HURRICANES IRMA AND MARIA

Situation Report No. 8

22 September 2017 – 19:00 EST

HIGHLIGHTS SITUATION IN NUMBERS  In Dominica, communication continues to be an issue as intermittent telecommunications is currently possible. Road access is still severely limited due to debris and landslides, and many communities have not been reached. 2 Hurricanes  The main airport is fully functional in Dominica. Cane Field airport that had been flooded That impacted the was cleaned, and small airplanes are able to land. and the Region in September:  Princess Margaret Hospital, the referral hospital in Dominica, sustained heavy damages. Irma and Maria Some hospitalizations remains intact, but further damage assessment is required to determine its operational capacity.  In the Dominican Republic, there are 2,991 houses affected, and 110 houses destroyed. 73,000 There are 10,929 people in 205 shelters. 92 healthcare centers are affected. Estimated people living in Dominica which was in the  In the United States Virgin Islands, Governor Juan F. Luis Hospital and Medical Center direct path of in Saint Croix has been affected, and all patients from the facility are being evacuated to 1 as a Category 5 storm the U.S. mainland.

 The Government of confirmed six deaths in three municipalities. The

Federal Emergency Management Agency (FEMA) reported 175 shelters housing 10,692 $10.3 million occupants. There are 1.5 million people without access to electricity. Funding required in the health  Repairing damaged health facilities in impacted islands is crucial in managing sector of the Regional emergency patients, quick diagnosis and treatment of diseases, and reestablish Response Plan for emergency treatment of non-communicable diseases. support to the most vulnerable 2 for Hurricane Irma

1. United Nations World Population Prospects 2017; Data estimate to 2015 2. UN OCHA Regional Response Plan

Source: Pan American Health Organization

PAHO sent 60,000 water purification tablets, solar panel, and two generators from the Barbados logistical hub with helicopter transport provided by the UK Military.

Pan American Health Organization Health Emergencies Department www.paho.org/disasters | © PAHO/WHO, 2017

SITUATION OVERVIEW

Hurricane Irma, a Category 5 Hurricane with record-breaking wind speed in the Atlantic, impacted several Caribbean Islands including Anguilla, Antigua and Barbuda, Bahamas, , Cuba, Saint Martin, Sint Maarten, Turks and Caicos and the US Virgin Islands that were in its path after making landfall on September 5, 2017. Two weeks later, another Category 5 Hurricane, Maria, followed bringing further devastation to the Caribbean Islands, adding Dominica, Guadeloupe, Martinique and Puerto Rico to the list of heavily impacted islands. The second hurricane also brought further rain and logistical challenges to population that had been particularly vulnerable and working on recovery efforts to re-establish electricity, water, and healthcare services. BRITISH VIRGIN ISLANDS (Population: 30,113)1 Hurricane Maria passed approximately 160 km from the British Virgin Islands bringing rain to the islands already heavily impacted by Hurricane Irma. There was damage to roads on the West End. Storm surge resulted in debris on the road, particularly on the West End. Minor landslides have been reported. Additional shelters were opened including private facilities to accommodate persons whose homes were damaged. Puerto Rico which was part of the relief operations for British Virgin Islands have been impacted by Hurricane Maria which may delay recovery efforts. DOMINICA (Population: 73,162)1 Dominica reported severe infrastructural damage to much of the island. Preliminary reports indicated approximately 90% of buildings damaged. Communication continues to be an issue as intermittent telecommunications is currently possible. Road access is still severely limited due to debris and landslides, and many communities have not been reached. The evacuation of eight dialysis patients is being coordinated with the Dominican Republic. There are six trauma patients whose medical evacuations are being coordinated. There is limited communication with the re-established EOC. Transport and Logistics: The Douglas-Charles International Airport, the main airport on the island, is fully functional. Cane Field airport that had been flooded was cleaned, and small airplanes are able to land. The Logistics Cluster reports that the road connecting Douglas-Charles International Airport to Roseau is affected by landslides, fallen bridges and debris. The Woodbridge Pier is operational. Princess Margaret Hospital, the referral hospital on the island, sustained heavy damages. According to the preliminary assessments from the French team, including medical staff, from Martinique, there is some hospitalization capacity at the gynecological unit. The roof of ICU is gone, and two ventilated patients were evacuated to a refurbished room. The radiology, CT and echography sustained moderate flooding, which may be functional after cleaning. The generator is partially working and access to electricity needs to be improved. Water reserve is available at the hospital for approximately 3 days at usual consumption rate. Further assessment is required at the hospital. Response: The National Emergency Operations Center has been relocated in the Financial Building in central Roseau. PAHO is coordinating with countries in the region and the Ministry of Health of Dominica to facilitate the safe evacuation of patients. PAHO sent 60,000 water purification tablets, solar panel, and two generators from the Barbados logistical hub with helicopter transport provided by the UK Military. The PAHO technical experts in logistics, public health, and epidemiology are being deployed to join PAHO personnel already on the ground. Needs: Road access continues to be limited, although clearing efforts are being undertaken. Further assessments outside Roseau and Portsmouth and distribution of food, water and supplies will be carried out as roads clear. The EOC is functioning and will need to be strengthened to coordinate with international agencies that are in Dominica for efficient delivery of relief aid. DOMINICAN REPUBLIC (Population 10,528,394)1 The Government of Dominican Republic placed 20 provinces on red alert, 5 on yellow alert, and one on green alert. There are 2,991 houses affected, and 110 houses destroyed. There are 10,929 people are in 205 shelters. One death was reported. 38 communities remain without communication. There are 40 aqueducts that were affected, of which 36 were shut off preemptively. Four bridges are damaged, affecting road access. Healthcare Services: There are 92 healthcare centers are reportedly affected. Response: Five damage and needs assessment response teams are being sent by the Government of Dominican Republic to help the provincial health departments of the most affected provinces of Maria Trinidad Sanchez, Espaillat, Samana, Duarte and Santiago. Needs: Identified needs include access to potable water, good sanitation and hygiene in shelters. TURKS AND CAICOS (Population: 34,339)1 Turks and Caicos Islands are reporting widespread damage after Maria. The eye of the storm passed less than 50 KM from Grand Turk Islands, which had been heavily impacted by Hurricane Irma and the hospital restoration was ongoing. Preparedness for Hurricane Maria was done with the assistance of the royal navy as well as Regiment. Inpatients from Grand Turk had been evacuated to Jamaica as a precautionary measure.

1 United Nations World Population Prospects 2017; Data estimate to 2015 2

UNITED STATES OF VIRGIN ISLANDS (Population: 104,977)1 The western and southwestern portion of the island received the greatest damage from Hurricane Maria. Much of the island’s electricity service has been compromised. FEMA reported 9 shelters are housing 558 occupants. Cellphone service is out for 77% of the island. 24-hour curfew is in affect for St Croix, and 6PM to 10AM curfew on St Thomas and St John. Transport and Logistics: The Ann E. Bramson Marine Facility pier in Frederiksted, Saint Croix is not damaged. The condition of the island’s Henry E. Rohlsen Airport is being assessed, but the runway has been cleared. Healthcare Services: Governor Juan F. Luis Hospital and Medical Center in Saint Croix has been affected, and all patients from the facility are being evacuated to the U.S. mainland.2 Response: HHS has medical teams providing care at a hospital emergency department on St Thomas, and is sending personnel to St John. PUERTO RICO (Population: 3,673,728)1 The Government of Puerto Rico confirmed six deaths in three municipalities. The Federal Emergency Management Agency (FEMA) reported 175 shelters are housing 10,692 occupants. There are 1.5 million people without access to electricity. Power Trucks are to be sent from mainland U.S. Transport and Logistics: All seaports in Puerto Rico are closed. Airports are available for military and hurricane relief. Cellphone service outage is affecting 95% of the island. Healthcare Services: All hospitals are operating on generators. Response: The Department of Health and Human Services (HHS) medical personnel are deployed to Puerto Rico to aid in patient evacuation and assist doctors and nurses.

NEEDS Immediate needs for Dominica and other islands that were impacted by Hurricane Maria is expected to include water and food supplies, as well as tarpaulins for damaged roofs. Due to lack of road access by cars and telecommunication outages, needs access is ongoing. In Dominica, road access is limited due to debris and landslides, which is affecting access to many parts of the island. As urgent humanitarian needs are identified, efficient coordination of humanitarian assistance and information management is necessary to effectively address them. Repairing damaged health facilities on the islands is crucial in managing emergency patients, quick diagnosis and treatment of diseases, and reestablish treatment of non-communicable diseases. For islands that continue relief operations after Hurricane Irma, continued improvements in healthcare access including patient referrals and medical evacuations are needed. Maintaining sanitary conditions, especially in shelters, continues to be a priority. Increases in mosquito and rodent vectors have been reported in heavily impacted islands. Vector control and cleaning supply needs list has been requested from affected island for consolidation.

RESPONSE ACTIONS PAHO is acting to quickly assess needs of impacted countries and territories and deploy supplies and human resources as needs are identified by impacted islands. PAHO medicines have been sent to Dominica on a boat in coordination with the Barbados Coast Guard. Additional shipment of generators, water purification tablets and solar panel was sent to Dominica with coordination with the UK Miltiary. Deployments of logistical coordinators, epidemiologist, and public health expert are being planned for Dominica. Transportation continues to be a problem during the response. The roads are impassable due to debris, and much of the cars that were on the island are not functional. The Deployment of Regional Response Teams to the islands included focus areas in coordination, damage assessment, epidemiological surveillance, logistics, information management, and water and sanitation. As needed medical and humanitarian supplies are identified by countries and shared with PAHO, medical and other supplies have been prepositioned in Panama and Barbados for rapid distribution in preparation for Hurricane Maria. As new information emerges from the field, new possible deployments may be considered by health authorities, especially after the passage of Hurricane Maria. A second round of deployments is being organized. The Pan American Health Organization (PAHO) is coordinating emergency projects to cover medical supplies, reestablish health services, and purchase of essential medicines and medical equipment. PAHO continues to coordinate with military, national governments, CDEMA, international NGOs and other UN agencies to improve the health response operations. FOR MORE INFORMATION:

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2 U.S. Virgin Islands Government House information as of 22 September 2017 3