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Hurricanes and illnesses

Tuesday, September 12, 2017

It’s an established fact that hurricanes named after women are more dangerous than hurricanes with male names. Seems that people simply take them on less so it’s calm before the storm, but no calm during the storm and no calm after… for long after.

The immediate effects of a hurricane (open wound injuries and deaths due to drowning from flash flooding, accidents and building collapse) can be and often are disastrous, so everyone is understandably concerned about these but the long-term health consequences, both physical and mental, can be equally as bad.

A recent article by my favourite health economist and fellow paediatrician Aaron E Carroll in the New York Times on August 31, “The Long-Term Health Consequences of Hurricane Harvey” documented some of these.

First, communicable gastrointestinal and respiratory diseases spread amid the breakdown in water sanitation or from the amount of people crowding into shelters. Flooding brings the risk of contamination and disease like gastro, typhoid and cholera. When it rains, sewer pipes get infiltrated with storm water so both human and animal faeces gets into the water supply.

Flood water is contagious and has to be avoided, especially by children who love to play in it. If it is touched, it needs to be washed off and that is a problem. Where you getting clean water? Flood water may not recede for weeks.

Another worry is contamination from industrial waste and I look forward to descriptions of potential toxicity from companies that occupy the Point Lisas estate.

Various phases of flooding and storm disasters affect health. Wounds, poisonings and infections of the skin appear immediately.

Gastrointestinal infections increase some days later. Leptospirosis infections, from rat contaminated urine and diabetes-related complications can increase after weeks. That last may puzzle you. People with chronic conditions like diabetes, cardiovascular disease or respiratory illness are particularly prone to health problems immediately after a storm, and their care can be complicated by lack of necessary medications or access to medical records.

Patients with kidney disease need dialysis two to three times a week to avoid complications. Dialysis centres may be unable to function with all that means.

But hurricanes have longer-term physical and mental health consequences. Well after the event has faded as a top news story, victims continue to suffer.

This is the tragedy of modern news. If it’s not on the booby screen, it’s not happening. Social media may change this.

After Hurricane Katrina, the mortality rate in the New Orleans area was 50 per cent above normal for up 10 months after the storm. After one hurricane in Hawaii in 1992, deaths from diabetes went up in the year after.

Heightened rates of chronic illnesses can persist in flooded areas for decades. We don’t like to think of this but mental health always takes a beating after any natural disaster. These, too, can last a long time. We seldom think of this, but police and other first-responders also suffer excessively from mental illness.

Infants and children are not protected either from the effects of a storm. Negative effects on pregnant women’s physical and mental health and problems associated with getting to maternity services, can make pregnancy outcomes worse.

A man-made complication is the propensity for assisting agencies to send “milk” to damaged areas. To save the hungry babies, you understand. This is dangerous and associated with gastro outbreaks and increased mortality among infants. You need clean water to mix the formula.

The best thing to send is food and clothing for the women, strengthen them so that they can continue to breastfeed.

It’s understandable that everyone is focused on the immediate dangers of a hurricane. But Irma’s survivors will need attention and care far into the future.

We are so lucky we have not been hit by a hurricane recently. It’s only a matter of time.

Let’s hope we have a healthy government and a healthy Prime Minister in power when that happens


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