How can the human dimensions of disaster impacts be more accurately captured and represented in the analysis, modeling and simulation of disasters?
Human dimensions of disaster impacts and priorities could be more accurately captured using a systematic approach that embraces the use of open data at the local level. For example; there is an urgent need to analyze individual care needs and impacts on people with both communicable and non-communicable diseases. Another dimension is how the health care burden in a community changes before and after disasters. To understand these changes we need a set of standards and variables to capture care needs and impacts in communities. A dynamic systematic process is recommended. This is particularly relevant in today’s shifting environmental; social; and fiscal climates. A tool that could provide the template to support such a capability is the United Nations Public Health System Resilience Scorecard (Scorecard). A modified version of this would help ensure a citizen led “systems of systems” mindset and approach. The data could be integrated into a fusion center type model; generating intelligence on health service needs in a crisis. Indicators for understanding human dimensions could be designed within the scorecard method to ensure various aspects are considered. For example; organization; understanding risks; transport; logistics; and continuity of treatment and care. During development; a population-based team approach would be used to ensure comprehensive discussion; providing high confidence in the priority areas for analysis; modeling; and simulation of disasters. This multidisciplinary approach recognizes no one authority or organization possesses all the resources and expertise required to address the lateral communications and decision-making processes required for success in disaster situations.
What type of data and supporting research infrastructure would be necessary to enable novel, transdisciplinary approaches to answering these and other human-centered disaster questions?
Shareable data and research infrastructure would be needed to ensure various dimensions are considered. This could include organization; understanding risks; transport; logistics; and continuity of treatment and care. This will vary by location and application of a locally led systematic process using a transdisciplinary team approach will help determine which priority actions should be kept or removed to maximize human-centered disaster resilience. The data could be rapidly integrated into a fusion center model to generate tactical; operational; and strategic intelligence that supports the delivery of healthcare before; during and after disasters. The validity and versatility of the scorecard method has been demonstrated in various settings with funders supporting implementation. For example; the World Health Organization has funded a project to systematically identify and evaluate strategies for strengthening public health system resilience in Australia; Bangladesh; Japan; Slovenia; Turkey; and the United States. The United States Department of Agriculture has funded a project to use a modified version of the Scorecard to identify; rank; and prioritize actions for strengthening food security in rural areas of the United States. A key aspect of success when implementing and applying the scorecard is a “systems of systems'' mindset and approach. The indicators are designed to ensure various aspects are considered; such as organization; understanding risks; transport; logistics; continuity of treatment and care; etc. During implementation a population-based team approach is used to ensure comprehensive discussion; providing high confidence in the priority areas for action.
In what ways can US-Japan collaborations advance these questions in new and important ways?
To advance these questions; five phases are recommended. The first would be working with a transdisciplinary group to modify the scorecard. The second phase would be a series of working groups to develop indicators for rapidly and frequently measuring human-centered disaster resilience needs. For this phase to be successful there would need to be a range of professions engaged; which could include; for example: doctors; nurses; environmental health; logistics; suppliers for medical equipment; pharmaceuticals; food; and other services; transport specialists; and engineers. This would be followed by the third phase; incorporating feedback to finalize a human-centered disaster resilience scorecard. The fourth phase would be development of the methodology for use and providing training to selected locations where this would be applied. Finally; a fusion center model could be developed to enable sharing of the findings to inform the tactical; operational; and strategic activities required to support health service delivery before; during and after disasters. The scorecard methodology presented provides a framework to develop a system for achieving high confidence in what is needed to advance human-centered data for resilience. This would be informed by latest data; information; and situational awareness. This approach also provides metrics for continuous improvement and comparing resilience in different cohorts. Providing the flexibility required to adjust rapidly to shifting environmental; social; and fiscal climates. Ultimately; using a citizen led systematic method to rapidly identify and prioritize actions for maximizing human-centered disaster resilience.