Public health and natural disasters: disaster preparedness and response in health systems

The number of natural disasters and the severity of their impact have increased in recent decades. These developments highlight the need for improved preparedness and response in the health sector, inter alia, and the important role of public health in disaster management. The purpose of this paper, which is based on a literature review, is to provide background information about the general framework of disaster management and present the core concepts of disaster preparedness and response in health systems. Three different strategies were used to collect information for this article. First, information was collected from various international databases. Then, the virtual health library for disasters provided by the World Health Organization (WHO) and the WHO Health Action in Crisis (HAC) online sources were reviewed for relevant WHO and Pan American Health Organization (PAHO) books, working papers and reports. Finally, PubMed abstracts were searched with key words and phrases. For greater completeness, five disaster journals were hand searched. Additional sources such as text books, working papers, and articles were included, relying on the bibliography of the original study mentioned in the introduction to this paper. The studies reviewed indicated that fragmented and response-oriented approaches have begun to change world wide, at least in the literature. Despite the publication of increasing numbers of research projects in disaster issues, there are still gaps in sharing experience through scientific papers, such as systematic evaluation of activities in different phases of disaster situation

Factors affecting the process of taking action at individual level regarding mitigation and preparedness for an earthquake in Istanbul

In order for disaster management to be effective and successful, efforts to improve preparedness at governmental, sectoral and institutional levels should be supported by corresponding efforts at community and individual levels. However, getting the cooperation of individuals and communities is a complex issue with many inherent difficulties. The megacity Istanbul is located in an earthquake risk zone and is expected to experience an earthquake in the near future, but on the individual level there appears to be limited interest in preparing for such an earthquake. This study aims to investigate the process of taking action to prepare for an earthquake and mitigate its effects at individual level, to identify the factors influencing this process and to asses the level of preparedness in Istanbul. The study was conducted in two districts of Istanbul with different levels of earthquake risk. Within these districts three socioeconomic levels (SEL) were considered. The study is in two parts. In the first part, 12 focus group discussions (FGDs) with citizens living in Bakırköy (higher risk) and Beykoz (lower risk) and 11 in-depth interviews with experts, authorities and key informants were conducted. In the second part, a field survey was carried out in the same districts. A questionnaire was prepared according to the results of the first part of the study and was administered face-to-face by trained interviewers. A total of 1123 people were interviewed. The qualitative part of the study demonstrated that, within our conceptual framework, which describes the process of taking action to prepare for an earthquake and mitigate its effects, the behaviour of the group participants fell into three different patterns. The first and most common pattern was interruption of the impetus towards taking action after or during the “awareness” stage by intervening social, personal and environmental factors. Less commonly, the first or subsequent step or steps were taken, but again the process was interrupted before successful completion. Completion of the process was the least common pattern among the group participants. The qualitative part of the study identified the obstacle to taking action to mitigate damage from earthquakes and to be prepared for them as: low socioeconomic level; absence of belief in the efficacy of measures, for example regarding nonstructural or microscale-measures; helplessness; a culture of negligence; lack of trust in the building sector; environmental factors such as poor predictability and suddenness of onset; and normalisation bias. Factors motivating individuals to take action were: living in higher-risk areas; a higher educational level; direct experience of earthquakes through participating in rescue and solidarity activities during past events; and social interaction. In our survey sample, 54% of the respondents had taken at least 3 of the 11 measures we asked about and 12% had not taken any measures. The five leading measures generally taken by the respondents were: getting the building tested for construction quality (51%), keeping a torch near the bed (49%), fixing high furniture to walls (39%), obtaining earthquake insurance (38%) and having a family disaster plan (32%). Testing the building for construction quality and obtaining earthquake insurance were significantly more frequent in the high-risk area (X2: 296.6, p<0.001; X2: 89.34, p<0.001). Logistic regression analysis indicated that education level of the respondents (odds ratio, OR: 2.8, confidence interval, CI: 1.8, 4.4) was the leading factor associated with taking at least three measures, followed by living in a higher-risk area (OR: 2.3, CI: 1.6, 3.1), participating in rescue and solidarity activities in past earthquakes (OR: 2.0, CI: 1.2, 2.1), a higher earthquake knowledge score (OR: 1.9, CI: 1.4, 2.6), owning the home (OR: 1.8, CI: 1.3, 2.4), living in a neighbourhood known to be inhabited by people with higher SELs (OR: 1.6, CI: 1.1, 2.3), a higher action-stimulating attitudes score (OR: 1.5, CI: 1.2, 2.1) and general safety score (OR: 1.5, CI: 1.1, 2.2) and being in the young age group (16-34 years olds, OR: 0.6, CI: 0.4, 0.99). It is not easy to change the situation of individuals regarding the factors that are significantly associated with taking action. They need interventions in the political, social and economic systems. But knowledge about earthquakes is the one factor that could be improved through simpler interventions such as effective awareness programmes. Thus every effort should be made effectively to provide earthquake information to the public. Awareness programmes should focus on informing people about how to cope with earthquakes and how to personalise the risk rather than on information about the risk itself and its consequences. In addition, these programmes should involve activities targeted on changing people’s attitudes towards different types of measure, actors in disaster management and their own capacity, and to creating a culture of safety in the public. The target populations in the awareness programmes should be people with a lower educational level living in all areas, tenants, people living in low socioeconomic districts and young people. People who have participated in rescue and solidarity activities could be given appropriate roles and responsibilities to reach the community and local people

Earthquake awareness and perception of risk among the residents of Istanbul

Awareness and perception of risk are among the most crucial steps in the process of taking precautions at individual level for various hazards. In this study, we investigated the factors affecting better knowledge and greater risk perception about earthquakes among residents of Istanbul. A field survey was carried out, and a total of 1,123 people were interviewed in two districts of Istanbul with different seismic risk levels and from three (low, moderate and high) socio-economic levels (SEL). The findings showed that although the level of knowledge regarding earthquakes and preparedness for them was promising, it could be improved. The results indicated that future preparedness programmes should target people with lower educational and socio-economic levels. The media were the leading source of information among the respondents. Location of the home was a strong influence on individuals having above average earthquake knowledge and even more on high risk perception. Socio-economic parameters (educational level, economic status, SEL of the sub-district and tenure of the home), gender and attitude score were other factors influencing greater risk perception with regard to earthquake

Learn from the past, prepare for the future: Impacts of education and experience on disaster preparedness in the Philippines and Thailand

This study aims at understanding the role of education in promoting disaster preparedness. Strengthening resilience to climate-related hazards is an urgent target of Goal 13 of the Sustainable Development Goals. Preparing for a disaster such as stockpiling of emergency supplies or having a family evacuation plan can substantially minimize loss and damages from natural hazards. However, the levels of household disaster preparedness are often low even in disaster-prone areas. Focusing on determinants of personal disaster preparedness, this paper investigates: (1) pathways through which education enhances preparedness; and (2) the interplay between education and experience in shaping preparedness actions. Data analysis is based on face-to-face surveys of adults aged ≥15 years in Thailand (N = 1,310) and the Philippines (N = 889, female only). Controlling for socio-demographic and contextual characteristics, we find that formal education raises the propensity to prepare against disasters. Using the KHB method to further decompose the education effects, we find that the effect of education on disaster preparedness is mainly mediated through social capital and disaster risk perception in Thailand whereas there is no evidence that education is mediated through observable channels in the Philippines. This suggests that the underlying mechanisms explaining the education effects are highly context-specific. Controlling for the interplay between education and disaster experience, we show that education raises disaster preparedness only for those households that have not been affected by a disaster in the past. Education improves abstract reasoning and anticipation skills such that the better educated undertake preventive measures without needing to first experience the harmful event and then learn later. In line with recent efforts of various UN agencies in promoting education for sustainable development, this study provides a solid empirical evidence showing positive externalities of education in disaster risk reduction

General approaches in health disaster and emergency planning and existing health plans in Turkey

This report aims to inform health workers about the general principles of health disaster and emergency planning, and to familiarize them with the existing plans in Turkey. The health sector has an important role in disaster management. All natural and technological hazards and complex emergencies have a direct or indirect impact on human health and wellbeing. Health systems have a vital role in responding to these disasters. Health disaster plans are important tools for disaster management. In the introduction of this report, the steps of a disaster management cycle and the general principles of emergency planning in health systems will be reviewed. Subsequently, health disaster plans, at national, provincial and hospital levels will be discussed. Finally, these plans will be assessed and some recommendations will be provided.Key words: Disaster, disaster management, health disaster, emergency plans </p

Emergency Medical Service (EMS) utilization by Syrian refugees residing in Ankara, Turkey

Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Ankara. Study Objective This study investigated Emergency Medical Service (EMS) utilization among Syrian refugees residing in Ankara.; This study was a descriptive, cross-sectional database analysis using data obtained from the Department of EMS of the Ankara Provincial Health Directorate.; Five stations in the Altındağ region of Ankara responded to 42% of all calls from Syrian refugees. Prehospital EMS in Ankara have been used mostly by Syrian refugees younger than 18-years-old. Study findings also suggest that medical staff in regions where Syrian refugees are likely to be treated should be supported and provided with the ability to overcome language barriers and cultural differences. Altıner AO , Tekeli Yeşil S . Emergency Medical Service (EMS) utilization by Syrian refugees residing in Ankara, Turkey. Prehosp Disaster Med. 2018;33(2):160-164

The role of the print media in earthquake risk communication: Information available between 1996 and 2014 in Turkish newspapers

WOS: 000454523300025Although individual preparedness plays a critical role in overall preparedness for earthquakes, people are not usually keen to adopt mitigation and preparedness measures. One of the reasons for this is that they lack information about how to cope with an earthquake at individual level. Newspapers are among the many sources of information. This study aims to understand how earthquakes and earthquake preparedness are depicted in Turkish newspapers by analysing the frequency and content of the related news published in six daily newspapers between 1996 and 2014, covering the periods before and after the 1999 earthquakes in Turkey. A total of 16.193 news items were identified and assessed. The findings show that earthquake-related news in the selected newspapers was largely about what was happening at the time, the impact of the earthquakes and response and recovery activities. Earthquake preparedness only received limited coverage. Even though earthquake-related news items reached a peak after major earthquakes, the indications are that the information provided in the newspapers could not have had a direct role in risk communication or, as a result, in changing people's behaviour

Individual preparedness and mitigation actions for a predicted earthquake in Istanbul

This study investigated the process of taking action to mitigate damage and prepare for an earthquake at the individual level. Its specific aim was to identify the factors that promote or inhibit individuals in this process. The study was conducted in Istanbul, Turkey-where an earthquake is expected soon-in May and June 2006 using qualitative methods. Within our conceptual framework, three different patterns emerged among the study subjects. Outcome expectancy, helplessness, a low socioeconomic level, a culture of negligence, a lack of trust, onset time/poor predictability, and normalisation bias inhibit individuals in this process, while location, direct personal experience, a higher education level, and social interaction promote them. Drawing on these findings, the paper details key points for better disaster communication, including whom to mobilise to reach target populations, such as individuals with direct earthquake experience and wome