Rich countries have gotten very good at keeping people alive in earthquakes. But that doesn't mean poor countries should try to emulate them.
The death and destruction in Japan may be horrifying, but the record earthquake that struck March 11 off the east coast of Honshu island still suggests one important lesson: Building codes and land use regulations can save lives. Japan's strict guidelines have been widely credited for keeping the death toll down to a fraction of the casualties in Haiti's quake last year. But that doesn't mean we should import them lock, stock, and barrel to the developing world, where the great majority of earthquake-related mortality occurs. The regulations are also complex and expensive. And there are much cheaper and more straightforward ways to save lives.
It is too early to know the full extent of the tragedy still unfolding in Japan. But one thing we do know is that the great majority of deaths -- and most of the problems at the nuclear plants -- are the result not of the quake itself, but of the resulting tsunami. Things could have been much worse. Although the YouTube images of shaken workers and crashing shelves in Tokyo were frightening, there were very few injuries or deaths reported in the capital city -- or anywhere else where flood waters didn't come rushing ashore. This despite the earthquake being the largest recorded in Japan's history -- and orders of magnitude larger than the devastating Haiti quake.
That means the usual pattern has been repeated: Earthquakes don't kill people in rich countries; they kill people in poor countries. The 1988 earthquake in Armenia was half as strong as the 1989 quake in Loma Prieta near San Francisco, and yet caused 25,000 deaths compared with 100 in San Francisco. The 2003 Paso Robles quake in California had the same power as the Bam quake in Iran in 2003; the death toll was two in California and 41,000 in Iran. Again, Chile's recent earthquake was more powerful than Haiti's, but the death toll was considerably lower. Chile is a member of the OECD club of rich countries; Haiti is the poorest country in the Western Hemisphere.
Regulation keeps people safe in rich countries. Japan is a perfect case study. The last major earthquake that country experienced hit Kobe in 1995, resulting in 6,000 deaths. But buildings constructed after a 1981 revision of Japan's building codes were far less likely to collapse than older buildings. As the regulation gets better, the death tolls get smaller.
The story is very different in poor countries. The 2010 Haiti quake was closer than the Japan quake to a large population center (Port-au-Prince) but, perhaps more crucially, the Haitians in that population center were mostly living in shoddily constructed buildings. Building regulations and land use codes were mostly disregarded, and rarely enforced. The result was 230,000 people dead. Similarly, many of the 17,000 deaths from the 1999 Marmara earthquake in Turkey were blamed on collapse due to poorly constructed reinforced concrete frames, construction using concrete diluted with too much sand, or construction near fault lines.
Why don't we learn our lesson? Why can't we at least earthquake-proof the most vulnerable major cities of the world? Simply put, it costs too much. Earthquake-resistant engineering solutions are expensive and technically demanding. In Istanbul, the cost of reinforcing 3,600 public structures to make them better able to withstand earthquakes, or retrofitting, was estimated at $1 billion -- approximately $280,000 per structure and a full third of the cost of rebuilding them from scratch. And that's just public buildings -- retrofitting all the private dwellings in the city would undoubtedly have cost far more.
Moreover, it's probably not money well spent -- at least in the developing world. The cost-effectiveness of these solutions is often unfavorable compared with other interventions designed to save lives in risk-prone countries. In part, that's because a lot of people live in areas at risk of an earthquake, but only a few actually witness large earthquakes in any particular year and deaths are concentrated in only a very few locations. It is impossible to predict where serious quakes are going to happen with any accuracy -- seismic risk maps had only put Haiti at moderate risk of a large quake before last January, for example. So earthquake preparedness necessarily involves spending a lot of money on strengthening buildings that may never be put to the test.
By contrast, countries like Haiti witnesses many thousands of deaths from very easily -- and cheaply -- prevented diseases in every month of every year. Choosing one over the other may be unfortunate, but it's hardly irrational. In Istanbul, the cost efficiency of retrofitting public buildings has been estimated at about $2,600 per healthy year of life saved. But in developing countries, millions of people die each year from diseases that can be cured using a simple regime of oral antibiotics, which costs as little as $0.25. More broadly, there are a range of interventions that cost less than $2 per healthy year of life saved in the developing world.
It is particularly tragic when children die when their schools collapse during earthquakes, as was the case in Sichuan, China, in 2008 when some 7,000 students died. In an average year, as many as 2,500 kids worldwide die each year in school collapses. And schools and hospitals should be first in line both for inspection to make sure they meet standard building codes and for resources to strengthen them against earthquakes.
But consider this tragedy: 10 million children under age 5 die each year from other causes before they can even make it to school -- the majority of which can be easily and cheaply prevented. And getting girls into school in the first place is one of the best ways to reduce future child mortality, as well as infant and maternal mortality. If there's $10 million for school construction and the choice is between building more schools (thus admitting more students) that may collapse in a large enough earthquake or building fewer schools that are completely earthquake-proof, you may actually save more lives by making the first choice than the second.
Even if the money is available, it takes more than cash to ensure safe construction. The regulations regarding reinforcement and design have to be enforced. Turkey's Marmara quake was of a magnitude and type accounted for by existing design specifications in the Turkish seismic code -- but it was lack of enforcement that led to deaths. Turkey, in short, wasn't Japan: Municipalities had weak and underfunded engineering and planning departments staffed with unaccredited engineers prone to corruption. In 2006, 40 municipal officials in three towns in Turkey were arrested for taking bribes in return for allowing unlicensed construction. Across a range of countries, construction permitting appears to be a regulatory area particularly prone to corruption.
That means that strict codes that are unenforced not only fail to save lives, but can also carry significant costs on the poor. Because non-code construction is illegal, it provides ongoing opportunities for officials to demand bribes while denying many owners legal title. At the turn of the millennium, as much as half of Turkey's urban population lived in illegal settlements with no rights to sale or transfer. That's a major factor in keeping them poor.
Earthquake deaths aren't "acts of God" -- they are the result of poverty and weak governance. And in poor, weakly governed countries, there are a lot of deaths cheaper and more straightforward to prevent -- from malaria, diarrhea, or measles, for example. In rich countries with well-functioning regulatory systems, building regulations and land use codes specifically responding to earthquake threats have a place. In poor countries where regulation is capriciously enforced, they may even be harmful. If we want to change that grim calculus, we have to learn to treat earthquake deaths as a symptom of misery -- not the cause.
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