The 22nd February 2011, Mw 6.3 Christchurch earthquake in New Zealand caused major damage to critical infrastructure, including the healthcare system. The Natural Hazard Platform of NZ funded a short-term project called “Hospital Functions and Services” to support the Canterbury District Health Board’s (CDHB) efforts in capturing standardized data that describe the effects of the earthquake on the Canterbury region’s main hospital system. The project utilised a survey tool originally developed by researchers at Johns Hopkins University (JHU) to assess the loss of function of hospitals in the Maule and Bío-Bío regions following the 27th February 2010, Mw 8.8 Maule earthquake in Chile. This paper describes the application of the JHU tool for surveying the impact of Christchurch earthquake on the CDHB Hospital System, including the system’s residual capacity to deliver emergency response and health care. A short summary of the impact of the Christchurch earthquake on other CDHB public and private hospitals is also provided. This study demonstrates that, as was observed in other earthquakes around the world, the effects of damage to non-structural building components, equipment, utility lifelines, and transportation were far more disruptive than the minor structural damage observed in buildings (FEMA 2007). Earthquake related complications with re-supply and other organizational aspects also impacted the emergency response and the healthcare facilities’ residual capacity to deliver services in the short and long terms.
Earthquake events can be sudden, stressful, unpredictable, and uncontrollable events in which an individual’s internal and external assumptions of their environment may be disrupted. A number of studies have found depression, and other psychological symptoms may be common after natural disasters. They have also found an association between depression, losses and disruptions for survivors. The present study compared depression symptoms in two demographically matched communities differentially affected by the Canterbury (New Zealand) earthquakes. Hypotheses were informed by the theory of learned helplessness (Abramson, Seligman & Teasdale, 1978). A door-to-door survey was conducted in a more physically affected community sample (N=67) and a relatively unaffected community sample (N=67), 4 months after the February 2011 earthquake. Participants were again assessed approximately 10 months after the quake. Measures of depression, acute stress, anxiety, aftershock anxiety, losses, physical disruptions and psychological disruptions were taken. In addition, prior psychological symptoms, medication, alcohol and cigarette use were assessed. Participants in the more affected community reported higher depression scores than the less affected community. Overall, elevated depressive score at time 2 were predicted by depression at time 1, acute stress and anxiety symptoms at time 2, physical disruptions following the quake and psychosocial functioning disruptions at time 2. These results suggest the influence of acute stress, anxiety and disruptions in predicting depression sometime after an earthquake. Supportive interventions directed towards depression, and other psychological symptoms, may prove helpful in psychological adjustment following ongoing disruptive stressors and uncontrollable seismic activity.
Following exposure to trauma, stress reactions are initially adaptive. However, some individuals’ psychological response can become maladaptive with long-lasting impairment to functioning. Most people with initial symptoms of stress recover, and thus it is important to distinguish individuals who are at risk of continuing difficulties so that resources are allocated appropriately. Investigations of predictors of PTSD development have largely focused on relational and combat-related trauma, with very limited research looking at natural disasters. This study assessed the nature and severity of psychological difficulties experienced in 101 people seeking treatment following exposure to a significant earthquake that killed 185 people. Peritraumatic dissociation, posttraumatic stress symptoms, symptoms of anxiety, symptoms of depression, and social isolation were assessed. Descriptive analyses revealed the sample to be a highly impaired group, with particularly high levels of posttraumatic stress symptoms. Path analysis was used to determine whether the experience of some psychological difficulties predicted experience of others. As hypothesised, peritraumatic dissociation was found to predict posttraumatic stress symptoms and symptoms of anxiety. Posttraumatic stress symptoms then predicted symptoms of anxiety and symptoms of depression. Depression and anxiety were highly correlated. Contrary to expectations, social isolation was not significantly related to any other psychological variables. These findings justify the provision of psychological support following a natural disaster and suggest the benefit of assessing peritraumatic dissociation and posttraumatic stress symptoms soon after the event to identify people in need of monitoring and intervention.
