Long-term disaster recovery processes are poorly understood, yet there is a growing imperative to improve knowledge of their complexity and timeframes to inform policy and post-disaster decision-making. This empirical study explores post-disaster change and recovery processes for the healthcare system on the island of Montserrat, West Indies. Taking a systems approach, we adopt a qualitative case study methodology to explore post-disaster changes over an extended timeframe (1995–2012). We identify many different aspects of change, which lends a new perspective on post-disaster change types for complex systems, and an alternative classification for analysis of their recovery. Recovery of the healthcare system is ongoing. We find that recovery is not a uniform process. Different elements of the system show signs of recovery at different times. This exploratory study documents the complex and long-term nature of disaster recovery in this context, which brings new understanding of change and recovery processes and raises important considerations for future studies.
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