Tsunami: Tragedy as a Teacher

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Tragedies are great teachers, but unfortunately too many people draw the wrong lessons from them. Not too long ago, major tragedies were interpreted as some form of divine retribution for our sins. Now, geology (plate tectonics and volcanology), meteorology, other sciences offer hope for preventative and ameliorative actions.

A tragedy of the magnitude of the Indian Ocean tsunami brings out the best and the worst in the twenty-four-hour TV news cycle, the Internet, and massive print coverage. There is now room for interviews with experts on every aspect of the issue -- its causes, likely short- and long-term consequences, and the most effective means of delivering assistance. With the seemingly wall-to-wall coverage, we will inevitably hear from those who, like the doomsday theologians of earlier times, blame human action and modern life in general for the calamity or the magnitude of its impact. Had we only heeded the warnings of the environmental ideologues and other prophets of doom, tragedies of this magnitude could have been avoided, they say. One true believer went so far as deny the tsunami tragedy was a "natural" disaster and likened it to a "plastic Christmas tree."

The Magnitude of the Disaster and the Risks of Low-Tech Living

It is true that environmental mismanagement can be a factor in a disaster, as when a flood is worsened by rampant deforestation in the watershed, as has occurred in China. (Anyone watching TV in China today knows that the authorities are well aware of the problem as there are many programs discussing reforestation projects.)

But no amount of romantic "living in harmony with Nature" would have provided protection to the victims of this tsunami. Contrary to popular opinion, science, technology, and modern life in general provide an enormous amount of protection from the worst hazards of nature, protection that we too often take for granted. For the better part of the past century, people in poor countries had roughly ten times the likelihood of dying in a natural disaster as those in developed countries such as the United States. In an extreme case, the ratio was a hundred to one, as in Bangladesh in the third quarter of last century, with a mortality rate from natural disasters of one in ten thousand compared to one in a million in the United States. And these differences do not capture the many other benefits of science, technology, and development -- such as day-to-day protection from disease, escape from extremes of heat and cold, and improved nutrition -- the causal factors for dramatic increases in life expectancies.

It is clearly true that if a tsunami of this magnitude had struck thirty to forty years ago, the initial death toll would have been far less for the simple reason that the overall population was about half of what it is today and many of the tourist areas had yet to be developed. (For the record, these countries have programs that have brought down their fertility and population growth rates.) My work as a development economist, both as a practitioner in the field and as lecturer, has taken me to the areas of South and Southeast Asia that were hardest hit -- Sri Lanka, Tamil Nadu in India, Bangladesh, Burma, Sumatra in Indonesia, Thailand, and Malaysia (as well as the East African coast). I frequently have meetings on an island south of Phuket. These are incredibly beautiful areas, and it is understandable that tourists would flock to them for a "dream vacation."

There was simply no reason not to develop them as tourist areas, nor is there any reason not to redevelop them for the same purpose, though prudence suggests the creation of a tsunami early warning system. Remember, this was a relatively unique event for the region -- the last strong tsunami there was over 170 years ago. Even so, it is likely we will now see the creation of the same kind of seismic and satellite warning systems and other protective measures that now exist in the Pacific Ocean region. An array of technologies combine with scientific knowledge of deep-ocean energy flows and surface wave actions to warn us of an emerging tsunami.

As for the indigenous population growth, the sole cause of the rapid growth in population was rapidly falling death rates -- that is, not because people were having more children but because more of the children that they had survived to become adults. Only the most mean-spirited population catastrophist could fault them for being successful in reducing infant and child deaths and overall mortality.

Still, some misanthropes will say it was hubris to live and vacation in the area. Similarly, most of us would not homestead at the base of an active volcano, but there are those with little or no choice. We have to live somewhere and occasionally have to travel to other places. Every place carries some potential danger that puts us in harm's way. The New York Times Week in Review (January 2, 2005) had side-by-side articles, one of which ("The Future of Calamity") attributed a rise in "natural calamities" to "where people live." Next to it was an article ("How Nature Changes History") on the many historical instances of past civilizations being devastated or destroyed by such calamities, while inside there was a series of maps showing danger zones of different kinds that seem to put most of the world's population at risk.

But note: in terms of numbers of lives lost, the top five worst droughts were all before 1943, and the top seven worst floods and worst earthquakes were all before 1950. Or stated differently: of the thirty worst tragedies (ten in each of the categories just mentioned), only three were after 1980. The five worst tragedies claimed over a million lives each (totaling over 12.5 million lives lost) and all were before 1960, even though the world's population was smaller and one might intuitively have expected smaller casualty counts. Whether the editor was deliberately giving the reader contrasting views or was oblivious to the apparent contradiction is an open question.

The Benefits of Science and Development: Lives Saved

Modern protection from natural disasters can best be understood in the context of the overall life-giving benefits of science, technology, and economic development. In 1950, there were about 2.5 billion humans on this planet, and around 50 million died each year. Interestingly, this latter number remained fairly constant over the next thirty-five years even as population doubled. Today the number dying each year is between 57 and 58 million -- with many of those whose lives were earlier saved now reaching advanced years. The world's population is now 6.4 billion, slightly better than two and one-half times that of 1950. What this means is that each year over the last half-century or so, over one million additional people were kept alive relative to the previous year. If 1950 death rates were still suffered by today's population, the number dying each year would be about 125 million -- 65 to 68 million more deaths, of which 20 to 25 million of the additional deaths would be infants and children.

Economic development is the best defense against death and natural disasters. After every major tragedy, those societies that can afford it institute major changes, from funding more research on prevention to improving building standards for protection against fire or collapse. As people build on hillsides and in forests in the United States, mudslides and forest fires are causing increasing property damage -- but little loss of life. The losses are substantial to those concerned but are minuscule in terms of the total economy. There are concerns, possibly legitimate, that evacuation during a major hurricane in some U.S. coastal areas, even with considerable warning, might be stymied by clogged roads. Nevertheless, major earthquakes and hurricanes in the United States normally have a death toll of well under 100, while earthquakes and storms of comparable magnitude hitting our neighbors to the south or in other developing areas too often have deaths in the tens of thousands.

We should continue to research and debate ways to minimize the impact of potentially harmful natural phenomenon, but tragedies like the tsunami should not inspire calls to be more "in harmony" with nature. And protective actions should not be taken at the expense of economic development.

How Not to Do Post-Disaster Intervention

Over the last thirty years, we have learned a lot about what to do and not do in post-disaster intervention. There are cases where relief aid may have actually made the situation worse rather than better. Two mid-1970s summer earthquakes in Central America did little damage to the crops in the field. Yet food aid was a major part of the relief effort. The result was that many farmers did not harvest their crops either because the price was too low or because their tool sheds and equipment had been damaged in the earthquake. The following spring, many farmers failed to plant for the same reasons. A post-relief analysis concluded that it would have been more helpful to send down farm equipment and building materials.

The media response to disaster for decades has been a call for food, clothing, and blankets, which were to be collected and sent to the effected region. A decade ago, I had an op-ed in the Houston Chronicle (August 14, 1994) in which I made the case against collecting and attempting to send commodities and argued instead for sending money. Even though I was merely relating what aid agencies had learned over the previous two decades from their mistakes, the idea of simply giving money was still novel and even radical to some and not fully accepted.

In 1994, I asked Houstonians to help alleviate the suffering in Rwanda and Haiti by opening their wallets and not their pantries if they really wanted to do some good. Callous as it sounded to some, the best way to have a positive impact, then and now, was to send money through reputable private voluntary organizations and not send food, clothing, or medicine directly overseas. Ten years on, amidst all this tragedy, I am heartened that the media itself and many of those whom they interviewed made this same argument. It is far easier, once a reputable organization is identified, to go to the Internet and give a donation using your credit card than it is to search through the house for items and then haul them off to a collection center, where they will likely collect dust and do little if any good. Giving money is both easier and more effective.

Because of past mistakes in sending the wrong forms of aid, it is now standard procedure for U.S. ambassadors to give an initial sum of money from a special fund for that purpose while donors like USAID send out a needs assessment team or teams before sending further aid. Each disaster is unique and generates its own special needs -- and in the case of the tsunami, different regions suffered differently and need different kinds of help. There are, however, enough underlying commonalities so that a team of experts going out to be briefed by local authorities will know what questions to ask and what to look for on the ground. About five years or so ago, when interviewing AID officials about our disaster response, one of the most respected TV journalists asked pointedly if the whole process was a bit too bureaucratic. In the current crisis, similar questions are being asked, but they are more respectful, giving experts an opportunity to explain the reason for a needs assessment team.

Some commonly-encountered problems with aid efforts:

-- Transportation problems. Elements of the situation that I described in 1994 resemble the current situation. In 1994, people were starving in Rwanda, as they are today in Darfur and in some of the remote areas of Sumatra. Neither in 1994 nor today can food collected in Houston get to where it is needed. In 1994, airports at Goma, Kigali, and Entebbe were so tight that shipments couldn't get through unless those in charge were assured they carried a top-priority item and that there was some mechanism for distribution to those in need. It is clear in the current crisis that what is holding back aid is not the lack of available commodities but the breakdown in the local transportation infrastructure. Intense coverage of this crisis has highlighted the difficulty of getting aid to those who need it. Local transportation bottlenecks occur more often than the public might realize.

-- Sending the right type of food. Disaster intervention has become something of a science in the last three decades. For famines, food is carefully formulated to meet nutritional needs in the particular areas involved. Sending culturally-appropriate food is also important, and difficult to do with large volumes of small donations. Who will sift out cans of pork and beans from shipments to Muslim countries? What works well in Houston may not fair as well in other cultures.

-- Having the right tools on-site. Another practical point that probably goes without saying but is worth a mention here: shipping canned goods to refugees in Third World countries like Rwanda helps no one if people don't have can openers and can't read the directions on the cans. In most if not all of the impacted areas of the tsunami, people probably had can openers that are now lost in the ruble.

-- Getting usable medicine to victims. Similarly, in 1994, there was a group in Houston trying to collect medicine for Rwanda refugees -- but there was no way that the medicine would reach its target as no reputable physician would use medicine of unknown provenance. Getting medicine abroad is another matter best left to the experts. Many critical vaccines and antibiotics so desperately needed in disaster areas are also temperature-sensitive. One of the biggest challenges for relief providers is to maintain what's called the "cold chain" all the way to the field.

-- Correctly identifying disease. In the early 1990s, word somehow got to the donors that there was an outbreak of meningitis in a disaster area. Only after medicine was sent out was it learned that it was actually cholera. That two diseases so vastly different in so many obvious ways could be confused shows the breakdown in communication that can be created by the chaos of a disaster.

-- Needs shift quickly. In Rwanda, cholera was the original problem, but suddenly the major medical concern became shigella. Relief workers had to wait for medicine to combat shigella, which quickly became the top-priority cargo at crowded airports.

-- Clothing supplies can spread disease. Most countries are fearful of spreading disease, so shipments of relief clothes and blankets aren't allowed unless they are properly cleaned and fumigated. This is most easily done in gigantic blocks, which are containerized and then shipped in bulk by those who do it regularly.

Sometime in the late 1980s or early 1990s, well-meaning groups in Houston collected goods for earthquake victims in Central America. Six months later, we saw and read news stories on how most of the donated items were still collecting dust in warehouses. If the food and clothing were not worth shipping from Houston to Central America by truck, they will most certainly not be worth flying to Asia or Africa from most anywhere in the United States.

What We Can Do Better

Some of the things we've learned from past efforts:

1) Release funds to local authorities and quickly dispatch needs assessment teams in order to prioritize the delivery of aid. Obviously, the more rapid the response, the better and more effective it is, as long as it is the right response. Better a brief interval to get things right then to clog the system with the wrong deliveries.

2) Those who wish to help should give money and give it as quickly as possible. Many relief NGOs (non-governmental organizations) may already have ongoing projects in the area, staffed by locals and others who know the language and can be the best first responders if they have the funds to get what they need.

3) Give commodities only if requested by those on the scene who know the needs and have the mechanisms to have the commodities delivered and used. The one exception to the cash-is-best theory of disaster relief is when there is a call from those on the scene for a specific item such as blood. Such a call implies, or should imply, that there is a mechanism in place to get the blood from where it is to where it is needed. This sort of call is most likely for an in-country disaster. Even if the blood that you give simply ends up in a local blood bank, it frees up other blood to be used immediately.

4) When possible, make purchases of relief items in the disaster area itself. This provides cash inflow that will later help the economy to rebuild. Even in some of the poorest areas, there may be already-existing aid programs with stocks of needed supplies. If it is locally obtained, it is more likely to fit into the culture and be acceptable.

Relief agencies keep warehouses stocked with items most needed in disasters. But, for instance, if they have a feeding program for pregnant women, they would rightly be hesitant to release food stocks in response to a disaster, even though that need may be greater and more immediate, since to do so could put their life-saving programs in jeopardy. These groups must have funding to restock supplies when disasters deplete them.

5) It is a truism in disaster intervention that far more people die from disease outbreaks after the event then directly from the disaster. Children are particularly vulnerable to dehydration and death from diarrhea diseases. In addition to provision of clean water, antibiotics are needed because diarrhea is likely to be endemic to the region already and to spread rapidly before assistance can be rendered. Even after the diarrhea-causing microorganisms are eliminated, it is difficult for already-malnourished children to rebuild the epithelial lining of the gastrointestinal track so that they can take in water.

Thirty years ago, one would see the very sad sight of children attached to IVs in an effort to rehydrate them. One knew that the failure rate was high. In the late 1970s, a cheaper, more effective treatment, Oral Rehydration Therapy (ORT), was discovered, involving the use of common items -- sugar, salt, and an electrolyte. Many women in Third World countries already know how to prepare them and have the ingredients on hand. Oral rehydration salts (ORS) packaged with language and pictorial instructions understandable to recipient populations are available in the tsunami disaster region (I have bought them for personal use in several of these places). The technology of ORT may be simple, but sophisticated scientific research discovered it.

Science and technology have also produced antibiotics that are more heat stable, are often in high-tech packaging that help to keep them at the right temperature, and arrive via more reliable means of transportation -- all of which makes it more likely the antibiotics will be effective. Thanks to the global effort to expand immunization, the vast majority of children in the tsunami area will have been immunized for six or seven basic diseases in contrast to thirty years ago when this was the case for only a small minority in the region and throughout the Third World.

6) There is an array of other basic knowledge about disaster intervention for floods, famines, earthquakes, hurricanes/typhoons, and now tsunamis that is almost the exact opposite of what was conventional wisdom three decades ago. And there is new technology that can help. We have all now seen the importance of helicopters in delivering aid, and most of us by now know about the use of sniffer dogs, robotics, and other specialized equipment to rescue people trapped in buildings collapsed by earthquakes.

The globalization of disaster intervention made possible by modern communication and transportation technologies has in recent decades begun to close some of the gap in loss of life from disasters between developed and developing countries. Thus the admonition to buy locally is coupled with a vast array of technologies and capabilities that are rushed to a region from all parts of the globe.

Remaining Obstacles to Disaster Relief

Unfortunately, there are some things that we could do better thirty or so years ago than we can today. Malaria and dengue fever are endemic to many of the areas hardest hit by the tsunami. The flooding water is likely to have cleaned out the mosquito larvae, creating a brief period of reduced disease and an opportunity to reduce it further. But with stagnant pools of water, the area will be quickly re-colonized by mosquitoes. Because of the breakdown of the material structure and to some extent social structure of villages, local defense measures against disease vectors, however inadequate they may have been to start with, will now be non-existent. These diseases will quickly return with a vengeance, as will other diseases, assaulting a physically and psychologically weakened population.

What is needed is the provision of the most effective weapon against the disease vectors, which in the case of the mosquito is DDT. Tragically, that won't happen thanks to activists who got it banned a little over three decades ago by the U.S., followed by European countries and in effect all donor organizations. In addition, water needs to be chlorinated even if it is not being drunk because, having been mixed with sewage, it will be harboring an extraordinary array of diseases. Again, at least one of the activist groups opposes the use of chlorine, but in this case their opposition is unlikely to be a deterrent to its eventual use.

We need to distinguish between those NGOs that are actually in the field helping people and the activists NGOs that do absolutely nothing to help those in need but somehow claim to be speaking and acting on their behalf. These latter groups are the ones that preferred to see Africans starve during a famine rather than have them eat perfectly good donated transgenic grain. They claimed that there was enough non-transgenic food available in Southern Africa to feed the famine-stricken populations, but none of them used any of their $100 million+ annual budgets to buy any of the allegedly available food for distribution to the needy. NGOs routinely oppose all dam construction, construction that could provide water for irrigation and/or electricity. They oppose the economic development that protects people while blaming technology for all the ills of the world, including the tsunami. Yet they live in developed countries and enjoy the benefits of the technologies that they oppose.

Clearly, one of the biggest problems that we face is not the destructive force of nature but the organized ideological opposition to the effective use of modern technology. One of the most important things we can do after donating money is to try to put pressure on donor groups, including our own government, to make use of the most effective means of saving lives of children and adults from malaria, dengue fever, and other mosquito borne diseases: use DDT.

In my work as a development economist, I have seen far more poverty and human tragedy than I really cared to see. I have been troubled over the last two decades as I watched, decent, caring people generously responding to the misfortune of others in ways that were ineffective and in some ways counter-productive, whether through misguided aid efforts or through opposition to the scientific and economic developments that enable populations to help themselves. Fortunately, there now seems to be better understanding in the media and in the public about how to respond to a disaster. Like all human inquiry, it is a continuous learning process and a battle against those who would have us reverse course. It is the scientific method applied to life's problems: learn from one's experience in order to do better then next time.

Thomas R. DeGregori is a professor of economics at the University of Houston and a member of the Board of Directors of the American Council on Science and Health. He has extensive overseas experience as development economist and advisor to donor organizations and developing countries. His recent publications include: Origins of the Organic Agriculture Debate, The Environment, Our Natural Resources, and Modern Technology, and Bountiful Harvest: Technology, Food Safety, and the Environment.