Global & Disaster Medicine

Yemeni healthcare system: Children dying of cholera in hospital hallways. Four sick people crammed into one bed. Patients connected to intravenous drips while sitting in their cars because the hospital is over capacity.


“…..The cholera outbreak has infected more than 200,000 people across Yemen, and it appears that 500,000 could eventually become sick. More than 1,300 people have already died…..”


Hundreds of families urgently evacuated apartments in five London high-rises  on Friday because the buildings all had exterior cladding and insulation similar to that used on Grenfell Tower

NY Times

Tropical Cyclone Potential in the western Pacific and Indian Oceans

US Precipitation Map

Daily (most recent day) Total Precipitation (millimeters)

Xinmo, China: More than 140 people in southwestern China are feared to have been buried under an avalanche of mud and rocks when a hillside collapsed on Saturday

NY Times

  • 40 homes appeared to have been engulfed


Yemen: 37 079 suspected cholera cases and 196 associated deaths during the period 13 June to 19 June 2017.


Weekly update – cholera in Yemen, 22 June 2017

22 June 2017 – The Ministry of Public Health and Population of Yemen has recorded a total of 37 079 suspected cholera cases and 196 associated deaths during the period 13 June to 19 June 2017.

A cumulative total of 185 301 suspected cases of cholera and 1233 associated deaths have been recorded as of 21 June during this outbreak, which started in October 2016. The overall case-fatality rate is 0.7%; however, it is higher among people aged over 60.

WHO and health partners are actively supporting the Ministry through a cholera task force to improve cholera response efforts at the national and local levels. This includes the establishment of 18 diarrhoea treatment facilities and 28 oral dehydration centres, training of health workers to manage cases, water purification in communities, deployment of rapid response team to manage cholera cases investigations and respond to the outbreak, enhancement of Yemen’s disease early warning surveillance systems, and provision of emergency medical supplies to treatment facilities.

Cholera has affected around 268 districts in 20 governorates across the country. While cholera is endemic in Yemen, the country has experienced a surge in cholera cases since 27 April 2017.

WHO and the King Salman Centre for Humanitarian Aid and Relief recently agreed to provide around US$ 8.3 million through health partners to support 7.3 million people in 13 priority governorates with life-saving health services, medical supplies and cholera case management efforts.

2017 Wildland Fires and Potential Impacts to Critical Infrastructure

2017+Wildland+Fires+and+Potential+Impacts+to+Critical+Infrastructure:  Document

2017 Wildland Fires and Potential Impacts to Critical Infrastructure – 8 June 2017, has been posted to the Office of Cyber and Infrastructure Analysis (OCIA) page on the HSIN-Critical Infrastructure (CI) portal. This new product can be found under the Recent OCIA Products section of the portal.  

Scope Note
This product provides an overview of the National Interagency Fire Center (NIFC) Predictive Services Unit’s National Significant Wildland Fire Potential Outlook for June through September 2017. It examines the potential effects to U.S. critical infrastructure and is an update to the May 2016 Office of Cyber and Infrastructure Analysis (OCIA) Wildland Fires and Potential Impacts to Critical Infrastructure infographic. This update supports U.S. Department of Homeland Security (DHS) leadership; DHS Protective Security Advisors; and other Federal, State, and local agencies.
Key Findings
  • For June through September 2017, the NIFC predicts above normal fire potential across parts of Arizona, California, Florida, Georgia, Hawaii, Nevada, and New Mexico as fine fuels (twigs, needles, and grasses that ignite and burn rapidly) become available to burn.
  • Most areas of the United States are expected to see normal significant wildland fire potential throughout the fire season. It is important to note that normal fire activity still represents significant numbers of fires and acres burned.
  • OCIA assesses the critical infrastructure sectors most vulnerable to wildland fires are Emergency Services, Food and Agriculture, Healthcare and Public Health, Transportation Systems, and Water and Wastewater Systems.
Please read the attached document for further information regarding 2017 Wildland Fires Outlook.
Current Drought Conditions
According to the NIFC, overall drought conditions improved in May 2017. Southern Georgia and Florida saw preexisting extreme drought conditions worsen while abnormally dry conditions along the Mexico border with Arizona and New Mexico developed into a moderate drought. Abnormally dry conditions were also observed across portions of central and southern Texas as well as across portions of the Alaskan interior.
Please read the attached document for more information on the effects of wildland fires on critical infrastructure.
This product was developed in coordination with the DHS/National Protection and Programs Directorate/Office of Infrastructure Protection/Sector Outreach and Programs Division, DHS/Federal Emergency Management Agency, U.S. Fire Administration, U.S. Department of the Interior/Office of Wildland Fire, and NIFC.
If you did not receive this OCIA New Product Alert directly, you can join the Critical Infrastructure Community of Interest (HSIN-CI) by sending your first and last name, your e-mail address, and your reason for requesting access to HSIN-CI to BOTH of the following addresses: and HSIN-CI members can access all of OCIA’s past products and join Sector-specific COIs.
Access to the site will require the use of your assigned HSIN-CI user name and password. Upon linking directly to the site, the user can then also navigate within HSIN-CI as well as within those Communities of Interest to which they have access.
If you need to update your HSIN password, please click here to be directed to a self-service portal.  For technical assistance, you may contact the HSIN Help Desk or toll free at (866) 430-0162.
Please take the time and fill out the NPPD Customer Feedback Survey located on the last page of the product. Please direct any additional comments you were unable to address regarding the newly posted product to OCIA
The 2017 Wildland Fires and Potential Impacts to Critical Infrastructure Report is wholly UNCLASSIFIED and is approved for the widest dissemination.
2017 Wildland Fires and Potential Impacts to Critical Infrastructure Report can be accessed via the OCIA HSIN-CI page by clicking the following link:
This and other OCIA products are visible at the following websites:
Please include feedback and suggestions using the NPPD Feedback Survey located as a second attachment compared to its usual location on the last page of the product.

UN: World population to hit 9.8 billion by 2050


21 June 2017 – The world population is now nearly 7.6 billion, up from 7.4 billion in 2015, spurred by the relatively high levels of fertility in developing countries – despite an overall drop in the number of children people have around the globe – the United Nations today reported.

The concentration of global population growth is in the poorest countries, according to World Population Prospects: The 2017 Revision, presenting a challenge as the international community seeks to implement the 2030 Sustainable Development Agenda, which seeks to end poverty and preserve the planet.

“With roughly 83 million people being added to the world’s population every year, the upward trend in population size is expected to continue, even assuming that fertility levels will continue to decline,” said the report’s authors at the UN Department of Economic and Social Affairs.

At this rate, the world population is expected to reach 8.6 billion in 2030, 9.8 billion in 2050 and surpass 11.2 billion in 2100.

The growth is expected to come, in part, from the 47 least developed countries, where the fertility rate is around 4.3 births per woman, and whose population is expected to reach 1.9 billion people in 2050 from the current estimate of one billion.

In addition, the populations in 26 African countries are likely to “at least double” by 2050, according to the report.

That trend comes despite lower fertility rates in nearly all regions of the world, including in Africa, where rates fell from 5.1 births per woman from 2000-2005 to 4.7 births from 2010-2015.

In contrast, the birth rate in Europe was 1.6 births per woman in 2010-2015, up from 1.4 births in 2010-2015.  “During 2010-2015, fertility was below the replacement level in 83 countries comprising 46 per cent of the world’s population,” according to the report.  The lower fertility rates are resulting in an ageing population, with the number of people aged 60 or over expected to more than double by 2050 and triple by 2100, from the current 962 million to 3.1 billion.  Africa, which has the youngest age distribution of any region, is projected to experience a rapid ageing of its population, the report noted.

“Although the African population will remain relatively young for several more decades, the percentage of its population aged 60 or over is expected to rise from five per cent in 2017 to around nine per cent in 2050, and then to nearly 20 per cent by the end of the century,” the authors wrote.

In terms of other population trends depicted in the report, the population of India, which currently ranks as the second most populous country with 1.3 billion inhabitants, will surpass China’s 1.4 billion citizens, by 2024.

By 2050, the third most populous country will be Nigeria, which currently ranks seventh, and which is poised to replace the United States.

The report also noted the impacts of the flows of migrants and refugees between countries, in particular noting the impact of the Syrian refugee crisis and the estimated outflow of 4.2 million people in 2010-2015.

In terms of migration, “although international migration at or around current levels will be insufficient to compensate fully for the expected loss of population tied to low levels of fertility, especially in the European region, the movement of people between countries can help attenuate some of the adverse consequences of population ageing,” the authors wrote.

Cindy makes landfall: Blamed for widespread coastal highway flooding, rough seas, scattered power outages, building damage caused by high winds, and 1 death.

National Weather Outlook

Southern Mississippi Valley sector loop

cone graphic

WHO training enables Syrian doctors and nurses to provide health care in Turkey


WHO training enables Syrian doctors and nurses to provide health care in Turkey19-06-2017


“We and the Turkish doctors are working like brothers and sisters.” These are the words of Muhammed Hattab, 1 of more than 3 million Syrian refugees now living in Turkey – the country with the highest number of refugees in the world. A doctor who fled his home in Aleppo more than 2 years ago, Muhammed did not know whether by leaving northern Syria he was also abandoning his profession and the career he had built in his home country. However, thanks to a joint programme of the WHO Country Office in Turkey and the Turkish Ministry of Health, he has been able to begin a new chapter of his life and career, working in the Turkish national health system and providing care for his fellow Syrians in Turkey.

In 2016, the Turkish government enacted a law that allows Syrian health professionals to enter the workforce in the Turkish health system, with the aim of both integrating Syrian professionals into the health system and also ensuring that Syrian refugees can receive health care without encountering language or cultural barriers. In order to implement this law, the Public Health Institution of Turkey, associated with the Ministry of Health, and the WHO Country Office developed an adaptation training for Syrian health workers living Turkey – including doctors, nurses and midwives. The initiative is supported financially by the European Civil Protection and Humanitarian Operations (ECHO).The training provides classroom and practical coursework, resulting in a certificate that authorizes Syrian health-care workers to practice in refugee health centres established in Turkey and to deliver health services to Syrian refugees.

Since the trainings began in November 2016, over 380 doctors and 360 nurses and midwives have received vocational competence certificates, allowing them to serve refugee populations in Turkey. Ultimately, they will staff the 260 refugee health centres and 600 refugee health units that the Ministry of Health has opened and will establish in the future. These centres and units provide primary health care, with services offered to Syrian refugees free of charge.

“This project in Turkey was the salvation for Syrian doctors,” says Muhammed. “With this programme, we felt like doctors for the first time in 2 years.”

WHO and Ministry of Health collaborate to provide training and support for Syrian health workers

While the health-care profession has general underlying principles that are universal across different parts of the world, some important regulations and practices differ greatly from country to country. The adaptation training seeks to give Syrian health workers the knowledge and experience they need in order to be fully competent and skilled in the Turkish setting. They must first apply for the programme and go through a selection process. Once approved by the Ministry of Health, they undergo a 1-week classroom training with Turkish university professors and lecturers, followed by 6 weeks of on-the -job training in a Refugee Health Centre. By working under the mentorship of Turkish health professionals for several weeks, they are able to familiarize themselves with the Turkish health system and prepare to provide care within this system. They are also evaluated at each stage of the training process before becoming certified to work in Turkey, helping to ensure good results for Syrian patients in the country.

“These trainings are not only a way to address language barriers but a good example of the collaboration between national and international partners in Turkey to help the integration of Syrian medical doctors, nurses and midwives to serve the community of refugees. We appreciate that the Government of Turkey, the Ministry of Health and Turkish health staff ensure equitable access to health services. And we consider this a one-of-a-kind collaboration among WHO, academia and the Ministry of Health to set an example for other countries, accommodating high numbers of refugees and migrants,” comments Dr Pavel Ursu, WHO Representative to Turkey.

WHO supports the classroom portion of the training, in collaboration with the Ministry, and is committed to making sure that Syrian health professionals are equipped with the essential theoretical background for their future career. In addition, WHO provides trainees with financial support for the duration of practical training to cover living expenses and travel costs.

Follow the links below and watch the video to learn more about the ways WHO’s work supports Syrian refugees in Turkey.

World Refugee Day: #WithRefugees

Each year on 20 June, the world commemorates the strength, courage and perseverance of millions of refugees. In a world where violence forces thousands of families to flee for their lives each day, World Refugee Day offers an opportunity for the global public to once again show that it stands with them. The United Nations Refugee Agency launched the #WithRefugees petition in June 2016 to send a message to governments that they must work together and combine their efforts to ensure the health and well-being of the world’s refugees.


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