"Children and Megadisasters- Lessons Learned in the New
Advances in Pediatrics 54 (2007) 189–214 ADVANCES IN PEDIATRICS Children and Megadisasters: Lessons Learned in the New Millennium Andrew L. Garrett, MD, MPHa,*, Roy Grant, MAb, Paula Madrid, PsyDa, Arturo Brito, MD, MPHb, David Abramson, PhD, MPHa, Irwin Redlener, MDa aNational Center for Disaster Preparedness, Columbia University, Mailman School of Public Health, 722 W. 168th St., New York, NY 10023, USA bChildren’s Health Fund, 215 West 125th Street, Suite 301, New York, NY 10027, USA he term megadisaster has worked its way into the mainstream since the start of the new millennium. The expression once reserved for the techni- T cal meaning of the word—a ‘‘one in a million’’ disaster—has recently been brought to the forefront by several large natural events that have occurred in the past 5 years, namely Hurricane Katrina in the United States and the Indian Ocean tsunami of 2004. These two disasters, as well as the terrorist attacks of September 2001 in the United States have directed a persistent spotlight on the systems by which the public and its government plan for, respond to, and recover from high-impact catastrophes. From the beginnings of human society, both nature and our own species have found ways to traumatically disrupt the status quo. Despite the many ca- tastrophes in our history, the term disaster has been difficult to define. Most def- initions include some reference to the event’s impact on people, the economy, or the environment. More theoretically, a disaster can be seen as a complex function of risk and vulnerability. As an example, the magnitude of a hurricane disaster is not as simple as the force of the hurricane itself upon a community but rather a sum of those forces (eg, storm-force winds) plus the special vulner- abilities faced by the community (eg, levee failure) plus the community’s capac- ity to reduce the actual or potential negative consequences of risk (eg, an inability to evacuate citizens).
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