Worldwide, the numbers of people living with chronic conditions are rapidly on the rise. Chronic illnesses are enduring and often cannot be cured, requiring a strategy for long term management and intervention to prevent further exacerbation. Globally, there has been an increase in interventions using telecommunications technologies to aid patients in their home setting to manage chronic illnesses. Such interventions have often been delivered by nurses. The purpose of this research was to assess whether a particular intervention that had been successfully implemented in the United Kingdom could also be implemented in Canterbury. In particular, this research assessed the perspectives of Canterbury based practice nurses and district nurses. The findings suggest that a majority of both district and practice nurses did not view the service as compatible with their current work situation. Existing workload and concerns over funding of the proposed service were identified as potential barriers. However, the service was perceived as potentially beneficial for some, with the elderly based in rural areas, or patients with chronic mental health needs identified as more likely to benefit than others. Practice nurses expressed strong views on who should deliver such services. Given that it was identified that practice nurses already have in-depth knowledge of their patients’ health, while valuing the strong relationships established with their communities, it was suggested that patients would most benefit from locally based nurses to deliver any community based health services in the future. It was also found that teletriaging is currently widely used by practice nurses across Canterbury to meet a range of health needs, including chronic mental health needs. This suggests that the scope of teletriaging in community health and its potential and full implications are currently not well understood in New Zealand. Significant events, such as the Christchurch earthquakes indicate the potential role of teletriaging in addressing mental health issues, thereby reducing the chronic health burden in the community.
At 4.35am on Saturday 4 September 2010, a magnitude 7.1 earthquake struck near the township of Darfield in Canterbury leading to widespread damage in Christchurch and the wider central Canterbury region. Though it was reported no lives were lost, that was not entirely correct. Over 3,000 animals perished as a result of the earthquake and 99% of these deaths would have been avoidable if appropriate mitigation measures had been in place. Deaths were predominantly due to zoological vulnerability of birds in captive production farms. Other problems included lack of provision of animal welfare at evacuation centres, issues associated with multiple lost and found pet services, evacuation failure due to pet separation and stress impact on dairy herds and associated milk production. The Canterbury Earthquake has highlighted concerns over a lack of animal emergency welfare planning and capacity in New Zealand, an issue that is being progressed by the National Animal Welfare Emergency Management Group. As animal emergency management becomes better understood by emergency management and veterinary professionals, it is more likely that both sectors will have greater demands placed upon them by national guidelines and community expectations to ensure provisions are made to afford protection of animals in times of disaster. A subsequent and more devastating earthquake struck the region on Monday 22 February 2011; this article however is primarily focused on the events pertaining to the September 4 event.
Disaster recovery is significantly affected by funding availability. The timeliness and quality of recovery activities are not only impacted by the extent of the funding but also the mechanisms with which funding is prioritised, allocated and delivered. This research addresses the impact of funding mechanisms on the effectiveness and efficiency of post-disaster demolition and debris management programmes. A qualitative assessment of the impacts on recovery of different funding sources and mechanisms was carried out, using the 2010 Canterbury Earthquake as well as other recent international events as case studies. The impacts assessed include: timeliness, completeness, environmental, economic and social impacts. Of the case studies investigated, the Canterbury Earthquake was the only disaster response to rely solely on a privatised approach to insurance for debris management. Due to the low level of resident displacement and low level of hazard in the waste, this was a satisfactory approach, though not ideal. This approach has led to greater organisational complexity and delays. For many other events, the potential community wide impacts caused by the prolonged presence of disaster debris means that publicly funded and centrally facilitated programmes appear to be the most common and effective method of managing disaster waste.
The timeliness and quality of recovery activities are impacted by the organisation and human resourcing of the physical works. This research addresses the suitability of different resourcing strategies on post-disaster demolition and debris management programmes. This qualitative analysis primarily draws on five international case studies including 2010 Canterbury earthquake, 2009 L’Aquila earthquake, 2009 Samoan Tsunami, 2009 Victorian Bushfires and 2005 Hurricane Katrina. The implementation strategies are divided into two categories: collectively and individually facilitated works. The impacts of the implementation strategies chosen are assessed for all disaster waste management activities including demolition, waste collection, transportation, treatment and waste disposal. The impacts assessed include: timeliness, completeness of projects; and environmental, economic and social impacts. Generally, the case studies demonstrate that detritus waste removal and debris from major repair work is managed at an individual property level. Debris collection, demolition and disposal are generally and most effectively carried out as a collective activity. However, implementation strategies are affected by contextual factors (such as funding and legal constraints) and the nature of the disaster waste (degree of hazardous waste, geographical spread of waste etc.) and need to be designed accordingly. Community involvement in recovery activities such as demolition and debris removal is shown to contribute positively to psychosocial recovery.
One of the great challenges facing human systems today is how to prepare for, manage, and adapt successfully to the profound and rapid changes wreaked by disasters. Wellington, New Zealand, is a capital city at significant risk of devastating earthquake and tsunami, potentially requiring mass evacuations with little or short notice. Subsequent hardship and suffering due to widespread property damage and infrastructure failure could cause large areas of the Wellington Region to become uninhabitable for weeks to months. Previous research has shown that positive health and well-being are associated with disaster-resilient outcomes. Preventing adverse outcomes before disaster strikes, through developing strengths-based skill sets in health-protective attitudes and behaviours, is increasingly advocated in disaster research, practise, and management. This study hypothesised that well-being constructs involving an affective heuristic play vital roles in pathways to resilience as proximal determinants of health-protective behaviours. Specifically, this study examined the importance of health-related quality of life and subjective well-being in motivating evacuation preparedness, measured in a community sample (n=695) drawn from the general adult population of Wellington’s isolated eastern suburbs. Using a quantitative epidemiological approach, the study measured the prevalence of key quality of life indicators (physical and mental health, emotional well-being or “Sense of Coherence”, spiritual well-being, social well-being, and life satisfaction) using validated psychometric scales; analysed the strengths of association between these indicators and the level of evacuation preparedness at categorical and continuous levels of measurement; and tested the predictive power of the model to explain the variance in evacuation preparedness activity. This is the first study known to examine multi-dimensional positive health and global well-being as resilient processes for engaging in evacuation preparedness behaviour. A cross-sectional study design and quantitative survey were used to collect self-report data on the study variables; a postal questionnaire was fielded between November 2008 and March 2009 to a sampling frame developed through multi-stage cluster randomisation. The survey response rate was 28.5%, yielding a margin of error of +/- 3.8% with 95% confidence and 80% statistical power to detect a true correlation coefficient of 0.11 or greater. In addition to the primary study variables, data were collected on demographic and ancillary variables relating to contextual factors in the physical environment (risk perception of physical and personal vulnerability to disaster) and the social environment (through the construct of self-determination), and other measures of disaster preparedness. These data are reserved for future analyses. Results of correlational and regression analyses for the primary study variables show that Wellingtonians are highly individualistic in how their well-being influences their preparedness, and a majority are taking inadequate action to build their resilience to future disaster from earthquake- or tsunami-triggered evacuation. At a population level, the conceptual multi-dimensional model of health-related quality of life and global well-being tested in this study shows a positive association with evacuation preparedness at statistically significant levels. However, it must be emphasised that the strength of this relationship is weak, accounting for only 5-7% of the variability in evacuation preparedness. No single dimension of health-related quality of life or well-being stands out as a strong predictor of preparedness. The strongest associations for preparedness are in a positive direction for spiritual well-being, emotional well-being, and life satisfaction; all involve a sense of existential meaningfulness. Spiritual well-being is the only quality of life variable making a statistically significant unique contribution to explaining the variance observed in the regression models. Physical health status is weakly associated with preparedness in a negative direction at a continuous level of measurement. No association was found at statistically significant levels for mental health status and social well-being. These findings indicate that engaging in evacuation preparedness is a very complex, holistic, yet individualised decision-making process, and likely involves highly subjective considerations for what is personally relevant. Gender is not a factor. Those 18-24 years of age are least likely to prepare and evacuation preparedness increases with age. Multidimensional health and global well-being are important constructs to consider in disaster resilience for both pre-event and post-event timeframes. This work indicates a need for promoting self-management of risk and building resilience by incorporating a sense of personal meaning and importance into preparedness actions, and for future research into further understanding preparedness motivations.
