Disaster management, from preparedness through mitigation, is a pivotal component of good governance, because it potentially affects the health, economy, and livelihood of a substantial population. 1 We attempted to study the paradigm shift in India’s disaster preparedness and response policy through the prism of events that unfolded during 2 severe cyclones striking the eastern state of Odisha (formerly Orissa), which is situated off the coast of Bay of Bengal, 14 years apart.
The October 1999 Cyclone 05B or Odisha Super Cyclone (category 5 hurricane) was the strongest in the past 100 years, affecting 12 coastal districts of Odisha.Reference Thomalla and Schmuck 2 Over 10 million people were affected, with more than 10,000 casualties and a total damage of about US $3.0 billion. 3 , 4 Exactly 14 years later (October 2013), Very Severe Cyclonic Storm (VSCS) Phailin (category 4) struck the state. 5 Ensuing heavy rains caused massive overflow of major rivers, crippling life in 18,117 villages across 17 districts and affecting a rural population of 13 million. 5 The final death toll in Odisha was 44, with 81 injured, 541,000 houses damaged, and 11.01x105 hectares of cropped area destroyed. Nearly 1 million people had been safely evacuated as part of preparedness in Odisha alone. 6 The total financial damage was estimated to be less than US $1 billion. 4
This stark contrast bears testimony to vastly improved preparedness measures. The death toll in 2013 was 0.5%, while the economic loss was about one-third of that during the 1999 Super Cyclone. The game-changer was a complete transformation of a response-oriented policy to one focused on preparedness, with concomitant improvements in early warning system technology, an integrated approach at all levels of administration including joint planning with major nongovernmental organization (NGO) players, and improved community participation. 7 It is therefore worthwhile to make an unbiased attempt to study each constituent of this effort, because replication of this model in the developing world could save thousands of lives.
The Policy Shift
Government of India (GoI) is responsible for providing guidelines on disaster preparedness, response, and financial aid. The Ministry of Home Affairs of GoI formulated the National Disaster Management Program in 1993 and established the National Centre for Disaster Management in 1995. In 18 states including Odisha, disaster management facilities and calamity relief funds were jointly set up by GoI and state governments.Reference Thomalla and Schmuck 2 Needless to say, as is evident from the 1999 cyclone management efforts, this policy remained largely on paper, with the super cyclone serving as a costly fallout of such inefficiencies.
The 10th Five Year Plan (2002-2007) of GoI, for the first time, recognized the importance of planning and preparing for natural disasters. The National Disaster Management Framework was developed in 2004, interlinking economic, environmental, and overall developmental issues for efficient response to and mitigation of disasters. The Disaster Management Act was endorsed by the Indian Parliament in 2009. Within this new integrated framework, the Cabinet Committee on Management of Natural Calamities is the nodal authority in charge of all aspects of preparedness and action in natural disasters. The National Crisis Management Committee under the Cabinet Secretary to GoI serves as “command, control, and coordination” of any disaster response. 8 GoI can call upon armed forces in different phases of prevention and management.
A new institutional framework has also been put in place, with the prime minister being the chairman of the National Disaster Management Authority, which outlines plans and policies and coordinates implementation at the national level. The mandate of human resource development and capacity building is entrusted with the National Institute of Disaster Management. The specialized National Disaster Response Force constitutes 10 battalions of central armed police forces. At the state level, the chief minister chairs the State Disaster Management Authority to coordinate program implementation. However, the most important step has been to constitute the District Disaster Management Authority, headed by the district magistrate, with an elected local representative as co-chairperson, in recognition of the need for decentralization. This facilitates translation of local knowledge in planning and preparedness. To complete this cycle, urban and rural local administrative bodies have also been entrusted with capacity building and community involvement. 8 Functioning within the national guidelines, Odisha Health Ministry drafted its own micro-plan document for use by health managers at district and subdistrict levels. It would be unjustified not to mention the determined political leadership in Odisha, 7 , 9 which proposed a zero-mortality vision.
Forecasting and Risk Communication
The Indian Meteorological Department (IMD) is entrusted with providing intelligence on cyclone forecasting and monitoring. In 1999, the first information was issued by the IMD 48 hours before landfall; national television and radio issued special bulletins in local language on an hourly basis. 3 Despite a 2-day head start and a hierarchical infrastructure in place, the death toll was unacceptable. A candid observation makes senseReference Thomalla and Schmuck 2 : “Imagine that a cyclone is coming, but that those living in the affected areas do nothing or too little to protect themselves. This is precisely what happened in the coastal state of Orissa, India.”
Research by Dash et al among 60 survivors from Jagatsinghpur, the worst affected district, showed that 47 of them received media warnings, but none paid heed.Reference Dash 10 Deeper analysis revealed that effective communication from the IMD regarding the super-cyclonic nature of the storm reached the Odisha government only 2 hours before complete breakdown of communications. 11 DashReference Dash 10 further found that the terminology used in warnings was not clearly understood by a minimally educated local population; 75% of those interviewed alleged that the warning never told what appropriate action was needed, whereas 83% never evacuated their houses because they had no idea about “sea level.” In a study of the 1991 Bangladesh cyclone, Bern et alReference Bern, Sniezek and Mathbor 12 noted that social mobilization and community awareness were key to reducing mortality. The highest death rate was among women older than 40 years (31%) and children less than 10 years (26%). While all people who sought refuge in a concrete or brick structure survived, 22% of those who did not died.
Following the criticism it faced during the Odisha Super Cyclone, the IMD improved its technical capacity (Doppler radars at multiple points of vulnerability, including land and sea) in early and accurate prediction of natural calamities. 7 Credit must also be accorded to creation of a separate Ministry of Earth Sciences under the 11th Five Year Plan (2007-2012).
VSCS Phailin was monitored and predicted continuously by the IMD and forecasting started 4 days in advance of landfall. Satisfactory predictions regarding track, intensity, point of landfall, and associated adverse weather were made. The IMD held onto its own predictions, faced with graver cyclone warnings issued by the US Navy Joint Typhoon Warning Center and Britain’s Meteorological Office, which repeatedly termed Phailin as a “super cyclone.” 13 Continuous media briefings were maintained by New Delhi headquarters, as well as by centers at Bhubaneswar, Kolkata, Chennai, and Visakhapatnam. 5 These messages were very clear and hence were correctly comprehended by local workers and the community, in sharp contrast to the 1999 situation. Mihir Bhatt, Director, All India Disaster Mitigation Institute, summarized, “The Red Message, the highest alert from the IMD in Delhi, is not only concise and to-the-point, but is also usable to a large extent by the local district officials. The alert also enlists where and what type of damage is expected to shelter and infrastructure.” 7
Nongovernmental Organizations in Mitigation Work
Prior to the 1999 Odisha Super Cyclone, a limited number of NGOs were specifically involved with disaster preparedness in Odisha. The German Red Cross and the Indian Red Cross built 23 cyclone shelters in 6 coastal districts but failed to influence the government on the importance of preparing for a cyclone, primarily because no such storm had struck since 1977. On the evening of October 29, 1999, 12-member disaster preparedness committees were sent to each shelter to ensure maintenance and proper use; a task force of 30 people per shelter was constituted to carry out educational campaigns, emergency medical aid, and search and rescue.Reference Thomalla and Schmuck 2
Sadly, these measures proved too little, too late. The public perception of risk communication being very casual, only 150,000 people were successfully evacuatedReference Kalsi 14 and they took minimal preparedness measures (not even carrying essential supplies like food and water).Reference Dash 10 Nearly 45,000 people took refuge in 23 Red Cross shelters 3 designed to accommodate 1500 people per building. Naturally, there was an acute shortage of food and drinking water in many places.Reference Thomalla and Schmuck 2
Thirty kilometers of coastal land remained submerged for a prolonged period, infested with carcasses of livestock and human corpses. The situation, predictably, led to the worst outbreak of diarrhea with 97,934 cases being reported and 81 deaths during a 1-month period after the cyclone. Vibrio cholerae, Escherichia coli, and Shigella flexneri strains were isolated by scientists from the Indian Council of Medical Research.Reference Chhotray, Pal and Khuntia 15 After cases of febrile illness with hemorrhagic manifestations were reported from 4 villages, another group of investigatorsReference Sehgal, Sugunan and Vijayachari 16 confirmed outbreak of leptospirosis with 14% of villagers directly infected and another 14% having serological evidence of infection. The unusual finding of a leptospiral outbreak further pointed to the grim health and hygiene conditions in post-cyclone Odisha. Kar et alReference Kar, Jagadisha and Sharma 17 studied the worst-affected villages and found 80% of villagers with probable psychiatric disorders, including post-traumatic stress disorder in 44%, anxiety disorder in 57%, and depression in 52%. The same group conducted another study 1 year after the Odisha Super Cyclone and found that 27% of cyclone-affected adolescents had post-traumatic stress disorder, 17.5% had major depressive disorders, and 12% had generalized anxiety disorder.Reference Kar and Bastia 18 Disproportionate effects were seen in lower socioeconomic classes and female adolescents.
In the aftermath, the inefficiency of the distribution system often led to serious allegations of misappropriation of funds.Reference Thomalla and Schmuck 2 , 11 Because the state failed to effectively manage relief operations,Reference Thomalla and Schmuck 2 , 3 about 40 NGOs led by the Indian Red Cross and UNICEF distributed food, temporary shelter materials, medicines, water purification tablets, and other essentials, extending this effort to renovating hospitals and building low-cost cyclone-resistant houses in the long term. An International Federation of Red Cross and Red Crescent Societies (IFRC) report concluded, “The super cyclone itself was of such proportions that by many standards many more vulnerable families would rightly need support and assistance since the needs were not fully covered even by the combined Government/UN/NGOs efforts.” 3
Since 2011, The World Bank, through the International Development Association, has been providing US $255 million in financial support to the National Cyclone Risk Mitigation Project in Odisha and Andhra Pradesh. The Global Facility for Disaster Reduction and Recovery provided US $270,000 to help implementation of this project, which mainly involves improving the early warning system to have an effective reach at the community level. This project also looks to boost infrastructure like multipurpose cyclone shelters and strengthening of embankments and roads. 9 The 28 cyclone shelters built under this project came into good use during Phailin.
The United Nations Development Programme (UNDP) has been credited with ably assisting the Odisha government during the mass evacuation efforts. In the run-up to Cyclone Phailin, the Odisha State Disaster Management Authority and the Special Relief Commission facilitated coordination meetings with a large number of humanitarian agencies, allotting specific roles and responsibilities. 7 , 19 Control rooms were established in 10 districts. Micro-planning was chalked out with local officials checking functional aspects of shelters and adequate stocking of food, water, and medicines. A number of public buildings were earmarked as additional shelters to avoid overcrowding, thereby facilitating about 2000 total functional shelters. The National Disaster Management Authority deployed 29 teams equipped with satellite communication across Odisha; the army was kept on standby with air transport facilities; and the navy and coast guard ensured the safety of fishermen and ships caught in the cyclonic sea. GoI medical teams and ration supplies were kept ready, complementing state efforts. National highways authorities kept all resources ready to restore communication after the cyclone. 7 , 19 - 22
With immense preparations and active community involvement, one of the largest ever evacuation exercises was carried out in coastal Odisha and Andhra Pradesh, shifting over 1 million people during the final 24 to 48 hours before landfall. Those who decided to stay behind followed media advice and took shelter in concrete buildings. Notably, 30,000 domestic livestock were successfully relocated. 7 , 19 , 21 , 22 The Indian Red Cross, as earlier, played a stellar role during the evacuation process as well as in managing 75 cyclone shelters, catering to over 100,000 people. 19
The final IFRC report (May 2014) 23 draws a much more coherent picture of combined government-NGO efforts in ensuring “customized” relief measures for the differently affected communities. Close coordination with GoI ensured active participation of the Indian Army and Air Force in post-cyclone rescue and relief operations, including aerial provision of food and water packet distribution and essential medicines.Reference Kerur 24 Rent-free accommodation and financial support to rebuild dwellings was provided by the state government. 23
Conclusion
India’s landmark success in minimizing deaths by evacuating over 1 million people has been hailed by the international humanitarian community as a model of disaster preparedness and response worth emulating elsewhere. 7 , 9 , 22 The details of ground-zero actions speak to the true worth of putting in years of meticulous planning, drills, and risk mitigation infrastructure; establishing incident command structure and evacuation protocols at all levels; and most importantly, working with communities and creating teams of local volunteers who enjoyed the trust of the people and knew what to do when the time came.
The time is also ripe to call for cutting-edge public health research analyzing different aspects of disaster management in this scenario, both strengths and weaknesses, to ensure that this significant effort is not passed off as a one-time instance. What are the capabilities to replicate this model in other types of natural disasters? How can the human resource capability be improved in other vulnerable states? What are the capabilities of the health system to respond to medical and humanitarian crises of such a large affected population? Cyclone Phailin was a short-lived event, but the resultant floods and ensuing human misery were not. It is easily imaginable that hygiene standards in all affected villages remained greatly compromised for a non-negligible period of time. Outbreaks and epidemics would have been natural corollaries. Unfortunately, we have no documented literature to assess these impacts.
LeaningReference Leaning 25 has defined the period of recovery as the most complex phase of disaster response, with myriad humanitarian challenges. A need remains to focus on futuristic approaches like cash-transfer programs and micro-credits as post-cyclone support measures for the affected population, working with the private sector on weather-related insurance, and improving the coastal environment. 19 Past research also reminds us of the importance of gender-sensitive recovery and rehabilitation processes and providing an environment of psycho-social security to vulnerable children. 7
Even though this was not an empirical study, our effort attempts to highlight the need for literature assessing the impact of investments in preparedness and response efforts. Toward that end, our article intends to raise a call for critical research scrutinizing different aspects of this disaster management effort and exploring the replicability of this model in other types of natural disasters and other disaster-prone resource-restricted settings.
Acknowledgment
The authors express their gratitude to Prof. Jennifer Leaning, François-Xavier Bagnoud Professor of the Practice of Health and Human Rights and Director of the FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, for providing valuable advice and suggestions in the course of development of this paper.
