On January 12, 2010, several earthquakes ranging in magnitude from 6.5 to 7.3 struck 15 miles west of the Haitian capital city of Port-au-Prince. The earthquakes exposed a population already struggling with deprivation to additional resource scarcities by reducing most buildings in the capital—including homes, schools, government offices, hospitals, and other health care facilities—to rubble. In addition, adequate provision of basic utilities such as electricity, potable water, and proper sanitation services to the vast majority of the population in Port-au-Prince was further restricted. Beyond the material losses, an estimated 200 000 people were killed, a figure that will only increase in the days and weeks following the earthquake, and 1.2 million people were left homeless.
In the period that followed this disaster, an abundance of international humanitarian assistance to rebuild Haiti's devastated infrastructure and provide basic aid including food, water, shelter, and medical care, poured into the country. The international community has made promises to provide a basic level of aid in the coming months and Haitians themselves have shown equally abundant resiliency, strength, and determination to be part of the process of reconstruction.
The focus on resource scarcities of food, water, energy, and sanitation and their impact on public health are often considered in the context of natural disasters. Yet, increasingly we are witnessing how human activities and public policies are engendering resource scarcities that adversely impact health status even in nondisaster settings.
In the case of the Haitian earthquake, many may wonder: with the abundance of data and knowledge about the geologic fault underlying the nation of Haiti and its likelihood for future activity, why were early warning systems and disaster preparedness plans not established in advance? The reason, in part, is a reflection of the scarcity of resources and inadequate infrastructure that Haitians struggle with on a daily basis. These daily scarcities place long-term planning and policy initiatives that could mitigate the social and structural impact of these kinds of natural disasters further down the list of national priorities.
In this issue of the Journal, Eichelberger provides an example of how skyrocketing energy and fuel costs, driven by shortsighted national and local policies, created water scarcity in three Iñupiaq Eskimo villages in Alaska's Northwest Arctic Borough. The water scarcity limited the ability of the Iñupiat people to take care of their basic hygienic needs and propagated the spread of infectious diseases that are completely preventable.
In the On the Other Hand forum are two papers that further depict the ways in which food scarcities arise even in the context of abundance. On one side of the debate, Yach et al. note that by creating and fostering private–public partnerships, multinational corporations can play a significant role in reducing global food insecurity with the goal of stemming acute and chronic malnutrition. In the countering piece, Monteiro et al. challenge this assertion by noting that reducing undernutriton associated with food scarcities “above all depends on improvements in income and other types of equity, population and community self-determination, and public investments in education, health, water supplies, and sanitation services, and indeed in social security and cohesion.”(p977)
Whether in times of crisis following natural disasters such as major earthquakes or through human activity, resource scarcities will present increasing challenges to the overall health of individuals and communities. Surmounting these challenges will require a sustained abundance of public health action.