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WASH Related Diseases. Session 2 Public Health Impact of Selected Disasters. Session Aim To understand the types of disasters and the types of public health impact associated with each type of disaster. Session Objectives – Describe one way in which disasters are categorised

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Wash related diseases

WASH Related Diseases

Session 2

Public Health Impact of Selected Disasters


Wash related diseases

Session Aim

To understand the types of disasters and the types of public health impact associated with each type of disaster


Wash related diseases

Session Objectives –

Describe one way in which disasters are categorised

Explain the risk of WASH related diseases in different types of emergencies

List the four major infectious diseases

Session Name here

3


Wash related diseases

Question to group

Are epidemics of communicable diseases inevitable after every type of disaster?


Wash related diseases

Myth

“Myth Number 3: Epidemics and plagues are inevitable after every disaster. Reality: Epidemics do not spontaneously occur after a disaster, and dead bodies will not lead to catastrophic outbreaks of exotic diseases. The key to preventing disease is to improve sanitary conditions and educate the public”

  • Source: Noji and Toole, 1997


Environmental wash related diseases

Environmental/WASH related diseases

  • Question to group?

  • What is the risk of WASH related diseases in different types of emergencies?


Public health impact of selected disasters

Public Health Impact of Selected Disasters

Source: 1st Draft, Health Chapter, Sphere, March 2010


Public health impact of selected disasters1

Public Health Impact of Selected Disasters

“Increased rates of morbidity and mortality due to communicable diseases occur more frequently in association with complex disasters than other disasters. In many of these settings, especially those occurring in developing countries, between 60% and 90% of deaths have been attributed to one of four major infectious causes:


Public health impact of selected disasters2

Public Health Impact of Selected Disasters

“CDC studies clearly documented evidence that mortality rates among refugee populations were sometimes 10 to 20 times higher than death rates in their countries of origin”

  • Source: Noji and Toole, 1997


Public health impact of selected disasters3

Public Health Impact of Selected Disasters

  • A recent review of over 600 geophysical disasters since 1985 found only three instances where such disasters led to epidemics (Floret et al., 2006, p. 543). This is hardly surprising as such disasters often lack the aggregation of populations which Topley’s work (1988) suggests is a factor in the biology of epidemics. Toole (1997, p. 79) makes the same point, that outbreaks of communicable disease are rare after natural disasters unless large numbers are displaced from their homes and placed in camps.

  • The problem with basing actions on myths is that resources that could be better used for dealing with real problems are frittered away on imaginary ones. Even though there was no confirmed case of cholera in Aceh, an immunisation campaign targeted 160,000 people with preparations for cholera (Guha-Sapir and Panhuis, 2005, p. 19) using an expensive two dose oral vaccine.

Source: ALNAP Lessons Earthquakes 2008


Public health impact of selected disasters4

Public Health Impactof Selected Disasters

  • Disaster response should be based on needs assessment and not on myths. As a review of health action after the 2004 tsunami noted: ‘There is no substitute[e], even in emergencies,for evidence based response’ (Guha-Sapir and Panhuis, 2005, p. 19).

Source: ALNAP Lessons Earthquakes 2008


Public health impact of selected disasters5

Public Health Impact of Selected Disasters

  • “More than 80% of current complex emergencies occur in malaria endemic areas”

  • Source: Malaria control in complex emergencies, WHO 2005


Public health impact of selected disasters6

Public Health Impact of Selected Disasters

  • Question to group

  • What are the four major infectious diseases associated with complex emergencies?


Communicable diseases

Communicable Diseases

  • Measles

  • Diarrhoea

  • Acute Respiratory Infections and

  • Malaria

Source: The Sphere Project, Health Chapter, 1st Draft, March 2010


Wash related diseases

Reported Deaths and Bodies Collected

Goma Area, Zaire, July 1994

Deaths Bodies % Dying

ReportedCollectedOutside Facilities

18/7-24/71,971 8,661 77.2

25/7-31/71,70729,513 94.2

1/8-7/8 652 7,361 91.2

Total4,33045,535 90.5

*Source: UNHCR/CDC Reports via Peter Salama, UNICEF, New York


Communicable diseases1

Communicable Diseases

“Acute malnutrition is often associated with increased case fatality rates of these diseases, especially among young children……..

…..Outbreaks of communicable diseases are far less commonly associated with acute onset natural disasters. When they do occur, they are generally associated with disruptions of sanitation and poor water quality”

  • Source: The Sphere Project, Health Chapter, 1st Draft March 2010


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