These five disaster myths have been so persistent over time they have been called the “ultimate disaster survivors.”
How many of these myths have you heard?
How many do you (gulp…) still believe?
5 DISASTER MYTHS
Disasters cause epidemics
The local population is helpless and waiting for aid
Disasters bring out the worst in people
Most disaster deaths occur when rescue is available
Things are back to normal in a few weeks
Near the start of my career at the CDC, one of my professional idols and mentors, Dr. Claude DeVille De Goyet published a scientific journal article entitled, “Stop propagating disaster myths”. Of course I had to read it! I (along with many others at the time) read everything this man had written. He was and still is truly one of the greats in our field.
In this particular article, Dr DeVille launched a very direct condemnation of those perpetuating disaster myths, dating back to his own experience in the 1972 Mexico City earthquake (some 27 years earlier). He later wrote an op-ed of the same title published in the NY Times. And yet, despite Dr. DeVille’s plea for evidence-based decision-making, we stand now 17 years later with very little changed in the way of disaster mythology. Many of these disaster myths still stand, not only among the press, but sadly are also being perpetuated by both governmental and nongovernmental institutions. I also note the danger involved when we deal with disaster myths because even if the wrongful assumption does not directly cause deaths, it still most commonly result in a misdirection of resources that (by the very definition of disaster) are already insufficient to limit additional deaths.
Disaster Myth #1 – Disasters cause epidemics
Perhaps the single most common disaster myth is that “Disasters cause epidemics”. People frequently believe this and it is rarely ever true. Disasters rarely cause epidemics. Because epidemics are more commonly associated with conflict disasters, people tend to think that this is the case for all disasters. But in the case of warfare, there are other factors that affect the population (such as the destruction of the healthcare infrastructure; malnutrition, etc.). In the case of geological disasters such as tsunamis, landslides, and earthquakes, the risk for infectious disease epidemics is negligible. There have been reports of disease outbreaks during floods, but these have been limited to very low resource nations.
Others point to the cholera outbreak that occurred after the 2010 Haiti earthquake. However subsequent studies proved that the cholera outbreak was, in fact, imported by a UN security worker. This worker was not involved with the earthquake response and not living in the earthquake affected area. So we shouldn’t be wasting our time trying to deal with epidemics in in the middle of an earthquake response when the real issues are injuries and shelter.
An all-too-common corollary of this myth exists within the misunderstanding that dead bodies of persons killed by disasters are likely to spread disease. I myself have seen this same tragedy unfold after the Indian Ocean tsunami when bodies were hastily buried in Thailand as well as misguided efforts in Sichuan province China after the earthquake occurred in Chengdu. In Thailand, mass graves that were hastily arranged and thought to be curbing a potential epidemic of infectious disease, instead created an international incident requiring exhumation and identification of many foreign tourists that were tsunami victims. In China, teams were dispatched to spray bactericidal solutions into the air to somehow sanitize the environment from potential contamination by dead bodies. All of these measures of course, are driven by the common perception that the smell of decomposing human tissue must somehow be infectious. One only has to spend a short period of time in tsunami and earthquake affected areas to realize the extent of this pervasive smell that one draws in with every breath.
However, the evidence shows us that bodies killed by disaster injuries do not spread disease. As a matter of fact, dead bodies have less potential to spread infectious disease than live bodies. Meanwhile, these events are also known for creating a tremendous number of injuries and displacement of hundreds of thousands of people that require emergent assistance. During these times of limited resources, our focus must remain on first helping those living survivors with critical health needs that do, in fact, exist today. Most commonly these needs involve mass casualty care and shelter for population displacement.
Disaster Myth #2 – The local population is helpless and waiting for aid
Of course, it’s only natural for us as human beings to see things through our own personal perspective. So, as responders from the outside who have yet to contribute to the emergency response, we may have the false impression that aid is not yet engaged. But make no mistake, all disasters start locally. And therefore it follows that all disaster response starts locally. The local response begins at the moment of impact when conditions allow for the first rescues to occur. From that moment on, the local population is activated and fully deployed. And while local resources may be damaged, crisis management and business continuity efforts are implemented in near real time, in many cases without outside assistance. Then, as local needs are assessed, requests for assistance are then channeled up the societal hierarchy (neighborhood to city to district to province to national and finally international requests for assistance) according to the size and scope of the event.
There is also this misconception that the international community should immediately send anything that it can. And this is such a big mistake. In our hurry to provide humanitarian assistance to a population perceived as “helpless”, it becomes tempting to send materials without asking first what is needed. This concept is known as “push” in the disaster response field. Donors often push materials to the disaster victims without an accurate assessment of local needs, that include not only the materiel, but also must address various social, political, ethnic and religious norms. The opposite of push is… (yes, you guessed it) “pull”. The disaster management concept of “pull” refers to the process of aid that is delivered according to the needs stated (“pulled in”) by the recipients.
One example of ineffectiveness of this “push” phenomenon can be seen in the flood of foreign volunteers with any medical skills that frequently arrive unexpectedly and without advance notice. Medical personnel of all types arrive at the disaster scene (in many cases on their first disaster deployment). They most commonly pack medical equipment and supplies focusing on severe traumatic injuries. However, these teams usually arrive 3-10 days after impact when most deaths have already occurred. The remaining patients are either treated locally or provide their own self-care. So that 1 to 2 weeks after the disaster, the real population needs are more closely aligned with that of primary care, maternal child care, rehabilitation, social services and mental health. Unfortunately, these medical specialties are relatively rare among response teams worldwide. This was a commonly reported occurrence after the Indian Ocean tsunami.
We also have to think about the social aspects of where people are living (e.g. disaster victims and so on). The cultural aspects of what they need from us as well.
For example, people that live in temperate climates may want to send winter clothing. Or people in Western societies may send to other societies that where the clothing is different. It’s not the same clothing for women or men and, and may not be appropriate for their particular culture. Or they many send a different type of technology or different types of foods and so on that may not be appropriate for everyone. So we really have to think about, “Are we really asking the people first? “What do they need?” “What do they normally use?” and “How can we replace that?” as opposed to carrying some sort of cultural change or “Anything that we can get to them should be good enough!”? That’s never the case. Instead, we really have to think about this international aid. We must empower local people to “pull” the most appropriate response, not have it “pushed” upon them.
Disaster Myth #3 – Disasters bring out the worst in people
This myth is most commonly perpetuated in the news media after disasters. Once again, this appears to be due to a lack of familiarity with the disaster phenomenon itself as compared to other social or political hazards that result in social disorder. Quarantelli and other social scientists have shown us that people actually become very altruistic after disasters. (This matches my personal experience over several decades). They give endlessly of themselves. People that are themselves severely injured, stop to help others. People give and share what little food or water that they have left. Instances of looting, theft and violence are extremely rare and isolated. However we must also recognize that these rather dramatic events do have the potential to draw public/media interest thus garnering a larger share of attention as compared to the more positive actions that are truly predominant.
Disaster Myth #4 – Most deaths occur when rescue is available
In fact, most disaster victims owe their lives to their neighbors, not outside medical teams. This is not meant as an indictment of state, national or international medical response systems per se, but rather a statement of the nature of the injuries caused by disasters. Most deaths occur while the disaster is happening, when no one (not even those with the best intentions) can reach the victim. These deaths occur when the storm surge or flash floods are flowing over 10 feet deep, or winds are blowing over 100 mph, or the earth is shaking violently- no one can reach you even though they want to do so. And nearly all of these associated injuries (i.e. drowning, bleeding, crush injuries) require immediate care to prevent death. Therefore, it is your neighbors that save your life. They are indeed not helpless and waiting for aid.
Disaster Myth #5 – Things are back to normal in a few weeks
What we really see is that people don’t get back to normal in months and they don’t get back to normal (many times) even in years. If we look at, for example the people in Hurricane Katrina, people’s lives are still disrupted even though that happened many years ago. Super-storm Sandy, other types of disasters including Hurricane Mitch in Central America or Indian Ocean tsunami…it’s the same issue when we’re talking about long-term recovery. There are also good studies from multiple countries looking at flood related health effects that show an increase health risk even five years after flood related displacements from homes.
So, long after the cameras and the news crews have all packed up and gone away; long after the responders have left people are still trying to recover their life to get back to normal. But but it takes months, and years for people to really get back to the life that they lost.
Finally, perhaps we may draw some final lesson from a quote by Leonardo da Vinci,
“Knowing is not enough; we must apply.
Being willing is not enough; we must do”.
To this I would humbly offer,
Doing is not enough; we must ‘do good’.
‘Doing good’ is not enough; we must ‘do good’ well.
We must therefore strive to recognize disaster myths, help dispel disaster myths among our colleagues, and educate those who we strive to protect.