Emergency Management and Public Health Systems
Bosher, Lee, The Journal of the Royal Society for the Promotion of Health
Tens of thousands of people have been made homeless by the devastation unleashed by recent hurricanes and earthquakes. The public health implications of these disasters are likely to be felt for years to come, thus it is imperative that public health systems are designed, located and maintained in a way that maximises their resilience to natural and man-made disasters.
Previous accounts from disasters of this magnitude, such as hurricane Andrew that affected Florida in 1992' and the Asian tsunami in December 2004,2 suggest that people in the affected regions are likely to suffer from a range of common short-term and long-term health problems. Past experience also suggests that it will be the poorest and most marginalised members of society who will suffer the most.3
During the response, relief and rehabilitation phases of a disaster, the ability of the transport and health care infrastructure to withstand the impacts of extreme events and meet the needs of the local population during the aftermath are a key element in how society can recover from traumatic events. The destruction of transportation networks indeed hindered the ability of the US government to evacuate affected populations and mobilise support services after hurricane Katrina in 2005. Professionals involved with the design, planning, construction, operation and maintenance of critical infrastructure need to work in tandem with health care professionals to mitigate the severity of extreme events by increasing the resilience of essential lifelines.
This observation raises two key issues, which are as pertinent to the UK as to the USA, or any of the nations affected by the Asian tsunami. The first issue is reactive and related to the rehabilitation and reconstruction of areas affected by extreme events. Market forces tend to establish pressures to reconstruct as quickly as possible,4 built assets such as water supplies, transportation networks and commercial buildings, sometimes hampering efforts to implement lessons learnt from previous disasters in an attempt to hastily minimise post-event economic losses, reduce social impacts and improve political ratings. It is imperative that more information (such as case studies) is obtained related to the quality and appropriateness of post-disaster reconstruction in the UK and globally, to encourage best practice.
The second issue is more proactive and related to the mitigation of hazards through sound urban planning and emergency management initiatives. At the moment in the UK there is insufficient interaction between urban and emergency planners, resulting in situations where new hospitals, Regional Fire and Rescue Control Centres, schools and entire communities are being located in areas that are significantly at risk from flooding. …