Natural Disasters: Health and Mental Health Considerations

The recent occurrence of the tsunami in southwest Asia heightened awareness of the devastating impact of natural disasters on human lives. What makes a natural disaster so devastating? The suddenness and magnitude of the occurrence renders the areas affected by natural disasters unable to respond effectively to the emergency because the devastation exceeds the capacity of the area's resources. By definition, a natural disaster is an ecological phenomenon that occurs suddenly and is of sufficient magnitude to require external assistance (World Health Organization, 1980). Noji (2000) identified the overall objectives of a public health response to disaster management as the following: 1. Assess the needs of disaster-affected populations; 2. Match available resources to those needs; 3. Prevent further adverse health affects; implement disease control strategies for well-defined problems; 4. Evaluate the effectiveness of disaster relief programs, and improve contingency plans for various types of future disasters. (p. 21) An effective public health response to natural disasters includes individual and community interventions that incorporate clinical, research, and community organization skills. Practitioners and authors have identified disaster response as a natural practice area for social workers given the crisis intervention and clinical orientation of the profession (Newhill & Sites, 2000). Much of the professional social work literature on natural disasters emphasizes the clinical aspect of social work intervention (Cohen & Ahearn, 1980; Kreuger & Stretch, 2003; Newhill & Sites; Puig & Glynn, 2003; Shah, 1985; Spitzer & Neely, 1992). Although social workers typically respond to disaster relief through clinical interventions, research and community responses also are needed to manage the disaster. A four-step approach to social work intervention incorporating research, administrative, community organization, and clinical practice elements provides a more complete approach to disaster relief efforts. Implementation of research protocols is a critical first step in responding to a disaster. Research intervention is important initially and at the end of the disaster relief effort to assess outcomes and the effectiveness of the response. As an initial intervention, Noji (2000) proposed that in the management of disaster relief workers connect data collection and analysis to disaster relief decision-making processes. Field surveillance data collection is important to reducing adverse health and mental health conditions and to rendering more effective the overall decision-making process related to the disaster response. Rapid disaster damage assessment techniques can be used to assess damage, define the nature and extent of the health and mental health problems, identify population groups at heightened risk, identify immediate health and mental health needs, assess resource needs, locate resources to meet identified needs, and assess the effect of the response to the disaster (Toole & Tailhades, 1991; World Health Organization, 1999). A sound management and community response is critical to the disaster relief effort. These responses should include an effective disaster plan and a system of communication including information about who is responsible for what and how to communicate if power lines and phone lines are damaged (Milsten, 2000). Coordination among provider networks and a developed response for how to gain access to resources are critical also. The management and community response must address the three phases of a disaster and what responses, services, and resources will be needed at each phase. The first phase--prewarning disaster preparation--emphasizes preparing for the disaster, which includes developing, reviewing, and revising disaster plans. Communities with predeveloped disaster plans will be better prepared to respond to the disaster as it occurs. …