From the Tsunami to Katrina:From the Tsunami to Katrina:Lessons Learned in DisastersLessons Learned in Disasters

UCSF Department of Surgery andUCSF Department of Surgery andUCSF Global Health SciencesUCSF Global Health Sciences

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PanelistsPanelists

Dr. Mark Stinson: Disaster ResponseDr. Mark Stinson: Disaster Response Dr. Jan Horn: Responding to Katrina and Dr. Jan Horn: Responding to Katrina and

the role of surgeons in disaster responsethe role of surgeons in disaster response Dr. Rochelle Dicker: Responding to the Dr. Rochelle Dicker: Responding to the

tsunami in Sri Lankatsunami in Sri Lanka Dr. Jess Ghannam: Mental Health in the Dr. Jess Ghannam: Mental Health in the

wake of disasterwake of disaster

What is a Disaster?What is a Disaster? An occurrence causing widespread An occurrence causing widespread

destruction and distress.destruction and distress. ““Major” Disaster: >50 deaths or 100,000 Major” Disaster: >50 deaths or 100,000

people affected (USAID, OFDA 1999)people affected (USAID, OFDA 1999) A situation or event that overwhelms the A situation or event that overwhelms the

local capacity for relieflocal capacity for relief

Walter, J.: World Disasters Report

““Disaster” ClassificationDisaster” Classification

• NaturalNatural: earthquakes, floods, tornadoes, : earthquakes, floods, tornadoes, landslides, and volcanoes landslides, and volcanoes

• Man-madeMan-made: plane or train crashes, building : plane or train crashes, building collapse, fires, industrial accidents, war or collapse, fires, industrial accidents, war or terrorist activitiesterrorist activities

Developing Countries:Developing Countries:Impact is DisproportionateImpact is Disproportionate

1990-1998: 1990-1998: 94%94% of 568 major disasters of 568 major disasters 97%97% deaths from disasters deaths from disasters 4x4x as likely to die of a disaster in a DC as likely to die of a disaster in a DC 13x13x as likely to die in a disaster in a DC as likely to die in a disaster in a DC

Economic ConsequencesEconomic Consequences 20% higher cost in GDP in DC’s20% higher cost in GDP in DC’s

$63 billion/yr over decade$63 billion/yr over decade

This only measures This only measures PHYSICALPHYSICAL losses losses

Total than world aid spent on development Total than world aid spent on development and humanitarian assistanceand humanitarian assistance

TRENDSTRENDS over 30 years over 30 years

DECREASINGDECREASING mortality mortality INCREASINGINCREASING numbers of people affected numbers of people affected INCREASINGINCREASING costs costs Increased Increased VULNERABILITYVULNERABILITY in in

developing countriesdeveloping countries

Disaster “cycle”Disaster “cycle”

PreparednessPreparedness Event + ImpactEvent + Impact RecoveryRecovery

– ReliefRelief– RehabilitationRehabilitation– ReconstructionReconstruction

MitigationMitigation

““Natural” Disaster?Natural” Disaster?

Disasters are not Disasters are not NATURALNATURAL There are natural There are natural HAZARDSHAZARDS What converts a What converts a HAZARDHAZARD into a into a

DISASTERDISASTER is related to is related to VULNERABILITYVULNERABILITY and and CAPACITYCAPACITY

United NationsUnited NationsIDNDRIDNDR

International Decade for Natural Disaster International Decade for Natural Disaster Reduction (1990-1999)Reduction (1990-1999)

UN ISDR (2000)UN ISDR (2000)

Greater emphasis on processes-> disaster Greater emphasis on processes-> disaster reduction and sustainable developmentreduction and sustainable development– vs. risk blind developmentvs. risk blind development

Disasters andDisasters andGlobal Health PrioritiesGlobal Health Priorities

AIDS/malaria = tsunami mortality every week in AIDS/malaria = tsunami mortality every week in AfricaAfrica

Complex EmergenciesComplex Emergencies– DRC tsunami every 2 monthsDRC tsunami every 2 months

Role of the media/short attention span/political Role of the media/short attention span/political risk?risk?

How much of pledged funds are disbursed?How much of pledged funds are disbursed?– Mitch 33%; Bam 16%Mitch 33%; Bam 16%