health care after the shock. In 12% of the cases, these disruptions were caused by road damages (9%) and transport issues (3%) (Kishore et al., 2018). More than half of the respondents in flood affected areas of Hanoi, Vietnam, reported not being able to access their usual health care or medication for one month after a big flood event in 2008. The main reason for this was road disruptions (69%) and transport issues (33%). In the affected areas, a higher incidence of dengue fever, pink eye, dermatitis and psychological problems was observed a month after the flood (Bich et al., 2011).

Road disruptions make it more difficult for households to access food and other essential goods, as well as potentially cause price shocks affecting the economy of an area more broadly. Having been collecting data on food losses since 1961, the Food and Agriculture Organization notes that distribution wastes tend to be larger in countries with hot humid climate and lacking reliable transportation infrastructure, with a particularly strong impact on perishable food. Baez et al. document the impact of Agatha, a tropical storm that struck Guatemala in 2010, in urban areas. They observe an increase in poverty by 18% in the aftermath of this climatic disaster, mainly because of higher food prices. This inflation, as documented by the authors, was likely to be caused by increased frictions along the food supply chain, including transportation links. Safir et al. (2013) found a 4% decrease in food consumption in areas of the Philippines recording precipitation levels below one standard deviation from the mean. The same pattern was observed after the 2015 flood in South Carolina. Even if there were no major food disruptions in the aftermath of this disaster, Cutter (2017) documents an impact on the longer-run, at the local level: the flood affected livelihoods and food security of many residents and small farmers. This impact is partly attributable to transportation disruptions: the flood caused more than 365 road closures, including parts of the main corridor for commerce along the US East Coast. The finding suggests that well-connected areas are less vulnerable to the consequences of natural disasters on food security.

Transport disruptions increase the risk of children not being able to go to school. In Dar es Salaam, a recent survey finds that 81% of households that report having at least one member of the households missing school due to heavy rainfall or flooding indicate that it is primarily due to inaccessible roads (Erman, Tariverdi, Obolensky, & Hallegatte, 2019). This result is corroborated in focus group discussions carried out in Dar es Salaam in April 2018, in which households report that it is commonplace for children to stay home after heavy rains due to transport disruptions and flooded roads. In one district in Zimbabwe, teachers observe that school absenteeism peaks during the rainy season. On average, half of the students were not attending school during this time and accessibility is seen as one of the main reasons (Mudavanhu, 2014). In Lagos, Nigeria, an assessment of the impacts of flood on urban poor communities shed light on mobility reduction and damages to road. These disruptions result in children not being able to go to school, but also, more generally affect social relationships as some respondents report suffering from more isolation in times of flooding (Adelekan, 2010).

Transport infrastructure connect households to labor and consumption markets, and disruptions impacts wages and business incomes. Findings from focus group discussions with households in Dar es Salaam that live both in areas directly impacted by recurrent flooding and households in proximity to those areas, indicate that flooding makes it more difficult to generate income (Erman et al., 2019). This is particularly true for owners of household enterprises. Transport disruptions impede the flow of clients to businesses and make it more difficult to transport goods to and from the business location and access inputs from providers. Some enterprise owners shut down their businesses completely during the rainy season for these reasons<sup>14</sup> . Finally, transport disruptions can affect wages: Mueller & Quisumbing (2009) find that the 1998 “flood of the century” in Bangladesh had a negative long-term impact on wages, primarily in

> 14 Notes from focus group discussions in Dar es Salaam in March, 2018 (A. Erman et al., 2019).

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