Over the last several decades alone, natural disasters have killed millions of people and adversely affected the lives of billions more. In addition to the severe accidents and substantial structural damage they cause, earthquakes, hurricanes, floods, and other natural calamities have grave social, economic, and health consequences as well.
Even if the population has been evacuated in time and there were no (or very few) casualties, the effects of a disaster ripple long after the actual event – many people lose their homes and need to live in emergency camps for months, or even years; the road infrastructure is damaged; there is insufficiency of healthcare resources; etc. All these factors cause great economic problems and severe health issues in disaster ridden communities.
From outbreaks of communicable diseases to various safety hazards within the home, natural disasters may have harmful, long-term consequences to the health and well-being of the people in the affected areas.
Natural disasters they do usually result in massive outbreaks of infectious disease, although in certain circumstances they do increase the potential for disease transmission. In the short-term, the most frequently observed increases in disease incidence are caused by fecal contamination of water and food; hence, such diseases are mainly enteric.
The risk of epidemic outbreaks of communicable diseases is proportional to population density and displacement. These conditions increase the pressure on water and food supplies and the risk of contamination (as in refugee camps), the disruption of preexisting sanitation services such as piped water and sewage, and the failure to maintain or restore normal public health programs in the immediate postdisaster period.
Communicable diseases spread after natural disasters
In the aftermath of a natural disaster, the risk for epidemic outbreaks gets higher:
The shortage of fresh food, typical for post-disaster periods, results in malnutrition that weakens the immune systems of the people in the affected area;
- The limited access to safe water and lack of proper sanitation pose a risk of infections and gastrointestinal problems (diarrhea, hepatitis, and various other bacterial diseases can be transmitted by direct contact with contaminated water);
- The crowded living conditions and poor hygiene levels in emergency camps facilitate the transmission of infectious diseases;
- The structural damage done to the hospitals and health facilities in the region and the loss of medical equipment and medicines prevent adequate health care.
All these factors contribute to the quick spread of communicable diseases after natural disasters.
In the longer term, an increase in vector-borne diseases occurs in some areas because of disruption of vector control efforts, particularly following heavy rains and floods. Residual insecticides may be washed away from buildings and the
number of mosquito breeding sites may increase. Moreover, displacement of wild or domesticated animals near human settlements brings additional risk of zoonotic infections.
In complex disasters where malnutrition, overcrowding, and lack of the most basic sanitation are common, catastrophic outbreaks of gastroenteritis (caused by cholera or other diseases).
Though all disasters are unique in that they affect areas with different levels of vulnerability and with distinct social, health, and economic conditions, there are still similarities between disasters. If recognized, these common factors can be used to optimize the management of health humanitarian assistance and use of resources.
The following points should be noted:
1. There is a relationship between the type of disaster and its effect on health.
This is particularly true of the immediate impact in causing injuries. For example, earthquakes cause many injuries requiring medical care, while floods and tidal waves cause relatively few.
2. Some effects are a potential, rather than an inevitable, threat to health. For example, population movement and other environmental changes may lead to increased risk of disease transmission, although epidemics generally do
not result from natural disasters.
3. The actual and potential health risks after a disaster do not all occur at the same time. Instead, they tend to arise at different times and to vary in importance within a disaster-affected area. Thus, casualties occur mainly at the time and place of impact and require immediate medical care, while the risks of increased disease transmission take longer to develop and are greatest where there is overcrowding and standards of sanitation have declined.
4. Disaster-created needs for food, shelter, and primary health care are usually not total. Even displaced people often salvage some of the basic necessities of life. Furthermore, people generally recover quickly from their immediate shock
and spontaneously engage in search and rescue, transport of the injured, and other private relief activities.
5. Civil wars and conflicts generate a distinct set of public health problems and operational constraints. They are not covered in any depth in this publication.
Effective management of health humanitarian aid depends on anticipating and identifying problems as they arise, and delivering specific materials at the precise times and points where they are needed. The logistical ability to transport maximum numbers of supplies and personnel from abroad to disaster areas in Latin America and the Caribbean is less essential. Cash is the most effective donation, particularly since it can be used to purchase supplies locally.
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TECHNICAL HEALTH PROGRAMS
In the event of disaster, the health sector is responsible for treatment of casualties, epidemiologic surveillance and disease control, basic sanitation and sanitary engineering, oversight of health care in camps or temporary settlements
for displaced persons and refugees, training, and logistic resources and support.
The responsibilities of the health sector in the aftermath of a disaster cover practically every aspect of normal pre-disaster operations. No technical department or support service can remain uninvolved or immobilized in case of a major disaster.
Preparedness should address all health activities and disciplines and cannot be limited to the most visible aspects of mass casualty management and emergency medical care. To reinforce these responsibilities, a standing advisory committee comprising specialists from health disciplines should meet on a regular basis to review preparedness activities and disaster plans in their respective areas of operation.
Treatment of Casualties
Prehospital and hospital plans for treating casualties are essential in organizing health services for disaster situations. The prehospital disaster plan focuses on search and rescue of victims requiring either specialized medical personnel
or equipment, as in the case of persons trapped in buildings collapsed by earthquakes.
Reliance on external assistance for search and rescue (SAR) activities should be minimized; instead, the health sector should promote the development of a national search and rescue capacity familiar with modern techniques and equipment.
Other prehospital activities include: first aid administered at the disaster site and, depending on the severity of injury, providing immediate treatment. The injured are identified or tagged at the disaster site, and classified according to
priority for treatment and/or transfer to hospital. This process, known as triage, uses an internationally accepted color coding system (see Chapter 6). Because many health workers are unfamiliar with mass casualty management, it should be included in the medical and paramedical curricula in health schools.
The hospital disaster plan refers to the organization within a hospital, and focuses on: development of emergency plans, training, information, safety of patients and hospital personnel, evacuation, and availability of medicines and medical supplies for emergency treatment. The plan also addresses backup systems for communication, power, water supply, and transportation. It should form part of the hospital disaster response network, with clear procedures for patient referral and
Health Management in Shelters
The health sector is responsible for establishing basic health programs for temporary shelters, including a surveillance and control system for infectious diseases and nutritional surveillance. Children should receive appropriate vaccinations, and opportunities should be taken to provide basic health education to residents of temporary settlements.
Training Health Personnel
Health ministries in countries vulnerable to disasters should institute comprehensive in-service training programs. Specific training in first aid, search and rescue (SAR) techniques, and public hygiene for the population at risk should be given,
and health officials should receive ongoing instruction in disaster management issues in their respective areas of responsibility. Health institutions should recruit professional staff with qualifications in disaster management to be in charge of disaster programs.
It is even more important, perhaps, for professional training institutions (universities, schools, etc.) to include disaster preparedness and response in their regular curricula or as part of continuing education programs.3
The health sector should also encourage the development of research protocols to be applied during the disaster phase to identify factors that would contribute to improving disaster management, or to characterize the effects of a disaster on the health of the population.
Tips To Prevent Health Problems After Natural Disasters
To avoid personal injuries and health problems in the aftermath of a disaster, make sure you:
Mold in the home is one of the most common and most harmful after-effects of a natural disaster.
- Do not return home until authorities declare that it’s safe;
- Do not enter your home if you smell gas. Open all doors and windows and call the gas company right away;
- Wear protective gear when cleaning up after a disaster – sturdy, waterproof boots, rubber gloves, goggles, a face mask, etc.;
- Carry a flashlight when you enter the home – do not use matches, candles, or lighters. If there has been a gas leak, sparks can ignite the gas and cause a fire or an explosion;
- Do not touch any exposed cable or electrical wires;
- Do not turn on the lights or any electrical equipment until you’re sure that there has been no damage to the electrical system in the home;
- Never use wet electrical appliances! Have household appliances and electrical devices serviced and sanitized before using them. The heating and cooling system should also be carefully inspected and cleaned before being put back into service;
- Open doors and windows to ventilate the space and run fans and dehumidifiers in the rooms to remove moisture from the air and help the building materials dry out faster;
- Remove debris and waste in a safe and appropriate manner. Call the local waste division if you suspect dangerous waste;
- Rinse all hard surfaces with a garden hose, then scrub them with a heavy-duty cleaner and hot water. Use a solution of chlorine bleach and water for better disinfection (Never mix bleach and ammonia as combining them can produce toxic fumes);
- Discard any carpets, area rugs, mattresses, upholsteries, and other similar materials that have been contaminated by sewage or been under water for more than 24 hours;
- Disinfect all household items before using them;
Ensure quick and efficient mold removal. It’s best to hire professional mold remediation services to clean the mold, restore the sustained damage, and prevent mold growth in the near future;
Have your home restored as soon as possible after the disaster.
- Throw away food and beverages that have been in contact with floodwater or smell bad or look bad;
- Boil drinking water;
- Keep children and pets away from pools of stagnant water and areas of the home that have not yet been sanitized and secured;
- Use insect repellents to avoid vector-borne illnesses and stay away from wild or stray animals – just in case.
To prevent disaster-related diseases, you need to have your home cleaned and restored to safety as quickly and efficiently as possible. This is a job better left to the professionals – the experienced disaster restoration specialists and water damage restoration experts will have the specialized equipment and professional know-how required to ensure the safe living conditions in your property. What’s more, they will restore your home to its former excellent condition and will help you return to your normal life as soon as possible after the disaster.
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