DISASTER CONCEPTS AND TRENDS
CASE BOX 2.7 THE HORROR OF THE GREAT KANTŌ EARTHQUAKE 1923 (PART 1): SECONDARY DISASTERS
On 1 September 1923, an earthquake of 7.9 magnitude struck the Kanto¯ region.
Seven prefectures were badly damaged by the quake: Tokyo, Kanagawa, Saitama, Chiba, Shizuoka, Yamanashi, and Ibaraki. The earthquake was fol-lowed by horrible fires that burned down many houses and buildings. In Tokyo and Yokohama, there were close to 300 major fires. Fires as secondary disasters occurred because people were preparing meals at the time of earthquake and many houses were made of wood. The death toll reached almost 140,000 peo-ple. Further discussion of this historical earthquake can be found in Chapter 5.
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Unlike clinical medicine, where physicians and allied health professionals focus on treating diseases and managing the health of individuals, public health profession-als focus on managing the health and well- being of populations . This chapter discusses the general public health implications of natural disasters.
After most natural disasters, there are fi ve general public health consequences that might affect the community. Disasters may (1) overwhelm local response capacity with unexpected mortality and morbidity, (2) destroy health infrastructure and disrupt the provision of services, (3) bring adverse effects on the environment and population, (4) affect psychological and social behaviour, and (5) result in unde-sirable long- term consequences to the affected community.
Overwhelming of local response capacity with unexpected mortality and morbidity
Unexpected mortality and morbidity often overwhelm the local emergency and relief response system. Excess negative health impacts may be caused by either direct or indirect result of the crisis. Mortality refers to a measure of deaths in a given popula-tion, location or other measures of interest; crude mortality rate and under- 5 mortality rate are two common mortality indicators in use. Morbidity is a measure of disease incidence or prevalence in a given population; it refers to physical or psychological states resulting from disease, illness, injury or sickness. Morbidity may present in different ways, but the number of people with a specifi c disease and the duration of illnesses are common measures of morbidity. In disasters, factors affecting these health outcomes might include the magnitude and causes of unexpected mortality and morbidity, which vary according to the type of disaster as well as the demographic and epidemiologic profi le of the population.