|Disasters Preparedness and Mitigation - Issue No. 64 - October, 1995 (PAHO-OPS, 1995, 8 p.)|
Chile: International Seminar on Medical Response
From 24 to 26 April 1996, the Health Services of Viña del Mar in Quillota, Chile, will host an international seminar on the health sector's response during disasters. The focus of the seminar will be to improve preparedness by updating disaster plans, and to facilitate interinstitutional and intersectoral coordination both in Chile and among other countries in the Region. The Ministry of Health of Chile, National Emergency Office (ONEMI), and PAHO/WHO are co-sponsors of the event. For details about the conference, please contact: Dr. Pedro Olivares Tirado, Hospital de Quilpue, Quillota, Chile; Tel: (56-32) 910-445/910-436/910-947; Fax: (56-32) 921875/926-837.
Central American: Emergency Response to Dengue
There is a growing threat of a full-fledged epidemic of dengue fever and its more dangerous form, dengue hemorrhagic fever (DHF) in Central America. According to PAHO's Communicable Disease Program, some 24,000 dengue cases have been reported this year in Costa Rica, El Salvador, Guatemala Honduras, Nicaragua. and Panama. as well as 352 cases of hemorrhagic dengue. Cases have also been reported in Mexico, Brazil, Venezuela, and areas of the Caribbean.
Dengue and the potentially fatal DHF are transmitted by the bite of the Aedes aegypti mosquito. Dengue hemorrhagic fever begins with acute febrile symptoms, accompanied by hemorrhage and eventual shock. It predominates in children, and the case-fatality rate can be as high as 1520%. While no vaccine or specific treatment is available for dengue, simple sanitation measures can get rid of the mosquito's breeding places.
Rapid control of the current outbreak of dengue and DHF requires a different approach to that used thus far. Short-term emergency response is needed, using mechanisms normally organized for disasters. An example of such a response is that of Cuba, which was faced with a serious outbreak of DHF in 1981. The epidemic was brought under control with disaster relief measures that mobilized the nation's Civil Defense and launched emergency campaigns to eliminate mosquitoes and breeding sites.
Managing this and similar emergencies demands immediate response
by the affected country and emergency humanitarian assistance from the
international community and donors. Funding is now being sought to support
national prevention and control programs, which include clean-up campaigns,
community education, spraying, treatment of water containers with larvicide, and
wide ranging surveillance activities. The United Kingdom has committed
US$300,000 to PAHO for control measures in Central America. and special funds
will be earmarked for different countries.
Mexico: Symposium on 1985 Earthquake
In September, Mexico's National Medical Academy, Ministry of Health, and PAHO/WHO organized a special symposium to commemorate the 10th anniversary of the 1985 earthquake, which cost an estimated 10,000 lives and devastated the infrastructure in Mexico City. The response of the health services to that disaster was remarkable. But the collapse of two major hospitals and serious damage in others showed that preparedness is not enough, and that investment in disaster prevention is necessary.
The symposium focused on how health and other sectors responded during the event, and what hospitals have done in the last ten years to lessen their vulnerability to natural hazards and to maintain a high level of preparedness. Participants also examined how the earthquake affected the development and strengthening of such institutions as SINAPROC (the National Civil Protection System).
Peru: Safeguarding Water Supply in Case of Disaster
Peru has made significant progress in applying disaster mitigation measures to their water supply and treatment facilities. The National Program for Potable Water and Sewerage reports that vulnerability analysis is underway in 20 of the country's water districts. Disaster mitigation and environmental protection measures are being included in service rehabilitation plans in 50 of the country's cities, including Lima. The program is being carried out in cooperation with the Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS).
Latin American Conference on Chemical Accidents
The First Latin American Conference on Chemical Accidents will take place in Buenos Aires from 22 to 25 November 1995. It is being sponsored by Argentina's Center for Chemical Emergency Information (CIQUIME), the WHO Program for Chemical Safety, and PAHO/WHO. The topics to be covered include risk analysis, response, national and international programs for preventing chemical accidents, and transport of hazardous materials. A simulation of a chemical accident will take place during the Conference. For more information, please contact: CIQUIME, Av. San Pedrito 220, (1406) Buenos Aires. Argentina; Tel: (541) 612-6912/6131100: Fax: (541) 613-3707; e-mail: email@example.com
Brazil: Society for Emergency Medicine
The recently established Society of Disaster and Pre-hospital Emergency Medicine in Brazil has 70 physicians as members and representatives from 15 of Brazil's states. The Society's main objectives are to encourage interchange with other specialists in the field and promote teaching emergency health management at the university level. For more information, please contact Dr. Luiz Henrique Horta Hargreaves, SOBRAMDEP, SQS 108-K406, 70347110, Brasilia, DF, Brazil.
Hurricane season '95 ... relearning lessons
The 1995 hurricane season has been a frenetic and destructive one, testing response capacity at local and international levels. We've nearly run through the alphabet this year: Hurricanes Erin, Felix, Iris, Luis, Marilyn, Opal, Pablo, and Roxanne caused widespread destruction in the Caribbean and Gulf of Mexico.
From 4 to 6 September, Hurricane Luis caused serious damage in Antigua and Barbuda, St. Kitts and Nevis, Dominica, and the Netherlands Antilles islands of Anguilla and St. Maarten. Public water systems were knocked out. The most important hospitals and majority of health centers on Antigua and St. Kitts suffered extensive damage. With roofs blown off or damaged, their power and communications systems were disabled, and medical equipment and supplies ruined. It is unacceptable for health services to continue to be paralyzed in such situations; the damage to the hospitals and health centers was mostly preventable. How often do we have to relearn the same lessons drummed into us by Gilbert and Hugo'?
Following this year's hurricane season, the following steps should be taken:
· Enact legislation to enforce use of building and maintenance standards in health facilities such as those in the Caribbean Uniform Building Code (CUBIC) and others. CUBIC is praised by many but no one has made it law;
Hurricane Hugo underscored the importance of collective Caribbean response. The message of the PAHO video, "Facing Disasters in Small Countries" (available from this newsletter's editor), still holds true: no small-island health sector has the necessary critical mass to be self-sufficient in case of national disaster. There is no unaffected area to call for reinforcements; essential staff may not report to work, justifiably concerned with the security of their own homes and families. Positive examples of regional cooperation can be seen in the case of nurses mobilized by PAHO to Montserrat from neighboring islands to assist populations displaced by the eruption of the Soufriere volcano, and Caribbean SUMA volunteers who traveled to islands affected by Luis to sort and inventory relief supplies.
During Hurricane Luis the roof, windows, doors, power and water supply were all lost in the building that housed the Antigua Emergency Operations Center and offices of the Ministry of Health, pictured here. Photo PAHO/WHO, D. Taylor