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Tuesday, 30 March, 1999, 11:48 GMT 12:48 UK
Natural disasters
The Colombian earthquake could cause major health problems
Major health epidemics are rare in the aftermath of natural disasters, but some disasters are so great that large numbers of the population are displaced, creating perfect conditions for the spread of disease. Lack of clean water and the suspension of public health programmes all help illnesses, such as cholera to multiply. Often these illnesses can be more deadly than the original disaster.

The main causes of disease

Population movement, poor sanitation, water contamination and the interrruption of public health programmes are the main reasons for the spread of disease after natural and humanitarian disasters.

Often displaced populations are forced to gather in confined spaces, further enabling the spread of epidemics, such as cholera, malaria and dengue fever.

In Central America, which was hit by Hurricane Mitch in 1998, cholera was already epidemic.

Another problem is the number of injured people who need to be treated. According to the World Health Organisation, the presence of dead bodies is not a major factor in the spread of communicable diseases.

Cholera

The spread of cholera is one of the main dangers following a natural disaster.

Cholera is an acute infection of the gut which causes chronic diarrhoea and vomiting.

This can lead to severe dehydration and, in some extreme cases, death.

However, most people who are infected by the bug do not become ill and 90% of those who do are only mildly or moderately ill.

Cholera is spread by contaminated water and food. Sudden outbreaks, such as those which follow a disaster, are usually caused by a contaminated water supply.

The bug is most deadly when it arrives unexpectedly - as in times of disaster - because there are often no facilities for treatment or because people cannot get treatment in time.

In communities which are unprepared for a cholera outbreak, up to 50% of people who become seriously ill may die.

Cholera can be effectively treated with oral rehydration salts and antibiotics.

Containing a cholera outbreak involves ensuring there are proper sanitation methods for disposing of sewage, an adequate drinking water supply and good food hygiene.

Food should be cooked thoroughly and should not be contaminated by contact with raw foods, flies or dirty surfaces.

The only cholera vaccine that is widely available is less than 50% effective and only lasts up to six months.

There are two other vaccines that protect against one strain of cholera for a short period.

Emergency response to disasters

The WHO has an Emergency and Humanitarian Action programme that is responsible for coordinating the international response to emergencies and natural disasters in the health field.

Set up in 1993, it works with other UN agencies and national health ministries.

Its first task in an emergency is to conduct a rapid health assessment in the affected areas within 48 hours of a disaster.

It is then likely to set up an early epidemic warning system, measures to control communicable diseases, a programme for repairing key hospitals and primary care agencies which may have been hit by the disaster, water and sanitation measures and programmes for ensuring necessary medical supplies are available.

This may mean an appeal to international donors for supplies, but the WHO tries to avoid importing medical supplies. It says it does not want to duplicate resources supplied by international non-governmental organisations or create a dependence on foreign aid "which may overkill the long-term efforts WHO has successfully invested in emergency preparedness in the region".

The WHO policy is to work within the emergency measures set out in the country affected. One of the main health aims is to ensure hospitals and health centres are kept open in the most affected areas.

This page contains basic information. If you are concerned about your health, you should consult a doctor

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