PAHO's Central American Disaster Office Strengthened

Dr. Rocio Saenz has joined the PAHO/WHO staff as a disaster preparedness officer for Central America. Dr. Saenz can be reached at phone: (506) 257-2141; fax (506) 257-2139; e-mail: rsaen@ netsalud.sa.cr. To contact PAHO's disaster advisers through-out the Americas see our web site: http://www.paho. org/english/ped/pedhome.htm (click on How to Contact Us) or consult the previous issue of this newsletter.

Hurricane Georges

Despite the devastating blow that Hurricane Georges dealt to the Caribbean, in some ways it was overshadowed one month later by the international coverage that focused on Hurricane Mitch. Nonetheless, Georges seriously affected the health sector of the Dominican Republic, Haiti and several countries of the English-speaking Caribbean, particularly Antigua and Barbuda and Saint Kitts and Nevis. The information that follows was excerpted from national reports prepared in the wake of Hurricane Georges. See page 1 for information on how to obtain the complete report.

Dominican Republic

Hurricane Georges was catastrophic in the Dominican Republic, with winds reaching 120 plus miles per hour and intense and prolonged rainfall that caused rivers and dams to overflow. Two hundred eighty-three people died and ECLAC estimated damages to all sectors to reach US$2 billion.

Although in the predisaster phase emergency plans and prevention measures could have been implemented sooner, once the hurricane struck, the Ministry of Public Health, together with other national agencies and international organizations, assumed leadership in mitigating the health effects and preventing outbreaks of diseases.

The health sector's postdisaster response activities were less affected by the actual impact of the hurricane than by the difficulties imposed by a lack of drinking water, the proliferation of disease-transmitting vectors, flooding, problems with drainage and collection of solid waste, food handling and overcrowding in temporary shelters.

Haiti

The mountains that separate the Dominican Republic from Haiti on the island of Hispaniola helped to diminish wind velocity as Georges entered Haiti on 23 September. But the hurricane, with its heavy and prolonged rains, caused serious damages in this country already suffering from a fragile economy and social infrastructure.

The most affected sectors were environmental health and drinking water, vector control and the epidemiological surveillance system. The cost of rehabilitation in the first two sectors was estimated at US$414.5 million; in the latter at US$515 million.

While the hurricane itself did not destroy any hospitals, in many cases pre-hurricane conditions in these facilities had left them vulnerable to the heavy rains and flooding. However, the hurricane may have provided the window of opportunity needed to continue the national policy of strengthening and rehabilitating the physical health infrastructure, a program that was already underway prior to the disaster. The hurricane also worsened existing problems in the water and sanitation sector and this placed the population at grave risk.

St. Kitts and Nevis

The JN France Hospital is the only secondary-care health facility in St. Kitts and Nevis and since opening in 1966, has suffered significant hurricane damage on ten separate occasions. The recent severe damage to several of the hospital's roofs was caused by water that entered from the roof, rather from the windows as had been expected and which had been boarded up before the storm. Having previously been devastated by Hurricane Luis in 1995, the roof of the JN France was, once again, destroyed.

Total health sector damage was estimated at US$4.5 million; lesser damages occurred to smaller health clinics and on the island of Nevis.

Thanks to funding from multilateral and bilateral donors, PAHO is focusing rehabilitation efforts on the maternity, pediatric and medical wards, and on the laboratory and eye clinic of the JN France. All external walls and several of the internal walls will be strengthened to become earthquake-resistant, and roofs will be completely replaced.

The vulnerability to disasters of the rehabilitated JN France Hospital is expected to be sufficiently low so that evacuation during hurricane warnings need not be necessary and the facility can function immediately following future hurricanes and earthquakes.

Antigua

Although Hurricane Luis left more widespread damage in 1995, Hurricane Georges did cause a major disruption of services in the Holberton Hospital (loss of power and the main water supply).

Many wards in the Holberton Hospital needed to be repaired following Luis, and those which had incorporated disaster mitigation measures into the rehabilitation efforts did not again fall victim to Georges. There was much less damage to other health centers and clinics, and island-wide, most operations were back to normal within one week.