Nutrition
Overview
In the immediate wake of a natural disaster, feeding and sheltering are two of the major issues that are addressed immediately following evacuation or search and rescue operations. These are core elements of survival and are an important area for government and nongovernmental responders.
In complex, humanitarian emergencies including famine and refugee crises, lack of nutrition is often a critical component. Malnutrition is not an immediate concern in most disasters, however, when a disaster occurs in an area that is already dealing with issues of famine, hunger or access to food/nutrition, it becomes increasingly more important. Complications that arise from malnutrition can contribute to increasing death tolls.
Malnourishment is an imbalance in a person’s intake of nutrients and other dietary elements (either too much or too little). The World Health Organization (WHO) groups malnutrition into three broad groups:
- “undernutrition, which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age);
- micronutrient-related malnutrition, which includes micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess; and
- overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers).”
WHO has set a series of global nutrition targets “to improve maternal, infant and young child nutrition” by 2025. Below is a list of goals, as well as key facts and definitions. These are linked to WHO policy briefs on each area.
- “Achieve a 40% reduction in the number of children under-5 who are stunted: Childhood stunting is one of the most significant impediments to human development, globally affecting approximately 162 million children under the age of 5 years.Stunting, or being too short for one’s age, is defined as a height that is more than two standard deviations below the World Health Organization (WHO) child growth standards median.
- “Achieve a 50% reduction of anaemia in women of reproductive age: Anaemia impairs health and well being in women and increases the risk of maternal and neonatal adverse outcomes. Anaemia affects half a billion women of reproductive age worldwide.
- “Achieve a 30% reduction in low birth weight: Low birth weight is defined by the World Health Organization (WHO) as weight at birth less than 2500 g (5.5 lb). Low birth weight continues to be a significant public health problem globally and is associated with a range of both short- and long-term consequences.
- “Ensure that there is no increase in childhood overweight: There has been a dramatic rise in the numbers of children under 5 years of age who are overweight. According to the new 2013 United Nations Children’s Fund (UNICEF), World Health Organization (WHO) and World Bank estimates (4), between 2000 and 2013, the number of overweight children worldwide increased from 32 million to 42 million. The prevalence of childhood overweight is increasing in all regions of the world, particularly in Africa and Asia.
- “Increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%: Exclusive breastfeeding – defined as the practice of only giving an infant breast-milk for the first 6 months of life (no other food or water) – has the single largest potential impact on child mortality of any preventive intervention.
- “Reduce and maintain childhood wasting to less than 5%: The World Health Organization (WHO) classifies wasting in children as severe or moderate, according to the WHO growth reference for weight-for-height. Wasting is a reduction or loss of body weight in relation to height…It is estimated that, at any point in time in the world, 52 million children aged under 5 years are wasted, with 17 million of those estimated to be severely wasted, based on national-level prevalence data.”
When an immune system is weakened by a lack of nutrients from a shortage of food and/or contaminated water, even typically “harmless” illnesses like diarrhea can have devastating effects – especially for children and others whose immune systems are not fully developed or at full strength. According to the Centers for Disease Control and Prevention (CDC), diarrhea kills more than 2,000 children every day – more than AIDS, malaria and measles combined.
While natural disasters do not immediately create malnutrition in populations where that was not a pre-existing concern, they can cause challenges in terms of access to food. The nature of food distribution problems stems from the type of disaster and its impact on transportation systems and community infrastructure. While natural disasters, such as earthquakes, do not usually create too many challenges for nutritional access, floods, tsunamis and hurricanes can dramatically affect food supply and distribution. These kinds of disasters can destroy existing food rations, agriculture crops and livestock, leading to severe shortages. When roads are flooded, or power infrastructure is destroyed, the ability to both access and prepare foods is impacted and the government must distribute safe water and food (or nutritional supplements) to its population. In the 2017 Caribbean hurricanes, food and water distribution to the U.S. Virgin Islands, and especially to Puerto Rico, after Hurricane Maria, was the “longest sustained air mission” in the history of FEMA. When affected populations must rely solely on the distribution of emergency relief rations for extended periods, they miss the full scope of nutrients needed for health.
Unfortunately, the answer is not as simple as just shipping grain to malnourished communities. Though immediate relief efforts—such as external aid being given for the famines in Yemen and the Sudan— significantly help reduce the number of deaths, for those who are seriously malnourished, eating is a physiologically difficult task. Bacteria in the digestive system necessary for processing food may no longer be present. As such, specialized feeding programs are necessary. So too are distribution efforts that do not require parents to bring children to hospitals or infirmaries for food. These trips not only potentially keep a parent from earning income elsewhere, they also put that parent at risk of becoming ill from exposure to others who are sick.
Well-funded research can have a profound effect in disaster preparedness to address nutrition. Consider the development of Plumpy’nut, an edible peanut paste, rich in calories and vitamins. Its use has contributed to bringing children back from severe malnutrition, having been distributed in areas such as Haiti and Africa with noted success. Opportunities still abound for creating innovative, lasting solutions for improving the worldwide picture of nutrition.
Key Facts
- Undernutrition accounts for 45 percent of deaths among children under 5 years of age. Most of these deaths occur in low- and middle-income countries.
- Post-disaster feeding intervention programs should be part of longer-term development strategies that prevent the cycle from continuing. Dependence on external assistance and feeding efforts can keep those living in areas prone to malnutrition from seeking new solutions.
- Even after immediate needs are met, malnutrition can have consequences for generations to come. When women are severely malnourished, they become unable to have children. In addition, chronic malnutrition can affect brain development, potentially diminishing cognitive ability in future years.
- Issues of malnourishment and food insecurity also exist outside the traditional definition of an “emergency.” Consider the pastoralists of rural Africa, nomadic communities constantly in search of appropriate pastures for goats and/or cattle. Settled members of the group—often women and children—regularly suffer from seasonal malnutrition as the herds go to graze. Nutritional supplements and culturally appropriate educational materials could make a significant impact.
- Ongoing nutrition surveillance is essential—especially in vulnerable populations. Disaster preparedness efforts around nutrition should take into account the ongoing specific needs of groups such as the elderly and those with HIV/AIDS or diabetes. Immune systems strengthened by good nutrition are better able to fight illness and disease.
How to Help
- Ensure disaster response grants incorporate nutrition. The Sphere Project, for example, offers standards for both preventing and correcting malnutrition. Those most at risk for micronutrient deficiencies and diseases include: children under two; women who are pregnant or breastfeeding; older people; and families with chronically ill members. Disasters often exacerbate pre-existing issues.
- Shore up plans to protect vulnerable populations should food supplies decline. Work with established agencies and programs that serve those whose immune systems are compromised by illness and/or age. For example, in the event of a disaster, what is the plan for those with diabetes or HIV/AIDS, who have different nutritional needs than the rest of the general population?
- Invest in educational and public awareness partnerships with local agencies. Partnering with experienced, well-connected individuals on the ground is more effective than simply delivering supplies. Communities invested in their own long-term success will reap greater rewards.
- Foster strategic partnerships to manufacture, distribute and stockpile supplies before a disaster occurs. Work with companies that widely distribute other items to carry food supplies and supplements, and/or encourage local companies to manufacture those supplies. Malnutrition does not occur overnight. As such, preparedness can have a marked effect. Non-perishable items must be available and a plan for getting them to the people most in need must be in place.
What Funders Are Doing
- CDP’s 2017 Atlantic Hurricane Season Recovery Fund awarded ASPIRA $300,000 to address food security via three work objectives. They will work to increase the amount of locally grown food, support economic development through tourism activities and develop agriculture and hospitality industry skills in youth ages 12 to 18.
- The fund also awarded Centro de Servicios Primarios de Salud de Patillas Inc. $50,000 to develop an educational program for elderly populations to keep food in good condition during disasters or emergencies with emphasis on securing food, potable water, food storage, reading and interpreting food labels, nutritional and healthy menus, among other food security issues. The program also provides coolers to keep medications safe, water filters, cans of food and bottled water.
- In 2018, the PepsiCo Foundation gave $500,000 to the Salvation Army to provide 350,000 nutritious meals over the course of a year in the wake of Hurricane Florence.
- The California Endowment gave $40,000 to Kern River Valley Revitalization Inc. in 2017 to support community health needs, including nutrition.
- In 2017, Abbot Laboratories Corporate Giving Program gave $600,000 to multiple recipients to support the delivery of nutrition products in the wake of hurricanes Maria and Harvey and earthquakes in Mexico.
Learn More
- CDP Issue Insights – Famine
- Food Security Information Network – Global Report on Food Crises 2019
- United Nations Office for the Coordination of Humanitarian Affairs (OCHA)
- UNICEF
- World Food Programme
- The Emergency Nutrition Network
- Sphere – Humanitarian Standards
- Famine Early Warning Systems Network (FEWS)
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Older Adults
Overview
Disasters disproportionately affect older people. Yet, this population is often “invisible” in terms of data about risks and needs, guidelines, planning and overall understanding of their unique needs during a disaster. This is gradually changing as the overall population ages and greater awareness about the needs for older adults is determined. However, seniors continue to be the group most vulnerable to loss of life in disasters.

(U.S. Coast Guard photo by Petty Officer 3rd Class Trevor Lilburn)
Prior to Hurricane Katrina, older adults composed only 15 percent of the population in New Orleans. But they made up 70 percent of the deaths related to the storm. It’s a familiar story. The majority of the identified victims of the 2018 Camp Fire were over the age of 60. Of the 77 victims who have been identified, the age range tells the story: five were under 50, six were 50-59, 19 were 60-69, 23 were between 70 and 79, 18 were 80-89 and six were 90 and older. When Typhoon Haiyan struck the Philippines, a third of those who died were over the age of 60, even though that age group accounted for less than 10 percent of the population in the hardest-hit areas. During Hurricane Sandy, half of the victims were older adults. And with the 2011 Japanese tsunami, two out of three who died were in the older age group.
There is no consensus worldwide as to what constitutes an older adult. In the U.S., and in many Western countries, the typical retirement age or ability to access a pension –usually 60 or 65—is used as a measurement of elevation to “senior citizen.” Yet, the AARP (formerly the American Association of Retired Persons) welcomes membership from those 50 and over. These age designations do not work in many Global South communities where limited access to health care means that life expectancy is much lower. The United Nations uses 60 and older as its definition, but some health researchers indicate that it should be country specific, and perhaps as low as 50 for some countries in Africa, based on life expectancy.
One in ten people worldwide are over 60. According to the United Nations Population Fund, “In 1950, there were 205 million persons aged 60 or over in the world. By 2012, the number of older persons had increased to almost 810 million. That figure is projected to more than double by 2050, reaching 2 billion…The population aged 60 or over is growing at a faster rate than the total population in almost all world regions. Globally, the population aged 80 years or over is growing faster than any younger age group within the older population. The population of centenarians, those aged 100 years or over, is growing fastest.”
This increasing number of older adults means that emergency planners, service providers and philanthropy need to take the specific needs of seniors into account when planning disaster preparedness, response and recovery. To start, this means understanding why and how older adults are more vulnerable in a disaster.
There are a number of reasons older people are more vulnerable during a disaster. They may be isolated and stay primarily in their homes, with few people who check on them. In the August 2003 heat wave in Paris 79.6 percent of deaths occurred in individuals aged 75 years and over. August is a typical time of year for families and many service providers to be on vacation and away from the city. This meant when the unusual temperatures hit, these individuals did not get notified or have someone available to check on them.
Additionally, there is a link between poverty and old age, so older adults may not have the financial resources to prepare for a disaster or to carry out an evacuation. The National Council on Aging states, “Over 25 million Americans aged 60+ are economically insecure—living at or below 250% of the federal poverty level (FPL) ($29,425 per year for a single person). These older adults struggle with rising housing and health care bills, inadequate nutrition, lack of access to transportation, diminished savings, and job loss. For older adults who are above the poverty level, one major adverse life event can change today’s realities into tomorrow’s troubles.”
Similarly, for some older individuals, especially those of a more advanced age, mobility can be an issue; they may not be able to drive or walk to a site for assistance/evacuation support. During a tsunami for example, individuals must move to higher ground very quickly and not all older people are physically capable of running.
The impact of past disasters plays a role too. During Hurricane Katrina, a number of older residents remembered Hurricane Betsy and felt that they would survive Katrina since they had made it through Betsy, so they did not evacuate. Similarly, during Hurricane Sandy — which followed a comparable path to the prior year’s Hurricane Irene that had had very little impact in New York and New Jersey –- people chose to ride out the storm that had much more significant impacts.
In Katrina, as with many other New Orleans residents, and common across many other senior populations, a significant percentage did not own vehicles yet there were no buses provided for evacuation. This is particularly challenging for older adults living in rural communities where transit resources are scarce and distances to evacuation shelters, safety or resources greater.
Key Facts
- We are an increasingly older population—well beyond just the large number of Baby Boomers in North America. According to the United Nations’ “World Population Ageing 2013” report, population aging is taking place in nearly all countries worldwide. “Globally, the number of older persons (aged 60 years or over) is expected to more than double, from 841 million people in 2013 to more than 2 billion in 2050,” the report states. In addition, the number of older people is expected to surpass the number of children for the first time in 2047. Currently, about two-thirds of the world’s older persons live in developing countries.
- Dementia and cognitive loss can quickly take hold in times of stress. This can cause confusion and lack of ability even in seniors who were relatively independent prior to a disastrous event.
- Community and support systems are essential for recovery. Older adults are often separated from caretakers or other familiar faces to receive services. They may also lose or be separated from their pets. There’s a general lack of understanding that this type of separation can increase vulnerability and decrease resilience.
- Vulnerability of older adults in a disaster is not only a problem in developing nations. Older people can be marginalized anywhere. And whether the nation is developed or established, as young adults increasingly migrate to urban areas, older adults will likely remain in more rural parts, adding to possibilities of isolation and increasing vulnerability. Support services and transportation are often limited in rural communities.
- In the U.S., there’s an assumption that government services will cover whatever seniors need, but that is not necessarily the case. The lack of comprehensive health care, services and decreasing financial resources, means that seniors’ needs may not be covered comprehensively.
- The experience of older adults can be a great asset in times of disaster. That’s especially the case when it comes to looking out for orphans and other vulnerable children. Older adults also may have experience and insight, having survived previous disasters. The seniors of one island in the Indian Ocean, for example, helped keep the entire community alive when they saw the island’s animals running for the hills—a sign of the impending disaster.
How to Help
- Ensure that those involved in immediate disaster relief have supplies specifically for older adults. Those might include, for example, prescription and over-the-counter medicines for common ailments or aids for mobility, hearing and eyesight.
- Fund studies and efforts that specifically consider the needs of older adults—and put into practice lessons learned from previous disasters. A 2016 report from HelpAge International confirmed previous research that only 1-2 percent of humanitarian funded projects target older people. And yet, older adults make up as much as a quarter of the population in some emergency contexts.
- Fund the collection of aggregated data to ensure that the needs of all parts of a population are being served. Almost every disaster-related issue – housing, health care, transportation – affects seniors. Ensure that data is being collected comprehensively and recommendations are implemented to support the needs of elderly populations.
- Support efforts to include guidelines for seniors in disaster preparedness, relief and recovery. Include older adults, value and implement their insights, in the development of such guidelines and technical resources.
- Fund initiatives that help older adults be part of providing services rather than just receiving assistance. Too often, disaster responders discount the value that seniors can provide as volunteers or paid staff. Rather than providing services to them, work with organizations that support service delivery with seniors.
- Support efforts to include older people in food security and livelihood assistance programs. All too often, older individuals are excluded from such programs, even though they may be helping to support family or community members.
- Fund local initiatives for outreach before, during and after disasters, particularly targeting those who live in rural areas or are otherwise unable to make it to assistance sites on their own. Older adults in some countries have higher rates of illiteracy and may lack survival skills (such as being able to drive or knowing how to swim). Community efforts can help alleviate these challenges and build resilience.
- Partner with foundations and organizations who have already worked in this area to become better informed and prepared. On the list: the AARP Foundation, National Council on Aging, Grantmakers in Aging, the Altman Foundation, the New York Community Trust, the John A. Hartford Foundation and the Leading Age.
Learn More
- Building Resilience: Older Adults, Disasters, and Philanthropy
- Capacity Building Toolkit for including Aging & Disability Networks in Emergency Planning
- Resilient Communities: Empowering Older Adults in Disasters and Daily Life
- United Nations Population Fund: Chapter 1 – Setting the Scene
- Ageways: Practical Issues in Ageing and Development
- World Population Ageing 2013
- Why Older Adults Face More Danger in Natural Disasters
- Grantmakers in Aging
We welcome republication of our content. Please credit the Center for Disaster Philanthropy.
Pandemics and Infectious Diseases
Overview
A pandemic is the sustained transmission of an infectious disease across a wide area of one country or across international borders.

Pandemics may be either naturally occurring (such as avian flu) or the result of human intervention through genetic engineering or biological warfare. The World Health Organization (WHO) identifies six phases of influenza pandemics:
- Phase 1: No animal influenza virus circulating among animals have been reported to cause infection in humans.
- Phase 2: An animal influenza virus circulating in domesticated or wild animals is known to have caused infection in humans and is therefore considered a specific potential pandemic threat.
- Phase 3: An animal or novel human-animal influenza virus has caused sporadic cases or small clusters of disease in people but has not resulted in sustained human-to-human transmission.
- Phase 4 (Outbreak): Sustained human-to-human transmission of an animal or novel human-animal influenza has resulted in ongoing community-level outbreaks.
- Phase 5 (Epidemic): The same identified virus as in Phase 4 has caused sustained community-level outbreaks in two or more countries.
- Phase 6 (Pandemic): The same virus as in Phase 5 has caused sustained community-level outbreaks in at least one other country outside of the same geographic region as Phase 5.
While the influenza virus is the most likely to cause more widespread outbreaks, the risk is not limited solely to influenza or even to viruses. The bubonic plague and anthrax are infectious diseases that are caused by bacteria which could also result in a pandemic.
WHO is the global body responsible for monitoring, tracking, responding to and mitigating infectious disease outbreaks around the world. Along with national health bodies such as the U.S. Centers for Disease Control and Prevention (CDC), WHO has established a series of International Health Regulations (IHR) to help reduce the possibility of a global pandemic. The IHR provide a framework upon which countries can build legislation and policies to ensure the safety of their citizens.
In the U.S., the CDC is responsible for monitoring, tracking, responding to and mitigating infectious disease outbreaks, along with local and state health authorities. Working cooperatively with other federal agencies such as Customs and Border Protection, the CDC ensures that outbreaks of infectious disease in the U.S. are handled quickly and appropriately before they can become epidemics or pandemics.
Most viral infectious diseases including polio, measles and mumps can be easily prevented through routine vaccinations. However, anti-science and anti-vaccination sentiments, coupled with the financial cost of healthcare in many countries, mean that some people are not receiving routine vaccinations. This has resulted in recent outbreaks of infectious diseases once considered eradicated, such as measles and polio.
WHO data about estimated vaccine coverage in nations show that some “still-developing” countries have better vaccine coverage than some “developed” countries. In 2018, only 87 percent of Canadian babies had received the first dose of the Diphtheria, Tetanus and Pertussis vaccine compared with over 99 percent of babies in Afghanistan. And, a 2019 article in The Lancet about vaccine coverage in Africa states: “Future increases in coverage are anticipated to return large health benefits, but coverage rates in many countries across the continent are far from national targets, with many rates stagnating or falling.”
Most bacterial infections, including anthrax and the bubonic plague, are easily treatable with good outcomes if they are quickly diagnosed and rapidly treated. Unfortunately, the cost of treatment in the U.S. and other countries without a national healthcare program often prevents people from seeking out treatment or causes significant financial hardship (up to and including bankruptcy).
Key Facts
- The next pandemic strain of influenza is expected to be a variant of an animal influenza. Viruses of all types are continually changing and adapting based on their interactions with the world around them. As animal influenza strains come into contact with humans, they adapt to become infectious to humans. Current animal influenza variants that have been identified as causing human infections include H5N1, H5N6 and H7N9 – all of which are capable of animal-to-human transmission but have not achieved sustained human-to-human transmission.
- Pandemic strains of influenza are different from seasonal strains of influenza. Humans have the ability to build up resistance to many infectious diseases either through exposure or vaccinations. Seasonal influenzas are those virus types that regularly circulate through the human population – currently Influenza A types H1N1 and H3N2, as well as Influenza B. Pandemic strains do not normally circulate through the human population so there is little to no immunity through either exposure or vaccinations.
- Infectious diseases can rapidly spread through global travel, especially by air. Affordable and plentiful air travel means a person with an infectious disease can travel to countries far away from where they contracted the disease, spreading it along the way. The person may not even be aware that they have an infectious disease because they have not started showing symptoms. They may spread the disease to others on the plane, who may in turn continue spreading it through their continued travel or to people around them.
- New research is changing previously fatal diseases into both preventable and treatable diseases. Recent years have seen multiple outbreaks of Ebola hemorrhagic fever (Ebola) that have killed thousands of people in Africa. Since it was first detected in humans 40 years ago, Ebola has been almost certainly fatal to those who contract it. Research and development in recent years have resulted in effective vaccines and effective treatments that have reduced the fatality rate to under ten percent in some cases.
- Proper Water, Sanitation and Hygiene (WASH) programs are essential to preventing infectious diseases and reducing the possibility of transmission. One of the most effective ways to reduce or prevent transmission of infectious diseases continues to be adequate handwashing with soap and water. People who do not have regular access to adequate WASH systems are often subject to outbreaks of easily preventable diseases.
- Displaced people and those in emergency and interim shelter are at increased risk for infectious diseases. Many people who are displaced do not have access to disease prevention tools such as vaccines and adequate WASH systems. Some may have already contracted an infectious disease during or prior to their displacement. Crowded conditions, along with inadequate WASH and medical systems in emergency and interim shelters can contribute to increased disease transmission within the sheltered or displaced population. Local, state and territorial public health units in the U.S. and abroad are often active in offering vaccines or treating illnesses. Many health-care based nongovernmental organizations (NGOs) provide support after a disaster or in a humanitarian emergency.
- Vaccines save lives. According to UNICEF, “Vaccines protect children against disease and death, saving up to three million lives every year – more than five lives saved every minute of every day. … 1.5 million deaths could be avoided if global immunization coverage improves.”
How to Help
- Support programs that provide immunizations to low-income people around the world. Most infectious diseases can be prevented by routine vaccination schedules for children and adults. While some people have legitimate reasons to not receive a vaccination (as identified by a medical professional), it is important that as many people as possible are vaccinated in order to prevent the transmission of infectious diseases and protect those who cannot receive vaccinations. UNICEF often offers mass vaccine clinics after disasters as it is an efficient way to reach a large population base. Some U.S. communities offer tetanus vaccines to people affected by a disaster.
- Support healthcare organizations who make vaccinations available at low- or no-cost. In the United States, along with many still-developing countries, people must often pay for vaccines out of pocket. These can be expensive, with single doses ranging in cost from $9.50 to $228.
- Fund research into new vaccines and treatments for infectious diseases. As evidenced by the advances in prevention and treatment for Ebola, research that provides new insights into vaccination and treatment for infectious diseases can radically change the risk from an infectious disease.
- Support WASH (Water, Sanitation and Hygiene) programs, particularly in still-developing countries or places where there are large numbers of displaced people. In addition to supporting WASH programs, support for research and development of new and lower-cost WASH technologies can also have a significant impact on infectious disease transmission.
- Provide support for health organizations working in places with large numbers of displaced people, ongoing conflict or low-income residents. The Center for Disaster Philanthropy works with donors and recipients to ensure that philanthropic funds are directed to the places where they will have the most impact.
What Funders Are Doing
- In 2018, the Bill & Melinda Gates Foundation gave more than $12 million to support infectious disease treatment and prevention, including $1 million to the University of California, Los Angeles to study Ebola and $2 million to Save the Children to improve routine vaccination levels in still-developing countries.
- The Wellcome Trust donated $2.3 million to the University of Edinburgh in 2017 to support the use of genetic sequencing (also known as genomic surveillance) to monitor and respond to viral epidemics.
- Also in 2017, the Skoll Foundation donated $2 million to Ending Pandemics to support early detection and information sharing across regions to promote containment of outbreaks and epidemics.
- The BP Foundation donated $25,000 to the International Federation of Red Cross and Red Crescent Societies to support their response to the Madagascar Plague outbreak.
- In 2016, the Paul G. Allen Family Foundation donated $1.5 million to the American National Red Cross in support of the response to the Zika outbreak in North and Central America.
Learn More
- Center for Disaster Philanthropy: 2019 Ebola Outbreak
- Center for Disaster Philanthropy: Water, Sanitation and Hygiene (WASH)
- Mayo Clinic: Infectious Diseases
- National Collaboration Centre for Infections Diseases: Emerging Infectious Diseases and Outbreaks
- World Health Organization: Infectious Diseases
- World Health Organization: Immunization Coverage Fact Sheet
- World Health Organization: Measles – Fighting a Global Resurgence
- World Health Organization: Global Influenza Strategy 2019-2030
- Centers for Disease Control and Prevention (CDC): Seasonal Influenza
- UNICEF: Immunization Programme
We welcome republication of our content. Please credit the Center for Disaster Philanthropy.
People Experiencing Poverty
Overview
While the official definition of people experiencing poverty is limited to those who live below the poverty line for their region, poverty cannot be defined by economics alone. A broader definition of poverty that is widely attributed to the World Bank is much more applicable to the conversation about how disasters affect people who have limited or no income.

“Poverty is hunger. Poverty is lack of shelter. Poverty is being sick and not being able to see a doctor. Poverty is not having access to school and not knowing how to read. Poverty is not having a job, is fear for the future, living one day at a time.
“Poverty has many faces, changing from place to place and across time, and has been described in many ways. Most often, poverty is a situation people want to escape. So poverty is a call to action — for the poor and the wealthy alike — a call to change the world so that many more may have enough to eat, adequate shelter, access to education and health, protection from violence, and a voice in what happens in their communities.”
In this Issue Insight, CDP uses person-centered or person-first language to refer to people who have a lower socioeconomic status, rather than more typical references of “poor people” or “poverty-stricken.”
People experiencing poverty are more vulnerable to disasters because of the significant impacts of poverty on their daily lives. Places that are more prone to flooding offer more affordable housing – one study found that a 1% increase in the risk of flooding led to a 0.6% decrease in housing costs. There are 28,500 homes in Miami with a 20% risk of flooding. While this means their homes are likely cheaper by 12%, they are more dangerously situated because of the flood risk. People living in these homes often have additional influences that make them more vulnerable to disasters. They may be working more than one job or experiencing health issues. They may be unable to escape a cycle of racism that denies them better employment opportunities. Rarely is poverty the only issue in a person’s life.
“Large-scale events make the news, but repeated small adverse events such as regular floods often have serious implications for poor people. Although poor and nonpoor people may decide to live in places that are sometimes affected by natural hazards, only poor people live in dwellings which are frequently exposed to natural hazards.” – Hallegatte et al. (2020)
Poverty limits a person’s ability to deal with a disaster in many ways adequately. They are unable to afford landscaping to reduce the possibility of floods or fires and other mitigation measures. Disaster preparedness is not an option for most people experiencing poverty, many of whom are simply wondering how they will put food on their table tomorrow – not worrying about a disaster that may or may not happen. During a disaster, they are more likely to require additional supports, especially if they do not have a strong support network in the area. When you cannot afford a car, your only option to escape a disaster is transportation provided by others – nongovernmental organizations, government, friends, family or neighbors. People in a lower socioeconomic class are also less likely to have adequate insurance – or any insurance at all – and are often unable to afford to repair or replace damaged items without support from government or philanthropic organizations.
Key Facts
- Most American families cannot afford the cost of an evacuation. According to Operation Hope, “Nearly 185 million people in the U.S. are under financial stress. Sixty-three percent of middle-income Americans say they’re unable to afford a $500 car repair or a $1,000 emergency room bill.” The costs vary per type, scale and location of a disaster but could include: travel (gas, flight, rental vehicle), hotel or other accommodation, food and water, hygiene items and clothing. Some experts estimate this could be as much as $5,000 for a family of four. This means they would be challenged to find the means to leave and may choose to stay in a dangerous situation.
- The COVID-19 pandemic has had a mixed impact on American poverty. Before the COVID-19 pandemic, about 34 million Americans or 10.5% of the population lived in poverty. In 2020, the largest annual increase since the 1960s saw 8 million people fall into poverty and brought the poverty rate to 11.8% as of December 2020. A comprehensive study by the Urban Institute found the an upward trend for 2021. It said, “The number of poor Americans is expected to fall by nearly 20 million from 2018 levels, a decline of almost 45 percent. The country has never cut poverty so much in such a short period of time, and the development is especially notable since it defies economic headwinds — the economy has nearly seven million fewer jobs than it did before the pandemic.” The decline in poverty in this study is linked to the immense investment in social aid programs such as increased food stamps, supplemental unemployment benefits, stimulus checks, a Child Tax Benefit and nutritional programs and food distributions. At a cost of $1 trillion annually, it is unlikely that this spending on a social safety net will continue, and the poverty rate is likely to jump back to 2020 levels when spending is cut.
- There is an overlap between fragile countries and poverty. As of 2020, over two-thirds of people living in extreme poverty resided in fragile countries. This means they were also at higher risk from ill impacts of COVID-19. At least 34 countries in 2020 were home to a protracted crisis[1]. And, an estimated 243.8 million people living in 75 countries were assessed to be in need of humanitarian assistance.
- In 2020, 66% of people living in extreme poverty also lived in fragile countries. Nearly all (95%) of people living in extreme poverty in fragile states were in countries at high risk from the impacts of the COVID-19 pandemic.
- The elimination of poverty is at the top of the UN’s Sustainable Development Goals. In 2019, 2% of the world’s population lived in extreme poverty – less than $1.90/day. This amounts to more than 700 million people, most of whom live in sub-Saharan Africa and are much more likely to live in rural areas than in urban. While this was an incredible reduction from the 1960s, when 80% of the world’s population lived in extreme poverty, the COVID-19 pandemic has set back decades of decline. The elimination of poverty is the biggest and most crucial step of the Sustainable Development Goals. It was already unlikely that the world would achieve its goal of eliminating poverty by 2030, despite the significant progress to date. However, COVID-19 reversed the decrease and, in fact, has added an estimated 124 million more people experiencing extreme poverty.
- The human and economic costs of disasters are likely being underestimated by as much as 60%. A 2016 report from The World Bank found that the impacts of extreme natural disasters force 26 million people into poverty every year. Beyond simply pushing people into poverty, the effect on well-being, such as people’s sense of comfort and security, their economic stability and the long-term generational effects, found that these extreme natural disasters are equivalent to losses of $520 billion every year.
- FEMA recovery funds do not come anywhere close to providing replacement value after disasters. In 2020, California was approved for two major disaster declarations related to wildfires: DR-4558-CA and DR-4569-CA. They approved 3,252 individual applications who each received an average of $8,440. While something is better than nothing, this does not come anywhere close to the replacement value of a lost home or even most vehicles. For people already experiencing poverty, this exacerbates their economic challenges and forces them deeper into poverty just to replace what they lost.
- According to a new report from the Global Facility for Disaster Reduction and Recovery and the World Bank, the effects of poverty on people experiencing disasters extend far beyond just the economic ones. “When unprecedented floods affected Mumbai in 2005, poor people lost 60 percent more than their richer neighbors—and when poor people lose the little they have, there are immediate and sometimes irreversible consequences for their health. In Ecuador, poor children exposed in utero to El Niño flooding in 1997-1998 were found to have relatively lower birth weights, shorter statures, and impaired cognitive abilities.”
How to Help
- Fund economic development, not just relief. While there is always an initial need for relief and aid after a disaster, it is far more effective and efficient to fund economic development. Long-term funding to help an economy grow will increase the employment rate and the number of people who can work. It is vital to help finance recovery for small businesses, particularly those owned by Black, Indigenous and People of Color. This will help pull more people out of poverty and reduce the long-term impact of a disaster on those people.
- Reduce or eliminate restrictions on funding. Many funding opportunities are restricted or designated for specific purposes. However, these restrictions can impede rapid and effective support after a disaster. Reducing or eliminating restrictions on how funds are spent can help ensure that local communities can fund needs that may be unique to their community, including poverty reduction.
- Support projects to reduce the cost of living and/or increase pay scales. There is a significant disparity between people who are wealthy and people who are experiencing poverty. The two most effective ways to reduce this disparity are reducing the living costs by subsidizing long-term costs or increasing pay rates. A living wage in Bozeman, Montana, will be different from a living wage in New York City, but people’s basic needs are the same in both places. Affordable housing, transportation, food, water, child care and other needs are all necessities and should be within reach of every person in every community.
- Fund projects that purchase locally. One of the fastest ways for a community to recover is for local businesses to be able to get up and running quickly. This brings jobs back into the community and helps stabilize the people living there. Feeding programs should only exist as long as local restaurants and grocery stores are closed or blocked. Once they reopen, residents and responders should get their meals there instead of a mass feeding site.
What Funders Are Doing
As part of our COVID-19 Response Fund, CDP awarded $100,000 to address the ongoing crisis of poverty in the Miami Valley region by supporting the Catholic Social Services of the Miami Valley’s Choice Food Pantry and Family Stabilization & Support (FSS). This is a case management and financial assistance program. Funding will increase program capacity and client emergency financial assistance to serve an increased number of families impacted financially by the COVID-19 pandemic.
Also as part of our COVID-19 Response Fund, CDP awarded $145,000 to the Atlanta Wealth Building Initiative for the immediate support of businesses owned by people of color to address the economic disruption caused by COVID-19, as well as support the long-term recovery and sustainability of the small business ecosystem.
Mercy Corps also received $475,000 from CDP’s 2019 Atlantic Hurricane Season Recovery Fund to support livelihoods on Abaco through their Restoring Industries and Sustaining Employment program, which provides small-scale grants, training and mentorship to support local economic recovery.
CDP awarded Golden Crescent Habitat for Humanity a total of $1.7 million across two grants from our Hurricane Harvey Recovery Fund. These grants were to help low-income homeowners achieve strength, stability and self-reliance by repairing and/or rebuilding their homes damaged by Hurricane Harvey. The grants also supported their involvement in repairing and rebuilding homes in Victoria County, Texas. There, they partnered with others to relocate individuals and families whose homes were in high-risk flooding areas who otherwise would not have been able to afford to move.
- In 2020, Mackenzie Scott made an unrestricted donation of $40 million to Texas A&M International University in Laredo, which primarily serves Hispanic students. This gift is part of $4.2 billion in funding Scott made to provide immediate support to people and organizations suffering the economic effects of the COVID-19 crisis. Special emphasis was given to those operating in communities facing high projected food insecurity, high measures of racial inequity, high local poverty rates and low access to philanthropic capital.
- In 2019, Comic Relief gave $965,918 to Habitat for Humanity Zambia to help residents and stakeholders increase legal homeownership and essential services, support communities to develop financial resilience through savings groups and gain access to micro-credit to improve their homes and secure them from floods.
- In 2021, the National Lottery Community Fund donated $34,048 to GM Poverty Action Limited to support their work to raise awareness, connect people and projects to share best practices in anti-poverty solutions and strengthen the voices of people in poverty.
- In 2018, the Maple Grove United Methodist Church received $7,500 to support their Bridges Out of Poverty program from the Columbus Jewish Foundation.
Learn More
- CDP Issue Insight: Remittances
- CDP Issue Insight: Insurance
- CDP Issue Insight: Climate Change
- The Atlantic: What the Camp Fire Revealed
- Borgen Magazine: How Natural Disasters Impact Impoverished Communities
- Ready.Gov/Operation Hope: Emergency Financial First Aid Kit
- Social Problems (Journal): Damages Done: The Longitudinal Impacts of Natural Hazards on Wealth Inequality in the United States
- World Bank: Understanding Poverty
- Operation Hope: Disaster Recovery Assistance
We welcome the republication of our content. Please credit the Center for Disaster Philanthropy.
[1] Development Initiatives defines countries experiencing protracted crisis as countries with at least five consecutive years of UN-coordinated humanitarian or refugee response plans as of the year of analysis. Protracted crises often involve more than one crisis happening at once (such as conflict, displacement and natural disasters). They combine acute and long-term needs, requiring strategic support to meet immediate needs and to address structural causes and reduce vulnerabilities to new shocks.
People with Disabilities
Overview
The UN Convention on the Rights of Persons with Disabilities uses the following definition, “Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others (emphasis added).”

According to the World Bank, “One billion people, or 15% of the world’s population, experience some form of disability, and disability prevalence is higher for developing countries. One-fifth of the estimated global total, or between 110 million and 190 million people, experience significant disabilities. Persons with disabilities are more likely to experience adverse socioeconomic outcomes than persons without disabilities, such as less education, poorer health outcomes, lower levels of employment, and higher poverty rates.”
This creates an interactive cycle as indicated in the diagram below.
Barriers can exist in a range of areas including health care, employment, education, transportation, recreation, social outlets, housing or access to information, political or public life. These barriers often create challenges for people with disabilities to live full and complete, independent lives. The societal barriers associated with hearing and visual impairments, chronic health conditions and mobility challenges place people with disabilities at a greater risk for being impacted by a disaster. When a disaster hits, the lack of inclusion in disaster preparedness – combined with adverse socioeconomic outcomes – creates increased risk and problems for people with disabilities. Disasters also increase the disparities between people with disabilities and others in their community, making it more likely they will be disproportionately negatively impacted during the disaster and afterward.
A World Bank blog outlines five actions that can be taken to support recovery for people with disabilities. It draws from a report titled “Disability Inclusion in Disaster Risk Management” from the Global Facility for Disaster Reduction and the Recovery (GFDRR) and the World Bank:
1. Ensure that persons with disabilities have a seat at the table.
2. Remove barriers to full participation of persons with disabilities.
3. Increase awareness among governments on the needs of persons with disabilities.
4. Collect data that is inclusive of persons with disabilities.
5. “Build back better” by improving accessibility for persons with disabilities.
Key Facts
- People with disabilities are at increased risk of morbidity and mortality during a disaster. After the 2011 earthquake and tsunami in Japan, researchers found that the fatality rate for people with disabilities was two to four times higher than the general population.
- Following a disaster, there is an increase in the number of people with physical, sensory and psychosocial impairments. It is estimated that for every death in a disaster, an additional three people are injured or disabled. In the 2010 earthquake in Haiti approximately 200,000 people experienced injury or disabilities out of the 3 million who were affected.
- Poverty hinders people’s ability to prepare, evacuate and recover. Given the high rate of people with disabilities living in poverty, they may be limited in their ability to prepare for a disaster – from home mitigation efforts to building an emergency kit. Evacuation efforts must include accessible transportation for those with mobility disabilities.
- Disasters limit access to services. Following a disaster, access to prescription medications, daily-living assistance, home-delivered meals, basic hygiene, mental health services and healthcare for chronic conditions may be interrupted.
- Disasters tend to have greater impact on people with disabilities. For this vulnerable population, disasters are more likely to result in medical emergencies and/or necessitate transitional housing, home modification and mental health services and counseling.
How to Help
- Review all emergency preparedness or disaster information for accessibility. Text descriptions of photos and ability to resize text are important for people with visual disabilities. Deaf and Hard of Hearing folks appreciate both closed-captioning and sign language interpretation of all emergency announcements and press conferences. Care must be taken to ensure news stations include the interpreters in the visuals, especially in replays on the news and do not place captions over the interpreters’ hands or face.
- Support the replacement of durable medical equipment (DME), communication and assistive devices, prescription medication and other disability-related needs. Following a disaster, if a person has lost their DME they may be hindered in their recovery and forced into a position of dependency. The loss of a cane, support animal or mobility device may force someone to be home-bound or isolated. The loss of a feeding pump or oxygen may be life-threatening.
- Ensure shelters are safe spaces for people with disabilities. Often in disasters, people are separated from their health care or home support provider who is unlikely to evacuate with them. Shelters, especially critical care shelters, must provide options for support workers to evacuate with their clients.
- Provide core funding and operational support to help nonprofits and agencies who serve people with disabilities. Assist them to provide both preparedness and recovery services to:
– Support coordination and communication efforts regarding preparation and evacuation.
– Support evacuation transportation methods.
– Provide workshops and educational seminars that assist the elderly and disabled community in accessing benefits and other assistance in the aftermath of a disaster.
– Engage in advocacy to ensure rebuilding efforts are in accordance with the Americans with Disabilities (ADA) laws and building codes.
– Establish funds that address immediate needs and long-term assistance for people with disabilities.
What Funders Are Doing
- Disability Rights Fund Inc. has provided several grants related to people with disabilities in line with the UN Convention on the Rights of Persons with Disabilities (CRPD) Article 11, situations of risk and humanitarian emergencies, including:
– In 2016, a $30,000 grant was provided to the Center for Improving Qualified Activity in Life People with Disabilities in Yogyakarta, Indonesia to help them advocate for disability-inclusive disaster risk reduction (DRR) programs to be taught within inclusive and special schools throughout Indonesia. This was followed by a second grant in 2017 to help them promote the now mandatory education about disability-inclusive DRR.
– A one year, $20,000 grant was provided to Uganda National Action on Physical Disability to build the capacity of persons with disabilities in disaster prone areas of Eastern Uganda to advocate for inclusive disaster risk reduction and response policies and programs.
- In 2015, the Abilis Foundation provided a $2,775 grant to Forum for Human Rights on Disability – Nuwakot to support the approximately 700 disabled people who lost their homes in that region of Nepal following an earthquake on April 25, 2015. Additionally, the project aimed to lobby the Nepalese government to take disabled people into account its housing program.
- The Unitarian Universalist Service Committee provided a $25,000 grant to Vanuatu Society for Disabled People to guarantee that people with a disability were included in the response effort and had the support necessary to ensure they are better protected during future disasters. In the space of a few weeks, Vanuatu was hit by an earthquake, a volcanic eruption and Category 5 Cyclone Pam.
Learn More
- Disability Inclusive Disaster Risk Reduction Network
- Disability Inclusive DRR Network for Asia and Pacific/CBM – Disability Inclusive Disaster Risk Management: Voices from the Field and Good Practices
- World Health Organization – Disasters, Disabilities and Rehabilitation
- Global Facility for Disaster Reduction and Recovery – Disability Inclusion in Disaster Risk Management: Promising Practices and Opportunities for Enhanced Engagement
- Administration for Community Living: Keeping Older Americans and People with Disabilities Safe and Healthy during Emergencies
- Global Disability Summit 2018
- Disability Rights Fund and Disability Rights Advocacy Fund
- Abilis Foundation
- 24 ASL Signs All First Responders Should Know
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Public Health
Overview
Disasters change the landscape in numerous ways and only a portion of the changes are immediately evident. This is especially true when it comes to public health, which encompasses efforts to protect and improve the health of communities as a whole. This includes the promotion of healthy lifestyles, research into the prevention of injury, disease and education. The healthier the community, and the more resources it has before disaster strikes, the greater resilience that community will show.
The impact a disaster has on an affected population’s health is far from predictable. A variety of factors influence the spread of disease and other health-related issues following an event. And, many can be mitigated with thoughtful pre-planning since one of the key factors related to disease spread and health after a disaster is connected to access. This is dependent upon the amount of destruction the disaster causes and the displacement of medical professionals and evacuees. Disaster preparedness efforts that consider, for example, health facility capabilities, reproductive health, mental health and water, sanitation and hygiene greatly lessen the toll of sickness on impacted populations.
A prime example of a catastrophic failure in public health occurred in Puerto Rico in the wake of 2017’s Hurricane Maria. The official death toll from the Category 4 hurricane stood at 64 for months after the storm because the disaster strained resources to the point where the dead were not counted or the government was uncertain how to determine what constituted a disaster-related death. In August 2018, the death toll was raised to 2,975 after more thorough research through an independent study. Puerto Rico was already struggling to maintain its public health before Maria significantly damaged key infrastructure across the island. Not only did hospitals receive direct damage in the storm, some were unable to access electricity or fuel for generators for significant amounts of time.
Key Facts
- Disaster-related health needs typically do not show up immediately. Some health concerns will not appear until much later, especially in terms of mental health. Consider the challenges of survival after livelihoods have been lost, such as the loss of livestock representing years of accumulated family wealth or ongoing issues following the death of the head of a household.
- Damage to health care facilities—and diagnostic equipment—can have long-reaching consequences. So, too, can damage to infrastructure such as roads and bridges that prevents people from being able to connect to services they need. In addition, losses that affect the personal lives of healthcare workers also affect the ability of health facilities to provide services.
- Water, sanitation and hygiene conditions before and after a disaster can greatly affect the level of impact on a community’s health. Drinking water supply and waste management are especially important factors in controlling disease, as is the management of toxic substances released by the disaster.
- Often, post-disaster outbreaks of disease are associated with population displacement. Widespread disasters such as hurricanes, famine or floods can result in large groups of people being evacuated to crowded facilities. Since disease tends to spread in overcrowded areas, without proper access to health care services, the evacuation conditions themselves can contribute to disease transmission. In resource-poor areas, already decreased nutritional status and lack of vaccinations can also contribute to the problem. Sometimes this can mean outbreaks of diarrhea, but other times, it could be respiratory infections or conjunctivitis with so many people in close quarters.
- Some health crises do not follow a natural disaster — they are disasters in their own right. Pandemics like the 2018 Ebola outbreak in the Democratic Republic of the Congo – and other disease outbreaks create public health concerns that act as a disaster by creating a community crisis, as well as a public health crisis Healthcare workers constituted five percent of the infected, in many cases due to the need to treat people without wearing protective equipment.
- Disasters can exacerbate reproductive health needs. Along with damage to facilities, equipment, medications and other infrastructure, access to services could be decreased. Frequently, other concerns can take higher priority. In addition, periods of high stress, overcrowding in temporary relief situations and hygiene-related challenges could increase the chance of sexually-transmitted diseases and gender-based violence.
- There is no health without mental health. The Center for Disaster Philanthropy has prepared an issue insight on Mental Health and Trauma needs during and after a disaster.
How To Help
Opportunities for reducing the health impact of disasters abound. Interested donors could:
- Support local efforts to bolster critical services and build community resilience. On a larger scale, strengthen water treatment and sewer facilities to better withstand disasters. On a smaller, but equally important, scale, fund efforts to improve health care equipment, support hygiene programs and ensure plans for mental health access are in place.
- Fund efforts to ensure post-disaster reproductive care and access. Consider both immediate needs and long-term concerns, including birth control, pregnancy, sexually-transmitted diseases and efforts to reduce gender-based violence in overcrowded displaced populations.
- Fund risk reduction activities such as vulnerability assessments for potentially disaster-prone areas and impact mitigation. Fund the creation of rapid needs assessments to collect reliable data about the needs of affected communities after disasters occur. In addition, identify marginalized and vulnerable populations that suffer the most in disasters and assess their unique needs. In terms of mitigating impact, include the creation of public health communications that are reliable, accessible, consistent and culturally relevant.
- Fund training for healthcare providers to identify and strengthen the most vulnerable populations. Recognize that different populations may be more vulnerable to different disasters.
- Support programs that assist caregivers in disaster-affected areas. They may be coping with their own grief while assisting others.
- Fund the transfer of paper files to electronic medical records. These are less likely to be destroyed during a disaster or lost or misplaced following a disaster.
- Support research into the ongoing effects of disasters on populations, as well as effective ways to build coping capacities among individuals and communities. This research should focus on the differential impacts on vulnerable populations.
What Funders Are Doing
- Kaiser Permanente Corporate Giving Program gave $1 million in 2017 to the Centers for Disease Control (CDC) to support public health in Puerto Rico following Hurricane Maria.
- In 2016, the Coca-Cola Foundation gave $500,000 to Uniting for Health Innovation to help mitigate the ongoing cholera outbreak in Haiti stemming from the 2010 earthquake.
- The New Venture Fund gave $100,000 in 2017 to Public Health Institute to promote public safety and disaster preparedness.
- The Robert Wood Johnson Foundation gave $150,000 in 2017 to the National Academy of Sciences to provide support to the Forum on Medical and Public Health Preparedness for Disasters and Emergencies.
Learn More
- Pan American Health Organization: Natural Disasters: Protecting the Public’s Health
- Centers for Disease Control and Prevention: Epidemics after Natural Disasters
- National Academy of Science: Linking Hazards and Public Health: Case Studies in Disasters
- World Health Organization: Communicable Diseases Following Natural Disasters
We welcome republication of our content. Please credit the Center for Disaster Philanthropy.
Refugees
Overview
According to the 1951 Convention on the Status of Refugees, a refugee is a person who, “owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable, or owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence as a result of such events, is unable or, owing to such fear, is unwilling to return to it.”

Refugees are different from internally displaced people who, while forcibly displaced from their homes do not choose or cannot cross an international border. They are also different from migrants who choose to travel to another country for work, education or to reunite with family.
Note: The phrase “climate refugee” is often used to refer to people who are (usually permanently) displaced from their homes due to climate change and/or the impact of a climate-related natural disaster. If these individuals do not cross an international border, they are more properly referred to as “internally displaced people” and are covered in our IDP Issue Insight. Even if they do cross an international border, they are unlikely to receive refugee status unless they can also show that they have a well-founded fear of persecution on one of the protected grounds.
Who Is a Refugee?
According to UNCHR – The UN Refugee Agency, in 2018, there were 70.8 million people who were “were forcibly displaced worldwide as a result of persecution, conflict, violence, or human rights violations.” This is an increase of 2.3 million from 2017.Of these, 25.9 million were refugees; 20.4 million were refugees under the protection of UNCHR and 5.5 million were Palestinian refugees under the protection of The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). Over half of all refugees are under the age of 18.
UNHCR stated that 67 percent of refugees came from five countries: Syrian Arab Republic (6.7 million), Afghanistan (2.7 million), South Sudan (2.3 million), Myanmar/Burma (1.1 million) and Somalia (0.9 million). UNHCR also noted that the movement of people out of Venezuela in 2018 began to resemble the characteristics of refugees and by the end of 2018 there were 3.4 million people who had left Venezuela as refugees or asylum seekers. For more information see CDP’s Venezuelan Humanitarian and Refugee Crisis disaster profile.
Refugees often do not travel far; 80 percent are residing in countries that border their home country. The countries hosting the most refugees in 2018 were: Turkey (3.7 million), Pakistan (1.4 million), Uganda (1.2 million), Sudan (1.1 million) and Germany (1.1 million). Many of these host countries need support, as do the refugees themselves.
In December 2018, after two years of consultation led by the UNHCR, the Global Compact on Refugees was affirmed by the UN General Assembly. While 181 countries voted in favor, Hungary and the United States voted against it and the Dominican Republic, Eritrea and Libya abstained. According to UNHCR, the Global Compact on Refugees is “a framework for more predictable and equitable responsibility-sharing, recognizing that a sustainable solution to refugee situations cannot be achieved without international cooperation. It provides a blueprint for governments, international organizations, and other stakeholders to ensure that host communities get the support they need and that refugees can lead productive lives. It constitutes a unique opportunity to transform the way the world responds to refugee situations, benefiting both refugees and the communities that host them. Its four key objectives are to: ease the pressures on host countries; enhance refugee self-reliance; expand access to third-country solutions; [and] support conditions in countries of origin for return in safety and dignity.”
Key Facts
- If conflict is involved, humanitarian assistance may need to remain fluid. This means donors need to be more flexible since they will likely need to put more trust in partnering nongovernmental organizations (NGOs) than they are accustomed to doing. Programs may be operating remotely, and therefore may be less transparent.
- Roughly three of four people who are displaced are women and dependent children. As a result, issues such as health care, nutrition and education must remain at the forefront.
- According to the Brookings Institution, the average length of displacement for a refugee is between 10 and 26 years. This occurs when the causes of displacement have not been addressed (i.e., the conflict and human rights abuses persist) or the conditions at home do not allow for return. At the same time, host and third countries are reluctant to provide full rights to the refugees. Better solutions are required to more efficiently and quickly move people out of refugee status.
- Most refugees are not living in camps but are living in protracted displacement in a community. UNHCR defines “protracted displacement” as five years or more. Most refugees are in urban areas, often living in overcrowded conditions, among other highly vulnerable and poor populations. This requires that the needs of host communities and refugees be considered in tandem.
- There are three traditional solutions for refugees: return, resettlement and local integration. These options are only used for about three percent of refugees annually. Host countries should be encouraged and supported to allow refugees to work, integrate them into local services including health and education, assist them to find better housing etc., even if they are not yet prepared to grant citizenship.
- Third country integration needs to be considered as a viable solution whenever possible. Host countries and wealthy countries can be part of the solution by welcoming large numbers of immigrants, as Canada did for Syrian refugees, bringing in 25,000 refugees in 100 days. A third country solution includes resettling more refugees and providing support to both refugees and local host communities.
- “Safe” third county agreements may prevent asylum seekers from reaching a place in which they can find safety as refugees. An asylum seeker is someone who is looking for international protection; all refugees are initially asylum seekers. A safe third country agreement requires an asylum seeker to stay in the first country where they arrive that may be able to provide sanctuary. So, an asylum seeker from Guatemala is required to apply for sanctuary in Mexico instead of proceeding to the United States.
How to Help
- Recognize that not all refugee situations are related to political issues. People can become refugees because of their race, religion, ethnicity or sexual orientation. As a funder, it may still be possible to be involved in providing humanitarian assistance without “taking sides” in the conflict. In any event, humanitarian aid can be provided impartially and can be seen as nonpolitical.
- Continue to put pressure on countries of origin to create conditions conducive for return. This includes: ending conflicts, restoring rights, reducing corruption, improving economic opportunities, etc.
- Fund organizations working to provide immediate, short-term relief needs. Funders can support international NGOs working to provide food, WASH (water, sanitation and hygiene), shelter, basic household items and cash assistance to arriving refugees.
- Fund resettlement needs. A donor can address the social needs as refugees are resettled or receive asylum status. These needs will include cash assistance, education (particularly considering some children have been out of school for two years or more), learning a new language, mental health and psychosocial support services to address trauma issues. Funding this component of recovery allows refugees to achieve independent status in their host country and integrates them into their new community.
- Support long-term needs in this crisis. It is unlikely that the swell of refugees will disappear. Donors should look for ways to fund organizations working to improve reception centers and refugee sponsorship programs. Investments to boost the internal capacity of host nations to handle the refugee flow are also vital.
- Support education programs that will prepare the next generation for working on humanitarian issues. Foundationally, build compassion among youth for those who are different from them. And, recognize that as the challenges grow, so too must the skills and expertise of humanitarian workers—many of whom are facing life-threatening situations in assisting and protecting refugees and IDPs.
- Strengthen assistance to refugees within the U.S. Each year the U.S. admits thousands of refugees who are escaping conflict, although this number has decreased in recent years. Funders can play an important role in helping them integrate into local communities. Public information and education could be strengthened to build support for more effective refugee policies.
- Increase understanding of land tenure issues and how they affect those displaced. The restoration of land and property rights, for example, is a key component of long-term recovery.
- Give to the CDP Global Recovery Fund, our exclusive fund for international disasters. This fund provides an efficient, flexible solution to expedite a donation to address medium- to long-term recovery at sudden on-set disasters or protracted humanitarian emergencies.
What Funders Are Doing
- The CDP Global Refugee Crisis Fund distributed six grants totaling $486,441 in 2016 and 2017. The Fund focused on capacity-building efforts to protect people forcibly displaced within Syria. It was used to strengthen community-based protection initiatives for women and adolescents struggling through the ongoing conflict, as well as programs to improve adolescents’ psychological well-being through leadership training, education services and trauma support. The majority of these grants are listed in the Internally Displaced People Issue Insight; one grant is listed below.
- CDP received a designated gift in 2015 to support the International Rescue Committee’s programs in Europe. The purpose of this grant was to create sustainable and dignified conditions for refugees fleeing to Europe, with a particular focus on those arriving in Greece.
- American Jewish World Service gave a $50,000 grant in 2019 to Rural Initiative for Community Empowerment-West Nile to support social cohesion and conflict transformation among South Sudanese refugees and Ugandan host communities in the Omugo zone in Rhino Refugee Camp in northern Uganda.
- Ford Foundation gave three grants in 2018 to support Syrian refugees in Jordan. A $450,000 grant was given to Kiron Open Higher Education to support digital education for Syrian refugees and host communities in Jordan. The University of Geneva received a $400,000 grant to strengthen a model for formal and non-formal higher education using blended learning for Syrian refugees in Jordan. Beyond Conflict received a $300,000 grant for the development of resources for Field Guide for Barefoot Psychologists that uses the science of stress, trauma and plasticity to empower young refugees affected by the Syrian conflict.
Learn More
- Grantmakers Concerned with Immigrants and Refugees
- The UN Refugee Agency (UNHCR)
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA)
- CDP Blog: A Better World Rests in Our Hands
- CDP Webinar: The Global Refugee Crisis: At Our Doors and Beyond
- 5 Things Funders Can Do to Address the Global Refugee Crisis
- Funding Worth Following in the Refugee Crisis
- A Donor’s Guide to Funding the Three Stages of the Refugee Crisis
- National Immigration Forum: Fact Sheet: U.S. Refugee Resettlement
- Institute for the Study of International Migration
- Internal Displacement Monitoring Centre
- Cato Institute: Terrorism and Immigration: A Risk Analysis
- Women’s Refugee Commission: Protection Risks for Women and Girls in the European Refugee and Migrant Crisis
- Women’s Refugee Commission: No Safety for Refugee Women on the European Route
- Women’s Refugee Commission: Falling Through the Cracks: Refugee Women and Girls in Germany and Sweden
We welcome republication of our content. Please credit the Center for Disaster Philanthropy.
Remittances
Overview
Remittances are the transfer of money by a person in one country to a person in another country, often used by migrant workers to send money to family who remain in their home country.
The United Nations says that remittances contribute three times as much capital to still-developing countries than international aid. “In 2018, over 200 million migrant workers sent $689 billion back home to remittance reliant countries, of which $529 billion went to developing countries.” The Financial Times attributes the increasing amount of remittances to the income disparity between developed and still-developing nations, estimated at over $42,000. In some cases, remittances can account for up to 28 percent of a nation’s gross domestic product.

In addition to providing capital to some of the poorest people in the world, remittances can make a significant difference in the lives of people affected by disaster. The money can serve as immediate and direct aid to family affected by disasters, helping to bridge the gap between the occurrence of the disaster and the arrival of official aid. A 2019 study by the Overseas Development Institute (ODI) says: “Benefits are similar to those of humanitarian cash transfers: recipients have the freedom to purchase what they actually need. This contrasts with in-kind assistance, which often needs to be resold to be useful to recipients, and voucher systems, which impose limits on purchases and so force households to buy less diverse sets of goods and services.” An article published in the January 2018 issue of Disasters Journal, also from the ODI, found that while remittances initially spiked after a disaster, the amount of money transferred annually did not change significantly. While the person working in the developed country was able to send money to the person in the still-developing country at a crucial time, they were unable to increase the amount of money sent because their overall financial position did not change. While they were able to provide support immediately after a disaster, the money served only to provide immediate support but no support for short- or long-term recovery after a disaster.
Migrants who send money home are often employed in minimum wage jobs or jobs that pay more than the minimum but less than a livable wage. As a result, their ability to remit money is disproportionately affected by cost of living increases and stagnant wages. Recent research in Canada shows that almost 90 percent of Canadians believe that food costs are rising faster than wages. This can significantly reduce the amount of money available for a person to use for remittances.
The 2019 ODI study also found a significant issue with reliance on remittances, specifically that those receiving remittances may not be the most vulnerable people affected by a humanitarian emergency. As a result, people who are already vulnerable, particularly those in rural locations without access to remittance receiving technology, along with women and children will continue to be disproportionately affected by a humanitarian emergency.
One of the biggest challenges for those sending and receiving remittances is the relatively high cost to process these transactions, both through banks and less formal services. Companies such as Western Union, MoneyGram and Xoom (part of PayPal) can charge a significant amount in fees associated with remittances. The World Bank reported that in 2018 the cost of sending $200 USD remained high, at an average cost of seven percent of the transfer. In some areas of the world, particularly in Africa and among small Pacific islands, fees can cost over 10 percent of the transfer.
Additionally, because of national and international laws regarding money laundering and the financing of terrorism, the safest ways of transferring money can also be the most expensive. The World Bank cites banks as being the most expensive, with an average fee of 11 percent, followed by national postal services at seven percent. While new technology companies are helping to reduce the cost of remittances, many people are still resorting to less secure methods such as mailing cash or relying on travelers to carry the remittance to the destination.
Key Facts

- About 800 million people around the world are recipients of money from family and friends who have migrated for work. This means that remittances help support approximately 11 percent of the global population.
- The vast majority of income received by people who send remittances remains in the country of origin. On average, only 15 percent of a person’s earnings are sent as remittances.
- Much of the money that is sent as remittances is sent through unofficial channels. This means it is difficult to track so the actual amount of money sent as remittances could be much higher.
- Money sent by remittances are considered to be key to helping countries achieve the 17 Sustainable Development Goals identified by the United Nations. All increases in human wealth will improve humanitarian situations.
- Remittances are much more than a form of assistance. They are often used by recipients to develop sustainable local industries that return significant benefits to their local communities.
How to Help
- Invest in technology to lower transfer costs. When it costs less to transfer money, people are more likely to send more. Also, they will be more financially stable because it costs less to send the same amount of money.
- Support better tracking of how remittances travel across the globe. There are significant challenges to tracking remittances, including the use of informal and unofficial methods of transferring money. Some countries may also over-report remittances for various reasons, including poor data collection.
- Support organizations and activities that focus on equitable aid distribution. People who receive remittances may not be the ones who need the most help. Aid supplied by philanthropists is key to making sure support is equitable for everyone in an affected area.
- Invest in sustainable infrastructure and transit. The receipt of remittances through safer, official channels requires access to things such as banks and reputable money transfer agencies. Sustainable infrastructure and transit will allow more people to have easier access to these official agencies in order to receive remittances.
What Funders Are Doing
- The Rockefeller Foundation gave a $249,728 grant in 2015 to the Institute for Social and Environmental Transition’s work in Nepal. The group used the grant to support a rebuilding approach, using remittance flows as a lever to create a lasting resilience dividend.
- In 2016, the MoneyGram International Corporate Giving Program waived all transaction fees for monetary transfers from the U.S. and South America to Ecuador and for donations made to the American Red Cross following the earthquake.
Learn More
- CDP’s Disaster Philanthropy Playbook: Immediate Relief/Individual Support
- Pew Research: Remittances
- Migration Data Portal: Remittances
- Global Knowledge Partnership on Migration and Development (KNOMAD): Remittances Data
- The World Bank: Migration and Remittances Brief
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Resilience
Overview
If you want to create an endless debate amongst disaster researchers or responders, academics, emergency mangers, nongovernmental organizations (NGOs) and philanthropists, ask them to define “resilience.” Every field has its own definition and most individuals within each discipline will define it differently.
The Latin root of “resilience” means to bounce back. While this definition of resilience has been used in discussions around disasters for some time, the following four common definitions reflect a more nuanced understanding of resilience:
- “The ability of a system, community or society exposed to hazards to resist, absorb, accommodate to and recover from the effects of a hazard in a timely and efficient manner,” United Nations International Strategy for Disaster Reduction (UNISDR).
- “The ability of a social or ecological system to absorb disturbances while retaining the same basic structure and ways of functioning, the capacity for self-organisation, and the capacity to adapt to stress and change,” Intergovernmental Panel on Climate Change.
- “The capacity of a system to absorb disturbance and reorganize while undergoing change,” the Resilience Alliance.
- “Disaster Resilience is the ability of countries, communities and households to manage change, by maintaining or transforming living standards in the face of shocks or stresses — such as earthquakes, drought or violent conflict — without compromising their long-term prospects,” Department for International Development (DFID), UK Aid.
In recent years, conversations regarding resilience have both broadened and deepened, expanding to incorporate elements of disaster risk reduction, development, climate change adaptation, land-use management, and socio-economic, political and ecological factors. There has also been increased emphasis placed on personal and community resilience. Funders need to determine what their definition of resilience is, what it includes (and does not include) and how it will be integrated across all their funding streams. It is no longer enough to provide immediate relief and longer-term recovery and/or mitigation for the next disastrous event. New ideas of resilience focus on a more systems-based, integrated approach that also considers sustainability despite future changes in, for example, political structure or the economy. A comprehensive resilience framework needs to include physical assets, culture and behavior. Context is also critically important. For instance, teaching women and girls to swim in coastal communities at risk of tsunamis develops their personal resilience and preparedness. It would do nothing however, for young women in Kansas, who would be more resilient by creating preparedness or evacuation kits and learning how to survive an earthquake or tornado.
It is important to look holistically at a community to see what resources and assets are in place before a disaster that will enhance resilience after a disaster. DFID’s ‘assets pentagon’ is based on the sustainable livelihoods framework and considers the social, human, physical, financial and natural resources and assets at play.

Key Facts
- Urban areas continue to grow at a rapid pace. Climate-related natural disasters continue to be on the increase—and the costs of recovery continue to rise, as well, especially in urban areas. While only 10 percent lived in cities in 1913, currently 55 percent of the world’s population lives in urban areas. The UN estimates that an additional 2.5 billion people could be added to urban centers by 2050, bringing the total percentage to 68. Of this growth, 35 percent will occur in China, India and Nigeria. And when the urban growth has been quick, the related structures and assets may also be more vulnerable.
- The impact of climate change continues to grow. It is estimated that the economic cost of extreme weather, triggered by climate change, is likely to rise from $240 billion annually to $360 billion annually, over the next decade, in the U.S. alone.
- The cost of recovery from disasters is also increasing. Munich Re estimated that the costs of disasters in 2018 was $160 billion, above the average of $140 billion, but below the $360 billion recorded in 2017. They also report that the number of people killed – 10,400 – is high but lower than the average, leading them to believe that “measures to protect human life are starting to take effect.”
How to Help
- Building the resilience of individuals and communities before a disaster is of great importance. The goal of disaster recovery is often stated as restoring a community to the way they were before the disaster struck. However, for communities that were facing great social challenges such as poverty, an affordable housing shortage, crime etc., it is better to look at how to make them even better and to address some of those challenges as part of recovery.
- Work to change the conversation about disaster risk reduction. Not all disaster risk reduction efforts are as beneficial as they could be—especially when they fail to consider potential changes in communities, economies and leadership over time.
- Focus on efforts that are ahead of the curve. Disaster philanthropy continues to happen primarily in the immediate wake of a catastrophe. However, efforts that reduce the impact of disasters – in addition to shoring up a community’s ability to rebound and adapt — can offer more “bang for the buck.”
- Understand that resilience is not just about individual traumatic events or disasters. Communities also can be affected by, for example, a manufacturing plant closing, which leaves a large percentage of the population in a more vulnerable state.
- Support efforts that are holistic in their approach. Back in 2012, Lucy Bernholz encouraged the philanthropic community to start listening for talk of resilient organizations rather than sustainability strategies. “Resilient leaders (and leadership) will be next,” she wrote in her blog, Philanthropy 2173. “Yes, it’s a buzzword. But with all the change taking place, and the uncertainty that comes with it, focusing on adaptability and bouncing back seems like a good idea. The word might become buzz, but the idea and capacity are the keys to evolution and survival.”
- Encourage better collaboration between the academic community that wants to focus on research and the NGOs that can bring efforts to life. As the conversation about resilience continues to come to the forefront, support convenings, creative thinking and inclusive, holistic approaches. Achieving resilience requires action and funders can help by supporting efforts that lead to positive, enduring forward movement.
- Invest in organizations that are building up resilience capacity. Look at what organizations are doing to create sustainability and reduce future risk, not just how they are solving the immediate crisis at hand.
- Invest in leadership of local, grassroots, community organizers. Community organizing is making a comeback and philanthropy is showing its support for organizing that begins at the ground-up. Starting at the local level and involving a wide variety of players is a great strategy to build comprehensive, community resilence. Asset-based approaches recognize that there is untapped potential in many communities and organizing can help bring those strengths to the forefront.
- Support core funding for your local Voluntary Organizations Active in Disaster (VOAD) network. Sometimes as Community Organizations Active in Disasters (COADs) these groups bring together disaster response organizations and help provide coordinated response. They are usually underfunded and need core, administrative support to do their best work. (See CDP’s VOAD Issue Insight or Playbook piece for more information).
Here are a few principles to keep in mind when funding resilience. Ensure your grant dollars are going to projects that are:
- Sustainable over time, yet adaptable to future changes in for example, the region’s politics and economy. These things can all impact an NGO or a funder’s ability to continue engagements.
- Contextual. “Resilience” is such a broad term that it can be applied in a variety of ways; consider what is relevant and responsive.
- System-based and holistic. At the same time, responsibilities—and accountability—must be clear.
- Inclusive and participatory. Multi-stakeholder resilience planning is the foundation of effective resilience building.
- Consider vulnerabilities of people, incorporating both tangible and intangible elements of human behavior. Consider the impact of chronic stress through, for example, poverty in a community—and how that could impact that area’s ability to withstand a catastrophic event.
What Funders Are Doing
- Lord Mayor’s Charitable Foundation gave in 2017 to Echo Youth and Family Services’ Ready2go Cockatoo program. Ready2go Cockatoo is community-led disaster resilience program that supports people living independently in the Hills region of the Dandenong ranges who are unable to adequately safeguard against the effects of extreme heat & other emergencies. The program matches vulnerable residents with volunteer community members who can provide information, support an early relocation, prior to high-risk events, including visitation checks, especially in urban and peri–urban settings.
- The Rockefeller Foundation gave $1 million in 2015 to BRAC USA Inc., to support providing subsidized financial services to poor and informally employed communities in Sierra Leone and Liberia in an effort to build resilience to the Ebola epidemic and to strengthen internal capacity to deliver services in periods of crisis.
- The Leona M. and Harry B. Helmsley Charitable Trust made multiple donations in 2015 and 2016 to World Vision, totaling over $2.5 million to support flood mitigation and community resilience in Amhara, Ethiopia.
- In 2015, The Kresge Foundation gave the Los Angeles Alliance for a New Economy a $660,000 grant over three years to ensure that climate-resilience investments made by the City of Los Angeles are maximized and reach those communities most impacted by climate stressors such as extreme heat and drought
- Beginning in 2017, the Latino Community Foundation co-designed with local Latino-serving community organizations impacted by the North Bay Fires in the San Francisco region to deploy $1.3 million to meet the immediate needs of Latino families, strengthen Latino-led nonprofits and build lasting community for a just and equitable recovery.
Learn More
- PreventionWeb: Resilience
- Resilience Matters: Strengthening Communities in an Era of Upheaval (book)
- Resilience to Disasters: A Paradigm Shift from Vulnerability to Strength
- Defining Disaster Resilience: A DFID Approach Paper
- Building Community Resilience to Disasters: A Way Forward to Enhance National Health Security
- Hyogo Framework for Action 2005-2015: Building the Resilience of Nations and Communities to Disasters
- The Australian Natural Disaster Resilience Index
- Community and Regional Resilience Institute
- Mercy Corps: Resilience, Development and Disaster Risk Reduction
- UNISDR
- The Rockefeller Foundation: Resilient Cities
We welcome republication of our content. Please credit the Center for Disaster Philanthropy.