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.
Sewerage systems convey sewage, or wastewater, from residential or commercial buildings through complex reticulation networks to treatment plants. During seismic events both transient ground motion and permanent ground deformation can induce physical damage to sewerage system components, limiting or impeding the operability of the whole system. The malfunction of municipal sewerage systems can result in the pollution of nearby waterways through discharge of untreated sewage, pose a public health threat by preventing the use of appropriate sanitation facilities, and cause serious inconvenience for rescuers and residents. Christchurch, the second largest city in New Zealand, was seriously affected by the Canterbury Earthquake Sequence (CES) in 2010-2011. The CES imposed widespread damage to the Christchurch sewerage system (CSS), causing a significant loss of functionality and serviceability to the system. The Christchurch City Council (CCC) relied heavily on temporary sewerage services for several months following the CES. The temporary services were supported by use of chemical and portable toilets to supplement the damaged wastewater system. The rebuild delivery agency -Stronger Christchurch Infrastructure Rebuild Team (SCIRT) was created to be responsible for repair of 85 % of the damaged horizontal infrastructure (i.e., water, wastewater, stormwater systems, and roads) in Christchurch. Numerous initiatives to create platforms/tools aiming to, on the one hand, support the understanding, management and mitigation of seismic risk for infrastructure prior to disasters, and on the other hand, to support the decision-making for post-disaster reconstruction and recovery, have been promoted worldwide. Despite this, the CES in New Zealand highlighted that none of the existing platforms/tools are either accessible and/or readable or usable by emergency managers and decision makers for restoring the CSS. Furthermore, the majority of existing tools have a sole focus on the engineering perspective, while the holistic process of formulating recovery decisions is based on system-wide approach, where a variety of factors in addition to technical considerations are involved. Lastly, there is a paucity of studies focused on the tools and frameworks for supporting decision-making specifically on sewerage system restoration after earthquakes. This thesis develops a decision support framework for sewerage pipe and system restoration after earthquakes, building on the experience and learning of the organisations involved in recovering the CSS following the CES in 2010-2011. The proposed decision support framework includes three modules: 1) Physical Damage Module (PDM); 2) Functional Impact Module (FIM); 3) Pipeline Restoration Module (PRM). The PDM provides seismic fragility matrices and functions for sewer gravity and pressure pipelines for predicting earthquake-induced physical damage, categorised by pipe materials and liquefaction zones. The FIM demonstrates a set of performance indicators that are categorised in five domains: structural, hydraulic, environmental, social and economic domains. These performance indicators are used to assess loss of wastewater system service and the induced functional impacts in three different phases: emergency response, short-term recovery and long-term restoration. Based on the knowledge of the physical and functional status-quo of the sewerage systems post-earthquake captured through the PDM and FIM, the PRM estimates restoration time of sewer networks by use of restoration models developed using a Random Forest technique and graphically represented in terms of restoration curves. The development of a decision support framework for sewer recovery after earthquakes enables decision makers to assess physical damage, evaluate functional impacts relating to hydraulic, environmental, structural, economic and social contexts, and to predict restoration time of sewerage systems. Furthermore, the decision support framework can be potentially employed to underpin system maintenance and upgrade by guiding system rehabilitation and to monitor system behaviours during business-as-usual time. In conjunction with expert judgement and best practices, this framework can be moreover applied to assist asset managers in targeting the inclusion of system resilience as part of asset maintenance programmes.
Recycling is often employed as part of a disaster waste management system. However, the feasibility, method and effectiveness of recycling varies between disaster events. This qualitative study is based on literature reviews, expert interviews and active participatory research of five international disaster events in developed countries (2009 Victorian Bushfires, Australia; 2009 L’Aquila earthquake, Italy; 2005 Hurricane Katrina, United States; 2010 and 2011 Canterbury earthquakes, New Zealand; 2011 Great East Japan earthquake) to answer three questions: What are the main factors that affect the feasibility of recycling post-disaster? When is on-site or off-site separation more effective? What management approaches improve recycling effectiveness? Seven disaster-specific factors need to be assessed to determine the feasibility of disaster waste recycling programmes: volume of waste; degree of mixing of waste; human and environmental health hazards; areal extent of the waste; community priorities; funding mechanisms; and existing and disaster-specific regulations. The appropriateness of on or off-site waste separation depends on four factors: time constraints; resource availability; degree of mixing of waste and human and public health hazards. Successful recycling programmes require good management including clear and well enforced policies (through good contracts or regulations) and pre-event planning. Further research into post-disaster recycling markets, funding mechanisms and recycling in developing countries is recommended.
A video of a presentation by Dr Erin Smith during the Community Resilience Stream of the 2016 People in Disasters Conference. The presentation is titled, "A Qualitative Study of Paramedic Duty to Treat During Disaster Response".The abstract for this presentation reads as follows: Disasters place unprecedented demands on emergency medical services and test paramedic personal commitment to the health care profession. Despite this challenge, legal guidelines, professional codes of ethics and ambulance service management guidelines are largely silent on the issue of professional obligations during disasters. They provide little to no guidance on what is expected of paramedics or how they ought to approach their duty to treat in the face of risk. This research explores how paramedics view their duty to treat during disasters. Reasons that may limit or override such a duty are examined. Understanding these issues is important in enabling paramedics to make informed and defensible decisions during disasters. The authors employed qualitative methods to gather Australian paramedic perspectives. Participants' views were analysed and organised according to three emerging themes: the scope of individual paramedic obligations, the role and obligations of ambulance services, and the broader ethical context. Our findings suggest that paramedic decisions around duty to treat will largely depend on their individual perception of risk and competing obligations. A reciprocal obligation is expected of paramedic employers. Ambulance services need to provide their employees with the best current information about risks in order to assist paramedics in making defensible decisions in difficult circumstances. Education plays a key role in providing paramedics with an understanding and appreciation of fundamental professional obligations by focusing attention on both the medical and ethical challenges involved with disaster response. Finally, codes of ethics might be useful, but ultimately paramedic decisions around professional obligations will largely depend on their individual risk assessment, perception of risk, and personal value systems.
