World Health Organization (WHO) Reducing Decreasing Health Standards Following Natural Disasters and. Humanitarian Aid

Transcription

1 World Health Organization (WHO) Reducing Decreasing Health Standards Following Natural Disasters and Humanitarian Aid Seahawk Model United Nations Conference 2018 Carsyn Baxter and Sara Ellis

2 Introduction Due to the catastrophic Haitian earthquake in 2010, it is estimated that $13.36 billion in aid will be sent to the country by 2020 (United Nations). This aid has been used for providing housing, food, water, and other sorts of aid to the people of Haiti, but it is not enough to handle the disaster that has ensued. After the calamitous earthquake, there was a devastating cholera outbreak in Haiti that has killed 220,000 people. Though the cause of the disaster remained unknown for a period of time, it was later discovered that the outbreak was caused by unsanitary dumping of waste into the Artibonite River. According to UN Office for the Coordination of Humanitarian Affairs (UNOCHA), the water-borne disease infected 21,666 Haitians in 2015, five years after the initial outbreak. With so many resources being poured into humanitarian aid, one would think that strict standards of disaster relief and humanitarian aid would have been put into place. However, many countries are still struggling with infrastructural, economic, political, and social barriers that are hindering the establishment of these standards. In 2012, the Sustainable Development Goals (SDGs) were drafted in Rio de Janeiro. These goals set specific targets for United Nations policy makers designed meet the economic, environmental, and political challenges that the world is being faced with. These goals replaced the Millennium Development Goals that were put into place in Up until 2015, these goals were the framework of international development. The new Sustainable Development Goals include achieving the eradication of extreme poverty and hunger. Goals three, six, nine, and eleven, however, are crucial goals when

3 it comes to increasing health standards in the event of natural disasters and the distribution of humanitarian aid. These goals are: Goal 3: Good health and well-being Goal 6: Clean water and sanitation Goal 9: Industry, innovation, and infrastructure Goal 11: Sustainable cities and communities By using these goals as an outline, the job of this session of the World Health Organization is to help countries develop disaster response plans and a procedure to safely and effectively distribute humanitarian aid. It is important that delegates look into all possible solutions: prevention of the spread of diseases, creation of infrastructure, promotion of community education, and international cooperation. The implementaion of these solutions will help to minimize future deaths caused by natural disasters, whcih over the last 20 years have killed 1.35 million people worldwide (UN Office for Disaster Risk Reduction).

4 Background Although only 33% of countries have experienced natural disasters, 4.4 billion individuals have been affected between 1994 and 2014 in developing nations. The majority of those killed (81% of the 1.3 million) were residing in less developed countries versus only 19% in higher developed nations. 1 The immediate danger to public health from natural disasters is blunt trauma and injury caused, for example, from the collapsing of building structures. Dangerous conditions become long-term problems as countries experience economic loss, infrastructural deterioration, and strain on health systems. Residents in developing nations face higher danger following natural disasters due to poor disaster relief plans and a lack of infrastructure. This contributes to negative health effects following natural disasters influenced by a heightened risk of disease outbreaks, contaminated water supplies, and injuries directly related to the weather event. Health infrastructure can be defined as a system that contributes directly to serving the health of a population. This includes but is not limited to emergency response systems, water sanitation plants, and hospitals. Hospital systems in developed countries are often built with at least one backup system to prevent disruption to the operation of the hospital. However, in less developed nations without the luxury of the backup systems, the ability to treat mass groups of injured individuals in disaster situations is challenged. Furthermore, the quantity of physicians, hospital beds, nurses, and surgical staff within a population is critical to determining a region s ability to protect civilians following a natural disaster. For example, the Philippines, a developing country, there is only 0.1 physicians per 1,000 residents. Developed nations 1

5 have a much larger physician population, such as Norway with 1.2 and Switzerland with 1.4 per 1,000 residents. 2 The presence and spread of communicable diseases following is exacerbated by crowding that takes place due to forced displacement of large populations, according to the United States Centers for Disease Control and Prevention. The World Health Organization agreed with this assessment when they explained that crowded living conditions create an ideal situation for the transmission of diseases, requiring higher immunization levels among populations in order to prevent outbreaks. Communicable diseases related to crowding include meningitis, acute respiratory infections, measles and pertussis. 3 Since evacuations following a disaster increase the risk for transmission of communicable diseases and the possibility of disease outbreaks it is essential that the international community formulate a method to minimize this issue. The risk of water and vector-borne diseases increases following weather events involving heavy rains and flooding because of contaminated water supplies, thus contributing to the spread of waterborne diseases such as cholera, dysentery, and hepatitis A. Additional habitat is also created by excess standing water for insects, such as mosquitos, to lay eggs in, leading to a higher risk of vector-borne diseases such as malaria, dengue fever, and yellow fever

6 Past Actions In order to reduce the risks associated with emergencies, The World Health Organization has started many initiatives that will also assist victims of disasters. The United Nations has established a day that helps empower women and girls when it comes to aiding in disaster relief. The International Day for Disaster Reduction is a day organized by the UN every year to promote a global culture of risk-awareness and disaster reduction. Held every October 13th, the day celebrates how people and communities around the world are reducing their exposure to disasters,and raising awareness about the importance of reining in the risks that they face. In October of 2016, IDDR marked the release of the new and improved Sendai Framework, in which the first goal is reducing disaster mortality. The framework, which is the successor to the Hyogo Framework for Action ( ), outlines disaster risk reduction both before and after disasters occur, and is set in place from Though this framework is crucial in establishing guidelines for in-need areas to follow, there are some weaknesses within the document and the plans involved with it. Cordaid, one of the largest developmental aid organizations in the Netherlands, points out that, the agreement recognizes that the resilience of communities is an essential part towards reaching sustainable growth and development. We all know that investments are necessary to accomplish this, yet Western nations in particular do not want to commit to financial agreements. The current text shows signs of weakness. Moreover, a number of essential parts of the agreement have been left out or have not been sufficiently established in this document. The goals of this agreement are not clearly defined and will ensue plenty of discussion. This means that in order for the plan to be efficiently

7 and successfully put into action, many wealthier Western nations must provide financial investments to countries that are less fortunate. Though these nations are much more wealthy, the amount they donate to foreign disaster relief is a small fraction of their national budgets. In the United States, the Office of Foreign Disaster Assistance (OFDA) received $1.4 billion USD for foreign disaster relief for the fiscal year from a $3.5 trillion federal budget, according to the OFDA 2017 Fact Sheet. This money was used to respond to 52 disasters in 52 countries. Other Western governments, such as the United Kingdom, also send money to countries in a post-disaster settings. After the 2010 earthquake that shook the small island of Haiti to its core, there was the danger of severe a cholera outbreak. The UK Government funded 115 doctors, 920 nurses, and 740 support staff from the region to set up 12 major cholera treatment centres and 60 subsidiary cholera treatment units through the Pan American Health Organisation according to the UK government website. Cordaid was one of the organizations present at the adoption of the document as a Partner of Resilience. These partners came to the signing of the Sendai Framework to show their commitment to reducing mortality in a post-disaster setting by establishing infrastructure and disaster-planning in nations. There are also many non-governmental organizations (NGOs) that work towards goals similar to those of this committee. Some of these organizations include SEEDS India, Pan American Development Foundation (PADF), Domes for the World (DFTW). These NGOs work towards establishing infrastructure within nations who are prone to being hit by natural disasters, something that is crucial in preventing long-term damage.

8 Another important aspect of this issue is helping to provide health standards and frameworks within nations who have not yet developed their own. After natural disasters, the sudden presence of dead bodies can pose a hazard to other victims of the disaster. However, WHO reports in WHO/CDS/NTD/DCE/2006.4, that health status and conditions in the area is what can cause a sudden and unexpected epidemic. The main hazards include inadequate water and sanitation, as well as poor access to health services. According to the WHO/UNICEF Joint Monitoring Programme (JMP), 844 million people in the world one in ten do not have access to clean water as of WASHwatch reports that around 289,000 children under five die every year from diarrhoeal diseases caused by poor water and sanitation. That's almost 800 children per day, or one child every two minutes. The first priority of many aid organizations after the 2010 Haitian earthquake was to renovate the technology in the area to deliver clean water to the inhabitants of the island. Employees from Martinique, Guyana, France,and the United States provided aid in setting up clean water systems for people in the Portau-Prince area, which has over 3 million inhabitants. Without clean water, the spread of disease can rapidly increase and cause the deaths of millions, as seen with the cholera crisis in the Artibonite River. Preventative health measures, such as vaccination, are essential to helping to lower mortality rates. The WHO estimates that immunization for communicable diseases such as pertussis and measles, can prevent millions of deaths worldwide. The WHO also reports that immunization can help prevent the spread of antimicrobial bacteria, a common issue following natural disasters. These resilient pathogens are

9 resistant to any sort of antibiotics, and therefore are extremely difficult to treat. After natural disasters, illnesses like pneumonia can wreak havoc on local communities, especially because of the lack of proper health services and standards. Although vaccines are the easiest way to immunize people around the world, the way to deliver these vaccines is not always plausible. The standard needle vaccination requires storage in a narrow, cold temperature range, from the point of manufacturing to the point of administration. This cannot be achieved in rural areas with little-to-no access to refrigerating technology. Vaccination requires trained professionals to deliver the vaccines, as well as proper disposal to contain the bio-hazardous waste. With many issues surrounding the standard way to deliver vaccines, scientists have begun to develop new, alternative ways to deliver them. Some of these methods include: Microneedle Patches: Microneedles are micron-sized needles that are manufactured with appropriate drug formulations and are directly penetrated into the skin. After a minute or so, the needles dissolve into the skin and release the correct dosage of a vaccine. This technology is painless, and can be applied like a bandaid in order to vaccinate the individual. However, this method of vaccination is not being utilized in a widespread manner due to a lack of development. Scientists and doctors see this technology becoming extremely popular for humanitarian aid in less developed nations. Oral Vaccines: Used in the treatment and prevention of polio, the oral polio vaccine (OPV) is relatively inexpensive. In 2011, the cost of a single dose for public health programmes in developing countries was between 11 and 14 US

10 cents. For several weeks after vaccination, the vaccine virus replicates in the intestine, then is excreted in the faeces, and can be spread to others in close contact. This means that in areas where hygiene and sanitation are poor, immunization with OPV can result in the passive immunization of people who have not been directly vaccinated. OPV is an extremely safe vaccine. Inhaled Vaccines: Inhaled vaccines are already used in many cases including influenza vaccines that are available in the form of a nasal spray. Some doctors who have started testing with inhaled vaccines ask, Why not go to the root of the problem? These vaccines are used mostly for respiratory diseases. Making sure that global citizens are both safe and healthy are goals that WHO and other UN bodies have worked towards for years. However, people around the world are still struggling with sanitation, health education, and infrastructural challenges. It is important that the council addresses innovative ways to help prepare and protect people from the wrath of these natural disasters. Current Events

11 Haiti Haiti s ability to protect and save lives as well as respond to mass injuries and causalities was challenged by major natural disasters. With lenient building codes compared to developed countries, powerful natural disasters, such as earthquakes and tropical cyclones that Haiti is frequently exposed to, result in thousands of deaths by collapsing buildings, bridges, and dams. 4 While the immediate health concern following natural disasters is death and injury by blunt force, health concerns arise as long-term problems following significant weather events. One of the most prominent situations that has occurred in recent years that involved a major health epidemic resulting from poor infrastructure and natural disaster is the current situation in Haiti. Multiple cholera outbreaks began following a sequence of weather events since 2010 including a 7.0 magnitude earthquake in January of 2010 and category 4 Hurricane Matthew in October of Cholera is a waterborne illness that impacts the gastrointestinal system of the body, caused by ingesting food or water that has been contaminated with the bacteria Vibrio cholerae. The initial outbreak of cholera involved in the chain of outbreaks that have a occurred in Haiti since 2010 was caused in part by the arrival of UN peacekeepers that traveled to the nation as members of the United Nations Stabilization Mission in Haiti (MINUSTAH) in 2004, who were originally brought to settle armed conflict throughout the nation. The illness s rapid spread, however, was due to infrastructural issues that had only worsened following the devastating earthquake that struck Haiti in January that had contributed to existing poor sanitation. The percentage of urban population in Haiti that had access to improved water sanitation facilities as of 4

12 2014 was approximately 34%, compared to 100% of urban populations in the United States, Italy, South Korea, and many more developed countries. Quickly following the first major earthquake to hit the nation that year, two additional earthquakes, known as the aftershocks of the initial quake, of magnitudes 5.9 and 5.5 occurred, and were followed by more aftershocks in the days and weeks following. The extent of building collapse, including the quantity of hospitals rendered unusable by health officials, were a direct consequence of Haiti s lacking of adequate building codes, and the country was still facing the repercussions of two tropical storms that struck in fall of Other infrastructural concerns included power failures and roadways blockaded by debris. India Another pressing matter in the world today is the extreme flooding faced by India each year as a result of annual monsoon rains. These floods pose great and numerous dangers to civilians. With these dangers worsening due to poor drainage systems, floods occur more frequently. Although heavy monsoon rains bring frequent flooding to various regions of India, the states of Tamil Nadu and Andhra Pradesh of southern India experienced rain 94.8 milliliters greater than average between October 1st and November 18th as a result of the yearly northeast monsoon. Tamil Nadu s capital city, Chennai, faced possibly the worst of the flooding aftermath, experiencing 41.3 inches of rainfall in November, the highest recorded amount of rainfall since November of 1918 with over 1,000 homes evacuated, 57,000 homes suffering structural damages, and at least 280 fatalities. With over 150,000 illegal building structures located in Chennai, poor urban planning methods in combination with a growing population are to blame for

13 the intensity of the flooding and extent of casualties, injuries, and displacement of Indian residents. 5 Southern Africa Severe flooding in southern Africa due to heavy seasonal rainfall and tropical weather systems has affected residents of Angola, Botswana, Malawi, Mozambique, Namibia, Swaziland, and Zimbabwe harshly since the beginning of In February of 2017, relentless rainfall in Mozambique resulted in as many as 44 deaths and 79,000 affected people, and an above-average rainy season in Malawi resulted in flash flooding across several districts causing over 7,200 displaced persons. 6 A heightened risk of water and vector-borne diseases, such as cholera and malaria, has occurred as well due to increased amounts of standing water. Chile On September 16th, 2015, an 8.3-magnitude earthquake struck just 29 miles offshore of Illapel, Chile resulting in the evacuation of over 1 million residents, but only 15 reported fatalities. The minimization of death and injuries in the 2015 earthquake compared to earlier seismic events was due to a sequence of infrastructural and emergency response improvements enforced by Chilean officials following the 8.8- magnitude earthquake in 2010 that resulted in 521 casualties, 56 missing persons, and 12,000 injuries. 7 In 2010, Chile was less prepared than they were for later earthquakes; due to premature announcements by government officials allowing the public to return United States Geological Service

14 to their homes and failure to provide a tsunami alert, many residents returned to areas that were later hit by powerful waves from the tsunami triggered by the earthquake and consequent aftershocks. Officials took action following the event to improve emergency alert systems, evacuation procedures, and raising construction standards to allow buildings to withstand powerful shaking from earthquakes. 8 The Philippines On November 7, 2013, category 5 Super-Typhoon Haiyan made its first of six total landfalls at Guiuan in Eastern Samar of the Philippines. As the strongest tropical cyclone ever recorded to make landfall on Earth with sustained winds at 195 mph, Typhoon Haiyan caused the Philippines to suffer over $2 billion in damages, approximately 6,300 casualties, and 4.1 million displaced people, affecting 11 million people in total. Cleanup efforts lasted several months, and bodies were still being found as of January 2014, nearly two months later. With already deteriorating transportation systems, frequent power failures, and existing water shortages throughout the Philippines, the frequency of tropical cyclones that strike the country each year challenge advancements in safety systems and economic growth, despite the Philippines holding one of the fastest-growing economies in Asia. 9 The trend of mass displacement by natural disaster has continued in recent years, with over 2.2 million displacements occurring in 2015 as a result from landslides, flooding, and storm surge initiated by heavy seasonal monsoon rains and four typhoons

15 Myanmar In May of 2008, category 4 Cyclone Nargis made landfall in southwest Myanmar, affecting nearly 2.4 million people according to estimates by the United Nations, including the deaths of over 84,500 people as well as over 53,800 missing persons. The situation in Myanmar is an example of the immediate health impact on populations in developing countries following natural disasters. With only 0.5 physicians per 1,000 residents compared to over 2 physicians per 1,000 people in most developed countries, weather events such as Cyclone Nargis strain health resources and the ability to efficiently care for mass populations of injured people. Low-altitude regions of Myanmar were affected the worst, with entire villages becoming submerged in flood waters caused by excessive rainfall and storm surge. Then vs. Now With Earth s population steadily rising above 1.1% each year, strain is already being placed on developing communities to supply safe and efficient city infrastructure. The percentage of people living in urban areas in projected to rise to 56% in Africa and to 64% in Asia by With this percentage growing worldwide, new residences and businesses are forced to be constructed in previously uninhabited areas that are more prone to danger by natural disasters, including growing populations along floodplains, coastal areas, mountainous terrain, and seismic zones, increasing risk of injury and damages in the event of tropical storm systems, landslides, earthquakes and more. 10 Although much of the world remains insufficient in areas of sanitation, emergency alert systems, and building safety, health indicators for all countries overall have 10

16 improved in recent years. The percentage of total world population with access to improved water sanitation facilities in 1990 was only 53%, but increased to nearly 70% in Goals for Committee The goals for this meeting of the World Health Organization include: 1. Discuss past disasters and the detrimental effects they had on health and infrastructure within the nation or region in which it took place. 2. Discuss how WHO and other organizations in the past both prepared for and reacted to disasters and address which areas they were both successful and lacking in. 3. Identify possible risks in a post-disaster state. These can be economic, political, social, or public-health related. 4. Establish guidelines and measures to be taken in states in order to limit economic, political, social, and public health impacts in a post-disaster state. 5. Help to create infrastructure in states to further limit damage in states. 6. Educate the public on proper sanitation practices to avoid the spread of communicable diseases after disasters. 7. Educate and train members of the public on aid relief practices such as nursing, construction, and other humanitarian needs. 8. Address preventative measures for the spread of pathogens and diseases such as cholera, tetanus, and typhoid. 11

17 9. Establish ways to hold aid workers accountable for actions that may result in disastrous effects for victims of natural disasters. 10. Ensure clean water supply for those living in areas where it is less accessible in new, innovative, and affordable ways. Guiding Questions 1. Other than the ones addressed in the guide, what are some major natural disasters and what were the major effects of them? 2. What have these countries done to prepare and to address said disaster? 3. Has your country been affected by a major natural disaster in the past? 4. How has your country provided aide to other nations who have been victims to major disasters? 5. Does your country have any guidelines in place for disaster preparedness? 6. What has the WHO done in the past to help establish guidelines and standards for disaster preparedness? 7. How can the WHO integrate economic and social inclusion and equality into plans it may make in the future regarding this topic? 8. How can we educate the public on matters such as sanitation, nursing, immunization, and planning in order to help areas prepare for natural disasters? 9. What are some NGOs that relate to the topic and what can they provide for states in times of need? 10. How can the WHO and other organizations involved obtain funding for said measures?