BASIC HEALTH INDICATORS CHANGES AFTER NATURAL DISASTER Oleg V. Mazurenko, MD, PhD Associated professor of Disaster medicine Shupic National Medical Academy of postgraduate education

Scope of the problem Well know: After earthquakes PH could be able to provide an emergency medical assistance to great number of trauma patients; After flood medical stuff could be ready to treat patients on communicable (infection) disease. Oleg V. Mazurenko

Scope of the problem On disaster site a kind of medical assistances provided by foreign and national medical teams has been variable. Greater part of foreign field hospitals has been organized for emergency medical care and life-saving intervention only. Oleg V. Mazurenko

Methods Have been research a Health impact after natural disasters: Earthquakes – 42 Floods – 38 Hurricane and Storms -37 Oleg V. Mazurenko

Health indicators Under-five child mortality rate (per 1000 live birth); Maternal mortality rate (per 100 000 live birth); Adult mortality rate (aged 15-60 years per 100 000); Immunization level by DTP (diphtheria, pertussis, tetanus) 3 and MCV (%) Oleg V. Mazurenko

Results

Under-five child mortality rate (worldwide) Main cause mortality rate worldwide: Neonatal death - 41% Pneumonia -14% Diarrhea – 14% MDG: to reduce under-five mortality rate worldwide with 3.5% annual progress. Oleg V. Mazurenko

Under-five child mortality rate Disaster Child mortality after earthquakes in the 73% suffering countries has been increased: ＋4.8%. After Floods (13%): ＋9.3% After Hurricanes (storm) (53%): ＋ 6.7% Oleg V. Mazurenko

Under-five mortality rate (Ukraine) Where and why it happened – 1. In some remote region 2. Among specifically inhabitants (Romani) Oleg V. Mazurenko

Main cause of maternal mortality (world) Direct cause (80%) Indirect cause (20%) Bleeding – 25% Infection (sepsis) -15% Dangerous abortion – 13% Hypertension disorder (eclampsia) – 12% Delivery complication – 8% Malaria AIDS Cardiovascular disorder Oleg V. Mazurenko

Maternal mortality MDG: to reduce worldwide maternal mortality on 75% Earthquake countries (68%) has increased ＋7.8%. Floods (37%) - ＋6.0% Hurricanes (storm) (37%) - ＋ 6.0% Disaster Oleg V. Mazurenko

Maternal mortality (Ukraine flood) Maternal mortality - ＋ 3.1% Why it happened? Extra genital pathology: 1)Influenza H1N1 (2009) - 33.9% (38 death from 112) 2)Pulmonary Embolism – 7% Oleg V. Mazurenko

Maternal mortality (Ukraine flood) Oleg V. Mazurenko

Adult mortality rate (disaster worldwide) Earthquake areas:＋4.3% : Why? -Dirrect hit on inhabitant, environmental and medical facilities destroyed. Floods (90%): ＋1.6%: Why? Access restriction to PH services. Hurricanes (storm) (23%): ＋ 5.8% Oleg V. Mazurenko

Adult Worldwide morbidity Cardiovascular disease – 47.2% Cancer - 21.1% Respiratory disease – 11.7% Diabetes – 3.6% These four groups are a main cause of deaths from Noncommunicable disease (≈ 80%) Oleg V. Mazurenko

Adult morbidity and mortality (Ukraine) Cardiovascular disease morbidity: ＋3.01-9.4%. Among cardiovascular decease – Acute Miocardial Infarction (AMI): ＋5.8-40.5%. Cardiovascular mortality: ＋3.3 – 75.5%. Respiratory morbidity: ＋11.8 – 15.6%. Skin disease morbidity: ＋ 5.0 – 8.0 %. Psyhobehavioral disorder: ＋ 11-23%. Infection disease: ＋ 2.9 – 5.7% Oleg V. Mazurenko

Acute Surgery Disorder (Ukraine) The Natural Disaster do not influence on the total amount of patients with acute surgical disease. On the flooded area the level of needs for urgent surgery is the same level such as before disaster. On the flooded area amount of hospitalized patient later than 24 hours grew up: ＋2.3% – 20.01% Oleg V. Mazurenko

Acute Surgery Disorder (flood Ukraine) Hospitalization more than 12 h. (patient) Hernia strangulates:+17,3±5,9%. Intestinal obstruction:+12,6±6,2%. Acute pancreatitis: + 10,4±1,1%. Acute cholestitis: +6,32±4,4%. Gastro-enteric bleeding: 5,6±2,6%. Oleg V. Mazurenko

TBC incident and prevalence Earthquakes: Tbc incident: ＋5.3%. Tbc prevalence: ＋15.8%. Floods: Tbc incident: ＋16.2% Tbc prevalence: ＋5.4% Hurricane: Tbc incident: 0 Tbc prevalence (17%): 0 Oleg V. Mazurenko

Immunization Immunization level decrease: 1.Earthquake: DTP: －5.0% MCV: －3.7% 2. Flood: DTP: －9.0% MCV: －6.0% 3. Hurricane: DTP: －1.9% Oleg V. Mazurenko

Conclusion Public Health could be able to provide primary medical health for Noncommunicable disease patients after natural disaster. After flood a total number of emergency surgery patients are the same before disaster. International field medical team could be ready to provide not only life saving intervention but Primary medical aid. Immunization campaign. Oleg V. Mazurenko

Indicator Quake (world) Flood Hurricane (Ukr) Under-five mortality rate + 4,8% +9,3% +6,7% Maternal mortality rate +7,5% +6% +3,1% + 98% Adult mortality +4,3% +1,6% +5,8% +1.7 % (cardio) Tbc incidence +5,3% +16,2% Tbc prevalence +15,8% +5,4% Oleg V. Mazurenko

Conclusion Our researches has evidenced the different level of health changes among suffering population after Natural disaster. Oleg V. Mazurenko

THANK YOU! ANY QUESTION?