This document discusses the impacts of disasters on health and the environment. It provides an overview of key topics including how disasters affect the health system and disease transmission. Disasters can indirectly impact health through effects on other sectors like water and sanitation. The health impacts of disasters depend on factors like the type of disaster, pre-existing public health conditions, and the effectiveness of the response. Both communicable and non-communicable diseases are discussed, as well as how different disaster types carry varying risks of epidemics. Specific health impacts of disasters like earthquakes, floods, and complex emergencies are also outlined.

1. MSDM 5244:
Impacts of Disaster on Health and Environment
Md. Serajul Islam, PhD
Professor
Department of Geography and Environment
University of Dhaka
E-mail: seraj0021@yahoo.com
Phone: 01711205198
Lecture Two

2. • Key facts about health and disaster
• The health system
• How disaster affects the health system?
• Public health situation
• Disease pattern
• Transmission dynamics of CD
• Risk of epidemics occurring after selected disasters
• Public Health Impact of Selected Disasters
Focus point for Today’s Lecture

3. • Morbidities always pre‐exists in communities prior to the
occurrence of disasters
• Not all natural disasters have an impact on the health
system
• Occurrence of health system consequences of disaster
depends on many factors:
• Type of disaster
• Pre‐disaster status of the health system
• Public health situation & disease pattern of the area prior to the crisis
• Impact of the disaster on other sectors such as water, sanitation,
shelter
• Population displacement
• Effectiveness of the response to the disaster
• Socioeconomic status of the area prior to the disaster
Key facts about health and disaster

4. • Occurrence of public health impact of crises depend on
other sectors such as protection, shelter, WASH
• Some disasters have direct impact on health while some are
indirect:
• Direct: earthquakes/conflicts/mines (trauma, lacerations,
fractures, amputations
• Indirect: floods/droughts/cyclones (epidemic diseases,
malnutrition, mental health & psychosocial problems, MCH)
Key facts about health and disaster

5. The health system
• What is Health System?
• Von Bertalanffy (1968) A “system” can be understood as an
arrangement of parts and their interconnections that come
together for a purpose.
What sets apart a health system is that its purpose is concerned
with people’s health.

6. The health system
Roemer (1991) Describing the parts,
interconnections, and purpose, defined a health
system as “the combination of resources,
organization, financing and management that
culminate in the delivery of health services to
the population.”

7. • The World Health Organization (2000) redefined the main
purpose in its definition of a health system as “all activities
whose primary purpose is to promote, restore, and maintain
health.”
In recent years, the definition of “purpose” has been further
extended to include the prevention of household poverty
due to illness.
The health system

8. To some extend
• A health system has many parts. In addition to patients,
families, and communities, Ministries of Health, health
providers, health services organizations, pharmaceutical
companies, health financing bodies, and other organizations
play important roles.
• The interconnections of the health system can be viewed as
the functions and roles played by these parts. These functions
include oversight (e.g., policymaking, regulation), health
service provision (e.g., clinical services, health promotion),
financing, and managing resources (e.g., pharmaceuticals,
medical equipment, information).

9. The health system: The building blocks
The
health
system
Human
resources for
health
Health
information
systems
Essential
medical
products and
technologies
Health
financing
Leadership
and
governance
Service
delivery

10. How disaster and health related ?
Health Workforce
(Human Resource)
Health Information
Management
Medical Facilities

11. How disaster and health related ?
Health Financing
(economic aspects)
1. Increasing
medicine price
2. Reducing spend
on health sector
investment.
3. Delivery cost
may high
4. Health care
cost increases
6……
Leadership &
Governance
Health service
delivery
1. Breakdown of
policies/strate
gy
2. Lack of
supervision
3. Lack of
monitoring
4. Inability to
enforce health
regulations
5. Ensure
accountability
1. No delivery
/supply
2. poor coverage of
public health
interventions
3. Delivery cost may
high
4. Health care cost
increases
5. Unsafe health
service
6. Poor quality
health service
6…. Reducing spend
on health sector
investment. …

12. Public health situation
• What is Public Health?
• Public health refers to all organized measures (whether public
or private) to prevent disease, promote health, and prolong
life among the population as a whole (WHO).
• Public health is "the science and art of preventing disease,
prolonging life and promoting health through the organized
efforts and informed choices of society, organizations, public
and private, communities and individuals” (Winslow, 1920).

13. Disease pattern
• International classification of diseases
• Diseases resulted in recovery or death
• The World Health Organization puts deaths into one of
the three major categories:
– Communicable, maternal, perinatal, and nutritional conditions;
– Non-communicable diseases; and
– Injuries.

14. Disease pattern: Communicable Diseases
• For most of human history, infectious diseases have been the major cause of
death, killing people before they had a chance to die of something else.
Classification of communicable diseases according to mode of transmission:
– airborne (influenza/pneumonia, TB, smallpox, measles, etc)
– water-food-borne (diarrhoea, typhoid, cholera)
– vector-borne (malaria, typhus, plague)
– sexually-transmitted diseases (HIV/AIDS, syphilis)
• The communicable diseases are those that can be transmitted from one person to
another or from animals to humans, such as respiratory infections, diarrhoeal
diseases, parasitic diseases and sexually transmitted infections, including HIV/AIDS.

15. Maternal conditions are related to pregnancy, labour or
delivery, including maternal haemorrhage and sepsis,
hypertensive disorders associated with pregnancy,
obstructed labour, and complications associated with
abortion.
Perinatal conditions are related to the late-foetal period or
the first weeks of life; they include prematurity and low
birth weight, birth asphyxia and birth trauma, and neonatal
infections and other conditions related to the neonatal
period.
They include 'causes arising in the perinatal period' as
defined in the International Classification of Diseases, but
not all conditions occurring in the perinatal period of life.
Nutritional deficiencies refer to deficiencies in iodine,
vitamin A and iron, as well as protein-energy malnutrition.

16. Disease pattern: Non-communicable diseases
• Non-communicable diseases include cardiovascular diseases, cancers,
diabetes and chronic respiratory diseases
• In American medicine, “[C]hronic diseases have been referred to as
chronic illnesses, noncommunicable diseases, and degenerative diseases.
They are generally characterized by uncertain etiology, multiple risk
factors, a long latency period, a prolonged course of illness, noncontagious
origin, functional impairment or disability, and incurability” (Taylor et al.
1993).

17. Non-communicable diseases take precedence over
communicable diseases as the important causes of
death as we move through the health and mortality
transition.
Non-communicable diseases are:
more difficult to detect than infectious diseases
non-contagious origin
multiple risk factors
long latency period
long duration of illness (associated with disability)
more difficult to cure than infectious diseases

18. Disease pattern: Injuries
• Accidental or unintentional death as a result of the way in
which we organize our lives and deal with products of our
technology.
• Homicide
• suicide
• Intentional injuries may be self-inflicted or result from war
or violence.
• Unintentional injuries include those resulting from road
traffic accidents as well as accidental falls, poisonings,
drownings, fires, and other causes of unintentional injury.

19. Transmission dynamics of CD
• A number of models of disease causation have been
proposed. Among the simplest of these is the epidemiologic
triad or triangle, the traditional model for infectious disease.
• The triad comprises an external agent, a susceptible host, and
an environment that brings the host and agent together.
• In this model, disease results from the interaction between
the agent and the susceptible host in an environment that
supports transmission of the agent from a source to that host.
• Agent, host, and environmental factors interrelate in a variety
of complex ways to produce disease in humans.
• Different diseases require different balances and interactions
of these three components.

20. Transmission dynamics of CD
Host
Environment Driving
Force
Health

21. Transmission dynamics of NCD

22. Risk of epidemics occurring after selected disasters
Disaster type Person to person Waterborne Food borne Vector borne
Flood
Earthquake
Fire
Cyclone
Industrial
accident

23. Risk for epidemics occurring after selected disasters
Disaster type Person to person Waterborne Food borne Vector borne
Flood Medium High Medium High
Earthquake Medium Medium Medium Low
Fire Low Low Low Low
Cyclone High High High Low
Industrial accident Low Low Low Low

24. Public Health Impact of Selected Disasters
Effect Complex
emergencies
Earthquakes High winds Floods Flash floods
Deaths
Severe
injuries
Increased
risk of CD
Food
scarcity
Major
population
displacem
ents

25. Public Health Impact of Selected Disasters
Effect Complex
emergencies
Earthquakes High winds Floods Flash floods
Deaths Many Many Few Few Many
Severe
injuries
Varies Many Moderate Few Few
Increased
risk of CD
High Small Small Varies Small
Food
scarcity
Common Rare Rare Varies Common
Major
population
displacem
ents
Common
(may occur in
heavily
damaged
urban areas)
Rare Rare Common Varies