Better Health For All

By Dr Mala Rao, Director of the Indian Institute of Public Health.

The harrowing accounts of the earthquake in Haiti are a reminder of the helplessness of humanity when faced with nature’s fury. And it isn’t only the developing world which can be overwhelmed by environmental calamities. Hurricane Katrina killed more than 1,000 Americans in 2005 and extreme levels of rainfall during the summer of 2007, the wettest in England since records began, resulted in the severest loss of essential services in the affected areas since the World War II.

Nevertheless, it is clear that the greatest human, economic and environmental losses following such disasters occur in socio-economically deprived communities with the least capacity to absorb such shocks and to recover quickly from them.  Such as in Haiti.

But the challenges are huge.  ‘Natural’ disasters are increasing in number and severity, and they are compounded by increasingly frequent extreme weather events, which result from anthropogenic climate change. The international effort to address disasters is usually reactive. All too often it is shaped by political agendas rather than what the recipients need. Local recovery efforts can also be hampered by well meaning and enthusiastic volunteers descending on disaster zones, offering impractical and sometimes insensitive interventions.  An Indian colleague recently recalled, with amusement and annoyance, a mountain of Western women’s clothes donated by a charity to a village devastated by the Indian Ocean tsunami.  A deeply conservative community in the Tamil Nadu region, these clothes were lying untouched and getting in everyone’s way.

Focus needs to be shifted to strengthening the affected region’s disaster response preparedness and to build the resilience of those communities most at risk. For it is multidisciplinary strategies, which anticipate and prevent or mitigate the effects of disasters, that have the best chance of reducing the carnage which accompanies so many environmental disasters.

This takes time, commitment and long-term collaboration.  Public health practitioners in the developing and developed countries have a crucial role in working together and with their partner organizations to help develop these strong, resilient communities, able to withstand such increasingly frequent shocks.