来自波士顿的声音：灾难学专家谈震后重建

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英文版——

Rebuilding Lives, not just Cities
Patrick Webb

A period of national and personal mourning for those who perished in this tragedy is important. But no time can be lost in preparing for the aftermath of such a terrible disaster. The lives of survivors must be protected and their livelihoods rebuilt, starting today.

Experience from similar kinds of crises around the world suggests that the on-going assessment of immediate needs (particularly medical care for the many crush wounds, fractures, renal injuries and other traumas, as well as shelter, and clean water) should be paralleled by assessment of reconstruction priorities. The delivery of life-saving assistance is best combined with a strategy for delivery of life-sustaining resources—the goal being to build and repair in ways that are better than what was in place before.

Three important facts need to be taken into account in the process of defining such a strategy. First, such massive earthquakes will happen again. Maybe not tomorrow, or in the very same location; but they will happen again and the threat to life and limb is growing as a result of rapid urbanization. Since 1990, earthquakes accounted for roughly one third of the economic damage caused by all forms of natural disaster across Asia. Of the people killed by earthquakes worldwide in the last decade, roughly 72% were in Asia. The relocation of large numbers of people to urban centers, happening at a fast pace in China since the 1990s, brings about large concentrations of people, many of whom live in areas vulnerable to tremors, living in houses, offices and schools often not constructed to withstand significant shocks. While training for disaster response in the 20th century was largely focused on crises in rural communities, disaster preparedness and relief in the 21st century has to be increasingly geared towards urban catastrophes. This has implications for what equipment and logistics will be needed (such as heavy lifting machinery like bulldozers to clear buildings), what foods to deliver as relief, and what coping capacities and experiences one might expect the survivors may be able to draw on.

A second important fact is that, as shown by the Kobe earthquake in Japan, more than two-thirds of victims die within minutes of the earthquake, while a further 10% percent die within six hours of the main tremor. This means that while expertise in finding trapped people and treating crushed bodies has to be capable to respond at short notice, protecting the survivors requires additional, equally specialized, medical and public health skills. On the one hand, there is a need to treat more than 220,000 people injured, and care for the millions made homeless. The forestalling of outbreaks of contagious disease is critical given such large numbers of people thrown out into the open. It is not (despite conventional wisdom) dead bodies that spontaneously spread epidemics, it is usually a lack of hygiene, cross-contamination among the sick when congregated for treatment, and lack of appropriate vaccinations and distribution of supplements, such as vitamin A to help reduce the mortality risk of measles among children. Immediate interventions must focus on supplying at least the recommended 20 liters of water per person per day, and providing culturally appropriate sanitation facilities to avert outbreaks of cholera and dysentery. On the other hand, psychological care to deal with trauma and stress is crucial in such large-scale disasters. Millions of survivors will experience grief and many will suffer survivors’ guilt. Experience suggests that preparing for appropriate group counseling early on can have large pay-offs in helping the process of rebuilding shattered societies.

The third point is that reconstruction should not merely re-construct—efforts should be made to build communities and infrastructure better (less vulnerable) than they were before. This has a physical dimension. Building and materials codes, and urban zoning must all be carefully considered to take into account the danger of future quakes. But it also has a social dimension. The government’s competent response to the tragedy in Sichuan has been widely praised, especially in contrast to the other recent disaster in Myanmar. Openness to appropriate international aid, responsiveness to local needs, and efficient mobilization of available resources have encouraged surviving communities to believe that they are not in this alone. Nothing builds confidence like evidence of effective action in support of those in need. It encourages volunteerism as communities train and prepare contingency plans against future threats. And it promotes attention to who the most vulnerable are in society, and how their vulnerability can be reduced outside of times of crisis.