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With Ebola crippling the health system, Liberians die of routine medical problems

By Lenny Bernstein - Sep 20 2014 - washingtonpost.com

MONROVIA, Liberia — While the terrifying spread of Ebola has captured the world’s attention, it also has produced a lesser-known crisis: the near-collapse of the already fragile health-care system here, a development that may be as dangerous — for now — as the virus for the average Liberian.

Western experts said that people here are dying of preventable or treatable conditions such as malaria, diarrhea, pneumonia and the effects of high blood pressure and diabetes, such as strokes. Where services do exist, Ebola has complicated the effort to provide them by stoking fear among health-care workers, who sometimes turn away sick people or women in labor if they can’t determine whether the patient is infected. And some people, health-care workers said, will not seek care, fearful that they will become infected with Ebola at a clinic or hospital.

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Risk and Risk Underwriting

In writing about the importance of promoting private enterprise, as well as in many other sections of my work, I suggested an almost near certainty that the risk management industry eventually will facilitate resilience and structural adaptivity in our built environment.  In my larger draft, I included a short section about this, which I am posting below (somewhat revised).  I believe it is beneficial to share this section now in order to explain my optimism for resilience. (I also wrote short sections on Time, Rapid Change, Optimism, A Futurist Perspective, and The Human Factor but do not necessarily intend to post them here.)

 

The future will be all about risk and trying to find protection from the rapidly increasing threats to our world as we advance in population size, social/cultural/economic complexity, and cutting-edge science and technology.  Risk underwriting will play a big role in how well or how poorly we adapt to accelerating change. 

 

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Ebola outbreak 'could top 20,000'

Published on Aug. 28, 2014

An outbreak of the Ebola virus in West Africa could amount to 20,000 cases, the World Health organisation says (Centres for Disease Control and Prevention/PA) 

 

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Some Examples of Structural Adaptivity - Part II

Here are some more examples of how I propose that structural adaptivity could be applied as a leading principle for resilient development in the US over the next 20-50-100 years.  These are intended to support my conviction that structural adaptivity is the only logical approach to advancing our built environment for a rapidly changing, uncertain, unpredictable future.  I am hoping that others will review these concepts and propose their own personal and team-researched applications of the principle.

 

In re-balancing our nation, do so by major watersheds.  I propose that the re-balancing of our nation’s urban development (as I discussed before) should be based on the locations and characteristics of our major watersheds.  All major urban development regions should have a long-term dependable natural source of fresh water. 

 

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Conflicting Scenarios Exercise

I have been proposing that, rather than trying to foresee the future, we consider accepting and conducting further research on a much more fundamental, all-encompassing and long-term-resilient approach to our built environment.  I have been proposing that such an elemental approach should be structural adaptivity.  I believe that our world must and will give maximum adaptivity to the basic elements of our built environment to adjust to and meet our needs for the unpredictable, rapidly changing world over the next 50-100 years. 

 

 

In working on this, I conducted an Exercise.  I experimented with a number of different future conditions, or scenarios, that I think are quite possible.  The first two that drew my strongest concern were the conflicting scenarios of: (1) how planners might address our urban areas after global warming has abated – and the problem is continuous hot weather and more storms – as opposed to (2) how planners are now addressing the need to stop or slow down global warming.  I also experimented with additional scenarios that I do not think we are able to, presently, forecast accurately.  Most of them, however, I believe will surface eventually, in one way or another, and cause huge problems.

 

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Electromagnetic Disaster Could Cost Trillions and Affect Millions. We Need to Be Prepared

      

Roasted by a pulse. Credit: arbyreed, CC BY-NC-SA

homelandsecuritynewswire.com - by Anders Sandberg - August 12, 2014

In 1962, a high-altitude Pacific nuclear test caused electrical damage 1,400 km away in Hawaii. A powerful electromagnetic pulse (EMP) – created either by a solar storm or a high-altitude nuclear explosion — poses a threat to regions dependent on electricity, as such pulses could cause outages lasting from two weeks to two years. The main problem is the availability of spare transformers. Superstorm Sandy’s worst effects were in a single location. In the case of a big EMP surge, replacement transformers would be needed in hundreds of locations at the same time. The cost of an EMP pulse to the U.S. economy would likely be in the range of $500 million to $2.6 trillion. A report by the U.S. National Academies was even more pessimistic, guessing at a higher range and a multi-year recovery. Besides disrupting electricity such storms can also destroy satellites, disrupt GPS navigation, and make other parts of the infrastructure fail.

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SOME FACILITATION EXAMPLES FOR STRUCTURAL ADAPTIVITY

  

I believe that structural adaptivity will become generally accepted in our world even without conscious effort.  As change continues speeding up, and as planners, developers, futurists, risk managers, and many others come to recognize that change is coming at an accelerating rate and that the future is ever more uncertain and unpredictable, they will focus on adaptivity.  However, the longer we wait for people to realize this, the greater the chances are that much harm will occur that should have been avoided or mitigated by the resilience we should have been already building.

 

The facilitation strategies and techniques that I propose are primarily intended to show some logical possibilities.  Hopefully other people will be better able than I am to come up with the best ones. 

 

For now, I will present the full list of the possibilities that I have come up with and then present a discussion of a few of them. <!--break-->

 

My full list:

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Some Examples of Structural Adaptivity

 

As a follow-up to my post titled A New Approach, following below are several examples of how I propose that structural adaptivity should be applied as a guiding principle for future growth and development in the US.  As I explained before, I believe that structural adaptivity is the only logical approach to building our man-made environment for a rapidly changing, uncertain, unpredictable future.

 

Bus Rapid Transit.  Bus rapid transit (BRT) is a system of individual self-propelled vehicles (often several linked together) that can and do travel on conventional streets and highways, on dedicated lanes on surface streets, and/or on separate intersection-free busways dedicated to buses only.  Likewise, the rapid transit buses can leave their normal routes of travel and enter and leave most all areas of a city or region.  As a modern system providing rapid mass transit, it also normally has features similar to rail rapid transit, e.g., off-board fare collection, platform-level boarding, efficient and rapid scheduling, etc., and it oftentimes has traffic signaling priority at any street intersections.

 

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Safe burial to reduce Ebola spread

Another challenge in trying to contain Ebola is the very strong cultural beliefs in that area of Africa.

The No. 1 contamination risk is touching the body around the time someone has died from Ebola.

"They do rituals before they bury the body that involves washing the bodies and even, sometimes, sleeping with them, the dead person."

So after someone dies at a treatment centre, the Doctors Without Borders staff bring the family to the centre and do what they call a safe burial.

"We wash the body and we put them in a body bag, but with the zipper open so they can see the face, and we bring the body to the village," in conjunction with the Guinea Red Cross, Forget says.

"People can still do a burial process but in a safe way so they don't touch the body … they can still pray and perform ceremonies but without touching the body.

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A New Approach

I would like to share the results of my research, thinking and writing with the U. S. Resilience System in the hopes that its viewers can incorporate some of it into their own work.  I also hope to receive feedback so I can improve my ideas.

 

My background is in city and regional planning.  More recently it has expanded to include futures research.  I believe that the much-needed resilience many of us are seeking can best be achieved if we are working on immediate plans and actions plus long-range plans and actions at the same time.  Immediate or short-term actions are seldom sufficient by themselves.

 

Resilience to the wide variety of critical problems and uncertainties we expect to face this century requires systemic changes in our country and world.  It requires changes in the way we think, act, organize and communicate, and in what and where we build.  We slowly build our man-made environment to fit our needs and then our man-made environment shapes and controls us for many decades - even after our needs have changed. 

 

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