dc.description.abstract |
Past records depict that both the intensity and frequency of climatic-related hazards are
increasing devastatingly. Although the number of deaths caused by these extreme events
has been comparatively less recently, the economic losses have increased considerably.
The complexity of the world with interconnected infrastructure systems has been the main
catalyst of these huge losses. COVID-19 and concurrent hazards have set out a perfect
example that shows hazards no longer affect discreet parts of the system but render the
failure of the whole system. Out of critical infrastructure sectors, damages on health
systems have attracted global concern more as the impacts on the health sector can cascade
further to socio-economic aspects as well. Therefore, currently, health is considered an
important part of disaster risk reduction. Sri Lanka, as a tropical country, experiences
climatic-related hazards more frequently. Although Sri Lanka has a disaster management
mechanism and public health system, a limited number of evidence exists on integrated
systemic risk management mechanisms in the country. Most of the existing emergency
and disaster management mechanisms have a hazard-by-hazard approach and fail to
incorporate synergized impacts of compound hazard events. The levels of integration of
public health and disaster risk management aspects into each other still needs to be
enhanced. In a context where systems thinking approaches are more promoted in disaster
resilience, this study aims at providing a framework for assessing the public health system
disaster resilience for multi-hazard contexts amidst biological hazards. In this regard, this
study has followed multiple steps to evaluate the existing health disaster management
approaches in the country. Initially, a desk study was conducted to identify key drivers of
effective response mechanisms for pandemics, which can affect the capacities of
integrated disaster risk management approaches. It was followed by a stakeholder
analysis, which used Social Network Analysis (SNA) to identify the stakeholder
behaviour in the country for multi-hazard preparedness planning. Furthermore, field data
collection was conducted under three phases, including forty-one key informants
representing the sectors that are related to disaster management in the country. Qualitative
information from this step was analysed using systems thinking and cascading effects
were modelled for early warnings, evacuation, shelter management, and hospital
functionality. Since functional continuity of healthcare facilities was identified as a key
driver of multi-hazard preparedness and response mechanisms, this study presents a model
that captures interdependencies within a hospital during a hybrid hazard scenario. As the
final outcome, the study presents a framework for enhancing public health systems
resilience for multi-hazard contexts. The developed framework was tested for its
applicability at the community level in Sri Lanka, through scenario workshops. Along
with these outcomes, the study further presents a set of gaps that needs to be immediately
addressed based on lessons from recent multi-hazard scenarios amidst the COVID-19
outbreak in Sri Lanka |
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