Ensuring Accessibility During Natural Disasters

September 12, 2011

Reports indicate that individuals with disabilities are disproportionately affected by natural disasters and emergency situations, due in large part to a lack of adequate planning. Available facilities are frequently inaccessible or are ill equipped to accommodate the needs associated with certain disabilities, therefore, by including individuals with disabilities in all stages of the disaster management process, particularly during the planning and preparation phases, the effectiveness of disaster responses can be greatly improved.

An estimated half a billion people – 10 percent of the world population – experiences some form of impairment or disability. Following recent natural disasters including Hurricane Katrina, studies have found that the regions affected by these disasters are frequently not prepared to evacuate, shelter, transport, or meet the medical needs of individuals with disabilities. In addition, the shelters, transportation services, and emergency communications and information broadcasts available in many regions are often not accessible.

By learning from problems identified following natural disasters, regarding the needs of individuals with disabilities, emergency response initiatives can be modified to ensure that the needs of people with and without disabilities are met. According to experts, all individuals, regardless of their disability status, should prepare for potential disaster situations by having a store of food and water on hand to last a minimum of three days. In addition, it is recommended that individuals with disabilities have a supply of items related to their specific needs – which may include eyeglasses, hearing aides, a laminated communication board, or medications – for at least seven days. FEMA, which recently launched a disaster preparedness app, notes that individuals with certain types of disabilities may need to take additional steps to prepare for and receive assistance following natural disasters. It is suggested that individuals with disabilities establish a network of friends, family, and neighbors who may be able to assist them in the event of an emergency.

While natural disasters affect everyone within a given region, individuals with disabilities may face barriers that can cause additional issues. A number of government agencies, including the Department of Health and Human Services (HHS) have put measures in place to help mitigate the barriers faced by individuals with disabilities in emergency situations. Ensuring the inclusion of individuals with disabilities and their representatives in strategic planning efforts and the provision of information in accessible formats before, during, and following natural disasters are among HHS’s chief concerns. In addition, the UN Convention on the Rights of Persons with Disabilities and other international policy initiatives aim to ensure that humanitarian responses to natural disasters are inclusive of the needs of individuals with disabilities.

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Click here to read the International Disability Rights Monitor (IDRM) report on Disability and Early Tsunami Relief Efforts in India, Indonesia and Thailand


On Crisis Mapping

April 11, 2011

Web-based mapping tools have been used to track disease outbreaks, and more recently have been employed in response to natural disasters. Many humanitarian relief efforts have employed crowd-sourcing as a means to gather and share information. By utilizing crowd-sourcing tools including digital maps, government agencies, non-governmental organizations, and other interested parties can collaborate more effectively and improve humanitarian relief responses to natural disasters. For example, crowd-sourced maps can provide disparate networks of volunteers with a simplified way to share information, and can give local relief workers a clearer picture of the situation on the ground as they establish priorities for food, shelter, sanitation services, and healthcare facilities.

The web-reporting platform Ushahidi has been used by human rights and humanitarian aid workers to document and track progress during and immediately following crisis and natural disaster situations. Unlike other similar tools, Ushahidi is open source, and allows for information to be input using cell phones and other web-connected devices. Specialized versions of the Ushahidi crisis-mapping tool are frequently developed following natural disasters, including the recent earthquake in Japan, to allow individuals on the ground to text the locations of individuals in need of assistance or the locations of clinics or hospitals. Recent iterations of Ushahidi have integrated “check-in” functionality as well, further simplifying the process of adding data to the map.

Though crisis-mapping tools were utilized following the 2010 earthquake in Haiti, the majority of their use was by international aid organizations. In contrast, updates to the Japan Crisis Map have been posted by volunteers, government employees, and others. By encouraging the active participation of more individuals, these types of crisis maps can give a fuller understanding of the situation on the ground. In addition, representatives from academic institutions are participating in efforts to examine the data gathered using crowd-sourced crisis maps and identify ways of improving how information is shared during and immediately following natural disasters. A recent report entitled “Disaster Relief 2.0: The Future of Information Sharing in Humanitarian Emergencies” is guiding these efforts by examining how new technologies can influence emergency relief work. The report documents how technology was used during the earthquake in Haiti and in the weeks and months following to locate survivors, provide information about where to receive assistance, and gather donations for aid organizations.

According to experts, “the crisis-mapping response to the earthquake that struck Haiti in 2010 was striking proof of the potential of new mapping tools,” and by examining the successes and shortcomings, the tools and technologies can be improved faster, and more efficient.”

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Healthcare Following Chile’s Earthquake

March 8, 2010

While aid organizations continue to support relief efforts in Haiti, some attention has now been diverted by the 8.8-magnitute earthquake which struck Chile on February 27, 2010. As with Haiti’s tragedy, many organizations are accepting donations to benefit relief efforts in Chile via text message, and individuals have banded together on Twitter and Facebook to request help locating loved ones, provide updates, and share information.

Chilean Earthquake

Experts, including Sergio Barrientos, science chief of the Seismology Institute of the University of Chile, indicate that this quake was 50 times bigger than the one that killed thousands and destroyed much of Haiti’s infrastructure on January 12, 2010. Richard Gross, a geophysicist at NASA’s Jet Propulsion Laboratory, indicated that the force of the quake was in fact so strong that it affected the Earth’s figure axis (the axis about which the Earth’s mass is balanced) and caused the length of the day to be shortened by 1.26 microseconds. Compared to Haiti’s relatively shallow earthquake which occurred just 8.1 miles below the surface of the earth, the depth of Chile’s recent quake was 21.7 miles. This increased depth, which allowed some of the quake’s energy to disperse, and Chile’s strict building codes lessened the earthquake’s potential to cause more serious damage.

According to the National Emergency Office, 795 individuals have died as a result of the earthquake, and the 40-foot tsunami and 131 aftershocks of magnitude 5 or greater that have followed. Chilean President, Dr. Michelle Bachelet stated that it is likely that two million people were affected in some way by the recent earthquake. Many lost family and friends, and an estimated 500,000 homes sustained considerable damage, according to reports from the Chilean Red Cross.

Efforts for locate and rescue survivors are ongoing, and it is expected that, as seen in Haiti, medical and rehabilitative care will be needed by many. Information regarding the number of individuals injured or displaced by the earthquake and the aftershocks and tsunami that followed is not yet available. Though current counts of individuals killed or injured are substantially lower than following Haiti’s earthquake, these figures are expected to rise as reports indicate that as many as 500 individuals are still missing in Constitución alone. In addition to the earthquake itself, which hit most strongly in six central regions of Chile, substantial loss of life and damage to infrastructure is due to the subsequent tidal wave which submerged fishing towns on the coast of south-central Chile. More than 20 boats were swept ashore in the port of Talcahuano, and rescue workers have located over 300 bodies in Constitución. Access to drinking water, food, electricity, and other supplies to many towns in these costal areas, including Bio Bio and Concepcion, have been disturbed, leading to tension and looting in some areas.

Amid civil unrest in areas with destroyed highways and collapsed bridges, the spread of disease and the delivery of healthcare is also a concern. According to UN Humanitarian spokeswoman Elisabeth Byrs, Chile’s government has identified its emergency needs as temporary bridges, field hospitals, satellite telephones, electric generators, damage assessment teams, water purification systems, field kitchens, and dialysis centers. While reports indicate that the health network in northern Chile is operating normally, in the south access to heath services has been disrupted by the collapse of six hospitals and damage to two others. To provide some assistance, the United Nations will be sending 45 satellite phones to Chile for officials coordinating relief efforts, and is prepared to send 30 tons of food and other aid. U. S. Secretary of State Hillary Clinton has indicated that the United States will offer “not only solidarity but specific supplies” to help Chile recover. Aid from the U.S. will include 62 satellite phones, eight water purification systems, and a mobile field hospital with surgical capability. Argentina has already sent medical supplies including three tent hospitals, water processing equipment, medications, and satellite telephones to Chile. Other nations including Canada, which has pledged $2 million to support relief efforts, and Singapore, which will supply $50,000, have also offered contributions. In addition to the need for facilities and supplies, the Pan American Health Organization (PAHO)/WHO noted a shortage of healthcare personnel and has assembled an emergency response team of 80 trained specialists.

As the outpouring of support for Chile begins, governmental agencies, non-governmental organizations, aid organizations, and individuals face the daunting task of coordinating their relief efforts and some areas are still awaiting support. It remains unclear how many individuals have been affected by the earthquake, both directly and indirectly, but it is of great import that they get the care and assistance they need.

Find out about how the iCons in Medicine teleconsultation program can help following natural disasters and what iCons in Medicine and the Center for International Rehabilitation are doing to ensure the provision of rehabilitation services in Haiti.

Helping Haiti

January 25, 2010

As the devastation of the 7.0-magnitude earthquake that hit Haiti on January 12th continues to unfold, public and mental health experts are likely to be at the fore of those monitoring the situation. In addition to the immediate needs of survivor rescue, survivors of earthquakes and other natural disasters are at risk of malnutrition, parasite infection, and post-traumatic stress disorder and depression. While it is important to ensure that emergency medical care is delivered to those in need, it is also critical that a plan be put in place to ensure that infection and stress disorders are recognized and treated efficiently.

Time magazine reports that before the earthquake, Haiti was one of the poorest countries in the world. No Haitian city had a public sewage system, less than half of the population had access to drinking-water services, and malnutrition and disease affected a large portion of the population. According to CNN, the Red Cross has estimated three million people – one-third of the total population of Haiti – are affected by the earthquake. Many of those not among the reported 200,000 who lost their lives were seriously injured and will likely require amputations or other surgeries. As time passes, these acute health problems will be replaced by chronic heath conditions that may worsen quickly if individuals are not receiving treatment.

According to Columbia University public health expert, Josh Ruxin “The number one risk [following a natural disaster] is always bacterial infections where they have open wounds.” Without antibiotics and proper treatment, wounds can become infected and put individual’s health at risk. Though some were not physically harmed by the earthquake, reports indicate that 40,000 were left homeless and forced to “cluster together in public places without food, clean water or sanitation.” For individuals displaced by earthquakes or other catastrophic situations, the risk of contracting diseases or developing parasitic infections is increased. Water supplies can become contaminated quickly in refugee camps or settings with damaged potable water distribution systems, leading to a rapid spread of water-borne illnesses such as cholera and dysentery as well as diarrhea, malaria, and measles.

Some experts note that not all of the harm of this disaster will be physical. Dr. Daniella David, professor of clinical psychiatry at the University of Miami’s Miller School of Medicine, explains that “Once the initial resources are in…is when the psychological aftereffects are going to hit people.” Further, she explains, there is a normal and immediate stress response that accompanies a devastating effect that causes damage to homes and loss of friends and family members. According to Sandro Galea, chair of the Department of Epidemiology and Columbia University’s Mailman School of Public Health in New York City, acute stress, post-traumatic stress, and depression will likely be seen in Haiti at three to four times higher than baseline in the coming months. Symptoms of post-traumatic stress disorder (PTSD), including depression, anxiety, emotional numbing, and sleep disorders, are usually seen within three months of the incident, according to the Canadian Mental Health Association. According to experts, assistance for potential sufferers of PTSD – often called “psychological first aid” – includes making individuals aware of what signs and symptoms to watch for, and letting them know that their feelings are normal and that help is available. While reporting of PTSD and other psychological disturbances is frequently a concern due to the social stigma attached to mental illness, Haitian-born psychologist Marie Guerda Nicolas of the University of Miami indicates that Haitians tend to be expressive of their grief and psychological distress. Further, members of rescue teams from other nations at as great a risk, if not an increased risk, of developing PTSD or psychological trauma.

Though a global humanitarian response is currently underway, aid organizations face a daunting task as they attempt to coordinate vast amounts of aid relief and get it to individuals who require it urgently. It remains to be seen exactly how many were affected by the earthquake and if assistance can be delivered effectively to them, but the impact of the earthquake on Haiti and its people is likely to continue after the initial wounds have healed.

Specialty physicians who wish to offer teleconsultation support to disaster-relief workers in Haiti, health professionals who wish to provide volunteer support on the ground in Haiti, and U.S. healthcare institutions that are willing to provide services to victims of the earthquake who are airlifted to this country for urgent medical or rehabilitation care can register through iCons in Medicine