Health issues in disaster management: a paradigm shift

by

Prof. Chandan Ghosh, NIDM, New Delhi

All natural disasters are unique in that each affected region of the world has different social, economic, and health backgrounds. Some similarities exist, however, among the health effects of different natural as well as man-made disasters, can ensure that health and emergency medical relief and limited resources are to be well managed.

Whether it's Louisiana hit by Hurricane Katrina in 2005, or Indian Ocean rim countries struck by the Tsunami in 2004, Sichuan earthquake in 2008, Haiti Earthquake in 2010 (Fig. 1) or Japan hit by earthquake-Tsunami in 2011 or more recently Nepal-India hit by earthquake in April-May 2015;  communities that suffer from such disasters also suffer from the side effects of the disaster long after the cameras have stopped rolling and the aid comes to a halt. 

Fig. 1: Health care emergencies due to Haiti (2010) earthquake have been  out of all limitations resulting in the complete collapse of the system and even  6 years after the earthquake, integrated efforts for the restoration of health care system are the greatest challenge, which is very significant on humanitorian grounds

Fig. 2: Emergency health care by a functional medical hospital system due to 2008 Sichuan earthquake, is not always guaranteed. However, it’s always preferred to have contingency arrangement for such emergencies.

 Some of the greatest challenges these people undergo is not the natural disaster itself but the residual problems stemming from the disaster, namely the long-term health problems kindled from the calamity, recovering from the loss and damages and setting development agenda back to anvil. The long-term health conditions typically addressed during the redevelopment phase include mental and psychological issues, vaccinating and eliminating the outbreak of communicable diseases like cholera, malaria, and measles and reinstating the infrastructure of the health services system. Mental health problems have proven to be some of the most common side effects of natural disasters. The great loss and devastation disasters incur makes mental health problems like post-traumatic stress disorder and depression, rampant among survivors of these horrific acts of nature. Disasters, therefore, cause a significant amount of stress; the death of loved ones can be particularly traumatic but also the loss of jobs, material goods and livelihoods.

Fig. 3: Having facilities for differently abled persons at public places is  mandatory but putting them in proper order is an unsettled socio-cultural dispute in many countries. If these are in place as seen in the photo, they can be used for positioning emergency vehicles during disaster response and operation.

Emphasis is required into a number of important areas in which, public health can contribute to making overall disaster management more effective and conducive to people affected by the disaster.  Some of the more important sudden impact of natural disasters and potential future threats (e.g., intentional or deliberately released biologic agents)  are required for effective emergency medical and public health response. The importance of protecting health infrastructure facilities and maintaining uninterrupted emergency medical services to the injured ones shall needs to be addressed upon. Some of the structural and non-structural measures to hospital safety, including state of the art of facilitating onsite establishment of field hospitals must be included along with case studies. 

Fig. 4: Caring for the injured (Haiti Earthquake 2010) ones in huge no. was not possible in Haiti due to poor economic status and inadequate health care facilities in general. Even deploying medical team thru’ international agencies were  extremely challenging.