News and Information for the International Community In the Spotlight 2 Perspective 4 Member Countries 6 Information Resources 11 ISASTERS Upcoming Events 12 Preparedness and Mitigation in the Americas March 2017 Issue 123 Photo: Luis de la Fuente, PAHO/WHO de la Fuente, Luis Photo: Verification mission visit to the Costa Rican Social Security Fund’s EMT. Hurricane Matthew, an overview Editorial of comprehensive action during and after The EMT initiative moves the emergency forward in the Americas urricane Matthew tested readi- and response actions. The resources mobi- he Americas rank second glob- Hness levels of Caribbean countries’ lized by PAHO allowed for the deployment Tally in terms of natural disasters, health services and their staff, as well as of 80 experts in logistics; in the coordina- after Asia. Between 2007 and 2016, the technical capacity of PAHO/WHO for tion of emergency medical teams (EMTs); 20.6% of the world’s disasters occurred mobilization and response. in damage assessment and needs analysis; in in the Region of the Americas, caus- The Category 5 hurricane put thousands water, sanitation, and hygiene; and in health ing 255,033 deaths, 898,816 injuries, of people at risk in Cuba, the Turks and Cai- response coordination. and damages worth 470 billion dollars; cos Islands, the Dominican Republic, Haiti, PAHO lead health coordination efforts 88% of those deaths occurred in earth- and the United States, and Colombia. ensuring the supply of drinking water and quakes in Peru (2007), Haiti (2010), PAHO/WHO continuously monitored uninterrupted medical services—including Chile (2010), and Ecuador (2016), the situation, keeping in touch with the health the distribution of equipment and essential while also leaving 541,787 people authorities and with their counterparts in the supplies—in the affected areas. (continued on page 2) >> Region, to be aware of the support, readiness, (continued on page 2) >> (from page 1) Hurricane Matthew, an overview of comprehensive action during and after the emergency From Tropical Storm to In the Bahamas, PAHO supported the Hurricane Haiti after Hurricane Matthew, Ministry of Health in the evaluation of needs in figures On 28 September 2016 a strong tropical for the Sandilands Rehabilitation Centre, the 1,410,744 people in urgent wave was reported, located near Barbados, Princess Margaret Hospital, the South Beach need of humanitarian producing winds of 40-45 miles per hour Health Centre, and the Anne’s Town Clinic. assistance (mph), as the storm system moved through In Cuba 320,00 people were evacu- 175,509 people in shelters the Lesser Antilles. ated and 44 health facilities were damaged. 2,271 suspected cases Preparedness and response measures In response, 30 EMTs were deployed to of cholera included, in Barbados, activation of the risk areas, continued epidemiological sur- 128 missing persons National Emergency Operations Centre and veillance and the provision of supplies the opening of 20 shelters. In Saint Vincent for health services and water quality were 546 deaths and the Grenadines, the Milton Cato Memo- ensured, as well as the rehabilitation of 65 affected health care facilities rial Hospital went into emergency operations health centers, including the restocking of mode. In Saint Lucia, communication with equipment and essential supplies. Jamaica the population was intensified. On 29 Sep- reported 900 people in shelters. Hospi- PAHO Haiti activated its Emergency tember, there were reports of evacuees, some tals were open for emergencies only. The and Disaster Preparedness and Response power outages, and floods. Ministry of Health implemented health Plan, set up a situation room, and deployed On 4 October, Matthew—now a Cat- monitoring systems with regard to water two logistics experts and a health coordina- egory 4 hurricane—made landfall near quality, sanitation, food security, and dis- tion expert. Les Anglais, Haiti, with winds of up to ease surveillance. The Dominican Republic PAHO/WHO working priorities in the 145 mph. Consequently, an alert went into put its 31 provinces bordering Haiti on red field focused on supporting the Ministry effect for Haiti, the Bahamas, the Turks and alert. There were 366 official shelters acti- of Health, on access to medical care and Caicos Islands, and Cuba. It was reported vated, and 35,000 families were affected. drinking water, and on health and hygiene that 601,241 people were in shelters in the Colombia reported 15,000 affected families, conditions, in addition to the recovery and affected areas. especially in the departments of La Guajira, strengthening of health services. Magdalena, César, Bolívar, and Atlántico. During the response phase in Haiti, two field offices were set up in Jérémie Haití and in Les Cayes to support the delivery of In Haiti, more than 750,000 people were basic medical supplies and equipment, and left in need of international assistance after the the transfer of experts to the field. More passage of Matthew. More than two million than 1.5 million doses of cholera vaccine were directly or indirectly affected. Approx- were distributed, targeting approximately imately 50% of the health infrastructure was 800,000 people. In December 2016, PAHO/ affected. Out of 15 hospitals, one was com- WHO estimated that the needs of the health Photo: David Spitz, PAHO/WHO David Photo: pletely evacuated and five were inaccessible. sector for rehabilitation and resiliency mea- Emergency Operations Center Furthermore, 75% of Acute Diarrhea Treat- sures would total US$ 230 million. in Port-au-Prince, Haiti. ment Centers (CDTA) were damaged. 2 March 2017 Issue 123 In the SpotlightEditorial (from page 1) Editorial The EMT initiative moves forward in the Americas injured (60% of the global total). 1 In the Haiti earthquake, 30 of 49 hos- pitals were damaged or destroyed. The immediate impact on health services was devastating in terms of professional staff and infrastructure, especially since the number of hospital beds (1.3 per 1000 pop- ulation) and health workers (3 per 10,000) was already insufficient.2 In the Chile earth- quake, 21.9% of hospital beds (4,249) were lost in the affected area.3 In Ecuador 29% of PAHO/WHO de la Fuente, Luis Photo: available beds (517) were lost, 86% of them in the public health network.4 Analysis of the health response to the 2010 earthquake in Haiti demonstrated Verification of water and sanitation capacities of the Costa Rican Social Security Fund’s EMT. the need to develop principles, criteria, and standards for medical team response EMT standards. It is on its way to becoming who need to be transferred to higher-level in emergencies and disasters. Based on the first country in the Americas to receive services. This EMT needs to be self-suffi- this analysis, the Pan American Health WHO International EMT classification. cient for at least two weeks, the minimum Organization brought together a group of In February of this year, after a rigor- expected mobilization period. experts, in December 2010 in Cuba, to lay ous verification process, an international To date, EMTs from Russia, China, the groundwork of the World Health Orga- expert mission confirmed that the EMT of Japan, Australia, Israel, and the United nization’s global Emergency Medical Teams the Costa Rican Social Security Fund meets Kingdom have been classified. Costa Rica (EMT) initiative. the standards and principles established by will be the seventh country at the interna- Twelve countries in the Americas are WHO and is ready for international deploy- tional level and the first in the Region to be already adopting the EMT initiative as part ment to emergencies and disasters. added to the WHO roster. About a third of of their national systems to ensure that The purpose of classification is to have the countries registered for the verification emergency medical teams can be requested a global roster of medical teams that meet process are in the Americas. and deployed in the shortest possible time, WHO’s minimum standards for EMTs and Since the initiative was launched, while building national medical emer- that can be deployed to emergencies in the EMT implementation in the Americas has gency teams that are ready to be deployed shortest possible time. had financial support from Spanish Coop- to neighboring countries or internationally. Costa Rica’s Type 1 EMT can serve at eration, which has also shared its own Costa Rica is one of the countries that has least 100 people per day on an outpatient experiences in the development and deploy- developed national medical teams in line with basis, in addition to stabilizing patients ment of EMTs. 1 The OFDA/CRED International Disaster Database. EM-DAT. Reviewed: 16 March 2017. 2 PAHO. Health response to the earthquake in Haiti. January 2010. 3 Information from the Ministry of Social Development of Chile, 27 August 2010. 4 Preliminary report on the Ecuador earthquake. DALA SALUD. 2016. Editorial March 2017 Issue 123 3 Photo. Alex Camacho, PAHO/WHO Camacho, Alex Photo. Participants at the parallel session: Health Intersections and Disaster Risk Reduction. Regional Platform for Disaster Risk Reduction in the Americas he Fifth Regional Platform for Disas- Parallel Session: Health Inter- 2016-2021, approved by the Ministers of sections and Disaster Risk ter Risk Reduction in the Americas Health of the Americas in September 2016, T Reduction was held in Montreal, Canada, from 7-9 were addressed. March 2017. Delegates from across the In recognition of the important role The session had six speakers and was Americas met to discuss efforts for disaster of the health sector in the Sendai Frame- co-chaired by Elaine Chatigny, Deputy risk reduction. Key outcomes included the work, the Public Health Agency of Canada Vice-Minister of PHAC’s Security Infrastruc- adoption of the Montreal Declaration and (PHAC) and the Pan American Health ture Branch, and Dr.