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Reduced Death Rates from Cyclones in Bangladesh

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Reduced Death Rates from Cyclones in Bangladesh PolicyPolicy & practice & practice Reduced death rates from cyclones in Bangladesh: what more needs to be done? Ubydul Haque,a Masahiro Hashizume,a Korine N Kolivras,b Hans J Overgaard,c Bivash Dasd & Taro Yamamotoa Abstract Tropical storms, such as cyclones, hurricanes and typhoons, present major threats to coastal communities. Around two million people worldwide have died and millions have been injured over the past two centuries as a result of tropical storms. Bangladesh is especially vulnerable to tropical cyclones, with around 718 000 deaths from them in the past 50 years. However, cyclone-related mortality in Bangladesh has declined by more than 100-fold over the past 40 years, from 500 000 deaths in 1970 to 4234 in 2007. The main factors responsible for these reduced fatalities and injuries are improved defensive measures, including early warning systems, cyclone shelters, evacuation plans, coastal embankments, reforestation schemes and increased awareness and communication. Although warning systems have been improved, evacuation before a cyclone remains a challenge, with major problems caused by illiteracy, lack of awareness and poor communication. Despite the potential risks of climate change and tropical storms, little empirical knowledge exists on how to develop effective strategies to reduce or mitigate the effects of cyclones. This paper summarizes the most recent data and outlines the strategy adopted in Bangladesh. It offers guidance on how similar strategies can be adopted by other countries vulnerable to tropical storms. Further research is needed to enable countries to limit the risks that cyclones present to public health. Background Cyclones in Bangladesh Bangladesh is especially vulnerable to cyclones because of its Cyclones and storm surges threaten coastal communities location at the triangular shaped head of the Bay of Bengal,6 worldwide. The World Meteorological Organization defines the sea-level geography of its coastal area, its high population a tropical cyclone as “a non-frontal synoptic scale cyclone density and the lack of coastal protection systems. During the originating over tropical or subtropical waters with organized pre-monsoon (April–May) or post-monsoon (October–No- convection and definite cyclonic surface wind circulation”.1 vember) seasons, cyclones frequently hit the coastal regions More specifically, a storm in the south-east Indian Ocean is of Bangladesh. About 40% of the total global storm surges are cyclonic when the sustained wind speed is more than 33 nau- recorded in Bangladesh,7 and the deadliest cyclones in the past tical miles per hour (> 62 km/h). The storm surge represents 50 years, in terms of deaths and casualties, are those that have a major cause of death and injury during a cyclone. A storm struck Bangladesh.8 surge is the difference between the water level under the influ- The number and severity of cyclones in Bangladesh and ence of a disturbance (storm tide) and the normal level that the associated mortalities have varied greatly during the past would have been reached in the absence of the meteorological 50 years (Table 1). The two deadliest cyclones occurred in disturbance.2 Over the past two centuries, around two million 1970 and 1991, with > 500 000 and almost 140 000 deaths, people worldwide have died and millions have been injured respectively. However, during the past 20 years, Bangladesh as a result of tropical storms, including cyclones, hurricanes has managed to reduce deaths and injuries from cyclones. For and typhoons.3 Globally, the number of cyclones has increased example, the most recent severe cyclone of 2007 caused 4234 more than threefold (Fig. 1) from 1970 to 2006.4 The strength deaths, a 100-fold reduction compared with the devastating and number of major cyclones may be increasing because of 1970 cyclone. higher sea surface temperatures associated with global warm- In addition to the immediate death and suffering caused ing.5 Tropical cyclones and storm surges are particularly severe by such disasters, cyclones also have direct and indirect im- in the Bay of Bengal region. pacts on general public health, livelihoods, infrastructure, the We review the impact of cyclones on health and liveli- economy and sociocultural foundations. They can affect access hoods in Bangladesh, in light of the progress made and the to food and drinking water, and increase the transmission risks challenges that remain. We explore cyclone-related severity of infectious diseases, such as diarrhoea, hepatitis, malaria, and death in Bangladesh over the past 50 years, and discuss dengue, pneumonia, eye infections and skin diseases,12 thus the experiences of other cyclone-afflicted countries. We also contributing to the interruption of livelihoods. Surface water, consider how we can learn from international experience to the main source of drinking water in coastal regions of Ban- reduce the adverse health impacts of natural disasters. Finally, gladesh, becomes contaminated by saline intrusion and poor we recommend mitigation and adaptation strategies, and sanitation systems.13,14 Open latrines and poor sanitation are future research needs. common in rural Bangladesh and coastal areas, and cyclones a Department of International Health, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki City, 852-8523, Japan. b Department of Geography, Virginia Tech, Blacksburg, United States of America. c Department of Mathematical Sciences and Technology, Norwegian University of Life Sciences, Ås, Norway. d Local Government Engineering Department, Sher-e-Bangla Nagar, Dhaka, Bangladesh. Correspondence to Ubydul Haque (e-mail: [email protected]). (Submitted: 16 March 2011 – Revised version received: 4 September 2011 – Accepted: 6 September 2011 – Published online: 24 October 2011 ) 150 Bull World Health Organ 2012;90:150–156 | doi:10.2471/BLT.11.088302 Policy & practice Ubydul Haque et al. Cyclones and health in Bangladesh Fig. 1. Frequency of cyclones in the world4 as increased suicide and crime rates, and adverse pregnancy outcomes, are clearly associated with cyclones.15 These 150 tend to increase in the post-disaster pe- riod, as a result of post-traumatic stress and depression. Literacy rates are low and poor knowledge of environmental 100 health issues creates additional problems following a cyclone. clones cy Progress and challenges 50 In the past 50 years, Bangladesh has Number of learnt how to adapt to recurrent cyclones and has succeeded in significantly re- ducing cyclone-related deaths. This has been achieved by modernizing early 0 warning systems, developing shelters 1960 1970 1980 1990 2000 2010 and evacuation plans, constructing Year coastal embankments, maintaining and improving coastal forest cover and rais- ing awareness at the community level. Cyclone preparedness has improved Table 1. Cyclone severity and deaths in Bangladesh 1960–20109–11 following the launch of the Cyclone Preparedness Programme by the Ban- Year Number of death Wind speed Severity index gladesh Red Crescent Society in 1970. The programme’s goal is to minimize 1960 8 119 210 5 the loss of lives and property in cy- 1961 11 466 146 5 clonic disasters by strengthening and 1963 11 520 203 5 developing disaster preparedness and 1964 196 NA NA response capacity in coastal communi- 1965 20 152 210 5 ties, and by increasing the effectiveness 1966 850 146 5 of volunteers. The programme’s activities 1969 75 NA NA include: disseminating cyclone warn- 1970 500 300 223 6 ing signals issued by the Bangladesh 1973 183 122 5 Meteorological Department through 1974 50 162 5 an extensive telecommunication net- 1985 11 069 154 5 work; providing and assisting in first 1986 12 100 4 aid, rescue, relief and rehabilitation 1988 9 590 162 5 operations; and coordinating and 1989 573 NA NA building community capacity, disaster 1990 132 102 4 management and development activi- ties. The Bangladesh Disaster Manage- 1991 138 958 225 6 ment Bureau also issues cyclone alerts 1994 170 200 5 through the national media as soon as 1995 172 100 4 a cyclone is detected by environmental 1996 545 70 3 satellites. The Bangladesh Meteorologi- 1997 410 225 6 cal Department has three radar stations 1998 233 112 4 in Dhaka, Khepupara and Cox’s Bazar 2007 4 234 250 6 that transmit minute-by-minute weather 2008 15 80 3 updates.16 The Department also receives 2009 197 95 4 information from the National Oceanic NA, not available. and Atmospheric Administration in the United States of America (USA) and from a Japanese satellite via the make this situation worse.13 The lack of and the release of contaminants into Bangladesh Space Research and Remote safe drinking water may be the most the water (e.g. from storage and waste Sensing Organization.16 The effective important cause of the spread of wa- disposal sites). Childhood malnutrition early warning system provided by the terborne diseases after a cyclone. Other is already a serious issue in Bangladesh, government in advance of Cyclone Sidr causes are through indirect impacts such and the loss of crops and reduced ac- in 2007 enabled the successful evacua- as damaged infrastructure, population cess to fish compounds the problem. tion of coastal communities resulting displacement, reduced food production Indirect health-related impacts, such in fewer than expected deaths. Initia- Bull World Health Organ 2012;90:150–156 | doi:10.2471/BLT.11.088302 151 Policy & practice Cyclones and health in Bangladesh Ubydul Haque et al. tives at central and local governmental, public
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