Deaths foretold

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Ninety per cent of the 50,000 persons who died in the October 29, 1999, super cyclone that hit the Ersama block in coastal Orissa would be alive today - if only the population there had been evacuated inland, beyond the reach of the three 10-metre-high tidal waves that swept away everything in their wake. And there was all the time in the world to do it.

Orissa was unprepared for this cyclone, some have argued, as it is rarely hit by super cyclones. Facts speak otherwise. India's east coast, one of the six major cyclone-prone regions in the world, is hit by four to six cyclones every year, of which one to two are severe. Orissa is hit by 20 per cent of all severe cyclones that make landfall on this coast. Once every few decades a super cyclone comes along, leaving mass death in its wake. Orissa alone has been hit in recent times by super cyclones in 1942, 1971 and 1999.

With recent advances in cyclone-detection technologies, a super cyclone need no longer be so deadly. Andhra Pradesh, the most cyclone-prone state in India, illustrates this well. The 1977 Divi super cyclone killed over 10,000 persons, but less than a thousand died in the 1990 Machhilipatnam one. The difference in the toll is due to the early warning given before the Machhilipatnam cyclone, which was used to evacuate people, saving 50,000 lives.

Six factors - event prediction, warning, risk-avoidance action, hardware, emergency plans (eps) and the activation of eps - when in place together, minimise loss of life in natural and human-made disasters. Each factor, out of place when disaster strikes, tends to increase loss of life. The Ersama cyclone's high death toll is because four factors, and a part of the fifth, were out of place when nature's fury struck.

EVENT PREDICTION : Prior information of an impending disaster helps identify vulnerable populations. Prediction information has five vital components: the nature of the expected event, its magnitude, location and time, and prediction's lead time.

Till the late 1970s, cyclone warnings provided little lead time, resulting in high death tolls in super cyclones. Since then, satellites and radars have increased warning time. The Indian Meteorological Department (imd) 'saw' the Ersama super cyclone gather itself into a fury for four days off Paradip port before it hit the coast. The imd advisory stated unambiguously that the cyclone would be very severe and make landfall on the night of 28th October between Puri and Balasore. The prediction was accurate and was available more than 75 hours before the event, providing ample time for an evacuation.

WARNING: A public warning of an impending disaster gives people a fighting chance to get out of harm's way quickly. To be effective, a warning must fulfil six criteria: should come in time, reach everyone at risk, be appropriate for the event, be unambiguous about the action people should take, sound credible and be specific to the risk posed by the event.

Public warnings for the Ersama cyclone were broadcast on the electronic media for more than 50 hours before the event and reached even remote villages through battery-operated radios and tvs. The warning advised evacuation of certain areas.

The Ersama cyclone warning met the first three criteria but failed the next three-unambiguity, credibility and specificity. Weather information puts the onus of making decisions on people. Emergency-action information instructs people to act in certain ways. The Ersama cyclone warning bundled weather and emergency-action information into a single message, creating doubt whether people should use their judgement or follow instructions. When in doubt people prefer the status quo; in this case they stayed home.

A lower intensity cyclone hit south Orissa's Ganjam district 10 days before the Ersama cyclone. The warnings for the Ganjam and the Ersama cyclones were very similar, thus were not cyclone-intensity specific - both warned of gale winds, widespread rain, 2-3-metre-high tidal waves, communications disruption, uprooting of trees and damage to houses. The mismatch between the Ganjam cyclone warning and its intensity, with no subsequent explanation for the mismatch, reduced the credibility of the Ersama warning, making people believe that the Ersama cyclone would be similar to the Ganjam cyclone.

Instead of evacuating to safer ground, they stayed in their mud-walled houses on the flat low-land Ersama coast, only to be swept away by the tidal waves, often 25 km inland. The destruction was completed by the incessant rain and howling winds that smashed houses, uprooted trees, power and telephone poles and felled all but the strongest structures that lay in the storm's track.

RISK AVOIDANCE ACTION : The chances of taking good risk-avoidance/ mitigation action are higher when people know the risks they face and the choices they have. No programme made Ersama's population aware of the consequences of super cyclones or what they should do after a warning for one is given.

INFRASTRUCTURE AND HARDWARE: The infrastructure Orissa has is woefully inadequate for saving lives during cyclones. Orissa has 23 specially constructed cyclone shelters compared to 1,041 in Andhra Pradesh (Orissa's coast length is about 40 per cent of Andhra's). The most rugged communication system in any Indian state, the police wireless system, failed in Orissa during the cyclone for want of radio masts which could withstand high wind speeds. A ham radio network - a good backup communication system which has played a vital role in many past disasters - is absent in Orissa.

EMERGENCY PLAN: An EP is the software which instructs government personnel and people on what to do before and during a cyclone. Orissa's ep for cyclones is available in two documents - The Orissa Relief Code (ORC), which is broad and generic in nature, and the district contingency plan, which is supposed to carry detailed plans for each district. The ORC, first prepared by the British for floods and famines, was updated 30 years ago to include cyclones. As with most revenue department documents, it concerns itself more with post-disaster relief modalities than with handling emergencies. The more major lacunae in the ORC are:

l The ORC does not demarcate areas vulnerable to tidal waves, rain and wind, respectively. Modelling techniques to delineate vulnerable zones have been available for years. This information is vital for EPS to determine how best to save lives. For example, in areas vulnerable to tidal action, death is usually by drowning or impact. Lives are saved here by moving people into specially-constructed double-storied cyclone shelters or evacuating them inland. Resistance to leaving their homes can be reduced by group-insuring properties. In inland areas affected only by rain and wind, where death is usually due to wall or roof collapse, they need to be shifted from weak houses.

l The ORC makes no distinction between weather and emergency-action information in warnings, and this contributed to the Ersama disaster. It is necessary to unbundle these two types of information.

l The ORC does not define emergency-action levels based on predicted cyclone intensity. Three emergency-action levels can be conceived for cyclones. The first level is for low intensity cyclones, when declared, will ask people to stay home and take necessary precautions; the second, for moderate intensity cyclones, will make people living in weak houses to move to stronger ones; and the third, for severe and super cyclones, where everyone evacuates to cyclone shelters, to safe ground or inland. Each village must have predetermined destinations and routes for the higher emergency levels.

l The ORC makes the revenue department (rd)double as a cyclone emergency controller. The rd's basic concern is revenue and law and order and its personnel are not trained in emergency management or to respond quickly, both essential for saving lives. A specialised emergency management agency needs to be set up to handle cyclones and similar emergencies.

ACTIVATING THE EP: Even the best EP will fail unless it is kick-started. The EP was activated in the Ersama cyclone, but sputtered to a stop quickly as communication systems completely failed and other hardware was not there. The ORC failed as it was not designed to tackle a super cyclone. Loss of life: who's to blame?
Musings that the Ersama cyclone was caused by carbon dumping into the atmosphere or exacerbated by destruction of coastal mangrove belts (their surface roughness factor will not significantly impede a tidal wave) need to be set aside and the task of saving lives in future cyclones needs a thrust.

Major industrial accidents and cyclones are similar in two vital respects. Both are large uncontrolled energy releases which happen with minimum warning. Technology can mitigate the effects of both events - in industrial accidents by reducing their occurrence frequency and magnitude and in cyclones, by providing adequate warning time.

Together with good ESP, technology has reduced loss of life in industrial accidents and cyclones in many parts of the world, so why not in India? But to do that, loss of life in cyclones, as is with industrial accidents, should now no longer be considered to be an :ct of God', but as human-made, and the principle of strict liability should be applied to cyclones to cajole governments to become more responsible.

Healthrisk management
Liberalisation is the nineties catchword for gain maximisation. Like other Indian states, Orissa too rode the rainbow and attracted industry by aggressively advertising its assets - mineral wealth, power surplus and cheap labour. With 3.5 per cent of India's population, Orissa in the recent past, was able to attract 9 per cent of India's new investments on hand, growing at 35 per cent per annum, and making Orissa one of the top five destination-states for new investments in India.

But, Orissa was totally unprepared for the Ersama cyclone and what happened there has close parallels in recent Indian history. For instance, Surat was a boom town in the early 1990s because of a rapid growth of business. But, the city neglected its public health programme and gained the dubious distinction of being the filthiest town in western India. The result was the 1994 plague which caused panic in India and abroad, the migration of a half million people from Surat, dislocation, stress and income loss to thousands of families, and a sharp whack for the city's and Gujarat's economy.

Orissa failed to learn from the Surat plague episode that a gain maximisation programme without an effective risk minimisation one - even though it fetches no returns - can be disastrous. The Surat plague episode caused Gujarat a financial loss of a few hundred crore. But the Ersama cyclone proved to be far more expensive. The Orissa Disaster Mitigation Mission estimates the material loss to be Rs 20,000 crore. If each life lost in the cyclone costs Rs 40 lakh, the total loss jumps to Rs 40,000 crore, which is about five times the annual expenditure of Orissa government.

Both Surat and Ersama clearly demonstrate that actual risk and human perception of it are separate factors which need not necessarily overlap. The Ersama super cyclone was a high-risk event with a mortality rate of 5,000 in a million (expressed as 5000E-6). Yet, Orissa's unpreparedness for it can be best explained by a public perception which associated low risk with cyclones. On the other hand, the Surat plague was a low-risk event with a mortality rate (5E-6) a thousand times lower than that of the Ersama cyclone. Yet, soon after the plague broke out, people perceived the risk to be so high that there was a frenzied exodus of a half million people from Surat.

In a risk management programme, should perceived risk - a construct of the human mind - be discarded in favour of the more measurable actual risk? Far from it, as human response to risk is influenced not by actual risk but by the way humans perceive it.

Risk perception is influenced by public memory and experience, economic status, culture and the ability to control the course of events. Plague concern in Europe is rooted in the images of the Black Death, so well depicted in paintings and writings, that wiped out half its population during the medieval period. Yet, Europe's measured response after the Surat plague, unlike that of some Gulf states, is derived from the confidence that it has in place a good health-care delivery system that can quickly detect and treat plague, even in small towns.

What matters is not whether perceived risk is greater or less than actual risk, but how large the difference between the two is. The greater the disparity between actual and perceived risk, the more difficult it is to manage risk.

A risk which is perceived to be low, even if it is not, is accepted with little ado. This generates a response which is inadequate to tackle the risk; a familiar situation illustrated by the Ersama cyclone, the 1984 Bhopal tragedy, the 1997 LPG explosion in Visakhapatnam, and many other instances.

If perceived risk is significantly higher than actual risk, it evokes an over-response. And if it exceeds a certain threshold, fixed heuristically by people as a fuzzy line beyond which they feel that death is imminent, the over-response may turn into mass hysteria, as happened during the plague episode - fleeing of people and even health workers from Surat; neighbours attempting to drive away a Delhi-based scientist who had visited Surat, by cutting utilities to his home; a man murdering a family that fled Surat and sought shelter close to his home in Thane district; initiated garbage clean-up on a warfooting in most Indian cities.

Altering risk perception
Attempting to reduce risk through technology shifts, legislation, campaigns and other administrative methods does not alter human behaviour to risk, unless these accompany programmes specifically geared to alter risk perceptions. Ideally, perceived and actual risk should converge for an appropriate and effective response to risk. This convergence is best achieved by involving the risk bearers in a risk management programme.

There is then a strong case for people's participation in risk management. The strength of such a programme is the community's readiness to tackle risks they perceive as vital. In the weeks after the Surat plague, several communities throughout the country had, without waiting for external help, collectively cleared garbage from their neighbourhoods.

Tackling risks
The nature and level of community participation in tackling a risk is linked to the nature and complexity of the risk. A class of risks such as dehydration can be tackled by a community quite easily with good information inputs on oral dehydration therapy. Other risks, such as cyclones, cannot be tackled by community action alone for they require wherewithals such as higher-level information, financial and manpower resources and specialised organisation, which communities lack.

A nationwide risk management programme is needed to tackle all manner of health risks - road accidents, pollution-related health effects, infant mortality, abortions, workplace injuries, vector-borne diseases and natural calamities. For a holistic risk management programme, a risk management cell needs to be formed within the Planning Commission, which operates at the central and state levels.

The first task of the cell would be to train teams to work with urban and rural communities and professionals to create a hierarchy of risks using a combination of simple risk-assessment techniques, epidemiology and behavioural sciences. In rural areas, operating this programme through panchayats will bolster government's recent effort to increase their role. In towns, an appropriate community size could be a municipal ward or its equivalent in smaller towns. The range of health risks that can be addressed by these methods are limitless.

The next task is to classify risks into two groups - those that can be abated with only the community's resources and those that require external assistance.

The third task is to help the community set up a risk management programme for risks that can be tackled at the community level and prioritise risk management programmes at the state and central levels. Risks which cannot be tackled by a community for lack of wherewithals, will come under the purview of the next higher level, a zila parishad or a municipality. The coverage area for the risk management programme for this level will increase. And risks that the second level cannot tackle will progressively be pushed up to the state and central levels.

Different aspects of many risks may have to be tackled simultaneously at several levels. For example, in the case of cyclones, event prediction which is essentially risk assessment, is done by the IMD, a central government agency. Aspects of risk management - sounding the warning, constructing cyclone shelters, providing rugged communication systems, making and executing an EP - should be done by the state government. And some aspects of EP should be left to the community - training the people in emergency procedures, in an emergency ensuring that everyone reaches safety, operating ham radios as an alternative communication system. This will help transform the community from being passive objects to active agents in risk management.

A proactive risk minimisation programme, which works to reduce and alter risk perception through people's participation, is the best way to reduce the high 'excess mortality' in India, particularly in episodes like Ersama, Latur and Bhopal.

The author is a risk analyst with Cerana Foundation, Hyderabad