THE DEVELOPMENT AND PRACTICE OF EMERGENCY AND DISASTER MEDICINE IN THE UNITED STATES

Accidents and sudden illness constitutes a major public health problem in many countries. Emergency medicine had developed as a vigorous new specialty in the U.S. and has fully integrated itself within the American medical and hospital system to provide improved emergency medical care. Emergency medicine plays a central role in disaster medical services, planning, and management and is the only specialty in American civilian medicine that includes disaster medicine as a primary field within its domain. Now that the basic framework of emergency medicine has been established, the American College of Emergency Physicians is implementing a nationwide training program on disaster planning and management for emergency physicians.     

Disaster journalism: fostering citizen and community disaster mitigation,preparedness, response,recovery, and resilience across the disaster cycle

Natural and human‐caused disasters pose a significant risk to the health and well‐being of people. Journalists and news organisations can fulfil multiple roles related to disasters, ranging from providing warnings, assessing disaster mitigation and preparedness, and reporting on what occurs, to aiding long‐term recovery and fostering disaster resilience. This paper considers these possible functions of disaster journalism and draws on semi‐structured interviews with 24 journalists in the United States to understand better their approach to the discipline. A thematic analysis was employed, which resulted in the identification of five main themes and accompanying subthemes: (i) examining disaster mitigation and preparedness; (ii) facilitating recovery; (iii) self‐care and care of journalists; (iv) continued spread of social media; and (v) disaster journalism ethics. The paper concludes that disaster journalism done poorly can result in harm, but done well, it can be an essential instrument with respect to public disaster planning, management, response, and recovery.     

Sources of organisational resiliency during the Thailand floods of 2011: a test of the bonding and bridging hypotheses

Based on the Institutional Collective Action framework, this research tests the impact of two competing hypotheses—bonding and bridging—on enhancing organisational resiliency. The bonding hypothesis posits that organisational resiliency can be achieved if an organisation works closely with others, whereas the bridging hypothesis argues that such a structure places considerable stress on an organisation and advocates for an organisation to position itself as a central actor to gain access to novel resources from a diverse set of entities to achieve resiliency. The paper analyses data gathered from semi‐structured interviews with 44 public, private, and non‐profit organisations serving communities affected by the Great Floods of 2011 in the Thai capital, Bangkok (urban), and in Pathum Thani (suburban) and Ayutthaya (rural) provinces. The findings suggest that: organisational resiliency was associated with the bridging effect; organisations in the rural province were more resilient than those in the suburban and urban centres; and private and non‐governmental organisations generally were more resilient than public sector organisations. The findings highlight the importance of fostering multi‐sector partnerships to enhance organisational resiliency for disaster response.     

Disaster resilience and population ageing: the 1995 Kobe and 2004 Chuetsu earthquakes in Japan

This paper provides a framework for evaluating the effects of population ageing on disaster resilience. In so doing, it focuses on the 1995 Kobe and 2004 Chuetsu earthquakes, two major disasters that affected Japan before the 2011 Great East Japan earthquake. It analyses regional population recovery on the basis of pre‐disaster and post‐recovery demographic characteristics using defined transition patterns of population ageing. The evaluation framework demonstrates that various recovery measures make different contributions to disaster resilience for each transition pattern of population ageing. With reference to regional population ageing, the framework allows for a prediction of disaster resilience, facilitating place vulnerability assessments and potentially informing policy‐making strategies for Japan and other countries with ageing populations.     

Health care system hazard vulnerability analysis: an assessment of all public hospitals in Abu Dhabi

Hazard vulnerability analysis (HVA) is used to risk‐stratify potential threats, measure the probability of those threats, and guide disaster preparedness. The primary objective of this project was to analyse the level of disaster preparedness in public hospitals in the Emirate of Abu Dhabi, utilising the HVA tool in collaboration with the Disaster Medicine Section at Harvard Medical School. The secondary objective was to review each facility's disaster plan and make recommendations based on the HVA findings. Based on the review, this article makes eight observations, including on the need for more accurate data; better hazard assessment capabilities; enhanced decontamination capacities; and the development of hospital‐specific emergency management programmes, a hospital incident command system, and a centralised, dedicated regional disaster coordination centre. With this project, HVAs were conducted successfully for the first time in health care facilities in Abu Dhabi. This study thus serves as another successful example of multidisciplinary emergency preparedness processes.     

Measuring vulnerability to natural hazards: a macro framework

The measurement of vulnerability—defined here as the asymmetric response of disaster occurrences to hazardous events—signifies a key step towards effective disaster risk reduction and the promotion of a culture of disaster resilience. One of the reasons for not being able to do the same in a wider context is related to conceptual, definitional, and operational issues. This paper presents an operationally feasible framework for conducting this task and measures revealed macro vulnerability as a function of disaster risk and hazard probability. The probabilities of hazard and its perceived disaster risk were obtained from past data and from probability distributions. In this paper, the corresponding analytical framework is constructed using the case study of floods in Assam, India. The proposed indicator will help policymakers to draw on available macro‐level data to identify the regions that are vulnerable to disasters, where micro‐level disaster vulnerability assessments could be performed in greater detail.     

地震类突发事件中公共财政应急机制分析

通过对我国地震应急组织体系及财政应对地震类灾害的流程分析,结合国外应对地震类突发事件的成功经验,分析了我国公共财政应对过程中存在的不足,最后建立了5个应对地震类突发事件的财政应急机制,分别是公共财政日常运行机制、震前预警防范机制、震时响应机制、震后恢复重建机制和财政监督检查机制。     

General overview of the disaster management framework in Cameroon

Efficient and effective disaster management will prevent many hazardous events from becoming disasters. This paper constitutes the most comprehensive document on the natural disaster management framework of Cameroon. It reviews critically disaster management in Cameroon, examining the various legislative, institutional, and administrative frameworks that help to facilitate the process. Furthermore, it illuminates the vital role that disaster managers at the national, regional, and local level play to ease the process. Using empirical data, the study analyses the efficiency and effectiveness of the actions of disaster managers. Its findings reveal inadequate disaster management policies, poor coordination between disaster management institutions at the national level, the lack of trained disaster managers, a skewed disaster management system, and a top‐down hierarchical structure within Cameroon's disaster management framework. By scrutinising the disaster management framework of the country, policy recommendations based on the research findings are made on the institutional and administrative frameworks.     

A proposed framework of key activities and processes in the preparedness and recovery phases of disaster management

This paper proposes an empirically grounded framework for examining the preparedness and recovery phases of disaster management activities and processes pertaining to predictable disasters within a developed country. The two‐stage framework provides a single model composed of important preparedness and recovery initiatives, as well as activities and processes derived from empirical data collected for case studies from Australia: the ‘Black Saturday’ bushfires in the state of Victoria in February 2009; and Cyclone Larry in March 2006. The framework enables a variety of analyses, including the generation of insights into disaster management preparedness and recovery in the context of events in wealthy developed countries. The paper combines two empirical examples, a series of bushfires and a severe tropical cyclone, to enhance understanding of, and to contribute to better, disaster preparedness and recovery in the future. The paper contributes to the growing literature on disasters, preparedness, recovery and associated logistics, and other issues.     

地震类突发事件中的公共财政应急机制

通过对我国地震应急组织体系及财政应对地震类灾害的流程分析,结合国外应对地震类突发事件的成功经验,分析了我国公共财政应对地震类灾害事件中存在的不足,最后通过对应急管理主体机理特征的分析,提出了公共财政应对地震类突发事件的五大机制,即公共财政日常运行机制、震前预警防范机制、震时响应机制、震后恢复重建机制和财政监督检查机制.     

The barriers to environmental sustainability in post‐disaster settings: a case study of transitional shelter implementation in Haiti

Disaster recovery operations that do not account for environmental sustainability (ES) risk exacerbating the impact of the disaster and hindering long‐term recovery efforts. Yet aid agencies do not always consider ES. This research is a case study of the recovery that followed the 2010 earthquake in Haiti. Using timber and concrete procurement as proxies for broader post‐disaster operations, research examined perceptions of ES as well as attempts at and barriers to incorporating it into programming. Identified barriers can be grouped into two categories: (1) prioritisations and perceptions within the disaster response sector that resulted in limited enthusiasm for incorporating ES into programming, and (2) structural and organisational barriers within the disaster response framework that impeded ES attempts and served as a further disincentive to incorporating ES into programming. As a result of those barriers, incorporation of ES was sporadic and inconsistent and often depended on the capacity and motivation of specific implementers.     

Towards a natural disaster intervention and recovery framework

Contemporary responses to facilitate long‐term recovery from large‐scale natural disasters juxtapose between those of humanitarian agencies and governments and those of the affected community. The extent to which these mechanisms articulate is crucial to the recovery propensity of the affected communities. This research examines such action by exploring the relationship between the scale of post‐disaster response interventions, the extent of community participation in them, and their impact on community recovery, using a community wealth capital framework. The investigation was applied to a study of the longer‐term community recovery of the island of Vilufushi, Republic of Maldives, which was almost completely destroyed by the Indian Ocean tsunami of 26 December 2004. Data were analysed through the employment of a pattern match technique and a holistic recovery network analysis. The research framework, informed by the case‐study results, other long‐term recovery evaluations, and existing resilience theory, is reconfigured as a testable roadmap for future post‐disaster interventions.     

Lateral knowledge: shifting expertise for disaster management in Chile

Deemed as technocratic and exclusionary, disaster management has failed in its promise of knowing, let alone controlling, catastrophic events. Consequently, disaster managers are searching outside of science for sense‐making analytics. This paper analyses the emergent narratives articulated by disaster managers in Chile to cope with the uncertain nature of their object of intervention. It explores how knowledge of disasters is modified and enriched by disaster managers in what is termed here as ‘lateral knowledge’: the epistemic adjustment by which practitioners revalidate their expert status by expanding key assumptions about disaster risk reduction. The study, which draws on in‐depth interviews with disaster managers in Chile, suggests that lateral knowledge is established both through the increasing validation of community knowledge and the recognition of politics as a critical mediator in the practice of disaster management. The paper concludes by making the larger point that public understanding of science scholars should pay more attention to the adapting capacities of expertise.     

How prepared is prepared enough?

Decisions about disaster preparedness are rarely informed by cost‐benefit analyses. This paper presents an economic model to address the thorny question, ‘how prepared is prepared enough?’ Difficulties related to the use of cost‐benefit analysis in the field of disaster management concern the tension between the large number of high‐probability events that can be handled by a single emergency response unit and the small number of low‐probability events that must be handled by a large number of them. A further special feature of disaster management concerns the opportunity for cooperation between different emergency response units. To account for these issues, we introduce a portfolio approach. Our analysis shows that it would be useful to define disaster preparedness not in terms of capacities, but in terms of the frequency with which response capacity is expected to fall short.     

综合应急救援能力描述理论架构及提升内容研究

基于代数这一数学工具,该文创新建立综合应急救援能力描述理论架构,包括面向自然灾害、事故灾难、公共卫生、社会安全等灾种建立的救援灾害轴,面向村、社区、街道(镇)、区(县、市)、市、省等区域建立的救援区域轴,面向准备、响应、处置、保障、善后等时间建立的救援时间轴,由此构成综合应急救援能力描述三维坐标系;在此基础上,抽象出应急救援能力途径通用表达式模型。研究出综合应急救援能力提升内容,包括综合应急救援能力提升内容的通用表达式,以及应急救援能力提升内容的通用表格;基于这些研究成果,就可根据实际的救援灾害轴、救援区域轴、救援时间轴等实际情况,得出具体的综合应急救援能力提升内容。     

Urban disaster recovery: a measurement framework and its application to the 1995 Kobe earthquake

This paper provides a framework for assessing empirical patterns of urban disaster recovery through the use of statistical indicators. Such a framework is needed to develop systematic knowledge on how cities recover from disasters. The proposed framework addresses such issues as defining recovery, filtering out exogenous influences unrelated to the disaster, and making comparisons across disparate areas or events. It is applied to document how Kobe City, Japan, recovered from the catastrophic 1995 earthquake. Findings indicate that while aggregate population regained pre‐disaster levels in ten years, population had shifted away from the older urban core. Economic recovery was characterised by a three to four year temporary boost in reconstruction activities, followed by settlement at a level some ten per cent below pre‐disaster levels. Other long‐term effects included substantial losses of port activity and sectoral shifts toward services and large businesses. These patterns of change and disparity generally accelerated pre‐disaster trends.     

The 2004 Madrid train bombings: an analysis of pre-hospital management

The terrorist train bombings in Madrid, Spain, on 11 March 2004 triggered a swift and massive medical response. This paper analyses the pre-hospital response to the attacks to gain insight into current trends in disaster management among Madrid's Emergency Medical Services (EMSs). To this end, the existing emergency planning framework is described, the basic structures of the different EMSs are presented, and the attacks are briefly depicted before consideration is given to pre-hospital management. Finally, an explanation of the main underlying misconceptions in emergency planning and management in Madrid is provided to aid understanding of the origins of some of the problems detected during the response. These are attributable mainly to inappropriate planning rather than to mistakes in field-level decision-making. By contrast, many of the successes are attributable to individual initiatives by frontline medics who compensated for the lack of clear command by senior managers by making adaptive and flexible decisions.     

Insuring against earthquakes: simulating the cost‐effectiveness of disaster preparedness

Ex‐ante measures to improve risk preparedness for natural disasters are generally considered to be more effective than ex‐post measures. Nevertheless, most resources are allocated after an event in geographical areas that are vulnerable to natural disasters. This paper analyses the cost‐effectiveness of ex‐ante adaptation measures in the wake of earthquakes and provides an assessment of the future role of private and public agencies in disaster risk management. The study uses a simulation model approach to evaluate consumption losses after earthquakes under different scenarios of intervention. Particular attention is given to the role of activity diversification measures in enhancing disaster preparedness and the contributions of (targeted) microcredit and education programmes for reconstruction following a disaster. Whereas the former measures are far more cost‐effective, missing markets and perverse incentives tend to make ex‐post measures a preferred option, thus occasioning underinvestment in ex‐ante adaptation initiatives.