John Seaman

Disaster epidemiology: or why most international disaster relief is ineffective

A report of a major disaster overseas, particularly in a developing country, generally evokes a powerful desire to help. We in the West are rich and have technology. They are poor and it seems a reasonable assumption that our resources must be of value. Any publicized major disaster is likely to be followed by a gift of government aid, fundraising by voluntary agencies and often by the spontaneous organizations of individuals who wish to travel to the disaster area to assist. The desire to help another people in time of great need is natural, and the gift of aid often received with gratitude by the recipients, who are often touched by the knowledge of outside interest. However, enormous resources can now be devoted to disaster relief operations, and their effects are far beyond that of a simple gift. All evidence is that our power to help is more limited than we might think: worse, there is much evidence that much, if not most, international disaster assistance is not only useless for its intended purpose but often, by its nature and quantity, actively obstructs actions which might be of use. This paper has two themes. The first is an attempt to define the health problems caused by disasters, a subject known as ‘disaster epidemiology’: that is who suffers, why, how this varies between disasters and, crucial for relief, the timing of these effects. The second is concerned with what can be achieved by international disaster relief. The material presented here is based on a book (Seaman et al., 1984) in which the topic is discussed in more depth and where more source material is given.

Malnutrition in emergencies : How can we do better and where do the responsibilities lie?

Over many years, the international relief system has been repeatedly criticised in terms of slowness of response, poor inter-agency co-ordination, and technical incompetence on a larger or smaller scale. Notwithstanding many initiatives to improve co-ordination and other aspects of international relief performance, relief failures, including epidemic malnutrition, continue to occur. The reasons for these failures are discussed from the perspective of the characteristics of the international system, and the way in which this would be expected to perform under different conditions. The chief limitations of the international system identified are: the lack of any focus for imposing co-ordination, other than governments of affected countries; the lack of any requirement for donor nations to ensure that adequate resources are supplied; and a tendency for the system to respond uncritically to the international media. A broad typology of international responses is proposed. It is suggested that relief failure can be recast in terms of the lack of any system which can ensure the correct allocation of food and other resources between emergencies, and ensure the systematic distribution of such resources as are supplied. It concludes that the scope for further improvement in the performance of the international relief system is now limited, but that the most promising area for investment would, where possible, support governments in affected countries to take greater control of the management of the international relief system.

Making Exchange Entitlements Operational: The Food Economy Approach to Famine Prediction and the RiskMap Computer Program

The effect of production failure or some other shock on household income and food supply depends upon: (a) the pattern of household income, and (b) its ability to compensate for any deficit which may have occurred, for example, by the sale of assets or finding additional paid employment. The corollary is that the prediction of the likely effect of some event on the future state of the economy or food supply of a population of households requires an understanding of the economy of the households concerned and the economic context to which these relate. This paper describes an attempt to develop an approach to prediction using a dynamic model of economy based on quantitative descriptions of household economy obtained by systematic rapid field-work and summarises the experience of the use of this approach to date.

The Effects of Disaster on Health: a Summary

I t is often believed that flood, cyclone, tidal wave and earthquake are not only causes of sudden, large-scale death but also of massive social disruption, outbreaks of epidemic disease and famine, leaving survivors entirely at the mercy of external relief. However, in recent years, the results of systematic observation of the effects of different types of disaster on the health of populations has led to rather different conclusions; conclusions which have major implications for the conduct of relief. From the point of view of its impact on health, disaster can be conveniently classified under three broad headings: (i) earthquake; (ii) flood, including sea surge and other inundations; (iii) cyclone and other destructive winds uncomplicated