Chapter II

REVIEW OF RELATED LITERATURE

This chapter presents the Review of Related Literature that can

further elucidate and support the study.

Natural Disaster

Disaster could either be human-induced or natural occurrences.

Disasters are natural if they just happen without being induced by humans

like tsunamis, volcanoes, earthquakes, storms and floods. Disasters are

those events that displace the structural, economic, organizational,

cultural and spiritual well-being of communities by destroying their means

of existence (Paton and Johnston (2001:270) and Alexander (1997:289).

Disaster is a natural or human-caused hazard that causes ‘a serious

disruption of the functioning of a community or a society involving

widespread human, material, economic or environmental losses and

impacts, which exceeds the ability of the affected community or society to

cope using its own resources’ (UNISDR). The concern over natural

disasters is increasing globally. During the last two decades, loss of life

and property due to disasters has increased. Disasters like floods,

earthquakes, fire, etc pose serious threat to people. Disaster education,

which includes education on disaster risks, mitigation and preparedness

strategies, is one approach to reducing the negative consequences of

disasters (Smith 1993; Mulyasari [Link]. 2011).

10
 Community or a society involving widespread human, material,

economic or environmental losses and impacts, which exceeds the ability

of the affected community or society to cope using its own resources’

(UNISDR). The concern over natural disasters is increasing globally.

During the last two decades, loss of life and property due to disasters has

increased.

It is imperative to increase the knowledge and attitude of people

regarding the natural and man-made disasters in order to make them able

to cope up with their adverse effects. For being well aware and prepared

for disasters, we need to develop knowledge, skill and values at all level.

According to the 2005-2015 Hyogo Framework for Action, the objective of

disaster education is ‘to build a culture of safety and resilience at all

levels,’ in order to reduce the adverse social and economic impacts of

hazards. Over the last decade, emergency management agencies,

schools and non-governmental organizations have increasingly targeted

children as an audience for disaster education (Lintner 2006; UNISDR

2007; Mitchell [Link]. 2008; NCCD 2010; Shiwaku and Fernandez 2011;

Sharpe and Kelman 2011; UNESCO 2013). Kashmir is a Himalayan

mountainous territory, therefore it is extremely vulnerable to natural

disasters and is a disaster hotspot of the world. Due to predominant

mountainous terrains some of the large rivers on the earth originating from

the Himalaya, and due to dominant strong rains snowfall, the country is

overwhelmed by floods and landslides. Geologically Kashmir is one of the

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most earthquake prone regions of the world, which have experienced

devastating earthquakes in the past and do expect a large earthquake in

future. All over the world, Kashmir is well known for disasters like floods,

landslides, and avalanches. The disaster statistics of Kashmir certainly

draw a worldwide attention.

Disaster impacts may include loss of life, injury, disease and other

negative effects on human physical, mental and social well-being, together

with damage to property, destruction of assets, loss of services, social and

economic disruption and environmental degradation. The Philippines was

located along the Ring of Fire which means the country including the

nearby countries are exposed to tropical storms and suffered from various

natural calamities such as earthquakes, volcanic eruptions and flooding. .

According to the World Risk Report, Philippines ranked third as one of the

most disastrous countries in the world in the year 2013. On the average,

20 typhoons visit the Philippines annually and leave trails of devastation in

their wakes which prove the very vulnerable position in the Philippines in

terms of disaster vulnerability.

These disasters do not only result to physical injuries and material

damages but also psychological harm. According to UN ISDR (2006-

2007), when a natural hazard strikes, children are among the most

vulnerable population group, especially those attending school in times of

disaster. Furthermore during disasters, school buildings are destroyed,

taking away the precious lives of children and teachers and stalling access

12
to education in the aftermath of disaster. This is supported by the Pakistan

earthquake in 2005, where over 16 000 children died in a school that

collapsed and in a mudslide in the Philippines, more than 200 school

children were buried alive. Therefore children need to be protected before

disaster strikes. Protecting children during natural hazards requires two

distinct yet inseparable priorities for action in disaster risk education and

school safety as reported by ISDR (2006).

Disaster Preparedness

Disaster preparedness refers to activities and measures taken in

advance to ensure effective response to the impact of disasters, including

the issuance of timely and effective early warnings and the temporary

removal of people and property from a threatened location (ISDR,

2002:25).Natural and man-made disasters cannot be prevented, but at

least communities can plan for them through disaster management

involving preparedness and mitigation measures as indicated by UNESCO

(2010:30). According to Ozmen (2006:384), to prevent the huge

destructions and to become a disaster resistant society, schools can play

a pivotal role.

Disaster preparedness, as an area of inquiry, is dynamic and in a

state of constant flux. Each new event teaches researchers and

practitioners more about community and individual responses to disasters.

While experience with disaster and crisis events is considerable, the

emergence of widely accepted “best practices” lags behind the need for

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holistic approaches. The lag is due in part to the uniqueness of each event

and the uniqueness of each community affected. As a result, a variety of

practice options have emerged, leaving practitioners to choose the

paradigms most fitting to their particular view of disaster preparedness.

Disaster preparedness practitioners, whether in government organizations

or private businesses, will seek out multiple models of disaster

preparedness and tailor one to their specific needs. The phenomena tends

to create rifts in the disaster preparedness profession, as no single theory,

or set of theories, can be identified as the core concepts upon which

disaster preparedness plans and practices are based. The following

reviews a selection of approaches taken to disaster preparedness that

have found acceptance among sets of practitioners

Considerable work has gone into identifying and evaluating the

principles and concepts of disaster preparedness. A few contributions

have been made to the theoretical development of comprehensive

disaster preparedness measures, some with the goal of creating a

“practice-based theory and a theory-based practice” (Gillespie & Streeter,

1987).

Most of the contributions do not have the specific aim of creating a

comprehensive approach to disaster preparedness, but through the

individualistic research, make small contributions when combined as a

comprehensive review. For example, much can be learned from

(Kirschenbaum’s 2002) article on disaster preparedness. While

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Kirschenbaum’s research is specific to Israel, the location of his research,

and the indicators and conclusions drawn from it, have general

applicability. Perry and Lindell (2003) approach disaster preparedness

from the planning perspective, identifying ten guiding principles to be

adhered to during the planning process. Perry and Lindell focus on the

planning process, while Kirschenbaum focuses on localized principles and

applications. Each presents an aspect of disaster preparedness planning,

but none completely encompasses the issue.

Recent catastrophic events such as hurricane Katrina and the

Asian tsunami have created a greater awareness and need for disaster

preparedness. For several communities, including the academic,

government, and insurance industries, this has translated into devising

methods that will allow for the measurement of different disaster

preparedness dimensions. The purpose being that these communities can

develop a greater understanding of their strengths and weaknesses with

respect to preparedness, and determine more efficient allocation of

resources to improve preparedness. Ultimately, the goal is to develop

more resilient communities, ones that can withstand crisis events and

disaster while minimizing the impacts.

Due to the high loss potential, the insurance industry has a vested

interest in hazard metrics, which allow more accuracy in determining risk

portfolios. Urban centers have high concentrations of capital and risk due

15
to higher densities, which in turn translates into high insurance density

(Munich Re, 2002).

While elements of disaster preparedness have long been a social

adjustment to environmental hazards, both the art and science of disaster

preparedness are relatively new courses of study in business, non-profit,

government, and academic sectors (Fox, 2006).

According to Twig (2004:287), the main aims of disaster

preparedness is to help people to avoid impending disaster threats, and to

put plans, resources and mechanisms in place to ensure that those who

are affected receive adequate assistance. Numerous scholars such as

Briton (1986), Pijawka and Radwan (1985), Bogand (1989),

Welchselgartner (2001) and Alexander (2002) cited in McEntire

(2005:213) agree that the purpose of mitigation and preparedness is to

reduce human vulnerability to disasters through hazard assessments,

improved engineering, wiser land use management, emergency exercises,

public education and more destruction of buildings and infrastructure.

Asian Disaster Preparedness Center, ADPC (2008), cited in UNISDR

(2008:20), reported the destructive nature of disasters to schools in

Cambodia as follows. Teaching disaster preparedness education in Middle

schools, according to Furmann et al. (2008:117) Students are introduced

to the USGS Natural Hazards to understand weather and flooding

patterns. Students utilize map aerial photographs and other images to

create a map with historical rainfall, contour lines and potential areas of

16
flooding. Furthermore in such a lesson students analyze ways in which

humans could respond to hazardous flooding conditions and synthesize

that information to a plan for emergency preparedness.

In addition Petal (2007) cited in Gaillard and Pangilinan (2010:178)

maintain that tools have been developed specifically for educating and

involving youth in disaster risk reduction. Participatory mapping is one of

the major activities carried out as a part of disaster risk reduction, for

raising disaster risk awareness among the youth and further enable them

to integrate scientific knowledge provided to

Mental Health

Disasters often connote destruction, pain, loss, and trauma.

However, not everyone is affected by disasters in the same way as there

are those who are more vulnerable to their impact. For example, studies

show that individuals who are chronically exposed to social and economic

deprivation and those who face structurally rooted diminishment of social

well-being, health protection, principal industry, and environmental

pollution are more vulnerable (Mitrovic, 2015).

According to International Federation of Red Cross and Red

Crescent Societies (2003) reported in Shaluf (2007:688), earthquakes can

cause high mortality from trauma, asphyxiation, dust inhalation (acute

respiratory distress) or exposure to the environment (i.e. hypothermia) as

well as serious .

17
 Internally displaced people are also vulnerable to trauma,

prompting the World Health Organization to intensify its efforts in

responding to their mental health needs (Brundtland, 2000).

The aforementioned studies show that much of the literature on

displaced survivors of disasters has been framed in terms of problematic

responses and trauma and there is a dearth of research on adaptive

responses. This is despite the finding that most adults are resilient and

rely on existing coping mechanisms when they are faced with difficult

situations (Warchal & Graham, 2011)

Longitudinal study on survivors of an earthquake in Turkey 3-6

months and a year after the disaster found no significant improvements in

depression, anger and hostility, paranoid thoughts, obsessivecompulsive

behavior, and somatization (Kisac, 2006). Adaptive coping has been

validated in studies among patients dealing with various medical

conditions (Büssing, Ostermann, Neugebauer, & Heusser, 2010)

According to Hassanain (2006:838), school occupants are children

and youth who can easily panic, and become difficult to manage in case of

emergencies or crises and damages are enormous when a school catches

fire. The disruption of school operation, psychological damage to students,

families, and teachers after a fire will impair the learning environment.

Hassanain (2006: 839) also maintains that school occupants, mostly

untrained children on evacuation drills, are at a risk of incurring high rate

18
of fatalities and/or injuries in the case of fire mainly because they may be

less able to take the quick action necessary.

To add to the issue of disruption, Bartlet (2008), Cuttle (1995) and

Peek cited in Global Assessment Report GAR (2011:4) state that

disasters have a disproportionate impact on the poor in developing

countries, especially affecting those segments of the population that are

more vulnerable. Children and especially young children are less well

equipped to deal with deprivation and stress due to their particular

physical, social and psychological characteristics.

Anxiety

The experience of dealing with disasters has demonstrated that

psychosocial characteristics and mental health are vital in disaster

preparedness and management. In vulnerable countries around the world

at high risk of natural catastrophe, disaster mental health preparedness

should play a vital role (Roudini et al., 2017).

The evidence suggests that natural disasters have a potentially

negative impact on mental health, with increasing levels of Post-traumatic

Stress Disorder (PTSD), depression, anxiety, and use of psychotropic

medications in populations post-disaster (McCabe et al., 2014).

Psychological preparedness differs from household or physical

preparedness in that what is referred to is an intra-individual and

psychological state of awareness, anticipation, and readiness - an internal,

19
primed, capacity to anticipate and manage one’s psychological response

in an emergency situation (Roudini et al 2017

. Psychological preparedness can assist people to think clearly and

rationally, which in turn may reduce the risk of serious injury and loss of

life during disasters (Malkina, 2013)

People are not fully aware of disasters and the mental effects on

human’s health, so natural disaster mental health preparedness is

frequently unnoticed due to the more immediate and basic physical needs

in disaster situations (Roudini et al 2017).

Roudini et al. (2017) conducted a literature review on this area and

found a lack of information on disaster mental health preparedness for

vulnerable groups such as children, women, people living with disabilities,

and the elderly.

A great many biological processes have been implicated in risk for

anxiety disorders, as well as in expression of anxiety disorders. In the past

decade, biochemical theories of anxiety—which, it should be noted,

overlap substantially with biochemical theories of depression—have

focused on neurotransmitter systems that use serotonin (5-HT) or

corticotropin-releasing factor (CRF), though numerous other

neurotransmitters and neurohormones have also been implicated. More

recently, there has been some convergence of theory (and supporting

evidence) that risk for many (though perhaps not all of the) anxiety

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disorders may overlap substantially with biological factors that influence

anxiety-related personality traits (e.g., the confluence of high neurosis and

low extraversion, sometimes referred to as “neurotic introversion”)

(Bienvenu, Hettema, Neale, Prescott, & Kendler, 2007).

Brain imaging has provided another window into the biology of

anxiety and related disorders. Having evolved from studies of symptom

provocation to the use of various types of emotion-processing tasks (e.g.,

the viewing of emotional faces), investigators have identified neural

circuits that seem to function differently in patients with anxiety disorders.

Two brain regions that have been consistently observed in patients with

anxiety disorders to exhibit increased responsiveness in these types of

paradigms are the amygdala and insula (Etkin & Wager, 2007).

Anxiety is a feeling of uneasiness and worry, usually generalized

and unfocused as an overreaction to a situation that is only subjectively

seen as menacing (Bouras N, Holt G 2007). It is often accompanied by

muscular tension (Bouras N, Holt G 2007). Restlessness, fatigue and

problems in concentration. Normally considered to be appropriate, when

anxiety is experienced regularly the individual may suffer from an anxiety

disorder. Anxiety is closely related to fear, which is a response to a real or

perceived immediate threat; anxiety involves the expectation of future

threat.  People facing anxiety may withdraw from situations which have

provoked anxiety in the past (Bouras N, Holt G 2007).

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 Contextual factors that are thought to contribute to anxiety include

gender socialization and learning experiences. In particular, learning

mastery (the degree to which people perceive their lives to be under their

own control) and instrumentality, which includes such traits as self-

confidence, self-efficacy, independence, and competitiveness fully

mediate the relation between gender and anxiety. That is, though gender

differences in anxiety exist, with higher levels of anxiety in women

compared to men, gender socialization and learning mastery explain these

gender differences (Behnke RR, Sawyer CR 2000).

Anxiety and depression reducing effects in mice, but not in subjects

without vagus nerves. The microbes of the gut can connect with the brain

to affect anxiety. There are various pathways along which this

communication can take place. One is through the major

neurotransmitters ( Kennedy P.J 2017). The gut microbes such

as Bifidobacterium and Bacillus produce the neurotransmitters GABA and

dopamine, respectively. The neurotransmitters signal to the nervous

system of the gastrointestinal tract, and those signals will be carried to the

brain through the vagus nerve or the spinal system. This is demonstrated

by the fact that altering the microbiome has shown (Dinan, Timothy G,

2015).

Resilience

Resilience is the ability to recover and regain readily one’s form or

particular state to rise from the rubble and recover without intervention,

22
knowing of the fact that every person has a natural physical and

intrapsychic capacity to recover without interventions (Ignacio, 2010).

Most adults are resilient and rely on existing coping mechanisms

when they are faced with difficult situations (Warchal & Graham,

2011).Disasters agency is manifested when individuals are able to

harness their strengths and abilities in order to confront and survive their

traumatic experiences (Fernando & Herbert, 2011)

Individuals are not mere subjects and have the power to create or

transform systems. Changes in norms and behaviors lead to changes in

policies and strategies (Manyena and Gordon, 2014). The present study

seeks to validate this by examining the relationship between adaptive

coping of disaster survivors and community resilience. Specifically, this

study hypothesizes that adaptive coping is positively correlated with

community resilience interventions to foster resilience among survivors

usually aim to facilitate positive adaptation and promote emotional well-

being including a sense of safety, calm, a sense of self- and community-

efficacy, connectedness, and hope (Hobfoll et al., 2007).

The complexities of defining what appears to be the relatively

simple concept of resilience are widely recognized. This paper analyses

the concept of resilience from a range of disciplinary perspectives and

clarifies a definition in order to inform research, policy and practice. The

work takes a life course approach to resilience, examining evidence

derived from research across the life [Link] incorporates the methods of

23
systematic review, concept analysis and consultation through face-to-face

meetings. The synthesis of methodological approaches enables a clear

identification of the antecedents, defining attributes and consequences of

resilience, validated with stakeholder partners.

Through this process, resilience is defined as the process of

effectively negotiating, adapting to, or managing significant sources of

stress or trauma. Assets and resources within the individual, their life and

environment facilitate this capacity for adaptation and ‘bouncing back’ in

the face of adversity. Across the life course, the experience of resilience

will vary. A large proportion of resilience research is routed within the

discipline of developmental psychology, and has mainly been developed

with children and adolescents. A major contribution to resilience research

could be made through more multi-disciplinary studies that examine the

dynamics of resilience across the lifespan, its role in healthy ageing and in

managing loss, such as changes in cognitive functioning.

Introduction Research on resilience has increased substantially

over the past two decades1 and is now also receiving increasing interest

from those involved with policy and practice in relation to its potential

impact on health, well-being and quality of life. This interest is due to a

move away from ‘deficit’ models of illness and psychopathology, as

theory focuses on understanding healthy development despite risk, and on

strengths rather than weaknesses (Fergus S, et al 2005)

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 Resilience is a vital attribute for nurses in their everyday work and

particularly amidst the current nursing shortage. It denotes a combination

of abilities and characteristics that interact dynamically to allow an

individual to bounce back, cope successfully, and function above the norm

in spite of significant stress or adversity. (Rutter M, 1993) Although

researchers agree on multiple domains to the concept of resilience, it can

be viewed as a qualitative categorical construct or as a continuum of

adaptation or success experiences. (Luthar S, et al 1993) Its complexity

necessitates an additional holistic nursing perspective.

Resilience has been studied particularly in relation to transitions of

greatest stress. Developmental transitions include school entry,

detachment from parents during adolescence, and childbearing.

Transitions also occur in unexpected or externally controlled events such

as disaster, family disruption, or unemployment (Luthar S, Zigler E, 1992)

Although each individual possesses the potential for resilience, an

interplay between the individual and the broader environment is

responsible for the level of resilience. (Rutter M, 1993) Further, the

interactions among risk and protective factors at an intrapersonal and

environmental level are integral to the definition of resilience. The

presence of risk factors indicates that a person has been identified as with

a group that is more likely than other groups to develop a specific difficulty

(Zuckerman M. 1999)

25
 The domains of resilience are developmentally appropriate and

change with different life stages. For example, in addition to the absence

of illness, children who function above the norm scholastically and in peer

relationships in spite of risk exhibit resilience. In adolescence and young

adulthood, resilience may be measured by accomplishments higher than

the norm in career development, happiness, relationships, and physical

well-being in spite of the presence of risk factors. Resilience is not static

(Baldwin A, et al 1993).

26