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Human disasters 

Human disasters

Chapter:
Human disasters
Author(s):

Amartya Sen

DOI:
10.1093/med/9780199204854.003.0305
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date: 24 April 2017

Human disasters, as massive misfortunes long recorded over history, have great importance for medicine, rightly prompting the call for prevention, relief, and practical intervention by medical personnel. But why do human disasters happen? A sharp distinction is sometimes drawn between natural disasters, e.g. earthquakes, and social disasters, e.g. wars, but detailed knowledge often shows that this contrast is not always clear.

The example of famines

Take the example of famines. These are popularly understood in terms of food output decline caused by droughts, floods, or storms, but such explanations are contradicted by many famines that have occurred without any decline in food production. Such misunderstanding has been responsible for the loss of millions of lives, mainly by undermining the role of social intervention. Starvation is a characteristic of some people not having enough food to eat, not of there being not enough food in the economy. The critical connection of the command over food is with the purchasing power to buy it (in a market economy), linked to jobs and incomes and relative prices of what people have to sell (their labour and the commodities they can make) to buy staple food. A famine is in this sense an economic phenomenon—not just as an issue of agricultural production—and can be prevented by a willingness to start relief programmes, mainly in the form of emergency projects, which provide jobs and incomes to the afflicted population.

Disasters and policy interventions

Even when nature plays a part, society can make a huge difference. Interventions that can be effective include (1) environmental policies that can make floods and droughts less likely; (2) mitigation of effects of disasters on the economy—e.g. an earthquake may not lead to a famine, but can leave an economy unsettled, making lives precarious for those who are not killed in the physical event itself; these effects can be prevented or at least reduced in their impact through careful social intervention (as described above for famines); (3) health care actions—the morbidity and mortality associated with human disaster can be large and extend far beyond those who are directly hit. Taking note of the likely dangers from local contagions, the scale of both illness and death can be radically altered through preventive measures, such as immunization, ensuring safe water, influencing the routes of contact and spread, and by self education and prompt medical response.

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