As search and rescue efforts continue, health facilities in the capital and affected areas are providing health care services to the affected populations. Time and again, due to lack of trained human resources and medical facilities, emergency health responses have not reached remote districts. Unfortunately, physical infrastructures of many health facilities have been severely damaged.Immediate public health risks are serious as earthquakes cause high mortality due to trauma. The wounds and injuries are widely visible due to the initial impact of the earthquake and subsequent rescue and clean-up activities. At this moment, it is evident that comprehensive health care needs are critically important during the first days and weeks.
During the disaster, the majority of the injured are likely to have minor cuts and bruises while a smaller percentage will suffer from simple fractures which demands immediate health response in the affected areas. In general, adults and children affected by disasters experience a substantial and diverse range of mental, neurological, and substance use problems. Grief and acute distress largely affect most people, and its impacts on health are enormous.
Mental health problems such as depressive disorder, post-traumatic stress disorder, or prolonged grief disorder—all of which can severely undermine daily lives—can appear. In addition, people with severe pre-existing conditions such as psychosis, intellectual disability, and epilepsy become even more vulnerable.
The 2010 earthquake that devastated Haiti had profound impact on Haitians' health and development. Ten months after the quake, cholera appeared in the country, for the first time in 100 years, leaving thousands of Haitians ill. Learning from Haiti, we need to plan for relief response to mitigate the future impact of disasters on individuals, families and communities.
The displaced populations are at high risk of water, sanitation, and hygiene-related diseases due to limited access to safe water and sanitation. It should also be noted that population displacement can result in overcrowding in resettlement areas, raising the risk of transmission of communicable diseases such as acute respiratory infection. Furthermore, overcrowding can also increase likelihood of meningitis, waterborne and vector-borne diseases.
The earthquake-affected populations are at an increased risk of malnutrition, especially in vulnerable groups such as young children, pregnant and lactating women and old persons. This risk is linked to lack of access to appropriate and adequate food, increased cases of diarrhoeal diseases and reduced access to health and nutrition services. The risk may increase due to lack of support for breastfeeding mothers.
Environmental risks resulting from poor management of waste, including health-care waste, can expose health-care workers, waste handlers, patients and the community to infection, toxic effects and injuries. This also increases the risk of pollution. From public health perspective, ensuring uninterrupted drinking-water is the most important preventive measure in reducing the risk of waterborne diseases.
Similarly, reproductive health interventions are important to ensure safe delivery and management of sexual violence, prevention of HIV transmission and contraceptives. These interventions are essential components of the Minimal Initial Service Package (MISP) for reproductive health, which is implemented in the acute phase of emergency.
During emergencies, information is important for rapid public health response in aid delivery. In addition, dissemination of information in timely and transparent manner also helps generate trust and credibility in agencies providing relief. This also helps to coordinate and harmonize support and relief services. In rapidly changing and unpredictable humanitarian environments, health-care providers are under enormous pressure to see as many people as possible in short time. In this situation, concerted effort of government, donors, civil society, and private sector are essential to ensure health and safety of affected populations. Multi-sector coordination is required to provide timely relief and health care services.
The author is a PhD research fellow in public health at Chulalongkorn University, Thailand
talk2jhabindra@gmail.com
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