Introduction to child health and disaster risk reduction

Editor's Notes

• #3 Facilitator; resource person-child health; disasters; DRR Oxford University; Glasgow University Paediatrics and Public Health
• #4 Why DRR is important The numbers Terms and concepts : group work
• #5 http://www.unisdr.org/archive/26823 News story-update with recent story and quote
• #6 DRR must be embedded within communities so that they can identify their own hazards and understand their options for response and support. Participatory risk assessments and contingency planning should be carried out with the active involvement of children and communities, so that vulnerable people can exercise ownership over their disaster plans and address their real needs and capacities as they see them. The health of a population is not solely dependent on the health sector. It requires multi-sector coordination and the integration of health into the DRR plans of other sectors, including education, water and sanitation, food, livelihoods and agriculture, and urban planning. Health should also be included as an integral component within national disaster risk management and national adaptation policies and plans . Effective coordination mechanisms and monitoring and evaluation of their impact should be established at local and national levels. No single organisation or sector can address every aspect of DRR therefore partnership working with multi-sectoral coordination and synergistic working across sectors is crucial to the success of DRR. We must mainstream DRR in health policies and programmes at national and local levels, while at the same time integrating health into the broader aspects of DRR and climate change adaptation.
• #7 “ Staying Alive and Well” CHILD HEALTH AND DISASTER RISK REDUCTION SCF Policy paper Mar 12 Summary - DRR and Child Health DRR saves lives and can help minimise the impact of disasters on children’s health both in the immediate aftermath of a disaster and in the long term. DRR is the responsibility of all in the health sector – from Ministries of Health to community health workers – they must be empowered and trained to be able to plan, prepare for and respond to disasters. Children are particularly vulnerable to the impact of disasters. They are more at risk of injury and loss of basic care services, and more susceptible to communicable diseases and malnutrition which often occur together. They are also vulnerable to disease, which can lead to a decrease in food consumption leading to more disease and further malnutrition, which can have long lasting impacts for the children’s future. Despite being more vulnerable, children should not be perceived as victims. Children and young people are active participants in a community and it is important that they have the opportunity to participate in DRR activities both before, during and after a disaster (child-centred action) In order for DRR to have an impact on health it must look at increasing the resilience of health systems (primary, secondary and tertiary level). An effective health system that improves a population’s health before a disaster and continues to function following a disaster is one of the most critical elements in making a country resilient to disaster. Proactively investing in the health systems before a disaster is much more efficient than reactively responding to the health problems that a disaster brings. It is also cost effective - $1 spent today on DRR saves $7 tomorrow on recovery and treatment. DRR must be embedded within communities so that they can identify their own hazards and understand their options for response and support. Participatory risk assessments and contingency planning should happen among children and communities, so vulnerable people can exercise ownership over their disaster plans and address their real needs and capacities as they see them. The health of a population is not solely dependent on the health sector. It requires multi-sector coordination and the integration of health into the DRR plans of other sectors including education, water and sanitation, food, livelihoods and agriculture or urban planning. Health should also be included as an integral component within national disaster risk management and national adaptation policies and plans of governments. Effective coordination mechanisms and monitoring and evaluation of its impact should be established at local and national levels.
• #8 “ Staying Alive and Well” CHILD HEALTH AND DISASTER RISK REDUCTION SCF Policy paper Mar 12 Disaster Risk Reduction (DRR) is any activity carried out by a village, community, aid agency or government that helps prepare, mitigate, adapt and increase resilience towards the impact of disasters. DRR saves lives. It can reduce deaths and help minimise the impact of disasters on health. DRR saves lives and can help minimise the impact of disasters on children’s health both in the immediate aftermath of a disaster and in the long term. DRR is the responsibility of all in the health sector – from Ministries of Health to community health workers – they must be empowered and trained to be able to plan, prepare for and respond to disasters. Disaster Risk Reduction (DRR) “ Conceptual framework of elements considered with the possibilities to minimize vulnerabilities and disaster risks throughout a society, to avoid (prevention) or to limit (mitigation and preparedness) the adverse impacts of hazards, within the broad context of sustainable development (Source: International Strategy on Disaster Risk Reduction) Risk Reduction involves measures designed either to prevent hazards from creating risks or to lessen the distribution , intensity or severity of hazards (know as mitigation). It also includes improved preparedness for adverse events. Disaster Risk Reduction is the concept and practice of reducing disaster risk through systematic efforts to analyse and manage the causal factors of disasters, including measures designed to prevent hazards from creating risks or to lessen the distribution, intensity or severity of hazards. Vulnerability reduction of people and property includes wise management of land and the environment, awareness raising, improving health security and improved preparedness for adverse events. Disaster Risk Management: The systematic process of using administrative directives, organization, and operational skills and capacities to implement strategies, policies, and improved coping capacities in order to lessen the adverse impacts of hazards and the possibility of disaster. Extensive Risk: The widespread risk associated with the exposure of dispersed populations to repeated or persistent hazard conditions of low or moderate intensity, often of a highly localized nature, which can lead to debilitating cumulative disaster impacts. Intensive Risk: The risk associated with the exposure of large concentrations of people and economic activities to intense hazard events, which can lead to potentially catastrophic disaster impacts involving high mortality and asset loss. Climate change is a statistically significant change in measurements of either the mean state or the variability of the climate for a place or region over an extended period, either directly or indirectly due to the impact of human activity on the composition of the global atmosphere or due to natural variability. Adaptation (climatic) is adjustment in natural or human systems in response to actual or expected climatic stimuli or their effects, which moderates harm or exploits beneficial opportunities.  
• #9 Child-centered Disaster Risk Reduction “Children and adolescents must not be perceived as mere victims but as effective actors, taking into account their levels of physical, social and emotional development, assessing their capacities and opinions, and promoting spaces and mechanism for their full participation in the whole process of disaster risk reduction” (Source: Save the Children)
• #10 30-50 percent of fatalities arising from natural events are children Disasters often exacerbate the most common causes of childhood mortality worldwide. These include acute respiratory illness, diarrhoea, malaria and measles, malnutrition and neonatal causes. Although the causes of death are the same, , mortality rates for young children can be up to 67 times higher than average during a crisis,. Children are vulnerable but disaster risk reduction can help minimise the risks from hazards Children have a vital role to play when building community resilience and should be involved in planning for, responding to and recovering from natural disasters The combined effects of urbanisation, environmental degradation and climate change means that the number of children affected by disasters is anticipated to rise. Estimates suggest that by 2015, 175 million children will be affected by naturally disasters each year 6 The majority of children surveyed in 21 of the world's most disaster-prone countries feel completely cut off from any information regarding disasters. Since 1989, 63,667 schools were damaged or destroyed in just 19 countries, including 46% in frequently occurring, low-severity extensive disasters. 73,000 kms of roads - almost twice the circumference of the earth - have been damaged or destroyed since 1989 in just 19 countries in Africa, Asia and Latin America. A total of 385 reported natural disasters in 2010 killed more than 297,000 people, affected over 217 million others and caused $123.9 billion of damage. Two mega disasters, the earthquake in Haiti (222,570 deaths) and extreme floods, temperatures and wildfires in Russia (55,800 deaths) made 2010 the deadliest years in at least two decades. The number of people affected by disasters has increased from an average of 100 million in the 1970s to more than 250 million today. This number is likely to increase to 350 million over the next decade. The percentage of the world’s population exposed to malaria, one of the biggest killers of children under the age of five, is expected to increase from 45 per cent to 60 per cent in the next 100 years due to climate change. By 2010, there will be 50 million 'environmentally displaced people', most of whom will be women and children. The number of natural disasters is now four times higher than in the 1970s, and 14 of the 15 flash appeals launched by the UN in 2007 were linked to climate change. While the number of people killed by natural disasters has sharply declined, the global trend towards increasing disasters presents a worrying picture for children’s futures. Disasters multiply and magnify the health risks for children, particularly those under 5 and those from poor households. Disasters disproportionately affect poor people. However there is some good news. The number of disasters reported and the numbers of people affected have risen in recent decades. Conversely, the number of people killed has fallen, as societies and individuals have become more able to protect themselves. Further reinforcing disaster risk reduction, early warning, and health action in emergencies can help to ensure that people are better protected from the increasing hazards and help communities recover faster following a disaster. Public health plays a critical role in this for example with effective disease surveillance and control. Why IFE Matters . www.ennonline.net: Paquet, C. and M. van Soest. Mortality and malnutrition among Rwandan refugees in Zaire. The Lancet, 1994. 344(8925): p. 823
• #17 Exercise 1 What is DRR Stop here and handout exercises to groups. Mix the groups where possible in terms of experiences, sector they work in, gender, if appropriate. Some people may have a lot of experience in DRR-invite them to give a quick overview of the local contextual issues at the feedback session
• #18 Feedback can be flexible; get the participants to ask questions; raise issues etc. Do people want to share their own presentations, stories etc?
• #19 Disaster risk is the probability of harmful consequences of expected losses (deaths injuries, property, livelihood, economic activity disrupted or environment damaged) resulting from interactions between natural or human induced hazards and vulnerabilities. Hazard : The more severe the hazard, and the more likely it is to occur, the greater the risk . Likelihood of loss or injury from hazard depends on exposure Vulnerability : The more vulnerable a community is (the less capacity it has to respond to a crisis) the greater the risk A hazard in itself is not a disaster but if a vulnerable population, with insufficient resilience and coping capacity, is exposed to the hazard it has the potential to cause a disaster. This potential is called disaster risk. Risk is the combination of the probability (or chance) of an event and its negative consequences; it is modified by the level of capacity and resilience of the exposed population. It is often conceptualised by the following function: Disaster risk = Hazard (exposure) x Vulnerability Capacity   Before the 1970s... Disasters are natural disasters (“naturalist” / “physicalist” explanations) 1970s – paradigm shift – enter vulnerability analysis (e.g. At Risk , Wisner et al) disasters socially constructed Disasters = Hazard x Vulnerability 1980s – enter “community”, capability, resilience… (e.g. Rising from the Ashes 1989 Anderson & Woodrow Disasters = Hazard x Vulnerability Capacity 1990s – enter “disaster risk reduction/ management” Disasters = Hazard x Exposure x Vulnerability Capacity 2000s – enter role of culture, innocence and disasters Disasters = Hazard x Exposure x Vulnerability x “Culture” Capacity/Resilience
• #20 Slide from SCF Indonesia A Natural Hazard is a geophysical, atmospheric, biological or hydrological event (e.g. earthquake, landslide, tsunami, windstorm, wave or surge, flood or drought) that has the potential to cause harm or loss. Hazards can also be induced by human processes (environmental degradation and technological hazards). Hazards are diverse in nature, magnitude, intensity, frequency, area of extent, likelihood of occurrence and speed of onset. They can be single or sequential or combined in their origin and effects. “ A hazard is a potentially damaging physical event, natural phenomenon or human activity that may cause the loss of life or injury, property damage, social and economic disruption or environmental degradation (U N ISDR, 2004).” Exposure: The location of people or economic assets in hazard-prone areas. Disaster Risk Reduction deals with hazards defined with the Hyogo framework (hazards of natural origin and related environmental and technological hazards and risks). This does not include conflict. Risk Reduction activities can also be undertaken for the mitigation and prevention of crises caused by conflict and civil unrest. Emergency Preparedness (of which Contingency Planning is a part) is relevant to both conflict and disaster scenarios and often uses a multi hazard approach. “ There is no such thing as a sudden onset disaster – each one has been in preparation for many years already..” James Lewis
• #21 The hazard is natural, but all disasters are socially constructed… Earthquakes do not kill people – buildings do (Terry Cannon) Social construction of different types: social systems lead people to live in dangerous places for different reasons: good place to gain a livelihood choose to live to live there for other benefits forced to live there by economic and/or political processes that reduce people’s choices: class-based exposure to risk combination of some or all these There are three categories of natural hazards: Hydro-meteorological, geological and biological. Hydro-meteorological hazards are natural processes or phenomena of an atmospheric, hydrological or oceanographic nature. Tropical waves and depressions/Tropical Storms/Hurricanes/Storm surges /Torrential rains /Floods/Tsunamis/Droughts Geological hazards are natural earth processes or phenomena that include internal earth processes of tectonic origin as well as external processes such as mass movements. Volcanic eruptions/ Landslides/ Mud flows/Earthquakes
• #22 Main component of risk Vulnerability is the potential to suffer harm or loss, related to the capacity to anticipate a hazard, cope with it, resist it and recover from its impact. Both vulnerability and its antithesis, resilience , are determined by physical, environmental, social, economic, political, cultural and institutional factors. The wide range of variables that determine exposure and susceptibility are related to the determinants of child health that include direct determinants such as underlying health status and age; underlying determinants such as socio-economic and political structural causes which in turn cause intermediate determinants such as household behaviours. Levels of vulnerability and the balance of variables underlying these levels are dynamic and can change over time and activities to reduce vulnerability can take place at all levels: individual; local; national and international. The capacity of children can be strengthened by: Promoting opportunities for children to access and understand information; Raising awareness and educating people to be aware of the needs of children; reducing the gap between vulnerable people and other people, including acting to end discrimination against marginalised people; including a disaster preparedness training in schools and communities. Capacity is often counterposed with vulnerability and is the ability to anticipate, cope with, resist and recover from hazard impacts and like vulnerability depends on the same determinants. It is the combination of all the strengths, attributes and resources that an individual, community or society has available. Increasing the capacity of an individual or community will decrease their vulnerability. There are various aspects of capacity. The capacity to survive and recover in a difficult situation includes skills such as the ability to: Run quickly; Swim quickly; Obtain funds to build a strong house in a safe area; Knowing what to do during a crisis, such as storing belongings in a safe place, keeping food stocks dry, not drinking contaminated water, etc. With proper support, a person’s capacity can be increased and developed. Resilience: The ability of a system, community or society exposed to hazards to resist, absorb, accommodate and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions. Sometimes this is distinguished from capacity by including a favourable institutional environment rather than individual resilience. A disaster is the occurrence of an extreme hazard event that impacts on vulnerable communities, causing substantial damage, disruption and possible casualties, and leaving the affected communities unable to function normally without outside assistance. Disaster risk is the probability of harmful consequences of expected losses (deaths injuries, property, livelihood, economic activity disrupted or environment damaged) resulting from interactions between natural or human induced hazards and vulnerabilities. Disaster Mitigation is any structural (physical) or non-structural (e.g., land-use planning, public education, health education and infection control) measure undertaken to minimise the adverse impact of potential natural hazard events. In the context of climate change, mitigation refers to the reduction of greenhouse gas emissions that are the source of climate change. The potential for confusion has meant that a number of practitioners now prefer to limit the use of the term ‘mitigation’ to the field of climate change. Preparedness means activities and measures taken before hazard events occur to forecast and warn against them, evacuate people and property when they threaten and ensure effective response (e.g., learning what to do when early warning of disaster is given). It is the knowledge and capacities required to effectively anticipate, respond to, and recover from, the impacts of likely, imminent or current hazard events or conditions. Disease surveillance and control measures, pre-positioning of stocks and the provision of support to Ministry of Health in disaster planning are all examples of preparedness. Preparedness requires that emergency plans be developed, personnel at all levels and in all sectors be trained, and communities at risk be educated, and that these measures be monitored and evaluated regularly. Relief, response, rehabilitation and reconstruction are any measures undertaken in the aftermath of a disaster to, respectively, save lives, reduce health impacts and address immediate humanitarian needs; restore normal activities; and restore physical infrastructure and services. Recovery Decisions and actions taken after a disaster with a view to restoring or improving the pre-disaster living conditions of the affected community, while encouraging and facilitating necessary adjustments to reduce disaster risk. Recovery affords an opportunity to develop and apply disaster risk reduction measures. Disaster Risk Reduction is the concept and practice of reducing disaster risk through systematic efforts to analyse and manage the causal factors of disasters, including measures designed to prevent hazards from creating risks or to lessen the distribution, intensity or severity of hazards. Vulnerability reduction of people and property includes wise management of land and the environment, awareness raising, improving health security and improved preparedness for adverse events. Disaster Risk Management: The systematic process of using administrative directives, organization, and operational skills and capacities to implement strategies, policies, and improved coping capacities in order to lessen the adverse impacts of hazards and the possibility of disaster. Extensive Risk: The widespread risk associated with the exposure of dispersed populations to repeated or persistent hazard conditions of low or moderate intensity, often of a highly localized nature, which can lead to debilitating cumulative disaster impacts. Intensive Risk: The risk associated with the exposure of large concentrations of people and economic activities to intense hazard events, which can lead to potentially catastrophic disaster impacts involving high mortality and asset loss. Climate change is a statistically significant change in measurements of either the mean state or the variability of the climate for a place or region over an extended period, either directly or indirectly due to the impact of human activity on the composition of the global atmosphere or due to natural variability. Early Warning is the provision of timely and effective information, through identified institutions, that allows individuals exposed to a hazard to take action to avoid or reduce their risk and prepare for effective response. Early warning systems include a chain of concerns, namely: understanding and mapping the hazard; monitoring and forecasting impending events; processing and disseminating understandable warnings to political authorities and the population; and undertaking appropriate and timely actions in response to the warnings. Hazard analysis is the identification, studies and monitoring of any hazard to determine its potential, origin, characteristics and behaviour. Risk assessment/analysis is a methodology to determine the nature and extent of risk by analyzing potential hazards and evaluating existing conditions of vulnerability that could pose a potential threat or harm to people, property, livelihoods and the environment on which they depend. The process of conducting a risk assessment is based on a review of both the technical features of hazards such as their location, intensity, frequency and probability; and also the analysis of the physical, social, economic and environmental dimensions of vulnerability and exposure, while taking particular account of the coping capabilities pertinent to the risk scenarios. Adaptation (climatic) is adjustment in natural or human systems in response to actual or expected climatic stimuli or their effects, which moderates harm or exploits beneficial opportunities.  
• #23 The wide range of variables that determine exposure and susceptibility are related to the determinants of child health that include direct determinants such as underlying health status and age; underlying determinants such as socio-economic and political structural causes which in turn cause intermediate determinants such as household behaviours. Levels of vulnerability and the balance of variables underlying these levels are dynamic and can change over time and activities to reduce vulnerability can take place at all levels: individual; local; national and international. The capacity of children can be strengthened by: Promoting opportunities for children to access and understand information; Raising awareness and educating people to be aware of the needs of children; reducing the gap between vulnerable people and other people, including acting to end discrimination against marginalised people; including a disaster preparedness training in schools and communities. Capacity is often counterposed with vulnerability and is the ability to anticipate, cope with, resist and recover from hazard impacts and like vulnerability depends on the same determinants. It is the combination of all the strengths, attributes and resources that an individual, community or society has available. Increasing the capacity of an individual or community will decrease their vulnerability. There are various aspects of capacity. The capacity to survive and recover in a difficult situation includes skills such as the ability to: Run quickly; Swim quickly; Obtain funds to build a strong house in a safe area; Knowing what to do during a crisis, such as storing belongings in a safe place, keeping food stocks dry, not drinking contaminated water, etc. With proper support, a person’s capacity can be increased and developed. Resilience: The ability of a system, community or society exposed to hazards to resist, absorb, accommodate and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions. Sometimes this is distinguished from capacity by including a favourable institutional environment rather than individual resilience. Early warning and preparedness can help to evacuate people in the case of a cyclone. But housing, schools and infrastructure cannot be evacuated and, if not structurally resistant, they are damaged or destroyed. (GAR 2009)
• #25 Capacity is often counterposed with vulnerability and is the ability to anticipate, cope with, resist and recover from hazard impacts and like vulnerability depends on the same determinants. It is the combination of all the strengths, attributes and resources that an individual, community or society has available. Increasing the capacity of an individual or community will decrease their vulnerability. There are various aspects of capacity. The capacity to survive and recover in a difficult situation includes skills such as the ability to: Run quickly; Swim quickly; Obtain funds to build a strong house in a safe area; Knowing what to do during a crisis, such as storing belongings in a safe place, keeping food stocks dry, not drinking contaminated water, etc. With proper support, a person’s capacity can be increased and developed. Increasing the capacity of an individual or community will decrease their vulnerability.
• #26 Vulnerability is the potential to suffer harm or loss, related to the capacity to anticipate a hazard, cope with it, resist it and recover from its impact. Both vulnerability and its antithesis, resilience , are determined by physical, environmental, social, economic, political, cultural and institutional factors. The wide range of variables that determine exposure and susceptibility are related to the determinants of child health that include direct determinants such as underlying health status and age; underlying determinants such as socio-economic and political structural causes which in turn cause intermediate determinants such as household behaviours. Levels of vulnerability and the balance of variables underlying these levels are dynamic and can change over time and activities to reduce vulnerability can take place at all levels: individual; local; national and international. The capacity of children can be strengthened by: Promoting opportunities for children to access and understand information; Raising awareness and educating people to be aware of the needs of children; reducing the gap between vulnerable people and other people, including acting to end discrimination against marginalised people; including a disaster preparedness training in schools and communities.
• #27 A disaster is the occurrence of an extreme hazard event that impacts on vulnerable communities, causing substantial damage, disruption and possible casualties, and leaving the affected communities unable to function normally without outside assistance. Disaster Mitigation is any structural (physical) or non-structural (e.g., land-use planning, public education, health education and infection control) measure undertaken to minimise the adverse impact of potential natural hazard events. In the context of climate change, mitigation refers to the reduction of greenhouse gas emissions that are the source of climate change. The potential for confusion has meant that a number of practitioners now prefer to limit the use of the term ‘mitigation’ to the field of climate change. Preparedness means activities and measures taken before hazard events occur to forecast and warn against them, evacuate people and property when they threaten and ensure effective response (e.g., learning what to do when early warning of disaster is given). It is the knowledge and capacities required to effectively anticipate, respond to, and recover from, the impacts of likely, imminent or current hazard events or conditions. Disease surveillance and control measures, pre-positioning of stocks and the provision of support to Ministry of Health in disaster planning are all examples of preparedness. Preparedness requires that emergency plans be developed, personnel at all levels and in all sectors be trained, and communities at risk be educated, and that these measures be monitored and evaluated regularly. Relief, response, rehabilitation and reconstruction are any measures undertaken in the aftermath of a disaster to, respectively, save lives, reduce health impacts and address immediate humanitarian needs; restore normal activities; and restore physical infrastructure and services. Recovery Decisions and actions taken after a disaster with a view to restoring or improving the pre-disaster living conditions of the affected community, while encouraging and facilitating necessary adjustments to reduce disaster risk. Recovery affords an opportunity to develop and apply disaster risk reduction measures.
• #30 Child friendly Flood Space SC India
• #31 “ Staying Alive and Well” CHILD HEALTH AND DISASTER RISK REDUCTION SCF Policy paper Mar 12 Examples of this can be early warning systems that allow governments and communities to prepare in advance of a hurricane or drought or how identifying potential hazards allows hospitals and health facilities to be built to withstand them, allowing people to access healthcare in the aftermath of a disaster. In order for DRR to have an impact on health it must look at increasing the resilience of health systems (primary, secondary and tertiary level). An effective health system that improves a population’s health before a disaster and continues to function following a disaster is one of the most critical elements in making a country resilient to disaster. Proactively investing in the health systems before a disaster is much more efficient than reactively responding to the health problems that a disaster brings. It is also cost effective - $1 spent today on DRR saves $7 tomorrow on recovery and treatment. Whilst we know and recognise the importance of DRR, hazards such as floods, cyclones and droughts continue to have significant impacts on health. There is a significant possibility that these impacts will increase with factors including climate change and urbanisation. Climate change/conflict/cities/cash....
• #33 Disaster risk is the probability of harmful consequences of expected losses (deaths injuries, property, livelihood, economic activity disrupted or environment damaged) resulting from interactions between natural or human induced hazards and vulnerabilities. Hazard : The more severe the hazard, and the more likely it is to occur, the greater the risk . Likelihood of loss or injury from hazard depends on exposure Vulnerability : The more vulnerable a community is (the less capacity it has to respond to a crisis) the greater the risk A hazard in itself is not a disaster but if a vulnerable population, with insufficient resilience and coping capacity, is exposed to the hazard it has the potential to cause a disaster. This potential is called disaster risk. Risk is the combination of the probability (or chance) of an event and its negative consequences; it is modified by the level of capacity and resilience of the exposed population. It is often conceptualised by the following function: Disaster risk = Hazard (exposure) x Vulnerability Capacity   Before the 1970s... Disasters are natural disasters (“naturalist” / “physicalist” explanations) 1970s – paradigm shift – enter vulnerability analysis (e.g. At Risk , Wisner et al) disasters socially constructed Disasters = Hazard x Vulnerability 1980s – enter “community”, capability, resilience… (e.g. Rising from the Ashes 1989 Anderson & Woodrow Disasters = Hazard x Vulnerability Capacity 1990s – enter “disaster risk reduction/ management” Disasters = Hazard x Exposure x Vulnerability Capacity 2000s – enter role of culture, innocence and disasters Disasters = Hazard x Exposure x Vulnerability x “Culture” Capacity/Resilience