THE PUBLIC HEALTH NEEDS AND INTERNATIONAL ASSISTANCE AFTER NATURAL DISASTERS Dr. Oleg V. Mazurenko

Classification of needs after disaster NEEDs: URGENT NEEDs MIDDLE TERM NEEDs 3. LONG TERM NEEDs DISASTER

Data for Decision-Making Victims Needs Available Services Eric Noii, 2005

Disaster reduction world’s attempts International Decade for Natural Disaster Reduction. Yokohama strategy and Plan of Action for a Safer World (1994). Hyogo declaration and framework for Action (2005 to 2015)

Assistance after disaster. Lessons learned “SO MANY AND SO LATE!” 2. “IN THE NOT RIGHT PLACE AND AT THE NOT RIGHT TIME!”

The P.H. tasks after earthquake Life saving interventions. Psychological aid. Prophylactic of infection morbidity. Prevention and control of Non-communicable disease. Finally treatment and rehabilitation of victims out side of disaster area.

What could we do after disaster? Increase of amount of medical staff, medical equipment and hospital’s beds. Redistribute of presence resources in suffer area. Renovate and reconstruct a P.H. facilities

MAIN Public Health NEEDS AFTER EARTHQUAKES Foreign tent hospitals – 32,16% Dressing materials, bandages, syringes -15,69% Intravenous solutions – 8,24% Antibacterial medicines– 8,24% First Medical Aid Kits - 5,10%

Dynamics of needs after earthquakes First 24 hours after disaster impact - 30,95% of total requests for international assistance were requests for P.H. Foreign tent hospitals, medicines and medical supplies – 46,2%. All other P.H. requests for assistance (53,8%) are not certain (chaos )

48-72 HOURS – 16,7-28,6% OF TOTAL REQUESTS FOR P.H. 1. Machines for artificial ventilation of lungs 2. Endotracheal tubes and face masks 3. Laryngoscopes 4. X-ray machine 5. Surgical materials and bandaging materials 6. Surgical sterile gloves (thousand units) 7. Antimicrobial medicines

48-72 HOURS – 28,57% OF TOTAL REQUESTS 8. Solutions for infusions 9. Plasma 10. Blood bags 11.Hormones 12. Vaccines (hepatitis A and B, immunoglobulin and tetanus) 13. Equipment for environmental disinfection 14. Mobile health laboratories, disinfection kits for water and water purification equipment.

MAIN NEEDS ON IV-VII DAYS AFTER EARTHQUAKES First priority needs Second priority needs Medical supplies for care of trauma complication Orthopedics equipment such as prosthesis appliances Emergency medical kits Ambulance vehicle Face masks Equipment for Water purification

MAIN NEEDS ON XI DAYS AFTER EARTHQUAKES PROBLEMS 1. Orthopedic equipment (prosthetic appliances). 1.Local hospitals are destroyed 2.Insufficient amount of medical personnel 2. Purification water supplies. 3.Most foreign hospitals abandon a country. 4.Impossibility to provide a primary medical aid.

International assistance after earthquakes Urgent financial support -38,2%. The estimation of Public Health needs and contribution for getting of assistance-26,5%. Emergency medical assistance to victims by foreign field hospitals – 21,6%. Medicines and medical supplies settings – 7,8% Infection control-3,9%. Technical assistance and projects for Public Health rehabilitation – 2,0%.

Balance of International assistance after earthquakes Main needs Assistance Medicines and medical supplies - 59 % Foreign field hospitals - 32,2% Medicines and medical supplies -20,35% (34,5% of needs) Foreign field hospitals - 60,71%

Public Health Tasks after floods Infection control. Emergency medical service. Vaccination against Hepatitis A and B, Tetanus (WHO and CDC has recommended provide a mass immunization programs during a flood).

Priority P.H. needs after floods Essential Medicine – 97,8%, including: 1. Vaccines – 30,4% 2. Oral Rehydratation salts – 16,3%. 3. Salt Solution – 6,5% B. Tents for Medical stations – 2,2%

International assistance after floods: Urgent financial support – 42,4%. Determinations of needs – 13,7%. Monitoring of situation – 12,9%. Essential Medicine and medical supplies – 11,5%. Emergency medical assistance to victims by foreign field hospitals – 8,6%. Technical assistance for P.H. rehabilitation – 7,9%. Infection control – 2,9%.

Balance of International assistance after floods MAIN NEEDS ASSISTANCE Medicines and medical supplies – 97,8% Medicines and medical supplies – 11,5% (providing only for 14% of total needs) Urgent financial grant - 42,4%.

Public Health Tasks after hurricanes Early epidemic warning and response. The operating for prevention of infection diseases. Providing of sanitary measures. Local purchase of facilities of the medical setting.

P.H. priority needs after hurricane Cleansers and disinfection supplies – 56,3%. Essential Medicine – 25,0%. Foreign tent hospitals – 9,1%. First aid Medical Kits – 4,5%.

International assistance after hurricanes Emergency total financial grant – 25,8%. Determination of Public Health needs – 25,3%. Monitoring of situation (only) – 14,7%. Essential Medicines and medical supplies -10,3%. P.H. reconstruction – 8,0%. Emergency medical assistance to victims by foreign field hospitals – 8,0%. Infection control -8,0%.

Balance of International assistance after hurricanes NEEDS ASSISTANCE Medications and medical supplies facilities - 83,4%. Foreign tent hospitals - 8,3%. Medications and medical supplies – 90,9%. Medical assstance by foreign field hospitals - 9,1%.

Misbalance of International assistance after Natural Disaster 68,4% PRIORITY P.H. NEEDS INTERNATIONAL ASSISTANCE Oleg Mazurenko, 2012

Conclusions National response is an advantage kind of response. The typical kind of International assistance are: a) Emergency financial aid for PH rehabilitation, b) medicines, c) medical supplies. After earthquakes a total amount of foreign tent hospitals at twice exceed a necessity. Providing of medicines and medical supplies as International aid after Natural disaster put together 24%.

Conclusions 4. After floods a Priority needs are Essential Drugs (96,7%). 5. After hurricanes a Priority needs are washing and disinfection facilities (56,4%) and Essential Drugs and medical assistance for evacuee people (27,1%). 6. Misbalance between Needs and International assistance for P.H. after Natural Disaster make up 68,4%.

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