Introduction
The force of a hurricane makes a devastating influence on the infrastructure of small island countries, leaving people without electricity, drinking water, and roads. Over the past ten years, the level of damage caused by floods and hurricanes amounted to more than $ 21 billion (Schwartz et al., 2018). The patterns of human health are also largely impacted by this natural disaster. It is possible to expect the onset of such infectious diseases as watery diarrhea, respiratory complications, and vector-borne diseases. In addition, the compromised critical facilities, including communications, hospitals, and gas, can deteriorate the state of people with chronic conditions. This report aims to shed light on the potential diseases that may appear as a result of the hurricane in order to provide feasible recommendations on their prevention.
Destroyed Infrastructure Threats
The hurricane that flooded the given island country largely affected buildings and facilities that provided services to the population. Considering that many buildings were flattered, it created the additional threat of their destruction due to cracks in the walls. Accordingly, people who were not evacuated and those who sought to be sheltered in them tend to be at a risk of injuries and death. McMichael (2015) claims that the surrounding standing water contaminated with sewage since this system is broken, which is likely to lead to tuberculosis, meningitis, cholera, et cetera. Since many people have to stay in camps or buildings without proper sanitation, it causes the endemic infections that are known to flourish after disasters. In other words, even one person having an infectious illness can contaminate others (McMichael, 2015). In this case, it should also be taken into account that the treatment plants are inoperable, which is associated with greater risks for the population walking in this contaminated water to have typhoid and hepatitis.
The collapse of communications, electricity, and gas deprived people of the ability to warm themselves, boil water for drinking, and call for help. This is associated with the threat of dehydration, chilblain, diarrhea, fever, and skin diseases (Saulnier, Ribacke, & von Schreeb, 2017). In addition, the fact that the roads were blocked without the opportunity to ensure vehicular traffic creates the difficulty with the transportation of injured persons and those who were locked in their houses. The water that submerged the roads and bridges degraded their integrity and left many people without the means of moving from the devastated area.
Impact on Infectious Diseases and Chronic Conditions
Water pollution is one of the key public health concerns since raw sewage spilled into the streets and buildings where the population should stay for a long time before the evacuation. The non-operational nature of treatment plants along with untreated sewage impacted the recreational water and reopened the most of shellfish water. A range of vector- and water-borne illnesses include such infectious risks as conjunctivitis, dermatitis, as well as throat and ear infections (“Flooding and communicable diseases fact sheet,” n.d.). The water becomes the mediator of diseases, while the mentioned conditions are not likely to turn to epidemics. Wound infections of people can contaminate those persons who also have injuries received in the course of the hurricane, before, or after it.
Leptospirosis, the bacterial infection transmitted via mucous membranes, can result from the direct or water contact with dead animals and humans. According to the World Health Organization (WHO), it is regarded as an acute infection characterized by intoxication with pronounced pain in the muscles, primary damage to the kidneys, liver, nervous and vascular systems, which is often accompanied by the development of hemorrhagic syndrome and / or jaundice (“Flooding and communicable diseases fact sheet,” n.d.). The source of the infection is sick and recovered wild and domestic animals that infect water and soil and form natural and mixed foci. Natural foci are due to the presence of infection among wild animals, which can also be found in the lakeside basins, marshy grass areas of forests, and in the standing water after disasters. Small rodents and insectivores are the key carriers of the infection along with cattle and pets.
Another direction in the onset of infectious diseases resulted from the identified hurricane refers to vector-borne issues. In particular, standing water can be the basis for breeding sites and the subsequent increase in the number of mosquitos that would spread the infections, such as malaria, dengue, and West Nile fever. With the receding of water, the outbreak of malaria may take only six-eight hours (Ahmed & Memish, 2017). Malaria and Zika virus are acute human infectious diseases caused by plasmodia and Aedes mosquitos accordingly, which are parasitic in the blood. The disease is characterized by febrile seizures, damage to the liver and spleen, anemia, and a relapsing course. The transferred disease does not leave a stable immunity even to the type of parasite that caused the disease, and the most serious complication is malarial coma, which is fatal without intensive specific therapy.
The risks caused by corps should also be taken into account as they present a significant threat: infections tend to survive for some time once their carriers are dead. For example, some bloodborne viruses such as human immunodeficiency viruses (HIV) can remain active up to six days after human death (Zorrilla, 2017). Gastrointestinal infections and tuberculosis are the two most common infections, which are typically transmitted via a fecal-oral route in the water. Tuberculosis agents may also be transferred when a person coughs or sneezes. People with weakened immune systems are much more likely to develop active tuberculosis. The likelihood of developing active tuberculosis is also high with HIV: in 2015, people with HIV accounted for 1.2 million (11 percent) of new cases of tuberculosis worldwide (Zorrilla, 2017). A lot of people who become infected do not show symptoms of the disease since the tuberculosis bacterium can live in the body in an inactive form. In most cases, the disease affects the lungs, and the symptoms comprise fever, persistent cough, chest pain, and dyspnea.
Considering the aggravating factors that are evident in case of the hurricane, the risk of malaria and other related infections raised drastically. Overcrowding, the inability to timely receive care services, and prolonged location outside lead to changes in human behavior (“Flooding and communicable diseases fact sheet,” n.d.). In this connection, anxiety, fatigue, shock, and other psychological factors are likely to set additional pressure on one’s health systems. In some places, people would have to wait for the dirt to dry completely to be able to move. This densely populated country would also experience an acute shortage of drinking water and rapid disease spread in the affected regions. A lack of food and water may affect not only the health of people, but also increase the risk of social conflicts over access to the scarce yet vital resources.
People trying to reach a hospital or other viral services, who had to walk into the water and by the obstructed roads, are more likely to meet roaming or dead animals. The latter present a higher risk of toxic waste contamination for persons walking around, which can occur by means of water and the contact with the skin, mouth ears, and nose. Among the most concerning infections, one may identify zoonosis that is a group of infections providing the potential to be transmitted from animals to humans. Blastomycosis, rabies, and intestinal Illness are the most widespread diseases that can be acquired during the aftermath of the hurricane since dead mammals leak feces, and spores can be inhaled by people.
Health care delivery insufficiency or the complete loss of the ability to provide services to the population is especially dangerous for people with chronic diseases. Cancers, respiratory problems, diabetes, and cardiovascular issues may be enumerated among those conditions that are associated with jeopardizing their care needs and leading to complications and deaths (Ryan et al., 2015). For people with the developing infection and having chronic obstructed pulmonary disease or asthma, dyspnea can be fatal if they have no drug intake opportunity. In their turn, persons with heart concerns are likely to develop a more acute response to long exposure to contaminated water and hydration insufficiency due to their deep vein thrombosis, coronary heart disease, et cetera (Ryan et al., 2015). Those with diabetes and / or cancer, being deprived of monitoring their condition and transportation means, are likely to encounter severe exacerbations and death. In addition, traumas and other chronic health problems may also become acute driven by the hurricane experience.
The social considerations regarding the hurricane consequences in terms of public health involve the decrease in the social functioning of the population. In particular, According to statistics provided by the United Nations, of all natural disasters, floods and hurricanes cause the highest levels of loss and damage to humanity (Schwartz et al., 2018). There are also social behaviors that affect the disaster chain, which demonstrates that risk awareness plays a rather important role. From the contextual stance, the response is a complex process, in which there are many social characteristics. For example, many members of society do not have the opportunity to change their residence to a safer area. People are not informed about risk and its potential impact on their health. They only plan their near future and do not present their capabilities in compatibility with disasters, rely on rapid aid from the government. Thus, post-traumatic stress disorder (PTSD) and depression tend to develop after natural disasters since people lose their typical way of life and turn out to be unready to recover.
Recommendations
In order to assist the population in recovering from the hurricane and reduce the inset of infectious disease, it is essential for the country to provide specific services. First of all, the local authorities should be focused on restoring clean water supplies (Ryan et al., 2015). Although this decision can save countless lives throughout the island, not all the population is likely to receive access to it. Therefore, in addition to the water supplied, new sewage treatment plants should be established as soon as possible. At least, temporary facilities should be constructed to avoid epidemics and allow people to address hydration needs. After a disaster of this magnitude, sanitary prevention is the most appropriate strategy: rehydration points where people can quickly have an oral rehydration solution to prevent serious dehydration can be organized (Ryan et al., 2015). In addition, nurses on duty who can promptly assist patients with suspected cholera or other serious diseases should be allocated in such centers.
In the long term, the structure of health effects from contagious diseases contains chronic diseases, mental disorders, and diseases associated with poverty, including malnutrition due to lack of water or healthy food. Therefore, Zorrilla (2017) stresses that increased attention to flood vulnerability and the hurricane impact on social development, economics, and health is necessary to overcome the health consequences of the population. An integrated approach to events and activities related to medical consequences during the elimination of the hurricane outcomes is a priority to combat them. The focus of institutions in terms of hygiene and anti-epidemic provision is a prerequisite for a quick solution to the onset and reduction of infectious diseases among the affected persons.
The preventative measures seem to be critical to conduct to prevent similar devastation in the future. The international organizations can be asked to provide technical equipment, logistical support, and planning assistance to the local authorities during vaccination campaigns. The evaluation of the food supply situation and the distribution of mosquito nets and hygiene kits in hard-to-reach settlements throughout the potential flood-hit region is another strategy (Zorrilla, 2017). Health care specialists should perform educational and advisory work to help people in realizing how the effects of hurricanes and other disasters can affect their physical and psychological states. In case of the suspected outbreak of an infectious disease, it is necessary to work with the population by explaining what the disease is and how to protect from it. It is possible to go to homes and tell the population about protection from cholera and malaria and where to get treatment in case of illness.
In addition, although it is regarded that insurance is one of the main tools of economic support for the suffered population, in developing countries, insurance costs are more inflated and difficult to access. In fact, disaster insurance has a high level of financial expenditure, and only national and transnational companies can be a source for insurance to compensate for the losses caused by significant natural disasters. In such countries, the government agencies can also take on such responsibilities, and there will be certain types of insurance support. In general, it can be stated that today, the assets of insurance companies to support the poor and rural communities are less accessible in developing countries.
Conclusion
To conclude, it should be emphasized that the country experienced an acute shortage of drinking water, timely medical services, and the potential onset of various infectious diseases. In particular, malaria, fever, cholera, and acute respiratory diseases were revealed as those that tend to spread rapidly. Professional monitoring of devastated areas, timely treatment, and responsible approach based on the preventative measures compose the key to successful recovery without the development of life-threatening complications. At the same time, the awareness of the population and the proactive approach of the government in responding to the hurricane consequences are likely to minimize the adverse impact of this natural disaster.
References
Ahmed, Q. A., & Memish, Z. A. (2017). The public health planners’ perfect storm: Hurricane Matthew and Zika virus. Travel Medicine and Infectious Disease, 15, 63-66.
Flooding and communicable diseases fact sheet. (n.d.). Web.
McMichael, A. J. (2015). Extreme weather events and infectious disease outbreaks. Virulence, 6(6), 543-547.
Ryan, B., Franklin, R. C., Burkle Jr, F. M., Aitken, P., Smith, E., Watt, K., & Leggat, P. (2015). Identifying and describing the impact of cyclone, storm and flood related disasters on treatment management, care and exacerbations of non-communicable diseases and the implications for public health. PLoS Currents, 28(7), 1-21.
Saulnier, D. D., Ribacke, K. B., & von Schreeb, J. (2017). No calm after the storm: A systematic review of human health following flood and storm disasters. Prehospital and Disaster Medicine, 32(5), 568-579.
Schwartz, R., Tuminello, S., Kerath, S., Rios, J., Lieberman-Cribbin, W., & Taioli, E. (2018). Preliminary assessment of hurricane Harvey exposures and mental health impact. International Journal of Environmental Research and Public Health, 15(5), 974-983.
Zorrilla, C. D. (2017). The view from Puerto Rico — Hurricane Maria and its aftermath. New England Journal of Medicine, 377(19), 1801-1803.