Part 2: Health and economical status of Bam before the earthquake Disaster Epidemiology Lessons From Bam Earthquake Dec 26, 2003 Iran Part 2: Health and economical status of Bam before the earthquake A. Ardalan MD, MPH, PhD student in Epidemiology 1

status of Bam before the earthquake To understand the health Learning objectives: To view the economical status of Bam before the earthquake To understand the health 2

Geographic location of Bam The Southeast of Kerman province, on the outskirts of the Dasht-e-Lut Desert in Southeast Iran. Distance from other cities: 220 Km from the city of Kerman 1,283 Km from Tehran 3

Demography of Bam district before the earthquake Total population: 240,000 Urban population: 40.4% Rural population: 59.6% 4

Economical status of Bam before the earthquake Direct employment in agricultural sector: 25% Most date farmers were small holders, and as such vulnerable in socio-economic terms. 5

Economical status of Kerman province Unemployment rate: 25% Population lived below the universal poverty line: 10% Kerman province faces a number of development challenges including: the presence of Afghan refugees, recurrent droughts and drug trafficking. 6

Citadel of Bam and economy The city of Bam is famous for its ancient architecture. Bam’s 2500 year-old ancient citadel drew in about 15,000 foreign tourists last year and as many as three times the number of Iranian tourists. 7

Some Health Indicators of Kerman province compared with National level 8

Some Health Indicators of Kerman province compared with National level (Non- communicable diseases) 9

Some Health Indicators of Kerman province compared with National level (Infectious diseases) 10

Endemic and Epidemic Diseases The most endemic diseases: Malaria Cutaneous leishmaniasis Recently epidemics: Typhoid fever Cholera 11

Health care services of Bam before the earthquake Health care services to the people in Bam District were provided by 95 Health Houses, staffed by primary healthcare workers (Behvarz) as the first level care providers, and 24 Health Centres (14 rural, and 10 urban) as the second level care facilities. Third level care services were delivered through three hospitals; two public and one private, with a total of around 255 beds altogether. 12

References: UN Flash Appeal, Bam Earthquake of 26 December 2003. Islamic Republic of Iran Relief, Recovery and Immediate Rehabilitation. Available at: http://www.emro.who.int/eha/UN-Flash-Appeal Source: World Health Organization. The Government of the Islamic Republic of Iran and WHO. Joint Project for: "Reconstruction of Health Services in Bam". Available at: www.emro.who.int/eha/BamPlan16.pdf 13