The importance of health action in disasters

The importance of health action in disasters

Access to healthcare is a critical determinant for survival in the initial stages of
disaster. Disasters almost always have significant impacts on the public health and
well-being of affected populations. The public health impacts may be described
as direct (e.g. death from violence and injury) or indirect (e.g. increased rates of
infectious diseases and/or malnutrition). These indirect health impacts are usually
related to factors such as inadequate quantity and quality of water, breakdowns in
sanitation, disruption of or reduced access to health services and deterioration of
food security. Lack of security, movement constraints, population displacement
and worsened living conditions (overcrowding and inadequate shelter) can also
pose public health threats. Climate change is potentially increasing vulnerability
and risk.

The primary goals of humanitarian response to humanitarian crises are to prevent
and reduce excess mortality and morbidity. The main aim is to maintain the crude
mortality rate (CMR) and under-5 mortality rate (U5MR) at, or reduce to, less
than double the baseline rate documented for the population prior to the disaster
(see table on baseline reference mortality data by region on page 311). Different
types of disaster are associated with differing scales and patterns of mortality
and morbidity (see table on public health impact of selected disasters opposite),
and the health needs of an affected population will therefore vary according to the
type and extent of the disaster.

The contribution from the health sector is to provide essential health services,
including preventive and promotive interventions that are effective in reducing
health risks. Essential health services are priority health interventions that are
effective in addressing the major causes of excess mortality and morbidity. The
implementation of essential health services must be supported by actions to
strengthen the health system. The way health interventions are planned, organised
and delivered in response to a disaster can either enhance or undermine the
existing health systems and their future recovery and development.
An analysis of the existing health system is needed to determine the system’s
level of performance and to identify the major constraints to the delivery of, and
access to, health services. In the early stages of a disaster, information may be
incomplete and important public health decisions may have to be made without
all of the relevant data being available. A multi-sectoral assessment should be
conducted as soon as possible 

Better response is achieved through better preparedness. Preparedness is based
on an analysis of risks and is well linked to early warning systems. Preparedness includes contingency planning, stockpiling of equipment and supplies, establishment
and/or maintenance of emergency services and stand-by arrangements,
communications, information management and coordination arrangements,
personnel training, community-level planning, drills and exercises. The enforcement
of building codes can dramatically reduce the number of deaths and serious
injuries associated with earthquakes and/or ensure that health facilities remain
functional after disasters.

(Edited by Friskila Damaris Silitonga SKep. NS. MPH)