What’s new in 2018
- Once a week through Spring I and II (Twice the time to read and prepare for your final assignment!)
- Training and support for online advocacy and communication during disasters and humanitarian crises (Students will learn to prepare podcasts, webinars or online blogs on issues of rights, equity and access in current crisis events; supported by the FXB Center)
- New topics covering mental health; crisis mapping; emerging technologies.
- Guest lectures from India, China and Australia
- New case-studies
ID 205: Societal Response to Disaster and War
Course Info: Spring I and II; Thursdays 3.45pm; FXB G12
Instructors: Jennifer Leaning, MD, SMH
FXB Professor of Health and Human Rights
Director, FXB Center for Health and Human Rights
Satchit Balsari, MD, MPH
Harvard Medical School / Beth Israel Deaconess Medical Center
FXB Center for Health and Human Rights
Teaching Assistant: TBD
Natural and technological disasters occur frequently, as do major public health crises associated with epidemic disease and armed conflict. These crises can cause significant mortality and morbidity, requiring rapid mobilization of health care resources, population protection initiatives, and professional expertise. These crises can also damage material and social infrastructures, and thus indirectly produce human misery of sweeping magnitude. Each disaster is very different yet they all have definable threat and impact characteristics. These characteristics reflect key structures of the society in which they take place: resource availability, population densities, environmental dependencies, managerial competence, and technological development. A study of how societies respond to disaster, including the advance planning to reduce risk or mitigate effects, reveals how these societies assess risk, cope with problems, evaluate loss, and approach the future. Thus a study of disaster management can present, in microcosm, a view of the social dynamics and social vulnerabilities unobtainable in static, unstressed situations.
Widespread epidemics and armed conflict also reflect underlying issues in society—particularly in the public health, political, and social realm. This course highlights these issues with three examples.
Since increasingly the same agencies and same professional cadres are summoned to support populations in disasters, epidemics, and armed conflict, the perspective of this course is on the core public health elements of these crises as well as on the individual decision-maker or small group who may be charged with organizing and carrying out the medical and public health aspects of the immediate crisis response. This immediate response period includes assessment, rescue and relief, initial recovery, and, as needed, strategies for longer-term population protection. There exist generally accepted categories of tasks that must be accomplished for a disaster response to be judged adequate or excellent. Very little work has been done, however, in using these categories to evaluate process and outcome in actual, specific disasters or emergencies that have occurred. Even less work has been done to explore individual leadership behavior in this context. Similarly, in the context of war and epidemic disease, the public health tasks might be well explored but the division of roles, the assignment of responsibilities, and the oversight of operations in the larger strategic context are topics that are less well explored.
From this perspective, crisis management can be seen as a function carried out by leaders, and can be studied in the context of the literature on decision-making under stress. A key problem in this kind of decision-making is maintaining a focus on ethical choices in situations where priorities are also placed on speed and inclusiveness of information-processing. The concept of triage, and its ethical dilemmas, will serve as a theme throughout the course.
A subtext of this discussion will be an evaluation of how individuals function in collective settings. The theory of small-group decision-making, and how this dynamic contributes to or detracts from the individual process of cognition and choice, will be explored in the context of actual crisis experiences.
The course will begin with a brief review of the theory and literature relating to crisis management and decision-making under stress, and then proceed to in-depth discussions of case studies, deriving analytic points from what can be learned in an assessment of recorded experience. By the end of the course, the student will understand the need for discipline (structure, doctrine, process), ethical assessment (application of norms and principles), and agility (creativity, improvisation, adaptability) in responding to a range of complex crises.
At the end of the course, students will be able to:
- Examine the range of issues involved in responding to natural and technological disasters and to crises with major public health consequences such as armed conflict and epidemic disease.
- Understand the factors that will enable them, as potential leaders and responders in the public health and medical arenas, to assess these crises comprehensively and assist effectively in their response.
Students taking the course for credit and auditors will be expected to attend all classes, cover all required readings, and participate in class discussion. Grades will be based on class participation, oral presentation of a critique of a specific aspect of one crisis selected by the student, and submission of the written critique (15-pages, 1.5-spaced). This critique will rely on key concepts elaborated during the course. Details regarding the critiques will be discussed in class. This critique will be due on the last day of class as noted (see course schedule).
This year, we have introduced an online advocacy component to train students to prepare an online blog, podcast or webinar to address a current or recent crisis.
The final grade will be based on the following components:
- Class participation, 20%
- Online Advocacy Product, 10%
- Oral presentation, 10%
- Written paper, 60%
Session 1 Key Elements of Disaster Response: Part 1
Session 2 Key Elements of Disaster Response: Part 2
Session 3 Decision-Making Under Stress: Philadelphia Move
Session 4 International Humanitarian Law and Humanitarian Crises
Session 5 Industrial Explosions: Bhopal, Tianjin
Session 6 Wind/Water Storms & Climate Change
Session 7 Mass Gatherings, Stampedes
Session 8 Mass shootings
Session 9 Disaster Risk and Impact Ascertainment
Session 10 Complex Disasters: Fukishima, Chernobyl
Session 11 Crisis Mapping: Case-study Ebola
Session 12 Civilian Protection: MSF in Srebrenica
Session 13 Civilian Protection: Syria, Forced Migration
Session 14 Current Events
Session 15 Final presentations
Session 16 Final presentations