From the Dean: Disasters, Natural and Otherwise

From the Dean: Disasters, Natural and Otherwise

Many of the graduates of the class of 2006 experienced both the horror of September 11th and the destruction of Katrina during their years of higher education. During the same period, they also witnessed the incomprehensible damage wrought by the Asian tsunami and the devastation of the earthquake in Pakistan. They are reminded daily of the threat of a global pandemic of a human-to-human transmissible version of avian flu. And the fear of another large-scale terrorist attack is never completely out of mind.

This is a generation of public health students that understands, and lives with, the threat of disasters. The recent rash of disasters has energized, mobilized, and focused public health students to a degree that I have rarely witnessed during my nearly 34 years on this faculty. Sixty-eight School of Public Health students have undergone disaster response training through PHAST (Public Health Action Support Team), a student organization run out of the SPH Office of Public Health Practice. At the end of February, 40 students, accompanied by faculty and staff supervisors, gave up the usual fun-in-the-sun spring break to devote the week to assisting residents of the Gulf Coast in Katrina recovery efforts. During the same holiday, students in Professor Gregory Button’s seminar on Katrina worked in the hurricane’s hardest-hit area, St. Bernard Parish in New Orleans.

Like it or not, disaster has become the driving force behind much of public health during the first decade of the 21st century. The silver lining in this dark cloud is that, rather than resign themselves to this unwanted fate, many of our public health students have chosen to embrace the opportunity to use their new-found knowledge and skills to contribute to the betterment of the welfare of their fellow human beings.

The generosity of spirit exhibited by these students stands in stark contrast to the malevolence of the perpetrators of the attacks on the World Trade Center, the Pentagon, and United Flight 93. We have learned much from that awful experience. We have learned the meaning of living with fear. We have, or should have, an appreciation of and sympathy for the anxiety that afflicts the citizens of so many countries around the world in which living with terror is a long-standing way of life. We have come to perceive in the ongoing mental health burden of September 11th the need for the field of public health to devote far more effort to addressing this challenging arena of morbidity and disability. We have learned, too, that possibly well-intentioned responses to terrorism can have unanticipated consequences that may themselves constitute grave threats to the public’s health. We need look no further for a vivid example than the recurring tragedy of car-bomb deaths in Iraq.

Katrina produced a different set of reactions and responses. While much criticism was (rightly) directed at the Bush administration for the slowness and incompleteness of its response to the hurricane, the fact remains that nearly everyone was slow to respond. At 8:46 a.m. on September 11th, 2001, it was as if the world had stopped: from that moment on, all eyes focused on the unprecedented attack on America. For days, all of the major media were on the story 24/7. In remarkable, even chilling, contrast, the night after Katrina hit the Gulf Coast, while bodies were floating inside flooded homes, the local NBC affiliate in Detroit presented Wheel of Fortune, as it did every weeknight. To my knowledge, only CNN got on top of the story and stayed there from the start.

To be sure, the event eventually garnered the attention its importance warranted. The outpouring of support, financial and emotional, was emblematic of the best in Americans (and much of the rest of the world). But our collective failure to be gripped by the importance of the event right at the outset speaks volumes about how we perceive risks. We fear terrorism far more than disasters wrought by nature, regardless of the ultimate “body count.” We fear limited risks that are out of our personal control more than significant risks over which we exert control. (The classic example: Americans’ fear of flying compared to their sense of risk-free equanimity when driving their cars.) Herein lies a subject of study—risk perception and response—that it behooves the field of public health to explore far more thoroughly than we have to date.

There is much to learn from these disasters, natural and otherwise, and much to do. I am pleased to report that the school is responding to the new-found emphasis on disasters with course development, professional training, new research, and, as noted above, important service. We are educating the public as well. Symposia this year, open to the public, have focused on risk science and communication, Katrina, and zoonosis, the transmission of disease from animals to humans. During this era of trepidation about bird flu, led by the often-quoted voice of reason of Professor Arnold Monto, several SPH faculty have used their expertise on infectious disease to enhance the public’s understanding and to ready the world to respond effectively to the threat of avian influenza.

Public health lessons about disasters are being learned. A 2005 evaluation identified the health problems that warrant attention and resources in the aftermath of natural disasters, as well as those that have proved to be of less consequence than expectations might suggest. An example of the latter: epidemics of communicable diseases are fairly uncommon following natural disasters, with the risk relating primarily to the artificial, crowded accommodations in which displaced victims are housed.

Finally, it behooves all of us to address an essential question: exactly how natural are “natural” disasters? Although good evidence can be mustered on either side of the argument, might Katrina-like hurricanes—more frequent, more savage—result in part from (human-made) global warming? How “natural” was the devastation from Katrina, considering that the Army Corps of Engineers chose consciously not to reinforce the levee system, and that urban development had destroyed much of the wetlands and barrier islands that previously had shielded New Orleans from severe storm damage?

Tsunamis, hurricanes, earthquakes, and even terrorism take their immense tolls somewhat indiscriminately. If there is one central lesson we have to learn, it is that we are all in this together. The sooner we come to understand that, the sooner we are likely to work effectively to minimize the damage.

Kenneth Warner

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