Category: 2022

After the occurrence of an emergency disaster, vulnerable and high-risk communities are often in a state of despair as they try to overcome the obstacles created by the disaster. By implementing early warning systems or structural modifications, mitigation can limit the adverse outcomes by giving the community tools to be less vulnerable. Ciara Freeman emphasizes the importance of informing communities to support their abilities to withstand and recover from adversity.

Especially for bigger disasters impacting large populations, like droughts, mitigation efforts in the form of community resilience can utilize local resources to improve outcomes. However, communities should be supported through regulations, policies, and resources to be able to be empowered and avoid perceptions that may hinder their ability to act.

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On December 26, 2004, the Indian Ocean tsunami resulted in 250,000 deaths and 2 million people displaced.  It caused widespread damage to infrastructure and interrupted the livelihood of millions of people.

In this case study, Yining Liu explains that the tsunami occurred when an underwater earthquake, registered as a magnitude 9 on the Richter scale, resulted from subduction of the Indian Ocean tectonic plates.  It pushed up the ocean floor by 40 m, killing 100,000 people within 20 minutes.  The damage to infrastructure impacted hygiene and sanitation services and precipitated the spread of diseases like cholera and bilharzia. Additionally, food security worsened when the agriculture and fishing industry was impacted, and major economic losses transpired when the tourism industry was crippled.

Yining points out that information was limited during the event and was a major contributor to the vulnerability of populations, effectively inhibiting their ability to respond and evacuate on time. Due to the abruptness and magnitude of the tsunami, Yining notes that the local management faced significant challenges, drawing on international aid to support their efforts. Government response efforts focused on rebuilding the food system, providing shelters and food to the displaced populations, rebuilding infrastructure and facilities, and facilitating the coordination between different hospitals.

The lack of information was the main cause of the high death tolls and financial damages, and this event highlighted the need for early warning systems, forecasting, and predictions when designing preparedness plans.

Download the case study here.

Hazard mitigation planning is a crucial step to reduce the risk of recovering from a disaster. Though emergency disasters pose a threat to the affected communities, it also creates an opportunity to improve upon risk management practices and policies for future events. Mitigation can reduce risk greatly or even eliminate it if plans focus on disaster-prone areas and consider all potential scenarios. One major way to enforce mitigation is through community resilience, which can strengthen response and recovery efforts. Michelle refers to the literature to discuss measures to strengthen local communities, which are frequently the first-line responders during an event,  such as the Community-Based Disaster Risk Reduction and the Community-Based Disaster Management programs. Resilient communities that are supported by such programs can improve their preparedness practices by addressing issues of health and health systems, resources, and adaptation.

Click here to read more about Michelle’s assessment. 

 

In this review of global trends, Nancy Daneau discusses the institutional public health challenge in earning public trust.  In recent years, especially during the pandemic, trust in doctors has decreased due to various reasons; there might have been a lack of patient respect, insufficient time with patients, failure to provide information patients need, or understanding patients’ complaints or their concerns.  As such, this leads to poorer health outcomes since patients are less inclined to follow doctors’ recommendations.  Patients prefer to seek support from other sources they trust, which may not provide high-quality and evidence-based advice.  

Nancy suggests several strategies to rebuild public trust:

1. affordable and accessible healthcare;
2. reliable information free of jargon;
3. real-time, accessible, data-driven information, and;
4. present clear, verifiable, and reproducible data to the public.

With reformed health systems inclusive of public trust, the targets of health equity, resilient workforce, coordination, knowledge transfer, and incentivization become more aligned. 

Read Nancy Daneau’s work here

In March 2010, the Icelandic volcano Eyjafjallajökull began erupting and led to an increase in respiratory illness, 100,000 flight cancellations, and $200 million in economic costs. In this case study by Katrina Paleologos, she describes the details of the eruption;  Eyjafjallajökull is one of Iceland’s ice caps, therefore the eruption caused consecutive vapor explosions from hot magma coming in contact with the snow.  This led to volcanic ash ejection, plume dispersion, and the melted glacial ice flowing into the volcano, further increasing the explosive power of the eruptions.  

Katrina reported the results of a longitudinal study conducted in 2010 and 2013 to identify the effects of the volcano on 1,000 residents, exposure level was analyzed alongside the reported physical symptoms, psychological distress, perceived stress, and symptoms of Post Traumatic Stress Disorder.  It was found that there were increased physical respiratory symptoms in the exposed participants.  

The evacuation and response plans included swift relocation of civilians and limiting mobility to high-risk areas by closing roads and airspace.  This event has led to the establishment of a policy advisory group for future environmental disasters and coordination with airlines.  

Read Katrina Paleologos’s case study here

In March 2015, Cyclone Pam struck the islands of Vanuatu as the second most intense tropical cyclone of the South Pacific Ocean. Though food stocks, water sources, crops, health facilities, and schools were severely damaged, there were only 11 deaths due to the efficiency of disaster preparedness and responses by the Vanuatu government. Namely, the warnings sent by Vanuatu’s National Warning Centre to inform residents despite nearly 65% of the gross domestic product being destroyed. Cyclone Pam was a category 5 storm of intense winds; resulting in up to 70% of the population being affected, more than 70% of Vanuatu’s health facilities were damaged, and 95% of the crops were spoiled. The consequences of the cyclone were further perpetuated by poor sanitation and increasing rates of acute diarrheal disease in children. Additionally, the public health sector was faced with the possibility of worsening incidence rates of respiratory illnesses, waterborne and mosquito-borne diseases such as typhoid and dengue fever.

The public health response to Cyclone Pam was very targeted; preventative interventions were prioritized such as childhood immunization, reproductive and sexual health services, and domestic violence prevention. Furthermore, international aid partners helped residents protect their homes and provided shelter kits/hygiene supplies, communal kitchens, and clean drinking water. 

Despite the commendable efforts of Vanuatu’s government and the Ministry of Health, Vanuatu is still very susceptible to disasters so monitoring disasters and warning systems are critical for future threats.

Read the full case study here. 

On December 26, 2004, an earthquake with a magnitude of 9.1 originated in the Indian Ocean and caused a tsunami with waves reaching speeds of 500 mph, impacting 14 countries surrounding the Indian Ocean.  The epicenter of the earthquake was recorded in Banda Aceh, Indonesia, resulting in the greatest death tolls at 108,100 with 127,700 people missing or presumed dead, and 426,800 displaced.  It was one of the deadliest disasters in modern-day history.  The destruction of the tsunami spanned multiple countries with recorded casualties occurring several hours later in southern Thailand, Sri Lanka, Chennai (India), and the east coast of Africa.  

In the case study, Sandhya Shankar reported the epidemiological details of the disaster found in the literature,  it was found that sex, age, and socioeconomic status were significant confounding variables in terms of mortality rates according to a study by Frankenberg et al.  The study noted that men and prime-age fishermen had lower mortality rates compared to their counterparts.

In terms of short-term management, Shankar points out that humanitarian donors were effective in raising a total of $13.6 billion dollars to fund the largest coordinated relief operation. However, negotiations determining recovery plans were unsuccessful and reconstruction of the infrastructure and health systems was not achieved, further impacting vulnerable communities with high levels of poverty.  

Overall, Shankar summarized that this event will become a valuable reference event for many organizations responding to a large-scale disaster in the future.

Read Sandhya Shankar’s case study here

Candida auris is a deadly fungus that can lead to death among infected patients, and it is highly resistant to drug treatments and is acquired mainly in hospitals and nursing homes.  In August 2016, the first case of the current ongoing outbreak was found in New York City, leading to 1,025 cases identified in New York State and deaths in 30-60% of the susceptible immunocompromised population.  In this case study, Caroline Romano investigates the epidemiological facts about this outbreak and reports that there is little information about the impact of C. auris on healthcare but journalists have identified that policies are poorly enforced, and lack of screening and irresponsible use of antifungals are contributing to the multi-drug resistance characteristic of the infectious agent. 

In managing the outbreak by the New York State, Caroline Romano points out that it has been ineffective since guidelines for handling or reporting infectious are not enforced and proper precautionary measures are yet to be mandated. Three years after its emergence, New York State labeled C. auris as a public health threat but did not make the screening, management, and reporting of the infection mandatory.  The lack of translational guidance from the state created gaps in communication and implementation in hospitals and public health departments alike. 

Read Caroline Romano’s case study here

In early April 2010, an explosion in a mine in Montreal, West Virginia killed over 90% of the workers that day and only 2 survived making it the most fatal explosion incident since 1970. The source of the ignition is still unknown but the high flammable methane levels were likely to have been a major contributor to the disaster. Initially, 25 out of the 29 men that were killed were discovered immediately and their deaths were attributed to the explosion or inhalation of toxic gases that resulted. Four more individuals, who were presumed missing, were later identified in the blast debris. The underlying problems with occupational health and safety protocols and processes and the response of the mine management company led to heavy criticism by the families of the deceased and public officials. 

 

Download the case study here. 

Callie presents the case by describing the human and economic impact of the deadliest tornado event in Kentucky’s history. Although the devastation from the “violent” level tornadoes spanned multiple states, Kentucky had the highest number of human casualties. Allowing this event to be labeled as a federal disaster by President Biden and facilitating the rapid mobilization of resources, aid, and assistance. Even though early warning systems were activated, Callie makes an interesting point that they may be less effective during the hours that people are usually sleeping, thus hindering response to the alerts. The slow civilian response may have played a role in this disaster as well as the vulnerability of the populations that live in the southern U.S. states. 

Download Callie’s case study here.