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    The International Federation of Red Cross and Red Crescent Societies promotes the humanitarian activities of National Societies among vulnerable people.

    By coordinating international disaster relief and encouraging development support it seeks to prevent and alleviate human suffering.

    The International Federation, the National Societies and the International Committee of the Red Cross together constitute the International Red Cross and Red Crescent Movement. extraordinary contribution to the field of disaster preparedness and emergency management...

    Eric K Noji MD, MPH National Center for Infectious Diseases, Centers for Disease Control and Prevention, USA

    Provocative and indispensable, the

    World Disasters Report 2000 focuses on public health disasters

    What are the underlying causes of public health crises? Where will resources make most difference? How can partnerships multiply the effects of aid interventions?

    Published annually since 1993, the World Disasters Report brings together the latest trends, facts and analysis of the world's ever- growing humanitarian crises. An indispensable information source and reference work with detailed case studies for those searching for strategies and tactics in the face of disaster.

    The 2000 edition examines: ■ chronic public health disasters ■ assessing and targeting public health responses ■ AIDS in Africa – from disease to disaster ■ Democratic People's Republic of Korea – where aid can

    make a difference ■ Chernobyl – cancers still rising 14 years on ■ Kosovo – the long road to recovery ■ surprise upturn in aid budgets ■ steps towards an international disaster response law

    plus.... ■ a comprehensive disasters database ■ overview of 1999 International Federation operations ■ national Red Cross and Red Crescent society contacts

    index, photos, maps, tables, graphs


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    9000-WDR-COVER.QXD 10/12/2003 13:36 Page 1

  • A global humanitarian organization The International Federation of Red Cross and Red Crescent Societies is the world's largest humanitarian organization, providing assistance without discrimination as to nationality, race, religious beliefs, class or political opinions. The International Federation's mission is to improve the lives of vulnerable people by mobilizing the power of humanity.

    Founded in 1919, the International Federation comprises 176 member Red Cross and Red Crescent societies – with an additional number in formation – a Secretariat in Geneva and offices strategically located to support activities around the world. The Red Crescent is used in place of the Red Cross in many Islamic countries.

    The International Federation coordinates and directs international assistance to victims of natural and technological disasters, to refugees and in health emergencies. It combines its relief activities with development work to strengthen the capacities of National Societies and through them the capacity of individual people. The International Federation acts as the official representative of its member societies in the international field. It promotes cooperation between National Societies, and works to strengthen their capacity to carry out effective disaster preparedness, health and social programmes.

    National Red Cross and Red Crescent Societies embody the work and principles of the International Red Cross and Red Crescent Movement. National Societies act as auxiliaries to the public authorities of their own countries in the humanitarian field and provide a range of services including disaster relief, health and social programmes. During wartime, National Societies assist the affected civilian population and support the army medical services where appropriate.

    The unique network of National Societies – which covers almost every country in the world – is the International Federation's principal strength. Cooperation between National Societies gives the International Federation greater potential to develop capacities and assist those most in need. At a local level, the network enables the International Federation to reach individual communities. Together, the National Societies comprise 97 million volunteers and 295,000 employees, who provide assistance to some 216 million beneficiaries each year.

    The International Committee of the Red Cross (ICRC) is an impartial, neutral and independent organization whose exclusively humanitarian mission is to protect the lives and dignity of victims of war and internal violence and to provide them with assistance. It directs and coordinates the international relief activities conducted by the Movement in situations of conflict. It also endeavours to prevent suffering by promoting and strengthening humanitarian law and universal humanitarian principles. Established in 1863, the ICRC is at the origin of the International Red Cross and Red Crescent Movement.

    Together, all the components of the International Red Cross and Red Crescent Movement are guided by the same seven Fundamental Principles: humanity, impartiality, neutrality, independence, voluntary service, unity and universality. In the same manner, all Red Cross and Red Crescent activities have one central purpose: to help those who suffer without discrimination and thus contribute to peace in the world.

    Natural disasters, such as the earthquake which shattered north-western Turkey in August 1999, seize media headlines and draw in donor resources. But silent public health disasters caused by infectious diseases rarely make the front page yet kill millions more.

    Photo: Mikkel Oestergaard/International Federation, Turkey 1999.

  • 2000 World

    Disasters Report Focus on public health

  • Copyright © 2000 by the International Federation of Red Cross and Red Crescent Societies.

    ISBN 92-9139-066-6

    All rights reserved. Except for quotation in a review of the work, no part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the International Federation of Red Cross and Red Crescent Societies. This publication is copyright, but may be reproduced without fee for teaching purposes but not for resale. Formal permission is required for all such uses. For copying in any other circumstances, or for re-use in other publications, or for translation or adaptation, prior written permission must be obtained from the publisher.

    The opinions expressed in this publication do not necessarily represent the official policy of the International Federation of Red Cross and Red Crescent Societies or of individual national Red Cross or Red Crescent societies. The designations used do not imply the expression of any opinion on the part of the International Federation or National Societies concerning the legal status of a territory or of its authorities.

    Printed by SADAG Imprimerie, Bellegarde/Valserine, France

    Acknowledgements The World Disasters Report 2000 was edited by Peter Walker and Jonathan Walter. Principal contributors: Chapter 1, Michael Day and Jonathan Walter; Box 1.1, Fred Pearce; Box 1.2, Michael Day; Box 1.3, Michael Day; Box 1.4, Patrick Fuller (International Federation) and Jonathan Walter; Box 1.5, Jari Vainio (International Federation) Chapter 2, Jane Cassidy; Box 2.2, Claude de Ville (PAHO); Box 2.4, Michael Day Chapter 3, John Sparrow Chapter 4, John Owen-Davies Chapter 5, Leyla Alyanak; Box 5.1, Sergei Neverkevitch (International Federation); Box 5.2, Jean-Pierre Revel (International Federation); Box 5.4, Shaun Burnie (Greenpeace International) Chapter 6, Edward Girardet; Box 6.1, Jonathan Walter; Box 6.4, Loretta Hieber (Media Action International) Chapter 7, Andrew Simms; Box 7.1, David O’Brien and Abby Stoddard (New York University) Chapter 8, Michael Hoffman (American Red Cross) Chapter 9, Centre for Research on the Epidemiology of Disasters; US Committee for Refugees Chapter 10, Box 10.2, World Bank/Disaster Management Facility Thanks to all those who assisted contributors during travel and research, including Guy Bentham, Aradhna Duggal, Isabelle Grondahl and Fernando Soares.

    Contact details: International Federation of Red Cross and Red Crescent Societies 17, chemin des Crêts, P.O Box 372 CH-1211 Geneva 19, Switzerland Tel.: (41)(22) 730 4222; fax: (41)(22) 733 0395 E-mail:; web site: To e-mail the World Disasters Report editors:


    World Disasters Report 2000

  • Contents International Federation of Red Cross and Red Crescent Societies inside front cover Acknowledgements 2 Introduction 6

    Section One Focus on public health Chapter 1 Public health – has it fallen off the map? 8

    Box 1.1 La Niña storms savage Venezuela 10 Box 1.2 Nicaragua needs a break 13 Box 1.3 Minamata – poisonous reminder of the past 14 Box 1.4 Orissa – from cyclone to suicide 18 Box 1.5 Turkish earthquakes leave long-term legacy 26 Figure 1.1 Investment in public health pays off 21 Figure 1.2 Public expenditure on health as a percentage of GDP 25

    Chapter 2 Assessing and targeting public health priorities 30 Box 2.1 Volunteers vital for meningitis vaccination 34 Box 2.2 SUMA in East Timor 39 Box 2.3 Dengue fever contained by cooperation in Cambodia 43 Box 2.4 Consigning polio to the grave 45 Figure 2.1 The planning cycle 32 Figure 2.2 Satellites map Mozambique’s floods 36

    Chapter 3