Patterns of substance use among Hurricane Katrina evacuees in Houston,Texas

This paper focuses on changing patterns of substance use among low income, African American drug users evacuated from New Orleans, Louisiana, during Hurricane Katrina of August 2005. It examines the relationship between increases and decreases in alcohol and tobacco (AT) use and illicit drug (ID) use after Katrina and pre‐disaster and within‐disaster factors. Data from structured interviews with 200 Katrina evacuees currently living in Houston were collected 8–14 months after the disaster. Multivariate analysis revealed that rises in AT use were positively associated with education. Females and younger evacuees were more likely to have increased AT use. ID use increase was positively associated with resource loss and leaving the city before Katrina. Decreases in AT and ID use were found to be associated with disaster‐related exposure. The paper discusses the specific consequences of disasters on disadvantaged minority substance users and the importance of developing public health disaster policies that target this population.     

Mortality,violence and lack of access to healthcare in the Democratic Republic of Congo

The people of the Democratic Republic of Congo for decades have been living in a situation of chronic crisis. Violence, population displacement and the destruction of infrastructure and health services have devastated the health of the population. In 2001, Médicins Sans Frontières conducted a survey in five areas of western and central DRC to assess mortality, access to health-care, vaccination coverage and exposure to violence. High mortality rates were found in front-line zones, mainly due to malnutrition and infectious diseases. In Basankusu approximately 10 per cent of the total population and 25 per cent of the under-five population had perished in the year before the survey. Humanitarian needs remain acute across the country, particularly near the front line. Infectious-disease control and treatment are a priority, as is increasing access to health-care. Humanitarian assistance must be increased considerably, especially in rural areas and zones that have been affected directly by conflict.     

Natural Hazard Reporting in the UK Press

Important sources of information concerning world natural hazards are provided by the mass media, especially newspapers. The nature, depth and consistency of the reporting, however, varies considerably depending upon the journalistic approach of the newspaper and on the perceived 'newsworthiness' of a disaster. Intensive events are much more likely to receive attention than pervasive hazards but other contributory factors play a part, such as the day, time, severity in terms of damage and loss of life, and location of the event. This paper reflects on the reporting of natural hazards in UK newspapers and is based on an analysis of press cuttings taken over a period of twelve months. The survey indicated that there is a very uneven coverage of world disasters, that location maps are scarce, and that valuable follow-up reporting is minimal.     

Long-Term Effects of Hurricane Andrew: Revisiting Mental Health Indicators

Two population-based surveys of South Dade County, Florida, were conducted after Hurricane Andrew to compare hurricane-related symptoms of mental distress and describe the impact of mental health outreach teams. Households were selected by three-stage cluster sampling and findings from the two surveys, 13 months apart, were compared. Response rates were 75 per cent and 84 per cent. The prevalence of symptoms of mental distress decreased over time. However, in the households contacted by the teams (25 per cent of sample), the prevalence of symptoms (50 per cent) did not differ from households not contacted (43 per cent). Households contacted by teams that reported symptoms were just as likely to have been referred for help by the teams (72 per cent) as those without symptoms (68 per cent). Households reporting symptoms were equally likely to get counselling regardless of whether the teams visited. Mental health teams had no significant impact on mental health symptoms or the use of mental health services. Alternative approaches to mental health outreach teams need to be explored.     

Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus‐group study

The terrorist attacks of 11 September 2001 (9/11) left workplaces in pressing need of a mental health response capability. Unaddressed emotional sequelae may be devastating to the productivity and economic stability of a company's workforce. In the second year after the attacks, 85 employees of five highly affected agencies participated in 12 focus groups to discuss workplace mental health issues. Managers felt ill prepared to manage the magnitude and the intensity of employees' emotional responses. Rapid return to work, provision of workplace mental health services, and peer support were viewed as contributory to emotional recovery. Formal mental health services provided were perceived as insufficient. Drawing on their post‐9/11 workplace experience, members of these groups identified practical measures that they found helpful in promoting healing outside of professional mental health services. These measures, consistent with many principles of psychological first aid, may be applied by workplace leaders who are not mental health professionals.     

Epidemiological assessment of food aid in the Bosnian conflict, 1994-97

Surveys in emergency settings are important for the accountability of food aid. Four household surveys conducted between 1994 and 1997 measured the performance of the Bosnia food aid programme, covering a random sample of clusters in Bosnia and Herzegovina and the Republica Srpska. The team calculated coverage, exclusion and inclusion errors, programme misses, and under-supply. Despite intended universal coverage from 1994-96, 15, 19, and 31 per cent, respectively, did not receive food across the three-year time frame. Households categorised as vulnerable were somewhat more likely to receive food. Programme misses were rare, whereas under-supply fell from 30 per cent in 1994 to four per cent in 1997, as the availability of other food increased. Extrapolation suggested that 61 per cent of the food distributed did not reach households. The programme introduced priority categories for targeting in 1997, yet nearly one-half of the highest priority households did not receive food. Incomplete coverage and weak targeting were related to political constraints.     

Zimbabwe's Child Supplementary Feeding Programme: a re-assessment using household survey data

In 1992-3 and 1995-6, Zimbabwe used a Child Supplementary Feeding Programme (CSFP) to combat child malnutrition during drought-induced emergencies. Previous evaluations of the CSFP relied on routine administrative data and key informant interviews and made only cursory use of available household survey data. These evaluations concluded that the CSFP was effective in preventing an increase in malnutrition among children under five, especially in 1992-3. The more-detailed analysis of household surveys provided in this article suggests that CSFP coverage was generally patchy and disappointingly low, especially in 1995-6. There is little evidence that children from poor or nutritionally vulnerable households got preferential access to supplementary feeding. The CSFP failed to feed many malnourished and nutritionally vulnerable children even in areas where the programme was operating. Household survey evidence suggests that the CSFP's impact on nutritional status was likely marginal, especially in 1995-6.     

我国部分省市初中生防灾素养调查研究

为了解我国初中生防灾素养水平,找出制约其防灾素养提升的关键因素,总结一般问题,并提出相应策略,分别选取了经济发展程度相对较高的北京、上海、天津、广东、福建及黑龙江6个省市的初中各年级学生作为调查对象,回收有效问卷7 313份(发放10 000份)。调查发现,我国初中生防灾素养总体水平偏低,初中生大多具有正向积极的防灾态度,防灾态度维度得分高于防灾技能,防灾知识维度最低。但这只能看作全国较高水平,而不能看作一般水平,真实情况可能更令人堪忧。针对此情况,提出要针对学生年龄及心理特点开展课程开发相关研究,以期促进灾害教育的开展与学生防灾素养的提升。     

城市中学生地震灾害感知研究——以陕西省宝鸡市石油中学为例

以陕西宝鸡石油中学学生为例,通过问卷调查方式,对其地震灾害认识水平、防震减灾基本技能、自救互救情况、震后心理倾向和信息传播进行了研究。采用权重法,利用Excel和SPSS17.0软件进行统计分析。结果表明:①城市中学生地震知识掌握的准确性和深度还很不够,防震减灾意识淡薄;②城市中学生掌握的实际防震减灾技能不足,但有迫切的学习需求;③城市中学生具有基本的自救能力,但自救互救的组织性和主动性较差;④城市中学生具有广泛的地震信息来源,但辨别地震谣言的能力不强,易于传播地震谣言。针对上述结果,提出了强化城市中学生防震减灾教育的相关建议。     

The living environment and children's fears following the Indonesian tsunami

The tsunami that struck South-east Asia on 26 December 2004 left more than 500,000 people in Aceh, Indonesia, homeless and displaced to temporary barracks and other communities. This study examines the associations between prolonged habitation in barracks and the nature of fears reported by school-age children and adolescents. In mid-2007, 30 months after the tsunami, the authors interviewed 155 child and parent dyads. Logistic regression analysis was used to compare the fears reported by children and adolescents living in barracks with those reported by their peers who were living in villages. After adjusting for demographic factors and tsunami exposure, the data reveals that children and adolescents living in barracks were three times more likely than those living in villages to report tsunami-related fears. The study demonstrates that continued residence in barracks 30 months after the tsunami is associated with higher rates of reporting tsunami-related fears, suggesting that barracks habitation has had a significant impact on the psychological experience of children and adolescents since the tsunami.     

Household evacuation characteristics in American Samoa during the 2009 Samoa Islands tsunami

Tsunamis represent significant threats to human life and development in coastal communities. This quantitative study examines the influence of household characteristics on evacuation actions taken by 211 respondents in American Samoa who were at their homes during the 29 September 2009 M_w 8.1 Samoa Islands earthquake and tsunami disaster. Multiple logistic regression analysis of survey data was used to examine the association between evacuation and various household factors. Findings show that increases in distance to shoreline were associated with a slightly decreased likelihood of evacuation, whereas households reporting higher income had an increased probability of evacuation. The response in American Samoa was an effective one, with only 34 fatalities in a tsunami that reached shore in as little as 15 minutes. Consequently, future research should implement more qualitative study designs to identify event and cultural specific determinants of household evacuation behaviour to local tsunamis.     

How much more exposed are the poor to natural disasters? Global and regional measurement

This paper proposes a simple indicator to measure the exposure to natural disasters for the poor and non-poor population, in order to assess the global and regional trend of natural hazard and poverty. Globally, poor people are two times more exposed to natural disasters than the non-poor in the twenty-first century. The time trend varies across regions, with poor people in East Asia and Pacific being most exposed to natural disasters, followed by those in South Asia and Sub-Saharan Africa. The change of exposure measure over time is decomposed into two factors: a pure exposure change, which could be fuelled by climate change; and a concentration component. The result shows that the total net increase of exposure between the 1970s and the 2000s is driven significantly by the increased concentration of the poor (26 per cent) in disaster-prone areas, whereas the contribution of that factor remains very small for the non-poor (six per cent).     

Emotional,physical, and social needs among 0–5‐year‐old children displaced by the 2010 Chilean earthquake: associated characteristics and exposures

An 8.8‐magnitude earthquake occurred off the coast of Chile on 27 February 2010, displacing nearly 2,000 children aged less than five years to emergency housing camps. Nine months later, this study assessed the needs of 140 displaced 0–5‐year‐old children in six domains: caregiver stability and protection; health; housing; nutrition; psychosocial situation; and stimulation. Multivariate regression was applied to examine the degree to which emotional, physical, and social needs were associated with baseline characteristics and exposure to the earthquake, to stressful events, and to ongoing risks in the proximal post‐earthquake context. In each domain, 20 per cent or fewer children had unmet needs. Of all children in the sample, 20 per cent had unmet needs in multiple domains. Children's emotional, physical, and social needs were associated with ongoing exposures amenable to intervention, more than with baseline characteristics or epicentre proximity. Relief efforts should address multiple interrelated domains of child well‐being and ongoing risks in post‐disaster settings.     

Disaster mental health training programmes in New York City following September 11, 2001

The need for mental health resources to provide care to the community following large‐scale disasters is well documented. In the aftermath of the World Trade Center (WTC) disaster on September 11, 2001, many local agencies and organizations responded by providing informal mental health services, including disaster mental health training for practitioners. The quality of these programmes has not been assessed, however. The National Center for Disaster Preparedness at Columbia University's School of Public Health reviewed disaster mental health training programmes administered by community‐based organizations, professional associations, hospitals, and government agencies after September 11. Results indicate that the quality and the effectiveness of programmes are difficult to assess. A wide range of curricula and a widespread lack of recordkeeping and credentialing of trainers were noted. Most of the training programmes provided are no longer available. Recommendations for improving the quality of disaster mental health training programmes are provided.     

Effects of floods on the use and condition of pit latrines in rural bangladesh

The severe floods of 1987 in Bangladesh had devastating effects on many development activities. Here, the use and condition of improved sanitation facilities (double pit water sealed latrines) during the 1987 peak flood period are presented. Two surveys on the use and condition of the latrines were carried out in May (pre-flood) and September (post-flood) 1987 in a rural area 60 km north of Dhaka, with a population of about 4500. General usage of the latrines by the population aged five years or more decreased from 88% to 78% ( p < 0.001) after the flood. Only 40% of the 343 latrines which were in use and had no damaged component at the time of the pre-flood survey still had no damaged components after the floods. Fencing was the component which suffered the most damage. It was the only component which was installed and maintained by the users, project staff being responsible for all other components. The estimated post-flood repair cost was approximately US $4.0 per latrine. Development of an affordable and durable fencing is recommended.     

Stimulating flood damage mitigation through insurance: an assessment of the French CatNat system

Flood risk has increased in France in the last 20 years and is projected to increase further in the future due to climate change and increase in exposure. Since 1982, France has had a natural disasters insurance system (‘CatNat’) in place that covers flood damage. This insurance system has been combined with what are called ‘Risk Prevention Plans’ (PPRs) in order to stimulate the undertaking of flood risk mitigation measures by communities and households. However, these schemes do not provide optimal incentives for flood damage reduction. This is confirmed by the results from a survey about flood preparedness of 885 households who live in flood-prone areas in France, which are presented in this paper. Moreover, this study provides suggestions for improvement, which are assessed on their potential economic, social and political implications. Among these suggestions are increasing the effectiveness of PPRs and increasing the incentives to apply and implement PPRs; improving the monitoring of the implementation of damage mitigation measures; and the possibility to differentiate premiums and deductibles according to flood risk.     

The Yellow Fever Epidemic in Western Mali,September—November 1987: Why Did Epidemiological Surveillance Fail?

Recent yellow fever epidemics in West Africa have underlined the discrepancy between the official number of cases and deaths and those estimated by a retrospective epidemiological investigation. During the yellow fever epidemic that broke out in western Mali in September 1987, a total of 305 cases and 145 deaths were officially notified, but estimates revealed true figures abut five times higher. This paper attempts to discuss the factors that hindered early case detection and more complete reporting. They were, first, the insufficient training on the clinical diagnosis, the blood sampling method for laboratory confirmation, and the curative treatment of patients (resulting in low utilization of services); second, the lack of an action plan to prepare in advance a quick response to the epidemic, affecting reporting procedures at the peripheral level and active case-finding during the outbreak; and third, the lack of laboratory facilities for a quick confirmation of the disease.
The difficulties experienced during the yellow fever epidemic in Mali demonstrated the importance of a preparedness strategy for epidemic control, based on an integrated approach of epidemiological surveillance within basic health service activities. The need for regional collaboration and for institutionalized funds in the donor community that could be mobilized for epidemic preparedness activities is also emphasized.     

Aberfan and the management of trauma

This paper is a case study of the management of post-disaster trauma in 1960s Britain. It explores the traumatic aftermath of the 1966 Aberfan disaster (where 116 children and 28 adults were killed when a colliery spoil heap collapsed on top of a school in a small Welsh mining community) which had a devastating impact on the village. The professional and voluntary services made available to help the bereaved, survivors and wider community are documented and assessed. The paper demonstrates how limited finance and the popular and professional contemporary understanding of trauma and disasters hindered those services, and how the actions of government and media had a negative impact on the community's recovery. This case study of disaster management in the 1960s illustrates many of the pitfalls that continue to haunt the response to man-made tragedies in the UK.     

Tears,fears and cheers: responses to the post‐disaster school relocation policy in China

This paper reports on the results of a qualitative study on the responses of Chinese school children in one junior middle school and their parents to China's post‐disaster school relocation policy. The sample comprised 22 pairs of parent–child dyads and two pupils whose parents could not be contacted. The study results were reported using Chambers and Wedel's (2009) conceptual framework, which delineates the fundamental elements of a policy. Content analysis was used to generate themes related to policy elements, such as goals, benefits and services. Both repetitive themes and idiosyncratic perspectives were reported so as to present a diversity of views. Despite adjustment difficulties and administrative problems reported by the study participants, the policy attention given to the rapid restoration of formal schooling for children was generally appreciated. The move back to the new school was greeted with cheer.     

Foreignness as a constraint on learning: The impact of migrants on disaster resilience in small islands

Knowledge about natural hazard management has increased significantly since Gilbert White's seminal research in 1945, yet people are still badly affected by natural hazards. A key question remains in natural hazards research: why, when all the conditions for effective disaster risk reduction are in place, do some people not take action to reduce their risk of harm? Through a questionnaire-based study we investigated the motivating factors that led residents of the Cayman Islands to prepare for annual tropical cyclones (hurricanes). Factors that increase the likelihood of individuals preparing for hurricanes are: previous experience of major storms, having linking networks and ties, having a child under the age of 15 in the home, and residency status—expatriate residents are less likely to prepare. Factors that appear to prevent adaptive behaviour include: living close to or adjacent to the coast, recent migration to the islands, and living in rented accommodation. The findings of the survey confirm that even within societies that are well prepared for tropical cyclones, there are still sub-groups who do not engage with the preparedness process. In the case of the Cayman Islands, new migrants are the most vulnerable to tropical cyclones as they tend to fall into the demographic groups least likely to prepare for cyclones, live in locations with high levels of exposure to cyclone impacts, and interact mostly with other expatriates with no previous experience of cyclone impacts. As climate change promises to bring an increasing intensity of tropical cyclones, these findings have relevance for all islands which draw on migrant workers to support economic growth.