Clean-up continues on the Indonesian island of Nias following last week's massive earthquake. William Frej, who directs humanitarian aid in Indonesia for the U.S. Agency for International Development, says the destruction was staggering, with an estimated 80% of all structures having severe damage.

"Churches are destroyed. Mosques are destroyed. The central market is destroyed," he says. "The road from the airport into the city is destroyed. It is another devastating blow for Aceh and Indonesia."

This earthquake is not an isolated incident. Each year hundreds of natural disasters, large and small, account for tens of thousands of deaths, hundreds of thousands of injuries, and billions of dollars in economic loss around the world.

A new study released (3/29/05) by the World Bank and the Earth Institute at Columbia University presents a country-by-county risk assessment of these events that can be used as a tool to help better manage disaster prevention and mitigation.

Margaret Arnold, co-author of the report on what are called Natural Disaster Hotspots says nations were ranked according to the threat they face from 6 major natural hazards: hurricanes, floods, volcanoes, drought, landslides and cyclones. Some of the countries most exposed to multiple hazards based on landmass, she says, are El Salvador, Costa Rica and the Philippines.

But even poor countries can take steps to minimize risk and save lives. Jeffrey Sachs, who heads Columbia University's Earth Institute and contributed to the report, says better communication is a good first step. He points to the 10,000 Hondurans who died when Hurricane Mitch struck in 1998.

"They died mainly in their sleep," he says, "living in the riverbed when the massive flood came because of the hurricanes. They didn't die of the winds. They died of drowning. Yet if there had been a social action system? it was known that the hurricane was there, the rains were intense, and if the neighborhoods had been awakened and the people brought out to high ground those lives would have been saved."

The report finds that in 35 countries, 1 out of every 20 residents live in an area that is at high risk from 3 or more hazards. In 90 countries, 10% of the population is at high risk from 2 or more hazards.

Mr. Sachs says the people at the margins of society often live in areas most prone to natural dangers. "The (people) are landless," he says. "They are hungry. They come to the cities as migrants. Either they can live in terrible slum conditions in crowded unhygienic places, or they might go to the hillside where they probably shouldn't live at all because the slope is so steep, but it is the only place they can squat. And, then the terrible hurricane comes and their hut is washed away and they or their children are killed. And, this is a repeated story."

Global Hotspots co-author Margaret Arnold says those stories will continue to be repeated, unless communities and managers set priorities to break the cycle. She says the global risk analysis in the report can help decision makers set priorities. "There is a culture of prevention that has to be built up," she says. "People have to take some responsibility for the risk they face. The government is going to have to do the same. So there are some non-expensive things you can do, just buying a kind of cheap straps if you live in a hurricane zone to keep your roof on, things that don't cost a lot of money. More importantly there are lots of things you can do just in terms of public education and awareness and community preparedness that can really reduce the impacts on communities."

Margaret Arnold says the report Natural Disaster Hotspots: A Global Risk Analysis promotes a proactive approach to disaster relief and mitigation. It supports the view that awareness of disaster risk must be part of a nation's economic development plan? and not simply a humanitarian effort, after the fact.