Disaster Deaths

Disaster Deaths This book conducts a systematic inquiry into the tragic deaths caused by natural disasters at different geographic scales. It employs key disaster concepts and classification of disasters to understand the high mortality rates and the various factors associated with these deaths. Deaths are the direct and immediate impact of disaster events, which have remained a major concern for disaster managers and policy-makers all over the world. Using primary research and secondary data, this book provides a comprehensive analysis of various facets of disaster deaths such as trends, circumstances and causes, and determinants at global, regional, national, and subnational scales. It offers a holistic perspective on disaster mortality, which has been lacking for some time. The book not only fills this research gap but also suggests important policy implications for disaster managers and policy-makers working in multilateral, bilateral, local, and international nongovernmental organizations (NGOs). These policies include effective strategies to significantly reduce the risk of deaths caused by natural disasters, which are explored through chapters written in a clear and accessible style. Drawing together the case studies on past major disasters as well as recent ones, the book provides new and critical insights into deaths precipitated by natural disasters. Suitable for both technical and nontechnical readers, the book has a broader appeal and will thus be useful for practitioners, researchers, students, as well as activists in the area of hazards and disasters who are interested in studying mortality due to extreme natural events. Bimal Kanti Paul is a Professor of the Department of Geography and Geospatial Sciences at Kansas State University, Manhattan, KS, USA. He is a human geographer with interests in natural hazards and disasters, including human–environment interactions, health and population geography, and geospatial analysis and applications. Routledge Studies in Hazards, Disaster Risk and Climate Change Series Editor: Ilan Kelman, Reader in Risk, Resilience and Global Health at the Institute for Risk and Disaster Reduction (IRDR) and the Institute for Global Health (IGH), University College London (UCL) This series provides a forum for original and vibrant research. It offers contributions from each of these communities as well as innovative titles that examine the links between hazards, disasters, and climate change, to bring these schools of thought closer together. This series promotes interdisciplinary scholarly work that is empirically and theoretically informed, with titles reflecting the wealth of research being undertaken in these diverse and exciting fields. Climate Hazards, Disasters, and Gender Ramifications Edited by Catarina Kinnvall and Helle Rydström The Anthropology of Disasters in Latin America State of the Art Edited by Virginia García-Acosta Disaster Resilience in South Asia Tackling the Odds in the Sub-Continental Fringes Iftekhar Ahmed, Kim Maund and Thayaparan Gajendran Crisis and Emergency Management in the Arctic Navigating Complex Environments Edited by Natalia Andreassen and Odd Jarl Borch Disaster Deaths Trends, Causes and Determinants Bimal Kanti Paul For more information about this series, please visit: https://www.routledge. com/Routledge-Studies-in-Hazards-Disaster-Risk-and-Climate-Change/ book-series/HDC Disaster Deaths Trends, Causes and Determinants Bimal Kanti Paul First published 2021 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 52 Vanderbilt Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2021 Bimal Kanti Paul The rights of Bimal Kanti Paul to be identified as the author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record has been requested for this book ISBN: 978-0-367-19626-4 (hbk) ISBN: 978-0-429-20339-8 (ebk) Typeset in TimesNRMTPro by KnowledgeWorks Global Ltd. Contents List of figures List of tables Preface vii viii ix 1 Introduction 1 2 Reasons for unexpected death toll numbers caused by disasters 29 3 Trends and levels of disaster deaths 58 4 Circumstances and causes of disaster deaths 86 5 Determinants of disaster deaths 114 6 Conclusion 147 Index 165 Figures 3.1 Worldwide aggregate disaster deaths by year, 1991–2015. 60 3.2 A mass-grave where 26 victims of Cyclone Sidr were buried in Sarankhola, Bagerhat district in Bangladesh. The cyclone made landfall on November 15, 2007. The brick walls seen in the picture were constructed later. 77 3.3 Simplified graphical depiction of dead bodies found after natural disasters. 78 4.1 Causes of death in the United States from Atlantic Hurricanes, 1963–2012. 93 4.2 The number of deaths induced by Hurricane Sandy by affected countries. 94 5.1 Epidemiologic triangle. 116 5.2 Hazard and vulnerability factors as determinants of disaster-induced deaths. 116 Tables 1.1 Disaster classification by Jan de Boer 1.2 Classification of disaster by Gad-el-Hak 1.3 Examples of differences in number of disaster-related deaths reported by three different agencies in the United States 1.4 Number of Tornado fatalities by location, 2011 2.1 List of disasters included by too many or too few deaths 2.2 Comparison of two earthquakes struck Haiti and Chile in 2010: selected parameters 3.1 Worldwide deaths caused by all natural disasters during 1991–2015 by individual event 3.2 Worldwide deaths caused by two broad types of disasters during 1991–2015 3.3 Deaths caused by all natural disasters during 1991–2015 by continent 3.4 Deaths caused by all natural disasters during 1991–2015 by HDI tier 4.1 Causes of deaths and activity at the time of deaths caused by super Hurricane Sandy (N = 233) 4.2 Summary of tornado deaths by location in Alabama and Joplin, Missouri 4.3 Major causes of deaths for selected volcanic eruptions, AD 79–1991 4 6 12 15 30 45 62 66 67 70 95 99 106 Preface When I began my academic career in Bangladesh in the mid-1970s, my primary focus was agricultural geography, particularly diffusion of agricultural innovations, such as green revolution technology in Bangladesh. After completing advanced degrees in North America in 1988, however, I continued my academic career in the United States as a medical/health geographer. In the late 1990s, my research and teaching interests evolved to include geography of natural hazards and disasters, encompassing topics such as mortality, which overlap with medical/health geography and hazards and disasters geography. I explained my transition from medical/health geography to geography of natural hazards and disasters in the preface of my first book, Environmental Hazards and Disasters: Contexts, Perspectives and Management published in 2011 by Wiley-Blackwell. The devastating floods in 1987 and 1988, the Category 4 tropical Cyclone Gorky that struck the eastern coast of Bangladesh in 1991, and the receipt of several Quick Response Research Grants from the Natural Hazards Center at the University of Colorado at Boulder helped direct my research focus toward natural hazards and disasters. Although I have conducted and published many studies on a wide range of topics associated with disasters, including hazard preparedness, public and household response, individual perceptions and coping strategies to overcome disaster impacts, recovery and rebuilding efforts, and compliance with hazard warnings and evacuation orders, my initial focus was on the disbursement of humanitarian aid to disaster survivors. Based on my writings and practical experience, I authored my fourth book, Disaster Relief Aid: Changes & Changes published in 2019. This book is an amalgamation of my research interests in medical/ health, population, and natural hazards and disasters geographies. I have been deeply involved in age- and gender-specific mortality studies, which incorporate perspectives of medical/health geography as well as population and hazards and disasters geography. As a Ph.D. student in the United States, I also was trained in epidemiology, public health, and quantitative techniques. I am also interested in health issues related to extreme natural events, particularly circumstance, causes, and determinants of deaths and injuries caused by floods, tornadoes, tropical cyclones, and earthquakes in Bangladesh, Nepal, the United States, and other countries. x Preface Since 1994, I have received 17 external grants to study natural disasters (e.g., blizzards, cyclones/hurricanes, droughts, earthquakes, floods, and tornadoes), and I have conducted field research throughout the world. Thus, many of my publications are based on primary data. Using secondary data, I have also authored research publications about cyclones, forest fires, heat waves, lightning, tsunamis, and volcanic eruptions in China, Iceland, India, Indonesia, Japan, Sri Lanka, Taiwan, Thailand, and the Philippines. Knowledge gained from my exposure of disaster literature, my involvement in disaster research, and my role as an instructor for an upper level disaster course for nearly two decades was used in this book, including examples of disaster deaths throughout the world. I also taught a disaster course at Jilin University in Changchun, China. Although this book is not specifically targeted for introductory or upper level interdisciplinary hazard courses, I am confident that undergraduate and graduate students will find it useful in such courses. In addition, emergency managers, planners, government officials, and humanitarian organizations, including nongovernmental organizations (NGOs) and donor agencies involved in disaster death reduction, as well as hazards and disasters researchers, could benefit from this book. Although the majority of this current book was written during the last one year, my teaching and research experience in three subfields of geography have contributed to the timely completion of the manuscript. Most importantly, its successful completion was contingent on the unconditional support, cooperation, and help I have received from colleagues, friends, and students at Kansas State University (K-State). I am thankful to Dr. Jeffrey Smith, professor of the Department of Geography and Geospatial Sciences at K-State, and Dr. Charles W. Martin, professor and head of the Department of Geography and Geospatial Sciences at K-State, Avantika Ramekar, also at K-State, for drafting all the figures in this book, M. Khaledur Rahman, Assistant Professor in the Geology & Geography Department at Georgia Southern University, Statesboro, Georgia, and Md. Nadiruzzaman, Research Fellow in the Institute of Geography, University Hamburg, Hamburg, Germany. I am particularly thankful to Dr. Martin for allowing me to have access to my office during the COVID-19 pandemic, which allowed me to complete this book project on time. I also received editorial help from Marcella Reekie and Michael Stimers. I would also like to thank Nonita Saha, the editorial assistant at Routledge Geography and Tourism Books for her guidance and patience during this project. Finally, my deepest gratitude goes to my wife, Anjali Paul, daughters Anjana and Archana, and son Rahul, for their enduring love, constant encouragement, inspiration, and support over the years, particularly when I was busy writing this book. Bimal Kanti Paul Manhattan, KS, USA 1 Introduction Natural disasters are widely conceived as adverse extreme natural events that have detrimental effects on humans and the environment and therefore cannot be considered disasters if they do not harmfully impacts people, or significantly disturb the day-to-day functioning of a community. However, not only can people amplify these harmful impacts, but they are also responsible, to some greater or lesser extent, for creating such damaging events through their activities. For example, floods are generally caused by excessive or prolonged rain over a large area.1 However, such rain, in turn, may result from human actions, such as deforestation, overgrazing, or drastic land use change (Paul 2011). The disastrous 2017 flooding in Houston, Texas, USA, was caused by a combination of heavy rainfall brought by Hurricane Harvey and unplanned and haphazard development of the city. This Category 4 hurricane not only brought heavy rainfall measured in feet, but also rain-induced water was not able to drain quickly because of sprawling and intense growth of the city. Paving so much ground had reduced its capacity to absorb or rapidly drain rainwater. Flood-control reservoirs in and around Houston not only were too small, but also too few, and building codes were inadequate. As a result, roads became rivers, and neighborhoods became lakes overnight (Coy and Flavelle 2017). In 2005, when Hurricane Katrina made landfall on the Gulf Coast, 80 percent of New Orleans, Louisiana, experienced catastrophic flooding caused by levee failures. The weak levees, which urgently needed repair, could not withstand the force of storm surge water associated with the extremely destructive Hurricane Katrina, which precipitated most of the 1,577 deaths in Louisiana (Levitt and Whitaker 2009; CNN Library 2019).2 However, disaster impacts are classified in many different ways. For example, they are popularly dichotomized as having direct and indirect impacts (Smith and Ward 1998). The former or first order impact is the immediate consequence caused by the physical contact of an extreme event with humans and/or with property. Indirect or second order impacts, in contrast, include all those not provoked by the disaster itself, but by its consequences; they manifest much later than the event, and they are often less easily connected to the event (Hallegatte 2015). Both direct and indirect impacts are 2 Introduction grouped by tangible and intangible impacts. Tangible impacts can be easily measured in monetary terms, while intangible impacts, which cannot be expressed in monetary terms, include disaster-induced stress, fear, discomfort, and pain (Paul 2011). In order of progression of impacts, Parker et al. (1997) and Smith and Ward (1998) have further trichotomized both direct and indirect impacts as primary, secondary, and tertiary impacts. In essence, primary impacts include immediate impacts, while secondary and tertiary impacts are long-term impacts (Paul 2011).3 Another way to express disaster impacts is simply by using three Ds: death, damage, and displacement. The focus of this book is on the first impact and aims to provide a comprehensive analysis of various facets of disaster deaths on global, regional, national, and subnational scales. First, this chapter provides background information to facilitate understanding of the complexities of deaths associated with natural disasters. It starts with a general definition of disaster death, which is often termed as disaster fatality or disaster mortality. Disaster mortality can be defined as deaths that caused by direct and/or indirect exposure of people to an extreme event. Isolating disaster deaths from non-disaster mortality is often a challenging task. Despite several ambiguities associated with disaster deaths, this definition provides a useful and reasonable starting point for analyzing them. In fact, there are several formal definitions of a disaster death. For example, the United Nations International Strategy for Disaster Reduction (UNISDR) defines disaster deaths as “The number of people who died during the disaster, or directly after, as a direct result of the hazardous event” (UNISDR 2015, 13). In context of flood, Jonkman and Kelman (2005, 75) defined flood fatality or flood-related fatality as “a fatality that would not have occurred without a specific flood event. Synonyms and related terms include ‘flood deaths’, ‘loss of life in floods’, ‘flood mortality’ and ‘killed by flooding.’” Applying this to other disasters, disaster deaths are those that would have not occurred without the disaster event. However, death tolls are widely used to help people conceptualize the magnitude of a disaster. A large number of deaths generally receives the attention of international print and electronic media, which, in turn, is directly tied to the volume of emergency relief to be received by survivors of such an event both from domestic and international sources (Heeger 2007; Paul 2019). Thus, the number of deaths is an important measure of the damage caused by natural disasters.4 Deaths and disaster definitions Death has been included as an important criterion in several definitions of natural hazards and disasters. For example, the Center for Research on Epidemiology (CRED) at the Catholic University of Louvain in Brussels, Belgium, assigns the term disaster if one of the following four criteria are met: 10 or more reported killed; at least 100 or more people reportedly Introduction 3 affected (meaning they are in need of immediate assistance from external sources during a period of emergency); call for international assistance; or declaration of a state of emergency (CRED 2015). Several other relevant organizations, such as Desinventar, and Munich Re, the latter a German insurance company, define disaster using the number of deaths caused by such events. Specifically, Munich Re considers a disaster as a situation involving damage and/or loss of lives beyond one million German marks and/or 1,000 persons killed (Dombrowsky 1998). Similarly, individual researchers have also used mortality in defining natural disasters. Sheehan and Hewitt (1969) defined disasters as events leading to at least 100 deaths, while Glickman et al. (1992) used a lower threshold of only 25 deaths. In the United States, the researchers at Resources For the Future (RFF) have compiled a disaster database with events that occurred between 1945 and 1986, including both natural and industrial disasters. The recording threshold was set at a minimum of 25 fatalities for natural disasters, compared with five for industrial disasters (Smith 2013). Similar to CRED’s EM-DAT, the GLobal IDEntifier Number (GLIDE) maintains an active register of all disasters that have been assigned a GLIDE number, as well as a short description of the event. In order to be assigned a GLIDE number, a disaster must meet the same criteria for EM-DAT (UNEP 2016). Meanwhile, Sigma, a Swiss Re’s global disaster loss database, considers an event as a disaster if it causes a certain amount of insured loss in U.S. dollars or results in a certain number of casualties (at least 20 dead or missing, 50 injured, or 2,000 homeless) (UNEP 2016). Unlike EM-DAT, which collects disaster data for hazard researchers and the humanitarian community, Sigma collects disaster data for use by the general public and for the insurance sector in particular. For this reason, Sigma includes a broader range of disasters than EM-DAT (UNEP 2016). Meanwhile, the German insurance industry, Munich Re, and the South American Desinventar consider a disaster as a situation involving damage or loss of life beyond one million German marks or 1,000 persons killed, respectively (Dombrowsky 1998; Aksha et al. 2018). Deaths and disaster classifications Apart from defining disasters in terms of number of deaths, often death is used as one of the important components to classify severity of extreme natural events. One of the earliest disaster severity-based classifications was proposed by Jan de Boer (1990). In formulating his classification scheme, he considered seven components or parameters and provided scores for each of the components, ranging from “zero” to “two” (Table 1.1). The sum of the scores lies between 1 and 13 where one reflects very minor disasters and 13 reflects devastating disasters. However, de Boer (1990) did not ascribe any identifier to each composite numerical score or scale, which he calls a Disaster Severity Scale (DSS). Nevertheless, he assigned a scale of 12 for 4 Introduction Table 1.1 Disaster classification by Jan de Boer Component Major Minor Effect (on the surrounding Simple disaster community) Compound disaster Cause Man-made disaster Natural disaster Duration Short Relatively long Long Radius (of the disaster Small area) Relatively large Large Number of casualties Minor Moderate Major Nature of injuries No hospitalization Hospitalization Large number of severely injuries Rescue time Short Relatively long Long Assigned value 1 2 0 1 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 Source: Compiled from de Boer (1990). the 1988 Armenian earthquake, which killed between 25,000 and 50,000 and injured between 31,000 and 139,000 people. His seven components or parameters and respective scores are presented in Table 1.1. 1 de Boer (1990) considered the effect on the surrounding community, with further differentiation into simple and compound effects. In the former case, local and regional rescue services are adequate to deal with the situation. In the latter case, the involvement of national and international organizations is required. A simple disaster is assigned a score of 1, while a compound disaster receives a score of 2 (Table 1.1). 2 de Boer (1990) divides the cause into two categories: man-made and natural disasters. He considers that natural disasters are generally more complex and more widely dispersed than man-made disasters. For this reason, the former disasters are accorded a score of one, while the latter get a score of “zero.” 3 The next component is the duration of an extreme event or how long the event persists in a given area. It is also termed as impact time, and is divided into three categories: short (less than one hour), relatively long (1–24 hours), or long (more than 24 hours). These categories are assigned scores of 0, 1, and 2, respectively. Introduction 5 4 The radius of the disaster area is also divided into three categories: small (less than one mile or 1 km), relatively large (1–6.7 miles or 1–10 km), or large (more than 6.7 miles or 10 km). Scores of 0, 1, and 2 are accorded, respectively. This component represents areal extent of physical dimension of disasters, which refers to the area over which a disaster event occurs. This dimension is closely associated with the extent of damage incurred as well as with the number of deaths and injuries (Paul 2011). 5 The fifth component is the number of casualties caused by a disaster, which is arbitrarily divided into three categories: minor (25–100 casualties alive or dead, or 10–50 casualties requiring admission to hospitals); moderate (100–500 casualties alive or dead, or 50–250 casualties requiring admission to hospitals); and major (more than 500 casualties alive or dead, or more than 250 casualties requiring admission to “hospitals’’ (Table 1.1). 6 The nature of the injuries sustained by disaster survivors gets a 0 score if no hospitalization is required for injuries. Otherwise, in a typical case a score of 1 is given, unless the disaster results in a relatively large number of seriously injured. In that case, a score of 2 is accorded. Unfortunately, de Boer (1990) did not explain what he means by “large number” (Table 1.1). 7 The time required by the search and rescue (SAR) teams to provide first aid to injured people and time to take seriously injured people to appropriate hospital earns a score. This component is also divided into three categories: short (less than 6 hours), relatively long (6–24 hours), or long (more than 24 hours). These categories are graded with a score of 0, 1, and 2, respectively (Table 1.1). This descriptive severity-based classification of disasters puts emphasis on medical outcomes of disasters, which reflects the bias of the author’s medical profession. Of the several physical dimensions of natural hazards (e.g., magnitude, frequency, seasonality, spatial distribution, speed of onset, and diurnal factors), de Boer (1990) only used two dimensions, duration and areal or spatial extent. These physical dimensions most directly affect the number of fatalities caused by a disaster. Using eight characteristics, one of which is deaths, McEntire (2007) classified extreme events into three classes: crisis, emergency/disaster, and calamity/catastrophe. Instead of using an absolute number, he categorized deaths into three: many, scores, and hundreds/thousands. The remaining seven characteristics are injuries, damage, disruption, geographic impact, availability of resources, number of responders, and time to recover. Similar to de Boer (1990), Mohamed Gad-el-Hak (2010) classified disasters into five groups. His classification is based on one of two criteria: either number of persons dead/injured/displaced/affected or the size of the affected area of the event. He classifies disaster types as Scope I–V according to the severity scale illustrated in Table 1.2. Although the term “mega-disasters” 6 Introduction Table 1.2 Classification of disaster by Gad-el-Hak Class (label) Scope I (small disaster) Scope II (medium disaster) Scope III (large disaster) Scope IV (enormous disaster) Scope V (gargantuan disaster) Number of persons killed, injuries, displaced, or affected Area impacted (in square km) <10 10–100 100–1,000 1,000–104 >104 <1 1–10 10–100 100–1,000 >1,000 Source: Based on information presented in Figure 1 by Gad-el-Hak (2010, 2). is increasingly used in disaster literature in recent years, particularly since the 1990s when “climate change” started to draw the attention of disaster researchers and others, none of the above classifications used this term. It technically means a high-impact disaster that occurs one-in-a million. Mega-disaster is usually defined as a large-scale disaster that affects five million people, or a one-in-a-million disaster (Sergeant 2011). The CRED (2015) defines a mega-disaster as an event that kills more than 100,000 people. This source identified three mega-disasters in the period 1994–2013. The 2004 Indian Ocean Tsunami (IOT), which killed 226,400 people in 12 countries, is widely considered a mega-disaster. The other two are the 2008 Cyclone Nargis in Myanmar and the 2010 Haiti earthquake. The former killed 138,000 people and the latter 222,600 people (CRED 2015). Once again, based on de Boer’s DSS, Hasani and his colleagues (2014) developed a holistic Disaster Severity Assessment (DSA) tool, which accommodates physical and socio-economic impacts of the disaster on the affected population of a country. It is based on six criteria: (1) impact time, (2) fatalities, (3) casualties, (4) relative financial damage (RFD) in U.S. dollars, (5) Human Development Index (HDI), and (6) Disaster Risk Index (DRI). The last two categories indicate the capacity of the affected country for coping with disaster. The Human development Index has been annually published by the United Nations Development Program (UNDP) since 1990 and is based on three variables: health (life expectancy at birth), education (mean years of schooling), and living standard (gross national income per capita) for each country. The DRI is also available from the World Risk Report published annually by United Nations University. Finally, RFD is calculated by the following formula: RFD = (original damage of disaster)/(per capita GDP of the affected country) RFD represents the relative financial damage caused by a specific extreme event in a specific year. The DSA shares three components (time, fatality, and casualty) of the disaster classification of Boer and adds three new parameters (financial damage, HDI and DRI) (Hasani et al. 2014). Similar to de Boer, the sum of the scores ranges from 1 to 13. Introduction 7 Types of disaster deaths Considering the timing of death caused by natural disasters, these deaths are dichotomized as direct and indirect (Smith and Ward 1998). The former is generally defined as immediate deaths occurring as a result of direct exposure to natural disasters, or deaths directly attributable to the forces associated with disasters. For example, if a person is killed by a building collapse during an earthquake, it can be considered a direct disaster death. Another person may be severely injured during the earthquake, but if the person died a few days or even one year after the event, this can be considered an indirect, secondary, peripheral, or delayed death. Indirect death is caused by the consequences of physical contact of disasters with people (Paul 2011; US DHHS 2017). Thus, disaster injuries provide an important source of information about indirect deaths from such events. Although injury-to-death ratio varies among different types of disasters, and by country to country, the number of injuries experienced across disasters and countries has been approximately twice the number of disaster-related deaths over the last several decades.5 Indirect disaster deaths also occur due to outbreaks of infectious/communicable diseases or epidemics in the days, weeks, or even months after the onset of extreme events; however, it is difficult to predict which diseases will occur following an extreme event as they differ by disaster types. For example, water-borne and vector-borne diseases are very common for floods events, particularly in developing countries. Surges of such diseases during and immediately after flood events are a recurrent feature, and people die from these diseases. The widespread prevalence of waterborne diseases is caused by a lack of safe drinking water as floods and other natural disasters often destroy water purification plants, and damage sewage system and sanitation facilities, which, in turn, contaminate drinking and other water sources (Montz et al. 2017). Although flooding flushes away sites for mosquitobreeding and thus reduces incidence of malaria in early stages, subsequently, residual waters may contribute to an explosive rise in the vector reservoir, which, in turn, is associated with increase in incidence of malaria or dengue.6 Similarly, problems related to post-disaster rescue and emergency efforts also contribute to an increased number of indirect deaths. The extent of the disaster, the lack of planning for such a disaster, the near total destruction of residential and other buildings, the damage sustained by hospitals, roads, the electrical grid, and other infrastructures, and the fact that medical facilities and professional SAR services and equipment were insufficient even prior to the disaster, all serve to undermine the success of any immediate response. The vast majority of SAR efforts historically have been conducted by friends, family, and neighbors using their hands and commonplace tools. Timely, professional medical treatment has been in drastically short supply; in too many cases, blood loss, infection, renal failure, and other treatable health problems have led to death. 8 Introduction Disaster-induced deaths may also be caused by the transmission of preexisting infectious diseases as well as by preexisting compromised health status of a disaster-affected community, and according to Bourque et al. (2007, 7), “In general, increases in infectious disease rates following disasters are more common in developing than in developed countries.” However, lack of access to medical facilities or personnel during and post-disaster periods have generally triggered delayed disaster deaths, and chronic conditions often may be exacerbated by an extreme event. For example, asthma-related deaths are caused by wildfires, and cardiovascular events are associated with blizzards, floods, heat waves, and hurricanes. Both are examples of indirect disaster deaths (US DHHS 2017). In developing countries, disaster-related deaths are exacerbated by lower immunization rates, and poor nutritional status relative to those in developed countries. Strictly speaking, disaster deaths usually refer to direct deaths. For example, the National Hurricane Center (NHC), located in Miami, Florida, USA, when it provides hurricane fatalities, only reports direct deaths. Thus, actual deaths caused by disasters are higher than the direct deaths, which are generally considered as reported deaths. Irrespective of direct or indirect deaths, disaster-induced deaths can occur before, during, or after any extreme event. People may die even while implementing safety measures before an impending disaster. Moreover, first responders, including police officers and recovery workers also die providing necessary emergency services. These deaths are not considered disaster-related deaths but rather occupation-related deaths (US HHHS 2017). For example, the City of Joplin, Missouri, USA, was hit by a strong EF-5 tornado on May 22, 2011. According to the city, the tornado killed 161 but excluded the death of one police officer who died from lightning while assisting recovery and cleanup efforts the day after the storm (Paul and Stimers 2014). Thus, direct disaster deaths are deaths that would not have occurred without the occurrence of the disaster event. In contrast, indirect disaster deaths are not caused directly by the forces of the event of the event; such deaths are products of the conditions resulting from the person’s contact with the event (McKinney et al. 2011). Accordingly, if a person dies from a heart attack while driving inland to heed a hurricane warning, her/his death is usually considered to be direct. Similarly, when someone dies of a heart attack while cleaning up after a hurricane, that can be considered a direct death caused by the event. Michael Glantz (2009) argues that disaggregating disaster deaths as direct and indirect is not useful because this diminishes the connection with the event, and thus less may have been done to prevent such deaths (also see Kelman 2005). Further, on his website, Ilan Kelman (www.ilankelman.org/ disasterdeaths.html) claims that all disaster deaths, both direct and indirect, are ambiguous. According to him, if a person dies because of drowning in floodwaters, this death can be termed ambiguous. This is because Introduction 9 for instance, the basic or fundamental cause of that person’s death may be related to poverty which makes the person weak from inadequate food consumption. Or the person dies because of failure of the relevant authorities to issue a warning or because of a lack of rescue. Similarly, a person dies during an earthquake event from a collapsing house, which may not be the inherent cause of the death. Once again, it could be that poverty prevented the person from building his/her house to be resistant to earthquakes. Despite the ambiguity, US DHHS (2017) maintains that for planning and preparedness purposes, recognizing and recording all disaster-related deaths is important, whether the deaths are directly or indirectly related. Challenges associated with disaster deaths Sometimes challenges and inconsistencies emerge in the context of disaster deaths or types of disaster deaths. For example, in the case of flood events, perhaps water deaths are confused with flood deaths. In a post, Michael Glantz (2009) provided an example of this confusion. “A heart attack during evacuation from a flood is not caused by water; however, it is directly related to the flood disaster. A flood disaster is much more than water. A flood disaster needs water, but it is a primarily disaster event rather than a water event, with all the vulnerability characteristics that a disaster event implies.” Similarly, Jonkman and Kelman (2005, 80) claim that deaths can be considered flood-related “only if they occurred during an event involving the presence of water on land that is usually dry. Thus, drownings and heart attacks during floodwater-induced evacuation are flood-related deaths”. …. (also see Green et al. 2019) Further complicating the issue is the fact that many natural disasters arise from a combination of individual geophysical events, or one disaster leading to other disasters (Paul 2011). In other words, one disaster event is connected through a causal sequence to the next extreme event (May 2007; AghaKouchak et al. 2018). For example, earthquakes produce landslides, liquefaction, tsunami, coastal flooding, and fire. In such cases, the disaster that initiated other disasters is called the primary disaster, and the disasters initiated by the primary disaster are most often referred to collectively as secondary or collateral disasters. Both primary and secondary disasters are called cascading disasters. If both primary and secondary disasters cause fatalities, it is often difficult to properly allocate deaths between these two types of disasters. Generally, primary disasters cause more deaths than the secondary disasters. For example, the Boulder, Colorado, USA, area experienced a severe flooding in 2013, which killed eight people. Among eight fatalities, seven were attributed to drowning and one to a flood-induced mudslides (Arnette and Zobel 2016). 10 Introduction Secondary disasters often cause far more damage and problems than does a primary disaster (Montz et al. 2017). For example, the 9.0 magnitude Japan earthquake of 11 March 2011, also known as the Great East Japan earthquake, Tohoku earthquake, or triple disasters, killed more than 18,000 people. Almost all deaths were caused by tsunami generated by the earthquake, which originated off the Pacific coast of Tohoku along a subduction zone 18 miles (29 km) below the sea surface (Pescaroli and Alexander 2015). The massive underwater earthquake triggered tsunami waves that reached heights of up to 133 feet (40.5 m) in Miyako in Tohoku’s Iwate Prefecture.7 These are the high waves that damaged the Fukushima Dai’ichi nuclear reactors whereupon melt down of the reactors led to the evacuation of 200,000 people. The total damage from this cascading disaster was estimated at $300 billion (Karan 2016; AghaKouchak et al. 2018). Another example of more deaths caused by a secondary disaster as opposed to the primary disaster is the 1960 Chile earthquake, which also triggered deadly tsunami waves. On May 22, 1960, at 3:11 p.m., the country was struck by a 9.5 magnitude earthquake, the world’s largest on record. The earthquake originated approximately 100 miles (160 km) off the coast of southern Chile and generated the largest tsunami in the Pacific region for at least the last 500 years. The tsunami was destructive not only along the coast of Chile, but also across the Pacific in Hawaii, Japan, and the Philippines. Tsunami-induced waves up to 82 feet (25 m) high severely battered the Chilean coast. The number of deaths associated with both the earthquake and tsunami in Chile has never been fully resolved; however, estimated fatalities range between 490 and 5,700, with most caused by the tsunami (Pallardy n.d.-b). Thus, the term “secondary” does not refer to scale but rather sequencing (Bradshaw 2013). Yet, for many cascading disasters, it may be difficult to allocate all fatalities appropriately to a single event. Problems with disaster deaths The number of disaster deaths has a direct association with media coverage, which not only attracts the world’s attention, but also determines the flow of emergency assistance from non-affected countries to the disaster-affected country (e.g., Heeger 2007; Letukas and Barnshaw 2008; Olofsson 2011; Paul 2019).8 Capitalizing on this, many governments of developing countries often inflate the number of disaster deaths with the intention to garner more foreign emergency aid, or it may be that they are operationally unable to calculate the death count accurately. The reverse may true for developed countries, which do not tend to seek external emergency assistance; often, high mortality is a prestige issue for such countries. As such, they underestimate fatality counts in an effort to hide dire situations. Also, countries often deliberately underestimate the death toll in an effort to reduce panic among the survivors and others as well as to avoid blame Introduction 11 for lack of adequate preparedness measures during the pre-disaster period (Daniell et al. 2013). For example, the 1991 Cyclone Gorky in Bangladesh caused an estimated death of 131,539 persons (Paul 2009). Instead of establishing adequate numbers of public cyclone centers and upgrading the early warning system, both of which could save many lives, the Bangladesh government and its officials blamed the west for the deaths of hundreds of thousands of people. They found an undeniable link between Cyclone Gorky and global climate change. They further claimed that climate change was the consequences of high emissions of greenhouse gases by advanced countries (Chowdhury et al. 1993; Dove and Khan 1995). Irrespective of level of development, the national government of the disaster-affected countries generally provides an initial estimate of the number of deaths, which needs to revised from time-to-time as more information becomes available.9 For example, Hurricane Maria, a category 4 hurricane which hit Puerto Rico on September 20, 2017, caused deaths of more than 4,000 people. Puerto Rico is an unincorporated territory of the United States and the government officials initially claimed the disaster caused the deaths of just 16 people. Later, the official estimates revised the number to 64 (Saulnier et al. 2019). Additionally, a debate raged after the Hurricane Maria struck Puerto Rico. As indicated, as of October 3, 2017, Puerto Rican government authorities reported an official death toll from the hurricane of 64. However, a joint study by the University of Puerto Rico and George Washington University estimated 2,975 excess deaths related to the hurricane in the six months following the event (O’Riley 2018). Their calculation was based on 16,608 carefully reviewed death certificates filed in Puerto Rico between September 2017 and February 2018. Based on household surveying, a Harvard University study put this figure at 4,645, which is nearly 73 times the official total (Arnold 2019). Both studies included both direct and indirect excess deaths in the total number of deaths. Lack of power, pure drinking water and emergency relief aid, inaccessible roads and highways, and mismanagement in handling relief assistance probably caused many indirect deaths after Hurricane Maria made landfall in Puerto Rico. Similarly, elevated deaths statistics have been reported by other researchers for other disasters (e.g., McKinney et al. 2011).10 Like most natural disasters, different sources provide different numbers of deaths for the same event; there can be significant disagreement over the exact figure caused by most, if not all, natural disasters. For example, many sources reported the number of deaths for the 2004 IOT, but the death figures differ from one source to another. The number generally increases as the length of reporting increases from the date of occurrence of the event (Paul 2019). For example, on a special issue of the Time on the January 10, 2005, It reported the death toll caused by the 2004 IOT was 123,442 (Time 2005). Almost a year later, Washington Post reported 216,858 deaths caused by the event in its internet site 12 Introduction (www.washington.post.com/wp-srv/world/daily/graphics/tsunami_122804. html) on December 22, 2005. At about the same time, the United Nations claimed a death toll of 186,019 (UN 2006). Similarly, depending on the source, the number of casualties from the 2010 Haiti earthquake differs by an order of magnitude, from a high of 316,000 by the Haitian government, to 222,750 reported by the United Nations to a low of 46,000 determined by an epidemiologic survey.11 Following the 2010 Haiti earthquake, at least three epidemiologic surveys were conducted and reported estimates from 46,000 to 158,000 deaths.12 Further a report commissioned by the U.S. government and made public in May 2011 significantly revised the estimate to 85,000. Officials from the U.S. Agency for International Development (USAID) later acknowledged inconsistencies in data acquisition. Given the difficulty of observing documentation procedures in the rush to dispose of the dead, it is considered unlikely that a definitive total would ever be established (Pallardy n.d.-a). This possesses a great challenge with disaster mortality data. Even in developed countries, counting disaster-induced deaths is a challenging task. Several agencies are responsible for reporting disaster deaths, but their numbers do not always mesh with one another. As death tolls are important in the United States to determine what federal resources are allocated for response, several agencies collect such information immediately after a disaster. Table 1.3, for instance, presents the number of disasterrelated deaths for three events occurred in the United States between 2009 and 2012, but the numbers do not correspond with each other. Ideally, death certificates are the primary and most reliable source of official death statistics, but those can take time to appear and do not always include the circumstances of a death. Epidemiological studies, particularly health/mortality surveillance, survey of disaster survivors, funeral homes, coroner’s office, or hospital records, are alternative sources of disaster mortality data.13 Surveillance, which is the systemic collection, analysis, and interpretation of Table 1.3 Examples of differences in number of disaster-related deaths reported by three different agencies in the United States Number of deaths by reporting agency Disaster Hurricane Ike (2009) Georgia Tornado (2011) Hurricane Sandy (2012) 1 Red cross FEMA1 NOAA–NWS2 storm data 38 15 34 104 9 61 20 15 12 Federal Emergency Management Agency National Oceanic and Atmospheric Administration–National Weather Service Source: Based on CDC (2017). 2 Introduction 13 deaths, injuries, and illnesses, is a vital source in the process of determining the extent and scope of the health effects of natural disasters on affected populations. However, each source of disaster fatalities information has limitations. Moreover, different methodologies yield different numbers as different agencies have differing guidelines for what to consider in their analysis and calculations. Reliable and complete disaster mortality data are hard to find. Although the terms excess death or mortality are often used for a particular natural disaster, both are closely associated with indirect disaster deaths. In the context of Hurricane Maria, Carrie Arnold (2019, 23) defines excess mortality as determining the following: “how many people perished in the months following the storm and subtract the number of people who, on average, probably would have died anyway.”14 Although epidemiologists have developed methods to overcome the problem of lack of absolute data, challenges in calculating disaster-induced excess mortality remain. For example, destroyed health-care infrastructure cannot be used for treating disease and illness during the post-disaster period; this leads to excess mortality among disease-stricken people, regardless of whether or not they have been affected by the disaster. It is very difficult to isolate mortality between these two groups of people. Additionally, damaged infrastructure cannot handle the ensuing spikes in disease and illness. But these deaths are most difficult to count (Arnold 2019). Furthermore, ambiguities exist in defining disaster deaths, even by reputed organizations, such as the CRED, which launched the Emergency Events Database (EM-DAT) in 1988. This database is widely used by hazard and disaster researchers throughout the world because of its reliability and comprehensiveness. The CRED defines disaster deaths as the number of people who lost their life because the event happened. Surprisingly, it includes deaths and persons missing in its count of total deaths caused by a particular extreme natural event. The 2013 World Disasters Report acknowledges that the CRED data on deaths were “missing for around 20 percent of reported disaster” for natural disasters over the last decade (IFRC 2013, 228). The CRED also acknowledges that initially reported data on deaths may sometimes require revision several months later (IFRC 2009). Often inconsistence exits between identification of a disaster and causes of death. The CRED considered Hurricane Floyd, striking North Carolina, USA, in 1999, and Tropical Storm Allison, which struck Texas, USA, in 2001 as windstorms, even though the majority of fatalities was caused by drowning in inland waterways. Similarly, the 1991 Cyclone Gorky in Bangladesh was classified as a windstorm by EM-DAT, yet most of the deaths were caused by drowning due to storm surges (Haque and Blair 1992; Chowdhury et al. 1993). Although the absolute number of deaths is widely used to determine the magnitude of a disaster, ideally one should use relative deaths or mortality rates/ratio. The absolute number ignores the scale of the disaster relative to the size of the affected population, which is referred to within the hazards 14 Introduction and disasters literature as “impact ratio” (Paul 2011). For example, assume two communities or two spatial units of similar scale (e.g., county or state) experienced 10 disaster deaths in the same event. One community has a total population of 100,000, while other has 10,000 people. In this case, comparing the absolute number of deaths between these two communities is meaningless. More meaningful statistics would be to express total number of deaths per 100,000 or million population and/or deaths per 25,000 square miles (64,750 square km).14 The former approach is also called the crude mortality rate (CMR). Thus, the number of deaths must be normalized by population or land area, since the impacted area with a larger population, or more land area, may potentially witness more deaths. Place of disaster deaths Place or location of death not only differs from one type of disaster to another, but also by national and subnational scales. For example, most earthquake fatalities occur inside buildings, while most flash flood deaths in Europe and North America occur outdoors when people drive through flooded roadways. In contrast, as with earthquakes, most tornado deaths in the United States occur inside buildings of different types: single family homes, mobile homes, apartments, factories, nursing homes, churches, and business buildings. When the location of tornado fatalities in the U.S. is analyzed for 1985–2012, slightly over 41 percent of fatalities occurred in mobile homes, followed by nearly 34 percent in permanent homes. Within buildings, deaths occur in different locations: bathroom, basement, bedroom, garage, hallway, kitchen, living room, and stairwell (Chiu et al. 2013). In the case of 2011 Joplin, Missouri, USA, tornado, other locations for tornado fatalities include about 10 percent in businesses (including hospitals, schools, stores, and churches), slightly over 8 percent in vehicles, and about 5 percent outdoors (Paul and Stimers 2014). Overall, the number and percentage of tornado deaths in mobile homes compared to those in permanent homes is remarkable because mobile homes accounted for only 7.6 percent of U.S. housing units in 2000, and only 6.9 percent of the population lives in mobile homes (Simmons and Sutter 2011). Place of tornado deaths also varies within a country at different sites in a given year. On April 27, 2011, a record number of 62 tornadoes, including eight EF-4 and three EF-5 tornadoes, struck the state of Alabama, killing 253 people (Chiu et al. 2013). Almost a month later, on May 22, 2011, a deadly EF-5 tornado tore through a densely populated section of Joplin, Missouri, USA, killing 161 people. An analysis of the location of deaths caused by the historic tornado outbreak in Alabama and of the location of all tornadoes that occurred in 2011 in the United States reveals that compared to the Alabama outbreak and nation as a whole, relatively more deaths occurred in business facilities in Joplin (Table 1.4). This is also true when the place of deaths of U.S. tornado victims is considered for the entire Introduction 15 Table 1.4 Number of Tornado fatalities by location, 2011 Location Mobile home Permanent home Vehicle Business building Outside/open Other/unknown Total USA Tornadoes (excluding Joplin Tornado) Alabama outbreak Joplin Tornado Number (percentage) Number (percentage) Number (percentage) 112 (28)* 164 (41) 19 (5) 26 (7) 6 (2) 69 (17) 396 (100) 51 (21) 148 (60) 11 (5) 3 (1) 4 (2) 30 (13) 247 (100) – 65 (41) 15 (10) 66 (42) 2 (1) 10 (6) 158 (100) * Because of rounding, the total percentage may not be 100 percentage. Sources: Paul and Stimers (2012), SPC (2012), and Chiu et al. (2013). 2000–2011 period. Nearly 35 percent of all deaths that occurred during this period occurred in permanent homes, and only 10 percent occurred in business facilities (SPC 2012). In Joplin, the largest number of deaths occurred in business facilities (i.e., in non-residential structures, such as hospitals, restaurants, churches, and retail stores), followed by permanent homes; this calls into question the protective ability and safety of such structures during tornadoes. More deaths occurred in Joplin in permanent homes and non-residential buildings (e.g., churches, nursing homes, restaurants, hospitals, and retail outlets) relative to the U.S. average primarily because of the lack of a basement in these structures. Surprisingly, no deaths occurred in Joplin in mobile homes, which typically account for 10–15 times more deaths than do permanent homes in the United States (Paul and Stimers 2014). According to an assessment by the National Oceanic and Atmospheric Administration (NOAA), Joplin residents took shelter after receiving the tornado warning in the most appropriate location (e.g., interior rooms or hallways, or crawl spaces) available to them (NOAA 2011). Even though many residents took action in the final few seconds, the report claims that in many cases, it was a life-saving measure. Unfortunately, below-ground shelters (i.e., basements) are not common in the Joplin area, and some people likely still found themselves in situations that were not survivable (NOAA 2011; NWS 2011). According to the Jasper County Assessor’s Office, nearly 78 percent of houses in the county lack basements, due in part to the rocky ground and high water table (Joplin Globe 2011). Joplin, a city in Jasper county, has an even lower percentage of basements than Jasper County communities as a whole. Also, most of the houses in Joplin are relatively old. In 2009, the median house value in Joplin ($93,108) was 34 percent below the Missouri state average of $139,700 (Joplin, Missouri [MO] Profile 2011). Older houses were constructed according to the standards of the time, which were far less stringent than today’s more rigorous building codes. For instance, many of 16 Introduction these older houses are not secured to their foundation; some do not even have a foundation (Paul and Stimers 2012). Not all deaths caused by a particular extreme natural event represent people from the affected areas or communities. For example, of all the deaths caused by the May 22, 2011, Joplin tornado, 138 (85.19 percent) were residents of Joplin; of these 138, 11 (7.97 percent) actually lived outside the damage zones, but at the time of the tornado, they were situated within the damaged zones. Twenty-four tornado victims were residents of 14 neighboring communities of Kansas and Missouri. The relatively high number of nonJoplin-resident deaths reflects Joplin’s status as a major regional center lying near the borders of Missouri, Kansas, Oklahoma, and Arkansas. Because the tornado occurred on a Sunday many Joplin residents were away from their homes attending church or high school graduations, visiting friends, shopping, or dining out, among other activities. People came into Joplin that day from neighboring communities for similar reasons, including work (Paul and Stimers 2014).15 People died from a particular natural disaster do not always from the affected and non-affected neighboring areas. A deceased person could be from non-affected country for mega-disaster such as the 2004 IOT. The tsunami killed over 200,000 from nearly 50 countries, including non-affected foreign countries. At least 9,000 foreign (mostly European) were among the dead or missing. They came as tourists primarily to Thailand and Sri Lanka. Among the European countries, Sweden suffered the most casualties, whose death was 428, with 116 missing. Other foreign countries experienced a considerable number of deaths were: Argentina, Australia, Austria, Brazil, France, Germany, Japan, Nigeria, Norway, South Africa, South Korea, Switzerland, Ukraine, the U.K., and the United States (Paul 2019). An analysis of place of disaster deaths is important for three reasons. First, it provides indication of the extent of indirect deaths. For example, if a death occurs in a hospital a few days after the extreme event, it is most likely an indirect death caused by the event. Second, it provides some insight regarding vulnerable structures or space. Lastly, it provides information regarding circumstances of death. In disaster literature, the circumstance of death refers to the timing and place of death (e.g., open space, highways, and residential buildings and non-residential buildings), which differs not only by disaster type but also by a specific type of event occurring over time (SPC 2011). This information is important for implementing mitigation measures as well as for reducing deaths from future such events. Disaster death studies The study of disaster deaths is truly multidisciplinary. Many researchers from social, environmental, business, engineering, and health science disciplines are interested in studying disaster deaths temporarily as well as spatially (e.g., Kuni et al. 2002; Kahn 2003, 2005; Jonkman and Kelman 2005; Introduction 17 Noji 2005; Donner 2007; Pradhan et al. 2007; Borden and Cutter 2008; Shapira et al. 2015; Paul and Mahmood 2016). Within a particular discipline, such research is relevant to scholars from more than one field. For example, mortality studies in general, and disaster deaths in particular, are of interest to social scientists of different backgrounds, such as anthropologists, climate scientists, demographers, economists, geographers, geologists, sociologists, and statisticians. Similarly, in the health science discipline, epidemiologists, health care professionals, including trained physicians, and public health specialists, also analyze deaths caused by natural disasters. Even within a particular discipline, many researchers of different subfields conduct research on disaster deaths. In geography, such analysis of mortality has a direct link with at least four of its subfields: historical geography, hazards and disasters geography, medical/health geography, and population geography. The topic represents one of the three traditional concerns of population geography. Glenn Trewartha (1953), who is considered the pioneer of the sub-field, proposed “a system for population geography.” This “system” lists three broad topics to be covered in population geography: historical population geography, population numbers, and qualities of population and their regional numbers. He appropriately identified mortality studies under population numbers. Mortality also represents one of the two traditional core areas of research in medical/health geography. The first area encompasses disease ecology, which, in the most general sense is the study of interaction between man and his total environment.16 The principal aim of disease ecology is to understand the dynamics of disease and deaths, which vary according to climate, vegetation, and environment (Paul 1985). Following this tradition, countless mortality atlases have been prepared to examine spatial patterns of cancer, cholera, and other diseases (Borden and Cutter 2008). Despite its direct links with population and medical/health geography, most of the recent work on mortality within geography has been undertaken primarily by hazards and disasters geographers. This subfield is relatively nascent within the broader discipline of geography.17 Objectives of this book Clearly, one of the direct and immediate impacts of natural disasters is deaths; this is universal and has remained a major concern of disaster managers and policymakers all over the world (see Borden and Cutter 2008; Paul 2011). Because of its direct and devastating psychological impact on households, communities, and nations, reducing the number of deaths has been the priority of governments of disaster-prone countries, particularly since the declaration of the 1990s (1990–1999) as the International Decade for Natural Disaster Reduction (IDNDR) by the United Nations (UN). More recently, the Sendai Framework for Disaster Risk Reduction 2015– 2030 (SFDRR or Sendai Framework) was adopted by UN member states in 18 Introduction 2015 at the Third UN World Conference on Disaster Risk Reduction held in Sendai City, Miyagi Prefecture, Japan. It is closely associated with the other UN Landmark agreements of the Sustainable Development Goals (SDGs – the 2030 agenda) (Green et al. 2019). The Sendai Framework is a 15-year, voluntary, non-binding agreement that emphasizes that the disaster-prone country has the primary role in reducing disaster risk, along with other stakeholders such as local governments and the private sector. It is the successor instrument to the Hyogo Framework for Action (HFA) 2005–2015: Building the Resilience of Nations and Communities to Disasters, which aims to prevent, prepare for, respond to, and recover from natural disasters as quickly as possible. Its principal objective is to “mainstream and integrate DRR within and across all sectors, including health, and at the same time to evaluate health outcomes from DRR implementation” (Aitsi-Selmi et al. 2015). The Sendai Framework outlined seven global targets and four priorities for action. Its first target is to “substantially reduce global disaster mortality by 2030, aiming to lower the average per 100,000 global mortality rate in the decade 2020–2030 compared to the period 2005–2015” (UNISDR 2015, 12). In this context, this book is not only timely, but it will assist in reaching the first target of the Sendai Framework. However, the Sendai Framework focuses on the reduction of short-term disaster deaths because this type of death is easy to identify, collect, and report than it is for disaster deaths occurring over a long period of time (Saulnier et al. 2019). It is worthwhile to mention that disaster deaths are often classified as short- or long-term depending on when they occur relative to a disaster’s onset. For rapid-onset disasters, most deaths caused are direct and occur in the short-term, while deaths caused by slow-onset disasters accumulate over a longer time (Saulnier et al. 2019). Although many mitigation and preparedness measures have been implemented across the globe to reduce disaster-induced mortality since the IDNDR, disaster deaths have not significantly decreased. A study by Karlsruhe Institute of Technology maintains that the absolute number of deaths by natural disasters has remained essentially constant with only a slight decrease (KIT 2016). Unfortunately, this decrease occurred in many developed countries, while the number of deaths from disasters has been increasing in some developing countries. Similarly, disaster-induced deaths have decreased for several extreme events, while others show an increasing trend. Further, compared to the global death rate due to all causes, the rate of deaths due to natural disasters has remained quite constant (Chan 2015). Yet, a huge number of disaster deaths occur each year: more than 100,000 per year (Paul 2019). Disaster deaths not only show considerable year-to-year fluctuation but also vary significantly by country, particularly by a country’s level of economic development. Analysis of EM-DAT data shows how levels of development impact a disaster’s death tolls. On average, more than three times as many people have died per disaster in developing countries (332 deaths) Introduction 19 as in developed countries (CRED 2015; also see Kahn 2005). Among the continents, Asia has experienced the highest number of disaster deaths during the recent decades. Furthermore, irrespective of economic development level, disaster mortality significantly differs within areas of a country. For example, for the United States, Borden and Cutter (2008) reported that the regions of the country most prone to deaths from natural disasters are the South and the Intermountain West (also see Cutter 2001). They also observed a distinctive urban/rural component to the country’s patterns of disaster mortality. Similarly, Thacker et al. (2008) claimed that cold-related deaths during the 1979–2004 period were highest in the states of Alaska, Montana, New Mexico, and South Dakota, while heat-related deaths were highest in the states of Arizona, Missouri, and Arkansas. The total number of deaths caused by natural disasters also differs by disaster type. EM-DAT data show that among natural disasters worldwide, earthquakes (including resulting tsunamis) are typically far more deadly than any other type, claiming 748,621 lives from the period 1996–2015 (CRED and UNISDR 2016). This means that, on average, 37,431 deaths occurred per year, accounting for about 56 percent of the disaster deaths during the above 20-year period – more deaths than all other natural disasters combined. In contrast, flooding is the most common type of disaster (in terms of frequency of occurrence), but it causes a relatively small number of fatalities (Saulnier et al. 2019). Not only does the number of deaths differ by disaster type, but the causes and circumstances of deaths vary as well. For example, nearly 59 percent of earthquake deaths occurred as a result of the collapse of masonry buildings, and 28 percent were due to secondary effects such as tsunami or landslides (CRED and UNISDR 2016). On the other hand, drowning is the leading cause of flood deaths. Jonkman and Kelman (2005) reported that drowning caused two-thirds of deaths from flooding, while just one-third resulted from physical trauma, heart attack, electrocution, carbon monoxide poisoning, or fire (also see Pradhan et al. 2007; Paul and Mahmood 2016). Another example of variation in causes of death by disaster type is drowning, which rarely occurs during earthquakes, but is a significant cause of death during hurricanes and associated storm surges, tsunamis, and floods (Bourque et al. 2007). Physical dimensions or characteristics (e.g., magnitude, duration, frequency, seasonality, rate of onset, and diurnal factors) of each natural disaster also determine the total number of deaths from extreme events. Disaster deaths also differ by gender, age, socio-economic condition, ethnicity, race, place of residence, immigration and disability status, and other personal, household, and community characteristics (Juran and Trivedi 2015). As noted, Cyclone Gorky made landfall on the eastern coast of Bangladesh on the night of April 29, 1991 (Paul 2009). A study (Chowdhury et al. 1993) conducted immediately after the cyclone reported that 63 percent of the deaths were children under age 10, who represented only 35 percent of the pre-cyclone population. Also, 42 percent more women than men 20 Introduction died. However, the lack of a safe water supply and proper sanitation caused a dramatic rise in the incidence of water-borne diseases, and nearly 7,000 people died from diarrhea, dysentery, and respiratory diseases during the post-disaster period (Chowdhury et al. 1993). Because of significant loss of life from natural disasters, studies are available on the extent, cause, timing, circumstance, and determinants of disaster mortality. Yet, most of these studies consider single year, specific country, or one type of extreme event. A comprehensive analysis of deaths caused by natural disasters is lacking. Moreover, there have been no attempts to review and summarize the multiplicity of disaster-induced deaths. Currently, not a single book or other type of publication is available that treat disaster deaths holistically (i.e., on different scales, either global or nationally) by individual and also by all types of disaster together for single or multiple years. This book also purports to present disaster deaths in an integrative way, for example, using perspectives of public health, social science, and medical science. Such perspectives are urgently needed to help develop a protocol to prevent more disaster deaths. The specific objectives of this book are essentially threefold: (1) to analyze levels and trends of disaster death patterns, (2) to examine the causes and circumstances of disaster deaths, and (3) to identify the determinants of disaster deaths. All three objectives are analyzed by disaster type and presented with empirical examples at global, regional, national, and subnational levels. Note that the second and third objectives, while they may appear so, are not identical; the former refers to the medical or pathological causes of deaths, the latter concerns antecedent and predisposing causes and causal factors. Throughout the book, case studies will draw from past major disasters as well as many recent ones across the globe. Sources of information Materials presented in this book have been drawn from two primary sources. First, a systematic and rigorous review of a large and often complex body of prior and relevant literature was conducted to derive helpful insights into the three key objectives of this book. Published materials were identified in a computerized literature search of open-source electronic databases that included Scopus, Google Scholar, ISI Web of Knowledge, Web of Science, Medline, PubMed, Science Direct, and Sirius. A number of keywords on each broad and specific topics were entered to perform the searches. Databases were supplemented with both printed published and unpublished works that provided additional information to electronic databases. In addition to pseudo-meta-analyses, primary data and information were collected empirically, as the author has been involved in more than one dozen grants in at least three different countries, studying different aspects of natural disasters, such as cyclones/hurricanes, droughts, earthquakes, floods, riverbank erosions, and tornadoes. Introduction 21 The majority of disaster deaths may be decreased by better planning, warning, and preventive measures that can result from this sort of research (Paul 2011). This research approach is also required to fully clarify the complexity of disaster mortality, particularly when social marginalization and rapid environmental degradation and urbanization have been occurring (Paul 2018). Moreover, UN officials maintain that disaster death tolls could rise in the near future if greenhouse gas emissions are not reduced. Among other issues, this book provides useful insights on how to reduce disaster deaths across the globe, and thus it is an important contribution to the body of knowledge on natural hazards and disasters, adding a significant and novel contribution to existing disaster literature. This book also has historical importance, as hazard and disaster researchers further argue that the best way to reduce disaster deaths is to know who and why people died from such extreme events. It will be of interest to government officials, disaster managers, planners, relief agencies, NGOs, donors, and other development practitioners, both undergraduate and graduate students, and teachers and researchers in the multidisciplinary fields of natural disasters. Chapter sequencing This chapter has begun with a brief section on selected definitions of natural disasters wherein human deaths are embedded either explicitly or implicitly in such definitions. Subsequent to this discussion, disaster deaths are presented by disaggregating between direct (immediate) and indirect (delayed) deaths as well as deaths caused by primary (e.g., earthquake) vs. secondary/ tertiary events (e.g., tsunami). This is followed by a discussion on the problems of disaster data and location/place of disaster deaths. The scope of multidisciplinary disaster death studies is then briefly discussed. The objectives of the book are presented, and finally, the chapter outline is provided. Eventually, Chapter 1 provides background information to facilitate understanding of the complexities of deaths associated with natural disasters. Chapter 2 explores the possible reasons why some disasters caused excess number of deaths, while others caused surprisingly low counts of fatalities. These reasons are primarily associated with physical characteristics of selected disasters, and preparedness and mitigation implemented by public authorities to reduce deaths from natural disasters. Chapter 3 addresses the first objective of this book, which is to examine the levels and trends of disaster-induced deaths to find out whether such deaths have decreased or increased in recent decades across all disaster types and geographical scales. A quantitative approach is used to analyze the trends of disaster mortality. Besides, this chapter also discusses two additional topics (one disaster myth, and mass-fatalities and their management) related to disaster deaths. In Chapter 4, a rigorous analysis of (medical) causes of deaths caused by different disasters in different geographic scales is presented, along with specific circumstances that led to those deaths. 22 Introduction In light of the presentation, several recommendations are offered, the implementation of which specifically should reduce disaster-induced fatalities. What factors actually affect disaster deaths? With the help of available empirical studies and theoretical frameworks, Chapter 5 explores the crucial determinants of disaster deaths by reviewing all types of available longitudinal and non-longitudinal studies (cross-sectional, cross-national, and cross-regional) on determinants of deaths caused by each type of disaster. The final chapter provides a summary of the main findings of this book and a discussion concerning how to reduce deaths resulting from future extreme events is presented by major disaster types. Finally, areas of future research are outlined. Notes 1. Thunderstorms, storm surges from hurricanes, and rapid snowmelt can also trigger floods. In addition, structural failures of dams and altered drainage behavior, such as the creation of concrete channels, are human activities that can produce a flood. 2. Hurricane Katrina also caused 256 deaths in Alabama, Florida, Georgia, and Mississippi (CNN Library 2019). 3. Generally, no distinction is made among disaster impacts, losses, and damages. Strictly, speaking these terms should not be used interchangeability. For example, with the emergence of climate change literature, researchers are increasingly making distinction between damage and loss. The former typically includes destruction of houses, crops, and infrastructure, while loss is the negative effects of natural disasters that cannot be repaired or restored. However, disaster loss overlaps with disaster damage (Paul 2019). 4. The death toll does not always perfectly equate with the size of the disaster, sometimes large disasters cause a small number of deaths, while small disasters can result large death tolls. Despite this, the death toll is an important indicator of disaster magnitude. 5. Number of injuries or injury rates differs within a country on subnational scales. 6. There are several myths related to disaster deaths, which are discussed in Chapter 3. 7. The height of the tsunami waves exceeded the record set by the 1896 Meiji earthquake, which generated the Sanriku tsunami. The Great East Japan earthquake triggered tsunami waves that travelled up to 6 miles (10 km) inland in the Sendai area. The waves also travelled across the Pacific at a speed of 533 miles (800 km) per hour, reaching from Alaska to Chile. The height of the tsunami wave was recorded at 5.1 feet (1.55 m) at Shemya, Alaska; meanwhile, up to 8 feet (2.4 m) tsunami surges were recorded in California and Oregon, while in Chile, the wave height was 6.6 feet (2 m) (Oskin 2017). 8. National and local media play an important role by requesting the public to donate emergency items such as food, bottled water, and clothing for the disaster survivors. Often media provide the addresses of collection center, which result in the distribution of spontaneous and adequate emergency supplies (see Hettiarachchi and Dias 2013). These necessary supplies contribute in reducing indirect deaths from the disaster. 9. Early casualty estimates after natural disasters are typically not very accurate as they are often based on guesswork. At this stage, it is difficult to accurately Introduction 23 estimate the death toll because of damage and destroy of infrastructure (Alexander 1996; Daniell et al. 2013). 10. Another example can be cited with reference to the number of deaths caused by 1991 Cyclone Gorky in Bangladesh. The Bangladesh government reported an estimated death toll of 131,539 people. But based on a detailed epidemiological study, Chowdhury et al. (1993) estimated a death toll of 67,226, about half the government estimate. This difference is comparable to the estimated deaths caused by the 1970 Bhola Cyclone in Bangladesh. While the government’s estimate was that 500,000 people died from the cyclone (Haider et al. 1991), using extensive surveys, Sommer and Mosley (1972) calculated that the Bhola Cyclone killed 224,000 coastal residents. 11. The number of deaths was provided by two official sources: The National Risk Disaster and Disaster Management Agency (SNGRD) and the Haiti’s Public Works Department (Centre Nationale des Equipments). As of January 11, 2011, the SNGRD reported a median death toll of 223,469, with a range of 222,570 to 230,000 (Daniell et al. 2013). 12. Based on available casualties report, Daniell and his colleagues (2013) claim that the median death toll is less than half of the official figures provided by the Haiti government. Using a logic tree approach they estimated that the 2010 Haiti earthquake more likely killed 136,933 people, with a range of 121,843– 167,082 dead. 13. The Centers for Disease Control and Prevention (CDC) in the United States conducts “death scene investigations” after most natural disasters. The CDC developed comprehensive forms and checklists to record disaster deaths for different types of natural disasters for investigators who collect such information during and after a natural disaster. 14. In disaster context, excess mortality is simply defined as mortality above what would be expected based on number of deaths without the disaster in the population of interest. It is thus mortality that is attributable to the disaster (Green et al. 2019). 15. In cases of tornadoes, deaths are often measured by damage zones or length of the tornado path. The former is applied to a particular tornado, while the latter is applied when death tolls are compared for several tornadoes. For example, Paul and Stimers (2014) analyzed the 2011 Joplin, Missouri, USA, tornado deaths by dividing the damaged area into four zones: catastrophic, extensive, limited, and moderate. These zones were identified based on the horizontal distance from the tornado path. Then death rates were calculated for each of these zones in two ways: death rates per 1,000 people and death rate per square mile. 16. The second major research tradition in medical/health geography focuses on the spatial arrangement and utilization of the principal elements of health care delivery systems, and the characteristics of the population involved (Paul 1985). 17. 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Flood Evacuation during the Floods of 1995 in the Netherlands. Floods, Vol. 1, edited by Parker, D.J., pp. 350–360. London: Routledge. Notes 1. The Modified Mercalli Intensity (MMI) scale depicts shaking severity and it ranges from I (not felt) through XII (nearly total damage). An earthquake has a single magnitude that indicates the total amount of energy released by the earthquake. However, the amount of shaking experienced at different locations varies based on several factors: magnitude, distance from the epicenter, and surface soil composition. The Italian volcanologist Giuseppe Mercalli originally developed this intensity scale in 1883. Since then it has been modified several times with the latest modification being done by Harry O. Wood and Frank Neumann in 1931. 2. Luckily the earthquake occurred at a time when many people were outside and returning from work or school to home and/or outside playing and talking (Daniell et al. 2013). 3. Had the 2010 Haiti earthquake struck during the night or earlier in the day when more people would have been at school or work, the fatalities likely would have been even greater. 4. Based on estimated wind speeds and related damage, a tornado in the United States was assigned a rating from F-0 to F-5 from 1971 through 2007. The ranking was developed by Theodore Fujita and was called the Fujita scale or F-Scale. The original Fujita Scale was revised in February 2007 to reflect better examinations of tornado damage survey. This revised scale is called the Enhanced Fujita Scale or EF-Scale (Paul 2011). 5. The Saffir-Simpson Hurricane Scale is used to measure both intensity and magnitude of tropical cyclones/hurricanes/typhoons. Based on a five-point scale, it measures strength of hurricanes, and assigns in ascending order Categories 1 (no real damage to building structures) through 5 (heavy damage). The Saffir-Simpson Hurricane Scale is dependent on the wind speed, which, in turn, causes damage to property (Paul 2011). 6. A district is the second largest administrative unit in Bangladesh and contains nearly three million people. 7. Experts believe that over 1,000 deaths in the 1960 Chile earthquake were caused by tsunami. 8. Almost five months after the Nepal earthquake, an earthquake significantly more powerful struck Chile on September 16, 2015, at 19:54:33 local time. The earthquake measured at 8.3 in the Richter scale lasted between three and five minutes. The epicenter was near populated areas, just 175 miles (282 km) north of the capital Santiago. It caused deaths of only 11 people and damaged only a few hundred houses (Vijaykumar 2015). This unusually low number of deaths was for three reasons. After the 1960 earthquake, Chile established strict anti-seismic building codes and modernized its tsunami warning system. Finally, the Chilean government was able to evacuate more than one million people from coastal areas in a matter of hours, escaping the tsunami waves, some of which were 15 feet (4.6 m) high in the region of Coquimbo (Vijaykumar 2015). 9. This translates to annual increase of cyclone shelter for the period was nearly 49 percent, while the population grew at a rate of 2.2 percent per year in the coastal districts (Rashid and Paul 2014). 10. Hiron Point is a protected wildlife sanctuary in the south of the Sundarbans and an important tourist spot in Bangladesh. As a wildlife sanctuary, this place is home to Royal Bengal Tigers, Chitra deer, wild pigs, monkeys, birds, and reptiles. Hiron Point, which is also called Nilkamal, is a UNESCO World Heritage site. 11. Like Bangladesh, districts in India are local administrative units inherited from the British Raj. They are administrative division of an India state or territory. 12. Experts also believe that if the 2010 Haiti Earthquake had struck during the night or earlier in the day when more people would have been at school or work, the fatalities likely would have been even higher. 1. The 2016 World Disasters Report covered the reported number of deaths for years 2006 through 2015. The 2011 World Disasters Report also published reported deaths for years 2006 through 2010. When compared these two sources of data, there are some discrepancies in the number of disaster deaths for the years 2006–2010. To maintain consistency, the deaths reported for these five years were drawn from the 2011 World Disasters Report (IFRC 2011). 2. CRED has been maintaining EM-DAT since 1988. Starting in 2014, EM-DAT also georeferenced natural disasters, adding geographical values to numeric data (CRED, USAID, and UNISDR 2015). 3. This represents 1.3 percent of global deaths (see Ritchie and Roser 2019). 4. The 2019 is the most recent year for which data on the number of disaster deaths can be available. Approximately 11,000 people died from a total of worldwide 409 natural disasters in 2019. This figure was slightly higher than the number of deaths in 2018. However, the deadliest disaster of 2019 was the flooding in India, which killed approximately 1,750 people (Statista 2020). 5. Following the 2004 IOT, a Tsunami Early Warning System was installed in the Indian Ocean, which now provides tsunami alert through three regional watch centers in Australia, India, and Indonesia. In addition, a network of 26 national tsunami information centers was also established after the 2004 IOT (CRED, USAID, and UNISDR 2016). However, none of the early warning system properly worked in 2018 when Indonesia was affected by more than one tsunami (Paul 2018). 6. Droughts are often multi-year events. For this reason, CRED has adjusted the following rules as regards mortality data for multi-year drought events: “The total number of deaths reported for a drought is divided by the number of years for which the drought persists. The resulting number is registered for each year of the drought’s duration” (IFRC 2013, 226). Further some disasters begin at the end of a year and may last some weeks or months into the following year. In such cases, CRED has applied the total number of deaths for both the start year and the end year (IFRC 2013). 7. The extreme temperatures in 2010 affected an area that was about twice as large as the area affected in 2003 (European Commission 2011). 8. Only nine deaths were caused by volcanic eruptions in 2016. All deaths occurred in Indonesia (Ritchie and Roser 2019). 9. For a longer period (1966–2015), the percentages of deaths caused by the two broad types of disasters are almost similar to the percentages reported in this study. For this period, UNISDR (2016) claims that climate-related disasters were responsible for 60 percent of all natural disaster deaths, and geophysical disasters contributed 40 percent of deaths. 10. Overall, 8,336 natural disasters occurred between 1991 and 2015. Of these 7,556 events are classified as climate-related disasters and the remaining 780 as geophysical disasters. 11. The Ring of Fire spans for nearly 25,000 miles (40,250 km), running from the southern tip of western coast of Argentina in South America, along the west coast of the United States and Canada, across the Bering Strait, down through eastern coast of Japan, and into New Zealand. Approximately 75 percent of the world’s volcanoes occur within the Ring of Fire. 12. Africa is characterized by relatively low levels of seismic activity. This activity is mainly confined to the East African Rift System and the Atlas mountain region of the northwestern part of the continent. Several deadly earthquakes struck North African countries in the last century before 1991. Only two major earthquakes occurred in Africa during the study period – the 5.8 magnitude earthquake that struck Cairo, Egypt on October 12, 1992 killed more than 500 people; and the 6.8 magnitude earthquake that struck Algeria on May 21, 2003 killed more than 200 people (ICFS 2017). 13. In their review of epidemics after natural disasters, Watson et al. (2006, 2007) noted that the extreme events that do not result in displacement are rarely associated with an outbreak of epidemic disease. They further claim that the outbreak of infectious diseases in post-disaster period is associated more with the characteristics of the displaced population (size, health status, and living conditions) than to the precipitating event. 14. Dry ice should not be placed on top of the dead bodies because it damages the bodies. Depending on outside temperature, about 22 lbs (10 kg) of dry ice is needed for each body per day (Morgan 2006). 15. RFID tags are affixed to dead bodies in order to track them using an RFID reader and antenna. 16. Following the 2002 Bali bombing in Indonesia, visual identification was incorrect for about 33 percent of victims (Lain et al. 2003). 17. Some identified bodies are buried by family members but rise to the surface. In this instance, the family members are buried again. 18. Unlike Muslims, Christians, and Jewish, Hindus and Buddhists cremate their dead. 1. Several hospitals records found that the injury-to-death ratio varies among earthquake disasters but averages about three injuries to every fatality (NHO 2012). 2. Thrust earthquakes occur where tectonic plates move vertically up and down and displace ocean water, while strike-slip earthquakes occur where tectonic plates move horizontally. 3. In the 1992 Puerto Rico floods, 11 of the 14 fatal car crashes occurred when drivers were crossing flooded bridges (Staes et al. 1994). 4. There are other disaster events where rescuers died during rescue operations. For example, five rescuers died in North Carolina when Hurricane Floyd hit in 1999 (MMWR 2000). 5. Compiled from different sources, average annual flood mortality in Bangladesh was 205 persons during the 1972–2019 period. 6. It was the largest cause of death when Hurricane Katrina hit in 2005. Most deaths occurred because of drowning. 7. During the last 20-year period (1998–2018), a total of 2,255 people died in the United States from hurricanes, averaging near 113 deaths per year (www.iii. org/fact-statistic/facts-statistics-hurricanes). 8. With few exceptions, relatively more indirect deaths occur from cyclones/hurricanes/typhoons in developing countries than in developed countries. 9. Indoor deaths in the continent of North America showed a higher percentage in comparison with Hurricane Katrina and Rita (Jonkman et al. 2009). 10. This represents 5 percent of the total deaths caused by Cyclone Gorky. 11. One police officer was also killed by lightening while he was assisting with recovery and cleanup efforts the day after the tornado. This indirect death was not included in the official death toll. 12. A district is the second largest administrative division in Bangladesh with an average population of 2.5 million. 13. A proximate death is a direct death, while the underlying cause of death refers to the disease or injury that ultimately leads to a death. 1. Two associated terms are relative risk (RR) and absolute risk (AR). The RR is a ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the nonexposed group. The AR is the probability or chance of an event, that is, the number of events that occurred in a group, divided by the number of people in that group. 2. The influence of these physical dimensions on deaths is discussed in the subsequent sections under each type of disaster. 3. The process of liquefaction occurs when ground shaking causes water to rise, filling pore spaces between granular sediments, increasing pore water pressure and resulting in the sediment acting as a fluid rather than a solid. 4. Ecologically, Nepal is divided into three zones: Northern mountains, central hills, and southern terai or lowlands. Because of higher elevation, districts located in the northern and central zones are more susceptible to both earthquakes and earthquake-induced landslides than the districts of the southern lowlands (Khazai et al. 2015). 5. Note that in deep waters, waves created by tsunami are relatively unnoticed, often felt by those in the sea as a gentle wave (Nishikiori et al. 2006). 6. Drought magnitude is widely expressed as the Palmer Drought Severity Index (PDSI). It is a measure of both the intensity and magnitude of any drought. The PDSI uses a value of “0” to show normal conditions while negative values are representative of drought conditions. The standardized index ranges from −10 (dry) to +10 (wet) (Paul 2011). 7. Cyclone Nargis made landfall in Myanmar in 2008 and killed 138,366 people. This event killed so many people because the Myanmar government was not prepared for this disaster. It neither issued a cyclone warning nor evacuated a single person from the potential affected areas (Asia-Pacific Center 2008). 8. In both developed and developing countries, women and girls are at greater risks than their male counterparts from postdisaster violence and exploitation. Howe (2019) reported that after Haiti earthquake in 2010 many women and girls were targets of armed gang. She further reported that the rate of gender-based violence toward women in Mississippi State increased from previous year more than threefold after landfall of Cyclone Katrina in 2005. 9. The length of a tornado track can be up to 100 miles (150 km). Width of tornado tracks also varies, ranging from a few feet to a mile (1.5 km) or more (Paul and Stimers 2014). 10. Paul and Stimers (2012) did not find significant variations by gender in the 2011 Joplin, Missouri, tornado deaths. Also, in a Bangladeshi study, Sugimoto et al. (2011) reported that tornado deaths did not vary significantly by gender after adjustment for differences in age and location during the tornado. 11. In some countries, such as Bangladesh, flood magnitude is often expressed as the maximum height reached by flood waters above sea level, or simply above ground (Paul 2011). 12. Flood frequency is often expressed as a return period. For example, the return period of a flood might be 100 years. It is expressed as a return period of 1 percent in any given year. Note that some countries experience more than one flood in a given year. 13. These huge number of deaths led to a shortage of space to store dead bodies in mortuaries. Temporary mortuaries were set up in refrigerator lorries. 1. In developed countries, people often voluntarily evacuate from areas outside a declared evacuation area, causing road congestion and delays in reaching a safe destination; this is called a “shadow evacuation,” which should be discouraged (Dow and Cutter 2002). 2. Paul and Dutt (2010) reported that cyclone shelters in some coastal areas did not function as planned because some of them had been used as a place of defecation and others as a cowshed. 3. The shelter’s basic component is the construction of a small house of durable cyclone-resistant materials attached to the main dwellings (Diacon 1992). 4. Post-Hurricane Katrina, the United States has established pet shelters where evacuees can keep their pets before hurricanes and other natural disasters. There were other reasons (e.g., taking care of disabled family member, elderly, no car, or no money for costs of transportation to leave the area or motel room) for decision to stay home in New Orleans during Hurricane Katrina. The event occurred at the end of month when people had not enough money. 5. Only around 7 percent of homes in the United States are mobile homes (Simmons and Sutter 2011).