I.
Abstract
Natural disasters are catastrophic event that occurs
uncertainly. Infection of communicable disease is in high chance during and
after the occurrence of different types of natural disasters such as flood,
landslides, earthquake, hailstorm, drought etc. (World Health Organization,
2006). However, the risk of communicable diseases can be minimized by creating
and implementing a proper health management plan during the disaster. This
paper tries to find out the ways of managing communicable diseases and
minimizing its impact during and after the occurrence of natural disasters.
Keywords: Natural Disasters, Communicable diseases,
Sanitation, Management
II.
Introduction
There
is a saying that one disaster invites another disaster. Situation becomes worst
in disastrous situation and people become hopeless. Surviving in any cost
becomes the most important and then food and shelter becomes next main priority
to the victims. People may die and get injured in some massive natural
disasters like flood, earthquake, tsunami, and landslides. During such
situation, quality of water and food is compromised. Hygiene and sanitation do
not become priority because people are in panic mood. It is difficult to think
about hygiene when you hardly get any food to eat. It is not possible to wash hands
when you do not have enough water to drink. Thus, lack of hygiene and
sanitation invites another disaster of communicable diseases.
Diarrheal diseases may be a main contributor
to overall morbidity and mortality rates following by the disaster. Huge
numbers of the population are displaced into temporary crowded shelters. Common
sources of infection are contaminated water supplies and contaminated foods.
Acute
respiratory infections can also be a cause of morbidity and mortality in
emergency settings. The mixture of vulnerability, overcrowding, malnourishment,
and poor ventilation in temporary shelters increase the risk for pneumonia.
Many acute infections involve only the upper respiratory system and may be mild
and self-limiting. Lower respiratory infections, such as bronchitis and
pneumonia, generally are more severe and require medical attention and even
hospitalization.
Malaria
epidemics represent severe public health emergencies that take place with
little warning. When disasters occur in malaria-endemic areas where the public
health infrastructure is disrupted and highly vulnerable populations exist, the
probability of an epidemic is high.
Dengue
spreads rapidly and may affect large numbers of people during an epidemic.
Dengue Hemorrhagic Fever is related with high mortality, particularly in
children (Waring, S. C., & Brown, B. J.
2005).
Disasters
affect a community in many ways. Telephone lines, roads and other
transportation and communication links are often destroyed. Public utilities
and energy supplies may be disrupted. Substantial numbers of victims may be turned
into homeless. Portions of the community’s industrial or economic base may be
ruined or damaged. Casualties may need medical care, and damage to food sources
and utilities may create public health threats. The more remote the area, the
longer it takes for external assistance to arrive, and the more the community
will have to rely on its own resources, at least for the first several hours,
if not days.
Although
natural disasters do not usually result in outbreaks of infectious disease,
under certain circumstances, disasters may increase disease transmission. 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 (like in refugee camps), the disruption of piped water and
sewage, and the failure to maintain or restore normal public health programs in
the immediate post disaster period. The most frequently observed increases in
communicable disease are caused by fecal contamination of water and by
respiratory spread (for example, flu in evacuation camps). In the longer term,
an increase in vector-borne diseases occurs in some areas because of disruption
of vector control efforts, particularly after heavy rains and floods. Residual
insecticides may be washed away from buildings, and the number of mosquito
reproduction places may increase. Moreover, displacement of wild or
domesticated animals near human settlements brings additional risk of zoonotic
infection.
The
public and government authorities are usually greatly worried about the danger
of disease transmission from decaying dead bodies. Responsible health
authorities should recognize, however, that health hazards such as epidemics
associated with unburied bodies are minimal, particularly if death resulted
from trauma. It is far more likely that survivors will be a source of disease
outbreaks. Although the risks for rescue workers who handle dead bodies are
higher than for the survivors of a disaster, those risks can be limited through
a set of simple measures (Noji, E. K. 2005).
Death
rates in disasters are highly variable, depending on a number of factors such
as the type of disaster, the density, and distribution of the population,
conditions of the environment, degree of preparedness, and opportunity for
warning. The nutritional indices developed so far, such as weight-for-height,
etc., consider only one face of the problem. Malnutrition, and its corollary
food aid, affects the population through a variety of mechanisms, which may
range from effects on fertility and abortion, to price and market structures,
and the distribution of wealth. Much more study is needed to develop
appropriate measurements of the effects of malnutrition and to evaluate the
appropriateness of various forms of food aid ( Lechat,
M. F., 1979).
Natural
disasters have a variety of health impacts. These range from immediate effects
of physical injury and morbidity and mortality through to potentially long
lasting effects on mental health as well.
Flooding
may lead to mobilization of dangerous chemicals from storage or remobilization
of chemicals already in the environment such as pesticides. Hazards may be
greater when industrial or agricultural land adjoining residential land is
affected. However, there is insufficient research on flooding that causes
chemical contamination to detect any causal effect on the pattern of morbidity
and mortality in the affected populations.
Droughts
may have wide ranging effects on health including on nutrition, infectious
diseases, and on forest fires causing air pollution, particularly in low-income
countries.
Global
climate change could increase or decrease in the overall incidence, and the
duration of the transmission season, in particular sites. Small changes in
seasonality may be important, as transmission rates tend to increase
non-linearly in relation to the transmission season (Haines, A., et al 2006).
Flood
disasters are the most common (40%) natural disasters worldwide and have been
more widely documented than any other natural disaster. They occur globally and
are weather and climate change related events. Immediate injuries and deaths
that result from flood disasters are caused by drowning and blunt trauma. The
public health consequences of flooding include disease outbreak resulting from
the displacement of people into overcrowded camps and cross contamination of
water sources with fecal material and toxic chemicals. Flooding is also usually
followed by the proliferation of mosquitoes resulting in an increase of
mosquito-borne diseases such as malaria. The public health after-effects of
tropical cyclones (hurricanes and typhoons) disasters and tornadoes, especially
infectious diseases outbreaks, have been less documented compared with flood
disasters (Kouadio, I. K., et al 2012).
In
this way, managing communicable diseases followed by a disaster is one of the
challenges during and after the disaster. The government, social organizations,
and other stakeholders have to consider this issue seriously to minimize the
impact caused by those diseases.
III.
Literature Review
The
sudden presence of number of dead bodies near the disaster affected area,
contaminated water and food, unhealthy environment and lack hygiene and
sanitation invite several communicable
diseases such as diarrhea, cholera, flu, dengue and malaria (WHO, 2006). Thousands of people have died from Ebola in the world;
over the last 10-15 years, Middle Eastern Respiratory Virus (MERS virus), SARS
virus, and H1N1- mutated flu viruses. 100 million people are infected
worldwide, annually, with about 60,000 to 75,000 died per year from various
HFVs (Altura, 2016). Japan has three different areas of action to
manage communicable diseases during disasters—first, prevention, including
disaster preparedness, second, emergency response; and third,
recovery/reconstruction. It has been targeted to minimize the impact of
infectious diseases, such as tuberculosis (TB), parasitic diseases such as
malaria, and childhood diseases through immunization (Japan International
Cooperation Agency, 2015)
In China, incidents are classified
into four types: natural disasters, accidental disasters, social security incidents,
and public health incidents. Natural disasters and man-made disasters are
distinguished. Natural disasters refer to earthquakes, floods, weather change,
and other nature processes of the Earth. Accident disasters mean large-scale
traffic accident, contamination of the environment and radiation, etc. The main
goal of public health management is to minimize the impact of communicable
diseases followed by disasters on human health by providing timely health
services and sustain usual healthcare during and after disasters.
Administrative Departments of Health including NHFPC, the CDC system (Centre
for Disease Control and Prevention at different levels) and the public and private
hospitals all belong to the health sector in China and all of them are involved
in responding to public health emergencies (The Disaster and Emergency Management System
in China, 2016).
Modern technologies such as mobile
phones, social Medias, online Medias, radio, and television can be utilized to
spread awareness to be aware of communicable diseases in the time of disasters
(Jones & Adger, 2016).
Sudan had a huge impact in the flood of 2013. The flood
caused wide spread of communicable diseases, where 82.5% experienced many
diseases mainly as Malaria 41.8%, Diarrhea 34.1%,
Respiratory disease 13.7%.
Other diseases such as allergic and typhoid killed 2.9% population. One of the
studies found that household preparedness was very poor in the disaster-affected
area due to the lack of awareness. The victims were unknown about the steps of evacuation
and dealing with flood disasters. This shows the poor communication between
locality and households. That is why communication between government, locality,
and households play crucial role to be safe from the infectious diseases
(Imperial Journal of Interdisciplinary Research, 2017).
America
has been practicing educational knowledge and clinical practices to the local
nurses so that they could be assigned to save the affected population from
being infectious by probable communicable diseases. This practice became very
useful in emergency response (Barasso, 2016).
IV.
Findings
Where the natural disasters occur, there is high risk of
communicable diseases such as malaria, dengue, diarrhea, cholera etc. Disaster
itself does not invite such diseases, but it is the unmanaged shelters, human
behavior, lack of safe drinking water, and lack of sanitation and hygiene. There
has to be proper coordination among stakeholders to minimize the risk of such
diseases. Most of the disaster-related deaths are caused by the initial
traumatic impact of the particular incident. Disaster preparedness plans have
to be considered to fulfill the health needs of the surviving disaster-affected
population. The health impacts associated with staying together of large
numbers of victims with insufficient access to safe drinking water and
sanitation facilities, have to be prevented on time. They must be provided rehydration
materials, antibiotics and measles vaccination materials. Disaster response
teams must be aware of latest updated guidelines for communicable disease
prevention and have access to the WHO field manual on Communicable disease
control in emergencies (34) and the Sphere project’s Humanitarian
charter and minimum standards in disaster response (33). The risk of
communicable diseases followed by natural disasters is also connected to the
presence of dead bodies, health, and living conditions of the displaced
population. Safe water, sanitation, site planning, primary health-care
services, early warning system, and immunization are the major preventions for
the risk of communicable diseases during and after natural disasters (WHO,
2006).
V.
Conclusion
Nepal is one
of the disaster prone countries. We have to deal with different types of
disasters like flood, drought, earthquake, landslides, and hailstorm every
year. Those disasters not only affect large number of population, but also
invite so many communicable diseases. Survivors become more vulnerable during
the disasters. They don't have enough food to eat. They hardly manage a shelter
to hide themselves. Large number of victims has to stay together. It becomes
challenging job to provide safe drinking water to all of them. They cannot be
conscious about hygiene and sanitation as it is difficult get enough food. This
negligence invites communicable diseases.
When the 7.8
magnitude earthquake occurred in 25th April 2015, thousands of
people were displaced. It caused huge damages. 8,896 people died, 22,302 are
missing, 198 injured, 6,49,815 families displaced and 8,86,456 families are
affected by the earthquake. 6,04,930 houses were fully damaged and 2,88,856
houses damaged partially. Total material loss was of 7,065 million US$ (Post
Disaster Need Assessment-PDNA, 2015).
People
suffered from malaria, diarrhea, cholera and other water borne disease. There
was symptoms of psychological trauma, anxiety and depression some of the
survivors. Water
and sanitation needs have to be fulfilled through a diverse range of
context-specific strategies. There
has to be enough distribution of safe latrines, private bathing spaces and hygiene materials
especially for women and girls (ALNAP/ODI, 2015).
There must be
proper preparedness plan and policies to prevent the risk of communicable diseases
followed by natural disasters. We have to adopt all the lessons such as
preparedness, proper disaster management plan and its effective implementation
learned from the earthquake. Effective communication and coordination from
national level to local level plays crucial role to manage any kind of
disasters. Our national government must have a clear chain of commands and
coordination with local government bodies. The victims have to be provided with
safe drinking water, hygienic food, medicines, and safety. People must be aware
of getting infected by communicable diseases. Government can also run
immunization vaccine campaign for the victims, so that there will be less risk
of diseases. Free health treatment must be provided to the victims. A nation
has
Managing and
reducing the risk of communicable diseases is a challenging task but it is not
impossible. If the policy makers take this problem seriously, it can be
managed. Disasters are uncertain, so uncertain are diseases. Proper disaster
risk reduction planning by the national government, its effective
implementation, enough awareness regarding the infectious diseases, sufficient
availability of sanitation and hygiene materials, planned settlement of the
victims and sufficient health service can prevent all kinds of communicable
diseases during and after the occurrence of natural disasters.
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Journal of Hematology & Thromboembolic Diseases, Florida,USA.
Barraso, S.
(2016). A Model for Emerging Infectious Disease/Disaster Preparedness
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Campbell-Lendrum, D., & Corvalán, C. (2006). Climate change and human
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Chan, E., Liu K.S. & PS YEUNG, M. (2016). The Disaster and Emergency
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(2005). The threat of communicable diseases following natural disasters: a
public health response. Disaster
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