The document summarizes a study on illnesses related to flood disasters at relief centers in Malaysia. It found that the most common illnesses were upper respiratory tract infections (URTI), musculoskeletal pain, headaches, and uncontrolled hypertension. URTI was likely due to overcrowding and difficulties maintaining hygiene. Musculoskeletal pain resulted from rescue efforts during the flood. Headaches were caused by stress and disrupted medical infrastructure led to uncontrolled hypertension. Overall, the study aimed to help medical relief teams prepare for future flood disasters.

1. A Study on Illness Related Flood Disaster at Relief Centers Assoc. Prof. Dr. Rashidi Ahmad School of Medical Sciences Health Campus USM Kelantan Humanitarian Conference Putra World Trade Center 12 – 14 th Nov 2009

2. Introduction On 19 Dec 2006, continuously heavy downpour occurred in State of Johor, Malaysia. Many towns such as Muar, Kota Tinggi & Segamat were seriously flooded with water levels as high as 10 feet above ground level. Flood in Johor State was considered as the worst in the Malaysia southern region history. Those flood victims were evacuated to the unprepared designated relief centers

3. Predisposing factors Living in temporary shelter or in the relief center is unpleasant memory to the flood victims. Uncontrolled crowds, limited spaces and facilities such as clean toilet, medicines and nutritional food were predisposing factors that exposed the flood victims to various type of diseases especially viral infection. More often there will be a mismatch between available health resources and facilities and patients need.

4. Objective The primary objective: provision of medical and humanitarian assistance to the flood victims. We took an opportunity to investigate the common illnesses related to the flood disaster at relief centers The presented data could assist the medical relief team, humanitarian organizations and agencies preparedness in the future.

5. DEMAT The team members were comprised of 4 medical officers from HUSM + Medic Asia. HUSM donated medical equipments and medications and Health clinics of Pagoh and Lenga provided the extra supplies. The duration of medical assistance to the affected local community - 5 days (4th to 6th Jan 2006).

6. Methodology Cross sectional study, convenience sampling 5 relief centers at District of Muar, Johor - Kampung Sungai Berani, Balai Raya Kampung Jawa, Kampung Jawa Mosque, Kampung Tulang Gajah and Kampung Sentosa. Those flood victims who registered and received the treatment were included.

7. Results Total = 170 patients were evaluated and treated 65 (38%) males; 105 (62%) females. The mean age = 31.89 ± 22.07 year old. 123 (72%) - an adults; 47 (28%) - children URTI = 58 of 170 visits; 34.1% URTI were common in children (20% of total visits) than an adult (14.1% of total visits).

8. Musculoskeletel problems = 39 of 170 visits; 22.9%. Headache = 18 of 170 visits; 10.6% HPT = 15 of 170 visits; 8.8% Dermatological problems = 14 of 170 visits: 8.2% Medical check up = 18 of 170 visits: 10.6% ~7% (12 out of 170 visits) required hospitalization (11 of them = uncontrolled HPT)

9. Distribution of IRFD according to the relief centers 170(100) 84 50 6 9 21 Total 4(2.4) 0 3 0 0 1 Others 11. 1(0.6) 1 0 0 0 0 Asthma 10. 1(0.6) 1 0 0 0 0 Abdominal pain 9. 2(1.2) 0 1 0 0 1 Dyspepsia 8. 2(1.2) 1 0 0 1 0 Trauma 7. 14(8.2) 3 5 2 3 1 Skin disease 6. 15(8.8) 8 3 1 1 2 Hypertension 5. 16(9.4) 12 3 0 0 1 Medical Check up 4. 18(10.6) 16 1 1 0 0 Headache 3. 39(22.9) 11 16 1 2 9 Musculoskeletal pain 2. 58(34.1) 31 18 1 2 6 URTI 1. N(%) Kg Sentosa Tulang Gajah Masjid Kg Jawa Balairaya Kg Jawa Sg. Berani Medical conditions Total Place

10. Discussion The occurrence of disasters creates varying degrees of chaos to the affected community. In health perspective, disasters result in immediate medical problems, longer-term public health and emotional & social disruptions.

11. URTI URTI was the commonest reason of visits to the mobile clinic. Sharing a bed among the victims, physical contact, lack of sleep, more prolonged contact with carriers and difficulty in maintaining good hygiene practices are the risk factors. In addition, over crowding may increase exposures to allergens, respiratory irritants, and infectious agents.

12. Musculoskeletal pain Musculoskeletal pain was common too. We postulated that this symptom is related to the heroic phase of flood disaster whereby during this phase, people are called upon and respond to save their own and others’ lives and property. Therefore, overuse of energy and at same time over stress predisposed the victims to such problem.

13. Headache Tension headache was common Disaster related stress is common among disaster survivors. Reasons of elevated stress level include financial loss, property loss, loss of family members, crowded relief center, lack of facilities and even nervous of recurrence of flood.

14. Uncontrolled HPT Medical infrastructure and common road are disrupted As a result, some of the patients have a poor accessibility to the nearest health facilities for a common treatment and continues routine medical care may not be available to survivors due to damaged healthcare facilities

15. Water borne illnesses There was no incidence of water borne illnesses outbreak such as diarrhea, hepatitis and cholera occurred post flood in the relief centers along the disaster event. This reflected the effectiveness and the efficiency of the local public health authority in controlling the non-vector borne illnesses in flood disaster.

16. Points to ponder Providing medical care in a disaster setting is a challenge to the HCPs. The obstacles include varying amounts of resources, type of acute illnesses & periods of time. The mobile medical relief team bringing health care to those sick and disable victims who had a difficult access to medical facilities. The mobile clinic is a viable option for victims who required routine medical requirements

17. Conclusion The common illnesses at relief centers - URTI, musculoskeletal pain, headache, HPT Future address- over crowded relief centers & clean water supply, environmental and personal hygiene. Hopefully the available data and the explanation will provide valuable information for our future mission on the medical preparedness and readiness post flood disaster

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