Focusing on health in disaster risk management
By Robert Glasser, Head of the UN Office for Disaster Reduction
Traditional views of disaster management were turned on their head by the Sendai Framework for Disaster Risk Reduction when it was adopted by UN Member States on March 18 last year to become a foundation stone of the new 2030 Development Agenda.
The agreement adopted at that Third UN World Conference on Disaster Risk Reduction celebrates its first birthday on March 18 and will be preceded by the first ever major conference devoted to health aspects of disaster risk reduction hosted by the Royal Thai government.
Health is a major element in the new vision for disaster risk management encapsulated in the Sendai Framework which covers both man-made and natural hazards and related environmental, technological and biological hazards and risks.
The Sendai Framework is not just the product of three years of exhaustive consultations but also of the experience gained in implementing its predecessor, the Hyogo Framework for Action (HFA) which was adopted in early 2005 by a world still shocked from the 227,000 deaths inflicted a few weeks earlier by the Indian Ocean tsunami of December 2004.
The introduction of health as a major focus for disaster risk reduction makes absolute sense when you consider the outbreak of dengue which Thailand is currently experiencing alongside the threat of the Zika virus. The elimination of mosquito breeding sites is now a major priority for many national disaster management agencies.
The inclusion of public health emergencies and the protection of health infrastructure in the Sendai Framework is further evidence that a culture of disaster risk reduction has been spreading across the world. This is nowhere more evident than in Asia where government ministers meet regularly to review progress.
It is obvious in legislative and policy changes, school curricula, new institutions and a decline in mortality from weather-related disasters in many countries thanks to improvements to early warning systems, including tsunami alerts, and timelier evacuations.
Many political leaders have embraced disaster risk reduction as a key element of government policy. In Thailand, the 2004 tsunami galvanised national efforts to take a pro-active approach to disaster risk.
With national and local elections coming in the Philippines, there have been several calls for candidates to demonstrate knowledge and understanding of disaster risk management in a country which experiences more cyclones than any other.
In Indonesia which bore the brunt of the Indian Ocean tsunami, disaster risk reduction is a national priority given the challenges of dealing with so many natural and man-made hazards such as the wildfires which spark health concerns across the region.
Implementation of the Sendai Framework has at least two key challenges.
One is to bring about a paradigm shift from managing disasters to managing the underlying risk factors which drive those disasters. These include poverty, unplanned urbanisation, poor land use, climate change, environmental degradation and weak governance.
The second and equally great challenge is the one which will be addressed at the health conference in Bangkok and that is how to bring about a shift in perspective on disaster management so that health -- both public health and public health infrastructure -- becomes a key area of focus for disaster risk reduction knowing that an under-resourced and poorly protected health system can multiply the impact of any initial disaster event.
The International Health Regulations are embedded in the Sendai Framework and this must act as a further incentive to those 67% of WHO Member States which do not comply with those regulations when it comes to appropriate response to public health emergencies of international concern.
What the Sendai Framework calls for is a breaking down of silos. We live in an interconnected world where natural hazards can trigger a health crisis or a technological disaster. Cascading impacts from one event can multiply and expand the number of people affected in unforeseen ways.
This was a feature of the Great East Japan Earthquake and Tsunami five years ago which claimed 19,000 lives and triggered a major health emergency following a nuclear meltdown at the Fukushima Daiichi nuclear power plant causing a major release of radioactivity.
The location of health facilities is a major cause of concern in disaster prone settings. The ground floor of the main regional hospital serving Tacloban was inundated by the tidal surge which accompanied Typhoon Haiyan when it struck the Philippines in November 2013 and staff had less than an hour to move patients in intensive care to safety. The hospital's power supply was knocked out for a vital couple of days as casualties started to arrive.
An integrated approach to health and disaster risk reduction is now an all-of-society imperative. This first conference on Health and the Sendai Framework has the potential to be a watershed gathering which will confirm the central place of health on the disaster risk reduction agenda for the foreseeable future.
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