What defines a disaster situation?
The Center for Research on the Epidemiology of Disasters (CRED) defines a disaster as “a situation or event which overwhelms local capacity, necessitating a request to a national or international level for external assistance; an unforeseen and often sudden event that causes great damage, destruction and human suffering‘ (1).
CRED identifies (1) an event as a disaster if at least one of the following criteria is met:
- 10 or more human deaths
- Reports indicating that 100 or more people are affected
- Declaration of a state of emergency
- Request for international assistance
Examples of disasters include hurricanes, tornadoes, floods, landslides, earthquakes, volcanoes, power outages, acts of terrorism and wars (2.3). These events have severe effects on agriculture, infrastructure, the economy and individual health. They place populations affected at increased risk of diseases or health situations that are preventable (2).
Humanitarian emergencies often result in large-scale movements of populations. The arrival of displaced persons into unprepared locations puts severe pressure on healthcare resources. People affected are often resettled in densely-populated temporary locations with inadequate food and shelter, unsafe water and poor sanitation. These conditions are linked to an increased transmission of infectious diseases and the worsening of existing health conditions, such as chronic conditions like diabetes. This can lead to higher rates of death (1).
How do disaster situations impact people living with a chronic condition like diabetes?
Disasters frequently occur without warning and can seriously threaten individual health and wellbeing. Populations affected are often left without electricity, refrigeration, means of communication or transportation, while also experiencing shortages of food, clothing, and shelter. In addition, access to medical facilities, providers, medical records and medications may be limited (3). When care or treatment is disrupted, people living with diabetes are at higher risk of serious and life-threatening complications, such as heart attack, stroke, kidney failure, blindness and lower-limb amputation.
Research demonstrates that diabetes management is impacted by disaster situations in the following ways:
- Blood glucose control often deteriorates after a disaster. Contributing factors include stress, reduced access to medicines, care, healthy food choices, clean water and sanitation, and possible exposure to infections (3).
- Disaster situations increase the risk of morbidity and mortality due to diabetes complications (3).
- People with diabetes often make more frequent visits to Hospital Emergency Departments (3). Increases in admissions of people with newly-diagnosed type 1 diabetes have also been reported after a disaster (4).
- Certain populations, such as the elderly, people of low socioeconomic status, people without health insurance, and minorities, become even more vulnerable during disasters and experience increased morbidity and mortality (4).
In addition, disruptions to the supply of electricity and refrigeration can impact the efficacy of temperature-sensitive medicines such as insulin. Therefore, early planning and ensuring that essential diabetes medicines are included on emergency medicine lists can reduce the impact of disruptions to people with diabetes during and in the aftermath of a disaster (3).
