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On tsunamis and economies: reflections on public health

By Anthony Shakeshaft - posted Tuesday, 13 May 2008

As far as it has been possible to establish, the 2004 Boxing Day tsunami claimed the lives of an estimated 230,000 people. Although the subsequent outpouring of concern was reassuring from a humanitarian point of view, the real effectiveness of the international community’s response to this disaster remained an open question, until a second major tsunami struck the Indonesian coast-line on July 17, 2006: an earthquake measuring 7.7 on the Richter Scale occurred 100 miles south of Java sending 2-7m waves up to 2km inland.

Although of little reassurance to the families and communities of the estimated 700 people who lost their lives to this second tsunami, it did provide a crucial sounding-board against which to examine the adequacy of the international response to the 2004 Boxing Day tsunami.

The short-term response to the occurrence of any disaster typically involves those relatively unaffected helping those adversely affected. This usually manifests in the form of donations (money, water, food, clothes and so on) and provision of skilled workers to boost local health-care efforts and re-build crucial infrastructure.


Although generous, this assistance was not provided without problems in the aftermath of the 2004 Boxing Day tsunami: money and goods may not have arrived where they were most needed (Meagre food supply stunting tsunami kids. The Sydney Morning Herald, January 30, 2005); and disagreements about how relief efforts ought to be organised and funded arose (Competition swallowing up tsunami aid money in Aceh. The Sydney Morning Herald, March 10, 2005). The principal danger of such short-term efforts, however, is that they become reduced to self-perpetuating repeats of humanitarian relief. If attempts are only ever made to solve immediate problems, then well-intentioned aid efforts inevitably succumb to a cycle of trying to help with one problem, while awaiting the next.

Since tsunamis are not preventable, and the time and location of their occurrence is not predictable with any useful accuracy, the most practical longer-term response is to minimise resultant harm. Early warning systems are one obvious harm minimisation strategy. In June 2006, the UN asserted that that an interim warning system was operational off the Indonesian coast, and although this system was triggered by the July 2006 tsunami, the estimated 700 lives lost indicates that such warnings (PDF 230KB) need to be communicated more efficiently to those most vulnerable.

A second harm minimisation strategy is the construction of built environments designed to withstand assaults far in excess of what might reasonably be expected to occur. New Zealand’s Federal Parliament House in Wellington, for example, is state-of-the-art earthquake resistant, using rubber and lead piers to separate the concrete beams of the building from the foundations, to minimise structural damage should the foundations move.

Given the technology for early warning systems and disaster-resistant built environments exists, and is most likely utilised by countries able to afford its additional cost, it might be expected that fewer deaths are associated with disasters that have impacted on economically developed countries. Even a cursory glance at a relatively recent history of earthquakes suggests this is the case.

On October 17, 1989, an earthquake measuring 7.1 on the Richter Scale struck San Francisco, followed by a 5.2 aftershock 37 minutes later, killing 62 people. On January 17, 1994, an earthquake measuring 6.6 hit Los Angeles, taking 60 lives. Exactly one year later, January 17, 1995, an earthquake measuring 7.2 struck Kobe in Japan, killing 6,432 people, while on September 26, 1997, an earthquake measuring 5.6 struck central Italy, killing 10 people.

In contrast, an earthquake measuring 6.1 on the Richter Scale struck Rostaq, Afghanistan on February 4, 1998, killing more than 4,000 people. On August 17, 1999, an earthquake measuring 6.7 in Izmit, Turkey, killed more than 17,000 people, while on December 26, 2003, an earthquake measuring 6.6 in Bam, Iran took approximately 26,271 lives. Finally, of course, the December 26, 2004 earthquake, which measured 9.0 and caused the tsunami, resulted in an estimated 230,000 deaths.


What do these figures indicate (other than that we ought to be very nervous on the days of the 17th and the 26th)? It is reasonably clear that the closer the earthquake’s epicentre is to populated regions, the closer the fault line is to the city, and the greater the population density, the greater will be the number of lives lost.

These factors would explain the discrepancy in the number of deaths in Japan, compared to the US and Italy: Kobe had a higher population density and the city itself was directly ruptured by the fault-line. However, these factors alone do not adequately account for the data. Los Angeles and San Francisco, in particular, would have had reasonably high populations and population densities at the time of their earthquakes and yet the number of lives lost in those cities was relatively small. In contrast, the earthquakes in Izmit and Bam claimed relatively high numbers of lives, despite those cities having relatively small populations of approximately 225,000.

Aggregating these earthquake data presents us with an emerging pattern that more adequately describes the relationship between the occurrence of an earthquake and the resultant number of lives lost. Earthquakes that have caused damage to developed countries have averaged a magnitude of 6.6 (excluding the San Francisco aftershock) and claimed 6,564 lives (or if the obviously more extreme case of Japan is removed, an average shock of magnitude 6.4, claiming 132 lives).

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Acknowledgements: Mr Stuart Gilmour (Statistician, University of NSW) produced the graphic. He, along with Associate Professor James C. Frankish (Assistant Director, Institute for Health Promotion Research, University of British Columbia, Canada) and Associate Professor Christopher Doran (NDARC, University of NSW) provided valuable improvements to the essay.

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About the Author

Dr Anthony Shakeshaft is a Senior Research Fellow at the National Drug and Alcohol Research Centre, School of Public Health and Community Medicine, University of NSW. He has been working in the field of public health research for over 10 years, addressing a wide range of issues from drug and alcohol problems to evidenced-based health care in public hospitals in Sydney, Australia. He has been a Visiting Fellow at the universities of London, Vancouver, Verona and Nijmegen. He has authored numerous scientific papers, published in peer-reviewed literature.

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