IRIN takes a look at some of the health lessons learned from four large earthquakes in the past decade - India (2001), China (2008), Chile (2010) and Haiti (2010).
India
The 7.6 Richter scale earthquake in 2001 that hit Gujarat State in western India killed almost 14,000 people, destroyed more than 1,800 health facilities, and partially destroyed 3,812 health centres, crippling the state’s ability to offer emergency care.
Since then:
Seismic-risk map created for Gujarat State
National seismic adviser created building guidelines according to seismic risk
UN Development Programme trained local communities on disaster preparedness in 13 of the state’s most earthquake vulnerable districts
International Committee of the Red Cross trained teachers and schoolchildren to handle injuries and water-borne diseases
Health facilities repaired, retrofitted and built closer to communities for quicker triage
Soil testing and building code norms applied to all health structures
Water storage capacity, electrical wiring, telecommunications, drug and chemical storage and laboratory facilities planned to withstand disasters
All health facilities must have emergency plans and triage protocols
Decentralization: hospital senior management authorized to take charge during emergencies. National disaster management act passed in 2005, which created state and district disaster management bodies
Health facilities assigned a manager trained in disaster response
Disaster drills carried out periodically
To do:
Advocacy training for non-health sectors and community representatives
Strengthen early warning system and map hazards nationwide
Start national chapter of Public Health and Emergency Management in Asia and the Pacific (PHEMAP) in 2010 to carry out regular training courses
China
On 12 May 2008, a 7.9 Richter scale earthquake - the deadliest China had had in more than three decades - rocked Sichuan Province, killing an estimated 87,000 people.
Conditions that helped contain the health care crisis:
Multi-agency emergency response
Cooperation between the military and civilians
Emergency response law in place since November 2007 that requires the government to provide accurate timely information during disasters
1997 law on protecting against and mitigating earthquake disasters
Earthquake administration at the national level with a secretary general that coordinates the army, police and government ministries
National health contingency disaster plan
Work plan for health response during earthquakes
Since then:
Guidelines on emergency management for health authorities established
National expert committee on health emergency response established
Equipment standards for emergency response set
Injuries caused by natural disasters researched
Training and simulation exercises carried out
Haiti
Haiti’s 12 January 2010 earthquake killed some 300,000 people– including health workers – wounded 250,000, resulted in 4,000 amputees and destroyed or damaged 30 out of 49 hospitals in affected areas, according to Health Minister Alex Larsen.
Conditions that helped contain the health care crisis:
Typically restrictive border policy with neighbour Dominican Republic was relaxed to allow paperless crossings for health care, and the delivery of supplies when airways were clogged
Immediate international response through hospital ships with operating capacities, evacuations and medical transport via helicopters and ships
Hundreds of health-related NGOs and volunteers
Contributions from diaspora
Pre-positioning of hurricane season stock that was readily available for relief
Security forces protected health workers
Priorities to clean water, epidemiological surveillance, immunization prevented epidemics
Activation of the “health cluster”, where all groups and individuals working on health issues after the earthquake coordinated and shared resources
To do:
Rebuild health centres to withstand most major earthquakes
Improved coordination of health volunteers and NGOs
Implement decentralized emergency care and draft national contingency plan
Create health contingency plan that includes management of cadavers, simulation exercises
Establish emergency communications system
Chile
The 27 February earthquake destroyed more than 80,000 homes and killed more than 480 people, 25 percent who died in post-earthquake coastal flooding. Eighteen out of 28 health districts were hit when the earthquake damaged 33 hospitals and destroyed another 10, affecting a total of three quarters of the country’s hospitals (135), according to Mirta Roses Periago, the World Health Organization regional director covering the Americas.
Health care reconstruction costs are estimated at US$2.8 billion; rebuilding is estimated to take up to a decade for some types of hospitals and at least six months for field hospitals.
To do:
Develop health care reconstruction plan
Evaluate 13 infrastructure improvement projects in non-affected regions (17 underway)
Re-evaluate national emergency plan
Continue health care operations with fewer health care facilities
Develop local capacities to face emergencies through training courses
Provide mental health care to health service workers
Reinforce epidemiological surveillance
Strengthen vaccinations
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