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Earthquakes and People's Health

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Earthquakes and People's Health Earthquakes and People's Health Table of Contents Earthquakes and People's Health....................................................................................................................1 INTRODUCTION....................................................................................................................................1 ILLUSTRATIONS (COLOUR PHOTOS).................................................................................................2 Opening Addresses..........................................................................................................................7 PART 1 − KEYNOTE PRESENTATIONS............................................................................................12 The epidemiology of earthquakes: implications for vulnerability reduction, mitigation and relief...12 Seismological forecasting: prospects within the International Decade for Natural Disaster Reduction................................................................................................................................18 Health implications of earthquakes: physical and emotional injuries during and after the Northridge earthquake1..........................................................................................................20 An overview of the Earthquake Insurance Programme in Japan...................................................28 Summary........................................................................................................................................32 PART 2 − THE CONSEQUENCES OF EARTHQUAKES ON PEOPLE'S HEALTH............................33 Medical consequences...................................................................................................................33 Health consequences.....................................................................................................................45 Panel discussions (synthesis)........................................................................................................65 PART 3 − VULNERABILITY REDUCTION AND PREPAREDNESS...................................................69 Forecasting of seismic hazards......................................................................................................69 Masterplans....................................................................................................................................79 Earthquake−resistant construction.................................................................................................89 Earthquake−proofing of hospitals.................................................................................................102 Emergency preparedness: organization and logistics..................................................................113 PART 4 − REHABILITATION.............................................................................................................142 Rehabilitation of earthquake victims: social and health aspects (the Cairo 1992 experience).....142 Basic principles of resort rehabilitation of earthquake victims......................................................148 Financial aspects following an earthquake: the bank's point of view...........................................149 Industrial reconstruction after the Great Hanshin−Awaji Earthquake...........................................151 Experience from rehabilitation and reconstruction of Skopje after the 1963 earthquake.............154 Summary......................................................................................................................................160 PART 5 − COUNTRY EXPERIENCES...............................................................................................162 Lessons learned from the Great Hanshin−Awaji Earthquake......................................................162 Earthquake preparedness in Chile...............................................................................................165 Health aspects of disaster preparedness in the former Yugoslav Republic of Macedonia..........169 Public health preparedness in relation to disasters......................................................................179 Country profile: Costa Rica..........................................................................................................185 Jordan's plan to face earthquakes...............................................................................................186 PART 6 − SUMMING UP....................................................................................................................187 Reports from the Working Groups...............................................................................................188 Conclusions and recommendations.............................................................................................192 Closing session............................................................................................................................193 Glossary.......................................................................................................................................194 Participants..................................................................................................................................194 Annexes.......................................................................................................................................197 i ii Earthquakes and People's Health WHO/WCK/SYM/97.1 ENGLISH ONLY DISTR: GENERAL WORLD HEALTH ORGANIZATION CENTRE FOR HEALTH DEVELOPMENT KOBE, JAPAN Earthquakes and People's Health Vulnerability Reduction, Preparedness and Rehabilitation PROCEEDINGS OF A WHO SYMPOSIUM KOBE, 27−30 JANUARY 1997 World Health Organization 1997 This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. The document may, however, be freely reviewed, abstracted, reproduced or translated, in part or in whole, but not for sale or for use in conjunction with commercial purposes. The texts in this document by named authors are based on their presentations at the WHO Symposium "Earthquakes and People's Health − Vulnerability Reduction, Preparedness and Rehabilitation" held at Kobe, Japan, 27−30 January 1997. The views expressed in documents by named authors are solely the responsibility of those authors. INTRODUCTION The International Symposium on Earthquakes and People's Health, held in Kobe from 27 to 30 January 1997, was an important event for three main reasons. Firstly, the symposium commemorated the second anniversary of the Great Hanshin−Awaji Earthquake which struck the urban areas of Kobe, leaving 6300 people dead, 30 000 injured and 300 000 homeless. Distressing as they may be, statistics of human and material loss can never adequately express the extent of suffering and disruption caused by such disasters which call for the utmost sympathy and support. The amount of casualties and damage caused by earthquakes worldwide has increased markedly over the last decades. Urbanization and modern technology have brought with them many benefits for our daily lives but they also increase specific risks for people's health and the environment. Such risks must be carefully assessed and taken into account by town planners as urbanization is expected to grow steadily. It is estimated that by the year 2000 half of the world's population will live in urban areas. Secondly, this was already the second symposium held by the WHO Kobe Centre for Health Development during its first year of existence. I wish to acknowledge the generous support of the Hyogo−Kobe community to the Centre which made it possible to organize this symposium and express my gratitude to the Hyogo Prefecture, the City of Kobe and Kobe Steel Ltd. As a result of the symposium, the WHO Centre itself is now better equipped to enhance its research and cooperation activities in support of health development both locally and worldwide. Thirdly, the symposium attracted 190 participants from 21 countries, five international organizations and a large variety of disciplines. Representation was truly intersectoral and useful proposals were made for tackling not only the health consequences of earthquakes but also issues related to vulnerability reduction. These include recommendations for improved structural standards, organization and logistics. The importance of community participation was stressed to enable rapid and effective emergency response, particularly in the first hours after an earthquake. This requires careful planning, management and training, far ahead of time. 1 Coordination must be ensured, between central and local governments as well as with the local people and volunteers. Similarly, the long−term harm done by disasters can be overcome more quickly if rehabilitation activities are well coordinated and involve consultation and participation of the local communities. Guidelines on the rapid assessment of health needs in cases of emergency, and on community preparedness, are being prepared by WHO in close cooperation with UNHCR, UNICEF, the Red Cross and Red Crescent Societies and Médecins Sans Frontières. The International Symposium on Earthquakes and People's Health, held by the WHO Kobe Centre for Health Development, has made an important contribution to WHO’s overall activities in the areas of standard−setting, technical cooperation and public information, which are all essential parts of its Constitutional mandate.
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