Maternal and Child Health in the Face of Natural Disasters

By Cherise Charleswell

Ironically, just three months after the unqualified, unethical, and unstable narcissist who occupies the White House, decided to pull out of the Climate Accords/Paris Climate Agreement , the United States has been struck by a number of natural disasters from the uncontrollable fires raging in Oregon and California, and other parts of the west coast, to hurricanes Harvey and Irma in the states of Texas and Florida, respectively. Irma first wreaked her damage on the Caribbean islands, leaving a trail of devastation, where in some places, such as the tiny island of B arbuda, where there was a reported 90% destruction of all structures. Both hurricanes have been recorded among the worse or most virulent in recorded history, in the past 150 years. There has also been hurricanes, flooding, and horrific mudslides in the countries of Nepal, Bangledash, and India, as well as Sierra Leone; where poverty and the lack of sustainable infrastructure has resulted in the deaths of thousands.

What is clear, and what has been long understood by scientists and those in public health, is that "climate change and environmental degradation is real". We have been sounding the horn for many decades now, and there has been many attempts to silence and discredit us. However, despite being climate change deniers, such as Republican Senator Ted Cruz of Texas and Florida Governor Rick Scott , have both called for federal aid, and declared a state of emergency. All while refusing to to truly address the root causes of this devastation. These climate change deniers and the internet trolls that they help to create through propaganda, misinformation, lies, and false promises of re-opening mines - which have likely already been stripped of all of its natural resources., continue to convince enough members of the public that climate change is a hoax. 45 (One seriously cannot refer to that man as President) even went as far as to claim that it was a hoax started by the Chinese to undermine US business interests.

Americans are now learning that they should be doing more than sending "thoughts and prayers" when a natural disaster occurs, and should instead do something to prevent or reduce the harmfulness of the next one, by voting into office legislators that would enact the necessary policies that address climate change and environmental degradation. Recognizing that climate change has become the most pressing public health issue impacting the lives of people globally, the American Public Health Association (APHA), as well as a number of its affiliates, such as the Southern California Public Health Association (SCPHA) have choose to make climate change the theme of their 2017 conferences. In fact, in January APHA has declared that 2017 is the Year of Climate Change and Health, APHA actually has an ongoing climate change initiative that has included monthly themes, webinars, and resources for advocacy. While SCPHA just established its Resolutions, with the first titled Resolution on Oil & Gas Development, Climate and Health . Again, the experts agree that "climate change is real".

Another issue that is not being openly discussed in these responses to natural disasters is the fact that, like most aspects of life, intersectionality is at play, and having an identity that encompasses any combination of the following factors, increases the degree of impact that a natural disaster has on one's health and wellbeing: being located in the global south, being a person of color, having a disability, being an immigrant or refugee, being a woman, being a mother, and being low income.

Further, the fact of the matter is that while Western nations, especially the US, utilize most of the natural resources and carry out activities that have increased pollution, environmental degradation, and have hasten climate change, nations in the Global South are disproportionately impacted by the effects of climate change, and suffer the greatest degree of destruction and burden. And again, what complicates matters is that these nations are among those without the wealth and resources to protect and provide services to its citizens, fortified their structures, and readily rebuild following the devastation; putting citizens at risk for disease and injury.

Whether abroad or within the US, due to those aforementioned intersections, those who are the most impacted by natural disasters are women and children ; particularly mothers. During the wake of Hurricane Harvey there were images of many mothers trying guide their children to safely. One could not helped to notice that many were single mothers, or simply had no men in sight who were able to assist. On a CNN interview there was an African American mother who lashed out at interviewers for their insensitivity in wanting to know all of the details about the trauma that she and her children went through trying to navigate the storm, and there was the tragic story of a three year old child being found alive, grasping to the body of her deceased mother . It is easy to talk about evacuation when there is available income to readily do that, as well infrastructure that can accommodate a mass exodus of people from major metropolitan areas; however it becomes far more difficult when

All of this points to a subset of maternal & child health that public health truly needs to consider more intently, and that is wellbeing during and after a natural disaster. This consideration needs to ask the questions:

• Are communities being effectively assisted in preparing for a natural disaster?

• Are special considerations being given to helping to evacuate and shelter single mothers and their children, knowing that they do not have any other support in the home?

• Are resources to withstand natural disasters being made available to those who may not be able to afford the, or have access to reliable transportation to gather them? The central argument is that more resources need to be invested in disaster preparation and not just focus all monies and other resources to disaster response.

• Are shelters being stocked with supplies that will be most needed by mothers of infants, toddlers, and small children: diapers, bottles, etc.?

• Are precautions being carried out to accept pregnant women into shelters, and assist if they go into labor?

Of course, we would want to ask where are the fathers, and the answer may be that they work a distance from their homes, particularly in the global south, have fell victim to the natural disaster, which was the case with the 2004 tsunami that pulled millions of people into the Indian Ocean, or that they were literally off saving themselves; leaving women to fulfill the traditional role of nurturer and protector of their children. One that they are showing that they are ready and willing to give their own lives to fulfill.