The Role of Environmental Health in Disaster Management: A Qualitative Study of Australian Experiences

Article excerpt

Introduction

In recent years, disaster management has been at the forefront of discussions in Australia and many other countries. This is in part due to a realization that the previous arrangements may not have been adequate to meet the range of emerging threats. The terrorist attacks of September 11,2001; the Bali bombings in 2002 and 2005; the London bombings in 2005; and fears of bioterrorism have resulted in a changed environment for disaster management in Australia and internationally (Bradt, Abraham, & Franks, 2003; Burkle, 2006; Caldicott & Edwards, 2002; Fisher & Burrow, 2003; Noji, 2001; Vinen, 2003).

Disaster management structures must continue to be effective for natural disasters, such as cyclones, bushfires, tsunamis, infrastructure or technological failure, and heat waves (Abrahams, 2001; Emergency Management Australia, 2005). These structures also need to ensure that appropriate mechanisms are in place to respond to emerging diseases, such as avian influenza, SARS, and the threat of pandemic influenza (Loeb, 2004; Srinivasan et ah, 2004). The changing landscape in disaster management means that new hazards must be identified and protected against in addition to existing hazards, requiring extensive reviews of disaster management structures (Armstrong, 2003; Berg, 2004; Caldicott & Edwards, 2002; Emergency Management Australia, 2003).

Despite the integral role of environmental health in disaster management, the specific role of environmental health practitioners in disaster management was rarely investigated until after the terrorist attacks of September 11, 2001. Since then, a substantial amount of literature has emerged; however, this has consisted primarily of descriptive accounts, opinion pieces such as editorials and interviews, and reports (Berg, 2004; Fabian, 2002; Fabian, 2004; Forsting, 2004; Lyman, 2003). Most of this literature focuses on the roles of environmental health professionals in the context of terrorism or bioterrorism; however, the emerging themes can be applied to many large-scale disaster situations (Fabian, 2002; Forsting, 2004; Khan, Morse, & Lillibridge, 2000; Noji, 2005 & Toole, 1997).

It is clear from the literature that a number of issues for environmental health in relation to disaster management require further research. The most common theme is that ambiguity exists about the role of environmental health in disaster management, particularly in its distinction from the broader roles of public health. This ambiguity is exacerbated by a lack of research on this topic (Fabian, 2002; Forsting, 2004; Lyman, 2003). Other themes that have emerged relating to environmental health generally and in the context of disaster management specifically include the following:

* the professionalization of environmental health (Brimblecombe, 2003; Kotchin, 1997; Roberts, 1996);

* the representation, profile, and visibility of the environmental health discipline (Berg, 2004; Emergency Management Australia, 2003; Fabian, 2002; Fabian, 2004; Logue, 1996; Lurle, Wasserman, & Nelson, 2006; Lyman, 2003);

* debate surrounding the separation of environmental health from public health (Kotchin, 1993; Kotchin, 1997; Leggat, 2003; Logue, 1996);

* the power and politics involved in role negotiation (Berg, 2004; Bashir, Lafronza, Fraser, Brown, & Cope, 2003); and

* the top-down approach to constructing disaster plans (Bashir et al., 2003; Rasmussin & Jansen, 1998).

Given the lack of research into an increasingly important topic, we conducted a rigorous qualitative study during 2005 in Queensland, Australia, to explore the role of the environmental health discipline in relation to disasters and how others perceive this role. This study also explored the broader role of environmental health and the perceptions of both environmental health practitioners and those external to environmental health. …