Nathan Grills

LAST year the media was awash with news of natural disasters and their impact on health, including a typhoon that devastated the Philippines and the bushfires that wreaked havoc near Sydney.

We also heard briefly about a flood disaster in North India that trapped 120 000 pilgrims, killed more than 5000 people, and destroyed the livelihoods of hundreds of thousands of the world’s poorest people.

While most of us are aware of the scale and impact of the typhoon and the bushfires, how many are aware of the magnitude of the disaster in North India and how it played out?

One of us (Grills) has worked in the worst affected area, where the disaster was only too real, and spent 3 weeks coordinating a large flood relief and medical aid program, facilitating a network of 50 locally mobilised health charities in Uttarakhand, though a group called CHGN, to respond to the floods.

However, in Australia you would be forgiven for being unaware of how the disaster unfolded, as it generated only a few news articles over a couple of days, with riders that “no Australians have been reported missing or dead”, before disappearing from the Australian media coverage almost entirely but for the odd late report.

This prompted us to wonder about the threshold for comprehensive international media coverage. How many people must die before a disaster becomes newsworthy, and does it not count if the victims do not include people from our own shores?

Media coverage of a natural disaster is not simply proportional to the number of people killed but instead seems more related to how “important” those lives were where the information is reported. This corresponds to what is termed the “cultural proximity” of those affected — that is, how similar they are to us. In developed countries, the media, and by extension the general public, care most when the disaster affects a rich western country, which is close to home and impacts on people like us.

Other factors that affect newsworthiness include the magnitude of destruction, the poignancy of the stories of the dead and surviving, and “compassion fatigue”.

The 2011 Japanese tsunami made headlines for months and has been identified as the best-ever funded relief effort. Some 19 300 mainly well-off people in a rich country died in a highly dramatic natural disaster. Assistance came from 116 countries and 28 international organisations to the tune of US$13.6 billion. There was similar media coverage following Hurricane Katrina in which 1833 Americans died.

Despite around 5000 people dying (none of them Australian), the Uttarakhand floods were not visually dramatic, and affected mainly poor people living in impoverished circumstances in a low-to-middle-income country.

Disproportionate media coverage of disasters matters. What became clear in the Uttarakhand flood disaster was that mobilising support is dependent on getting the story out, and that job is effectively done through media coverage.

After the disaster only two Australian donors approached us after both became aware of the floods mainly through their local Indian offices. Other individual donors who have contributed generously became aware of the floods through Facebook posts, blogging and emails.

One year after the floods have subsided in Uttarakhand the disaster is no longer media-worthy apart from a few articles in Indian papers marking the first anniversary last week.

Yet the public health response must continue. In the previous 6 months we have been involved in providing basic interventions including the provision of shelter and safe water, and prevention of communicable diseases, which are common requirements for all displaced people.

The return to some sort of normal routine such as schooling for children takes effort and resources and ideally should not be delayed. However, while clean children in new school uniforms and the arrival of “the first baby after (insert disaster-of-choice here)” make for good media stories, it gives the impression that things are basically back to normal, when in reality normality is a long way off.

Livelihood rehabilitation requires long-term commitment and includes reclaiming lost farmland and providing seed in order to prepare for the next crop planting, otherwise undernutrition and chronic poverty will impact the health of these populations for many years.

And it needs to be paid for — but how, in resource-poor countries?

The public health efforts in Uttarakhand will be necessary for some time and it is likely that resources allocated will be inadequate. The daunting recovery, rehabilitation and public health response will receive little media attention, especially outside India, and is unlikely to be news- or donor-worthy.

Such patchy disaster relief and disproportionate media coverage raises a troubling hypothesis — if the disaster doesn’t impact Australians, or people like us, then who cares?

Dr Nathan Grills is a public health physician with the Nossal Institute of Global Health at the University of Melbourne. He facilitates a network of programs that work together to help train community health workers through CHGN.

Dr Priscilla Robinson is an epidemiologist and public health senior lecturer at La Trobe University with teaching and research experience in resource-poor settings.

To find out more about disaster relief in Uttarakhand please contact Nathan Grills at ngrills@unimelb.edu.au