In the infancy of the 21st century, two sudden human tragedies have found dramatic attention in the global eye: the terror attacks of Sept. 11, 2001, and the tsunami of Dec. 26, 2004. That the former, a shocking mass murder resulting in 2,000 deaths, can be compared to the latter, a numbing horror of tens of thousands of deaths, is testament to the importance of 9/11’s immediate and lasting influence on the order of global political power. But the tsunami, ostensibly a natural force for which no people or nation can suffer blame, has its political dimension, too.

That death and suffering have once more fallen upon the poor of the world is not surprising. Indeed, it is an axiom that those with the least seem sure to always suffer more than their fair share of tragedy. The damage wrought by a 5-meter high wall of water was amplified by the fragility of the structures that the waves fell upon; and the quality of those structures is directly related to the poverty of those peoples and to the lack of political capital to be wielded and spent by their nations. The lingering suffering that we shall see in coming weeks—starvation, infection, injury, exposure and malnutrition—will be all the more acute and lengthy due to the economic and political limitations of the nations hit by this tragedy. The suffering of the poor will only accelerate.


Consider if the tsunami had struck a wealthier part of the world, perhaps the eastern seaboard of the United States. No doubt there would have been death and horror. But there would have also been forewarning sufficient to evacuate a large part of the population. A lack of investment in wave detectors in the Indian Ocean prevented such advance warning in South and Southeast Asia. The cities of America’s east would have also quickly mobilized emergency response services; bodies would have been retrieved, quarantined and disposed of; and, as was observed after Sept. 11, aid from the rest of the country and from abroad would have quickly found its way, via reliable transit systems, to where it was most needed. There is no such luxury of organization and infrastructure in South and Southeast Asia, not necessarily for lack of planning or forethought, but simply for lack of money.

In Sri Lanka, Indonesia and South India, a chronic shortage of health services, poor roadways and communications, and a dearth of appropriate building materials combine to make these populations disproportionately vulnerable to natural disasters of this type. As has been observed in the wake of the HIV/AIDS epidemic, the health systems of poor countries are geared toward delivering limited primary care services on an as-needed basis. There is typically a minimal budget for disease prevention and long-term sanitation upgrades, except for that small amount provided by foreign organizations, and almost no consideration for large-scale or sustained emergency medical responses, hence the ease with which HIV/AIDS has ravaged the poorest nations of Africa, Asia, and the Caribbean.


While countries like India are experiencing an economic re-awakening, they remain yoked to the beast that drags all Southern economies from the solvency needed to address their infrastructure concerns: national debt. With large proportions of their GDP earmarked for servicing debt to wealthier nations, poor countries have little discretionary capital to invest in improved healthcare, infrastructure, and disaster response strategies. Again, the HIV/AIDS experience exemplifies this truth: by some reports a nation like Kenya, beaten down by its epidemic, spends 17 times more on repaying its $6 billion debt than it does on HIV control. Indonesia’s debt hovers at 73 percent of its GDP, while the people of Sri Lanka have accrued a public debt valued at over 105 percent of the national GDP. These financial burdens are compounded by governmental corruption and policy distractions, such as, in Sri Lanka’s case, overspending on the civil service and national defense to keep a simmering civil war in check.

The importance of political image and revenue in the face of this nightmare is best exemplified in both the Thai government’s response to the tsunami and in Western media’s initial instincts. CNN reports that in Thailand special hospitals have been set aside exclusively for tourist use, while both CNN and CBC focused much of their time showing footage of Western tourists being airlifted from Phuket while the real story was the untold thousands of dead washed out to sea in Indonesia and Sri Lanka. The lesson seems to be that, beyond all else, the revenue flow must be protected, so dependent are nations like Thailand on the currency of beach-going Westerners.

Nations will rally, emergency response teams and millions of dollars of short-term aid will be sent; yet thousands more will die, a majority of them children, as the chronic developing-world problems of water quality, nutrition, road quality, and housing will not be fixed by such temporal measures. We must not forget that while an earthquake and a monstrous wall of water were the immediate cause of this tragedy, its root remains with the inability of Southern nations to marshal sufficient resources to make their people less vulnerable to such events; in a word, poverty.

Raywat Deonandan, Ph.D., is an epidemiologist and international health consultant. www.deonandan.com