Inclusive tsunami preparedness: Why the people most at risk must help shape the plan

When UNDRR published its Concept Note for World Tsunami Awareness Day 2026, Call to Action 5 stood out as the most critical: 

“We call on organizations representing persons with disabilities, older persons and migrants to help shape inclusive preparedness materials and activities.” 

Why? Because standard evacuation plans can fail precisely the people who need them most. 

The reality of exclusion 

• Persons with disabilities: 

  A deaf person does not hear the siren. A wheelchair user cannot climb stairs to high ground. A person with an intellectual disability may need information presented in an accessible format to understand the evacuation route. After the 2011 Great East Japan Earthquake and Tsunami, surveys found mortality rates among persons with disabilities approximately 2 to 4 times higher than among the general population, depending on the survey: about twice the rate of the general victim population according to the Japan Disability Forum, and about 4.3 times in the Miyagi Prefecture survey. A separate Kyodo News survey found that people with disabilities accounted for 24.6 per cent of “disaster-related deaths” (indirect deaths from illness or stress) in Fukushima, Iwate and Miyagi, although they made up only about 7 per cent of the population. 

• Older persons: 

  Reduced mobility, hearing loss, medication that requires refrigeration and isolation can all create additional challenges. On a route such as the one from Rethymno’s Venetian harbour to the Fortezza fortress in Crete, Greece, an older person with a cane risks being left behind. The approach is along a paved, cobbled lane and the Fortezza has no specific disability-access provisions; the ground on the hill is rocky, uneven and uphill, with almost no shade, and the site has no lifts or ramps. The Fortezza is nonetheless listed as a designated refuge point for the old-town sector in the Municipality of Rethymno’s earthquake emergency plan “Egkelados 2”. The municipal civil protection office has also said that these  refuge points should also guide people away from the beaches in the event of a tsunami. Access arrangements have relied on event-specific measures, such as a festival shuttle, which would not be available in an emergency. 

• Visitors, migrants and migrant workers: 

  These groups are not interchangeable. In Rethymno in August, I estimate that 60–70 per cent of people on the central beach between 08:00 and 11:00 are visitors. This is my personal estimate, based on my own observations in the summers of 2023–2025, not an official statistic, and it does not reflect the presence or proportion of migrants among beachgoers. Short-term visitors need immediate, visual, multilingual cues (for example in the hotel room) as they may not follow local Civil Protection channels. Migrants and migrant workers, whether long-term residents or seasonal workers, may face different barriers, such as limited Greek, less familiarity with or trust in local authorities, and work schedules that prevent participation in drills. A seasonal worker whose first language is not Greek or English may need alert messages in that language and a buddy who speaks it. 

What does shaping inclusive preparedness mean in practice? 

The Sendai Framework for Disaster Risk Reduction 2015–2030 calls for all-of-society engagement (para. 19(d)) and states that persons with disabilities and their organizations are critical in designing and implementing plans tailored to specific requirements (para. 36(a)(iii)). The disability-rights principle “Nothing about us without us”, which comes from the disability rights movement, was the theme of the UN’s 2004 International Day of Disabled Persons; the UN Convention on the Rights of Persons with Disabilities requires close consultation with persons with disabilities through their representative organizations (Article 4(3)) and protection in situations of risk (Article 11). Inclusive preparedness is therefore not doing something for these groups, but with them. 

The five steps to achieving inclusive preparedness below apply to hospitals, hotels, schools, workplaces and neighbourhoods in tsunami zones. They are based on my work on Personal Emergency Evacuation Plans (PEEPs) in hospitals. I introduced this work in a post on the Disaster Ready Hub (in Greek) and summarize in my book, A Unified Framework for Preparedness, Response, and Resilience: A Synopsis (Hospital Risks & Disaster Management). 

1. PEEPs: 

   Not a generic plan, but: What support does this person need? Who will provide it? Who is the backup if the buddy is absent? As an illustration, consider a nurse with a mobility impairment. Her PEEP might state that she needs two extra minutes and a clear corridor, name the head nurse on the shift as primary buddy and a security officer as backup, and identify a refuge area on the way out. The same structure works in a hotel: a guest in room 204 who uses a wheelchair needs a named primary buddy (the floor manager), a backup (the receptionist) and a refuge area that does not require stairs. 

2.  An accountable buddy system: 

   Responsibility for assigning and training buddies lies with facility management (hotel manager, ward manager, school principal), not with volunteers. Each shift has designated buddies, who are recorded in a daily roster log. If a buddy is absent or changes shift, the named backup takes over. There should be no conflict with critical duties (for example, a nurse does not abandon a patient to become a buddy). Exercises should involve persons with disabilities as participants, not spectators. 

3. Accessible communication before, during and after: 

   Use multiple communication formats: visual (maps with pictograms), audible, easy-to-read and multilingual formats. For example, a hotel could provide an evacuation card in every room showing a simple sequence of pictograms: earthquake → follow the arrow upwards → high ground. Sirens should be complemented by visual and vibrating alerts. For guests who do not read Greek, a QR code can link to audio in several languages and to an International Sign video. This sequence is an illustration and has not been formally tested; any pictogram sequence should be tested with organizations of persons with disabilities, older persons and non-Greek speakers before use. 

4. Accessibility audit of evacuation routes:

   Is the route to high ground accessible by wheelchair? Are there resting points for older persons? Is there sufficient shade and access to water? An audit can uncover problems that go beyond whether a route is technically passable: signs placed too high for a wheelchair user to see, curbs or steps without a ramp, no tactile paving for blind persons, sand that stops wheelchairs, no audible crossing signal, no shaded bench for resting. Have persons with disabilities walked the route and given feedback? In Rethymno this raises a practical question for the municipality: if a designated refuge point is hard to reach for some residents and visitors, what accessible alternatives, assisted transport and tailored warnings exist? The warning time for a locally generated tsunami can be very short, so these questions are best answered with organizations of persons with disabilities and older persons before an emergency, not during it. 

5. Co-design of materials: 

   Organizations representing these groups should not just receive leaflets; they should help develop and write them from the outset. 

Connection to hospital preparedness 

This is exactly why a hospital evacuation plan must include staff who need support, not just patients. A colleague who needs assistance during evacuation is often invisible in plans, and one person’s support needs can influence the evacuation of an entire unit. Imagine an ICU in which the technician who knows how to shut off the oxygen supply needs help evacuating, but has not been assigned a buddy: the whole unit may wait for them, putting patients at risk. Inclusive planning maps critical functions and personal support needs together. The same approach is needed in tsunami-affected communities: preparedness plans must consider the needs of everyone, including those responsible for helping others. 

Checklist: Is your plan inclusive? 

• Do you know who in your neighbourhood, on your floor or on your shift may need help? 
• Do you have a PEEP for each person who requires individualized evacuation support? 
• Do you have a buddy and a designated backup, assigned by management and recorded in the shift log? 
• Is signage multilingual, supported by accessible icons and pictograms, and tested with the people who will use it? 
• Have you conducted an evacuation exercise with the people who may need support during  the past year? 
• Have they helped design or review the plan? 

Resilience starts with you — but inclusive resilience starts with us, leaving no one behind. 

On 5 November, take two actions: learn your route to high ground, and ask the people around you who might need assistance what support they would need and involve them in the planning. Don’t just identify them; co-plan with them. That is what Call to Action 5 asks us to do: shape inclusive preparedness with them. 

The same gaps appear wherever coastal tourism, migration and ageing population meet tsunami risk, from Rethymno to Sendai. Inclusive preparedness is therefore not a local issue but a requirement for Early Warnings for All. 

#GetToHighGround #WTAD2026 

Vaitsis Koutsipetsidis is a researcher in hospital preparedness and disaster resilience based in Crete, Greece. Author of A Unified Framework for Preparedness, Response, and Resilience: A Synopsis. He writes on the Disaster Ready Hub and has contributed to UNDRR’s DRR Voices.