The latest issue of the Journal of Asian Midwives was published last week. In the accompanying editorial we focused on the environment and sustainability in midwifery and maternity care.
Climate disasters appear to be on the rise worldwide, owing mostly to global warming, but also to urbanization and other human factors. Some Asian countries are among the world’s most climate-vulnerable, such as Nepal ranking 139th out of 182 in terms of exposure, sensitivity, and ability to adapt to the negative effects of climate change. Nepal, well-known for its mountains, the Himalayans, and especially, Mount Everest, is grappling with not solely earthquakes, but also floods, landslides, wildfires, and droughts. In the past decades we have also seen major natural disasters in many other South Asian countries, such as cyclones in Bangladesh, earthquakes and flooding in Pakistan, tsunami and drought in India, and so on.
Marginalized populations, suffer already from poverty, food insecurity, and discrimination, and agriculture-based livelihoods, are especially susceptible to environmental effects. These calamities frequently adversely impact low-income populations. We must not forget that when a disaster strikes, regardless of climate change, the impacted areas will require emergency rescue teams, temporary shelters, food and medication, and other necessities, as well as infrastructure support to keep non-emergency services functional. Remember that even after an earthquake, flood, or volcano eruption, there will still be a mother going into labour!
The Journal of Asian Midwives is Open Access and hence freely available to everybody with internet access in Asia (and elsewhere in the world).
Prof. Edwin van Teijlingen
Joint editor Journal of Asian Midwives
Reference:
van Teijlingen, E., Musaddique, A, & Jan, R. (2024) Editorial – July 2024. Journal of Asian Midwives, 11(1): 1–2.
Congratulation to Dr. Rachel Arnold and her Centre for Midwifery & Women’s Health research team on the publication yesterday of their paper ‘I might have cried in the changing room, but I still went to work’. Maternity staff balancing roles, responsibilities, and emotions of work and home during COVID-19: An appreciative inquiry [1]. This paper focuses on how to support staff and enhance their well-being in a small UK maternity service. The underpinning methodological approach is appreciative inquiry using interviews with 39 maternity staff and four group discussions exploring meaningful experiences, values and factors that helped their well-being.
The key findings are that maternity staff members were highly motivated, managing a complex melee of emotions and responsibilities including challenges to professional confidence, mental health, family situation, and conflict between work-life roles. Despite staff shortages, a demanding workload, professional and personal turmoil, and the pandemic participants still found meaning in their work and relationships. The authors go on to argue for a ‘whole person’ approach, since this approach provided insight into the multiple stressors and emotional demands staff faced. It also revealed staff resourcefulness in managing their professional and personal roles. They invested in relationships with women but were also aware of their limits – the need to be self-caring, employ strategies to switch-off, set boundaries or keep a protective distance. Overall, the paper concludes hat staff’s well-being initiatives, and research into well-being, would benefit from adopting a holistic approach that incorporates home and family with work. Research on emotion regulation strategies could provide insights into managing roles, responsibilities, and the emotional demands of working in maternity services. Emotion regulation strategies could be included in midwifery and obstetric training.
This paper was proceeded by a more methodological paper on the application of Appreciative Inquiry in this study [2].
Dr Henry Ngenyam Bang writes for The Conversation about the potential dangers associated with crater lakes located in a region of volcanic activity in Cameroon…
Cameroon’s ‘exploding’ lakes: disaster expert warns deadly gas release could cause another tragedy
A sudden change on 29 August 2022 in the colour and smell of Lake Kuk, in north-west Cameroon, has caused anxiety and panic among the local residents. Fears are driven by an incident that happened 36 years ago at Lake Nyos, just 10km away.
On 21 August 1986, Lake Nyos emitted lethal gases (mainly carbon dioxide) that suffocated 1,746 people and around 8,300 livestock. It wasn’t the first incident like this. Two years earlier, Lake Monoum, about 100km south-west of Lake Nyos, killed 37 people.
Research into the cause of the Lake Nyos disaster concluded that carbon dioxide gas – released from the Earth’s mantle – had been accumulating at the bottom of the lake for centuries. A sudden disturbance of the lake’s waters due to a landslide resulted in a sudden release of around 1.24 million tonnes of carbon dioxide gas.
Survivors briefly heard a rumbling sound from Lake Nyos before an invisible gas cloud emerged from its depths. It killed people, animals, insects and birds along its path in the valley before dispersing into the atmosphere where it became harmless.
Both Kuk and Nyos are crater lakes located in a region of volcanic activity known as the Cameroon Volcanic Line. And there are 43 other crater lakes in the region that could contain lethal amounts of gases. Other lakes around the world that pose a similar threat include Lake Kivu at the border of Rwanda and the Democratic Republic of Congo, Lake Ngozi in Tanzania and Lake Monticchio in Italy.
After Lake Nyos erupted, its water turned a deep red colour and survivors reported the smell of rotten eggs. These are the same characteristics to have recently manifested at Lake Kuk. The change in colour of Lake Nyos was only noticed after the gas burst.
In an official press release, heavy rainfall was linked to the odour and change in colour of Lake Kuk. The tens of thousands of people living around the lake were urged to “remain calm while being vigilant to continuously inform the administration of any other incident noted”.
As a geologist and disaster management expert, I believe that not enough is being done to address and manage the potential danger from crater lakes in the region.
To start with, it’s important to know which lakes are at risk of “exploding”.
Initial checks in some of the lakes were done more than 30 years ago and not thoroughly – it was just one team and on one occasion. Further investigations and regular monitoring are required.
Currently it’s believed that, of the 43 crater lakes on Cameroon’s Volcanic Line, 13 are deep and large enough to contain lethal quantities of gases. Although 11 are considered to be relatively safe, two (Lakes Enep and Oku) are dangerous.
Research has revealed that the thermal profile (how temperature changes with depth), quantity of dissolved gases, surface area or water volume and depth are key indicators of the potential for crater lakes to store large quantities of dangerous gases.
The factors that lead to the greatest risk include: high quantities of dissolved gases, held under high pressures, at great depths, in lakes with large volumes of water. They are at an even greater risk of explosion when the lakes sit in wide or large craters where there are disturbances.
The two lakes that caused fatalities (Nyos and Monoum) are deep and have thermal profiles that increase with depth. Other lakes are too shallow (less than 40 metres) and have uniform thermal profiles, indicating they do not contain large amounts of gases.
Investigating all the crater lakes in Cameroon would be a logistical challenge. It would require significant funding, a diverse scientific team, technical resources and transportation to the lakes. Since most of the crater lakes are in remote areas with poor communication network (no roads, rail or airports), it would take a couple of years for the work to be completed.
Since Cameroon has many potentially dangerous crater lakes, it is unsatisfactory that 36 years after the Lake Nyos disaster, not much has been done to mitigate the risks in other gas-charged hazardous lakes.
Managing dangerous lakes
Lake Kuk was checked shortly after the 1986 Lake Nyos disaster and found not to contain excess carbon dioxide. Its relatively shallow depth and surface area means the risk of gas being trapped in large quantities is low.
Nevertheless, authorities should have immediately restricted access to Lake Kuk pending a thorough onsite investigation. The official press release urging calm was sent just one day after the incident was reported. It’s not possible that a scientist could have carried out a physical examination of the lake. The release said that rainfall was responsible for the changes, but this will be based on assumptions.
Lake Kuk might be considered safe, but due to the dynamic and active nature of the Cameroon Volcanic Line, there is a possibility that volcanic gases can seep into the lake at any moment.
An onsite scientific investigation would determine with certainty the abnormal behaviour of Lake Kuk. Keeping people away from the lake until a swift and credible investigation had been done would be the most rational decision.
An additional step would be for a carbon dioxide detector to be installed near Lake Kuk and other potentially dangerous crater lakes. This would serve as an early warning system for lethal gas releases.
A carbon dioxide early warning system is designed to detect high concentrations of gases in the atmosphere and to produce a warning sound. Upon hearing the sound, people are expected to run away from the lake and onto higher ground. After the Lake Nyos disaster, carbon dioxide detectors and warning systems were installed near Lakes Nyos and Monoum. Nevertheless, no simulation has been conducted to determine their effectiveness.
The Directorate of Civil Protection is the designated agency responsible for coordinating disaster risk management in Cameroon. The agency should liaise with other stakeholders in the government and private sector to ensure the safety of Cameroon’s dangerous lakes. If the authorities are not proactive, the Lake Nyos disaster scenario may repeat where thousands of people and livestock are suddenly killed.
Yesterday the latest issue of the Nepal Journal of Epidemiology carried our paper ‘A survey of Post-Traumatic Stress Disorder, Anxiety and Depression among Flood Affected Populations in Kerala, India‘ [1]. This paper was co-authored by two Faculty of Health & Social Sciences (FHSS) Visiting Faculty, namely Prof. Padam Simkhada (in the School of Human & Health Sciences at the University of Huddersfield) and Dr. Brijesh Sathian (in the Geriatrics & Long-term Care Department at Rumailah Hospital, Qatar). This study is longer-term follow-up of the 2018 floods in Kerala. The authors conducted a cross-sectional household survey between November 2019 to January 2020 in one district of Kerala with adults who had been directly exposed to the 2018 flood. The paper concludes that the vast majority of respondents (92% of women & 87% of men) still showed sub-clinical psychiatric symptoms one year after the flood. An earlier paper had argues for further research in India to explore “the long-term sequelae of catastrophic floods on physical and mental trauma on disaster-affected populations” [2].
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health (CMMPH)
References:
Asim, M., Sathian, B., van Teijlingen, E., Mekkodathil, A. A., Babu, M. G. R., Rajesh, E., Kumar, R. N., Simkhada, P., & Banerjee, I. (2022). A survey of Post-Traumatic Stress Disorder, Anxiety and Depression among Flood Affected Populations in Kerala, India . Nepal Journal of Epidemiology, 12(2), 1203–1214. https://doi.org/10.3126/nje.v12i2.46334
Asim, M., Mekkodathil, A., Sathian, B, Elayedath, R., Kumar N.R., Simkhada, P., van Teijlingen, E. (2019) Post-Traumatic Stress Disorder among the Flood Affected Population in Indian Subcontinent, Nepal Journal of Epidemiology9(1): 755-758. https://www.nepjol.info/index.php/NJE/article/view/24003
I joined the Disaster Management Centre as a Senior Lecturer in December 2019 and my post is also part of the Academic Targeted Research Scheme. The Bournemouth University Disaster Management Centre (BUDMC) is part of Bournemouth University Business School (BUBS).
My research is focused on Immersive Environments for Disaster Management. This involves a review of current Disaster Management education, training and exercise methodologies and recognised practice and how technology enhanced learning platforms might be used to inform and add to current practice in Emergency Preparedness and Disaster Management. Although my research will be wide-ranging, after a career of more than 20 years in Public Health, my initial research has centred around looking at the potential of immersive environments, Artificial Intelligence and Virtual Reality for preparing for pandemics and other high consequence infectious diseases (HCIDs) with the potential to cause pandemics.
I started out in public health research and then went into health sector emergency preparedness, resilience and response (EPRR). I began my career as a research scientist specialising in microbiology and moved into health emergency preparedness and response with the Health Protection Agency (HPA) in 2005. This organisation became part of Public Health England (PHE) in 2013 where I was the strategic lead for EPRR.
While with HPA and then PHE, I managed teams involved in the development and delivery of training, simulations and exercises in health security for the health sector both at home and abroad. These included the UK Department of Health and Social Care’s strategic schedule of emergency response training and exercises and international training and exercise events for organisations such as DGSante, (European Commission), the World Health Organisation and the European Centre for Disease Control (ECDC).
My national EPRR responsibilities included managing PHE’s EPRR Programme which included preparing for and management and co-ordination of emergencies such as the Swine Flu pandemic in 2009, the 2014 Ebola outbreak in West Africa and the Novichok poisoning in Salisbury in 2018.
My international public health work includes the development and delivery of a programme of work to strengthen the emergency preparedness and response capability and capacity for public health emergencies in Africa and Asia. This involved the co-creation of EPRR solutions, including “off-the-shelf” tools using innovative solutions, such as simulations, in order to build EPRR capability and capacity in these countries.
I’m going to be reaching out to colleagues across BU to foster collaborations and in order to enrich my research in the area of immersive environments and enhanced learning platforms, including the potential for these technologies to be applied in emergency preparedness and response in a post CoVID-19 world.
If you’re interested in the work that I am doing or if you think I can provide input into your areas of interest please get in touch.
Today saw the publication of a new paper from an international research team from the UK, Japan and Nepal. Our research article ‘Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal’ has been published in the Open Access journal PLoS ONE[1].
The paper reminds us that natural disasters often disrupt health systems affecting the whole population, but especially vulnerable people such as pregnant women, new mothers and their babies. Despite the global progress in maternal, newborn and child health (MNCH) programmes over the years, emergency responses after a disaster are often poor. Post-disaster health promotion could play an important role in improving MNCH outcomes. However, evidence remains limited on the effect of post disaster health promotion activities in low-income countries such as Nepal.
The paper reports on an post-disaster intervention study aimed at women in Nepal following the 2015 earthquake. In total, 364 mothers were recruited in the pre-intervention group and 377 in the post-intervention group. The post-intervention group was more likely to have knowledge of at least three danger signs in pregnancy (AOR [Adjusted Odds Ratio] = 2.96, P<0.001), at least three danger signs in childbirth (AOR = 3.8, P<0.001), and at least five danger signs in newborns (AOR = 1.56, P<0.001) compared to the pre-intervention group. The mothers in the post-intervention group were also more likely to ever attend ANC (AOR = 7.18, P<0.001), attend a minimum of four ANC sessions (AOR = 5.09, P<0.001), and have institutional deliveries (AOR = 2.56, P<0.001).
Religious minority groups were less likely to have knowledge of all danger signs compared to the majority Hindu group. Mothers from poorer households were also less likely to attend four ANC sessions. Mothers with higher education were more likely to have knowledge of all the danger signs. Mothers whose husbands had achieved higher education were also more likely to have knowledge of danger signs and have institutional deliveries. The paper concludes that the health promotion intervention helped the disaster-affected mothers in improving the knowledge and behaviours related to MNCH. However, the authors also comment that vulnerable populations need more support to benefit from such intervention.
Yesterday the Nepal Journal of Epidemiology published its latest issue which included the paper on ‘Post-Traumatic Stress Disorder among the Flood Affected Population in Indian Subcontinent’ [1]. This Short Communication is co-authored by Prof. Edwin van Teijlingen and two members of the Visiting Faculty in our Faculty of Health & Social Sciences, namely: Prof. Padam Simkhada and Dr. Brijesh Sathian. The Nepal Journal of Epidemiology is an Open Access journal hence this paper is freely available for anybody with internet access to read.
The panel, chaired by Professor Lee Miles (Professor of Crisis and Disaster Management) was awarded after a highly competitive submission process. The panel together combined a Professor, a Senior Research Fellow (Dr Henry Bang) and three BUDMC PhD candidates (Michael Clark, Grace Kingsbury and James Stride) to deliver papers on their respective research in disaster management. The panel was distinctive in that the panellists also had significant experience, not just in the academic study of disaster management, but also in working in the field and in the crisis management industry – thereby representing practical examples of co-creation and the thriving research environment at the Disaster Management Centre here in Bournemouth.
The panel called ‘Ruling in Unruly Times? Foreign Policy Dynamics of Disaster Management’ opened with a jointly co-authored paper by Professor Lee Miles, Dr Henry Bang and Michael Clark on understanding resistance factors and enhancing entrepreneurial resilience in disaster management in Ghana that represented unique research findings from the BUDMC’s acclaimed AFRIGATE project. This was followed by research papers delivered by BUDMC PhD candidates on ‘Synthesizing Foreign Policy Considerations and Health Systems Resilience’ in Africa’ (Michael Clark), ‘The International Dimensions of Maritime Disasters’ (James Stride) and a co-authored paper by PhD candidate, Grace Kingsbury and Professor Lee Miles, on ‘The Scandinavian Foreign Policy Collective: Managing Greater Imperatives of Resilience and Safety’ – that each demonstrated the depth of international-focused work undertaken by BUDMC researchers. The panel were subject to notable scrutiny by a discussant, and a vibrant debate; and the papers were warmly welcomed by an international audience of prominent academics from the field of international studies. The papers will form the basis of manuscripts to be submitted to key journals by summer 2018.
This year BU is host to the 15th BNAC (Britain Nepal Academic Council) Nepal Study Days. This two-day event will be held next week (12-13 April) in the Executive Business Centre. The EBC is convenient due to its proximity to Bournemouth railway station. In previous years this prestigious event has been hosted by a geographically wide-spread group of universities from the University of Edinburgh to Liverpool John Moores University and from the University of Oxford to Reading University. BNAC was established in 2000 at a large meeting at the School of Oriental and African Studies (SOAS) in London of British academics and researchers interested in various aspects of Nepal.
Over twenty papers and eight posters have been accepted for next week, and there will be a specialised workshop targeted at the PhD students on ‘Capacity Building: Writing a PhD Application’. There will be sessions on post-earthquake Nepal, , history, culture & politics, sexual & reproductive health, energy as well as health & health services.
In addition, there will be a short keynote address and plenty of time for discussion. Presenters will be from across the UK with various guests coming over from Nepal. Several BU PhD students will be presenting a poster at the two-day Nepal Study Days.
Normal registration fee is £25 but members will participate for free (small charges towards cost of lunch will have to be paid). Membership costs £15 for Associate members and £30 for Ordinary members but with direct debit payment, you can enjoy a discounted rate of £12 and £24 respectively.
For details along with downloading membership form please visit this link: bnac.ac.uk/membership/
Lee Miles (Professor of Crisis and Disaster Management) and the Bournemouth University Disaster Management Centre (BUDMC) convened a panel at the 58th Annual Convention of the International Studies Association (ISA) – widely regarded as the premier international conference for international studies/International Relations entitled ‘Policy Entrepreneurship and Political Change at Times of Crisis’, held in Baltimore in the USA (Friday 24 February 2017).
Not only did the panel include papers from leading academic authorities on the subject of policy entrepreneurship in the US (Professors Ralph Carter and James M. Scott), and Canada (Professor Charles-Philippe David) that examined policy entrepreneurship in handling crisis in the US Congress and US Presidency, but the panel also included contributions from leading members of the Disaster Management Centre. Alongside a sole-authored paper by Lee Miles on ‘Group Dynamics as Drivers of Political Change’, Lee and Dr Henry Bang (Research Fellow in Disaster Management) delivered key 2017 preliminary findings from the ‘Mini-AFRIGATE’ project on policy entrepreneurs in the African disaster management context in their paper: ‘A Glass of Crisis Management with a Foreign Policy Twist? Entrepreneurial Resilience in the Cameroon’. The paper and feedback acquired at the panel will also form the basis of a policy-oriented best practice workshop with African policy-makers scheduled to take place at Bournemouth University in late March 2017.
Professor Lee Miles and Dr Henry Bang at ISA in Baltimore
The final paper in the panel focused on the Ukrainian Crisis and the role of policy entrepreneurs in handling longer term crisis and constitutes dissemination of an innovative project that brings together researchers from the UK (Lee Miles) and Sweden (Dr Viktoriia Panova). The panel was well received and highlighted how policy entrepreneurship represents a key area of interest that provides further insights into how the innovative skills of policy-makers, legislators, disaster managers and entrepreneurs may be a factor during times of crisis and turmoil. It also represents yet another major success for the BUDMC in competitively securing and convening a panel at one of the world’s premier IR conferences for the second year running.
Professor Lee Miles was invited as the Professor of Crisis and Disaster Management to give an address to the Centre for British Studies at Humboldt University in Berlin (12 December 2016) – one of Germany’s most prestigious universities.
Lee’s lecture was entitled ‘A (Dif)Fusion Perspective on BREXIT Crisis Management: Reflections on a single market outside the Single Market?’. During the lecture, Lee examined the implications of the UK vote in 2016 to leave the European Union from a crisis management’s point of view, and as a process of ‘crisis alleviation’. Lee also combined these ideas with work on fusion theory in European Integration for which he is widely associated. He outlined the challenges of UK withdrawal from the European Union and considered a number of scenarios from the perspective of fusion/diffusion if the main terms of reference focus on being outside the Single European Market. Lee spoke to a packed audience and the address was very well received.
On 26th November 2015, BUDMC’s Professor of Crisis and Disaster Management, Lee Miles, gave a keynote presentation at a prestigious client forum examining ‘Cyber Resiliency – Protecting Your Business in an “Always On” World’, organised by IBM Resiliency Services and held at the IBM Client Centre at IBM UK’s headquarters in London.
Lee spoke on the subject of ‘Understanding Entrepreneurial Resilience and its Contribution to an ‘Always On’ World’. He discussed the need for senior business managers to value the entrepreneurial and innovative talents of staff in order to maximise the effectiveness of their resilience planning and processes in cyber security. Lee introduced the twin expectations of being ‘resilient about “always on”’ and ‘always on resilience’; two paradigms that successful resilience managers need to balance strategically and innovatively if they are to meet the challenges of handling future crises and disasters that have major implications for the business world.
IBM Client Forums bring together senior resilience, emergency and business continuity managers from some of the UK’s leading, and most prestigious, FTSE-indexed commercial and business interests. The forums provide key platforms for discussing the most contemporary issues in resilience. Lee joined a high profile list of speakers that included senior representation from the UK’s Cabinet Office, the Business Continuity Institute (BCI), Barclays Bank as well as experts from IBM’s own Resiliency Services Division.
Lee also participated in a major and lively panel discussion, debating the most cutting-edge issues in cyber resilience.
Lee’s invitation and participation represent further evidence of the BUDMC’s continuing profile in all aspects of disaster management. The substantial strategic cooperation that is developing between BUDMC and the University’s Cyber Security Unit (SCU) continues to attract external recognition. Considerable interest was also generated among members of the IBM Client Forum in the forthcoming BUDMC short course in ‘Entrepreneurial Resilience in Crisis and Disaster Management’ to be offered (in association with the BU Centre for Entrepreneurship) for the first time in May 2016.
Lee Miles Giving Keynote at IBM on ‘Entrepreneurial Resilience’
Tourism throughout much of the 20th Century following World War II was characterised by strong growth and an ever-reaching spread of countries. However, since the mid-1990s and throughout this first part of the 21st century tourism has been beset by an ever-increasing number of obstacles ranging from health issues, such as SARS, Avian and Swine Flu, natural disasters such as the 2004 Tsunami and Hurricane Katrina in New Orleans, and human-induced crises such as the events of 9/11 in the USA, 7/7 in London and the Bali bombings, not to mention the myriad of events related to the Middle East and pressures created by the current global financial crisis.
It is against this backcloth that the world’s largest export industry is being re-moulded and, to some extent finding its strong growth pattern to be faltering, like many other industries. In an attempt to mitigate the damage that crises bring to the tourism industry it is vital that emergency planning agencies and the tourism industry are closely integrated in their approaches to planning for, responding to and recovering from disasters, this way they can implement technologies such as a community notification system that helps send push notifications about safety alerts, weather updates, and emergency information.
This is perhaps more true for the tourism industry than any other, because the tourists, the consumers, have to travel out of their normal environment in order to enjoy the output of the industry. The Disaster Management wing of the International Centre for Tourism & Hospitality Research is currently helping the UN WTO develop a framework which will facilitate this integration. In addition to reviewing the literature on emergency planning and tourism crises, the team are currently engaging more than 120 Ministries, Airlines, Tourist Authorities, Tour Operators, Hotel Chains and academics in a Delphi Panel Exercise to establish which functions should be undertaken from a integrated platform. The results of the study will be presented to the UN WTO early next year.
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