Such breakdown of medical, pharmaceutical and other social services can result in death and serious harm to those whose survival depends on them. The size of this vulnerable group may depend on the stage of development of the country and the extent to which the survival of elderly and people with a disability is dependent on the seamless provision of certain critical services. This chapter examines the nature of disaster risk (Roberts J L, 2010), and offers fresh analysis and recommendations for action with special reference to small and island states, to avert and mitigate the wide-ranging service implications of the aftershocks of disasters. Hurricane Irma in Puerto Rico in 2017 resulted in 52 direct deaths plus 82 indirect deaths, with an estimated US$64.76 billion in damage.