ening the construction of houses, changing building codes, and improving emergency response systems and public health infrastructure. Broad public understanding of the dangers posed by natural hazards is absolutely crucial for hazard avoidance and the technical mitigation process, and collaboration between the earth science and public health communities is a critical component for increasing public knowledge.

Infectious Disease Impacts

Longer term public health threats from natural disasters include infectious diseases, often vectorborne. For example, following flood inundations in tropical areas (either from storms or tsunamis), ecological conditions are frequently optimal for anopheline mosquito reproduction if they are already present in the ecosystem, resulting in an increase in malaria in vulnerable populations (NRC, 2002c; Toole, 1997). In 1963, 75,000 cases of Plasmodium falciparum—a potentially deadly form of malaria— were recorded in Haiti following Hurricane Flora.

Many disasters result in population displacement and migration, frequently to refugee camps with high population densities, and in such environments infectious diseases result from both overcrowding and poor sanitation. Ecological and social conditions are conducive to the spread of enteric diseases that include cholera (Kalipeni and Oppong, 1998). Refugee camps are also associated with the spread of diseases via the respiratory route, including meningitis, tuberculosis, and multiple drug-resistant tuberculosis (Rutta et al., 2001), as well as HIV/AIDS and other sexually transmitted infections (UNAIDS, 2005; Salama and Dondero, 2001). In recent years, vulnerability to HIV/AIDS in sub-Saharan Africa has increased as a result of drought and famine; in turn, the famine has been exacerbated by the loss of agricultural workers who have succumbed to AIDS (UNDP, 2003, 2004).

Noninfectious Disease Impacts

Longer term health effects of disasters are not limited to infectious diseases. Food production may decline due to the agricultural effects of a natural disaster. For example, following the 2004 Indian Ocean tsunami, the incursion of saltwater in parts of Sri Lanka through mangrove swamps into inland rice paddies led to increased salinity. This will probably lead to decreased productivity (IWMI, 2005). Malaysia faces a similar problem, and both countries are seeking saline-tolerant forms of rice to mitigate the impacts.

A growing body of research suggests that there is a notable increase in acute myocardial infarctions (heart attacks) following earthquakes, up



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