3. Reconstruction

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The primary objective of reconstruction work is not only to rebuild dwellings and infrastructure damaged or affected by the disaster, but to reduce the future vulnerability, making at-risk areas more economically secure, and improving safety and the quality of life of the population.

 

3.1. Reconstruction in the context of development

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According to the Center for Research on the Epidemiology of Disasters (CRED), in 2010 alone there were 385 disasters, with over 297,000 fatalities, more than 217 million people affected. Total damage was estimated at US$123.9 billion. The Region of the Americas experienced 98 disasters in the course of the year, with more than 225,000 fatalities, some 13 million people affected, and economic losses of US$49.188 million.

According to data on the health sector provided by the PAHO/WHO Member States, 67% of the Region’s 18,000 hospitals are located in areas of disaster risk. In the last decade, nearly 24 million people in the Americas were without health care for months, and sometimes years, due to damages caused directly by disasters.

 

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3.2. Health sector reconstruction planning

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SafeWorldBook Box3 7 IconAs shown in previous chapters, the effects of disasters vary. For example, in the case of an earthquake, the impact on the community can be so great that the capacity to provide health services is sharply reduced for a long time afterward. Floods, not only impact the land and the production sector but also cause serious damage health infrastructure and hospital equipment, which often causes the functional collapse of health facilities, as this article on understanding critical infrastructure failure in the wake of Hurricane Katrina illustrates.

The reconstruction period offers both challenges and opportunities in the aftermath of disasters.

 

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3.3. Other health priorities for reconstruction

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In addition to rebuilding health facilities seriously damaged or destroyed in a disaster, planning for reconstruction in the health sector should look to the future and prioritize other areas where strengthening contributes to improved preparedness and response, including:

 

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3.4. Challenges in reconstruction

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Reconstruction is extremely complex, from a political, strategic, and funding standpoint. The time it takes to execute reconstruction works poses serious challenges for the health sector, including the following:

  • The necessary financial resources to implement programs. Many countries exhaust their available resources during the emergency phase FOR response activities.
  • Health must compete with other priorities; government officials often give greater priority to strategic and production sectors.

 

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3.5. Components of a reconstruction plan

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Post-disaster reconstruction is a complex challenge that requires careful intersectoral and multidisciplinary planning. The essential components at this stage are:

3.5.1. Damage and loss assessment to estimate the socioeconomic impact of the disaster (DaLA) and post-disaster needs assessment (PDNA)

Assessing the damage and losses caused by a disaster—its impact on the economy, impact on the society, the economic value of lost infrastructure, impact on the social fabric, and finally, impact on development is of paramount importance.

The Economic Commission for Latin America and the Caribbean (ECLAC) has developed a methodology for assessing the socioeconomic and environmental impact of disasters (DaLA). Initially, the methodology concentrated on natural hazards only, but it has expanded and is now looks at the health impact as well. In use in over 45 events, it has repeatedly demonstrated the Iink between disasters and development. 

 

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3.6. Health ministries’ role in reconstruction

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3.6.1.Organization of the ministry of health and its incorporation in the PDNA process and in reconstruction planning

3 6 1 organizacionWhen a country is affected by a disaster, the ministry of health should, from the beginning, take a very active role on reconstruction committees or councils. The definition of needs should be solidly based on the assessment of damage, losses, and the strategic approach that health authorities wish to promote to recover and improve physical infrastructure, equipment, and the operation of services affected by the disaster.

 

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