Post Earthquake Trauma in Haiti and Japan

Last week, the “Final Report of the Independent Panel of Experts on the Cholera Outbreak in Haiti” was released. The outbreak occurred ten months after the January 12, 2010 earthquake, and it claimed 4500 lives and sickened 300,000 people. Cholera as an infectious disease had been absent from Haiti for nearly a century, although non-pathogenic strains are present in Haiti. Now a pathogenic strain has spread throughout Haiti as a result of the confluence of numerous factors, including:

1. Introduction of a pathogenic strain of the current South Asian type Vibrio cholerae, resulting from an infected UN worker(s) and improper disposal of human waste at a MINUSTAH (United Nations Stabilization Mission in Haiti) camp. The waste contaminated a tributary of the Artibonite River, Haiti’s longest and most important.

2. Salinity gradient of the Artibonite River delta that favored rapid bacterial proliferation

3. Widespread use of the river water for washing, bathing, drinking, agriculture, and recreation

4. Lack of immunity in the Haitian population.

5. Poor water and sanitation conditions

6. Migration of infected individuals to home communities and treatment clinics

7. Pathogenicity of the cholera strain related to increased toxin production

8. Deficiencies in medical facilities to contain disease spread to health care workers and other patients

News releases on this tragic situation highlighted the cause of the outbreak (UN peacekeepers) but failed to discuss environmental and behavioral factors that lead to the dissemination of the disease and its long term impact.

Natural disasters have an immediate impact on life and limb, but they also disrupt or destroy infrastructures critical to human health (water treatment, sewage disposal, medical facilities). The Great East Japan earthquake was the most powerful earthquake to have hit Japan, but it was the resulting tsunami that obliterated coastal towns and villages. The death toll from this disaster was far less than that reported in Haiti (approximately 25,000 versus 230,000); but post event, there have been significant public health consequences that stand in stark contrast to the cholera epidemic in Haiti.

Japan initially struggled to reach and bring aid to survivors because the earthquake and tsunami destroyed transportation infrastructure (road, rail and air). Survivors, many of them elderly, suffered from the cold and a lack of food and water leading to problems with hypothermia, upper respiratory infections, and gastroenteritis. Endemic diseases, such as Japanese encephalitis, could have created additional problems had the weather been much warmer and the mosquito vector able to breed in standing water created by the tsunami. However, as a highly industrialized nation, Japan has been able to relocate 300,000 survivors to the safety of its cities and reduce public health risks.

The health crisis created by the Japan earthquake was the result of the nation’s industrialization, specifically its reliance upon nuclear energy. The earthquake caused the Fukushima Daiichi Nuclear Power Plant to shut down its reactors as a precaution, but the tsunami damaged the diesel electric generators that operated the cooling systems for the reactors and storage ponds. Overheating in the reactors led to hydrogen explosions and radiation leaks resulting in a nuclear accident second only to Chernobyl in severity. Based upon radiation levels from fallout, the population in a 30 km zone around the plant was evacuated. The Department of Energy has mapped the one year exposure dose in areas that were contaminated; and there is a hot zone 50 kilometers northwest of the plant where exposures exceed 2000 mrems/year. This level of exposure could result in one extra cancer case in 500 young adults and is not insignificant. However, this highest level of exposure is exceeded by natural background radiation is parts of the world and will decline over time. Morbidity and mortality from the incident is expected to be limited to those directly working around the damaged power plant and with delayed consequences, e.g., increased incidence of cancer.

In two societies at both ends of the developmental spectrum, natural disasters created long term health sequelae – one for lack of technology (adequate sanitation) and one because of technology (nuclear power). In Haiti, their major river now harbors a highly pathogenic strain of Vibrio cholerae, whose impact on national health and potential transmission to other countries in the Americas has yet to be fully determined. Destruction and release of radiation at the Fukushima Power Plant appears to have a more far reaching impact – not from human morbidity and mortality but from international concerns over the safety of nuclear power.

PRSI Contributor

Dr. David Danley, COL (ret) spent his career in medical research and developing products (detectors, drugs, and vaccines) against biological and chemical threat agents. Currently, he is employed as a consultant focused on recognizing evolving threats to human health and promoting technologies to mitigate their risks.

Nation & World | Malaysia says Singaporean helped Philippine rebels | Seattle Times Newspaper

Nation & World | Malaysia says Singaporean helped Philippine rebels | Seattle Times Newspaper

State Department remarks on the killing of bin Ladin

Remarks

Hillary Rodham Clinton
Secretary of State

Treaty Room

Washington, DC

May 2, 2011

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Well, good morning. As President Obama said last night, Usama bin Ladin is dead, and justice has been done. And today, I want to say a few words about what this means for our efforts going forward.

First, I want to offer my thoughts and prayers to the thousands of families whose loved ones were killed in Usama bin Ladin’s campaign of terror and violence, from the embassy bombings in Africa, to the strike on the U.S.S. Cole, to the attacks of September 11, 2001, and so many more. These were not just attacks against Americans, although we suffered grievous losses; these were attacks against the whole world. In London and Madrid, Bali, Istanbul, and many other places, innocent people – most of them Muslims – were targeted in markets and mosques, in subway stations, and on airplanes, each attack motivated by a violent ideology that holds no value for human life or regard for human dignity. I know that nothing can make up for the loss of the victims or fill the voids they left, but I hope their families can now find some comfort in the fact that justice has been served.

Second, I want to join the President in honoring the courage and commitment of the brave men and women who serve our country and have worked tirelessly and relentlessly for more than a decade to track down and bring Usama bin Ladin, this terrorist, to justice. From our troops and our intelligence experts, to our diplomats and our law enforcement officials, this has been a broad, deep, very impressive effort.

Here at the State Department, we have worked to forge a worldwide anti-terror network. We have drawn together the effort and energy of friends, partners, and allies on every continent. Our partnerships, including our close cooperation with Pakistan, have helped put unprecedented pressure on al-Qaida and its leadership. Continued cooperation will be just as important in the days ahead, because even as we mark this milestone, we should not forget that the battle to stop al-Qaida and its syndicate of terror will not end with the death of bin Ladin. Indeed, we must take this opportunity to renew our resolve and redouble our efforts.

In Afghanistan, we will continue taking the fight to al-Qaida and their Taliban allies, while working to support the Afghan people as they build a stronger government and begin to take responsibility for their own security. We are implementing the strategy for transition approved by NATO at the summit in Lisbon, and we supporting an Afghan-led political process that seeks to isolate al-Qaida and end the insurgency. Our message to the Taliban remains the same, but today it may have even greater resonance: You cannot wait us out. You cannot defeat us. But you can make the choice to abandon al-Qaida and participate in a peaceful political process.

In Pakistan we are committed to supporting the people and government as they defend their own democracy from violent extremism. Indeed, as the President said, bin Ladin had also declared war on Pakistan. He had ordered the killings of many innocent Pakistani men, women, and children. In recent years, the cooperation between our governments, militaries, and law enforcement agencies increased pressure on al-Qaida and the Taliban, and this progress must continue and we are committed to our partnership.

History will record that bin Ladin’s death came at a time of great movements toward freedom and democracy, at a time when the people across the Middle East and North Africa are rejecting the extremist narratives and charting a path of peaceful progress based on universal rights and aspirations. There is no better rebuke to al-Qaida and its heinous ideology.

All over the world we will press forward, bolstering our partnerships, strengthening our networks, investing in a positive vision of peace and progress, and relentlessly pursuing the murderers who target innocent people. The fight continues, and we will never waver. Now I know there are some who doubted this day would ever come, who questioned our resolve and our reach. But let us remind ourselves, this is America. We rise to the challenge, we persevere, and we get the job done.

I am reminded especially today of the heroism and humanity that marked the difficult days after 9/11. In New York, where I was a senator, our community was devastated; but we pulled through. Ten years later, that American spirit remains as powerful as ever, and it will continue to prevail. So this is a day, not only for Americans, but also for people all over the world who look to a more peaceful and secure future – yes, with continued vigilance, but more so with growing hope and renewed faith in what is possible.

Thank you all very much.

Is this the beginning of the end or the end of the beginning?

Bin Ladin is gone and with him vanishes his view of the future. But there are others with their own view of the future. For some time now it has been debated in the Intelligence Community (IC) exactly how much influence he has had on al Qaida. Many believe that his influence wained quite some time ago and he has been merely a figure head for a greater organization. We have seen al Qaida morph over the past ten years with leaders in different regions seeming to control much of their own destiny. What does bin Ladin's death mean in the context of daily operations? Probably not much at this point in time. Bin Ladin will go down as a martyr and from that aspect may draw more recruits to the cause. The Base has extended itself to be more than just a Cult of Personality. It is doubtful that al Qaida will disappear anytime soon. We can look forward to more of the same. This has been an important victory for the U.S. from a Psychological stand point. The U.S. has shown that it will stop at nothing to bring terrorists to justice no matter how long it takes. The war on terrorism has been going on for more than 40 years and it would be a mistake to think that bin Ladin's death will change the terrorist landscape.

9/11 speech by President George W Bush

Good evening. Today, our fellow citizens, our way of life, our very freedom came under attack in a series of deliberate and deadly terrorist acts. The victims were in airplanes, or in their offices; secretaries, businessmen and women, military and federal workers; moms and dads, friends and neighbours. Thousands of lives were suddenly ended by evil, despicable acts of terror.
The pictures of airplanes flying into buildings, fires burning, huge structures collapsing, have filled us with disbelief, terrible sadness, and a quiet, unyielding anger. These acts of mass murder were intended to frighten our nation into chaos and retreat. But they have failed; our country is strong.
A great people has been moved to defend a great nation. Terrorist attacks can shake the foundations of our biggest buildings, but they cannot touch the foundation of America. These acts shattered steel, but they cannot dent the steel of American resolve.
America was targeted for attack because we're the brightest beacon for freedom and opportunity in the world. And no one will keep that light from shining.
Today, our nation saw evil, the very worst of human nature. And we responded with the best of America -- with the daring of our rescue workers, with the caring for strangers and neighbours who came to give blood and help in any way they could.
Immediately following the first attack, I implemented our government's emergency response plans. Our military is powerful, and it's prepared. Our emergency teams are working in New York City and Washington, D.C. to help with local rescue efforts.
Our first priority is to get help to those who have been injured, and to take every precaution to protect our citizens at home and around the world from further attacks.
The functions of our government continue without interruption. Federal agencies in Washington which had to be evacuated today are reopening for essential personnel tonight, and will be open for business tomorrow. Our financial institutions remain strong, and the American economy will be open for business, as well.
The search is underway for those who are behind these evil acts. I've directed the full resources of our intelligence and law enforcement communities to find those responsible and to bring them to justice. We will make no distinction between the terrorists who committed these acts and those who harbour them.
I appreciate so very much the members of Congress who have joined me in strongly condemning these attacks. And on behalf of the American people, I thank the many world leaders who have called to offer their condolences and assistance.
America and our friends and allies join with all those who want peace and security in the world, and we stand together to win the war against terrorism. Tonight, I ask for your prayers for all those who grieve, for the children whose worlds have been shattered, for all whose sense of safety and security has been threatened. And I pray they will be comforted by a power greater than any of us, spoken through the ages in Psalm 23: "Even though I walk through the valley of the shadow of death, I fear no evil, for You are with me."
This is a day when all Americans from every walk of life unite in our resolve for justice and peace. America has stood down enemies before, and we will do so this time. None of us will ever forget this day. Yet, we go forward to defend freedom and all that is good and just in our world.

Red Alert: Osama bin Laden Killed | STRATFOR

Red Alert: Osama bin Laden Killed | STRATFOR