Critical decisions
Magnitude of the impact
Morbidity and mortality
Environmental sanitation
Food and nutrition levels
The local health center
Surveillance systems

Evaluating Health Sector Needs After Floods and Hurricanes (PAHO, 1989)

In spite of the frequency and severity of floods in Latin America and the Caribbean, relief efforts are often accompanied by confusion and inefficiency. Accustomed to dealing with disasters as acute phenomena marked by sudden increases in the loss of life and property, the international community often responds by providing expensive medical equipment, teams of specialists, emergency medical supplies and field hospitals. However, the most cursory examination will show that there is no dry ground where the hospitals can be set up and no acute traumas have occurred that the local personnel cannot handle. Even though media reports on "epidemics" during the early stages of a flood may be unfounded, health authorities feel pressured by public opinion to engage in urgent vaccination campaigns and aerial spraying, provide emergency food relief, and other such measures.

Paradoxically, since the impact of floods can last several months, the true health hazards may occur when media interest has waned and international aid has evaporated.

This lack of synchrony between the nature of the disaster and the relief offered is largely due to the lack of an appropriate method for assessing current needs. These needs vary depending on the prevailing stage in the disaster cycle and the type of disaster itself - earthquakes or floods, volcanic eruptions or hurricanes. A uniform methodology is required to assess these needs promptly and reliably, enabling the implementation of the correct short-term measures while - especially in the case of floods - establishing a longer-term control system to provide health authorities with early warning of late-developing risks.

This publication is a step in that direction, presenting a method for selecting pertinent data from appropriate sources based on the premise that, although each flood has its own peculiarities, key decisions must be made between fairly standard alternatives.