PUBLIC HEALTH HUMANITARIAN RESPONSES TO NATURAL DISASTERS The pressure of climate change, environmental degradation, and urbanisation, as well as the widening of socio- economic disparities have rendered the global popu- lation increasingly vulnerable to the impact of natural disasters. With a primary focus on medical and public health humanitarian response to disasters, Public Health Humanitarian Responses to Natural Disasters provides a timely critical analysis of pub- lic health responses to natural disasters. Using a number of case studies and examples of innovative disaster response mea- sures developed by international agencies and stakeholders, this book illustrates how theoretical understanding of public health issues can be practically applied in the context of humanitarian relief response. Starting with an introduction to pub- lic health principles within the context of medical and public health disaster and humanitarian response, the book goes on to explore key trends, threats and chal- lenges in contemporary disaster medical response. This book provides a comprehensive overview of an emergent discipline and offers a unique multidisciplinary perspective across a range of relevant topics including the concepts of disaster preparedness and resilience, and key challenges in human health needs for the twenty- fi rst century. This book will be of interest to students of public health, disaster and emergency medicine and development studies, as well as to development and medical practitioners working within NGOs, development agencies, health authorities and public administration. Emily Ying Yang Chan is a professor and assistant dean at The Chinese Univer- sity of Hong Kong (CUHK) Faculty of Medicine and visiting professor of public health medicine at the Oxford University Nuffi eld Department of Medicine. She is also associate director at CUHK JC School of Public Health and Primary Care, centre director at Collaborating Centre for Oxford University and CUHK for Disas- ter and Medical Humanitarian Response (CCOUC), director at CUHK Centre for Global Health, visiting scholar at the Harvard University FXB Center for Health and Human Rights, senior fellow at Harvard Humanitarian Initiative, fellow at Hong Kong Academy of Medicine, member of The Asia Science Technology and Aca- demia Advisory Group of the United Nations Offi ce for Disaster Risk Reduction (UNISDR ASTAAG) and co- chairperson of World Health Organization Thematic Platform for Health Emergency & Disaster Risk Management Research Group. Routledge Humanitarian Studies Series Series editors: Alex de Waal and Dorothea Hilhorst Editorial Board: Mihir Bhatt, Dennis Dijkzeul, Wendy Fenton, Kirsten Johnson, Julia Streets, Peter Walker The Routledge Humanitarian Studies series in collaboration with the International Humanitarian Studies Association (IHSA) takes a comprehensive approach to the growing fi eld of expertise that is humanitarian studies. This fi eld is concerned with humanitarian crises caused by natural disaster, confl ict or political instability and deals with the study of how humanitarian crises evolve, how they affect people and their institutions and societies, and the responses they trigger. We invite book proposals that address, amongst other topics, questions of aid delivery, institutional aspects of service provision, the dynamics of rebel wars, state building after war, the international architecture of peacekeeping, the ways in which ordinary people continue to make a living throughout crises, and the effect of crises on gender relations. This interdisciplinary series draws on and is relevant to a range of disciplines, including development studies, international relations, international law, anthropol- ogy, peace and confl ict studies, public health and migration studies. The New Humanitarians in International Practice Emerging actors and contested principles Edited by Zeynep Sezgin and Dennis Dijkzeul Natural Hazards, Risk and Vulnerability Floods and slum life in Indonesia Roanne van Voorst UNHCR and the Struggle for Accountability Technology, law and results- based management Edited by Kristin Bergtora Sandvik and Katja Lindskov Jacobsen Australia’s Foreign Aid Dilemma Humanitarian aspirations confront democratic legitimacy Jack Corbett Public Health Humanitarian Responses to Natural Disasters Emily Ying Yang Chan People, Aid and Institutions in Socio- economic Recovery: Facing Fragilities Gemma van der Haar, Dorothea Hilhorst, and Bart Weijs PUBLIC HEALTH HUMANITARIAN RESPONSES TO NATURAL DISASTERS Emily Ying Yang Chan First published 2017 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2017 Emily Ying Yang Chan The right of Emily Ying Yang Chan to be identifi ed as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identifi cation and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Chan, Emily Ying Yang, author. Title: Public health humanitarian responses to natural disasters / authored by Emily Ying Yang Chan. Description: Milton Park, Abingdon, Oxon ; New York, NY : Routledge, [2017] | Series: Routledge humanitarian studies Identifi ers: LCCN 2016036341| ISBN 9781138953680 (hbk) | ISBN 9781138953703 (pbk) | ISBN 9781315667218 (ebk) Subjects: LCSH: Disaster medicine. | Medical assistance. | Disaster relief. | Humanitarian assistance. Classifi cation: LCC RA645.5 .C43 2017 | DDC 363.34/8—dc23 LC record available at https://lccn.loc.gov/2016036341 ISBN: 978- 1- 138- 95368- 0 (hbk) ISBN: 978- 1- 138- 95370- 3 (pbk) ISBN: 978- 1- 315- 66721- 8 (ebk) Typeset in Bembo by Apex CoVantage, LLC Dedicated to Eric, Ellie and Ernest and to those who risk their lives in the remote corners of our world to make it healthier and more humane CONTENTS List of illustrations ix List of boxes xii List of contributors xvii Foreword by Professor Joseph J. Y. Sung xxiii Foreword by Professor Andrew Hamilton xxv Foreword by Professor Virginia Murray xxvi Acknowledgements xxviii List of abbreviations xxx Introduction 1 1 Key public health concepts of disaster preparedness and response 3 2 Disaster concepts and trends 27 3 General public health impacts of natural disasters 61 4 The specifi c human health impacts of natural disasters 81 5 When public health and disaster collide: responding to health needs in natural disasters 118 6 Current and likely medical and public health threats and challenges for disaster response in the twenty- fi rst century 149 viii Contents 7 Resources for disaster response and beyond 183 8 From public health emergency preparedness to resilience 208 9 Conclusion 247 Index 249 ILLUSTRATIONS Figures 1.1 Three domains of public health 6 1.2 An iceberg of health outcomes 8 1.3 Determinants of health 10 1.4 Social advantages and health across lifetimes and generations 12 1.5 Pathway of care 16 1.6 Hierarchy of prevention pyramid 18 2.1 Five phases of disaster 29 2.2 Classification of disasters 33 2.3 An example of categorising technological disasters 34 2.4 The nuclear power plant at Chernobyl in Ukraine 35 2.5 Mindanao armed conflict 39 2.6 Fragile state: Afghanistan – Kabul in April 2004 41 2.7 Sidoarjo mudflow in Indonesia 42 2.8 Natural disaster trends by disaster type (2014) 44 2.9 Risk formula 48 2.10 Landscape of Bhutan 50 2.11 Disaster Risk Index (DRI) 52 2.12 The economic and human impact of disasters 2005–2014 54 2.13 Emergency threshold 55 2.14 Measuring health impact 56 3.1 Four tiers of health care 65 3.2 Medical humanitarian response after 2010 Haiti earthquake 65 3.3 The correlation of environmental causes and consequences of disasters 68 3.4 Water and sanitation 69 3.5 Shelter 69 x Illustrations 3.6 Health services 69 3.7 Logistics 70 3.8 Biopsychosocial model of mental disorder 72 3.9A Absolute economic impact and mortality rate of disasters from high- to low- income countries 75 3.9B Relative economic impact and mortality rate of disasters from high- to low- income countries 75 3.10 The aftermath of the Great East Japan earthquake 77 4.1 Global seismic hazard map 84 4.2 Survival rates (%) of extricated people by rescue time after Tangshan earthquake in 1976 85 4.3 A victim of crush injury 86 4.4 Ring of Fire 88 4.5 The aftermath of Typhoon Haiyan in the Philippines 93 4.6 Contribution of components to 1990, 1995, 2000, 2005 and 2014 Global Hunger Index Scores, by region 107 5.1 Minimum standards for health services 124 5.2 Water treatment using chlorine tablet 127 5.3 A typical simple pit latrine design in a school in Kenya 128 5.4 School children in Nepal 129 5.5 Food aid distribution 132 5.6 A temporary shelter funded by DFID in Malawi after an earthquake in 2010 136 5.7 Two hundred rolls of heavy- duty plastic sheeting being provided to earthquake- affected households in Nepal’s Kathmandu District’s Sankhu village and