Increase In Natural Disasters Health And Social Care Essay

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11th Feb 2020 Nursing Essay Reference this

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Extreme weather temperatures and increase in natural disasters in recent years have finally made the policy makers think earnestly about “Climate change and Natural disasters”. The stern review and the Intergovernmental Panel on Climate Change’s fourth (revised) assessment report in 2008 [A] had clearly stated that increase in natural disasters due to climate change will have adverse affects on social and economic sectors. The report which had declared that climate change will cause increase in natural disasters in coming years, has lived up to its prediction. According to UNISDR from year 2008-2011 natural disasters have been responsible for economic damages worth 730 Billion USD, have adversely affected 843 million people and killed about 598,000 people around the world. There has been an increase of more than 50% in the number of floods in the last decade in comparison to the 1990s and similarly the occurrence of total natural disasters has also increased over the last decade. [Error: Reference source not found]

The increase in both the intensity and frequency of floods over the last decade has raised concerns within development agencies, governments and regional co-operations; natural disaster management has gained priority among all stakeholders. In 2005 U.N created “The Hyogo Framework for Action” [B] ; a global blueprint for disaster risk reduction efforts with a ten-year plan, the framework was adopted in January 2005 by 168 governments at the U.N World Conference on Disaster Reduction. [2]Although all 168 countries did accept the framework in principle, however there has been little done to reduce greenhouse emissions or adapt disaster risk reduction strategies across the board. Similarly in response to the December 2004 tsunami and the earthquake of December 2005 in South Asia, a Special Session of the SAARC Environment Ministers (Malé, 25 June 2005) adopted the Malé Declaration on a collective response to large scale natural disasters. A SAARC Disaster Management Centre (SDMC) was established in New Delhi in October 2006, the SDMC was created to provide policy advice and facilitate capacity building including strategic learning, research, training, system development, expertise promotion and exchange of information for effective disaster risk reduction and management. [3] Policy making has also been activated at the state level, for example the government of Queensland in Australia has taken initiative on a state level of creating a policy framework to reduce and tackle natural disasters. The framework called the “Disaster Management Strategy Policy framework” includes Research, Policy and Governance, Risk Assessment, Mitigation, Preparedness, Response, Relief and Recovery, Post-Disaster Assessment. [4]

One might be of the opinion that disaster events are probabilistic events and their occurrence can only be calculated on a probability basis and there is no escape from their destruction. However it is important to understand the consequences of the occurrence and what can be done to help the affected populace overcome the calamity natural disasters cause. Research has shown despite the scale of the disaster, a combination of national and international policy can help ward off disease and death in countries with functioning governments. This literature review investigates previous studies conducted on the socio economic impact of floods in context to Gender.

The 2010 floods in Pakistan

The geological department of the Australian government defines floods as “the covering of normally dry land by water that has escaped or been released from the normal confines of: any lake, or any river, creek or other natural watercourse, whether or not altered or modified; or any reservoir, canal, or dam.” [4]Floods primarily impact the human community either directly through contact with the water or indirectly through the damage the water does to the natural and human built environment. [5] “Localized floods can have a significant impact on people’s physical and mental health.” [6]

The 2010 monsoon floods were one of the largest floods in the history of Pakistan causing unprecedented damage and killing more than 1,700 people. The floods affected over, 20 million people, inundated almost one fifth of the country’s land and caused loss of billions of dollars through damages to infrastructure, housing, agriculture and livestock, and other family assets. [8]The World Bank and Asian Development Bank estimated that the flooding had caused the economy $9.7 billion in losses. [9] Cases of malnutrition, gastroenteritis, diarrhea, skin infections, cholera, typhoid, malaria, and hepatitis were reported. Food prices dramatically increased after the flooding, putting an economic strain on the entire population.

The southern province of Sindh was hit quite heavily by the floods, it was reported that nearly Seven million people were affected by floods in the province; thousands were trapped by flood waters and had been in need of assistance. Our study region the southern district of Thatta was affected in a catastrophic manner by the floods, as the flow of the flood waters touched 9,50,000 cusecs the feeble dykes built to protect the district’s populace overflowed causing both banks of the Indus River to flood causing enormous amount of destruction.

At the time of flooding the state machinery which included both the provincial and federal government along with many international and national NGOs led the relief efforts and was able to avoid the occurrence of any larger catastrophe such as far spread hunger or famine. However in recent years continuous acts of terrorism have kept the government preoccupied with matters of public safety and security, this has diverted the government’s attention from institutional reform to matters of ad-hoc nature. The presence of situational challenges has reduced state capacity to productively provide basic services for which resources had already been deficient. This has limited government’s response to natural disasters mostly to needs assessment and immediate relief operations. The assessments have typically focused on direct damages of capital assets which includes number of deaths and injuries, damages to buildings and public infrastructure, loss of crop and livestock.

Assessments of disaster impacts on social sectors such as health and education are also limited to the measurement of damages to school and hospital buildings, the assessments tend to ignore the long term affects on the health and education levels of the affected populace. Long term assessments of social sectors is critical even more so for a country like Pakistan as it already struggles with low social development indicators, ranking 145 out of 187 [C] countries in the Human Development Index and a Gender Development Index (GDI) ranking of 120 out of 146 [D] countries.

Approaches to measure impact of natural disasters

Researchers across the world have used diverse approaches to determine the impact of floods. In Pakistan the EU has previously employed the EMMA (Emergency Market Mapping and Analysis), which is a rapid market analysis designed to be used in the short term aftermath of a sudden-onset crisis. A better understanding of the most critical markets in an emergency situation enables decision makers (donors, NGOs, government, other humanitarian actors) to consider a broader range of responses. The aim of the approach is to gauge and understand the structure and functioning of key markets in the short term so that immediate recovery programs are in consistent to the on the ground situation. Although the research is useful in providing immediate relief, however the approach does not take into consideration the long term effects of the disaster. [10]

Likewise another approach which can help donors target their recuperation efforts is ECLAC, ECLAC’s methodology is related to post disaster evaluation; it focuses on rehabilitation and recuperation. It advocates using a dynamic and sectoral perspective that enables the researchers to calculate future losses derived by the destruction of productive structures and forfeitures of business opportunities and its middle/long term effects in different terms. The methodology aims to enable its users to try to define if and which type of international cooperation the community affected needs. Although precise knowledge of various sectoral damages and losses, present and future, suffered by the communities enables the disaster relief agencies to execute more specific rehabilitation projects, however usage of a macro-perspective to gauge the damages and provides losses in monetary terms leaves out the impact on social sectors and chiefly focuses on economic costs. [11]

In a Flood-site project report on the Mulde River in Germany the researchers have taken the bottom up perspective to analyze social vulnerability posed by floods. The methodology seeks to categorize the circumstances that make an individual or a community vulnerable and investigate how some groups in these circumstances might be more vulnerable than others. The researchers who define social vulnerability as “the characteristics of a person or group in terms of their capacity to anticipate, cope with, resist, and recover from the impact of a natural hazard” primarily focus on how communities and social groups are able to deal with the impacts of a natural hazard. The approach provides valuable insight into the dynamics of social capital, but lacks detail of sectoral assessments. [12]

Along with well targeted programs it is important that recovery programs are sustainable. In Sudan, AIACC has employed a research method based upon the sustainable livelihood conceptual framework; the research method aims to evaluate the performance of sustainable livelihood and environmental management measures. International Institute for Sustainable Development defines sustainable livelihoods as being “concerned with people’s capacities to generate and maintain their means of living, enhance their well-being, and that of future generations. Sustainable livelihood assessment is intended to generate an understanding of the role and impact of a project on enhancing and securing local people’s livelihoods. It primarily relies on a range of data collection methods, a combination of qualitative and quantitative data indicators and, to varying degrees, application of a sustainable livelihoods framework. The model focuses on five types of capital namely; natural, physical human, social and financial. The framework employs the Livelihood Assessment Tracking (LAST) System to measure changes in coping and adaptive capacity. Quantitative and qualitative indicators are combined with the LAST system for its use; the LAST system is developed through creation of development indicators by the help of the local community. [13]

All the above mentioned frameworks, even with their short-comings provide valuable inputs into the assessment methods of disaster impacts. However, the above discussed frameworks which focus on immediate needs assessment, macro-economic impacts, social capital, and sustainable livelihoods do not seem to be gender sensitive and lack concentration on social sectors in a gender sensitive manner. It has been time and again noted that women are most adversely affected by natural disasters. Sara-Bradshaw in her paper socio-economic impacts of natural disasters advocates the use of a gender approach; the paper states that the first step to ensuring that the specific basic needs of women are addressed over the short and long term is to collect data broken by sex and age segments immediately after the occurrence of a disaster. This is important because breaking up of data helps realize the affects of the flood on women in particular and assists in highlighting the specific requirements of the gender. For example in many cases in a Muslim country women might opt not to visit a male doctor, hence if the researchers have the number of women who need medical attention they can arrange female doctors accordingly. [14]

Gender Aspects of Natural Disasters International

Enarson et al 1998, Fordham 1998, Morrow 1999 and Tapsell et al 2000 are of the view that floods and other disasters can impact upon men and women in different and distinct ways. Similarly “It is believed that men and women will be faced with different vulnerabilities to climate change impacts due to existing inequalities such as, their role and position in society, access to resources and power relations that may affect the ability to respond to the effects of climate change” (WEDO 2007; Commission on the Status of Women 2008; Carvajal et al 2008; Bridge, 2008). [15][16] [17] [18] [19] It is a basic fact that majority of the women in developing countries and particularly in the South Asian region are at a disadvantage when compared to their male counterparts.

International Literature such as Tapsell et al 2003 illustrates that women suffer markedly more than men at the worst time of flooding. Research has shown that due to socially constructed roles and responsibilities, women seem to bear the most burdens resulting from climate variability impacts. Due to the traditional gender roles in many developing countries, it is seen that women are in charge of the house and responsible for household needs such as cooking, washing, hygiene, children and raising small livestock. Children, in particular girls share these responsibilities. In Africa, women do 90% of the work of collecting water and wood, for the household and food preparation. It is noted that women have to work extra workloads when faced with natural catastrophes as they try to manage their everyday tasks during an emergency situation. [20] [21] Qualitative research suggests that this is because women have the main responsibility for, and probably, a greater emotional investment in the home than men. They also usually have the key responsibility for the care of children and the elderly in the home, for example even in a post flood situation it is the central responsibility of the woman for getting the home back to normal after the flood. [22]

In many developing countries and especially in the south Asian region, food hierarchies favor male nutritional requirements and often women nutrition and health requirements are ignored. In Bangladesh it has been reported that “Given the already precarious nutritional state of large numbers of girls and women in Bangladesh…any further increase in discrimination would have serious consequences.” In poor households, throughout the world, women go without food for the benefit of their children or male family members. [30][31] Moreover an ADB report in 2001 found that in Bangladesh of the 20-30% female headed households, 95% are living below poverty line. Even in developed countries such as the U.K, lone parent and single pensioner households-the majority of which are female headed are most likely to be living in poverty. It is noted that in some instances pressure on families has been so severe that there have been reports of children being offered for domestic employment, and of female children being sold. The evidence informs us that women headed households already tend to have limited economic resources and hence a natural disaster can have a greater impact on their livelihoods in comparison to others.

Other than the over-all poverty rates, health and education are two sectors where women in the region still lag behind men. The poor nutritional status of women makes them more susceptible to disease infection, particularly in developing countries where there is little social provision and limited or no access to proper medical care. Poor nutrition also makes women more vulnerable to disasters, and makes the physically strenuous tasks of water and fuel collection more difficult. Research in India has found that girls’ nutrition suffers most during periods of low consumption and rising food prices , which is common during disaster situations [36][37].

Fewtrell and Kay (2006) provide evidence of floods causing Bacterial, fungal, respiratory disease, and gastrointestinal infection along with earache and skin rashes among others. It is widely acknowledged in health research that some groups, such as women (especially pregnant women), the young, the elderly and immune compromised people are more vulnerable to health impacts (especially infection) than other people (e.g. Flynn and Nelson, 1998; White et al., 2002; WHO 2004). [28] Moreover floods can also have an impact on the mental health of the affectees. It has been suggested that women may suffer more mental strain in certain situations, due to cultural norms. Women in poor health prior to the flood are more likely to experience the flooding as traumatic. When whole families move to urban slums or relief camps the women face challenges adapting to the new environment. Problems include harassment, lack of security, unreliable water supplies which increases their workload, and gender insensitive conditions such as lack of privacy also have a tolling effect. Long journeys to the relief camps can cause both physical and mental stresses when coupled with experiences of sexual harassment on these journeys. Women’s’ dramatically expanded care giving roles following a disaster, and putting family needs before their own, may explain overall decline in emotional well being. [29]

Gender Aspects of Natural Disasters Pakistan

The international literature on women in relation to climate change clearly highlights the severe vulnerability and adverse exposure natural disasters pose to women in particular. Similarly research studies have been conducted by different development organizations to gauge the impact of the severe floods that hit Pakistan recently. The research results are in line with international research literature. As Pakistani women particularly tend to mainly have reproductive and domestic roles in the households and are barely visible in the public spheres, particularly in rural areas, these characteristics make way for a greater impact on their socio-economic conditions from natural disasters. The existing situation of women in Pakistan cannot be fully valued without an understanding of the ways in which religion, culture and traditions have organized social relations and fractured society along class, racial, ethnic and gender lines. Pakistan therefore, presents a distinctive situation from a socio-economic perspective. In Pakistan Men and boys are given more weightage over the family resources in comparison to women and girls. A survey conducted by OCHA as a Needs Assessment study on the 2011 floods in Sindh found that 37% of households had reduced or skipped food intake; practice adopted by women and girls in the household to meet the ration requirements, which is similar to findings mentioned earlier from Bangladesh. [32]

Nazish brohi et al have analyzed emerging trends and data, relying primarily on the Gender Needs Assessment (GNA), the Multi‐cluster Rapid Assessment Mechanism (McRAM), case studies and emerging secondary information. Their study includes case studies based on the various experiences of women to floods. The women respondents in the study have insisted that they had no prior information about the floods and many were taken back by surprise. The unexpectedness of the floods magnified its impact and also increased the exposure of the flood victims. The study present insights into the experiences of women through case studies, for example “in Mianwali, a thirty year old woman, Jawwahi, rushed out with her family in waist high water and saw her house crumble before her; in Charsadda, women awoke to cries and found water rushing into their houses”. Similarly the study also illustrates how women hygiene had been affected due to floods. For example in Kalabagh district, “Baghat Bibi, a sixty year old woman with her three daughters and three daughters in law visited the river every few days and submerged themselves’ in the water to clean themselves and their clothes, and then dry themselves while wearing the same clothes – it is reported that the they had been doing it for over three weeks”. As women in rural areas are not used to moving about in public spaces other than their villages’; girls and women are often embarrassed to be seen accessing lavatories and hence do so during nightfall or early morning. Such overwhelming circumstances coupled with cases of harassment can have profound impacts on mental health. [35]

The Preliminary Gender Needs Assessment report by UNIFEM [E] reports that the women were under severe stress as the devastation caused by the floods destroyed their limited assets, worsened their personal security situation, and changed their responsibilities as they were forced to respond to emergency conditions. The report stresses upon the fact that even though women’s health is vital to the well-being of their families, after disasters, traditionally as caregivers, they tend to place their needs last. It also affirms that in certain provinces, cultural norms such as ‘purdah’ limit women from being able to express their needs, additionally women also tend to have a chance of going unnoticed in the compensation process as their economic contributions are usually unseen.

Similarly the women interviewed by IDMC in Sindh alleged that access to income-earning opportunities has been their biggest challenge and a major concern for women heads of household. The slow pace of recovery from the extensive damage the floods caused to the agricultural sector was expected to have a major impact on women’s employment. Women also lacked the documentation to prove their property rights. As a result, widows and women heads of household interviewed by IDMC reported great difficulty in claiming inheritances, land and possessions left at home when they fled. [23]

A March 2011 report by the UN Office for the Coordination of Humanitarian Affairs (OCHA) found that internally displaced women and girls across the country could not venture out to receive emergency food aid without being threatened for violating purdah. [24] Women complained that most health services available in the aftermath of the floods concentrated on primary health care with little specialized focus on reproductive health for women. [25] A 2010 assessment by the UN Development Fund for Women (UNIFEM) quoted women as reporting sexual harassment in flood displacement camps where different tribes, families and villages were placed together. [26]

Hence it is essential that researchers while assessing the effects of flood take both long term and short term health impacts into account. It is important for the research study to describe the characteristic impacts of floods on health outcomes, describe the factors that influence human health as a result of floods, describe the direct health impacts of floods and develop a conceptual framework to aid in the management and evaluation of flood related health management.

The literacy rates of women in developing countries are much lower than their male counterparts. A study by UNICEF in the aftermath of the 2010 floods showed that there are gender disparities in supply side factors in Sindh including availability of schools for girls and boys. Pre flood institution break up by gender, level and sector shows that at the primary level there are 60% mixed schools in the public sector and 42% mixed schools at the middle level. At the primary level parents are more comfortable with sending their girl child to mix school; however there is reluctance when it comes to middle school when the girl attains puberty, the dropout rates are also highest at that point and majority of the dropouts occur when girls move from primary to middle level. Similarly the study provides evidence of gender disparities existing in Thatta; the study demonstrates the trends in pre and post flood situations in primary enrollment. [38] Lack of access to education isn’t always related to scarcity of schools however the unavailability of this supply side factor can play a major role in decreasing access to education along with the unavailability of female teachers as well. Economic costs, social traditions, and religious and cultural beliefs also limit girls’ educational opportunities particularly when it comes to middle and high level schooling. As these social development indicators become worse due to the affects of climate change it is important for the authorities to not only measure them but also address them with sustainable development programs.

Given that men and women in the study area are poverty-stricken with dependency on agriculture and natural resources for their livelihoods, natural disasters pose a high risk for them. As evident by the literature reviewed vulnerability seems to be higher for women as they do not have alternative means of employment and most of all employed women in the study area are employed by the agriculture sector. More and more researchers have concluded that it is important to opt for a gendered analysis when researching on flood impacts, Sarah Bradshaw in her study Socio-economic impacts of natural disasters: a gender analysis states “The first step towards ensuring that the specific basic needs of women are addressed over the short and long term is to collect data broken down by sex and age segment immediately after a disaster.” The breaking up of data helps researchers understand women specific needs better, which in turn can help policy makers design and implement women specific strategies and programs. [27]

Even though the evidence provided above from both international and local research literature clearly advocates the case for greater vulnerability of women from natural disasters; not much has been done to assess the post disaster impact of floods on women. Research studies have remained limited to rapid assessments or need assessments, post disaster impact have not been concentrated upon. In order to design long term sustainable gender sensitive recovery programs it is crucial to understand the post disaster impact of floods on women, keeping this in mind the present study “Social-Economic Impact of Flood in District Thatta: A Gendered Analysis” is a pioneering work in Pakistan in which SPDC’s researchers have gone a step ahead from other studies and have tried to assess the post disaster impact of one of the worst floods of the century.

Furthermore, research has shown that despite obstacles faced by women, they are already developing effective coping strategies which include adapting their farming practices. Literature such as (WEDO, 2003; Gurung et al., 2006; Mitchell et al., 2007) pointed out that women are very knowledgeable and experienced with regards to coping with climate related impacts. They are aware of their needs and are very innovative in the face of change. Communities on the frontline in adapting to the effects of natural disasters need but so far often lack, adequate information about climate change and adaptation strategies. Due to the women’s lower literacy levels in many regions, and other barriers to accessing information, such as culture, it is vital that women’s needs are addressed in efforts to provide necessary information. [43]

Ariyabandu and Wickramasighe (2005:26) suggest that although women are often more vulnerable to disasters than men (owing to conventional gender responsibilities and relations) however they are not just helpless victims as often represented. Women have valuable knowledge and experience in coping with disasters. Yet these strengths and capabilities of women are often ignored in policy decisions and in mitigation, thereby, allowing these valuable resources to go to waste and sometimes creating dependency situations. Ignorance of gender differences in the past has led to insensitive and ineffective relief operations that have not been able to target women’s needs and their potential to assist in mitigation and relief work. [44] Hence this research is also important because not all is gloomy, as international research has suggested that in developing countries already experiencing negative effects of climate change, women have been identified as particularly adaptive and innovative, therefore the current research study shall play a valuable role in making policy makers better understand the long term issues of Pakistani women in particular and identify their strengths and weaknesses.

Taking the above into consideration, SPDC has designed a gender sensitive research study to determine the impact of the 2010 flood of Thatta. A gender sensitive primary survey is vital in helping identify Gender gaps, hence SPDC researchers created separate questionnaires for men and women. The study helps understand the differences in the socio-economic impact of the flood on women, men, girls and boys. This includes gathering gender sensitive data on the sectors of education, health, economic, flood coping capability and the overall impact of the flood. In order to assess and evaluate the effect of flood on the household welfare and behavior, the study collects individual and household information from both male and female respondents separately, making use of gender sensitive approaches which in the past have been limited to needs assessments or rapid assessment studies.

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