The impact of disasters: long term effects on health

摘要

Disasters occur more often since the world gets overpopulated, air traffic is busier, terrorists are operating worldwide and therefore, risks are increasing. According to the Federal Emergency Management Agency major disasters in the USA have been increasing in frequency, from fewer than 25 per year in the 1980s to more than 40 per year in the 90s (Washington, 1998).Disasters have happened throughout history. But the reaction to these events has varied according to the mood that prevailed in society at the time. As Frank Furedi stated (2002): "Many of our fears are not based on personal experiences. Despite an unprecedented level of personal security, fear has become an ever-expanding part of our life. Western societies are increasingly dominated by a culture of fear". Characteristic of trauma after a disaster is a perceived loss of control. The accustomed sense of security has vanished; the victim fears being struck by a new calamity.Especially after 9-11 there is a lot of attention to the aftermath of disasters, to post-traumatic stress (disorders), medically unexplained physical symptoms (MUPS) and functional somatic syndromes (FSS). However, there is not much long-term research on this phenomena (with a few exceptions like Three Mile Island (Cleary & Houts, 1984; Prince-Embury & Rooney, 1989; Dew & Bromet, 1993), which was only a disaster because residents thought it was, and the Gulf war (Rook & Zumla 1997; Straus, 1999; Unwin et al, 1999; Ismail et al., 1999; Haley, 1997; Haley & Kurt, 1997; Haley et al., 1997; Wegman et al., 1997; Holmes et al., 1998; The Iowa Persian Gulf Study group, 1997; Southwick et al. 1993 and 1995)). For that reason we use in this chapter the Amsterdam air disaster as a 'casus belli'. For public health and for the authorities there are lessons to be learned, in the absence of a protocol for dealing with disasters, and in the lack of experience in dealing with man-made disasters.We pay attention to the role of the media in the aftermath of disaster as well: "The ironic thingabout the seemingly endless coverage of the 1986 Chernobyl accident - and the relatively harmless, because much diluted, radiation that then blew around the world-, is that, with few exceptions, the media have done more injury to the truth than was ever done by cover-up or whitewash. Television is the worst offender because the visual impact is unforgettable and any reasonable sense of proportion goes out of the window..." (Bre-win, 1994). Earlier research showed the impact of media on consultation frequency in general practice (Elie, 1992; Poets et al., 1993).