Briefly Noted is a short PAHO/WHO monthly bulletin containing disaster news and notes. Please feel free to share this message with colleagues. To subscribe, send your name, organization and email address to disaster-newsletter@paho.org.

Our print newsletter, Disasters: Preparedness and Mitigation in the Americas is now published twice a year in September and March, allowing time and space for in-depth articles, interviews and other forms of technical support for disaster management. Back issues are online at www.paho.org/disasters.

Taking Care of Children in Disaster Situations

Many people believe that disasters affect everyone equally. However, reality demonstrates that the impact is overwhelmingly higher among vulnerable population groups such as the poor and children. Many disaster reports highlight the fact that the growing cost of disasters is due less to the increased frequency or magnitude of the events than it is to the growing number of vulnerable populations. Despite the fact that the weak, the poor and children make up the groups that are often disproportionately affected in disasters, they have not yet been at the center of preparedness efforts. Therefore, it is necessary to step up the production of guidelines, tools and training materials that target the protection of the health of these populations in emergency situations.

As a part of efforts to provide the best care possible to children affected by disasters, the Association for Health Research and Development (ACINDES) has already developed the course “Pediatric Education in Disasters,” at the request of the American Academy of Pediatrics (AAP) and in collaboration with the Pan American Health Organization (PAHO/WHO) and other institutions. This course, designed to train pediatricians to lead efforts to protect children, has been conducted in several countries in Latin America and the Middle East.

However, there is no such course or training material available for general physicians and surgeons, nurses, and other members of the health team involved in children’s health care in disasters. To fill this gap, selected experts from the Americas, from the Pan American Health Organization, from WHO’s Eastern Mediterranean Regional Office and ACINDES met recently in Buenos Aires to develop the fundamentals of a course, including the agenda, curriculum and contents. ACINDES is organizing the new material into manuals, guides for instructors and facilitators and supporting reference materials.

The new course “Protecting Children’s Health in Disasters” will use multidisciplinary educational activities to develop skills that help health personnel become more child-centered and ready deal with the needs of children in emergencies. View the course outline.

General Hospital in Grenada Tests Fire Readiness

Like many other hospitals, the staff of Grenada’s General Hospital had never participated in an internal disaster simulation exercise (the exception to this was staff from the Accident and Emergency Department). Although many hospitals in the Caribbean have a wealth of experience with simulation exercises, for the most part these have been limited to external exercises used to test areas such as the response to mass casualties.

However, when the Grenada General Hospital finished applying the Safe Hospitals Checklist, one of the areas found to be at high risk for fire was the facility’s oxygen bank. (The Safe Hospitals Checklist is part of the Hospital Safety Index. The standardized form assesses the safety of 145 areas of the hospital. The Hospital Safety Index was applied as part of a project to strengthen communities through safer health facilities in the Caribbean, funded by the European Union (DIPECHO) and executed by the Pan American Health Organization. Click here to learn more about the Hospital Safety Index.)

To correct this deficiency, the hospital decided test its readiness to respond to a fire. The objectives of the exercise were to successfully evacuate the surgical floor, test the hospital’s command, control and coordination procedures as well as crowd and traffic control, and assess the Fire Department’s response time and its ability to deal with an oxygen fire.

Smoke bombs were used to simulate a fire that started at the oxygen bank, which adjoins the hospital’s kitchen and workshop and which is also in close proximity to the administrative wing of the hospital. The hospital’s acting director made the decision to evacuate the surgical wards as a precautionary measure because oxygen lines were running directly to those wards.

The response time of the Fire Department was excellent, considering the distance they needed to travel and traffic congestion. However, once they arrived, the officers were not appropriately equipped to handle an oxygen fire. Nurses had to find creative ways to move non-ambulatory patients through the emergency exits. At the end of the one-hour exercise, the staff was unable to evacuate the 30 role-playing patients from the wards.

The public cooperated fully with hospital security at the entrance to the hospital. However, there was no control of the persons who were already inside the hospital compound, including the area where the fire was located.

The hospital’s Emergency Operations Centre was activated and the Minister of Health, Carl Hood and the Minister of State in the Ministry of Health, Ann Peters, joined the hospital staff in the EOC, demonstrating a commitment to the importance of this learning exercise.

Many lessons were learned that were shared with the Ministers and the hospital staff during the debriefing, including problems with the malfunctioning elevator, no fire escape in place and badly structured exit points for the hospital. The hospital plans to use the lessons learned to update the Hospital Emergency Plan and to implement the recommendations.

Just When You Thought Hurricane Season Was Over!

Hurricane season officially ends each year at the end of November, yet it is rare to see major hurricanes so late in the season. Hurricane Paloma was one of them. A powerful Category 4 storm with winds reaching 225 km/h (140mph), Paloma struck the Cayman Islands and later lashed Cuba on November 8, leaving up to 12in (30cm) of rain before exiting the island.

In Cuba, approximately 1.2 million people (almost 11% of the population) were evacuated in anticipation of the hurricane. Another 220,000 were relocated to 1,448 shelters, while the rest were housed in the homes of relatives and friends. Almost 10,000 homes in the municipality of Santa Cruz del Sur (province of Camaguey) were damaged and 1,353 were completely destroyed. Three family doctor clinics and a pharmacy in the area were affected as well. Safe drinking water remains a concern, although the municipality has a sufficient stock of supplies to disinfect water for human consumption.

Cuban authorities continue to implement measures in the recovery phase. Temporary accommodation and food are still being provided for people who have lost their homes. General cleanup and restoration of electricity and telecommunications are ongoing, as are repairs to roads/highways, railway lines and bridges.

The passage of Hurricane Paloma reminds us that the health impact does not disappear once the storm has passed. Haiti is a case in point. Although Haiti was spared the brunt of Paloma, four hurricanes and tropical storms made a direct hit earlier in the season and the effects still linger, particularly in Gonaives, where available resources are insufficient to meet needs.

Gonaives was one of the hardest hit areas, and more than two months after the storms much devastation remains. More than 30 malnourished children were evacuated from the southeast community of Baie d’Orange. While there has been some improvement in coordinating interventions among different sectors, targeting has been poor in some areas due to information gaps and restricted access.

Schools reopened in Gonaives on November 10—just three days after the tragic collapse of a school building that left 93 students and teachers dead and 162 injured. A second school partially collapsed less than a week later, injuring another seven 7 students, as confirmed by the UN Stabilization Mission in Haiti (MINUSTAH).

So far, only 48% of the US$ 105.7 million emergency appeal issued by the Haitian Government and UN agencies in response to the disasters of August and September has been funded.

Don’t Forget our Catalog of Disaster Publications!

Are you in need of authoritative information and guidelines about preparedness for your country? Looking for excellent resources for your next research paper or presentation on disasters? We have just the solution for you. PAHO/WHO’s Publications Catalog on Disasters and Humanitarian Assistance offers access to a wide variety of materials covering more than 32 subjects.

Excellent sources of information and training materials can be found in both English and Spanish on topics such as chemical accidents, water and sanitation, humanitarian assistance, volcanic eruptions, hurricanes, floods, managing dead bodies, epidemiological surveillance, and many more.

This catalog not only offers extensive information through documents and publications, but also, provides guidelines you can apply in your own country or local health sector. Learn how to assess risk in your local hospitals by using the Guide for Evaluators and Hospital Safety Index Evaluator Forms. Improve water quality in disaster situations by following the Guidelines for Water Quality Surveillance and Control in Emergencies and Disasters. In addition, you can also consult the list of “bestsellers,” back editions of the Disasters: Preparedness and Mitigation in the Americas newsletter, and our production of DVDs and CDs (the latter includes the Virtual Health and Disaster Library).

The Publications Catalog is available at www.paho.org/disasters under the “Publications Catalogue” tab. From there, you can also access the Regional Disaster Information Center for Latin America and the Caribbean (CRID) www.crid.or.cr, a website that offers a compilation of information and publications about disasters in the Region.

We wish you a safe and successful journey on your exploration through our Publications Catalog!