China is counting the cost. After another horrendous flood season, countless earthquakes, droughts and a series of typhoons the disaster toll in the world's most populous nation has again been crippling.
The Ministry of Civil Affairs has reported that in the first nine months of this year alone more than 1,300 lives were lost and 170 million people were affected. Direct economic losses across the country, it says, amounted to almost US$ 11 billion.
The day after the ministry released those figures, it was recalculating. A couple of million more people are now suffering from serious drought in the south, over a million of them in Guangdong province and over 1.4 million in neighbouring Guangxi autonomous region.
Many of them have insufficient drinking water but their livelihoods are also affected. Many animals have been killed and several hundred thousand hectares of farmland are reportedly parched and cracking. Reservoirs have run dry and major ones in Guangdong are said to have a billion cubic metres less than they did in October last year.
Meanwhile, Guangxi's western neighbour, Yunnan province, had another earthquake this week with state media reporting that 20,000 homes had collapsed.
There was no reported loss of life but it was something Yunnan could do without. It was hit by a quake in August - the third in one county in less than 12 months - which left four people dead, nearly 600 injured and 126,000 homeless.
Yunnan, north China's Inner Mongolia autonomous region and the northwest's Qinghai province have all had earthquakes measuring more than five on the Richter scale this year.
China is among the most disaster-prone countries on the planet and catastrophe, it seems, is hitting ever harder. The summer flood season in particular was a harsh reminder of the vulnerability of the country's rural poor to an unholy alliance of disaster, poverty and gruesome threats to health.
Besides loss of life and livelihood, they face enormous health hazards from poor sanitation and unsafe and unprotected water supplies, particularly during flooding. Last summer, effluent again washed from crude village latrines to contaminate surface and ground water.
It doesn't have to be that way, argues the Chinese Red Cross. Natural hazards need not turn into natural disasters.
Groundbreaking work on reducing community vulnerability has been ongoing since 2001. With support from the European Commission's Humanitarian Aid Office (ECHO), the Chinese Red Cross and the International Federation have been working to turn the tide by providing good sanitation, improved water supplies and health and hygiene education where floods have hit hardest.
Now the Australian Red Cross and the Danish Red Cross are integrating community-based disaster preparedness into the package. Australian Michael Annear, the Federation's programme coordinator, explains: "We are going into communities which have been devastated by floods and saying: Do you want to go through all that again? If you don't, we can help you do something about it. The risks can be minimized."
So far, the programme has been piloted in Guangxi and south-central Hunan province, and in 2005 it will spread to the Chongqing region which suffered terribly in this year's late-summer devastation of the southwest.
Annear, who designed the disaster preparedness component that the Australian Red Cross began to introduce to Guangxi last July, provides some perspective. "Despite the country's highly publicized economic development, China remains home to nearly 20 per cent of the world's poor," he points out. "Some 160 million people live on incomes of less than one US dollar a day, and according to the Asian Development Bank 203 million can be classified as extremely poor. When such people are exposed to the consequences of natural disaster, a major humanitarian challenge emerges."
Most people severely affected by floods are struggling as subsistence farmers. "That in itself is bad enough," says Annear. "They have no savings to help them recover. But then they are also left facing disease." Waterborne and sanitation-related illness accounts for more than 70 per cent of infectious disease in China.
Hygiene is dubious to start with, he says. Pigs, buffalo and chickens may share the same housing space as people. The latrine, if there is one, is often a simple pit with a couple of planks placed across it.
Surveys have shown that almost 60 per cent of rural families do not even have that, going instead to fields and open spaces. The consequence, says Annear, is that diarrhoeal illness and viral hepatitis - both associated with faecal pollution - are the two leading infectious diseases in China.
"The faecal-oral route is the major means of transmission which is why minimizing oral ingestion through improving personal hygiene, or water and sanitation is of primary concern," he says.
The village of Shi Tang, in Hunan's Lou Di prefecture, a couple of hundred kilometres west of the provincial capital, Changsha, saw diarrhoeal disease increase dramatically after floods in both 2000 and 2001. "We had old traditional latrines," says village leader Liu Xu Weng, a farmer and now Red Cross volunteer. "The whole environment was just contaminated."
It will not happen again. Since the Red Cross programme reached Shi Tang, most of its 383 homes have acquired improved sanitation and its population has received basic health education. It has learnt how to better protect itself against disease both on a daily basis and during flood seasons. Trained Red Cross volunteers have gone house to house to impart new knowledge to them.
The change for the better does not just relate to cleanliness in the home. Because the toilets, and the toilet areas, are tiled, they are easy to keep clean but they have another advantage. Farmers can go on doing what they have done for millennia - using human waste as fertilizer - but doing it safely.
The Ecosan toilets the Red Cross provides separate urine from faeces. Urine can be used directly as fertilizer because its nitrate content replenishes nutrients in the soil, but solid waste is stored in one of the toilet's two chambers for a period of six months, neutralizing dangerous bacteria. Now the village is looking to secure its water supply.
Some 24,800 families in poor rural communities of Hunan and Guangxi have benefited so far from this vulnerability reduction. But improved water and sanitation is only one way to decrease the risks. Each community can assess and minimize the danger of direct harm from natural hazards.
"The critical factor here is self-assessment, determining the nature of potential disasters and where they will come from," says Michael Annear. "The community must ask itself how it can get people out of harm's way. It rapidly comes to the conclusion that having a home on a flood plain or under an unstable hillside isn't a good idea. People are soon making plans to plant trees on that hillside, to reduce rain runoff and stabilize the soil with a strong root network. We want communities developing their own, specific disaster preparedness plans."
The Australian warns that widespread community vulnerability reduction programmes are essential if China's appalling losses to natural disaster are to be curtailed.