Background: We are in a period of history where natural disasters are increasing in both frequency and severity. They are having widespread impacts on communities, especially on vulnerable communities, those most affected who have the least ability to prepare or respond to a disaster. The ability to assemble and effectively manage Interagency Emergency Response Teams (IERTs) is critical to navigating the complexity and chaos found immediately following disasters. These teams play a crucial role in the multi-sectoral, multi-agency, multi-disciplinary, and inter-organisational response and are vital to ensuring the safety and well-being of vulnerable populations such as the young, aged, and socially and medically disadvantaged in disasters. Communication is key to the smooth operation of these teams. Most studies of the communication in IERTs during a disaster have been focussed at a macro-level of examining larger scale patterns and trends within organisations. Rarely found are micro-level analyses of interpersonal communication at the critical interfaces between collaborating agencies. This study set out to understand the experiences of those working at the interagency interfaces in an IERT set up by the Canterbury District Health Board to respond to the needs of the vulnerable people in the aftermath of the destructive earthquakes that hit Canterbury, New Zealand, in 2010-11. The aim of the study was to gain insights about the complexities of interpersonal communication (micro-level) involved in interagency response coordination and to generate an improved understanding into what stabilises the interagency communication interfaces between those agencies responding to a major disaster. Methods: A qualitative case study research design was employed to investigate how interagency communication interfaces were stabilised at the micro-level (“the case”) in the aftermath of the destructive earthquakes that hit Canterbury in 2010-11 (“the context”). Participant recruitment was undertaken by mapping which agencies were involved within the IERT and approaching representatives from each of these agencies. Data was collected via individual interviews using a semi-structured interview guide and was based on the “Critical Incident Technique”. Subsequently, data was transcribed verbatim and subjected to inductive analysis. This was underpinned theoretically by Weick’s “Interpretive Approach” and supported by Nvivo qualitative data analysis software. Results: 19 participants were interviewed in this study. Out of the inductive analysis emerged two primary themes, each with several sub-factors. The first major theme was destabilising/disruptive factors of interagency communication with five sub-factors, a) conflicting role mandates, b) rigid command structures, c) disruption of established communication structures, d) lack of shared language and understanding, and e) situational awareness disruption. The second major theme stabilising/steadying factors in interagency communication had four sub-factors, a) the establishment of the IERT, b) emergent novel communication strategies, c) establishment of a liaison role and d) pre-existing networks and relationships. Finally, there was a third sub-level identified during inductive analysis, where sub-factors from both primary themes were noted to be uniquely interconnected by emergent “consequences” arising out of the disaster context. Finally, findings were synthesised into a conceptual “Model of Interagency Communication at the Micro-level” based on this case study of the Canterbury earthquake disaster response. Discussion: The three key dimensions of The People, The Connections and The Improvisations served as a framework for the discussion of what stabilises interagency communication interfaces in a major disaster. The People were key to stabilising the interagency interfaces through functioning as a flexible conduit, guiding and navigating communication at the interagency interfaces and improving situational awareness. The Connections provided the collective competence, shared decision-making and prior established relationships that stabilised the micro-level communication at interagency interfaces. And finally, The Improvisations i.e., novel ideas and inventiveness that emerge out of rapidly changing post-disaster environments, also contributed to stabilisation of micro-level communication flows across interagency interfaces in the disaster response. “Command and control” hierarchical structures do provide clear processes and structures for teams working in disasters to follow. However, improvisations and novel solutions are also needed and often emerge from first responders (who are best placed to assess the evolving needs in a disaster where there is a high degree of uncertainty). Conclusion: This study highlights the value of incorporating an interface perspective into any study that seeks to understand the processes of IERTs during disaster responses. It also strengthens the requirement for disaster management frameworks to formally plan for and to allow for the adaptive responsiveness of local teams on the ground, and legitimise and recognise the improvisations of those in the role of emergent boundary spanners in a disaster response. This needs to be in addition to existing formal disaster response mechanisms. This study provides a new conceptual model that can be used to guide future case studies exploring stability at the interfaces of other IERTs and highlights the centrality of communication in the experiences of members of teams in the aftermath of a disaster. Utilising these new perspectives on stabilising communication at the interagency interfaces in disaster responses will have practical implications in the future to better serve the needs of vulnerable people who are at greatest risk of adverse outcomes in a disaster.
Natural hazard disasters often have large area-wide impacts, which can cause adverse stress-related mental health outcomes in exposed populations. As a result, increased treatment-seeking may be observed, which puts a strain on the limited public health care resources particularly in the aftermath of a disaster. It is therefore important for public health care planners to know whom to target, but also where and when to initiate intervention programs that promote emotional wellbeing and prevent the development of mental disorders after catastrophic events. A large body of literature assesses factors that predict and mitigate disaster-related mental disorders at various time periods, but the spatial component has rarely been investigated in disaster mental health research. This thesis uses spatial and spatio-temporal analysis techniques to examine when and where higher and lower than expected mood and anxiety symptom treatments occurred in the severely affected Christchurch urban area (New Zealand) after the 2010/11 Canterbury earthquakes. High-risk groups are identified and a possible relationship between exposure to the earthquakes and their physical impacts and mood and anxiety symptom treatments is assessed. The main research aim is to test the hypothesis that more severely affected Christchurch residents were more likely to show mood and anxiety symptoms when seeking treatment than less affected ones, in essence, testing for a dose-response relationship. The data consisted of mood and anxiety symptom treatment information from the New Zealand Ministry of Health’s administrative databases and demographic information from the National Health Index (NHI) register, when combined built a unique and rich source for identifying publically funded stress-related treatments for mood and anxiety symptoms in almost the whole population of the study area. The Christchurch urban area within the Christchurch City Council (CCC) boundary was the area of interest in which spatial variations in these treatments were assessed. Spatial and spatio-temporal analyses were done by applying retrospective space-time and spatial variation in temporal trends analysis using SaTScan™ software, and Bayesian hierarchical modelling techniques for disease mapping using WinBUGS software. The thesis identified an overall earthquake-exposure effect on mood and anxiety symptom treatments among Christchurch residents in the context of the earthquakes as they experienced stronger increases in the risk of being treated especially shortly after the catastrophic 2011 Christchurch earthquake compared to the rest of New Zealand. High-risk groups included females, elderly, children and those with a pre-existing mental illness with elderly and children especially at-risk in the context of the earthquakes. Looking at the spatio-temporal distribution of mood and anxiety symptom treatments in the Christchurch urban area, a high rates cluster ranging from the severely affected central city to the southeast was found post-disaster. Analysing residential exposure to various earthquake impacts found that living in closer proximity to more affected areas was identified as a risk factor for mood and anxiety symptom treatments, which largely confirms a dose-response relationship between level of affectedness and mood and anxiety symptom treatments. However, little changes in the spatial distribution of mood and anxiety symptom treatments occurred in the Christchurch urban area over time indicating that these results may have been biased by pre-existing spatial disparities. Additionally, the post-disaster mobility activity from severely affected eastern to the generally less affected western and northern parts of the city seemed to have played an important role as the strongest increases in treatment rates occurred in less affected northern areas of the city, whereas the severely affected eastern areas tended to show the lowest increases. An investigation into the different effects of mobility confirmed that within-city movers and temporary relocatees were generally more likely to receive care or treatment for mood or anxiety symptoms, but moving within the city was identified as a protective factor over time. In contrast, moving out of the city from minor, moderately or severely damaged plain areas of the city, which are generally less affluent than Port Hills areas, was identified as a risk factor in the second year post-disaster. Moreover, residents from less damaged plain areas of the city showed a decrease in the likelihood of receiving care or treatment for mood or anxiety symptoms compared to those from undamaged plain areas over time, which also contradicts a possible dose-response relationship. Finally, the effects of the social and physical environment, as well as community resilience on mood and anxiety symptom treatments among long-term stayers from Christchurch communities indicate an exacerbation of pre-existing mood and anxiety symptom treatment disparities in the city, whereas exposure to ‘felt’ earthquake intensities did not show a statistically significant effect. The findings of this thesis highlight the complex relationship between different levels of exposure to a severe natural disaster and adverse mental health outcomes in a severely affected region. It is one of the few studies that have access to area-wide health and impact information, are able to do a pre-disaster / post-disaster comparison and track their sample population to apply spatial and spatio-temporal analysis techniques for exposure assessment. Thus, this thesis enhances knowledge about the spatio-temporal distribution of adverse mental health outcomes in the context of a severe natural disaster and informs public health care planners, not only about high-risk groups, but also where and when to target health interventions. The results indicate that such programs should broadly target residents living in more affected areas as they are likely to face daily hardship by living in a disrupted environment and may have already been the most vulnerable ones before the disaster. Special attention should be focussed on women, elderly, children and people with pre-existing mental illnesses as they are most likely to receive care or treatment for stress-related mental health symptoms. Moreover, permanent relocatees from affected areas and temporarily relocatees shortly after the disaster may need special attention as they face additional stressors due to the relocation that may lead to the development of adverse mental health outcomes needing treatment.
Environmental stress and disturbance can affect the structure and functioning of marine ecosystems by altering their physical, chemical and biological features. In estuaries, benthic invertebrate communities play important roles in structuring sediments, influencing primary production and biogeochemical flux, and occupying key food web positions. Stress and disturbance can reduce species diversity, richness and abundance, with ecological theory predicting that biodiversity will be at its lowest soon after a disturbance with assemblages dominated by opportunistic species. The Avon-Heathcote Estuary in Christchurch New Zealand has provided a novel opportunity to examine the effects of stress, in the form of eutrophication, and disturbance, in the form of cataclysmic earthquake events, on the structure and functioning of an estuarine ecosystem. For more than 50 years, large quantities (up to 500,000m3/day) of treated wastewater were released into this estuary but in March 2010 this was diverted to an ocean outfall, thereby reducing the nutrient loading by around 90% to the estuary. This study was therefore initially focussed on the reversal of eutrophication and consequent effects on food web structure in the estuary as it responded to lower nutrients. In 2011, however, Christchurch was struck with a series of large earthquakes that greatly changed the estuary. Massive amounts of liquefied sediments, covering up to 65% of the estuary floor, were forced up from deep below the estuary, the estuary was tilted by up to a 50cm rise on one side and a corresponding drop on the other, and large quantities of raw sewage from broken wastewater infrastructure entered the estuary for up to nine months. This study was therefore a test of the potentially synergistic effects of nutrient reduction and earthquake disturbance on invertebrate communities, associated habitats and food web dynamics. Because there was considerable site-to-site heterogeneity in the estuary, the sites in this study were selected to represent a eutrophication gradient from relatively “clean” (where the influence of tidal flows was high) to highly impacted (near the historical discharge site). The study was structured around these sites, with components before the wastewater diversion, after the diversion but before the earthquakes, and after the earthquakes. The eutrophication gradient was reflected in the composition and isotopic chemistry of primary producer and invertebrate communities and the characteristics of sediments across the sample sites. Sites closest to the former wastewater discharge pipe were the most eutrophic and had cohesive organic -rich, fine sediments and relatively depauperate communities dominated by the opportunistic taxa Capitellidae. The less-impacted sites had coarser, sandier sediments with fewer pollutants and far less organic matter than at the eutrophic sites, relatively high diversity and lower abundances of micro- and macro-algae. Sewage-derived nitrogen had became incorporated into the estuarine food web at the eutrophic sites, starting at the base of the food chain with benthic microalgae (BMA), which were found to use mostly sediment-derived nitrogen. Stable isotopic analysis showed that δ13C and δ15N values of most food sources and consumers varied spatially, temporally and in relation to the diversion of wastewater, whereas the earthquakes did not appear to affect the overall estuarine food web structure. This was seen particularly at the most eutrophic site, where isotopic signatures became more similar to the cleaner sites over two-and-a-half years after the diversion. New sediments (liquefaction) produced by the earthquakes were found to be coarser, have lower concentrations of heavy metals and less organic matter than old (existing) sediments. They also had fewer macroinvertebrate inhabitants initially after the earthquakes but most areas recovered to pre-earthquake abundance and diversity within two years. Field experiments showed that there were higher amounts of primary production and lower amounts of nutrient efflux from new sediments at the eutrophic sites after the earthquakes. Primary production was highest in new sediments due to the increased photosynthetic efficiency of BMA resulting from the increased permeability of new sediments allowing increased light penetration, enhanced vertical migration of BMA and the enhanced transport of oxygen and nutrients. The reduced efflux of NH4-N in new sediments indicated that the capping of a large portion of eutrophic old sediments with new sediments had reduced the release of legacy nutrients (originating from the historical discharge) from the sediments to the overlying water. Laboratory experiments using an array of species and old and new sediments showed that invertebrates altered levels of primary production and nutrient flux but effects varied among species. The mud snail Amphibola crenata and mud crab Austrohelice crassa were found to reduce primary production and BMA biomass through the consumption of BMA (both species) and its burial from bioturbation and the construction of burrows (Austrohelice). In contrast, the cockle Austrovenus stutchburyi did not significantly affect primary production and BMA biomass. These results show that changes in the structure of invertebrate communities resulting from disturbances can also have consequences for the functioning of the system. The major conclusions of this study were that the wastewater diversion had a major effect on food web dynamics and that the large quantities of clean and unpolluted new sediments introduced to the estuary during the earthquakes altered the recovery trajectory of the estuary, accelerating it at least throughout the duration of this study. This was largely through the ‘capping’ effect of the new liquefied, coarser-grained sediments as they dissipated across the estuary and covered much of the old organic-rich eutrophic sediments. For all aspects of this study, the largest changes occurred at the most eutrophic sites; however, the surrounding habitats were important as they provided the context for recovery of the estuary, particularly because of the very strong influence of sediments, their biogeochemistry, microalgal and macroalgal dynamics. There have been few studies documenting system level responses to eutrophication amelioration and to the best on my knowledge there are no other published studies examining the impacts of large earthquakes on benthic communities in an estuarine ecosystem. This research gives valuable insight and advancements in the scientific understanding of the effects that eutrophication recovery and large-scale disturbances can have on the ecology of a soft-sediment ecosystem.
