The sanitary revolution: a paradigm for disaster mitigation

MITIGATION

Mitigation means taking actions to reduce the effects of a hazard before it occurs. The term mitigation applies to a wide range of activities and protection measures that might be instigated, from the physical, like constructing stronger buildings, to the procedural, like standard techniques for incorporating hazard assessment in land-use planning.

The 1990s will be a decade of major effort to encourage the implementation of disaster mitigation techniques in development projects around the world. The United Nations has adopted the decade of the 1990s as the International Decade for Natural Disaster Reduction. The aim is to achieve a significant reduction in the loss of life and material damage caused by disasters by the end of the decade. DHA and UNDP will play a central role in encouraging national governments and non-governmental agencies to tackle disaster related issues through projects focused directly on reducing the impacts of hazards and through incorporation of risk awareness as part of the normal operations of development projects.

A useful analogy with the recently developing science of disaster mitigation is the implementation of public health measures that began in the mid 19th century. Before that time tuberculosis, typhoid, cholera, dysentery, smallpox and many other diseases were major causes of death and tended to assume epidemic proportions as the industrial development of cities fuelled increasing concentrations of population. These diseases had a major effect on life expectancy at the time and yet were regarded as just part of the everyday risks of living. The apparent randomness with which the diseases struck and the unpredictability of epidemics meant that superstition, mythology and a certain amount of fatalism was the only public response to the hazards: the high risk of disease was generally accepted because there was little alternative.

Jan/Feb 1990

As the understanding of what caused diseases increased, chiefly through the efforts of scientists and epidemiologists in the 19th century, so the incidence of epidemics and illnesses generally became demystified. It became evident that disease was preventable and gradually the concept of public protection against disease became accepted.

It became evident that sanitation, purification of the water supply, garbage disposal and public hygiene were key issues for public health. The measures necessary to reduce the risk of disease were expensive - massive investment in infrastructure was needed to build sewers and clean water supply networks - and required major changes in public practices and attitudes. Social historians refer to this as the 'Sanitary Revolution'. Garbage collection and disposal had to be organized. It became socially unacceptable to throw garbage or to dispose of sewage in the streets. Personal hygiene, washing and individual sanitation practices became important. Initially encouraged by public awareness campaigns, they gradually became part of the social norms and were taught by parents to their children. Attitudes changed from the previous fatalism about disease to a public health 'safety culture', where everyone participated in reducing the risk of communal disease.

"Father Thames Introducing His Offspring to the Fair City of London" from Punch, 1858.

The "children" are named Diptheria, Scrofula and Cholera.

Public health advances went hand-in-hand with public medicine, medical care, vaccination, preventive health care and a health industry that in most developed countries today consumes a very significant proportion of national economic production. Today public epidemics are unacceptable. High levels of risk from disease are not tolerated and outbreaks of disease are followed by outbursts of public opinion demanding medical and government response to protect them. Everyone now considers it normal to participate in their own protection against health hazards and accepts the high levels of cost involved in society's battle against disease. The level of risk from public health hazards that is judged acceptable by modern society is far lower than it was three or four generations ago.

Disasters today are seen in much the same way as disease was in the early 19th century: unpredictable, unlucky and part of the everyday risk of living. Concentrations of people and rising population levels across the globe are increasing the risk of disasters and multiplying the consequences of natural hazards when they occur. However, the 'epidemiology' of disasters - the systematic science of what happens in a disaster - shows that disasters are largely preventable. There are many ways to reduce the impact of a disaster and to mitigate the effects of a possible hazard or accident.

Just like the fight against disease, the fight against disasters has to be fought by everyone together and involves public and private sector investment, changes in social attitudes and improvements in the practices of individuals. Just as the Sanitary Revolution occurred with the development of a 'safety culture' for public health, so disaster mitigation has to develop through the evolution of an equivalent 'safety culture' for public safety. Governments can use public investment to make stronger infrastructure and a physical environment where a disaster is less likely to occur, but individuals also have to act to protect themselves. Just as public health depends on personal hygiene, so public protection depends on personal safety. The type of cooking stove an individual uses, and an awareness that a sudden earthquake could tip it over is more important in reducing the risk of conflagration than the community maintaining a large fire brigade. The type of house an individual builds and the sites that each individual considers a suitable place to live affects the potential for disaster in a community more than large engineering projects to reduce flood risk or landslide stabilization or sophisticated typhoon warning systems.

The science of disasters is in a similar state of development to that of epidemiology in the latter half of the 19th century: the causes, mechanisms and processes of disasters are becoming understood rapidly. As a result of this understanding, the more developed countries have begun to implement individual measures to reduce the risk of future disasters. A catalogue of techniques are known for disaster mitigation, and their relevance to the countries that need them most is now clear.

Disasters are very largely a developmental issue. The great majority of casualties and disaster effects are suffered in developing countries. Development achievements can be wiped out by a major disaster and economic growth reversed. The promotion of disaster mitigation in the projects and planning activities of development protects development achievement and assists populations in protecting themselves against needless injury.

Q. Do you agree with the "Sanitary Revolution" analogy presented here as a parallel to modern day disaster mitigation programs? If so, what are the parallels, and if not, what are the differences?

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