Globalization, Global Health, and Disaster

Although Globalization is not a new phenomenon, it has been accelerating in recent years. The world is now more than ever interconnected and interdependent with flows of goods, capital, people, and ideas. This process has had positive as well as negative health effects (1), has become an important health determinant, and has accounted for the emergence of new concepts of " global health " (2). The importance of Globalization and its effect on global health often becomes highlighted during disasters, as in the case of a large scale earthquake or the emergence of a new infectious disease. If a disaster occurs in low and middle income countries, such countries often do not have the capacity to handle an immediate response in terms of rescue, treatment, and shelter. This can result in inadequate management of affected people and environment and can lead to further disasters including epidemics and social instability, which in turn may affect global health (3). In this era of Globalization, it is possible to have a timely global response after the occurrence of a disaster and to provide substantial help to affected countries and communities to restore and maintain health services. After a magnitude 7.8 earthquake in Nepal on April 25, 2015, there was just such a response. This disaster caused 8,659 deaths and over 100,000 injuries with more than 500,000 houses and 1,000 health facilities destroyed. The health facilities included primary health care centers, village health posts, and birthing centers (4). Nepal is in a risk prone area for earthquakes and its capital, Kathmandu, is classified as being very vulnerable should a strong earthquake occur. Kathmandu has seen much unmanaged urbanization, mainly due to centralized resources and failure to enforce even existing laws. Urbanization is another challenge to global public health in the twenty-first century. Cities have been growing unsustain-ably with poor roads and urban transport, and inadequate water and waste disposal systems. In Kathmandu, many buildings have been constructed without regard to proper engineering principles and people frequently compound the problem by adding floors to houses with weak foundations (5). A national preparedness platform does exist in Nepal: The Disaster Preparedness Network Nepal consists of governmental and non-governmental organizations. The Network coordinates and shares information to manage disasters such as earthquakes, floods, droughts, landslides. But while a " National Strategy for Disaster Risk Management in Nepal " has been formulated, this strategy does not include separate …