Medium-term health of seniors following exposure to a natural disaster

The article aims to describe the medium-term impacts of a major earthquake event (Chile, February 27, 2010) on 26 seniors. The authors adopted a qualitative study approach. Data obtained using the Impact of Event Scale–Revised (IES-R) show the presence of manifestations of posttraumatic stress in the majority of respondents. In addition, data collected in interviews demonstrated a progressive deterioration of the health of respondents over a period of 4 years following the disaster. Seniors are particularly vulnerable to the effects of material loss, emotional stress, and postdisaster health complications. These impacts are exacerbated by low economic status. Furthermore, broader research is necessary involving elderly living in poverty who have survived natural disasters and others without such experiences, in order to better identify and differentiate between health complications associated with exposure to disaster events and those linked more strictly with natural aging processes

Injury epidemiology after the 2001 Gujarat earthquake in India: a retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster

The number of injured far exceeds those dead and the average injury to mortality ratio in earthquakes stands at 3:1. Immediate effective medical response significantly influences injury outcomes and thus the overall health impact of earthquakes. Inadequate or mismanagement of injuries may lead to disabilities. The lack of precise data from immediate aftermath is seen as a remarkable weak point in disaster epidemiology and warrants evidence generation.To analyze the epidemiology of injuries and the treatment imparted at a secondary rural hospital in the Kutch district, Gujarat, India following the January 26, 2001 earthquake.Discharge reports of patients admitted to the hospital over 10 weeks were analyzed retrospectively for earthquake-related injuries.Orthopedic injuries, (particularly fractures of the lower limbs) were predominant and serious injuries like head, chest, abdominal, and crush syndrome were minimal. Wound infections were reported in almost 20% of the admitted cases. Surgical procedures were more common than conservative treatment. The most frequently performed surgical procedures were open reduction with internal fixation and cleaning and debridement of contaminated wounds. Four secondary deaths and 102 transfers to tertiary care due to complications were reported.The injury epidemiology reported in this study is in general agreement with most other studies reporting injury epidemiology except higher incidence of distal orthopedic injuries particularly to the lower extremities. We also found that young males were more prone to sustaining injuries. These results warrant further research. Inconsistent data reporting procedures against the backdrop of inherent disaster data incompleteness calls for urgent standardization of reporting earthquake injuries for evidence-based response policy planning

Estimating the welfare loss to households from natural disasters in developing countries: a contingent valuation study of flooding in Vietnam

Background: Natural disasters have severe impacts on the health and well-being of affected households. However, we find evidence that official damage cost assessments for floods and other natural disasters in Vietnam, where households have little or no insurance, clearly underestimate the total economic damage costs of these events as they do not include the welfare loss from mortality, morbidity and reduced well-being experienced by the households affected by the floods. This should send a message to the local communities and national authorities that higher investments in flood alleviation, reduction and adaptive measures can be justified since the social benefits of these measures in terms of avoided damage costs are higher than previously thought. Methods: We pioneer the use of the contingent valuation (CV) approach of willingness-to-contribute (WTC) labour to a flood prevention program, as a measure of the welfare loss experienced by household due to a flooding event. In a face-to-face household survey of 706 households in the Quang Nam province in Central Vietnam, we applied this approach together with reported direct physical damage in order to shed light of the welfare loss experienced by the households. We asked about households’ WTC labour and multiplied their WTC person-days of labour by an estimate for their opportunity cost of time in order to estimate the welfare loss to households from the 2007 floods. Results: The results showed that this contingent valuation (CV) approach of asking about willingness-to-pay in-kind avoided the main problems associated with applying CV in developing countries. Conclusion: Thus, the CV approach of WTC labour instead of money is promising in terms of capturing the total welfare loss of natural disasters to households, and promising in terms of further application in other developing countries and for other types of natural disasters

How do I know if I’ve improved my continental scale flood early warning system?

Flood early warning systems mitigate damages and loss of life and are an economically efficient way of enhancing disaster resilience. The use of continental scale flood early warning systems is rapidly growing. The European Flood Awareness System (EFAS) is a pan-European flood early warning system forced by a multi-model ensemble of numerical weather predictions. Responses to scientific and technical changes can be complex in these computationally expensive continental scale systems, and improvements need to be tested by evaluating runs of the whole system. It is demonstrated here that forecast skill is not correlated with the value of warnings. In order to tell if the system has been improved an evaluation strategy is required that considers both forecast skill and warning value. The combination of a multi-forcing ensemble of EFAS flood forecasts is evaluated with a new skill-value strategy. The full multi-forcing ensemble is recommended for operational forecasting, but, there are spatial variations in the optimal forecast combination. Results indicate that optimizing forecasts based on value rather than skill alters the optimal forcing combination and the forecast performance. Also indicated is that model diversity and ensemble size are both important in achieving best overall performance. The use of several evaluation measures that consider both skill and value is strongly recommended when considering improvements to early warning systems

Multiple Shocks, Coping and Welfare Consequences: Natural Disasters and Health Shocks in the Indian Sundarbans

Background: Based on a household survey in Indian Sundarbans hit by tropical cyclone Aila in May 2009, this study tests for evidence and argues that health and climatic shocks are essentially linked forming a continuum and with exposure to a marginal one, coping mechanisms and welfare outcomes triggered in the response is significantly affected. Data & Methods: The data for this study is based on a cross-sectional household survey carried out during June 2010. The survey was aimed to assess the impact of cyclone Aila on households and consequent coping mechanisms in three of the worst-affected blocks (a sub-district administrative unit), viz. Hingalganj, Gosaba and Patharpratima. The survey covered 809 individuals from 179 households, cross cutting age and gender. A separate module on health-seeking behaviour serves as the information source of health shocks defined as illness episodes (ambulatory or hospitalized) experienced by household members. Key findings: Finding reveals that over half of the households (54%) consider that Aila has dealt a high, damaging impact on their household assets. Result further shows deterioration of health status in the period following the incidence of Aila. Finding suggests having suffered multiple shocks increases the number of adverse welfare outcomes by 55%. Whereas, suffering either from the climatic shock (33%) or the health shock (25%) alone increases such risks by a much lesser extent. The multiple-shock households face a significantly higher degree of difficulty to finance expenses arising out of health shocks, as opposed to their counterparts facing only the health shock. Further, these households are more likely to finance the expenses through informal loans and credit from acquaintances or moneylenders. Conclusion: This paper presented empirical evidence on how natural and health shocks mutually reinforce their resultant impact, making coping increasingly difficult and present significant risks of welfare loss, having short as well as long-run development manifestations.DFI