Disasters: Preparedness and Mitigation in the Americas, Issue No.125, December 2017
Hurricanes Irma and Maria: health sector response
In the space of one month, several nations of the Caribbean were ravaged by two category 5 hurricanes packing winds of up to 160 mph (260 km/h). Hurricane Irma passed through 11 islands in the Caribbean starting on 5 September 2017, followed a week later by Hurricane Maria, which impacted six islands, including three in Puerto Rico, Turks and Caicos, and the U.S. Virgin Islands, that had already been hit by Irma. The total population of the islands is 37.2 million people.
The impact of these hurricanes ranged from moderate wind and rain on some islands to a significant loss of infrastructure and livelihoods in others. According to initial damage assessments, Antigua and Barbuda, Saint Martin, and Sint Maarten suffered an average loss of more than 85% of their infrastructure from Irma, while Anguilla and Bahamas were less affected, with an average loss of 30% of their buildings and infrastructure.
The country most affected by Hurricane Maria was Dominica, with more than 90% of the island’s infrastructure destroyed, including severe damage to the drinking water, electricity, and telecommunications services.4 Reported mortality was 37 deaths per 100,000 population, followed by Saint Martin and Anguilla with rates of 28 and 27 per 100,000, respectively. The highest total mortality was in Puerto Rico with 45 deaths, followed by Dominica with 27, and Saint Martin (information on Saint-Martin or Sint Maarten, or the whole island?) and Cuba, both with a total of 10 deaths.
The impact of the hurricanes went beyond physical infrastructure. Routine visits to health centers and hospital care were interrupted until those facilities could be repaired. There was damage to structures and to critical systems such as water, electricity, and communications. There was also damage to high-cost specialized equipment and medical supplies. Damages to roadways hindered the arrival of supplies to the affected facilities, which also affected health care.
According to preliminary data, as of 1 October 2017, 1,140 health centers in the Caribbean had to be repaired or rebuilt. (Cuba reported damages at 969 health facilities, while the other islands had a total of 171 damaged facilities.)
PAHO/WHO supported Member States during this emergency through response activities that included: activation of regional response teams to help national authorities assess health damages; restoring the capacity for medical care and access to health services in the most impacted areas; increasing epidemiological surveillance; support in the distribution of safe water; emergency sanitation and vector control measures; strengthened coordination of humanitarian assistance; and information management.
As of 11 October, 50 expert missions had been sent to 11 countries and territories of the Caribbean (Anguilla, Antigua and Barbuda, Bahamas, Barbados, British Virgin Islands, Cuba, Dominica, Haiti, Sint Maarten, and the Turks and Caicos Islands).
In order to resume operations in health facilities, support was provided to strengthen the capacity of national authorities to assess damages in hospitals. Joint evaluations were conducted in Anguilla, the British Virgin Islands, Sint Maarten, and Turks and Caicos to determine the functionality of critical systems in affected medical facilities.
The different ministries of health were provided with medical supplies, equipment, medicines, vaccines, and insecticides. These supplies were sent from PAHO’s strategic warehouse in Panama or procured from local and regional suppliers and transported by air or sea, with the support of the International Medical Corps (IMC), Direct Relief, the Dutch Navy, and other partners. In addition, vaccines were flown in from Haiti and Jamaica with support from the PAHO/WHO Strategic Fund in response to an urgent request made by Dominica and the British Virgin Islands.
Available capacity on the ground was used to solve problems, as exemplified by the case of Dutch engineers who coordinated with PAHO to repair the water plant at Dominica’s hospital.
The Medical Information and Coordination Cell (CICOM) was activated as a part of support for the coordination and monitoring of emergency medical teams (EMTs). At the time of this report, 12 teams were coordinating or reporting on their activities to CICOM. Nine of these 12 teams are active in Dominica, where they continue to support emergency efforts.
Hurricanes Irma and Maria demonstrated the importance of disaster preparedness. The health sector’s efforts facilitated the good response, reflected in the low number of deaths and affected hospitals, despite the destructive capacity of both events. The support of the international community will be vital for the recovery phase.
More information can be found on the PAHO Web site: www.paho.org/emergencies.