Global climate change is expected to lead to an increasing number of extreme climate events (see Chapter 10). There are two categories of climate extremes to be considered:
• extremes of climatic statistical ranges, such as very low or very high temperatures
• complex events: droughts, floods, or hurricanes.
The health effects of weather-related disasters such as droughts, floods, storms and bushfires are difficult to quantify. Initial deaths or injury tolls are reported, but the delayed consequences of the disaster are often poorly reported.
The number of natural disasters is increasing. This can be attributed to a number of causes and may in part be a consequence of the better recording of events. Com- pared to the 1960s, there has been a tripling in the number of natural disasters in the past ten years, according to an analysis by the reinsurance company Munich Re. This is probably partly due to increasing population vulnerability rather than to an increased frequency of extreme climatic events themselves; however, increased population vulnerability is partly a result of global climate change. For example, a large number of people live in areas at increasingly high risk of flooding par- ticularly in low and middle income countries, and these communities tend to be poorly equipped to deal with weather extremes. This has led to the huge rise in the number of people killed, injured or made homeless by natural disasters. A recent example of this is the tsunami on the 26th December 2004 when thousands lost their lives and millions had their homes and livelihoods destroyed. A description of the tsunami and its after-effects is given in the following extract from the BBC (2005).
Table 12.2 Health effects of natural disasters
Health effect Earthquake Hurricane,
high wind
Volcanic eruption
Flood Tidal wave, flash flood
Death many few varies few many
Severe injury (requiring extensive medical care)
overwhelming moderate variable few few
Increased risk of infectious disease
a potential problem in all major disasters;
probability increases with overcrowding and deteriorating sanitation
Food scarcity rare (may occur as a result of factors other than food shortages)
rare common common common
Major population movements
rare (may occur in heavily damaged urban areas)
rare common common common
Source: Moeller (1997)
Disasters 169
Tsunami
On December the 26th 2004 a series of earthquakes with epicentres off the Northern Sumatra (Aceh) in Indonesia and the resultant tsunamis hit Southeast Asia causing serious damage and loss of life. The earthquake measured 9 on the Richter scale, the largest earthquake in 40 years. The initial priorities were to ensure clean water, adequate shelter, food, sanitation and healthcare for the 3–5 million people affected, and to identify and bury thousands of bodies. A week after the disaster there was widespread shortage of clean water and a risk of disease outbreaks. Health education received a high priority in India and Sri Lanka to help prevent the spread of disease. Providing health services to displaced people was a significant challenge. Six weeks after the disaster the second phase of the post-disaster health programme is in place and the focus is on rebuilding infrastructure, increasing capacity and assessing and rehabilitating their health systems. The mental health and nutritional status of many tsunami survivors remain serious concerns (WHO 2005).The worst affected area was Aceh on the island of Sumatra in Indonesia; more than 70%
of the inhabitants of some coastal villages are reported to have died. The exact number of victims will never be known, the number of homeless is estimated at 800 000. After the disaster, at least 100 aid organisations and UN agencies were operating in Indonesia.
They provided emergency food, water and shelter to about 330,000 people and now are constructing temporary settlements for 150,000 families.
Indonesia was hardest hit in terms of loss of life and physical damage, but seems to have escaped the worst of the tsunami’s economic disruption. The main affected area, Aceh, is rich in resources but far from crucial to overall output. The government estimates that reconstruction will cost $4.5bn (US) over the next three years.
The reconstruction bill for Sri Lanka, the second hardest hit country, is expected to be enormous because the damaged infrastructure was more developed than in many affected areas. There is expected to be a loss of valuable tourist revenue all over the region as resorts were devastated and many foreigners were killed in the disaster.
Activity 12.1
Haiti was struck by a huge storm in September 2004 that killed more than 1,100 people, leaving many other thousands injured or homeless. Read the following article from Joseph Delva (2004) that reported the storm. Then answer the question: What are the health effects of this disaster?
Hundreds buried in Haiti
Haiti began burying hundreds of flood victims in mass graves on Wednesday while emergency food was distributed to some of the thousands of people made homeless by Tropical Storm Jeanne.
The death toll rose to 1,008 in the Artibonate region around the northern coastal city of Gonaives and 72 in Haiti’s Northwest province, said Dr. Carl Murat Cantave, a government official. Another 1,000 people were missing and the final death count was likely to hit 2,000, he said.
170 Environment, Health and Sustainable Development
Walls of water roared down from the Caribbean country’s deforested hills as the storm passed north of Haiti during the weekend, and left Gonaives and Port-de-Paix, another northern city, under a dense crust of mud. Government workers and U.N.
peacekeepers were burying the dead in mass graves to prevent the spread of disease.
Truckloads of bodies in plastic bags were delivered for burial at the Bois Marchand cemetery near Gonaives and police were called in to calm neighbors who angrily protested the mass burials, Cantave said.
The U.N.’s World Food Program said its first convoy of trucks carrying 40 metric tons of food arrived Tuesday night and aid agencies were distributing rice, beans, cooking oil and loaves of fresh bread. ‘At this point we think at least 175,000 people are affected across the country. Many of them were already very vulnerable and now, they have lost their homes, their entire crops, their animals and the few belongings they had,’ said the WFP country director, Guy Gauvreau. ‘It is a huge disaster. The water has just washed away everything,’ he said.
Police tried to keep order as desperately hungry people swarmed the food distribution sites. One policeman was hit by a rock and injured while trying to hold back the crowd.
The WFP has long provided food for 500,000 people in the poorest country of the Americas, and increased operations after a violent revolt forced ex-President Jean-Bertrand Aristride to flee into exile on Feb. 29.
Devastating floods and mudslides in May, in which about 2,000 people died, further aggravated the humanitarian disaster facing the country. Haiti is chronically vulnerable to flooding because of widespread deforestation caused by Haitians digging up roots to make charcoal for cooking.
U.N. forces maintaining the peace after Aristide’s departure were helping with rescue and relief efforts. The international Red Cross, meanwhile, launched a worldwide appeal for $3.3 million to help the flood victims.
Haitian-American hip-hop artist Wyclef Jean joined aid workers. ‘I came here to see my people, to see their desperation and to assess the situation and see how we can help,’
Jean told Reuters, ‘I want to be able to tell the world about the disaster I witnessed here.’ He said he was trying to organize a ‘peace concert’ for Haiti later this year featuring top international stars.
Jeanne also killed 11 people in the Dominican Republic, which shares the island of Hispaniola with Haiti, and two in the U.S. Caribbean territory of Puerto Rico. By 5 p.m.
on Wednesday, Jeanne was 500 miles east of Great Abaco island in the northeastern Bahamas and moving slowly west-southwest. Packing winds of 100 mph, the storm was expected to swing west eventually and may threaten the east coast of the United States next week, the U.S. National Hurricane Center said. Florida has already been battered by three big hurricanes this season.
Two other storms continued to swirl through the Atlantic. Hurricane Karl was about 1,400 miles west-southwest of the Azores and unlikely to threaten land. Tropical Storm Lisa was also far from land, at about, 1,205 miles west of the Cape Verde islands.
Disasters 171
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Health effects
• death
• psychological effects of grief; loss of family, homes and livelihoods
• sanitation-related diseases
• lack of food and water Other effects
• destruction of the infrastructure leading to loss of crops and food shortages; con- taminated crops
• economic effects of loss of exports; loss of tourist trade; diversion of national funds for clean-up and damage relief