Heathcare centers and older people in the context of disasters in Chile: Integrating perspectives for resilience to earthquakes

The older population is increasing rapidly worldwide and in the context of disasters produced by earthquakes, elders are considered a vulnerable population. This occurs especially when they have lower mobility and chronic diseases. Given this situation, healthcare centers are recognized as critical institutions to support the healthcare needs of vulnerable populations such as the older people (according to the United Nations, aged 60 and over). However, recent literature is increasingly paying attention to the idea that older people are not just vulnerable populations in need of support but contributors to resilience on disasters, mainly because of their past experiences on disasters.

To know how older people contribute to earthquake resilience, this study explored the perspective of both the staff of the healthcare center and some speakers from the elders' community who frequently receive assistance there. This study was carried out in a hospital of the central zone of Chile, in the county of Peñalolen (overall, 20% of its population is aged 60 and more), regularly exposed to earthquakes. The research team explored the perspectives of the healthcare center Cordillera and the older people with previous experiences on earthquakes in the central zone of Chile.

This group of elders was affected by different earthquakes in the last century, such as the 1960 Mw 9.5 in Valdivia, the 1985 Mw 8.0 in Algarrobo and the 2010 Mw 8.8 in Concepción. Relevant data was gathered from one interview conducted with the head of the hospital and one focus group with the hospital emergency team. Furthermore, two focus groups were conducted with older people aged 60 years and over. They were part of a consultative group of the hospital and representatives of their neighborhoods. Both were asked about their perspective on the support requested and received from the healthcare centers after an earthquake.

We analyzed the interviews and focus group under the model of resilience considering the disaster lifecycle, involving mitigation, preparedness, response, and recovery. While the healthcare center was concerned about the physical impairment of older people in the context of an evacuation needed if the facility does not maintain its functionality after an extreme earthquake, older people identify themselves as supporters of others, and the healthcare center as a safe place to meet and socialize, but not to request any support after earthquakes. The divergence on views from older people in comparison to the staff of healthcare centers suggests that for the stage of response, healthcare centers consider the frailty of elders, while the older people feel crucial for the recovery phase, especially because of their past experiences on disasters and the learned lessons from those disruptive events. These findings suggest that the vulnerability associated with older people should be revised, to understand how they contribute to the resilience later in life, being supporters of others and not just vulnerable population in need of support from healthcare services.