from Part III - Clinical care and interventions
Published online by Cambridge University Press: 09 August 2009
Introduction
A disaster is a serious event that causes an ecological breakdown in the relationship between humans and their environment on a scale that requires extraordinary efforts to allow the community to cope, and often requires outside help or international aid (Lechat, 1990; Noji, 1997). Berren et al. (1980) mention five factors that can be used conceptually to distinguish one disaster from another: (1) type of disaster: human-made or natural; (2) duration; (3) degree of personal impact; (4) potential of recurrence; and (5) control over future impact. In natural disasters, a natural hazard affects a population or area and may result in severe damage and destruction and increased morbidity and mortality that overwhelm local coping capacity. Similarly, in human-made disasters such as complex emergencies, wars or terrorist attacks, mortality among the civilian population substantially increases above the population baseline mortality, either as a result of the direct effects of war or conflict, or indirectly through the increased prevalence of malnutrition and/or transmission of communicable diseases, especially if the latter result from deliberate political and military policies and strategies (Salama et al., 2004). In 2000, an estimated 1.6 million people worldwide died as a result of violence, and one-fifth were war related (World Health Organization, 2002b). As Chapter 2 shows, mental morbidity increases too, and varying risk groups need additional attention as well as preventative efforts to alleviate their plight.
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