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

2. 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

3. 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

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

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

6. Results

7. 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

8. 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

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

10. 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

11. 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

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

13. Maternal mortality (Ukraine flood)
Oleg V. Mazurenko

14. 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

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

16. Adult morbidity and mortality (Ukraine)
Cardiovascular disease morbidity: ＋ %. Among cardiovascular decease – Acute Miocardial Infarction (AMI): ＋ %.
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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

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

24. THANK YOU!
ANY QUESTION?