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PubMed2006

Hurricanes Katrina and Rita: evacuee healthcare efforts remote from hurricane affected areas.

Hurricanes Katrina and Rita produced the largest evacuation due to a natural disaster in United States history. Many people were evacuated or rescued from New Orleans and the Gulf Coast, resulting in a need for mass disaster shelters and medical care for months following the storms. The shelter healthcare system that was successfully developed in the Shreveport-Bossier City, Louisiana area was accomplished with little support from customary sources. This report is written after much discussion and introspection of community leaders involved "on the ground," who organized and provided medical services to evacuees of south Louisiana. Its purpose is to compile "lessons learned" in preparation for the next disaster recovery effort that might affect this or any other region of our country.

Community Health Services↗
PubMed2006

Terrorism preparedness: Web-based resource management and the TOPOFF 3 exercise.

BACKGROUND: The bombings of London on July 7, 2005 highlight the need for continued vigilance and readiness to respond to terrorist attacks. Trauma centers need to be at the core of preparedness activities. The State of Connecticut has taken a lead in preparedness and was selected as a site for the US Department of Homeland Security's Top Officials Three Exercise (TOPOFF 3), the largest and most extensive antiterrorism drill ever conducted. METHODS: All 32 acute care hospitals in Connecticut took part in the drill. The simulated attacks were designed to test all aspects of emergency preparedness including the ability of hospitals to treat large numbers of victims and effectively monitor and implement mechanisms for surge capacity. In Connecticut, TOPOFF 3 tested the Bioterrorism Preparedness Web Application that was designed to be the primary communication and resource management tool during a terrorist event or public health emergency. This paper describes: 1) the impetus for the State of Connecticut Department of Public Health's Bioterrorism Preparedness Web Application; 2) the strategies used to ensure its readiness and appropriate utilization during a public health emergency; and 3) its use for communication and resource management by the Department of Public Health and the acute care hospitals during TOPOFF 3. RESULTS: The Bioterrorism Preparedness Web Application was successfully implemented and used during TOPOFF 3 to assess surge capacity and other resources. CONCLUSIONS: Careful development and implementation of the Web application, or any communication system, as well as training and regular practice are required to ensure effective use during a public health emergency.

Bioterrorism↗
PubMed2005

Weather patterns, food security and humanitarian response in sub-Saharan Africa.

Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hence the economic and social well being of rural communities. The rainfall pattern in sub-Saharan Africa is influenced by large-scale intra-seasonal and inter-annual climate variability including occasional El Niño events in the tropical Pacific resulting in frequent extreme weather event such as droughts and floods that reduce agricultural outputs resulting in severe food shortages. Households and communities facing acute food shortages are forced to adopt coping strategies to meet the immediate food requirements of their families. These extreme responses may have adverse long-term, impacts on households' ability to have sustainable access to food as well as the environment. The HIV/AIDS crisis has also had adverse impacts on food production activities on the continent. In the absence of safety nets and appropriate financial support mechanisms, humanitarian aid is required to enable households effectively cope with emergencies and manage their limited resources more efficiently. Timely and appropriate humanitarian aid will provide households with opportunities to engage in productive and sustainable livelihood strategies. Investments in poverty reduction efforts would have better impact if complemented with timely and predictable response mechanisms that would ensure the protection of livelihoods during crisis periods whether weather or conflict-related. With an improved understanding of climate variability including El Niño, the implications of weather patterns for the food security and vulnerability of rural communities have become more predictable and can be monitored effectively. The purpose of this paper is to investigate how current advances in the understanding of climate variability, weather patterns and food security could contribute to improved humanitarian decision-making. The paper will propose new approaches for triggering humanitarian responses to weather-induced food crises.

Africa South of the Sahara↗
PubMed2000

Microwave life-detection systems for searching human subjects under earthquake rubble or behind barrier.

A new sensitive microwave life-detection system which can be used to locate human subjects buried under earthquake rubble or hidden behind various barriers has been constructed. This system operating at 1150 MHz or 450 MHz can detect the breathing and heartbeat signals of human subjects through an earthquake rubble or a construction barrier of about 10-ft thickness. The basic physical principle for the operation of a microwave life-detection system is rather simple. When a microwave beam of appropriate frequency (L or S band) is aimed at a pile of earthquake rubble covering a human subject or illuminated through a barrier obstructing a human subject, the microwave beam can penetrate the rubble or the barrier to reach the human subject. When the human subject is illuminated by a microwave beam, the reflected wave from the human subject will be modulated by the subject's body movements, which include the breathing and the heartbeat. If the clutter consisting of the reflected wave from stationary background can be completely eliminated and the reflected wave from the human subject's body is properly modulated, the breathing and heartbeat signals of the subject can be extracted. Thus, a human subject buried under earthquake rubble or hidden behind barriers can be located. This system has been tested extensively in a simulated earthquake rubble in the laboratory and also in a field test using realistic earthquake rubble conducted by a Federal Emergency Management Agency (FEMA) Task Force.

Diagnosis, Computer-Assisted↗
PubMed1997

Ten criteria for evaluating the management of community disasters.

The discussion herein concerns important factors in the local management of disasters. We contrast this with the related but distinct process of disaster planning. Our assumption is that what is crucial is not management per se, but good management. Thus, to assess intelligently the management of community disasters requires an answer to the question: What is good management? The results of empirical research carried out by social scientists over the past 40 years are drawn upon in considering this question. The criteria identified entail: (1) correctly recognising differences between response and agent-generated demands; (2) adequately carrying out generic functions; (3) effectively mobilising personnel and resources; (4) generating an appropriate delegation of tasks and division of labour; (5) adequately processing information; (6) properly exercising decision-making; (7) developing overall coordination; (8) blending emergent and established organisational behaviours; (9) providing appropriate reports for the news media; and (10) having a well-functioning emergency operations centre. An issue also raised in the paper is how applicable these research findings-derived mostly from developed countries-are to the developing world.

Developing Countries↗
PubMed1997

An assessment of disaster risk and its management in Thailand.

Historically, Thailand has been a disaster-free country, suffering only minor losses from natural hazards through the years. Emerging as a newly industrialised nation, the kingdom now faces an increased risk of economic and public damage from manmade disasters associated with rapid development. A risk assessment was carried out on the level of disaster management. That assessment was preceded by an analysis of the traditional definitions of disaster risk, resulting in a redefinition to fit the needs of this study. This holds that the risk of disaster is the product of hazards, vulnerability and the level of management exercised over both the hazard and the vulnerable elements. The results of the risk assessment, conducted through analysis of those three components, are discussed along with impediments which may hinder good disaster or accident management. Floods, in both natural and man-made manifestations, were identified as the highest risk factor, followed by major accidents and explosions, both man-made hazards. Major recommendations arising from the study included the consolidation of disaster management responsibilities currently held by several agencies into a central co-ordinating committee, the review and restructure of related law and regulations, the conduct of provincial and country-wide hazard assessments and the creation of a 'culture of safety' in Thailand.

Developing Countries↗
PubMed1997

A research note about military-civilian humanitarianism: more questions than answers.

'Military-civilian humanitarianism'--or the coming together of military forces and civilian aid agencies to deal with the human suffering from complex emergencies--has numerous forms, but disenchantment has resulted from the Somalia and Bosnia syndromes. There is little political will at present, but evidence from the immediate post-Cold War era suggests how multilateral military operations could expand or contract in future to the benefit or peril of war victims. Partly a literature review but more importantly a framework for interpreting recent publications, this essay seeks to move beyond exchanging assertions. There is a contextualisation of recent literature; a definition of military-civilian humanitarianism; a discussion of possible military contributions to humanitarian action; a framework to assess the effectiveness of military-civilian humanitarianism; and a preliminary analysis of experience from northern Iraq, Somalia, Bosnia, Rwanda and Haiti. Caveat lector: At this point in time, there are still 'more questions than answers'.

Altruism↗
PubMed1997

Local institutional development and relief in Ethiopia: a kire-based seed distribution programme in North Wollo.

Highlighted here is the important role played by community-based organisations in relief supply operations. In the context of an emergency seed supply project in northern Ethiopia in 1995, it examines the participation of burial societies, known as kires, in targeting, distribution and management. The paper illustrates that factors of local institutional legitimacy, transparency and accountability are central, both to the effective representation of community views and to long-term partnerships between local institutions and non-governmental organisations.

Agriculture↗
PubMed1997

Cruel wars and safe havens: humanitarian aid in Liberia 1989-1996.

This article considers the role of military intervention by peace-keeping and peace-enforcement troops in the provision of humanitarian aid to Liberia during the armed conflicts of the past seven years. The article focuses on the role of the de facto safe haven which peace-keeping and enforcing troops protected in Liberia between 1990 and 1996 and puts the Liberian case in the context of the growing debate about the usefulness of military interventions in humanitarian emergencies. It argues that the safe haven has enabled significant humanitarian achievements but has also demonstrated fundamental failures. Central to these failures have been the absence of consent, under-resourcing and a loss of control of the safe haven to factional interests.

Child, Preschool↗
PubMed1997

Conflict, the continuum and chronic emergencies: a critical analysis of the scope for linking relief, rehabilitation and development planning in Sudan.

The concept of the 'relief-to-development continuum' has been the subject of renewed interest in recent years. Concerned by the rise in relief budgets over the past decade and the absolute fall in development aid resources, support has been growing for the concept of developmental relief. In the context of complex political emergencies, it has been argued further that as effective development aid can reduce vulnerability to the impact of natural hazards, so it might also be used to contribute to a process of conflict prevention. In this way, the concept of the relief-development continuum has become entwined with broader discussions about the contribution of official development assistance management. Drawing on a Review of Operation Lifeline Sudan (OLS), this paper cautions against uncritical application of the concept of the continuum in complex political emergencies and rehabilitation in particular, in the current Sudanese context. It argues that in order to move legitimately from relief aid programming to development aid programming, three fundamental conditions must be in place: first, a minimum level of security, respect for human rights and humanitarian access. Second, empirical evidence from the field needs to demonstrate that the emergency is over. Finally, moving from relief to development aid programming is contingent on donor governments accepting the legitimacy of national governmental structures and of the rebel movements. In other words, for donor governments, moving along the continuum is in significant part determined by foreign policy considerations, not only technical ones. Consideration needs to be given to the actual and perceived legitimation of the different movements that a move to rehabilitation might be seen to imply. The paper argues that none of these conditions had been satisfied in Sudan by mid-1997. Instead of a process of normalisation paving the way to long-term development, the current situation in Sudan is better described as a chronic political emergency. In such a context, uncritical pursuit of developmental strategies may negatively affect the welfare of conflict-affected populations.

Humans↗
PubMed1997

The historical development of public health responses to disaster.

The first of a of series state-of-the-art reviews commissioned to mark Disasters' 21st anniversary, this paper considers key publications on public health aspects of natural disasters, refugee emergencies and complex humanitarian disasters over the past twenty-odd years. The literature is reviewed and important signposts highlighted showing how the field has developed. This expanding body of epidemiological research has provided a basis for increasingly effective prevention and intervention strategies.

Disaster Planning↗
PubMed1998

Humanitarianism and local service institutions in Angola.

The role of local service institutions is not a major focus of current discourse on humanitarianism and complex emergencies. These institutions, in the few places where they are mentioned, are usually presented as either the seed of civil society and future democracy, or as pawns and components of the predatory economic, political and military élites. Few would deny that examples can be found which conform to both of these stereotypes. This simplistic representation of local institutions ignores the perspectives of the actors themselves--the nurses, extension agents, school teachers and others who actually staff most NGO-supported projects. The debate has focused on what 'we' should do; the moral dilemmas of aid agencies and their expatriate staff, inevitably leading to the question of whether or not humanitarian workers should stay or leave situations in which aid may be causing more harm than good. Without denying the fundamental importance of these issues, it is important to consider also how the discourse has unfortunately moved away from those humanitarian workers who have no such choice, since they live there. Current concerns about keeping humanitarian aid from feeding local political and military struggles may inadvertently and paradoxically serve to constrain room for maneuver in the field, particularly among those individuals with the greatest tacit understanding of the predatory environment. There is a need to understand how actors in local service institutions make sense of their own situations, including the factors which frame their moral dilemmas and their day-to-day choices. By analysing the organisational processes within local service institutions, this study is intended to provoke consideration of how these individuals and their institutions may be effectively supported in complex emergencies through a focus on how they themselves deal with danger and complexity. It is suggested that there is a value in considering the lessons learnt in recent years about how service organisations in the North function in turbulent environments. This experience points to the importance of allowing workers the discretion to develop a relationship with their clients, and in so doing make sense of a confusing and ambivalent environment.

Altruism↗
PubMed1998

The Northridge earthquake: community-based approaches to unmet recovery needs.

The 1994 Northridge, California earthquake has proven to be one of the most costly disasters in United States history. Federal and state assistance programmes received some 681,000 applications from victims for various forms of relief. In spite of the flow of US$11 billion in federal assistance into Los Angeles and Ventura counties, many victims have failed to obtain adequate relief. These unmet needs relate to the vulnerability of particular class and ethnic groups. In response to unmet needs, a number of non-governmental organisations (NGOs) have become involved in the recovery process. This paper, based on evidence collected from hundreds of in-depth interviews with the people involved, examines the activities of several community-based organisations (CBOs) and other NGOs as they have attempted to assist vulnerable people with unmet post-disaster needs. We discuss two small ethnically diverse communities in Ventura County, on the periphery of the Los Angeles metropolitan region. The earthquake and resultant disaster declaration provided an opportunity for local government and NGOs to acquire federal resources not normally available for economic development. At the same time the earthquake created political openings in which longer-term issues of community development could be addressed by various local stakeholders. A key issue in recovery has been the availability of affordable housing for those on low incomes, particularly Latinos, the elderly and farm workers. We discuss the successes and limitations of CBOs and NGOs as mechanisms for dealing with vulnerable populations, unmet needs and recovery issues in the two communities.

California↗
PubMed1998

Crop failure in Dalocha, Ethiopia: a participatory emergency response.

This case study of an NGO's response to a food crisis due to crop failure focuses on the extent of active community participation at each stage of the project. With the current debate on the relationship between relief and development, and in particular the focus on encouraging more active community participation in relief responses, this study has relevance both in the Ethiopian context and beyond. In this example the participation process was greatly facilitated by the prior relationship between the international NGO and the communities, and also by the high level of staff input into the project. Where resources or conditions are less favourable, as might be the case in similar responses by local NGOs or government agencies, the paper suggests that the participatory approach can be adapted or partially implemented and still result in a more effective and locally relevant operation.

Agriculture↗
PubMed1998

Coping strategies in an ethnic minority group: the Aeta of Mount Pinatubo.

The particular problems arising in the aftermath of natural disasters in indigenous societies in the Third World, especially in ethnic or cultural minorities, have until now received only little attention in social scientific research. The potential of such indigenous groups to use their traditional knowledge and behaviour patterns in coping with natural disasters has been badly neglected. The example of the Aeta in Zambales, Philippines, a marginal group who were hit directly by the eruption of Mt Pinatubo in 1991, shows how traditional economic and social behaviour can in some measure determine their various survival strategies.

Cultural Characteristics↗