Abstract
Major disasters pose significant threats to population health: rapid-onset crises can result in a massive loss of life, while protracted emergencies can result in both direct and indirect adverse effects to population health and livelihoods. In many cases, windows of opportunity present themselves to mitigate the effects of emergencies, but these opportunities must be seized and acted upon. Regrettably, current models of international development and global public health are frequently reactive, rather than preventive, with regard to major emergencies; major humanitarian responses frequently occur only once select indicators have reached or breached established emergency thresholds, which are late indicators of a population’s health. In order to avoid these predictable late responses, current models of international development and their relationship to emergency humanitarian responses need to be placed under the microscope. The public health community must serve as strong advocates for interventions to address worsening public health situations before they tip into crisis, and should be advocates for the reconceptualization and reform of priority setting in international development. The failure to do so quite clearly comes at the expense of some of the world’s most vulnerable populations.
Key Words: Disasters, relief work, international cooperation, malnutrition, public health, emergencies
Résumé
Les grandes catastrophes constituent une menace importante pour la santé des populations: les crises soudaines peuvent entraîner de lourdes pertes en vies humaines, tandis que les urgences prolongées peuvent avoir des effets indésirables, directs et indirects, sur la santé et les moyens de subsistance des populations. Dans de nombreux cas, il se présente des occasions d’atténuer les effets des urgences, mais il faut les saisir et agir. Regrettablement, les modèles actuels du développement international et de la santé publique mondiale sont fréquemment réactifs plutôt que préventifs en ce qui concerne les urgences majeures; la riposte aux grandes crises humanitaires ne s’enclenche souvent que lorsque certains indicateurs atteignent ou dépassent les seuils d’urgence établis, mais ce sont des indicateurs tardifs de la santé d’une population. Pour éviter les délais prévisibles dans la riposte, il faut scruter au microscope les modèles actuels du développement international et leurs liens avec les interventions humanitaires d’urgence. La communauté de la santé publique doit promulguer vigoureusement les interventions qui empêchent les problèmes de santé publique de s’aggraver jusqu’à devenir des crises, et elle doit promulguer la reconceptualisation et la réforme de l’établissement des priorités en matière de développement international. L’inaction à ce chapitre pose clairement un risque pour certaines des populations les plus vulnérables du monde.
Mots Clés: catastrophes, secours, coopération internationale, malnutrition, santé publique, urgences
Footnotes
Acknowledgements: Jason Nickerson is supported by an Ontario Graduate Scholarship from the Ontario Ministry of Training, Colleges and Universities.
Conflict of Interest: None to declare.
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