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Social science risk brings into play factors such as perception that cannot easily be quantified, or when quantification is attempted the result is less than satisfying Purchase and Slovic, Thus risk and its dominant component vulnerability are in essence hypothetical concepts. Paradoxically they are no less real for being hypothetical.

However, once they are mobilised they are instantly transformed into impact. It is thus hardly surprising that risk and vulnerability remain elusive — though not illusive — concepts that defy holistic measurement or assessment. To understand either we must descend to the level of partial estimation, using a set of qualifying conditions, for example, risk over defined time periods and with respect to one sector, such as economic activity, or infection and disease. Their full development requires considerably greater and more penetrating observation over longer periods of time.

In addition, such periods will inevitably be characterised by rapid and profound changes in society and the environment of life.

Modeling the Injury Flow and Treatment after Major Earthquakes

Nevertheless, it is possible to make a start on interpreting current reality using new models. The next section will present a short example. In total, people were killed, were injured, of them seriously, 67, people were left homeless and about , buildings were seriously damaged. The earthquake formed part of a swarm of tremors that began in October and did not attenuate until the following summer. L'Aquila had been struck by a devastating seismic event in with 6,, deaths, but the last major earthquake in Abruzzo happened at Avezzano, about km southeast of L'Aquila in It killed 32, people, including 94 per cent of the population of Avezzano.

The death toll in could have been much higher had the earthquake not occurred during a long weekend when many people were away from the area. The disaster was thus a significant test of the Italian national civil protection system, which responded with a major and sustained mobilisation of national resources. Given the risk of structural collapse among buildings weakened by the earthquake, L'Aquila city and several local towns were put off limits to the general population, the first time in the history of modern Italy that a major city had been totally evacuated, moreover for a period exceeding one year Stucchi et al.

Within 24 hours the first of two large field hospitals was set up and active in the vicinity, but several hours after the earthquake San Salvatore had to be taken out of use and evacuated for fear of structural collapse. Immediate medical response was thus largely carried out by military medivac, evacuation of seriously injured patients by air to hospitals in the surrounding region, most of them at considerable distance from L'Aquila.

A similar number were put up in hotels, many on the Adriatic coast on the other side of the Apennine Mountains. The remainder were either found accommodation on their own or left the region. The tent camps remained for six months, throughout the summer, until they were replaced with transitional housing. This was of two types: C. Complessi Antisismici Sostenibili ed Ecocompatibili and M. Moduli Abitativi Provvisori. The CASE project consisted of multiple occupancy units with antiseismic base isolation constructed at 19 sites in the vicinity of L'Aquila Figure 2.

The MAP units were smaller prefabricated buildings without base isolation that were erected at more than 50 sites in the area. Figure 2. The base isolation columns support the building and protect it from earthquake shaking. Photo by author. Huge numbers of vehicles and vast stockpiles of materials were rapidly assembled and applied to the problems of cordoning off the areas of destruction, buttressing precarious buildings, feeding and housing displaced populations and coordinating the flow of relief goods and personnel.

As usual, the Italian Fire Brigades constituted the lead agency. Blue-light services and the hundreds of civil protection volunteer organisations were coordinated by the National Department of Civil Protection. The strategy was successful, but it remains to be seen whether such a measure could be adopted in the case of a major earthquake over a much wider area and involving a much larger population.

Because of the damage to vernacular housing, earthquake disasters involve sudden and massive homelessness. The most common strategy for dealing with this is to use tents and improvised shelter for a very short period of time a matter of days or a very few weeks and then provide cheap but robust transitional shelter using container homes or small, light-walled prefabs, which typically have a floor area of sq.

At the same time much money was spent on intensively buttressing the ruined buildings in the town centres, which remained cordoned off against public access. However, the government could not afford to remove the estimated million tonnes of rubble from these sites. The CASE units did not live up to their designation as 'ecocompatible'.

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Although they have solar panels for water heating, lack of services and public transportation has induced a massive dependency on the private car. Nor has the economy been bolstered. There is evidence of economic stagnation, outmigration of workers and the loss of something between 16, and 26, jobs as a direct result of the destruction of shops, studios and businesses by the earthquake. Moreover, the devolution of taxation so ardently promoted by successive Italian governments since the s has proved advantageous to some provinces of Italy and fiscally regressive to others. L'Aquila is the worst affected example of the latter.

In mid, the Prime Minister, Silvio Berlusconi, afflicted by scandals and loss of popularity, pledged to rehouse within six months all the families made homeless by the earthquake. Hence they were left in tents during the long hot summer and as the autumn weather cooled they were rehoused in the rapidly constructed CASE and MAP units. It was a remarkable logistical achievement, and one that involved little or no loss of quality between the design and the realisation of all the homes.

It gave the Government and Prime Minister a substantial political advantage that they were able to exploit, adroitly, in order to gain votes in regional and local elections.

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To begin with, the cost of the transitional housing was more than twenty times what more economic shelter would have cost. Secondly, nothing was invested in transportation and services, leaving sites that had populations of up to 2, people devoid of shops, community centres, coffee bars, bus services, clinics, schools and doctors' surgeries. Moreover, little attention was paid to the problem of conserving social cohesion in the assignment of transitional housing units. This has led to high levels of isolation, depression and post-traumatic stress among the assignees.

In conclusion, the lavish scale of buttressing and vast sums spent on transitional housing have left little or nothing for reconstruction. The physical aspect of these two initiatives suggests that the Government has prepared the way for a long interval, perhaps decades, before reconstruction occurs — if it ever does. There is a precedent for this as the Belice Valley of western Sicily, another Italian backwater, went through 15 years of stagnation between the earthquakes of and the inauguration of a significant amount of reconstructed housing and urban services Angotti, The Italian Government provided everything, right down to furniture, cutlery, crockery, linen, televisions and electrical equipment.

The model for this is Milano Due, the speculative residential development in Segrate, Milan, built over the period , that propelled Silvio Berlusconi from obscurity to national prominence. Largesse was an instantaneous vote winner, but state paternalism has destroyed governance, in the sense intended by the definition given earlier in this paper.

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Dissent is barely tolerated and L'Aquila has once again become politically, economically and socially marginalised in national life. The tyranny of geography is that, although it is barely km from the centre of Rome, L'Aquila lies in an intermontane basin with relatively poor connections to other parts of Italy. Its only major source of employment is the local university, at a time in which Italian higher education is in a state of very severe depression.

Taxation has been inimical to enterprise. Emergent groups have been created, but they have not achieved the critical mass or prominence to have much influence on a situation characterised by stagnation and decline.

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The ancient cultural background of the area is characterised by poverty and feudal dependence. Although absolute poverty has gone, traces of the feudal dependence remain, along with the economic depression of a region that has not been given the best possible incentives to grow and develop its rather scarce resources. Although chronicles of the miseria of the peasant area are in no way diagnostic of modern conditions, there are parallels in the inherited cultural background, especially in the conservatism of a people that for too long has had too much to lose by protesting Russo, The biggest victim is good governance and any prosperity that might have resulted from it.

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  • Although the situation in L'Aquila is not as severe as it is in many countries, the earthquake nevertheless created a discernable gender bias cf. Enarson and Morrow, Even when one corrects for the demographic imbalance between the sexes in old age, the anomaly remains Alexander, The explanation is difficult to formulate but probably relates to the lower mobility of women than men: some of the men who were registered as resident in the area were probably not physically present on the night of the earthquake.

    To begin with, it was the first major test of the current Italian civil protection system since the earthquake in southern Italy. It thus reflected the competence of the nation in the face of a severe natural emergency. Secondly, the whole disaster was overshadowed by political considerations, in the light of the Italian government's need to gain short-term popularity for electoral reasons and in order to maintain its power base. The G8 summit that was held in L'Aquila from July represented the apex of this process.

    In reality the summit did little for the plight of the Aquilani, but it was redolent with symbolic moments. For example, the village most affected by the earthquake was Onna, in which 40 of the inhabitants died when 60 per cent of the building stock collapsed. On 11 June Onna had been the scene of a massacre of 18 local civilians by German troops and during the summit the German Foreign Minister pledged funds towards the post-earthquake reconstruction, a highly symbolic gesture in the light of current moves towards European unity.

    Modern post-disaster solidarity has a very public face, much at variance with the discretion of previous ages Alexander, However, the problem with media coverage is that it does not necessarily present a consistent and accurate picture of the reality on the ground. Coverage varies from day to day much more than the situation itself does. Moreover, many of the most serious problems, for example bureaucratic stagnation, are not particularly newsworthy. In contrast, it proved easy to interpret the disaster in terms of, for example, the charity, piety and pity inherent in Catholicism, one of the principal cultural subtexts.

    For instance, construction in the region has for centuries been dominated by the use of stone from which reinforced concrete has taken over with decidedly mixed results in terms of seismic response. Suddenly, in the aftermath of the earthquake there was an enormous accession of wood and steel construction, much of it arranged in parks, or estates, in the Anglo-Saxon manner. Symbolically, it seemed to represent a sudden modernisation of a very ancient area L'Aquila city is years old and many of the surrounding settlements are twice as ancient , or at least a desire for modernisation.

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    Given the paternalism and lack of governance, one might almost call it a forced modernisation. There is a strong risk in such cases that it will destroy a genius loci acquired over the centuries. In Italy historic settlements depend for their identity on a number of iconic monuments and a distinctive kind of urban form. To erase any of that would only cut people off from their history and diminish their sense of social identity.

    There would thus be discord in the semantics of semiotic analysis, and probably also in the pragmatics Eco, However, that must await further research and in the meantime it is necessary to draw some conclusions. Hazard acted upon vulnerability to produce disaster. It followed that, as hazards were at the start of the process, they received the lion's share of the attention. This was also in line with the dominance of physical over social sciences at the time.

    Lulu Zhang

    As a result of feedback loops, hazard can be regarded as a trigger for the social processes that create vulnerability, which is the principal determinant of disaster potential. The vulnerability of human socio-economic systems is acted upon by physical hazards whether natural or anthropogenic , as well as cultural and historical factors. The plexus of the context and consequences of these associations is what determines the form, entity and size of any ensuing disaster. Much work needs to be done to fill in the details and clarify the relationships. For instance, history is a vital explanatory factor and we live in an age that is apt to forget its lessons , but it does not determine the future, it merely contributes some important ingredients.

    Much lateral thinking will be required if disaster is to be interpreted creatively and with penetrating insight. Trends and tendencies will have to be understood and incorporated into this process, and we live in a world that is consuming resources at an accelerating rate, that is undergoing environmental change at an ever faster speed, and that is becoming increasingly crowded with people who live, travel and work in hazardous areas.

    Finally, any valid, workable explanation of disaster for the new millennium must include the effects of technological change, which has radically altered the ways in which we see and interpret catastrophe. Hence, we face both an intellectual and a practical challenge, which is worth rising to, as theory is the "road map" by which we navigate through the chaos of disaster and risk situations and are thus able to manage them.

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    Enarson, Elaine; Morrow, Betty Hearn eds. Westport, CT: Greenwood. London: Routledge. London: Unwin-Hyma, Focus on Urban Risk.

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      Comparative analysis on the characteristics of casualties medical evacuation in Wenchuan and Yushu earthquakes [J]. The Israeli field hospital in Haiti—ethical dilemmas in early disaster response [J]. New England Journal of Medicine. Xiao-Ming LI. Organization and command of medical rescue in Yushu earthquake.

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      Strategic supporting forces grouping in emergency medical relief of Yushu earthquake. Characteristics of military health forces use in earthquake medical rescue. Medical support in Wenchuan earthquake relief: characteristics and reflections. Emergency medical rescue efforts after a major earthquake: lessons from the Wenchuan earthquake. Rescue efforts management and characteristics of casualties of the Wenchuan earthquake in China. Emerg Med J. Personalised recommendations. Cite chapter How to cite?

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