재난관련 감염병의 관리와 자연재난의 젠더 영향에 대한 고찰
Study on the management of Disaster related infectious diseases and Impact of Natural disasters on Gender
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갑작스럽게 발생하여 사람과 자연, 인공물에 손상을 초래하는 재난과 재난관련 감염병은 최근 코로나19 바이러스 범유행과 관련하여 많은 관심을 받고 있다. 우리나라에서도 태풍, 호우와 같은 풍수해를 비롯한 자연재난이 끊이지 않고 있어 현재 질병관리청을 중심으로 재난과 재난관련 감염병에 대한 대비를 하고 있다. 그러나 아직도 재난, 특히 재난관련 감염병의 감시 체계는 미흡한 것이 현실이다. 또한 다양한 분야와의 협력연구가 필요한 재난의학 분야에서 재난의 젠더 영향에 대한 연구는 아직 걸음마 단계라고 할 수 있다. 이 글에서는 첫째, 우리나라 재난관련 감염병 감시체계의 개선을 위한 방안을 제시하고자 하였으며, 둘째, 재난에 의한 젠더 영향에 대한 고찰을 시도하였다. 우리나라 재난관련 감시체계의 개선 방안으로는 1) 기존의 보건소 기반 감시 체계의 개선과 활성화, 2) 이재민 대피소에서의 새로운 감염병 감시 체계 제안, 그리고 3) 재난 피해 지역에 대한 보건응급조사의 활성화와 함께, 4) 국가응급진료정보망(NEDIS)의 적극적인 활용 방안을 그 대안으로 제시하였다. 또한 재난과 재난관련 감염병에 의한 젠더 영향을 살펴본 결과, 사망률과 사회적 불평등을 다룬 대다수의 연구들에서 여성의 취약성과 불평등은 분명한 사실로 보인다. 그러나 일부 문헌에서 논란을 초래하는 결과들이 존재하며 이들의 유형을 분류하면 남성의 생물학적 취약성, 사회경제적 요소와 문화적 요소의 영향, 성 역할의 영향과 함께 주요 결과의 설정에 따른 결론 해석의 문제 등으로 요약할 수 있다. 향후 우리나라에서 재난과 재난 관련 감염병, 젠더 영향에 대한 깊은 성찰과 노력, 이를 위한 다학제적 협력과 제도, 정책의 개선이 필요할 것으로 사료된다.
Abstract
Recently with COVID-19 pandemic, disaster and disaster-associated infectious diseases (DAID) gather lots of attention and concern of people. In Korea, Center for Disease Control and Prevention (KCDC) has already set up the preparedness plan against various types of disasters since its inauguration, however, surveillance system for DAID is not well prepared in Korea. Moreover, the concept or study of impact on gender of DAID is very rare. The aim of this study was twofold: The first aim was to develop advanced surveillance system for DAID in Korea. Second objective was to explore the impact on gender of disasters and DAID. For improvement of the surveillance system for DAID in Korea, we proposed the four practical systems: 1) Improvement of surveillance system based on already present public health center, 2) development of individual and shelter reporting forms in shelter clinic for short-term living centers for disaster victims, 3) adaptation of PHASER (Public Health Assessment for Emergency Response) programs for disaster, and 4) augmented modification and utilization of NEDIS (National Emergency Department Information System). Gender impact by natural disasters has been clearly reported in terms of mortality rate by Dr. Neumayer’s study. In this study adverse effect of natural disasters on female’s life expectancy was proved. In accordance with this study, many other studies also showed similar unequal impact of disaster or DAID on female. However, through the literature review, many mixed, even contradictory results are found. The types can be summarized as follows. By biologic or physiologic vulnerability of male, or by socioeconomic factor, or by cultural background or conventional role model of each community/country, the interpretation of gender impact can be changed or conditioned in some studies. Furthermore, by changing the primary outcome of the study the implication of the result of gender impact can be differed. For better preparedness of disaster and DAID, we need to establish advanced infection surveillance system in Korea in near future. Furthermore, we also need to make inter-science collaboration and to improve legal and social system to mitigate the aftermath of disaster and DAID.
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