Haiti

Jeanne had already been downgraded to a tropical storm when it hit Haiti, but nonetheless, heavy rains caused serious flash floods in the Artibonite and North West departments of the country and left more than 1 ,800 dead. Health structures in the affected areas, already crippled by underdevelopment and years of political unrest, took a heavy blow. An estimated 90% of private and public clinics and the government hospital, serving a population of approximately 220,000 people, were damaged. Departmental health authorities, NGOs and other actors worked to reestablish basic health care. The Red Cross movement set up a field hospital. An epidemiological surveillance system was set up to identify, as early as possible, emerging epidemic health problems, vector control programs have begun again and a very basic cold chain was re-established.An enormous amount of work however remains to be done. One month after the disaster an estimated 2,500 families were still in need of shelter and the clean-up of Gonaives, the capital of the Artibonite, remains a high priority. Large quantities of mud and debris need to be removed, houses and roads rebuilt, schools and other public buildings cleaned and repaired. Food distribution will have to continue for some time, as crops were destroyed, leaving the population dependent on external assistance. Deforestation, poverty and political instability contributed to the high number of lives lost in the disaster and long-term assistance will be necessary to reduce the vulnerability of the Haitian population.

Dominican Republic

Strong rains brought on by Tropical Storm Jeanne caused heavy flooding in the north and northeast part of the country. Eleven provinces were affected. As rivers overflowed, communication with many areas was cut off, homes were destroyed or damaged and electric power and drinking water was lost.

Some 22,000 sought refuge in shelters and at least 37,000 people were evacuated from their homes. This situation raised concerns about an increase of communicable diseases already present in the area, such as dengue, malaria, leptospirosis, diphtheria and meningococcal disease.

Fortunately, the Dominican Republic has a well coordinated health services network, which was put into action as soon as the storm hit. All the main health facilities were evaluated and made ready with supplies and personnel. To avoid the spread of diphtheria and tetanus, all those in shelters and most children under six in the affected area were vaccinated.

Cayman Islands

When it comes to hurricane preparedness, the Cayman Islands ranks high. However, even this was not sufficient to withstand the force of Ivan, which battered the islands with winds up to 165 mph and generated a 20-foot storm surge. Fortunately, only two deaths were reported.

85% of housing in the West Bay area of Grand Cayman suffered damage; the sewage system collapsed and raw sewage contaminated the flood waters. The Bodden Town Civic Centre, a designated shelter collapsed at the height of the hurricane and had to be evacuated. The airport was completely flooded and without power for several days, and the island was left without communications of any kind for two days.

Fortunately, the capital, George Town, was on the sheltered side of the island and it weathered the storm fairly well. The hospital was recently built to hurricane standards and it held up to expectations. It provided shelter for homeless staff, relatives and many others for up to 2-3 weeks after the storm.

Grenada

Hurricane Ivan was a category 3 storm when it devastated the island of Grenada, destroying concrete homes, uprooting trees and ripping the roofs from many buildings. More than 30 people lost their lives and damage was estimated at about US$560 million (150% of the nation’s GDP).
The island’s only referral hospital, St. George’s, was damaged, but the wards remained operational. The Princess Alice Hospital suffered structural damage to more than 75% of the roof and could not function for a time. Although to some extent all health facilities suffered some damage, none was completely destroyed. Damage to individual facilities ranged from 5% to 75% of the structure. The cost to repair damage to health centers and hospitals throughout the island has been assessed at more than US$ 5 million. One month after the passage of Hurricane Ivan, more than 8,000 persons still remained in shelters.

Cuba

Cuba evacuated 1.3 million people—more than 10% of its population—from coastal areas of Isla de la Juventud and the provinces of Pinar del Rio and Havana. This opportune decision helped avoid a loss of life. Hospitals readied 5,000 hospital beds and 1,100 medical brigades. The storm downed power and telephone lines and trees in Isla de la Juventud and other areas, and destroyed many crops. There was also widespread damage to houses and other buildings, flooding in Pinar del Rio and blocked highways near Santiago de Cuba.

In Isla de la Juventud houses and other buildings were damaged and electric and telephone services were interrupted. In New Gerona, capital of Pinar del Rio, many streets were flooded. In Santiago de Cuba, at the east of the island the storm destroyed part of the main highway and blocked transit between that city and Pilon, 180 km. to the east.

St. Vincent and the Grenadines

In St. Vincent and the Grenadines, houses were damaged, but the main hospital in Kingstown did not sustain severe damage. There was no call for international assistance. However, in the islands of the Grenadines, the main hospitals in Union Island and St. Andrews lost their roofs. The island’s school also lost its roof. The storm downed trees, caused severe flooding and brought down telephone lines.

Jamaica

The eye of Hurricane Ivan passed 30 miles south of Jamaica, reducing the anticipated impact on the island. Preparedness measures were put into place and thousands of people were evacuated from potential danger zones to ensure safety. Fifteen people lost their lives, and 207 communities in 11 parishes suffered damages.
The National Emergency Operations Centre (NEOC) reported extensive damage to house roofs and roads. There was also widespread damage to infrastructure. Light and water services were cut off for some time after the storm had passed. Fallen utility poles and trees made several roads impassable. Damage to coastal roads in the east was primarily due to storm surges and flooding. There were also several reports of persons trapped in their homes due to cave-ins.
Jamaica suffered extensive damage to the environment and the agricultural sector was also severely affected. Losses were reported in livestock and banana industries. Many health facilities sustained some kind of damage, but were quickly brought back to service.

The Bahamas

Hurricane Frances affected all inhabited islands of the Bahamas chain; the most affected islands were San Salvador, Cat Island, Eleuthera, Abaco, Grand Bahama (the second most populated island) and parts of New Providence. Some of these islands house particularly vulnerable population groups. Two people died as a result of the hurricane, but more than 1,500 were evacuated to shelters; approximately 88,000 persons were at risk for vector and water-borne diseases due to water contamination and disruption of environmental health services.

The Princess Margaret Hospital in Nassau, a 400-bed hospital and the only hospital that provides tertiary care, only temporarily was forced to relocate patients. The Rand Memorial Hospital in Grand Bahama was partially evacuated due to infrastructure damage and flooding. The Bahamas has a network of 115 clinics strategically located throughout the islands to provide primary level health care. Several clinics were affected, significantly compromising the provision of health services.