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9781284145403_SLID_CH16.pptxChapter Sixteen
Natural Disasters and Complex Humanitarian Emergencies
Learning Objectives
Describe several types of disasters that affect human health
Discuss the health effects of natural disasters and complex humanitarian emergencies
Review how those health impacts vary by age, sex, location, and type of disaster
Describe key measures that can be taken to mitigate the health impacts of natural disasters and complex humanitarian emergencies
The Importance of Natural Disasters and Complex Emergencies to Global Health
They lead to increased death, illness, and disability
Large economic impacts
Measures can be taken to reduce costs of disaster and conflict
Key Terms
Disaster: “any occurrence that causes damage, ecological destruction, loss of human lives, or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community area”
Can be rapid (e.g., earthquake) or slow-onset (e.g., drought)
Key Terms
Complex humanitarian emergency: “complex, multi-party, intra-state conflict resulting in a humanitarian disaster which might constitute multi-dimensional risks or threats to regional and international security”
Example, Liberia: Civil war from 1990–2004 led to almost 500,000 IDP and more than 125,000 refugees in Guinea alone
Key Terms
Refugee: “a person who is outside his or her country of nationality or habitual residence; has a well-founded fear of persecution because of his or her race, religion, nationality, membership in a particular social group or political opinion; and is unable or unwilling to avail him- or herself of the protection of that country, or return there for fear of persecution”
Refugees are accorded certain rights by international law
Key Terms
Internally displaced people (IDPs): people who are forced to flee or migrate and leave their homes during a disaster or complex humanitarian emergency but stay in the country in which they were living
Legal definition not well defined
No agency or organization responsible for IDPs
Key Terms
Crude mortality rate: the proportion of people who die from a population at risk over a specified period of time
Expressed per 10,000 population, per day
Key Terms
Attack rate: proportion of an exposed population at risk who become infected or develop clinical illness during a defined period of time
Case fatality rate: number of deaths from a specific disease in a given period, per 100 episodes of the disease in that same period
The Characteristics of Natural Disasters
Includes droughts, hurricanes, typhoons, cyclones, heavy rains, tsunamis, earthquakes, and volcanoes
Number of natural disasters are increasing, affecting larger numbers of people, causing more economic losses, but causing proportionally fewer deaths
90% of the deaths from these disasters occur in low- and middle-income countries
Cause damage to health systems and other infrastructure
The Characteristics of Complex Emergencies
Often go on for long periods of time
Sometimes groups that are fighting will not allow humanitarian assistance to be provided
Combatants often target civilians
Systematic abuse of human rights
Food shortages
Breakdown of publicly supported health system
Unhealthy living circumstances in refugee camps
The Health Burden of Natural Disasters
Direct and indirect effects depend on type of disaster
2015: 22,765 deaths and 110.3 million victims globally
2016: 8,733 people deaths and 564 million people were displaced worldwide
Some effects are short-term such as death; others are long-lasting, such as mental health problems
Very old, very young, and very sick are most vulnerable
The Health Burden of Natural Disasters
More than 100,000 people are thought to have died as a result of the earthquake in Haiti in 2010
© Claudiad/E+/Getty Images.
The Health Effects of Complex Humanitarian Emergencies
Large and underestimated because of difficulties in collecting data
Between 320,000 and 420,000 people killed each year as a direct result of CHEs
Malnutrition, lack of safe water, food shortages, and breakdown of health services can lead to illness, disability, and death
The Health Effects of Complex Humanitarian Emergencies
Causes of Death in CHEs
In the early stages, most deaths occur from diarrheal diseases, respiratory infections, measles, or malaria
Populations affected are generally poor and have poor nutritional status
The Health Effects of Complex Humanitarian Emergencies
Violence Against Women
Security conditions put women at considerable risk of sexual violence
Rape is used as a weapon of war
Economic distress and chaos may force women to trade sex for food or money
The Health Effects of Complex Humanitarian Emergencies
Mental Health
Social and psychological shocks due to changes in way of living, loss of livelihoods, damaged social networks, and physical and mental harm
The Health Effects of Complex Humanitarian Emergencies
Mental Health
Studies have found that affected children and adults suffer from high rates of depression and PTSD
For example, prevalence of PTSD is about 37% among Cambodian refugees versus about 1% in the U.S.
Important to help people rebuild their lives and social networks as quickly as possible
Addressing the Health Effects of Natural Disasters
Assess the health situation immediately
Address needs of immediate trauma cases
Help other injured people who are in need of early care and treatment
Establish continuous disease surveillance
Provide food, water, and shelter
Addressing the Health Effects of Natural Disasters
To be helpful, external assistance will have to:
Include all of the external partners
Be based on a cooperative relationship among the partners
Have partners working in ways that are complementary to each other
Be evidence-based and transparent
Involve the affected communities
Addressing the Health Effects of Natural Disasters
Disaster preparedness plans can be formed to:
Identify vulnerabilities
Develop scenarios of what might happen and the likelihood
Outline the role that different actors will play in the event of an emergency
Train first responders and managers to deal with such emergencies
Addressing the Health Effects of Complex Humanitarian Emergencies
Assessment and Surveillance
Carry out assessment of displaced population
Establish a system for disease surveillance
Check weight for height of all under-5 children
Assess the daily crude mortality rate
Daily rate twice the baseline rate signifies a public health emergency
Addressing the Health Effects of Complex Humanitarian Emergencies
A Safe and Healthy Environment
Maintain environmental and personal hygiene
Adequate clean water
Recommended: 15 L per person per day
Adequate number of toilets, segregated by sex
Recommended: 1 toilet per 20 people
Provide effective and culturally appropriate shelter
Addressing the Health Effects of Complex Humanitarian Emergencies
Food
Provide at least 2,100 kilocalories of energy per day for adults
Ensure female-headed households and children get their rations
Give Vitamin A given to all children
Provide urgent nutrition supplementation to severely malnourished children
Addressing Health Effects of Complex Humanitarian Emergencies
Disease Control
Handle injuries and trauma first
Vaccinate all children aged 6 months to 15 years old for measles
Properly manage diarrhea and malaria
Provide health education and promote hygiene
Provide minimum package of care for pregnant women
Attend to urgent psychiatric conditions
Addressing Health Effects of Complex Humanitarian Emergencies
Coordination of International Emergency Responses
Office of Humanitarian Affairs – a UN body responsible for strengthening the coordination of UN responses to humanitarian emergencies
NGOs have also created common standards and guiding principles for humanitarian action
Sphere Project
Future Challenges
How to reduce negative health impact
Need to further develop and use standards and protocols for responses to disasters among all actors
Need to respond with the most cost-effective approaches
Main Messages
Natural disasters, such as droughts, famines, hurricanes, typhoons, cyclones, and heavy rains, have important health impacts
More than 90% of deaths from natural disasters occur in low- and middle-income countries
Some effects are short-term, such as death; other effects are long-term, such as mental health impacts
Main Messages
CHEs have direct and indirect impacts on health
Countries at risk can take a number of measures to mitigate vulnerability to damage from natural disasters, including:
Building seawalls and levees
Requiring earthquake-proofing
Strengthen water supply infrastructures
Main Messages
Health during CHEs need to be assessed quickly and continuously
Early attention to environment, shelter, water, and food when dealing with displaced peoples
Particular attention must be paid to malnutrition, pneumonia, and malaria
Main Messages
There has been important progress in coordination and standardization of measures to address CHEs and natural disasters
There are still gaps in preparation and training in response agencies
There has been inadequate attention to cost-effectiveness of interventions and information about the lessons of CHE and natural disaster response
