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Kathryn Barbara LT, MSC, USN Navy Entomology Center of Excellence Jacksonville, FL

Environmental Health Site Assessments in Southeast Asia USNS MERCY (T-AH 19) 2006 Humanitarian Assistance Deployment. Kathryn Barbara LT, MSC, USN Navy Entomology Center of Excellence Jacksonville, FL. MERCY Deployment May – September 2006. http://www.cpf.navy.mil. Jolo, RP. Tawi Tawi, RP.

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Kathryn Barbara LT, MSC, USN Navy Entomology Center of Excellence Jacksonville, FL

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  1. Environmental Health Site Assessments in Southeast Asia USNS MERCY (T-AH 19) 2006 Humanitarian Assistance Deployment Kathryn Barbara LT, MSC, USN Navy Entomology Center of Excellence Jacksonville, FL

  2. MERCY DeploymentMay – September 2006 http://www.cpf.navy.mil Jolo, RP Tawi Tawi, RP Zamboanga, RP Chittagong, Bangladesh Simeulue Island, ID Nias Island, ID Dili, Timor Leste Banda Aceh, ID Kupang, ID Tarakan, ID

  3. U.S. Navy: Forward Deployed Preventive Medicine Unit (FDPMU) 1 Public Health Physician 1 Microbiologist 1 Industrial Health Officer 1 Environmental Health Officers 1 Entomologist 1 Biological Technician 6 Preventive Medicine Technicians U.S. Public Health Service: 2 Primary Care Physicians 2 Civil Engineers 2 Environmental Health Officers U.S. Air Force: 2 Public Health Officers 4 Physical Health Journeymen U.S. Army: 1 Veterinarian 2 Veterinarian Techs USNS MERCY (T-AH 19) Public Health Cell

  4. FDPMU-6Vector Component Mission • Conduct Environmental Health Site Assessments (EHSAs) on hospital grounds. • Provide vector surveillance and control to host nation (when possible). • Provide training and education in vector identification, surveillance, control to host nationals.

  5. Common Encounters • Filth Flies • Improper Waste Management • Accumulation • Disposal • Hazardous Waste • Mosquitoes • Larvae • Adults • Force Health Protection

  6. Waste Management • Trash accumulation

  7. Waste Management • Trash maintenance • Burning • Burying

  8. Waste Management • Biological Waste Disposal

  9. Waste Management • Biological Waste Disposal

  10. Waste Management • Trash disposal techniques • Patients and staff are often not educated in proper disposal practices

  11. Waste Management • Hazardous Material Disposal

  12. Filth Fly ManagementOur Contribution • Provided temporary control • Methomyl (Blue Streak) • Nithiazinine (Quick Strike) • Sticky fly paper

  13. Filth Fly ManagementOur Contribution • Suggested ways to improve solid waste management

  14. Mosquitoes • Larvae • Standing water common (commonly septic water) • Artificial containers • Open sewers and septic tanks • Adults • Limited surveillance conducted • Landing rates not conducted (inability to RON) • Interviews often revealed common disease vectors

  15. Mosquitoes • Common Issues throughout deployment area: • Rain water collection • artificial containers • often used for drinking or wash water

  16. Mosquitoes • Common Issues throughout deployment area: • Rain water collection • artificial containers • often used for drinking water • Open sewer systems • Culex spp.

  17. Mosquitoes • Common Issues throughout deployment area: • Rain water collection • artificial containers • often used for drinking water • Open sewer systems • Open or unsecured septic tanks

  18. Mosquitoes • Common Issues throughout deployment area: • Rain water collection • artificial containers • often used for drinking water • Open sewer systems • Culex spp. • Open or unsecured septic tanks • “Indonesian Style” toilets/ mandi

  19. Mosquitoes • Common Issues throughout deployment area: • Rain water collection • artificial containers • often used for drinking water • Open sewer systems • Culex spp. • Open or unsecured septic tanks • “Indonesian Style” toilets • Open windows or doors

  20. Mosquitoes • Adults • Limited surveillance conducted

  21. Mosquitoes • Adults • Limited surveillance conducted • Landing rates not conducted (often unable to RON) www.collier-mosquito.org/factsheet.asp

  22. Mosquitoes • Adults • Limited surveillance conducted • Landing rates not conducted (inability to RON) • Interviews often revealed prevalent disease vectors • Unable to leave secured area around hospital due to force protection concerns

  23. Larval insecticide applications No adult applications (inability to RON) Donations of larval and adult insecticides compatible with host nation equipment Advice on IPM techniques and equipment maintenance Mosquito ManagementOur Contribution

  24. Training Activities • Requested at nearly every location • The most valuable product delivered to the countries visited • Audiences consisted of: • Physicians, nurses, mid-wives • Medical/ nursing students • Sanitarians/ public health workers • Non-governmental organization members

  25. Training Activities • Classes were didactic and/or hands on • Class sizes ranged from 5-200 students • Topics included: • Mosquito biology, identification, and control • Country specific disease and vector information • Integrated pest management • Non-chemical pest management

  26. Training Activities • Development and distribution of educational pamphlets and posters

  27. Udana School of Public Health Students Kupang, Indonesia IOM Public Health Physicians Banda Aceh, Indonesia Chittagong Sanitarians Chittagong, Bangladesh Training Activities

  28. Overall Effectiveness/Lessons Learned • Training of host nation public health personnel is a high-impact activity for Preventive Medicine as component of humanitarian assistance missions. • Preventive Medicine team could have been more effective if they had the ability (and security) to asses community efforts. • Longer duration of visits would be more effective for preventive medicine efforts.

  29. Overall Effectiveness/Lessons Learned • Use of the FDPMU equipment set and personnel is appropriate for HA missions. • A preventive medicine professional should be a part of the advanced party. • Remaining overnight is required for effective vector control measures.

  30. http://www.cpf.navy.mil Thank You

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