Cyclone and health

One of the problems of preparing for natural onslaughts such as the cyclone that hit our east coast last evening is that we are always caught under-prepared despite met warnings and visits of chief ministers to the potential disaster sites to oversee preparations. 

The problems are understandably formidable with very  large number of vulnerable people living in ramshackle homes with scanty food reserves. The scenario is compounded by poor communication, proneness to crime and disinclination to follow instructions.

It is worth looking back at what happened after hurricane Katrina struck America in 2005. Despite the USA being far more resourceful than us, Hurricane Katrina brought with it flood waters, loss of power and livable space, created a breeding ground for mosquitoes and turned into crime havens. It caused molds to grow, endotoxin levels to rise, depleted clean drinking water, spoiled food, allowed diseases to spread. Close to 2000 people died and around 800 went missing after the storm, and the adverse health legacy still lingers on after 7 years.

The immediate concern is from being washed away or drowned by floods, for which staying indoors or preventive evacuation to safer zones is the best method.  Early casualties occur from trees and walls falling on people causing injuries to head and limbs. For this, there needs to be functional hospitals and clinics with easy access (remember roads may have been washed away making it impossible to carry a comatose person on the shoulders across flood waters).

For those who have survived the first strike, the next wave of disease and deaths come from infections:  diarrhoea, cholera, typhoid, skin infections, and pneumonia. Ensuring an adequate store of safe drinking water is an absolute necessity. It can be supplemented with disinfection tablets. With electricity wires snapping and poles falling, homes are likely to be without power; hence one needs to be prepared with alternate methods of cooking and cleaning water. Keeping a stock of antibiotics at home makes practical sense.

It is unpleasant but essential to be think-through and prepare how to deal with dead-bodies of those who die in and dispose bodies of dead animals. It is equally important to make sure that adequate facilities are made for people to defecate and urinate: these should be at a distance from where food is prepared, should be disinfected frequently and should be in adequate numbers. This step is essential to prevent outbreaks of disease amongst huddling survivors.

The effect of such natural disasters on the mind can be significant: it starts with fear, is followed by horror, and then replaced often by a sense of anger or grief. These feelings often interfere with rescue operations, rehabilitation and even survival. Loss of crops, livelihood, home, relatives and sometimes health makes a deadly combination.

For those who survive, life usually never returns to quite normal: anxiety, depression and a sense of permanent loss often persist for the rest of life, much after the TV crew and their cameras have left.

As published in HT City ( Hindustan Times) dated 13 October, 2013.