ABSTRACT
Disasters and emergencies have significant impacts on economic, social, and human development. Natural and humanitarian disasters promote illness and disease in ways proximal and distal to the immediate event, such as through direct physical injury, destruction of infrastructure, worsening of poverty, disruption of primary health care services, increased vulnerability to communicable diseases such as cholera through poor sanitation and lack of preventive resources such as vaccines, and the triggering of psychological and emotional distress. Disasters worsen poor health outcomes at the intersection of communicable diseases and non-communicable diseases (NCDs), including mental health. Complex mechanisms promote comorbidity of mental disorders with other NCDs such as cardiovascular, lung and liver diseases, diabetes, and cancer. 1 In the context of natural disasters all of these problems compound one another when co-occurring. Disasters therefore increase the need to directly address and promote mental health and wellbeing, and to minimise greater morbidity and mortality from co-occurring NCDs, infectious disease outbreaks or transmission, and other problems such as substance abuse which can be sequelae of the experience of living through the crisis, stress and grief related to disasters and humanitarian emergencies. In addition, in contexts where there is a lack of services for people living with disabilities, either those pre-existing or caused by the disaster, individuals with disabilities are left particularly vulnerable, including to mental health problems but also other significant psychosocial challenges.
