Tim Radford In 1999 there were more disasters than ever before and they killed more people than any year in the decade except one. According to the latest Red Cross report, there were 623 forest fires, floods, landslides, avalanches, earthquakes, tsunamis, epidemics, droughts and volcanic eruptions around the world. They did economic damage estimated at $72-billion, they disrupted the lives of 212-million and they killed more than 80E000. This death toll was the worst since 1991, when a single cyclone swept over Bangladesh and killed 139E000 and a series of cholera epidemics took 19E000 lives in Africa. Last year, floods in Venezuela alone claimed 30E000 lives when a hillside collapsed, taking shanty towns with it. But the sum of these apalling events was nothing compared to the real catastrophe, says Peter Walker, director of disaster policy at the International Federation of Red Cross and Red Crescent Societies in Geneva. The real disaster was that in the same year 30-million died from entirely preventable diseases. “I have just had a colleague come back from the Sumatra earthquake. It was a huge earthquake in geological terms, and hit a very undeveloped area of Indonesia. But when he gets there, the actual damage from the earthquake isn’t that great. But what he found was an endemic problem of rampant malaria, rampant communicable diseases. That is the disaster, not the earthquake.” People who are sick cannot work. People who cannot work cannot feed themselves or their families. People who are not well-fed cannot get better. Poverty and ill-health stalk each other and sick nations end up with sick governments, which have spent up to 50 times as much on military hardware as on health. Since 1945 war has killed 23-million people; Aids, malaria and tuberculosis have taken 150-million. Recently the World Bank asked 60E000 poor people what poverty meant for them. The biggest factor was poor health. “In many ways we at the Red Cross have got to change our arsenal. It is no longer good enough to have the commando troops, we have got to have the infantry on the ground – our volunteers – and they have got to start working in a way that is much more programmed,” says Walker. Aid organisations and governments recently brainstormed 20 things that could be done in disaster- struck communities. They were simple things that Red Cross volunteers could tackle: clean water, nutrition advice, hygiene education, and vaccination against the great child-killing diseases. “It is not about income. If I had my health, I could work, I could support my family,” says Walker. People could recover from disaster if they had some control over their own health. “If you know what makes you healthy, then you have a chance; you can start to do something about it. If you don’t know, you can’t. In Africa it is estimated that something like 90% of the people who have Aids don’t know they have got it.”