively
– Resilience is the aim of planning and recovery
Societal Response to Disaster
• Response capacity is improving—globalization
– Shared planning and risk assessments
– Enhanced technology for ascertainment and
communications
– Humanitarian capacities more sophisticated
Societal Response to Disaster
• But major problems persist—conceptual
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Awareness and vigilance
Priority setting
Resources for planning and mitigation
Training and coordination
Ongoing evaluation and re-design
Societal Response to Disaster
• Characteristics that make disasters hard to
study
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Retrospective view
Always without case controls
Technical complexity
Data quality and availability
Evaluation costs
Confidentiality
Lack of theoretical framework
• Yet study is imperative to improve future
response
Environment and Climate Change
• Increasingly important factor in disasters
and forced migration
• Weather instability, water scarcity, and
flooding
• Sea level rise, coastal flooding
• Food insecurity, drought, famine
Environmental Degradation
• Environmental change
– Desertification
– El Nino/ La Nina cycles
– Degradation (land use, development, extraction,
pillage, population growth)
– Urbanization
– Intensifying water shortages
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Courtesy James McCarthy Harvard
University
Courtesy James McCarthy Harvard University
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Courtesy James McCarthy Harvard University
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Courtesy James McCarthy Harvard University
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Trends
• Highly likely that world is now locked into
temperature and sea level rise by 2100
– 2-4 degree F temperature increase
– 2-3 foot increase in sea level
• Adaption and mitigation strategies are
urgently needed
Implications for Human Health
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More water-related natural disasters
More frequent episodes of heat waves and droughts
Increased food insecurity
Shifts in patterns of disease pathogens and vectors
Possible increased morbidity and mortality
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Heat stroke
Malnutrition/famine
Stress and disruption from forced migration
Cardiopulmonary/cancer from air pollution
Infectious disease (water-borne, insect vectors)
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Climate-Affected Populations
• Those living in low-lying coastal regions and
river deltas
– South and southeast Asia, US east coast, US
Gulf coast, island nations
• Those living in dry and hot areas
– US south and plains, central Russia, Mideast,
north Africa, Sahel, Horn and East Africa, South
Asia, Amazon, Australia
• Those who are food and land insecure
• Large urban populations in these categories
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Forced Migration
• Population movement
– Flight from war and atrocity
– Flight from major disasters/famine
– Voluntary or involuntary due to climate change
• Emergency needs
– Health, nutrition, security
• Temporary vs. permanent settlement
• Loss of livelihoods, culture, history
Forced Migration
Forced Migration and Human
Rights
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Forced migration
Loss of livelihoods
Loss of past
Disrupted futures
Power disparities in collective choices
Immiseration of those without options
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Key Examples
Hurricane Katrina
August 29, 2005
Hurricane Katrina
• Major category 3 hit very close to New Orleans,
LA August 29, 2005
• City of 485,000 on US Gulf Coast with one road
north for evacuation
• Disaster resulted in rapid forced migration
within and then out of the city
• As of 2010, only 345,000 have returned
• Over 1,800 deaths
• Underlying racial and socio-economic fissures
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Hurricane Katrina 8/26/05
Hurricane Katrina 8/29/05
Hurricane Katrina 8/30/05
Hurricane Katrina
Hurricane Katrina Devastation, September 2005
Memorial Medica
Center
St. Rita’s Nursing Home
Hurricane Katrina
Indus River Floods,
Pakistan
July-August, 2010
Indus Flood Facts
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Worst floods in 80 years
killed at least 1,600 people and affected about 12 million others
Croplands devastated: 17 million acres submerged, 200,000 livestock killed
800,000 cut off, only reachable by air
INFRASTRUCTURE:
• Power lines, Jinnah Hydro Power plant , shortfall of 3.135 gigawatts
• Roads, bridges, railway swept away
DISEASE:
• Gastroenteritis, diarrhea, skin, cholera, malaria
UNEXPLODED ORDNANCE/INSECURITY
• Landmines washed down from Kashmnir and Waziristan
• Taliban issued death threats against foreign aid workers
Satellite
images of
upper indus
river valley
comparing
water levels
on 1 august
2009 (top)
and 31 July
2010 (bottom)
Pakistan Floods in 2010:
20 million people affected
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Indus Flood Facts
• Worst floods in 80 years
• killed at least 1,600 people and affected about 12 million others
• Croplands devastated: 17 million acres submerged, 200,000 livestock killed
• 800,000 cut off, only reachable by air
• People trapped for months--landless
INFRASTRUCTURE:
• Power lines, damage to Jinnah Hydro Power plant , shortfall of 3.135
gigawatts
• Roads, bridges, railway swept away
DISEASE:
• Gastroenteritis, diarrhea, skin, cholera, malaria
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Indus Flood Response
• National response slow and not coordinated
• Reports of riots and looting of aid convoys
• Slow international response: only US$45 million
committed by Aug 9, far less than usual
• Affected population: 6/14 million children and 3
million women of childbearing age (MORE THAN
TSUNAMI)
• Not attractive aid target because of low death
toll, protracted timeline, lack of celebrity
involvement, politics
Bangladesh Cyclones
• Population 150 million, 80% live on flood
plain
• Three devastating cyclones 1970, 1991,
2007 in Bay of Bengal
• Improved warning and evacuation
• Cyclone mortality reduced markedly
despite 3x population growth in last 40
years
• Remarkable adaptation but inexorable sea
level rise this century
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Bangladesh Cyclones
1970, 1991, 2007
Bangladesh Cyclone
November 11, 1970
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Bangladesh Cyclone
April 29, 1991
Bangladesh Cyclone 1991
Sample study
Mortality by age and sex
Vast majority by drowning
Disproportionate deaths
among elderly, women, and
girls
Reluctance to evacuate
Upper body strength
Hair entanglement
Female malnutrition
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Cyclone Sidr 2007
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Cyclone Sidr 2007
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Bangladesh Cyclones
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Hurricane Sandy 10/29/12
Hurricane Sandy 10/29/12
• North-east Atlantic coast of US
• New York City and New Jersey shore
• Category 3 (115 mph) but largest span on
record (24 states affected)
– 10 million people affected
– $65 billion in damages
– 286 people killed
Hurricane Sandy 10/29/12
• Climate change
• Warning/evacuation
• Dependencies of diverse urban population
– High rise/tenements and low income
– Elderly
– Electricity dependent
• Planning failures
– HVAC
– Hospitals
– Bottlle-necks for aid delivery
Disasters as a Way of Life
• Threat Assessment: Kinds and Types
– Huge wind and water storms (climate)
– Massive earthquakes
– Famine and drought (climate)
– Pandemics (climate)
• Risk Assessment: Predictability
– Existing risks
– Climate change induced
– Population settlement
Impending Threats
Gujarat
Earthquake
1/26/01
Asian Tsunami 12/26/04
Disasters as a Way of Life
Disasters as a Way of Life
• Disaster response reflects key structures and
values of society (the experts’ view)
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Resource availability
Environmental dependencies
Managerial competence
Technological state
Risk assessment
Problem-solving capacities
Vulnerabilities
• Disasters strike the vulnerable disproportionately
Disasters as a Way of Life
• We are all vulnerable now (the global view)
– Accelerating trends in human interactions with the
environment
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Land use
Population growth
Population settlement
Energy consumption/development policies
Climate change
– Result:
• Increase in intensity and scope of natural disasters
• Risks spread more evenly across the globe
Disasters as a Way of Life
• These macro-trends reduce the advantages of
rich societies
– Technological state and managerial competence
remain more widely distributed in the developed world
– Environmental dependencies, related vulnerabilities,
and capacity for risk assessment and problem-solving
do not seem in recent disasters always to follow the
distribution of wealth
Disasters as a Way of Life
• Natural disasters
– Prevention means mitigation of human impact
– Prevention means developing vigorous and
appropriate strategies to:
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assess risk
reduce risk
identify vulnerabilities and resiliencies
prepare to respond
Disasters as a Way of Life
• Dominant discourse
– Faith in progress
– Technological fix
– No substantial change in human behavior
required
– We will confront whatever occurs
Example: US response to coastal hurricanes
Disasters as a Way of Life
• Dominant discourse
– Disasters are disruptive aberrancies
– We must mobilize to reduce their incidence
and impact
– We have the resources and bureaucratic
competencies to do so
• The Planning Enterprise
• The Response Enterprise
• The Regulatory Enterprise
Disasters as a Way of Life
• Non-dominant discourse
– Cautionary sense of our place in nature and
time
– Need to re-examine human ecology
– Accommodate rather than confront
Disasters as a Way of Life
• Non-dominant discourse
– Disasters are part of life
– Disasters are predictable
– Disasters are increasing in intensity and
scope
– We must plan to adjust to them as well as
confront them
Disasters as a Way of Life
• This century will see the tipping point
• Resolution is urgent
• Major paradigm and policy shifts are required
– Learn from local communities about local coping
strategies
– Identify preparedness strategies that go from bottom
up as well as top down
– Assess community coping strategies and governance
capacities in areas most likely to face extreme water
and temperature effects from climate change
Disasters as a Way of Life
• Governance challenges
– Central planning
– Local planning
– Coherence and cooperation in bridging gap
between current coping strategies and
massive shifts that may be necessary
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