Suzanne Phibbs

Synergising Public Health Concepts with the Sendai Framework for Disaster Risk Reduction: A Conceptual Glossary

The Sendai Framework for Disaster Risk Reduction (2015) is a global strategy for addressing disaster risk and resilience that has been ratified by member countries of the United Nations. Its guiding principles emphasise building resilience through inter-sectoral collaboration, as well as partnerships that facilitate community empowerment and address underlying risk factors. Both public health and the emergency management sector face similar challenges related to developing and implementing strategies that involve structural change, facilitating community resilience and addressing individual risk factors. Familiarity with public health principles enables an understanding of the holistic approach to risk reduction that is outlined within the Sendai Framework. We present seven concepts that resonate with contemporary public health practice, namely: the social determinants of health; inequality and inequity; the inverse care law; community-based and community development approaches; hard to reach communities and services; the prevention paradox; and the inverse prevention law. These ideas from public health provide a useful conceptual base for the ”new” agenda in disaster risk management that underpins the 2015 Sendai Framework. The relevance of these ideas to disaster risk management and research is illustrated through drawing on the Sendai Framework, disaster literature and exemplars from the 2010–2011 earthquakes in Canterbury, New Zealand.

What about Us? Reported Experiences of Disabled People Related to the Christchurch Earthquakes

Abstract Internationally there is limited research on the experiences of people with disabilities during and following a major disaster. This research explores the reported experiences of disabled people related to the 2010-2011 Christchurch, New Zealand earthquake series. Methods Qualitative inquiry involving purposive sampling and face to face interviews with 23 disabled people living in Christchurch during the earthquakes. The qualitative research was followed by a pilot quantitative survey involving 25 disabled people living in Christchurch during the earthquakes and 10 people who work in the disability sector. Qualitative interview material was analysed using thematic analysis while quantitative data was analysed using descriptive statistics. Results Disabled people preferred to shelter in place as their homes are organised to suit their specific needs. Our research suggests that urban disaster risk reduction strategies are needed that enhance opportunities for disabled people to maintain autonomy in an emergency situation. Key factors identified by participants that increase earthquake vulnerability among disabled people include a lack of personal disaster preparedness, public information that is not disability accessible and social isolation. Resilience was enhanced through disaster preparedness planning and good support networks. Implications: Individuals, communities and responding agencies could learn from the experiences of disabled people in order to improve preparation and response to disasters for vulnerable groups. Disaster recovery should be seen as an opportunity to reduce risk through avoiding recreating the conditions of vulnerability that may have existed previously.

Ngā Mōwaho: an analysis of Māori responses to the Christchurch earthquakes

Since September 2010, a series of earthquakes have caused widespread social, financial and environmental devastation in Christchurch, New Zealand. Anecdotal evidence suggests that local Māori responded effectively to facilitate community recovery and resilience. However, the form, content and extent of that response has not been adequately recognised or documented. This qualitative research project, conducted in partnership with Te Rūnanga o Ngāi Tahu, has documented the way in which Māori cultural factors have facilitated disaster risk reduction and management in response to the earthquakes. This paper explores sets of understandings about marginalisation and inclusion within the narratives of 70 Māori community members who contributed to this research. Forms of marginalisation expressed in participants’ narratives include delayed linkages to the formal emergency management infrastructure, difficulties integrating Māori volunteers into the mainstream response as well as enduring barriers to Māori engagement within Civil Defence, illustrated in a lack of Māori representation as well as tikanga Māori within emergency planning. We argue that the knowledge, principles and practices embedded within Māori responses to the Christchurch earthquakes may be contextually relevant for national and regional policy development in the area of disaster risk management, response and recovery.

Shakes, Rattles and Roll Outs: The Untold Story of Māori Engagement with Community Recovery, Social Resilience and Urban Sustainability in Christchurch, New Zealand

Abstract On September 4, 2010 a 7.1 magnitude earthquake struck the Canterbury region of New Zealand, heralding a sequence of earthquakes, which included a fatal 6.2 earthquake centred under Christchurch City on February 22, 2011. In response, local Māori recovery initiatives were collaborative, effective and shaped by cultural values, including the principle ‘aroha nui ki te tangata’ (extend love to all). Disaster sector stakeholders are increasingly recognising the value of community-led initiatives that facilitate social resilience. In contrast, cultural approaches to facilitating community resilience receive minimal acknowledgement. The Māori response to the Christchurch earthquakes and subsequent recovery process constitutes an exemplar of best practice. The Joint Centre for Disaster Research in partnership with the Christchurch Iwi (tribe) Ngāi Tahu, conducted research to identify, and document the ways Māori cultural factors facilitated community resilience in response to the earthquakes. A Māori qualitative research methodology has shaped the community-based participatory research design. Māori research participants views were ascertained though semi-structured and focus group interviews. Dialogical and narrative interviewing approaches were used to foster community engagement, as well as capture Māori understandings and practices associated with disaster management, recovery and resilience. Data analysis drew on social theories, risk perspectives and indigenous epistemological concepts. Analysis of the results suggest that New Zealands disaster response policies may be enhanced by the integration of Māori approaches to facilitating disaster risk mitigation, community recovery and social resilience. This paper documents the different levels of support that were extended to whānau (families), communities and responding agencies. The cultural principles that underpin the extension of support are examined in relation to Bruno Latours theories about how technologies shape action and Putnams ideas on social capital. The impact of cultural support strategies on social resilience is addressed and the relevance to national and local authority disaster recovery strategies outlined.

Reasons for Stopping Exclusive Breastfeeding Between Three and Six Months: A Qualitative Study

Purpose: Scant published qualitative literature exists focusing on why exclusive breastfeeding rates decline between three and six months. This study aims to develop an understanding of why exclusive breastfeeding tails off so dramatically between three and six months after birth in New Zealand. Design and Methods: A generic qualitative methodology was employed in this study and social constructionism selected as the main epistemological framework underpinning the research. This study was carried out between September 2013 and July 2014, involving face‐to‐face interviews with 30 women who were characterised as highly motivated to complete six months exclusive breastfeeding prior to the birth of their child. In order to gain an in‐depth understanding of the research material, thematic analysis of the interview transcripts was completed using manual coding techniques. Results: After thematic analysis of the data four key themes were identified: 1) The good employee/good mother dilemma. 2) Breastfeeding is lovely, but six months exclusively is demanding. 3) Exclusive breastfeeding recommendations should be individualised. 4) Introducing solids early as a cultural practice. Conclusions: Most studies have linked barriers to six months exclusive breastfeeding to difficulties within the mother‐infant dyad, as well as negative maternal socioeconomic and socio‐demographic characteristics. However, this study has shown that the maintenance of six months exclusive breastfeeding is also challenging for this group of mothers who were socially advantaged, well‐educated and highly motivated to breastfeed their babies exclusively for six months. HIGHLIGHTSConsideration of the mother‐infant dyad as the main target for promoting six months exclusive breastfeeding has failed to address the low rate of this behaviour particularly between three and six months postpartum. The drop off in breastfeeding after three months suggests that infant feeding behaviour is not limited to the mother‐infant dyad; the sociocultural contexts of this behaviour need to be taken into account.The maintenance of six months exclusive breastfeeding behaviour is challenging and demanding even for mothers who are socially advantaged, well‐educated and highly motivated to breastfeed their babies exclusively for six months.Returning to work and maintaining exclusive breastfeeding is very difficult for mothers. Therefore, this study recommends the development of a Baby Friendly Workplace Initiative (BFWI) which provides education to both employees and employers about the legislation, their obligations and responsibilities as well as the importance of breastfeeding for the long term health of mothers and babies, staff retention, reduced sick leave and increased productivity of female employees.

‘When morals and markets collide’: Challenges to an Ethic of Care in Aged Residential Care

ABSTRACT Recent concerns about the quality of care within aged residential care (ARC) highlight a sector in crisis. Many Western nations are experiencing rising life expectancy rates, an increase in the number of elderly people as a proportion of the population and an intensification of demand for ARC. Growth in the provision of formalised care has come under scrutiny in New Zealand and in other developed countries, largely because of complaints about inadequate caring practices, particularly in rest homes. Responsibility for instances involving inadequate care is often placed on individual nurses, general practitioners, managers and caregivers, with little acknowledgement of the wider context in which ARC is situated. In this paper we examine how tensions between state regulation, markets and localised rest home practices impact upon an ethics of care. We conclude that systemic issues relating to the regulation and funding of rest home care, when combined with a market ethos in the provision of services, does not adequately support the creation of an environment in which an ethics of care is a priority.

The Inverse Response Law: Theory and Relevance to the Aftermath of Disasters

The Inverse Care Law is principally concerned with the effect of market forces on health care which create inequities in access to health services through privileging individuals who possess the forms of social capital that are valued within health care settings. The fields of disaster risk reduction need to consider the ways in which inequities, driven by economic and social policy as well as institutional decision-making, create vulnerabilities prior to a disaster, which are then magnified post disaster through entrenched structural differences in access to resources. Drawing on key principles within the Inverse Care Law, the Inverse Response Law refers to the idea that people in lower socio-economic groups are more likely to be impacted and to experience disparities in service provision during the disaster response and recovery phase. In a market model of recovery, vulnerable groups struggle to compete for necessary services creating inequities in adaptive capacity as well as in social and wellbeing outcomes over time. Both the Inverse Care Law and the Inverse Response Law focus on the structural organisation of services at a macro level. In this article, the Inverse Care Law is outlined, its application to medical treatment following disasters considered and an explanation of the Inverse Response Law provided. Case studies from recent disasters, in London, New Zealand, Puerto Rico and Mexico City are examined in order to illustrate themes at work relating to the Inverse Response Law.