4. Mortality

4.1. Vulnerable victims

Vulnerable Populations During Disasters

Most diseases associated with disasters can be prevented by adequate interventions, especially by ensuring that the basic life-saving needs of the population are met. These include shelter, food, water, sanitation, healthcare services, and security measures.

Immediate mortality in any type of disaster is not higher in a specific age group; instead, it usually reflects the age distribution of the overall population. However, in later stages, mortality rates tend to be disproportionately higher among the youngest and oldest people. For example, during the refugee crisis in Northern Iraq in 1991, children aged 0 to 5 accounted for only 18% of the total refugee population but represented 64% of overall refugee mortality.

The most vulnerable groups include children, especially those separated from their families; pregnant or lactating women; women living without their spouses; individuals in female-headed households; people with disabilities; and the elderly.

In addition to disproportionately high mortality rates, children separated from their families are at high risk of adverse consequences such as violence, exploitation, and abuse, including child labor, trafficking, and recruitment as child soldiers. Furthermore, infants and children are more vulnerable to toxic exposures and overcrowding associated with large population displacements (Table 3).

Table 3. Vulnerable pediatric characteristics

Pediatric characteristic Special risk during disaster
Respiratory Higher minute ventilation increases exposure to inhaled agents. Nuclear fallout and heavier gases settle closer to the ground and may affect children more severely.
Gastrointestinal Higher risk of dehydration from vomiting and diarrhea after exposure to contaminated food or water.
Skin Greater body surface area increases exposure risk. Skin is thinner and more susceptible to burns, chemicals, and toxin absorption. Increased evaporation also raises the risk of hypothermia.
Endocrine Increased risk of thyroid cancer following radiation exposure.
Thermoregulation Reduced ability to regulate body temperature, increasing the risk of hypothermia.
Developmental Limited ability to recognize or escape environmental dangers.
Psychological Higher vulnerability to prolonged stress and separation anxiety.

Consequently, it is critical to reunite children with their families as soon as possible and to prioritize reducing their vulnerability in all disaster response planning (Box 4).

BOX 4. Immediate measures developed to reduce population vulnerability during a disaster

  • List vulnerable individuals in the community.
  • Provide visible identification tags for all children.
  • Identify community leaders—preferably women—capable of caring for vulnerable individuals or groups.
  • Ensure the care and safety of refugees.
  • Consider vulnerable individuals when planning distribution systems.
  • Prioritize locating families of unaccompanied or vulnerable individuals.
  • Display photographs of separated children in central locations to support identification.
  • Ensure camps or shelters are located as close as possible to affected areas.
  • Keep families and community groups together whenever possible.