|Year : 2015 | Volume
| Issue : 3 | Page : 163-168
Disaster preparedness amongst women, the invisible force of resilience: A study from Delhi, India
Rahul Sharma, Vikas Kumar, Dinesh Raja
Department of Community Medicine, University College of Medical Sciences, Guru Teg Bahadur Hospital, Delhi, India
|Date of Web Publication||20-May-2015|
Department of Community Medicine, University College of Medical Sciences, Guru Teg Bahadur Hospital, Delhi - 110 095
Source of Support: None, Conflict of Interest: None
Context: Women participation in disaster risk reduction has been stressed as they are the 'invisible force of resilience'. A sizeable number of the women in Delhi are homemakers. Objective: To study disaster preparedness amongst the women who are homemakers in a part of Delhi, India. Study Design: Cross-sectional community-based study. Setting: Four residential areas in east Delhi. Participants: Total 754 homemakers aged 18 years and above. Results: Amongst the women, 22.7% were illiterate while 19.7% had done college graduation or higher studies. The level of concern amongst them was highest for earthquake, fire and swine flu. Just 2.7% had the confidence that their household is well-prepared for a disaster situation. The top reasons for not being prepared were 'nothing can be done during a disaster', 'disasters are God's will' and 'will prepare only after seeing a disaster'. Only 15.1% had a family member trained in what to do in case of a disaster. Conclusion: The current analysis revealed several gaps in the women's preparedness. The adoption of positive behaviour by homemakers can directly impact the well-being of their family and their community.
Keywords: Community, disaster preparedness, homemakers, women
|How to cite this article:|
Sharma R, Kumar V, Raja D. Disaster preparedness amongst women, the invisible force of resilience: A study from Delhi, India. Int J Health Syst Disaster Manage 2015;3:163-8
|How to cite this URL:|
Sharma R, Kumar V, Raja D. Disaster preparedness amongst women, the invisible force of resilience: A study from Delhi, India. Int J Health Syst Disaster Manage [serial online] 2015 [cited 2021 Feb 27];3:163-8. Available from: https://www.ijhsdm.org/text.asp?2015/3/3/163/157402
| Introduction|| |
Disaster preparedness is an important mitigation strategy to protect human lives from adverse health effects arising from unforeseen disasters. The last decade of the 20 th century was celebrated as the International Decade for Natural Disaster Reduction by the United Nations.  The UN General Assembly also decided to designate 13 October each year as the International Day for Disaster Reduction.  Disaster preparedness can be understood as consisting of measures that enable different units of analysis - individuals, households, organisations, communities, and societies, to respond effectively and recover more quickly when disasters strike. 
Disaster risk reduction begins at home and throughout the local communities. It is here where one either save lives, or lose them, depending on the steps taken today to reduce the vulnerability to tomorrow's hazards.  At the same time, individual emergency preparedness is also of considerable interest to both public health and government agencies.  Gender plays a significant role in individual emergency preparedness as it has been found to be a social vulnerability attribute for risk of adverse consequences from a disaster. In addition, it has been shown that women and men not only assess risk differently, they often respond to disasters and losses in different ways.  Women participation in disaster risk reduction initiatives has been stressed by making the theme of the International Day for Disaster Reduction as "Women and girls: The invisible force of resilience" for the year 2012. , In Delhi, 89.4% of all women are non-workers as per the Census of India 2011, which means that a sizeable number of women are homemakers.  The inadequacies and inequity in the decision-making power of women especially of those who are non-workers, vis-à-vis the males, has been explored earlier. ,,
India has witnessed several unfortunate mass scale disasters leading to loss of considerable human life and sustenance resources. Delhi too has had experience of disasters in recent memory. With a river running through the heart of the entire city, there is a omnipresent risk of flooding, that has happened on occasions in the past. , Delhi is also located in a seismologically active zone, leading to a risk of earthquakes. , The data collection phase of the current study took place in April 2013, just a couple of months before the catastrophic heavy rainfall and floods in the north Indian state of Uttarakhand that caused large-scale devastation and loss of life and property. Precious lives lost lead to introspection and remind of the solemn importance of capacity building of the community for disaster preparedness and resilience.
A lot of research on disaster preparedness has been undertaken in several countries as mentioned by Becker et al.  However, the studies available from developing countries like India are few in number. Despite best efforts, we could not come across previous studies on disaster preparedness in the specific study area of Delhi and especially those detailing the population group of women who are homemakers. In the present study, we sought to cover various aspects of disaster preparedness amongst the homemakers in a part of Delhi, the capital city of India. This study was a part of a larger study on health-related behaviours amongst women.
| Materials and Methods|| |
The study was conducted in a part of Delhi, the capital city of India. Having a total area of 1483 sq.kms and a population of 16.75 million (as of 2011), the city represents a microcosm of urban India, and one is likely to find people from virtually all parts inhabiting this city.  The geographically eastern part of the city is bound from the remaining city by the river Yamuna that flows through the city. The study comprised a cross-sectional interview of women who were homemakers in the age group of 18 years and above, residing in four selected residential areas in East Delhi for more than 6 months. A homemaker was defined as a woman in charge of the homemaking, who is not employed outside the home. The four areas were chosen to get representation of the women from different socio-economic strata, with each of the residential localities representing broadly different socioeconomic profiles. A group of undergraduate medical students was given training in data collection, and each student was asked to interview homemakers from each of the four different types of colonies. A systematic random sampling design was used with each student being allotted specific house numbers to visit each day of interview. This was done to ensure a fair representative sample from all parts of the selected residential areas, and was possible as all the four areas had well-demarcated house numbering. All respondents were informed that their individual responses would remain anonymous, and informed consent was obtained. The data collectors being medical students, this ensured good cooperation from the population and a good survey response.
As this was a students' project, the study was reviewed and approved by departmental experts. The methodology was similar to previous studies undertaken in the same area. , A pre-tested semi-open-ended questionnaire was prepared based on review of literature. Questions were framed to elicit socio-demographic profile and attitude and behaviours amongst the homemakers about various health-related topics including disaster preparedness. The questionnaire was pre- tested amongst homemakers not included in the final study and suitably modified before use. The data collection was supervised by the investigators. The data thus collected was converted into a computer-based spreadsheet and analysed. At the end of each interview, illustrated pamphlets on disaster preparedness and response in the local vernacular language, sourced from the National Institute of Disaster Management, India, were distributed to the participants.
| Results|| |
The study results are based upon the information collected from a total of 754 women belonging to different families in the study residential areas. The age of the women ranged from 21 to 80 years with mean 41.6 ± 12.3 years. Amongst the women, 171 (22.7%) were illiterate while 140 (19.7%) had done college graduation or higher studies. The respondents were first asked how concerned they were about various disasters possibly affecting their community. The disaster names were read out one by one, and the women were asked to indicate their response as 'not concerned', 'somewhat concerned' or 'very concerned'. The findings are depicted in [Figure 1]. The bubble graph shows both the level of concern i.e., how many were concerned, as well as the severity of concern. The level of concern amongst the homemakers was highest for earthquake, fire and swine flu, amongst the disasters asked about. From the size of bubbles, it can be seen that the perceived severity of concern was higher for earthquake, swine flu and terrorist attack. It was disproportionately low for windstorm.
|Figure 1: Level and severity of concern regarding various disasters among the home makers (n = 754) Footnotes: |
• X axis represents the particular disasters asked about
• Y axis represents the level of concern. It is the proportion of participants who were concerned (somewhat or very) about the disasters
• Size of each bubble represents the severity of concern. It is the ratio of 'very concerned' to 'somewhat concerned' participants
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The women were asked about how well-prepared they feel their household is to handle a large-scale disaster or emergency. Majority (455; 60.3%) felt they are not at all prepared. Another 279 (37.0%) rated their preparation as 'somewhat prepared' while just 20 (2.7%) had the confidence that their household is well-prepared. They were then asked to think and answer what all they need to keep in store prior to a disaster. The responses given by the women were ticked in the checklist with the interviewer. The findings are shown in [Table 1]. The women were mostly likely to recall food, water and mobile phone as items to be stored as part of disaster preparation.
|Table 1: Items that need to be kept in store prior to a disaster, as per responses given by the women (n=754)|
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After this unprompted question on 'items requiring availability', a series of specific questions were asked on 'household readiness' i.e., items already available. The women were asked whether the item was in store in their household for three days of supply [Table 2]. There were significant proportions of the households that were not maintaining three days' worth stores of essentials like food, water and medicines in their homes. Even though mobile phone is an almost ubiquitous possession these days in Indian households, only 47.6% trusted their phone to be having battery charge sufficient for three days, if required in a condition where battery charging facility may not be available.
|Table 2: Items that are available in their household stores for three days supply, as per the knowledge of the women (n=754)|
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A large majority (594; 78.8%) of women said none in their family had received training, while only 114 (15.1%) families had at least one member trained in what to do in case of a disaster. The remaining 46 (6.1%) gave the answer as 'not sure/don't know'. When questioned about the source of training of their family member, the most common source reported was school (74 of 114; 64.9%) indicating that the family member trained in disaster response was usually the school children group. Other sources mentioned were 'government organisation' (21; 18.4%), 'college' (14; 12.3%), office (6; 5.3%) and National Cadet Corps - NCC (2; 1.8%). The total exceeded 100% as in few (three) families, more than one family member had received such training.
When asked about the reasons for not being prepared for a disaster, 82 women responded that they consider themselves prepared. This included some of the women who had regarded their household as 'somewhat prepared' for a possible disaster, in response to an earlier question. The top reasons mentioned by the other 672 women were 'nothing can be done during a disaster' (30.4%), 'disasters are God's will' (28.6%) and 'will prepare only after seeing a disaster' (23.7%). 'Don't have enough money' was mentioned as a reason by 9.4% of the women.
The homemakers were later asked whether they would evacuate if authorities announce a mandatory evacuation of their area due to a large-scale disaster. While a majority (88.7%) said they would comply, 85 (11.3%) responded they will not evacuate. The reasons given by these 85 women are depicted in [Table 3]. The biggest reason for the people not wanting to evacuate was concern about leaving their property behind (60.0%). The most common emergency helpline phone number the women would call when a disaster strikes was 100, the number for the Police services (74.0%). Awareness about the toll-free emergency number for disaster response - 1077 was in fact very low (1.1%) amongst them [Table 4].
|Table 3: Main reasons why the women might not evacuate even if asked to do so by authorities in case of a disaster (n=85 who stated they would not evacuate)|
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|Table 4: Emergency telephone numbers to be called in case a disaster strikes, as reported by the women (n=754)|
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| Discussion|| |
The study results are based upon information collected from a total of 754 women belonging to different families in the study residential areas. The level of concern amongst the homemakers was highest for earthquake, fire and swine flu, amongst the disasters asked about. Previous studies have shown geographical differences in the concern levels for different types of disasters. Burke et al., found hurricanes and floods to be a top concern amongst migrant and seasonal farm workers in USA.  In a national survey in New Zealand, awareness was highest for earthquake, tsunami and flood.  While in a survey in Oregon, USA, the results showed that the respondents were most concerned about household fire, wildfire, severe winter storm, drought and windstorm.  A terror attack was a concern for two-fifths of the respondents in the current study. Delhi as a city has unfortunately been a victim to several small- to medium-scale terrorist attacks over the years. This probably resulted in the fact that the severity of concern was disproportionally high for it. A study in New York, USA, an year after the 9/11 attacks, too had found high concern about future terrorist attacks. 
Majority of women (60.3%) felt their household is not at all prepared to handle a large-scale disaster, while just 2.7% had the confidence that their household is well-prepared. Burke et al., too reported that only 11% in their study felt that their household was well-prepared for a natural disaster.  A study from rural China reported that many of the respondents reported practically no disaster preparedness at all.  It is not just the lay community, but even health care workers have been reported to feel ill-prepared in responding as individuals to a disaster situation.  A survey found that only about a third (32%) of all New Zealand residents are prepared for an emergency when at home.  However, New Zealand has been having a government-sponsored social marketing campaign to increase residents' disaster preparedness, since 2006. Serial evaluation surveys show that the level of preparedness is gradually increasing nation-wide. 
In the present study, the women were mostly likely to recall food, water and mobile phone as items to be stored for availability as part of disaster preparation. However, there was a chasm between the knowledge of the women about preparation and their actual practice. There were significant proportions of the households that were not maintaining three days' worth stores of essentials like food, water and medicines in their homes. Chan et al., too reported very low disaster preparedness in their China study, with only 10.7% reported to have a readily available disaster emergency kit at home. This, despite the high knowledge about the importance of essentials during any disaster situation.  Lack of essential items such as food, water and medication in people's homes is important because of the concept of 'community shielding'. Lack of these essentials reduces the length of time that people could stay at home and increases the urgency with which government and other agencies would need to deliver supplies. 
Even though the mobile phone is an almost ubiquitous possession these days in Indian households, only 47.6% had a phone with battery charge sufficient for three days. People need to be sensitised about the value of mobile services in the eventuality of a disaster situation, and about doing their best to stay prepared to stay connected. Over periodic annual surveys in New Zealand, where a comprehensive sensitisation campaign is running, it was observed that more residents have become aware that mobile phone services may be disrupted following a disaster. The awareness of the importance of mobile phone services was especially high (93%) amongst the residents in Christchurch, a region that had recently experienced an earthquake. 
In the present study, very few of the interviewees (15.1%) had a family member who had received some training in what to do in case of a disaster. Besides spreading awareness through the mass media, it is also imperative to spread the basic skills and knowledge about disaster preparedness and emergency response, for capacity building of the community. The top self-reported reason for not being prepared for a disaster were 'nothing can be done during a disaster', 'disasters are God's will' and 'will prepare only after seeing a disaster'. In a qualitative study from Istanbul, Turkey, the people did not believe much in the effectiveness of measures that were taken at personal level.  These findings indicate the potential value and need for disaster preparedness education in these communities.
There is almost an 'ignorant' reaction to disaster preparedness, sometimes bordering on the realms of fatalism, as reported in previous studies. For example, a report on the super-cyclone in the state of Orissa, India, in the year 1999, mentions of several survivors who admitted they did not make any or negligible preparation, even after receiving warning of the impending cyclone over the media.  A general theme in why people do not have a disaster readiness plan, is that people wait until something happens to act. 'Trusting God' during disaster situations is a theme reported by people in previous studies.  Financial constraints have been reported as barrier to disaster preparedness, in earlier qualitative studies. , It was reported by 9.4% of the women in the present study. Probably more of the women did not immediately anticipate the costs involved in maintaining resource stocks at their homes, on being asked. The item (financial constraints) can perhaps be expected to emerge as a significant factor in a more in-depth interview design.
It is reassuring that the wide majority of the women in the present study expressed willingness to comply with the instructions of public authorities regarding any mass evacuation. However, the people who may lag in following instructions, and their expressed reasons, represent an important focus point for disaster response strategies by policy makers. Awareness about dedicated toll-free emergency numbers for disaster response was low amongst the women in the current study. This needs to be the focus of special awareness dissemination campaigns, as dedicated helpline numbers can help in saving precious time in setting about emergency responses during a disaster situation. People may be confused in their response and other vital response services may get clogged up if sufficient information is not widely available about the dedicated emergency response numbers.
The study had a few limitations. The cross-section design precludes testing whether and how the respondents' attitude and readiness for disasters, translates into actual behaviour. The women self-reported their disaster preparation (items in stock in their homes), and this was not independently verified. The new exclusive number for disaster response had not really been popularised much at the time the study was conducted. And finally, the non-response rate was not calculated during the study. Several future directions emerge from this research. In longitudinal studies, it would be interesting to study how the current attitudes convert into real-time response and behaviour at the time of a disaster. The role of gender in the disaster response would need to be nuanced in a study that involves all genders. There is a definite need to popularise the designated emergency telephone numbers for disaster situations, and the role of mass media in this as well as other facets of disaster preparedness also is a pertinent topic for future research.
The current analysis of the disaster preparedness amongst the homemakers in a part of Delhi revealed several gaps in their knowledge and preparedness. Their adoption of positive behaviours can directly impact the well-being of themselves, others in the family, and those around them in the community. Being one of the first studies of its kind in this particular study area and population group, the present research has brought up some salient findings that can be a useful beginning ground for framing public health strategies for the imperative objective of increasing disaster preparedness amongst the community.
| Acknowledgment|| |
Dr. S.K. Bhasin for the kind guidance in various stages of the study.
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[Table 1], [Table 2], [Table 3], [Table 4]