Earthquakes are amongst the most unpredictable natural disasters people can experience. In a matter of moments, with little or no warning, thousands and millions of people are in danger.
Spread of diseases is one of the imminent threats which survivors shall fear. However, not all we hear about public health concerns and cadavers being the source of epidemics is necessarily true. Nonetheless, we must try to prepare ourselves for such situations.
In the wake of a disaster, people naturally want to help. In addition, if the unthinkable should happen, what should I do if I was a survivor?
Health Consequences of Earthquakes
Inaccurate information on the public health consequences of natural disasters is commonly disseminated. This happens through informal channels of communication and relayed by the media which doesn’t check facts.
The problem with these myths and rumors is that they often mislead potential donors and inadvertently promote misallocation of resources. The truth is that, from a public health standpoint, situations normalize in a matter of a few weeks, if not days.
Immediate Health Problems
One of the most common myths is that cadavers are the source of epidemics.
The demand for health services occurs within the first 24 hours of an event.
Injured people may continue to appear at medical facilities only during the next three to five days. Afterwards, presentation patterns return almost to normal.
Patients tend to appear in two waves; the first consisting of casualties from the immediate area around the medical facility. The second is of referral as humanitarian operations in more distant areas become organized.
Victims of secondary disasters may arrive at later stages.
About 85% to 95% of rescuing missions at collapsed buildings occur in the first 24-48 hours after the earthquake. A week after the earthquake, the surgical and healthcare demand is typically back to normal.
Late arrival of referred patients and injuries due to secondary disasters may occur. Little information is available about the kinds of injuries resulting from earthquakes, but regardless of the number of casualties, the broad pattern of injury is likely to be a mass of injured with minor cuts and bruises, a smaller group suffering from simple fractures, and a minority with serious multiple fractures or internal injuries requiring surgery and other intensive treatment. Fatalities are nearly instantaneous with the event.
Epidemic Risk
Natural disasters don’t import diseases that aren’t already present in the area. Furthermore, outbreaks of communicable diseases don’t usually occur after earthquakes (and after any natural disasters) although the risk of an increasing incidence of sporadic cases (below epidemic threshold) exists.
Epidemic risk factors in the aftermath of an earthquake can be the rupture of water sanitation infrastructures. It also includes interrupting public health services and sanitation measures in urban settings. In addition to lacking control of vectors like mosquitoes and rodents.
Post-disaster sanitation measures and strengthening the disease surveillance are sufficient for controlling transmission of epidemic-prone diseases.
Management of Dead
One of the most common myths associated with natural disasters is that cadavers are the source of epidemics. In fact, according to the World Health Organization (WHO), the health hazard associated with dead bodies is negligible.
Contamination may occur in very limited cases when the cadavers are in contact with the water system and transmit gastro-enteritis. In the case of cholera, cadaver removal has little impact on the transmission of the disease.
Rather, the hygienic measures and the control of water quality are essential for controlling cholera. Diseases transmitted by mosquitoes such as malaria and dengue aren’t associated with the presence of cadavers. A relationship between cadaver and epidemics has never been scientifically demonstrated or reported.
However, the scientific argument can’t override the cultural obligation to take care of corpses, and the psychological consequences.
What is the Best Response?
We should focus on disaster relief to avoid duplication of resources covered by NGOs already present in the field.
Based on the 1999 experience in Turkey’s devastating earthquake crisis, national and international health agencies, including the WHO, cited secondary prevention and management of crush syndrome cases as the major needs facing health services and the survivors in an earthquake disaster region, such as Bam.
Crush syndrome refers to a host of serious medical complications that follow unattended traumatic injuries.
These things commonly occur in areas where rescuers can’t reach survivors for long periods of time.
In the immediate aftermath of an earthquake, trauma patients need to receive intravenous (IV) fluids and such fluids need to be available in large quantities in the areas of damage.
Question of Management
The management of crush syndrome cases requires dialysis for renal failure.
Assessment of hospital capacity in the country will measure the current hospital response capacity for the management of complex trauma patients. In general, disaster relief should be targeted and focused.
The direct shipment of inessential medical supplies isn’t helpful. This may lead to duplication of resources covered by international health NGOs already present in the field.
There is little question that during and immediately after a disaster, needs are acute and the human tendency to help and succor comes to the fore.
Yet, as the dust begins to settle hope rekindles. Also, the ability of most agencies to handle disaster assures that the survivors will be able to make the road to recovery.