Health Management after Natural Disasters (PAHO)
Environmental health is defined as the control of those factors
in the environment that may have deleterious effects on people's
physical, mental, or social well-being. Because natural disasters
expose people to danger by disrupting or threatening to disrupt
their immediate environment, effective management of environmental
health after a natural disaster is of primary importance.
disasters often increase morbidity and mortality rates. Taking
appropriate measures to maintain environmental health helps to
reduce or eliminate the risks of preventable disease and death.
Such measures contribute not only to the health of individuals
in and near disaster-stricken areas, but they also contribute
to decreasing the high costs of providing emergency health services
in the aftermath of disaster.
environmental health measures that must be considered after a
natural disaster include the provision of appropriate shelter
for individuals or groups of people left homeless; the distribution
of safe and accessible water, first in sufficient quantities for
drinking purposes and then for other domestic uses; and the protection
and distribution of safe food products. Other measures that must
be considered for the control of environmental hazards associated
with disaster are sanitary evacuation for excreta, liquid wastes,
and refuse; protecting populations form common vectors of disease
in stricken areas; and promoting healthful living particularly
sanitary housing and personal hygiene.
effectively manage environmental health during and after a disaster,
it is crucial that a state of preparedness was in effect before
the event actually occurred. During an emergency, success largely
depends on exercising good, rapid judgement and appropriate response
measures. High-level decision makers therefore must be familiar
with sound measure beforehand and should be given an accurate
assessment of the disaster's specific effects as quickly as possible.
document is intended to serve as a guide for those who may be
called upon to make emergency decisions after disaster strikes.
The recommended environmental health measures have been listed
in the order of priority in which they should be taken during
an emergency. However, each natural disaster is unique in the
degree or type of emergency it poses. In response to any given
disaster, decision makers may find it necessary to change the
priority assigned to any particular measure.
proper reordering of priorities will be greatly simplified if
the principal objective of environmental health measures during
times of emergency is kept in mind. The object is to protect the
health of individuals who live in or near disaster-stricken areas
by keeping the deterioration of environmental health conditions
ans services to a minimum. Implied is that the specific objective
of emergency measures is to restore environmental health conditions
and services to whatever levels existed before disaster occurred,
regardless of judgements about predisaster quality. If predisaster
quality was less than desirable, the risk of disease will increase
only if environmental health conditions change for the worse,
all other things being equal. Measures to improve preexisting
conditions should be scheduled for the rehabilitation phase, not
the recovery phase.
document is divided into several parts. The first section primarily
addresses the effects of natural disasters on environmental health
conditions and services. In the second section, environmental
health measures are described that should be undertaken in each
of three time frames: the predisaster, disaster, and postdisaster