Gender and Hurricane Mitch: reconstructing subjectivities after disaster

Much of the gender and disaster literature calls for more gender-sensitive disaster relief and research by focusing on the ways in which women are more vulnerable in a disaster or on their unique capabilities as community leaders or natural resource managers, which are often overlooked or underutilised in emergency management strategies. As well as seeking to overcome the (strategic) essentialism that is part of these calls and debates, this paper pays closer attention to gender identity and subjectivity as these are constructed and reworked through the disaster process to highlight the complexities and contradictions associated with women's responses to a disaster. This focus, while crucial to gaining a deeper understanding of the gendered dimensions of disaster, also complicates attempts to create more gender-sensitive frameworks for disaster response. It draws on qualitative research conducted with a number of women in the wake of Hurricane Mitch (1998) in Nicaragua.     

Cross-sectional survey methods to assess retrospectively mortality in humanitarian emergencies

Since the rates and causes of mortality are critical indicators of the overall health of a population, it is important to evaluate mortality even where no complete vital statistics reporting exists. Such settings include humanitarian emergencies. Experience in cross-sectional survey methods to assess retrospectively crude, age-specific, and maternal mortality in stable settings has been gained over the past 40 years, and methods appropriate to humanitarian emergencies have been developed. In humanitarian emergencies, crude and age-specific mortality can be gauged using methods based on the enumeration of individuals resident in randomly selected households—frequently referred to as a household census. Under-five mortality can also be assessed through a modified prior birth history method in which a representative sample of reproductive-aged women are questioned about dates of child births and deaths. Maternal mortality can be appraised via the initial identification of maternal deaths in the study population and a subsequent investigation to determine the cause of each death.     

Violence and complex humanitarian emergencies: implications for livelihoods models

This paper explores the nature of the violence that characterises complex humanitarian emergencies and the related implications for modelling livelihoods systems. While noting the importance of livelihoods approaches in complex humanitarian emergencies, it deliberates the limitations of sustainable livelihoods frameworks when applied in environments marked by protracted instability. Adaptations to the model are discussed, with a particular focus on the relationships among violence, assets and liabilities within livelihoods systems. Political economy of violence theories intimate that the assets on which livelihoods systems are constructed in peaceful times may instead become life-and livelihood-threatening liabilities in periods of conflict. Adaptations to livelihood systems in violent settings require that analysts consider violence from policy, institutional and process perspectives. It is suggested that vulnerability should be re-conceptualised as endogenous to livelihoods systems in violent settings. Building on the work of others, a livelihoods model adapted for complex humanitarian emergencies is presented.     

Controlling disasters: recognising latent goals after Hurricane Katrina

Classic sociological theory can be used to interpret the aftermath of Hurricane Katrina, which made landfall in the United States on 29 August 2005. The delayed and ineffective response to the storm and the subsequent failure of the levees become more understandable when one considers the latent goals of social control in disaster recovery. Constructing the survivors as suspect or criminal and conceptualising the impacts of the disaster as individual problems occurred in order to justify the emphasis on controlling the survivors of Katrina rather than on assisting them. Parallels are drawn here between the disaster response featuring social control efforts and a recent paradigmatic shift in criminal justice from justice to 'risk management'. Recognition of the implicit aims of the inadequate disaster response provides a more complete explanation of why post-Katrina efforts failed to achieve the manifest goals of response and recovery. The conclusion suggests ways to ensure more equitable and just disaster responses.     

Operation Child-ID: reunifying children with their legal guardians after Hurricane Katrina

Children constitute a vulnerable population and special considerations are necessary in order to provide proper care for them during disasters. After disasters such as Hurricane Katrina, the rapid identification and protection of separated children and their reunification with legal guardians is necessary in order to minimise secondary injuries (i.e. physical and sexual abuse, neglect and abduction). At Camp Gruber, an Oklahoma shelter for Louisianans displaced by Hurricane Katrina, a survey tool was used to identify children separated from their guardians. Of the 254 children at the camp, 36 (14.2 per cent) were separated from their legal guardians. Answering 'no' to the question of whether the accompanying adult was the guardian of the child prior to Hurricane Katrina was a strong predictor (27.8 per cent versus 3.2 per cent) of being listed as 'missing' by the National Center for Missing and Exploited Children (NCMEC). All the children at Camp Gruber who were listed as 'missing' by the NCMEC were subsequently reunited with their guardians.     

Prospects for improved hurricane protection on oceanic islands: Hawaii after Hurricane Iwa *

Hurricane Iwa (23rd November 1982) produced Hawaii's costliest natural disaster and revealed serious flaws in the area's hurricane preparedness, response and mitigation programs. Twenty-eight months later, a follow-up study showed that impacted communities and facilities had been reconstructed with only selective and limited attention to mitigating future coastal storm hazards. Prospects for the reduction of hazard vulnerability on oceanic islands through post-disaster mitigation measures are assessed in the light of Hawaii's experience.     

The rationality of resistance: alternatives for engagement in complex emergencies

The different conceptualisations of conflict in the complex emergency literature have profound implications on the perception of the agency of different groups and the prospects for conflict management. While much recent analysis has focused on the rational political and economic functions of violence, relatively little analysis has focused on why the majority of people chose not to resort to violence. Using Foucault's analysis of power relations, a new framework for conflict analysis is proposed which includes non-violent resistance as well as violence as a means of domination. Non-violent resistance is explored as a rational, highly adaptable response to acts of domination. A comprehensive understanding of conflict must recognise local forms of resistance and identify the barriers and opportunities for the engagement of the international humanitarian community with these groups. This engagement can be used to foster capacities for the creation of legitimate, inclusive, non-violent political and economic processes in the attempt to provide alternatives for everyone in the conflict. If the purpose of the study of complex emergencies is to understand the nature of various conflicts and, based on that understanding, make recommendations for possible routes to conflict management, the analysis of local resistance and efforts to foster it must become a major aspect of the research agenda.     

Biodiversity versus emergencies: the impact of restocking on Animal Genetic Resources after disaster

Restocking is a favoured option in supporting livelihoods after a disaster. With the depletion of local livestock populations, the introduction of new species and breeds will clearly affect biodiversity. Nevertheless, the impact of restocking on Animal Genetic Resources has been largely ignored. The aim of this paper, therefore, is to examine the consequences of restocking on biodiversity via a simple model. Utilising a hypothetical project based on cattle, the model demonstrates that more than one-third of the population was related to the original restocked animals after three generations. Under conditions of random breed selection, the figure declined to 20 per cent. The tool was then applied to a donor-led restocking project implemented in Bosnia-Herzegovina. By restocking primarily with Simmental cattle, the model demonstrated that the implementation of a single restocking project is likely to have accelerated the decline of the indigenous Buşa breed by a further nine per cent. Thus, greater awareness of the long-term implications of restocking on biodiversity is required.     

Quantitative assessment of post‐disaster housing recovery: a case study of Punta Gorda,Florida, after Hurricane Charley

Quantitative assessment of post‐disaster housing recovery is critical to enhancing understanding of the process and improving the decisions that shape it. Nevertheless, few comprehensive empirical evaluations of post‐disaster housing recovery have been conducted, and no standard measurement methods exist. This paper presents a quantitative assessment of housing recovery in Punta Gorda, Florida, United States, following Hurricane Charley of August 2004, including an overview of the phases of housing recovery, progression of recovery over time, alternative trajectories of recovery, differential recovery, incorporation of mitigation, and effect on property sales. The assessment is grounded in a conceptual framework that considers the recovery of both people and place, and that emphasises recovery as a process, not as an endpoint. Several data sources are integrated into the assessment—including building permits, remotely sensed imagery, and property appraiser data—and their strengths and limitations are discussed with a view to developing a standardised method for measuring and monitoring housing recovery.     

Business closure and relocation: a comparative analysis of the Loma Prieta earthquake and Hurricane Andrew

The occurrence of a number of large‐scale disasters or catastrophes in recent years, including the Indian Ocean tsunami (2004), the Kashmir earthquake (2005), Hurricane Katrina (2005) and Hurricane Ike (2008), have raised our awareness regarding the devastating effects of disasters on human populations and the importance of developing mitigation and preparedness strategies to limit the consequences of such events. However, there is still a dearth of social science research focusing on the socio‐economic impact of disasters on businesses in the United States. This paper contributes to this research literature by focusing on the impact of disasters on business closure and relocation through the use of multivariate logistic regression models, specifically focusing on the Loma Prieta earthquake (1989) and Hurricane Andrew (1992). Using a multivariate model, we examine how physical damage to the infrastructure, lifeline disruption and business characteristics, among others, impact business closure and relocation following major disasters.     

A 'Principled' Approach to Complex Emergencies: Testing a New Aid Delivery Model in the Nuba Mountains

This paper provides an analysis of the Nuba Mountains Programme Advancing Conflict Trans-formation (NMPACT) as an example of an operational response in a complex emergency that innovatively addressed an incipient food security crisis. NMPACT is notable for having brought together an array of actors around a common principled agenda and for being the only operational programme in the Sudan to which both warring parties subscribed during the conflict. The key features of the programme are presented and the main innovative elements are reviewed, including the role of the principles of engagement and the 'political humanitarianism' of NMPACT. The paper looks at how NMPACT broke from traditional externally driven responses to food insecurity, and, drawing on lessons from Operation Lifeline Sudan, adopted an approach that focuses on capacity building, sustainable agriculture and market revitalisation, alongside conflict transformation and peace-building. The limitations of the model are also assessed, and preliminary lessons regarding its replication in other complex emergency contexts are presented.     

Supporting breastfeeding in emergencies: protecting women's reproductive rights and maternal and infant health

Women have the right to support that enables them to breastfeed. Supporting breastfeeding in emergencies is important because artificial feeding places mothers and children at risk. In emergencies, artificial feeding is dangerous to the infant, difficult and requires substantial resources. In contrast, breastfeeding guards infant health. It is also protective against postpartum haemorrhage, maternal depletion, maternal anaemia and closely spaced births and should therefore concern not only nutritionists, but also those involved in reproductive health. However, it is common for women's ability to breastfeed to be undermined in emergencies by the indiscriminate distribution of breast-milk substitutes and the absence of breastfeeding support. Controlling the distribution of breast-milk substitutes, providing supportive environments, and appropriate medical and practical assistance to breastfeeding women safeguards the health and well-being of mothers and babies. Greater collaboration between the nutrition and reproductive health sectors is required to promote best practice in protecting breastfeeding women and their children in emergencies.     

NGO initiatives in risk reduction: an overview

NGOs appear to be well placed to play a significant role in natural disaster mitigation and preparedness (DMP), working, as they do, with poorer and marginalised groups in society. However, there is little information on the scale or nature of NGO DMP activities. This paper reports the findings of a study seeking to address that gap. It confirms that NGOs are involved in a diverse range of DMP activities but that a number of them are not labelled as such. Moreover, evidence of the demonstrable quality and benefits of DMP involvement is poor. The paper concludes that a number of problems need to be overcome before DMP can be satisfactorily mainstreamed into NGO development and post-disaster rehabilitation programmes. However, there are some early indications of momentum for change.     

Establishing moral bearings: ethics and expatriate health care professionals in humanitarian work

Expatriate health care professionals frequently participate in international responses to natural disasters and humanitarian emergencies. This field of practice presents important clinical, logistical and ethical challenges for clinicians. This paper considers the ethics of health care practice in humanitarian contexts. It examines features that contribute to forming the moral landscape of humanitarian work, and discusses normative guidelines and approaches that are relevant for this work. These tools and frameworks provide important ethics resources for humanitarian settings. Finally, it elaborates a set of questions that can aid health care professionals as they analyse ethical issues that they experience in the field. The proposed process can assist clinicians as they seek to establish their moral bearings in situations of ethical complexity and uncertainty. Identifying and developing ethics resources and vocabulary for clinical practice in humanitarian work will help health care professionals provide ethically sound care to patients and communities.     

From Policy to Practice: Challenges in Infant Feeding in Emergencies During the Balkan Crisis

The preparation and dissemination of policy statements are necessary but insufficient to prevent the inappropriate use of infant-feeding products in emergencies. The widespread failure of humanitarian agencies operating in the Balkan crisis to act in accordance with international policies and recommendations provides a recent example of the failure to translate infant-feeding policies into practice. This article explores the underlying reasons behind the failures which include: (1) the weak institutionalisation of policies; (2) the massive quantities of unsolicited donations of infant-feeding products: (3) the absence of monitoring systems; (4) inadequate co-ordination mechanisms; (5) the high costs of correcting mistakes; and (6) the cumulative effects of poor practice. Efforts to uphold best practice during the crisis are also documented. Finally, the article identifies actions that could be undertaken in advance of and during future emergencies to enhance the application of infant feeding policies in emergencies.     

HIV risk and prevention in emergency-affected populations: a review

While basic guidelines on HIV prevention in emergencies have been available for several years, international agencies involved in the provision of health services have not placed sufficient priority on the prevention of the human immune deficiency virus (HIV) and other sexually transmitted infections (STIs) in complex emergencies. This paper reviews the factors that may increase the risk of HIV transmission in populations affected by complex emergencies and outlines recommendations for research and programmes. Research into the most appropriate methods of carrying out HIV surveillance and interventions in these settings is needed. In the post-emergency phase programmes need to be far more extensive than those offered under the Minimal Initial Services Package (MISP). While the potential for stigmatization represents an important constraint, there is a need to prioritize HIV/STI interventions in order to prevent HIV transmission in emergency-affected populations themselves, as well as to contribute to regional control of the epidemic.     

The barriers impeding precautionary behaviours by undocumented immigrants in emergencies: The Hurricane Ike experience in Houston,Texas, USA

Emergency management tends to be planned for legal, resident populations that are responsive to mainstream channels of communication and enforcement. For many areas prone to extreme events and emergencies, populations are also composed of transitory tourists, temporary visitors and migrant workers. This latter group may be a large population and, while not completely invisible to residents, may prefer obscurity and concealment within the social landscape. Tending towards poverty, technologically disconnected and linguistically isolated, undocumented migrants seek employment and attempt to avoid local law enforcement and immigration officials for fear of imprisonment and deportation. In this context, the behaviours prompted by developing public emergencies will be different for undocumented migrants than for the population at large. We examine the experience of 135 Hispanic undocumented migrants in the coastal zone of Houston-Galveston, Texas to understand the factors and issues that influence decision making and behaviours under region-wide mandatory evacuation conditions. Undocumented migrants’ decisions to evacuate rest upon: the presence (or absence) of family and/or children, their access to risk information that they find meaningful and rational and is in harmony with their pre-conceptions about their circumstances, their openness to information that either confirms their experiences or confronts rumour-generated biases they carry, their familiarity with social groups and governmental agencies and the services they offer, and the outcome of their risk analyses that consider the dangers of remaining in situ against the danger of exposing themselves to discovery as ‘illegal aliens’. The results suggest that emergency management plans ought to promote the dispelling of rumours that weaken the effect of emergency communication, promote non-emergency outreach to peripheral populations through community groups, and promote better, basic, non-technical, Spanish-language media through mainstream conduits (i.e. the most commonly watched non-Spanish television channels) that do not require high-tech devices or advanced understanding of visual media tools.     

Providing health services during a civil war: the experience of a garrison town in South Sudan

The impact of conflict, particularly conflict arising during civil wars, on the provision of healthcare is a subject that has not been widely considered in conflict‐related research. Combatants often target health services to weaken or to defeat the enemy, while attempts to maintain or improve health systems also can comprise part of counter‐insurgency ‘hearts‐and‐minds’ strategies. This paper describes the dynamics associated with the provision of health services in Malakal, an important garrison town in South Sudan, during the second Sudanese civil war (1983–2005). Drawing on the concepts of opportunity hoarding and exploitation, it explores the social and political dynamics of service provision in and around the town during the war. These concepts provide a useful lens with which to understand better how health services are affected by conflict, while the empirical case study presented in the paper illustrates dynamics that may be repeated in other contexts. The concepts and case study set out in this paper should prove useful to healthcare providers working in conflict zones, including humanitarian aid agencies and their employees, increasing their understanding of the social and political dynamics that they are likely to face during future conflict‐related complex emergencies.     

Rapid Assessment of Population Size by Area Sampling in Disaster Situations

In the initial phase of a complex emergency, an immediate population size assessment method, based on area sampling, is vital to provide relief workers with a rapid population estimate in refugee camps. In the past decade, the method has been progressively improved; six examples are presented in this paper and questions raised about its statistical validity as well as important issues for further research. There are two stages. The first is to map the camp by registering all of its co-ordinates. In the second stage, the total camp population is estimated by counting the population living in a limited number of square blocks of known surface area, and by extrapolating average population calculated per block to the total camp surface. In six camps selected in Asia and Africa, between 1992 and 1994, population figures were estimated within one to two days. After measuring all external limits, surfaces were calculated and ranged between 121,300 and 2,770,000 square metres. In five camps, the mean average population per square was obtained using blocks 25 by 25 meters (625 m2), and for another camp with blocks 100 by 100 m2. In three camps, different population density zones were defined. Total camp populations obtained were 16,800 to 113,600. Although this method is a valuable public health tool in emergency situations, it has several limitations. Issues related to population density and number and size of blocks to be selected require further research for the method to be better validated.