disability and disaster risk reduction / emergency ...€¦ · with disability, people with...

Disability and Disaster Risk Reduction / Emergency Preparedness

Scoping Review

The University of Sydney’s Centre for Disability Research and Policy (CDRP) and Asia Pacific Natural

Hazards and Disaster Risk Research Group

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Disability Inclusive Disaster Preparedness in NSW: Enabling Local Community Resilience through Collaboration


Scoping Review

November, 2016

Professor Gwynnyth Llewellyn Associate Professor Dale Dominey-Howes Dr Michelle Villeneuve Alexandra Lewis-Gargett

Contact Centre for Disability Research and Policy, Faculty of Health Sciences: Professor Gwynnyth Llewellyn C43A - A Block Cumberland Campus Ph. +61 2 9351 9553 e-mail [email protected] Asia Pacific Natural Hazards and Disaster Risk Research Group Associate Professor Dale Dominey-Howes Room 448, F09 - Madsen Building Ph. +61 2 9351 6641 e-mail [email protected] Centre for Disability Research and Policy, Faculty of Health Sciences Dr. Michelle Villeneuve J106, Cumberland Campus C42 Ph. +61 2 9356 7438 e-mail [email protected] Acknowledgements The study team would like to acknowledge the NSW and Commonwealth governments’ National Partnership Agreement – Natural Disaster Resilience Program for funding this project under the Community Resilience Innovation Program, Office of Emergency Management, NSW Department of Justice.

mailto:[email protected]

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CONTENTS

Background ............................................................................................................... 1

Purpose of the scoping review .................................................................................. 4

Method ...................................................................................................................... 5

Search strategy ..................................................................................................... 5

Review phase ........................................................................................................ 6

Analysis and synthesis phases .............................................................................. 8

Findings .................................................................................................................... 8

Numerical analysis ................................................................................................. 8

Thematic analysis .................................................................................................. 9

Conclusion .............................................................................................................. 18

References .............................................................................................................. 20

Appendix 1 – Search terms and databases ............................................................. 25


Background Including people with disability in disaster risk reduction (DRR) policy, planning and

implementation is a relatively new phenomenon worldwide. The international disaster

risk reduction framework, the Sendai Framework for Disaster Risk Reduction

(SFDRR) 2015 – 2030 underpinned by the rights framework of the UN Convention on

the Rights of Persons with Disabilities [CRPD], United Nations, 2006) provides

impetus for further development in this field.

The World Report on Disability (WHO, 2010) reported that 15% of the world’s

population lives with disability. People with disability are known to be more vulnerable

in the face of a natural hazard emergency. There is now evidence to suggest that

people with disability are two to four times more likely to die or be injured during

natural disasters than the general population (UN Office for Disaster Risk Reduction

[UNISDR}, 2013). They are also less likely to receive aid and ongoing support to

recover over the longer term. Risk for people with disability is further increased when

systems are fragmented and the responsibility for people with particular needs and

capabilities is unclear.

This paper presents a scoping review of the scientific literature undertaken as part of

the Disability Inclusive Disaster Preparedness in NSW: Enabling Local Community

Resilience Through Collaboration project. This project was funded under the

Community Resilience Innovation Program (2014-2015), Office of Emergency

Management, NSW Department of Justice. This program is part of the NSW and

Commonwealth governments’ National Partnership Agreement – Natural Disaster

Resilience Program.

The project approach brought together community service organisations for people

with disability, people with disability, other community organisations and agencies

and personnel from emergency management agencies to build community capacity

that includes people with disability. Within the context of this project, this scoping

review presents an overview of the state of knowledge about people with disability

and disaster risk reduction contained in the scientific literature. Prior to the findings of

this review, we provide an overview of the relevant international and national

frameworks and definitions and concepts used in the field of disability inclusive

disaster risk reduction (DiDRR).

International frameworks

The relevant international framework for disaster risk reduction is the Sendai

Framework for Disaster Risk Reduction (SFDRR) 2015 - 2030. This is the first

international framework in which disability is specifically mentioned. Prior to this as

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noted by UNISDR (2013b), disaster risk reduction (DRR) stakeholders had not

generally engaged with disability, and organisations serving people with disability had

not engaged with DRR stakeholders. The two earlier international DRR frameworks,

the Yokohama Strategy 1994 – 2004 and the Hyogo Framework for Action 2005 –

2015 [HFA] did not recognise or reference disability (Stough & Kang, 2015).

Disability was first acknowledged by the international DRR community in 2012 in a

regional document, the Yogyakarta Declaration. This Declaration was produced as

an outcome of the 5th Asian Ministerial Conference on Disaster Risk Reduction

(AMCDRR) that occurred as part of regional HFA consultations. The declaration

specifically noted the importance of the active participation of at-risk communities as

follows:

“....to ensure the active contribution of risk-prone communities, particularly

persons with disabilities, women, children and the elderly, and to meet their

different needs...” (UNISDR, 2012, p.2)

The UN Convention on the Rights of Persons with Disabilities (United Nations, 2006)

is the first comprehensive, international framework devoted to disability. Article 11 of

this Convention obligates State Parties to ‘take all necessary measures to ensure the

protection and safety of persons with disabilities in situations of risk, including

situations of armed conflict, humanitarian emergencies and the occurrence of natural

disasters’. Other articles in the CRPD are also relevant to DRR. Article 9 specifies

that people with disability have a right to equally access the physical environment,

transportation and communication technologies and systems. In a disaster context

this right includes equal access to warning systems, evacuation plans or emergency

shelters. Further, Article 29 requires that people with disability must be included in

planning, policy development and implementation in any matters that affect their

lives. This requires actively including people with disability in DRR activities and

emergency preparedness policy, planning and implementation.

Regional frameworks

In Asia and the Pacific region, the most recent regional framework, Make the Right

Real. The Incheon Strategy for Persons with Disabilities in Asia and the Pacific 2012-

2020 has a clear focus on disability inclusive disaster risk reduction (DiDRR). This

framework recognizes the particular vulnerability of this region to natural disasters

and, building on CRPD, takes a rights based approach to implementing DiDRR. Goal

7 is Ensure disability inclusive disaster risk reduction and management. This is

further specified in two targets accompanied by core and supplementary indicators.

The two targets are as follows. Target 7.A Strengthen disability-inclusive disaster risk

reduction planning. Target 7.B Strengthen implementation of measures on providing

timely and appropriate support to persons with disabilities in responding to disasters.

This regional focus on DiDRR is an important step towards realising the rights of

persons with disability as required by the CRPD.

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National frameworks

Australia has a National Strategy for Disaster Resilience (COAG, 2011) agreed by

the Council of Australian Governments in February 2011. This framework is built on

the concept of shared responsibility to create community resilience and thereby

reduce risk in the face of natural hazard emergencies and disasters. The concept of

shared responsibility includes the role of the federal government, state and territory

governments, and local government, and the role of business, non-government

organisations and volunteers, and individuals in each and every community. The

strategy document is accompanied by the National Strategy for Disaster Resilience

Companion Booklet (Commonwealth of Australia, 2012) which contains seven priority

areas including: (1) leading change and coordinating effort; (2) understanding risks;

(3) communicating with and educating people about risks; (4) partnering with those

who affect change; (5) empowering communities to exercise choice and take

responsibility; (6) reducing risks in the built environment; and (7) supporting

capabilities for disaster resilience. Illustrated case studies accompany each priority

area for action.

The high-level governance arrangements for overseeing the implementation of the

Australian framework include the Standing Council on Police and Emergency

Management (SCPEM). SCPEM has six key responsibilities – one of which is the

provision of national leadership on emergency management and disaster resilience.

There is no mention of disability in the National Strategy for Disaster Resilience. In

the National Strategy for Disaster Resilience Companion Booklet people with

disability receive mention as a group that requires special attention by SCPEM, as do

other groups considered to be at additional risk including indigenous people.

Disaster risk reduction: definition and concepts

According to the UN Office for Disaster Risk Reduction (UNISDR), DRR is defined as

the concept and practice of reducing disaster risks through systematic efforts to

analyse and manage the causal factors of disasters, including through reduced

exposure to hazards, lessened vulnerability of people and property, wise

management of land and the environment, and improved preparedness for adverse

events (https://www.unisdr.org/we/inform/terminology).

DRR approaches consider the scale of a disaster in terms of impact on the

population, on housing and on livelihood and public services rather than the severity

of the event. DRR encompasses a broad range of activities that target the causal

factors of disaster to lessen disaster impact. DRR policy and practices aim to

combine the best available knowledge of natural hazards and associated risks. From

a population perspective the question is: “what factors can be controlled or influenced

to limit the human impact from a natural hazard and associated disaster event?

Emergency or disaster preparedness are terms more often used in the community or

public information approaches to communicate awareness and the need for

individuals and communities to be involved, prepared and to build resilience to face

natural hazard emergencies. Emergency preparedness is often described in ways

such as the following that comes from the US Center for Disease Control and

Prevention and Disease and focuses more specifically on health emergencies:

https://www.unisdr.org/we/inform/terminology)

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‘Many people are concerned about the possibility of a public health

emergency such as a natural disaster, act of terrorism, or disease outbreak.

You can take steps now to help you prepare for an emergency and cope if an

emergency happens’.

(https://emergency.cdc.gov/preparedness/)

Disaster preparedness is frequently used in Australia for example by orgnaisations

such as Australian Red Cross to raise awareness of the need for individuals and

communities to be adequately prepared:

‘Being prepared for a bushfire, cyclone, flood or whatever emergency may

come your way means you're more likely to cope and get your life back on

track’.

(http://www.redcross.org.au/prepare.aspx)

In this scoping review the terms emergency preparedness and disaster risk reduction

are used in this dual sense of preparedness for individuals and for communities.

Purpose of the scoping review

This scoping review set out to address the following question: What do we know

about reducing disaster risk and increasing emergency preparedness for people with

disability?

The aim of a scoping review is to ‘scope’ the parameters of the field of study rather

than to provide a detailed analysis of the state of knowledge. Scoping reviews are

frequently carried out where there is a newly emerging field, typically with few

theoretical and empirical underpinnings. As Mays, Roberts and Popay (2001) noted

scoping studies “aim to map rapidly the key concepts underpinning a research area

and the main sources and types of evidence available, can be undertaken as stand-

alone projects in their own right, especially where an area is complex or has not been

reviewed comprehensively before” (p.194). Thus, scoping reviews aim to locate the

major writings in the field without aiming to obtain a comprehensive data base of all

available scientific publications, position papers, policy documents, program

descriptions and evaluations and so on (Arksey & Malley, 2005; Gough, Oliver &

Thomas, 2012; Levac, Colquhoun & O’Brien, 2010).

The advantage of scoping reviews undertaken in an emerging field such as disaster

risk reduction for people with disabilities is the capacity to highlight initiatives from

around the world as these are reported. Papers are often prepared for example in

response to implementation of international frameworks or particular events or

circumstances that give rise to new concerns or considerations. Both of these

reasons are apparent here. In the first instance the coming into force of the UNCRPD

in 2006 and the relatively rapid signing and ratifying by member nations of this

international human rights convention. Second, there has been strong advocacy

https://emergency.cdc.gov/preparedness/

http://www.redcross.org.au/prepare.aspx)

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internationally and in Asia and the Pacific by the Disability Inclusive Disaster Risk

Reduction Network (DiDRRN) to include people with disability as first occurred in the

Yogyakarta Declaration in 2012, followed by their inclusion in the SFDRR in 2015.

And third, impetus for new initiatives has come from the large scale natural disasters

in the United States including Hurricane Katrina and Typhoon Sandy and the Great

East Japan Earthquake and Tsunami where for the first time data became available

on the number of PWD who died or were injured.

Given this rapidly emerging field of DRR and emergency preparedness for people

with disability, we set out to provide a scoping review of the scientific literature on this

topic. We initially also explored the grey literature via relevant websites of

organisations engaged with persons with disability such as CBM International,

Handicap International, and the Centre for Disability and Development in Bangladesh

and those engaged with DRR such as UNISDR. Projects reported on these websites

and reference lists were hand searched for reference lists of key papers. In doing so,

it quickly became clear that due to the variety of terms used and project specific

terminology, ‘locked’ access requiring membership to obtain reports or papers,

languages other than English, and instability of URLs, scoping this literature was not

possible. Rather, a grey literature review needed to be undertaken as a separate and

comprehensive stand-alone project beyond the time and resources available in the

current project.

Instead we refer the reader to a recent and up-to-date compilation of grey literature in

this field of DiDRR hosted by Ask Source (http://www.asksource.info/ ). In this

disability and development repository there is a section on DiDRR activities and

projects in the context of international development at

http://www.asksource.info/topics/humanitarian/disability-inclusive-drr. This is a

welcome new development. Since its inception the resources referenced on this

website have expanded exponentially. These resources are a mix of position papers,

case studies, reviews, UN documents and research study reports. This website

provides an excellent portal for those interested in non-peer-reviewed documents

and a useful proxy at this time for a more comprehensive and systematic search of

the grey literature.

Method

Search strategy

A systematic search of scientific journal databases was conducted in April 2014 then

updated in March 2015 and complemented at that time by a new search of an

additional 8 databases. The databases and keywords used in each search are

included in Appendix 1. The results of each search were exported to an EndNote

Library and duplicates removed after all search results compiled. The titles and

abstracts of the remaining papers were screened against the following exclusion

criteria. Papers were excluded if they were:

published before 2000,

http://www.asksource.info/

http://www.asksource.info/topics/humanitarian/disability-inclusive-drr

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conference or meeting papers and procedures,

editorials or letters to the Editor,

not in English,

not published in a peer-reviewed journal,

about occupational accidents, and were

resource manuals or international frameworks.

The final exclusion criteria related to alternative meanings of the search keywords for

example, the term disaster used to describe the global financial crisis.

Review phase

Search results

The first search undertaken in March 2014 returned over 800 papers (n=805). After

duplicates and excluded papers were removed one hundred and seven papers were

retained for screening. A further 64 papers were obtained from the updated search of

Medline, Sociological Abstracts, Scopus and Web of Science in May 2015. The new

searches of the 8 additional databases (Embase, Premedline, Cinahl, APA FT,

Environmental Abstracts, Geobase, Compendex, and GreenFILE) added a further

231 papers. After screening the total 502 papers using the exclusion criteria above,

88 papers were considered relevant for this scoping review. Five papers identified

through snowballing and hand searching were also added making a total of 93

papers included in the pre-analysis and coding phase.

Pre-analysis and coding phase

In the pre-analysis and coding phase, four coding frameworks were developed

following review of all abstracts. The first framework was related to country of

location of the paper. Papers were divided into North America and other countries.

This was based on understanding of the recent efforts in North America and

particularly the United States of the Federal Emergency Management Agency

(https://www.fema.gov/) in relation to people with disabilities in natural hazard

emergencies (https://www.fema.gov/office-disability-integration-and-

coordination).

The second coding framework related to type of paper and methods employed based

on the diversity of approaches in this newly emerging field. The third framework

developed at this pre-analysis phase was in relation to preparedness and response.

Although the primary aim of the review was to scope papers addressing

preparedness, it became apparent that many papers also addressed response as

part of their preparedness topic and some papers combined discussion of both

preparedness and response.

During this phase, one paper was identified as not meeting the inclusion criteria and

thus excluded. A further seven papers were also excluded as these did not include

abstracts in the exported file from the database and we were unable to locate the full

https://www.fema.gov/)

https://www.fema.gov/office-disability-integration-and-coordination

https://www.fema.gov/office-disability-integration-and-coordination

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article. These exclusions resulted in a final number of 85 papers included in this

scoping review. Of these the majority (n=55) came from North America; the

remaining 30 papers were from other countries.

Definitions for coding frameworks

Paper type by method

Descriptive: papers that provide description of activities or programs; not

empirical studies

Literature review papers: papers that provide a narrative or systematic review

of the relevant literature

Secondary analysis: analysis of existing data sets such as population

surveys, administrative data bases or data sets from previous research

studies.

Interview studies: papers that report empirical research using interview

methods

Survey studies: papers that report empirical research using survey methods

Intervention studies: papers that report evaluation of preparedness

interventions

Preparedness or response phase

Preparedness was defined according to the UNISDR description as follows: “The

knowledge and capacities developed by governments, professional response and

recovery organizations, communities and individuals to effectively anticipate, respond

to, and recover from, the impacts of likely, imminent or current hazard events or

conditions” (https://www.unisdr.org/we/inform/terminology). The papers coded

with ‘preparedness’ use this term or refer to a broad number of activities that

contribute to preparedness e.g. evacuation planning, identifying and engaging

vulnerable groups in needs analysis, stockpiling supplies or medications. Papers

coded with preparedness also include those that report on planning for disasters.

Papers that report learning about preparedness from a disaster were coded as

‘response’.

Response was defined according to the UNISDR description as follows: “The

provision of emergency services and public assistance during or immediately after a

disaster in order to save lives, reduce health impacts, ensure public safety and meet

the basic subsistence needs of the people affected”

(https://www.unisdr.org/we/inform/terminology). Papers coded with response

reported on analysis or review of the response phase including learning about

preparedness from a disaster as noted above under Preparedness.

A number of papers reported on both preparedness and response and were coded

accordingly in a joint category of preparedness and response.

https://www.unisdr.org/we/inform/terminology

https://www.unisdr.org/we/inform/terminology

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Analysis and synthesis phases

All 85 papers were coded using the four coding frameworks. There were two analysis

phases. First, numerical analysis was undertaken on the 85 papers according to the

first three coding frameworks; country location of paper, paper type or method, and

preparedness, response or both. Then all 85 papers were coded using the fourth

coding framework on population of interest to identify the papers that addressed

disability specifically. The second phase involved a thematic analysis of the 45

papers that were coded as addressing disability and preparedness to meet the

requirements of the research question. (Papers addressing disability within

vulnerable populations and papers addressing response were therefore excluded

from this thematic analysis). Synthesis of this material was then undertaken to

provide discussion on the current state of knowledge in this emerging field of

DiDRR/emergency preparedness and potential ways forward.

Findings

The findings are presented first in matrix format using the coding frameworks to

capture country location, paper type by method, and preparedness or response or

combination of both. The overarching country location framework is used to

differentiate between North America and other countries. This was considered an

important distinction given that the context of a high-income country such as the

United States is significantly different from papers addressing this topic in low and

middle-income countries. The findings from the thematic analysis are then presented.

Numerical analysis

A numerical analysis was conducted of the type of paper and preparedness or

response. This is presented in Figure 1. Over half of the papers (n=55) came from

the North American context. Findings from this numerical analysis show that almost

half of papers (n=40) across both North America (n=19) and other countries (n=21)

are descriptive. That is, these papers describe the issues for people with disability in

disaster situations and/ or programs and approaches applied in response to these

issues. This finding is not surprising given the early stage of development of research

knowledge about people with disability in natural hazard and disaster situations. In

the early stages of field development, papers describing the issue or problem

dominate (Llewellyn et al., 2014 at http://sydney.edu.au/health-

sciences/cdrp/projects/auditresearch.shtml). As a field of study matures,

empirical papers that seek to answer specific questions or test interventions begin to

appear.

Most of the papers focused on preparedness (North America n=40; other countries

n=12) or both preparedness and response (North America n=3; other countries n=8).

A total of 22 papers (North America n=12; other countries n=10) were coded as

response only and therefore excluded from the thematic analysis.

http://sydney.edu.au/health-sciences/cdrp/projects/auditresearch.shtml)

http://sydney.edu.au/health-sciences/cdrp/projects/auditresearch.shtml)

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In terms of the fourth coding framework on disability and vulnerability a total of 17

papers (North America n=10; other countries n=7) were coded as papers that

discussed vulnerability more broadly and included people with disability as one of

several groups of people who are more at risk during a disaster. These also were

excluded from the thematic analysis. This left a remaining 45 papers that had a

disability focus and were relevant to preparedness for thematic analysis.

Figure 1 presents the numerical analysis by methodology (paper type) of the papers located and the

phase of disaster (preparedness, response or both preparedness and response) they address. To

reflect the large amount of research conducted in North America the papers have been grouped in two

categories of country location: North America and all other countries.

Thematic analysis

Thematic analysis of empirical research papers (n=45) was guided by the research

question underpinning this scoping review: What do we know about reducing disaster

risk and increasing emergency preparedness for people with disability?

The themes derived from our analysis are presented in this section. The themes are:

degree of preparedness of people with disability; organizational responses to

including people with disability in preparedness activities; and community

preparedness including people with disability.

The overwhelming majority of the empirical research papers come from studies

conducted in North America. The most frequent type of research method utilised was

survey, North America papers n=20, other countries n=3; followed by interview, North

America papers n=6, other countries n=4; intervention, North America papers n=5,

other countries nil; literature review, North America papers n=1, other countries n=2;

secondary analysis North America papers n=4, other countries nil.

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8

4

14

5

2

1

12

6

2

4

1

1

1

2

2

5

1

5

0 5 10 15 20 25 30 35 40

Preparedness

Response

Both

Preparedness

Response

Both

All

oth

er

cou

ntr

ies

No

rth A

meri

ca

Figure 1: Paper type, disaster phase and country location

Descriptive Survey Secondary Analysis Literature review Interview Intervention

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Preparedness of Individuals with disability and household preparedness

The majority of papers in this section come from the US. The primary focus is on

assessing the personal or household preparedness of people with disability and

discussing how preparedness could be increased at the individual or household level.

Several papers have used surveys to assess the preparedness of people with

disability or their families. For example, Sakashita, Matthews & Yamamoto (2013)

evaluated the preparedness of a convenience sample of 50 families with a child

dependent on electrical medical equipment and found that most were inadequately

prepared for a power failure. Gershon et al. (2013) surveyed by way of an on-line

questionnaire a convenience sample of 253 people with cognitive and/ or physical

disabilities living in the community and all receiving personal assistance services.

These authors found that when people with disability had involvement of a personal

assistant in their emergency plan they scored higher overall on an emergency

preparedness scale.

Another approach to assessing preparedness comes from two studies that evaluated

the evacuation plans of full time wheelchair users (Hogaboom, Oyster, Riggins &

Boninger, 2013; McClure et al., 2011). Hogaboom et al. (2013) conducted telephone

interviews with a convenience sample of 21 people with spinal cord injury living in the

community. McClure et al. (2011) surveyed a convenience sample of 487 people with

spinal cord injury who use a wheelchair more than 40 hours a week and located via

six Spinal Cord Injury Model Centers. Both studies found that while most of the

respondents indicated they would be able to evacuate in an emergency the majority

did not have an evacuation plan or they had a plan that had not considered all

potential scenarios.

Only one paper outside the US context examined individual preparedness in a similar

manner to that of the US papers mentioned above. In this study by Tomio et al.

(2012) the authors assessed by survey the preparedness of over 500 (n=553)

participants from a nationwide patient group of over 1000 people with rheumatoid

arthritis in Japan. Only one-half had taken medical preparedness measures and only

one-quarter had taken general preparedness measures. They concluded that overall,

preparedness measures taken by the participants was insufficient. As the study did

not compare the preparedness scores of the participants with that of the general

population it is not clear whether this insufficient preparedness would also be found

more broadly than this specific group of people.

Preparedness of people with disability compared to the general population

The studies above rely on within-group methods to assess individual preparedness.

That is, they examine the preparedness of a particular group of people, in this case

people with disability. Missing from this method is data that would permit

understanding of the preparedness of people with disability in relation to the general

population. Ideally this would also include information on geographical location,

capacity as well as functional limitations, and inter-connectedness (or otherwise) with

local community and social networks. This information is critically important for policy

and planning purposes.

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Five studies were located which assessed disaster preparedness of people with

disability (and often including people with poor health and chronic diseases

compared to the general population. These studies typically use survey or secondary

analysis of existing administrative data sets to understand behavioural intentions.

(Bethel, Foreman & Burke, 2010; Smith & Notaro, 2009; Uscher-Pines et al., 2009).

For example, Bethel et al. (2010) examined the association of general health status,

disability status, and chronic disease status, respectively, with disaster

preparedness, among Behavioral Risk Factor Surveillance System (BRFSS) survey

respondents. Vulnerable populations were generally less likely to have household

preparedness items but more likely to have medication supplies than their

counterparts. Using data from the 2006-2007 Behavioral Risk Factor Surveillance

System of 6 states that included 188,288 self-reported respondents with disabilities

Smith and Notaro (2009) found that persons with a disability are 1.22 times more

likely to be unprepared for an emergency. For those with a disability, being female,

nonwhite, with less education, less income, and uncoupled and living in an urban

area this increases the likelihood of being unprepared for an emergency.

These findings suggest that when authors compare the emergency preparedness of

people with disability to the population as a whole, people with disability score lower

on preparedness scales than the general population without disability. However, the

findings are mixed using this method. For example, Uscher-Pines et al. (2009)

conducted a random-digit-dial telephone survey with 501 adults in southeastern

Pennsylvania in 2008. The survey instrument gathered data on socio-demographic

characteristics, disability status/functional limitations, and preparedness behaviors

related to an evacuation emergency. The authors reported that no significant

differences were identified with respect to awareness of evacuation routes,

purchasing of food and water, or creation of an emergency plan to guide evacuation

decision-making. Indicators such as arranging a place to meet, having identified a

shelter or packed a bag, people with disability were consistently around twice as

likely to have done so that then general population.

It is also helpful for policy and planning purposes to understand similarities and

differences between sub-groups in a population experiencing a similar situation.

Spence et al. (2007) study investigated, in the aftermath of Hurricane Katrina,

whether there was a difference in preparedness, information seeking behaviour and

media use between evacuees with and without disability. Their survey of 554

evacuees temporarily located in other areas of the United States found that people

with disability were more likely to prepare for a crisis by stockpiling food, medication,

emergency supplies and so on however they were less likely to plan for an

evacuation.

Interventions for improving individual or household preparedness

As noted in the early stages of an emerging field few reports of interventions are

available. We located only four papers that reported on preparedness interventions

emanating from two separate research studies. Baker and Baker (2010) first

surveyed a convenience sample of 145 families of children presenting to tertiary care

centres about their preparedness and reported significant under-preparedness.

Baker and colleagues then evaluated an education program for a convenience

sample of randomly assigned families with children with special health care needs

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and delivered by community health care professionals aiming at increasing their

household preparedness. Using a pre and post survey design these authors and their

colleagues found a statistically significant increase in preparedness as a result of the

training 30-35 days post intervention including when families were located in different

geographical regions (Baker & Cormier, 2013; Baker, Baker & Flagg, 2012).

Hooper (2010) reported the findings from a pilot program in Washington State that

sought to use community networks to improve preparedness among people with

disability. The program developed a curriculum for building preparedness and

response skills in people with disability. The train the trainer model involved training

disability advocates to deliver the curriculum to people with disability in their

community. However, despite its apparent success, the author reports that the

curriculum was not adopted by government agencies as an ongoing program. The

author concluded that the concept of disability inclusiveness is still in its infancy in the

field of emergency management, which lacks sophistication in addressing issues for

people with disabilities in emergency preparedness and response policy and

planning decisions.

The last intervention located employed a peer-to-peer intervention for young adults

with intellectual disability living independently in the community. Eisenman et al.

(2014) reported on a study in which adults were randomly assigned to an

experimental arm or a wait-list control arm with pre-and post- testing. Four two-hour

classes co-taught by a health educator and peer-mentors focused on earthquake

safety knowledge and preparedness supplies. Improvements in preparedness were

maintained at 1-month post-intervention. Interventions such as this align with more

recent approaches to DRR and emergency preparedness which emphasise the

critical importance of including those most at risk such as people with disabilities in

learning from and teaching each other.

The second theme addresses how organisations consider people with disabilities in

their preparedness activities.

Organisational responses to including people with disabilities in preparedness activities

The papers grouped in this theme report on the measures organisations have taken

to prepare for a disaster such as developing evacuation plans and designing

communication and alert systems. These papers specifically focus on the inclusion of

disability in these activities.

Organisational responses: is disability on the agenda?

Writing from the UK context, Twigg (2014) analysed vulnerability and capacity

assessments often used to understand the vulnerability within particular geographic

or social communities. The author found that while the stated purpose of these

assessments is to identify and understand what makes members of a community

vulnerable at the time of disaster, identifying people with disability are often

overlooked. Of the 28 assessments reviewed, 15 did not mention disability and only

two engaged with the social exclusion of people with disability. As Stough and Kang

(2015) noted this is in contrast to the SFDRR that explicitly mentions people with

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disability in the preamble, guiding principles, priorities for action and guiding

principles.

Organisational responses: schools

Inclusive response measures can be implemented in diverse institutional contexts in

the community. A series of Australian papers addresses the preparedness of

Australian schools to offer appropriate protective measures and inclusive responses

for children with disability. This series of papers comes from a team at James Cook

University led by Professor Helen Boon. The papers are described in some detail as

these come from the local context and are currently the most fulsome in the literature

with regard to specific institutional responses. Boon et al. (2011) published a critical

literature review of the literature on the preparedness of schools for responding to

disaster or emergency and protecting children with disabilities in their care. The

authors searched four major scientific databases relevant to disability and education

research. Their searches returned 1,080 papers of which 10 met the criteria for full

manuscript review. All of the 10 papers were US studies. The authors found from

these 10 papers that although most schools had engaged in disaster planning there

were significant gaps in preparedness efforts for accommodating the needs of

children with disabilities. The gaps included mobility or communication needs of

children with disability during evacuation procedures or connecting with local health

authorities to ensure specific health needs could be accommodated during the

response phase. The authors also noted the small amount of empirical evidence

available for schools to use when framing and developing policy in this area of

disaster risk preparedness for school children with disability.

Two further papers from Boon and her colleagues built on this literature review. The

first paper presented the results of an analysis of the publicly available policies,

guidelines and frameworks used for disaster planning in Australian schools for

disability inclusiveness. The results demonstrated that inconsistencies in definitions

and terminology around vulnerability, special needs and disability could impact on the

inclusion of children with disabilities in other policies such as those for disasters and

emergencies. The authors noted the possibility that some groups will be overlooked

for example children who function independently on a daily basis but may have an

underlying condition that places them at greater risk during an emergency. They also

identified that while students with disabilities usually have an individualised care plan

for day to day, usually these have not considered their needs in an emergency

situation. The specific requirements of students with mental health needs during and

after an emergency were also discussed noting that current plans and documents for

mental health needs of students do not consider emergency situations. In sum the

authors suggest that at risk students must be identified during the planning phase

with information relevant to emergency situations included in their individualised

plans. Coordination with local support services such as the ambulance service was

also considered critical.

In the second of the two papers reporting their follow up study Boon, Brown and

Pagliano (2014) present their findings of a survey of Australian schools about

planning for students with disability in emergency. The survey was mailed to 450

government schools in Western Australia and South Australia and 80 responses

were received. The survey was structured around five ‘types’ of disability

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(physical/mobility impairment, chronic conditions/special needs, sensory

impairments, emotional/behavioural disability, cognitive impairment) and asked about

planning for each in the planning, acute and recovery phase of disaster and for

different types of hazards. Seventy-seven percent of the respondent schools had

experienced a disaster. Less than one third of the schools had specifically addressed

the needs of students with disabilities in their disaster planning. The survey also

found that most schools were not represented at the local disaster planning group.

The authors conclude that further research, including qualitative studies, is needed to

better understand how schools appropriately include children with disabilities in their

disaster response planning.

Organisational responses: service providers

In a similar approach a group of researchers from South Carolina conducted a

telephone survey with administrators from 16 agencies that provide in-home personal

care to 2,147 clients, and five agencies that provide in-home health care to 2,180

clients to understand whether and how agencies involved in the provision of home

care services to people with disability and elderly clients were involved in preparing

their clients for disaster (Laditka et al., 2008). This qualitative study found that there

was large variation in the level of preparation amongst the agencies and that in

general health agencies were better prepared than personal care agencies. Better

coordination with other agencies and more staff training were identified as major

need for improvement by the participants.

Maja-Schultz and Swain (2012) also writing in the US context raised similar issues in

a narrative literature review of the risks for people with disability living in adult care

facilities (ACFs). The authors discussed the importance of services being involved in

preparedness activities to build the personal preparedness of staff and clients in

these facilities. Further they noted that emergency response systems need to have

built in measures to accommodate the needs of their clients at time of disaster. This

could include appropriate evacuation facilities and communication systems.

Organisational responses: Accessible preparedness and response measures and resources

Another group of papers have explored how organisational preparedness and

response measures can be made accessible for people with disability. There are

several papers from the US context that examine communication and education

materials for their accessibility including for all literacy levels (Davis, 2007) and

people with vision or hearing impairments (Davis, 2007; Ivey et al., 2014; Neuhauser

et al., 2013). Christensen, Blair and Holt (2007) for example discussed the

importance of emergency warning systems that consider the accessibility needs of

people with disability. Johnson et al. (2010) reported on a framework for inclusive

mobilebased alert systems. Putkovich (2013) in a recent paper assessed the national

emergency warning system of the US as suitable or not for people with disability.

This paper identified needs and provided recommendations for reaching members of

the community with disability.

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Organisational responses: Appropriately trained emergency personnel and related workforce

Organisational preparedness responses have also been examined at the level of

workforce and training. This is a critically important issue in the response phase and

no less in the preparedness phase for building community networks and resilience

that are inclusive of people with disability. In an early paper Batscha (1997)

suggested that mental health care providers must be aware of the increased risk of

heat-related illness for their clients with longstanding mental illness and develop

heat-wave management plans with these clients, a group of persons with disability

rarely considered in DRR research.

In a paper a decade later, Rowland, White, Fox and Rooney (2007) analysed

emergency personnel training practices to assist people with mobility impairments in

three rural and three urban locations in Northeast Kansas for the extent to which they

prepared responders to assist people with disability. They reported on the barriers

and facilitators that emergency services staff identified to training specifically

focusing on building skills to assist people with disability. More recently, Wolf-

Fordham, Twyman and Hamad (2014) reported the results of an online training

program that was developed to build knowledge for disability inclusive preparedness

and response in emergency responders. Promisingly, participants improved in post-

test scores after completing the training.

Two relatively recent papers have drawn attention to the role of one particular group

of health professionals in disaster preparedness and response. In an editorial for the

Australian Occupational Therapy Journal Sinclair (2014) discussed international

health and disability and disaster risk reduction policy and their relevance for the

occupational therapy profession. She concludes by stating that increasing numbers

of people affected by disasters or conflict means that occupational therapists will

increasingly be working within these contexts and therefore the profession must

engage with translating these international policies into practice. Explaining this by

way of case study from Bangladesh, Habib et al. (2013) offered a real life example of

the experience and roles of occupational therapists in disaster management. In the

qualitative study reported, six occupational therapists were interviewed about their

experience and roles pre, during and post disasters. Their primary role pre-disaster

and during disaster was to assist with training and developing inclusive responses

such as inclusive shelters. Post disaster they supported counselling, rehabilitation,

vocational training and home modifications/rebuilding.

Community preparedness including people with disability

Community and social networks

Another group of papers have explored the social and community factors that can

contribute to vulnerability or resilience for people with disability. Bricout & Baker

(2010) discussed online social networks playing a role in communicating and locating

people with disability during disasters. These authors have proposed ‘an analytic

model for understanding the role of distributed networks in mediating the negative

impacts of a disaster or an emergency on persons with disabilities is proposed,

16


together with key objectives for change’. This provides one example of a social

strength that could build resilience. A survey with a convenience sample of 710

people with disability from 7 US states (Zakour, 2015) found that informal social

support, voluntary memberships, and personal assistance frequency were

statistically significant predictors of preparedness.

In similar vein, Tanaka (2013) writing after the Great East Japan Earthquake noted

factors that led to children with disability dying in this disaster at twice the rate of the

rest of the population. This led the author to stress the importance of engaging

families and service workers who provide the day to day care of children with

disabilities being actively engaged in all discussions about individual and household

preparedness – given their familiarity with and knowledge about the particular

capacities, needs and constraints for children with disabilities and their families. This

finding came from the authors’ analysis of responses to the disaster in which ‘those

who, whether as assisters or the assisted, were involved with the disabled on a daily

basis from before the disaster’. Tanaka (2013) concludes that ‘raising children as part

of their local communities is the biggest factor in saving them from disaster’.

Learning from experience

Priestly and Hemingway (2007) writing in the UK context analysed the recovery

responses to two significant events – The Great Asian Tsunami (2004) and Hurricane

Katrina (2005). Their analysis was framed by the social model of disability. Put

simply, this means that disability is regarded as an outcome of societal structures

and lack of accommodation for people with impairments or chronic health conditions.

These authors suggested that future preparedness planning needs to move beyond

individual preparedness and focus on structural measures. They found that in both

disasters, although occurring in very different social, political and economic contexts,

the response measures failed to meet the needs of people with disability. They also

suggested that the way in which people with disability are framed as vulnerable and

lacking capacity is one reason why response measures fail. This is because this

approach excludes people with disability from preparedness activities. Their lived

experience knowledge of disability and for many previous disasters is not taken into

account.

More recently Abbott and Porter (2013) writing from the United Kingdom conducted a

scoping review of the literature, reports and policy documents, conversations with

relevant voluntary organisations and groups of disabled people to understand their

views on the relationship between environmental hazards and disability. They set out

to examine the extent to which the voices of people with disability are included only

to find these voices largely absent from the literature on environmental hazards.

Again, these authors suggested that the skills, knowledge and lived experience of

people with disability are of great value and need to be taken into account in

preparing to manage natural disasters.

Information needs about people with disability and inclusion of disability perspectives

Enders & Brandt (2007) and Kailes & Enders (2007) writing in the US context

identified both the importance of disability data being included in geospatial

17


information systems which guide the coordination of emergency response, and the

development of frameworks for understanding the functional needs of people with

disability in communication, mobility, transportation, and their medical needs in a

disaster scenario. Again in the US context, Webster (2014) explored the legal

implications of emergency preparedness plans and the requirements that

jurisdictions ensure the ability of plans, planning efforts, programs, and services to

meet the needs of people with disability and others with access and functional needs.

This focus is particularly relevant in the Australian context, where local government

areas are now required to prepare Disability Inclusion Plans as the third level of

government required to do so under the National Disability Strategy 2010-2020 as

well as Emergency Preparedness Plans.

With regard to policy approaches, from the US context Fox et al. (2007) reported the

findings from a survey of 30 randomly selected Federal Emergency Management

Agency sites. They found that people with disability were not represented in planning

activities and that only one fifth of the agencies had disability guidelines in place.

Further to this, the majority had no plans for updating policies and guidelines to

include people with disability. Rooney and White (2007) also reported on the

information needs of people with disability during a natural disaster and how people

with disability use media at those times. From an online Internet survey with a

convenience sample, 56 persons with mobility impairments who have experienced a

catastrophic event shared what they found helpful for survival, what was difficult, and

suggestions for future planning. Overall, individual preparedness was reported as

helpful however most difficulties were experienced when community or institutional

preparedness had not included people with disability in their plans or response

measures such as shelters were not inclusive.

As we reported in the research and policy briefs (attached) from the Department of

Foreign Affairs and Trade Australian Aid Research and Development Project in

Indonesia 2013-2015, building capacity within individuals, communities and

organisations is critical to increasing resilience for all in the face of natural disasters.

The SFDRR specifically addresses the inclusion of people with disability in

preparedness and planning policies and implementation. International activities

following this framework initiated by the Disability Rights Fund

(http://www.disabilityrightsfund.org/) included a funding round for DiDRR. Three

Disabled Persons Organisations in Indonesia were the recipients of funding under

this scheme and are currently implementing their own disability led disaster risk

reduction programs in two locations on Java Island and one on Sumatra (Pertiwi,

2016). However, the findings from the scoping review reported in this section suggest

there is much yet to be achieved in involving people with disability in preparedness

planning and implementation and importantly, in policy so that the aspiration

embedded within SFDRR for disability inclusive disaster risk reduction and

emergency preparedness can be realised.

http://www.disabilityrightsfund.org/)

18


Conclusion

This scoping review of the scientific literature on disaster risk reduction/ emergency

preparedness for people with disability demonstrates an emerging field of study.

Although people with disability have been recognised as likely to be at greater risk in

natural disasters it is only recently that they have been acknowledged specifically in

disaster risk reduction frameworks at the international and regional levels with

specific recognition yet to come at the Australian national level. The contribution of

CRPD from 2006 as the international human rights instrument about persons with

disability has driven a greater interest over the past decade in including people with

disability in all aspects of daily life. That said, it is as recent as 2015 when people

with disability were first specifically mentioned in an international disaster risk

reduction framework, SFDRR 2015-2030.

Prior to this time people with disability were seen primarily through the lens of

vulnerability to the extent that the earlier literature and much that was initially sourced

for this scoping review focused on individual vulnerability of people with disability and

as a sub-group of vulnerable persons. With the advent of CRPD and accompanying

initiatives to empower people with disability about their rights such as the Disability

Rights Fund the emphasis now is on inclusion and participation of people with

disability in all matters that affect their lives. Similarly, in the field of disaster risk

reduction and emergency preparedness there has been a move away from a focus

on vulnerability to addressing the capacities and capabilities of individuals and

communities to engage in preparedness activities to enhance their resilience in the

face of natural disaster events.

This scoping review demonstrates that the majority of the literature on people with

disability and emergency preparedness remains primarily US based in a context of

relatively highly developed emergency preparedness and warning systems. The

focus, not surprisingly, therefore is on particular events and being prepared taking

into account the usual population based approaches to ensuring the least possible

loss of life and injury. There is a scattering of empirical reports from other countries

including Australia which focus more specifically on the inclusion and participation of

people with disability in planning, preparedness and policy. This approach comes

directly from more recent international approaches which stress the importance of all

of community responses both at the individual and the organisational level.

As noted the literature on this topic is still in its infancy. Of the 85 papers sourced

only around half (45) reported on empirical studies in which investigations, either

quantitative or qualitative, had been undertaken. Of these most papers addressed

specific research questions using convenience samples of people with disability.

Although providing a useful starting point to understanding the capacities and needs

of people with disability in emergency preparedness, convenience samples contain

inherent bias and the findings cannot be considered as generalisable to people with

disability beyond the limits of the sample taking part in the study. A further limitation

of the literature is that most studies in essence describe the ‘problem’ rather than

proposing and testing solutions. This is to be expected at the current early stage of

development in this field however to advance the field well designed interventions

19


tested with rigorous designs are now needed. This is essential to move beyond

declaring a commitment to including people with disabilities in emergency

preparedness and ensuring their inclusion leads to effective and efficient positive

outcomes for all – people with disability, their families and carers and the

communities of which they are part. It is to be hoped that in the short term more

intervention endeavours are undertaken and reported to build a solid knowledge

base on best practice for including people with disabilities in emergency

preparedness policy, planning and implementation.

20


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Appendix 1 – Search terms and databases

Jan 2014 Search Terms

Database Disability Disaster Preparedness and risk reduction

Medline Exp. Disabled person/s OR disab* OR handicap* OR “mental* retard*” OR “development* disability*” OR “intellectual disability*” OR “learning disabilit*” OR “learning disorder*” OR “vision impairment*” OR “hearing impairment*” OR “vision disorder*” OR “hearing disorder*”

Disaster/s OR disaster* Avalanche* OR Earthquake* OR Volcan* OR Flood* OR Tsunami* OR Blizzard* OR Cyclone* OR Drought* OR Hurricane* OR Typhoon* OR Hailstorm* OR "Heat wave*" OR Tornado* OR Wildfire

prep* or plans or planning or "risk reduction" OR "emergenc* plan*" OR "emergenc* prep" OR management

Scopus, Sociological Abstracts, Web of Science

disab* OR handicap* OR "mental* retard*" OR "development* disabilit*" OR "intellectual disability*" OR "learning disability*" OR "learning disorders*" OR "vision impairment*" OR "hearing impairment*" OR "vision disorder*" OR "hearing disorder*"

disaster* OR Avalanche* OR Earthquake* OR Volcan* OR Flood* OR Tsunami* OR Blizzard* OR Cyclone* OR Drought* OR Hurricane* OR Typhoon* OR Hailstorm* OR "Heat wave*" OR Tornado* OR Wildfire

prep* or plans or planning or "risk reduction" OR "emergenc* plan*" OR "emergenc* prep" OR management

March 2015** Search terms


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Medline Exp. Disabled person/s OR disab* OR handicap* OR “mental* retard*” OR “development* disability*” OR “intellectual disability*” OR “learning disabilit*” OR “learning disorder*” OR “vision impairment*” OR “hearing impairment*” OR “vision disorder*” OR “hearing disorder*”

Disaster/s OR “disaster planning” OR disaster* OR “natural hazard*” OR “natural disaster*” OR mitigation OR avalanche* OR earthquake* OR volcan* OR flood* OR tsunami* OR blizzard* OR cyclon* OR drought* OR hurricane* OR typhoon* OR hail* OR "heat wave*" OR tornado* OR wildfire* OR storm* OR * OR landslide*

prep* OR plans OR planning OR "risk reduction"

Sociological Abstracts

disab* OR handicap* OR "mental* retard*" OR "development* disabilit*" OR "intellectual disabilit*" OR "learning disabilit*" OR "learning disorder*" OR "vision impairment*" OR "hearing impairment*" OR "vision disorder*" OR "hearing disorder*"

disaster* OR Avalanche* OR Earthquake* OR Volcan* OR Flood* OR Tsunami* OR Blizzard* OR Cyclon* OR Drought* OR Hurricane* OR Typhoon* OR Hail* OR "Heat wave*" OR Tornado* OR Wildfire* OR storm* OR landslide* OR "natural disaster*" OR "natural hazard*" OR mitigation


Scopus disab* OR handicap* OR "mental* retard*" OR "development* disabilit*" OR "intellectual disabilit*" OR "learning disabilit*" OR "learning disorder*" OR "vision impairment*" OR "hearing impairment*" OR "vision disorder*" OR "hearing disorder*"

disaster* OR avalanche* OR earthquake* OR volcan* OR flood* OR tsunami* OR blizzard* OR cyclon* OR drought* OR hurricane* OR typhoon* OR hail* OR "Heat wave*" OR tornado* OR wildfire* OR storm* OR landslide* OR "natural disaster*" OR "natural hazard*" OR mitigation


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Web of Science




New Searches March 2015

Search Terms


Embase “disabled person”/exp OR disab* OR “learning disorder”/exp OR “developmental disorder”/exp OR “intellectual impairment”/exp OR “visual impairment”/exp OR “hearing impairment”/exp OR “visual disorder”/exp OR “hearing disorder”/exp

disaster* OR avalanche*OR earthquake* OR volcan* OR flood* OR tsunami* OR blizzard* OR cyclon* OR drought* OR hurricane* OR typhoon* OR hail* OR “heat wave” OR tornado* OR wildfire* OR storm* OR landslide* OR “natural disaster” OR “natural disasters” OR “natural hazard” OR “natural hazards” OR mitigation

prep* OR plans OR “planning”/exp OR planning OR “risk reduction”/exp OR “risk reduction”

Premedline disab* or handicap* or "mental* retard*" or "development* disabilit*" or "intellectual disabilit*" or "learning disabilit*" or "learning disorder*" or "vision impairment*" or "hearing impairment*"

disaster* or avalanche* or earthquake* or volcan* or flood* or tsunami* or blizzard* or cyclon* or drought* or hurricane* or typhoon* or hail* or "Heat wave*" or

prep* or plans or planning or "risk reduction"

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or "vision disorder*" or "hearing disorder*”

tornado* or wildfire* or storm* or landslide* or "natural disaster*" or "natural hazard*" or mitigation

Cinahl disab* or handicap* or "mental* retard*" or "development* disabilit*" or "intellectual disabilit*" or "learning disabilit*" or "learning disorder*" or "vision impairment*" or "hearing impairment*" or "vision disorder*" or "hearing disorder*"

disaster* or avalanche* or earthquake* or volcan* or flood* or tsunami* or blizzard* or cyclon* or drought* or hurricane* or typhoon* or hail* or "Heat wave*" or tornado* or wildfire* or storm* or landslide* or "natural disaster*" or "natural hazard*" or mitigation

prep* or plans or planning or "risk reduction"

APA FT via Informit Online




EVA – Environmetal Abstracts via Informit

disab* OR handicap* OR "mental* retard*" OR "development* disabilit*" OR "intellectual disabilit*" OR "learning disabilit*" OR "learning disorder*" OR "vision impairment*" OR "hearing impairment*" OR "vision disorder*"

disaster* OR avalanche* OR earthquake* OR volcan* OR flood* OR tsunami* OR blizzard* OR cyclon* OR drought* OR hurricane* OR typhoon* OR hail* OR "Heat wave*" OR tornado* OR wildfire* OR storm* OR landslide* OR "natural disaster*"

prep* OR plans OR planning OR "risk reduction”

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OR "hearing disorder*"

OR "natural hazard*" OR mitigation OR emergenc*

Geobase via Engineering Village

disab* OR handicap* OR "mental* retard*" OR "development* disabilit*" OR "intellectual disabilit*" OR "learning disabilit*" OR "learning disorder*" OR "vision impairment*" OR "hearing impairment*" OR "vision disorder*" OR "hearing disorder*”

disaster* OR avalanche* OR earthquake* OR volcan* OR flood* OR tsunami* OR blizzard* OR cyclon* OR drought* OR hurricane* OR typhoon* OR hail* OR "Heat wave*" OR tornado* OR wildfire* OR storm* OR landslide* OR "natural disaster*" OR "natural hazard*" OR mitigation OR emergenc*


Compendex via Engineering Village

disab* OR handicap* OR "mental* retard*" OR "development* disabilit*" OR "intellectual disabilit*" OR "learning disabilit*" OR "learning disorder*" OR "vision impairment*" OR "hearing impairment*" OR "vision disorder*" OR "hearing disorder*”

disaster* OR avalanche* OR earthquake* OR volcan* OR flood* OR tsunami* OR blizzard* OR cyclon* OR drought* OR hurricane* OR typhoon* OR hail* OR "Heat wave*" OR tornado* OR wildfire* OR storm* OR landslide* OR "natural disaster*" OR "natural hazard*" OR mitigation OR emergenc*


GreenFILE via Proquest

disab* or handicap* or "mental* retard*" or "development* disabilit*" or "intellectual disabilit*" or "learning disabilit*" or "learning disorder*" or "vision impairment*" or "hearing impairment*" or "vision disorder*" or "hearing disorder*"

disaster* or avalanche* or earthquake* or volcan* or flood* or tsunami* or blizzard* or cyclon* or drought* or hurricane* or typhoon* or hail* or "Heat wave*" or tornado* or wildfire* or storm* or landslide* or "natural disaster*" or "natural hazard*" or


30


mitigation or emergenc*

**Differences between April 2014 and May 2015 search

- added mitigation, natural hazard, natural disaster, storm, and landslide

- took out keywords "emergency plan*, emergency prep*, management

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END OF REPORT The views expressed herein do not necessarily reflect the views of the NSW Government, unless the views expressed in the project materials have been publicly supported by the Government, or Government Agency.

disability and disaster risk reduction / emergency ...€¦ · with disability, people with...

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