Historical perspective

The first existing literature on reconstruction and rehabilitation dates back to 79 ad when Mount Vesuvius erupted and destroyed surrounding villages. A document by the historian Pliny details search and rescue attempts to save individuals from debris. The Emperor Titus declared a state of emergency and immediately sent his army to assist with the relief effort in Stabia, Ercolano, and Pompei. The survivors were relocated to unaffected areas to rebuild with new cities. Despite all the populations’ efforts and funding from Titus, the devastated populations were unable to recover. Only decades later under Emperor Adrian, in 120 ad , was the devastated area restored.

The modern concept of recovery, reconstruction, and rehabilitation began in 1755 with the Great Lisbon earthquake. Lisbon was struck by a 9.0 magnitude earthquake which caused between 10,000 and 100,000 deaths. It was one of the deadliest earthquakes in modern history. The Royal Family escaped unharmed from the catastrophe, and the Prime Minister implemented and managed a formal search and rescue initiative with regional rehabilitation efforts. After the first response phase, the King and Prime Minister Marquis de Pombal proposed plans to rebuild the city. Less than a month after the event, five plan options were proposed for the rebuilding of Lisbon and, within a year, the city was cleared of debris and reconstruction began. The event had wide-ranging effects on the population. Moreover, a disaster recovery program was established that included, among other things, rebuilding the city with more solid construction. ^,

A good example of reconstruction and rehabilitation was observed in 1945 after the atomic bomb was dropped on Hiroshima and Nagasaki. The bomb destroyed nearly 70% of each city’s infrastructure and had a devastating effect on the population’s health. Within the first few months after the bombing, it is estimated that 140,000 people died in Hiroshima, while another 70,000 died in Nagasaki. Among the long-term health effects suffered by survivors, the most deadly was leukemia, and children were the population group affected most severely.

In 1946 a plan was proposed to reconstruct the destroyed cities. However, due to a lack of financial backing, the plan made very little progress. In 1949 the Hiroshima Peace Memorial City Construction Law and the Nagasaki International Culture City Reconstruction Laws were implemented. The initiatives covered by these laws fueled the funding for reconstruction by promoting the development of foreign trade, shipbuilding, and fishing, thereby bolstering the local economy. Little more than a decade later, the cities of Hiroshima and Nagasaki were completely restored and the population had recovered to its former numbers.

The 2010 Haiti Earthquake affected nearly 3 million people with a death toll estimated to be about 100,000. Many countries responded to appeals for humanitarian aid, pledging funds and dispatching rescue and medical teams, engineers, and support personnel. Six months after the earthquake as much as 98% of the rubble remained uncleared, making most of the capital impassable. In 2015, more than 5 years after the disaster, the capital is still not completely clear of debris. More than 1.6 million citizens remain displaced and live in refugee camps with no electricity, running water, or sewage disposal. A cholera epidemic, which began in October 2010, killed more than 8000 Haitians. Crime in the camps is widespread with women and children as the predominant victims. Despite the estimated 1.1 billion USD collected for the Haitian relief efforts, the rehabilitation and reconstruction have been stagnant.

Current practice

In the United States, recovery planning started in 1803 when local resources were overwhelmed during a fire in Portsmouth, New Hampshire. The local government asked Congress for help, creating the first legislative act for federal resources. In 1950 the first permanent and general legislation, the Federal Disaster Act, came into existence. This was revolutionary because it was the first act to create a general response to all disasters. Before this, each disaster resulted in Congress passing a new localized piece of legislation. In 1978, President Jimmy Carter pulled all the distinct response groups together along with the military resources to create FEMA, the Federal Emergency Management Agency, which was formally implemented by executive orders on April 1, 1979.

The U.S. Congress passed the Stafford Act in 1988, an amended version of the Disaster Relief Act of 1974. This focused FEMA toward hazard mitigation and coordination of disaster recovery programs. The Disaster Mitigation Act of 2000 established specific requirements for hazard mitigation planning, and grants became available to allow local and state governments to use mitigation funds for predisaster planning. In 2001 the actions of September 11 pushed Congress to create the Department of Homeland Security, which was the largest reorganization of federal agencies since the Great Depression.

The magnitude of disaster recovery depends on the magnitude of destruction. In a small local disaster, volunteer organizations such as the Red Cross and private insurers may be enough to aid victims. When a disaster overwhelms the recovery forces of a community, that community in the United States can turn to the State government, and ultimately to FEMA, for resources. Within the first 48 hours of a disaster, assessment teams should provide an initial assessment of the damage. This includes identifying immediate needs such as food, shelter, and infrastructural deficits and requirements. Local government will conduct a preliminary damage assessment to determine whether federal aid should be requested. Once the immediate needs are identified, and if federal aid is requested, a second, more in-depth survey should be done by FEMA. This second survey should include reviewing plans of and for the displaced citizens: Do they plan to move, or rebuild in the same spot? Public infrastructure, sewers, and storm drains should be examined. What about the town? What was there before the disaster? What currently exists? Were there any existing plans for expansion of the area that could be used for rebuilding? What are the opportunities looking at the long term?

Every U.S. state maintains an Emergency Management Agency (EMA) and an Emergency Operations Plan. Their role is to establish and maintain an emergency program concerned with preparedness, response, mitigation, and recovery; to coordinate and train state and local governments; to recommend whether federal aid is needed in the case of a disaster; and to coordinate state and federal resources and act as an intermediary between local and federal groups. In the past, the majority of these plans have been concerned primarily with the short-term response. Recently states have been trying to adapt to a more long-term response.

When a disaster impacts a community in any part of the United States, the federal government may declare a federal disaster under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, if that state is overwhelmed and state resources are not enough to provide aid. In 2000 there were 45 major disaster declarations from 31 states and the District of Columbia. These disasters ranged from tornados to wildfires to winter storms. Initial resources supplied included food, water, emergency generators, and the mobilization of specialized teams (e.g., search and rescue, medical assistance, damage assessment, and communications). For longer term relief, there are loans and grants to repair or replace housing and personal property, roads, and public buildings. There is also assistance for mitigation opportunities, counseling, and legal services. These services are outlined in the U.S. Federal Response Plan (FRP), which describes the policies and plans of 25 federal departments and the U.S. Red Cross. The FRP can be implemented in conjunction with other specialized groups including plans for telecommunications support, the National Oil and Hazardous Substances Pollution Contingency Plan, the Federal Radiological Emergency Response Plan, and the Terrorism Incident Annex. Some federal agencies have the authority to provide disaster aid even when the magnitude is not sufficient for the president to declare a federal disaster, such as the Department of Agriculture, Department of Commerce, Department of Housing and Urban Development, and the Small Business Association (SBA). The FRP employs a multiagency operations structure based on the Incident Command System (ICS). Disaster Field Offices under the Department of Homeland Security may be created along with a national emergency response team. Recovery efforts are the responsibility of logistics and administration teams within disaster field offices.

The first source of insurance for all homeowners, businesses, and towns is private insurance. If that is not adequate or not available, the next action should be to register with FEMA by the stated deadline, usually within 2 months of the disaster. After individual private insurance carriers, the SBA provides the next largest portion of aid. All those above a minimum income are referred to SBA and should apply for SBA loans. The loans must be repaid, but they carry low interest rates.

These loans include the following:

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  Home disaster loans to homeowners or renters to repair personal property;

  
  
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  Business physical disaster loans to businesses to repair or replace property including real estate, equipment, and inventory (not-for-profit organizations are also eligible);

  
  
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  Economic injury disaster loans to small businesses and agricultural cooperatives to replace working capital.

FEMA also offers three types of assistance as noted in the following:

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  Individual and family grants: These loans are granted to persons with needs not met by private insurances, SBA, or volunteer organizations. These grants are for basic needs only, not to return life to normal. Costs can include medical and counseling assistance, housing repair, funeral expenses, and insurance premiums.

  
  
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  Public assistance: This program gives aid to local governments for emergency services and the repair or replacement of public facilities, for example, the removal of debris, repair of infrastructure, or emergency protective measures. It is often the most costly element of recovery, and typically the cost is shared with the state in a 75%/25% split.

  
  
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  Hazard mitigation grant program: These grants are used by the federal, state, and local governments to incorporate mitigation into the recovery process. Actions may include acquisition of homes, public education, and retrofitting structures to better resist subsequent disasters such as floods and hurricanes. Cost will be shared between federal and state resources.

Businesses have special considerations in light of a disaster. The primary objective of recovery planning is to enable an organization to survive a disaster and to continue normal business operations. To survive, the organization must ensure that critical operations can resume or continue normal processing and minimize the duration of a serious disruption to operations and resources (both information processing and other resources); a premade contingency plan is the best method of accomplishing this. Specific measures may include having an alternate site of operations if the current facility is damaged, storing vital documents off-site or virtually in the Cloud, and having an alternative energy source such as a generator which is located well above the high water line and not in a basement. Larger businesses may be better able to withstand a disaster because assets and the workforce may be dispersed across a wider geographic area.

A disaster is a life-altering event. Survivors share a considerable experience and come to view the world around them in new and different ways. Seeking help from the government, voluntary agencies, and insurance companies can be a frustrating prolonged process, which may only compound the feelings of helplessness. Anger and despair are common. Mental health staff may assist persons by reassuring them that this “second disaster” is a common phenomenon and that they are not alone in their frustration. Some may not want to seek formal counseling, either because of the perceived stigma associated with seeking help or because they are unwilling to take time away from putting their lives back together or helping others. Very effective mental health assistance can be provided while the worker is helping survivors with concrete tasks. The “over a cup of coffee” method of informal intervention may be the best method to help. A trained effective mental health worker can use skilled but unobtrusive interviewing techniques to help a survivor sort out demands and set priorities while they are jointly sifting through disaster rubble.

Although having community involvement is beneficial to the process of recovery, it is also very important for the mental health resilience of the community. Failing to involve the community can lead to resentment and fragmentation. The inhabitants may be unhappy when aid is not appropriate to the community’s perceived needs, and this insult may be compounded if they are then labeled unappreciative of the federal help. When people have a hand in their own recovery, they feel empowered and will increase their involvement. This leads to a stronger community network that in turn increases the ability to provide self-help and community resilience.