Global & Disaster Medicine

Archive for the ‘Environment’ Category

After the hurricanes: Inside a Senior Complex in Puerto Rico

NY Times

“…..With large areas of Puerto Rico still in the dark three months after the first of the storms — according to government reports, only 60.4 percent of the pre-storm power grid load has been restored — older residents and those with chronic medical conditions are suffering in even more ways than their neighbors. Many nursing homes have no power. The failure to re-establish functioning telephone networks and transportation systems in many areas makes it difficult to get regular medical care. Fire safety systems are inoperable, posing special dangers for those who cannot easily escape.….”


About 5,000 barrels of oil, or about 210,000 gallons, gushed out of the Keystone Pipeline on Thursday in South Dakota

NY Times

 


Triage at a sweltering nursing home……

NY Times

“…..After a third rescue call, around 5 a.m., the hospital’s staff was concerned enough to walk down the street to check the building themselves.

What they found was an oven.

The Rehabilitation Center at Hollywood Hills needed to be evacuated immediately. Rescue units were hurrying its more than 100 residents out. Dozens of hospital workers established a command center outside, giving red wristbands to patients with critical, life-threatening conditions and yellow and green ones to those in better shape.

Checking the nursing home room by room, the hospital staff found three people who were already dead and nearly 40 others who needed red wristbands, many of whom had trouble breathing. The workers rushed them to Memorial’s emergency room, where they were given oxygen. The rest went to other hospitals nearby….”


Irma turned the Rehabilitation Center at Hollywood Hills into a living hell. Was it a tragic error or was it criminal?

Miami Herald

Bobby Owens, 84;

Manuel Mario Mendieta, 96;

Miguel Antonio Franco, 92;

Estella Hendricks, 71;

Gail Nova, 71;

Carolyn Eatherly, 78;

Betty Hibbard, 84;

Albertina Vega, 99.

“…..yet to be determined is how long these vulnerable people — either residents or recovering from surgery — were left in such stifling heat and, most important, why…..

The eight nursing-home residents who died were not the only seniors trapped by sketchy planning. In Miami Dade, WLRN reporter Nadege Green found elderly residents in a series of Coconut Grove senior-living apartments who remained trapped, no elevator, no electricity; on Tuesday, about 50 residents of a senior-citizens tower in Miami’s Civic Center neighborhood damaged by Irma were being taken to a shelter…..”

 


8/21/1986: An eruption of lethal gas from Lake Nyos in Cameroon kills nearly 2,000 people and wipes out four villages.

History Channel

 


8/24/2003: A major outage knocked out power across the eastern United States and parts of Canada. Beginning at 4:10 p.m. ET, 21 power plants shut down in just three minutes. Fifty million people were affected, including residents of New York, Cleveland and Detroit, as well as Toronto and Ottawa, Canada.

History Channel

 


Electricity was restored Sunday to tens of thousands of customers (affected 140,000 customers at its worst) who lost service when a power station in suburban Los Angeles caught fire amid a blistering heat wave.

ABC

 


Heat-related mortality in India between 1960 and 2009

ScienceAdvances

“….[B]etween 1960 and 2009, [m]ean temperatures across India have risen by more than 0.5°C….., with statistically significant increases in heat waves. Using a novel probabilistic model…..the increase in summer mean temperatures in India over this period corresponds to a 146% increase in the probability of heat-related mortality events of more than 100 people…..”

 

 


In Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, 26 states and Washington, D.C. scored a six or lower on 10 key indicators of public health preparedness.

TFAH

Ready or Not? examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies. Some key findings include:

  • 26 states increased or maintained funding for public health from Fiscal Year (FY) 2014-2015 to FY 2015-2016.
  • Just 10 states vaccinated at least half of their population (ages 6 months and older) against the seasonal flu during the 2015-2016 flu season (from July 2015 to May 2016).
  • 45 states and Washington, D.C. increased the speed of DNA fingerprinting using pulsed-field gel electrophoresis (PFGE) testing for all reported cases of Shiga toxin-producing E. coli O157, a measure of a state’s ability to detect foodborne outbreaks.
  • 10 states have a formal access program or a program in progress for getting private sector healthcare staff and supplies into restricted areas during a disaster.
  • 30 states and Washington, D.C. met or exceeded the overall national average score (6.7) of the National Health Security Preparedness Index (as of 2016).
  • 32 states and Washington, D.C. received a grade of C or above in States at Risk: America’s Preparedness Report Card, a national assessment of state-level preparedness for climate change-related threats – which have an impact on human health.

In addition, the report examined trends in public health preparedness over the last 15 years, finding successes and ongoing concerns.

  • One-third of funds for health security and half of funds for healthcare system preparedness have been cut: Health emergency preparedness funding for states has been cut from $940 million in fiscal year (FY) 2002 to $660 million in FY 2016; and healthcare system preparedness funding for states has been cut by more than half since FY 2005 – down to $255 million.
  • Some major areas of accomplishment: Improved emergency operations, communication and coordination; support for the Strategic National Stockpile and the ability to distribute medicines and vaccines during crises; major upgrades in public health labs and foodborne illness detection capabilities; and improvements in legal and liability protections during emergencies.
  • Some major ongoing gaps: Lack of a coordinated, interoperable, near real-time biosurveillance system; insufficient support for research and development of new medicines, vaccines and medical equipment to keep pace with modern threats; gaps in the ability of the healthcare system to care for a mass influx of patients during a major outbreak or attack; and cuts to the public health workforce across states.

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Requiring strong, consistent baseline public health Foundational Capabilities in regions, states and communities-so that everyone is protected.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of foundational capabilities alongside a complementary Public Health Emergency Fund which would provide immediate surge funding during an emergency.
  • Improving federal leadership before, during and after disasters – including at the White House level.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as the Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks by developingstronger coalitions and partnerships among providers, hospitals, insurance providers, pharmaceutical and health equipment businesses, emergency management, and public health agencies.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop Superbugs and antibiotic resistance.
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.

Ready or Not? was released annually from 2003-2012, and more recently, TFAH has released Outbreaks: Protecting Americans from Infectious Diseases, from 2013-2015.The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. The data for the indicators are from publicly available sources or were provided from public officials.

10 out of 10: Massachusetts

9 out of 10: North Carolina and Washington

8 out of 10: California, Connecticut, Iowa, New Jersey, Tennessee and Virginia

7 out of 10: Colorado, Delaware, Florida, Indiana, Maryland, Michigan, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Carolina, Utah and Wisconsin

6 out of 10: Arizona, Arkansas, District of Columbia, Georgia, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Montana, Nebraska, Ohio, Pennsylvania, Texas and Vermont

5 out of 10: Alabama, Missouri, Oklahoma, South Dakota and West Virginia

4 out of 10 Nevada and Wyoming

3 out of 10: Alaska and Idaho


WHO: Don’t pollute my future! The impact of the environment on children’s health

WHO

Don’t pollute my future! The impact of the environment on children’s health

Cover: Don’t pollute my future! The impact of the environment on children’s health

Background

In 2015, 5.9 million children under age five died. The major causes of child deaths globally are pneumonia, prematurity, intrapartum-related complications, neonatal sepsis, congenital anomalies, diarrhoea, injuries and malaria. Most of these diseases and conditions are at least partially caused by the environment. It was estimated in 2012 that 26% of childhood deaths and 25% of the total disease burden in children under five could be prevented through the reduction of environmental risks such as air pollution, unsafe water, sanitation and inadequate hygiene or chemicals.

Children are especially vulnerable to environmental threats due to their developing organs and immune systems, smaller bodies and airways. Harmful exposures can start as early as in utero. Furthermore, breastfeeding can be an important source of exposure to certain chemicals in infants; this should, however, not discourage breastfeeding which carries numerous positive health and developmental effects (4). Proportionate to their size, children ingest more food, drink more water and breathe more air than adults. Additionally, certain modes of behaviour, such as putting hands and objects into the mouth and playing outdoors can increase children’s exposure to environmental contaminants.

 


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