By Ali S. Khan
Seeing images of the devastation in the Philippines reminded me of my own experiences with Hurricane Katrina and the Asian Tsunami. During both of those events, I had the honor to join CDC (and WHO in the case of Indonesia) teams to help re-establish crucial public health services and support the impacted communities. Disaster recovery isn’t just about rebuilding damaged homes and businesses; it has everything to do with health.
When something as devastating as Typhoon Haiyan occurs, it can be daunting to consider what a recovery effort might look like. Providing for basic needs and preventing potential injuries and outbreaks are usually at the forefront of any recovery plan. Despite the widespread devastation and lack of infrastructure people still need access to food and water. Groups with special needs, such as pregnant women or the elderly, still need care. These basic needs can present a host of health problems in the face of disaster. And as people begin to get their lives back in order, injuries from cleanup efforts and potential outbreaks due to contaminated food or water sources are a constant concern.
Stabilizing and Surveillance
The initial health response usually centers on setting up field hospitals, to take care of those who need immediate medical attention. We then turn our attention to disease monitoring efforts to understand the needs within the community and provide critical public health services. These services initially focus on environmental health concerns such as food and (especially) water safety, worker safety, and injury prevention.
Following an event such as a hurricane or typhoon – where you have excess flood waters – communities must be vigilant about preventing the spread of water borne illness (think E. coli or cholera), which often cause diarrhea and severe dehydration. Although these are two seemingly treatable symptoms, they can be difficult to manage when infrastructure is down and basic supplies (such as clean water) are hard to come by. Crowded and unsanitary conditions can also lead to the spread of disease. Following Hurricane Sandy, several recovery centers had to act quickly to halt the spread of norovirus, a common “stomach bug” that can spread quickly in close quarters. We’ve also learned about the risk of spread of communicable diseases within shelters and the need to provide select immunizations.
Cleanup can be a mess
Aside from possible disease outbreaks, one of the most common health problems we saw post-Katrina were injuries related to cleanup, people falling from ladders, carbon monoxide poisoning from generators, and cuts and lacerations people got moving through the rubble. Following a disaster health officials are often on the lookout for cases of tetanus or other wound infections. In 2011, after the F5 tornado struck Joplin, Missouri, a deadly fungal outbreak was discovered among those who had sustained wounds from the cleanup effort. Public health officials work around the clock after a disaster to warn the public of these dangers and track potential disease outbreaks before they get out of hand.
As the Philippines grapple with the mammoth effort of rebuilding their homes, roadways, and towns, they will first have the task of addressing the health needs inherent to a major disaster. Disease pathogens and hazards are opportunistic and strike when we are at our most vulnerable. My thoughts are with the people of the Philippines and the aid workers helping to get the country back on their feet.
If you would like more information about recovery efforts or how you can help, please visit: http://www.usaid.gov/haiyan/.