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Audio, Radio New Zealand

When the 2011 Canterbury earthquakes struck, the region was hit with disaster on an unprecedented scale and the health system was challenged like never before. The injured needed immediate treatment, buildings and equipment were badly damaged, and yet those working in health system rallied to keep it going. Emergency Medicine specialist Dr Mike Ardagh and independent science writer Dr Joanne Deely have written a book, Rising from the Rubble, which tells the stories of those who were part of the health system response, and a record of the long-term issues that have been caused by it.

Images, UC QuakeStudies

A photograph of Erica Duthie and Struan Ashby from Tape Art NZ leading a workshop for Skillwise at St Mary's School. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of Erica Duthie from Tape Art NZ blowing bubbles in front of the 'bubble maker' artwork section of the mural. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of the tape art mural. To the side Erica Duthie from Tape Art NZ is standing with other tape artists. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of Erica Duthie and Struan Ashby from Tape Art NZ leading a workshop for Skillwise at St Mary's School. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A close-up photograph of Erica Duthie from Tape Art NZ creating a mural during a workshop for Skillwise held at St Mary's School. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of Struan Ashby from Tape Art NZ turning the tape art creation of St Mary's School pupils into bubbles. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of a tape artist standing in front of the large tape art mural. Struan Ashby from Tape Art NZ stands at right of frame. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of tape artists with their creations - tape art bubbles for the mural. Struan Ashby from Tape Art NZ is in the background creating tape art bubbles. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of Erica Duthie from Tape Art NZ blowing bubbles in front of the 'bubble maker' artwork section of the mural. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of Erica Duthie from Tape Art NZ blowing bubbles in front of the 'bubble maker' artwork section of the mural. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of the tape art mural. To the side Erica Duthie from Tape Art NZ is standing with other tape artists. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A photograph of Struan Ashby from Tape Art NZ assisting tape artists from Skillwise during a workshop held at St Mary's School. The photograph was taken at Street Talk, a Tape Art residency held from 6 - 9 March 2014. Street Talk was a collaborative project between All Right?, Healthy Christchurch and Tape Art NZ that had Christchurch communities create large tape art murals on the south wall of Community and Public Health.

Images, UC QuakeStudies

A notice nailed to a tree near the river reads, "Health warning, contaminated water. Due to sewage overflows this water is unsafe for human contact and activity and is a public health risk. Please keep all people and pets out of contact with the water and do not consume any seafood or shellfish collected from this area".

Videos, UC QuakeStudies

A video of a presentation by David Meates, Chief Executive of the Christchurch District Health Board and the West Coast District Health Board, during the first plenary of the 2016 People in Disasters Conference. The presentation is titled, "Local System Perspective".The abstract for this presentation reads as follows: The devastating Canterbury earthquakes of 2010 and 2011 have resulted in challenges for the people of Canterbury and have altered the population's health needs. In the wake of New Zealand's largest natural disaster, the health system needed to respond rapidly to changing needs and damaged infrastructure in the short-term in the context of developing sustainable long-term solutions. Canterbury was undergoing system transformation prior to the quakes, however the horizon of transformation was brought forward post-quake: 'Vision 2020' became the vision for now. Innovation was enabled as people working across the system addressed new constraints such as the loss of 106 acute hospital beds, 635 aged residential care beds, the loss of general practices and pharmacies as well as damaged non-government organisation sector. A number of new integration initiatives (e.g. a shared electronic health record system, community rehabilitation for older people, community falls prevention) and expansion of existing programs (e.g. acute demand management) were focused on supporting people to stay well in their homes and communities. The system working together in an integrated way has resulted in significant reductions in acute health service utilisation in Canterbury. Acute admission rates have not increased and remain significantly below national rates and the number of acute and rehabilitation bed days have fallen since the quakes, with these trends most evident among older people. However, health needs frequently reported in post-disaster literature have created greater pressures on the system. In particular, an escalating number of people facing mental health problems and coping with acute needs of the migrant rebuild population provide new challenges for a workforce also affected by the quakes. The recovery journey for Canterbury is not over.