Managing post-cyclone health problem

Dr. Turin Chowdhury

Devastating cyclone ‘Sidr’ recently hit Bangladesh. So far this is the most devastating natural event. The initial blow of the cyclone has created a disastrous situation in Bangladesh, and probably the initial blow will last for a few days to weeks. But not only the initial blow, the aftermath of the cyclone will start setting in within this period simultaneously.
   The first step of limiting the human casualty has been done somewhat effectively. But now comes the emergency part of the immediate health care service or emergency aid giving phase followed by the continuous health service delivery and facility restoration phases.
   
   Healthcare
   To manage a health disaster we are to ensure certain things. Those are –
   1) To ensure immediate healthcare delivery to the people affected in the disaster needs immediate dispatch of healthcare delivery personnel with the necessary basic supplies for the work. A pilot team should be dispatched who can give prompt feedbacks by quick surveying the affected areas. Getting the feedbacks the central control should decide on the dispatch of the bigger emergency health work force according to the needs of the different area populations.
   2) To have strong backup preparation for fulfilling the emergency health needs of the people. We need to have a ready supply of first aid materials to meet the initial blow. Every person in the cyclone effected area needs health care but the priority should be given for the life savings needs. A person with less severe injury can be left out in the initial screening for getting health care in the second round of service. But these have to be done during the initial phase.
   
   Stabilising health situation
   Next comes an extensive stage in terms of health environment. As we can see that the Sider cyclone has turned the once inhabited communities of the southern costal areas into wastelands with wrecked homes, crops, livestock and fields. The environmental contaminations will be growing with the decomposed bodies of the livestock. The lack of food supply will start taking its toll on the effected population making them physically vulnerable towards ill health and diseases. The unavailability or short supply of pure drinking water or water purification activities with the presence of destroyed and bad sanitation will cause the epidemics of diarrhoea, cholera to set in. To prevent these to happen we need to initiate attempts of environment sanitisation. Sources of clean water, facilities of good sanitation, nutritional supply have to be ensured.
   Simultaneously the treatment facilities have to be broadened for covering the entire population. In this aspect we need the “disease disaster management preparation” approach right now rather than the “conventional disease prevention” approach. In Bangladesh we have all the reasons to be worried about health threats of various kinds to become an epidemic. Our crowded dense living quarters, malnourished population, lack of cleanliness in personal and collective environment, bad sanitation, lack of education and awareness all makes our country very vulnerable towards a disease eruption.
   In general containing disease epidemics after the cyclones or similar environmental disasters are more difficult – and we will need obviously a national platform initiative for that. We have to get prepared by ourselves and management plan or approach should have two components.
   Primary component — preparation of the system.
   Secondary component — the disease identification, prevention.
   The government has to prepare actively with a concrete plan to face the epidemic situation with a disease disaster management preparation activity. The Government is the best and the only institution to take these initiatives. The private sectors have to be of secondary help.
   The private health care sector has to understand the importance and use their full utility to create a parallel infrastructure for facing the disaster. The government will have to take the central role and some measures such as stockpiling of medical supply, emergency service preparation, plan a strategy for systematic response, be realistic in identifying priority population, etc.
   Re-establishment of health service:
   This would include rebuilding damaged structures, infrastructure development etc. It would not be possible with personal efforts. The government has to take the primary initiatives for this purpose.
   
   Comprehensive approach
   The struggles right now are to give the effected people the supply of the basic necessities for their survivals against the initial health shock. Followed by the preparation of the second step of should stabilising the health environment of the affected area. Under-preparedness for crisis management will make things worse.

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In the trap of trickery

Col. (Retd.) Mirza Shafi

Let me start with a practical joke- The Azad Kashmir Regular Forces (AKRF) were known as the Aao, Khao, Ration Free force. That does not mean that we did not have our ‘ration free’ time in the Karakoram Highway (KKH) project and during border area duties we had our own share of free rations. Then someone in the early 1960s thought of a bright idea — a bright general for construction of huts, small bridges and culverts etc on ‘no cost’ basis.
   The general was someone with a message that transcended military strategy, someone who normally spoke loud (yet not clear), and had that so-called operational toughness, thought of construction for the poor and calamity-affected people of West Pakistan. And we the engineers suffered the most, for we needed to first collect the construction materials, by hook or by crook, construct those huts, roads, culverts etc and also ensure our peace-time training fitness, as the others in his formation.
   Nothing comes free in this world. Your very coming in this world, is the desire and hard work of the parents. If anyone desires to achieve something in this life (or for that matter in life thereafter), one has to work towards that end. Surah An ‘am or Cattle (VI-132) says, “To all are degrees (or ranks) according to their deeds; for thy Lord is not unmindful of anything that they do.”
   The other day we happened to see an advertisement either or both from two multi-national firms. It categorically expressed that if their ACs are purchased, the installation will be ‘free’. But there was a gimmick in that advertisement — they meant only carriage of the items and placing the AC on the wall or at the prepared place/location would be free, all other expenses to be borne by the buyer. In the name of free instillation they are collecting a few takas — a new form of corrupt practice and hoodwink of the general public.
   The story did not end there. In one case we had to report to the head office of the Siemens, for redress when the arrogant sales executive even gave it in writing that in such cases the decision of the ‘mechanic’ is final, (charging us a sum of Tk. 3,000 extra). What an outright bluffing!).

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Obama Rayyan Kamal

I doubt Barack Obama will be the next American president. In fact, even his chances of getting the democratic nomination are quite slim. But, as one of my professors pointed out, just the fact that he’s gotten this far (whatever that means) is a testament to the strides that America has made to racial equality.
    Obama, the son of a black man and a white woman, was raised by his mother after his parents got divorced when Obama was just two. His multiracial heritage has always been a crucial component of his identity. In one of his memoirs, he says when he was a young child, “That my father looked nothing like the people around me – that he was black as pitch, my mother white as milk – barely registered in my mind.” This ignorance was short-lived, however. During adolescence, tortured by the lack of belonging to any one group felt by many multi-racial individuals, Obama turned to marijuana and cocaine.
   As a presidential candidate, the issue is perhaps less about his multiracial heritage and more about the fact that he has any black blood in him. It is almost impossible for Americans to view him as just another candidate who happens to be of colour. Rather, he is a man of colour who is running for president. Hilary Clinton perhaps faces a comparable challenge as a female candidate.
   But despite their similar situations, it appears that their reactions are anything but similar. According to a Wall Street Journal piece I read last week, Clinton is never reluctant to remind voters that, if elected, she would be the first woman president of the U.S. Obama, on the other hand, rarely ever plays the “race card.”
   Obama has to strike a delicate balance between appeasing whites without alienating blacks. One must not forget that he is not the “average” person of colour – he was raised by a single white mother. Many African-Americans feel that he is simply too white. A black school teacher was quoted in the Wall Street Journal article as saying that “He is close enough to what is a tolerated white norm, very much what is palatable and acceptable and good.” Telling is that in several polls of African-American democratic voters, Obama trails Clinton.
   Yet no one can deny that something about Obama seems to resonate with the American youth. Maybe they feel that, if elected, he would not only serve as a reflection of America’s racial harmony, but also speed up the journey to a “colour blind” U.S. Or maybe they just like him because he’s relatively young for a presidential candidate. Whatever the case, Obama’s highest ratings come from voters below the age of 50.
   A Yale for Obama group is growing in prominence on campus. A few days ago my friend went to a meeting they were holding. What struck him was that the majority of the students in attendance were white. Maybe this is no surprise, considering that whites constitute the majority of Yale’s student body. Regardless, I thought this, more than Obama’s candidacy, was a testament to the strides that America has made to racial equality.
   Rayyan Kamal is a sophomore at Yale University.

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Last week’s Sidr killed several thousand people and destroyed millions. In a flash of a second, hearth and homes were destroyed and souls separated. The mother found her bosom empty in one single stroke, and hundreds of children were orphaned. All went quiet by dawn. No words spoken. The daylight told the tale of devastation in silence. Very few survived to recollect the rage of the hurricane. The air was heavy; the world could only behold the scene of death and destruction but groped for words to describe those.
   The wide stretch of sea once filled with sweet fragrance of flowers, crops, sands and soil was now a land of the dead. The stench of the bloating carcasses hung in the air- making life difficult for the living.
   The hurricane went on rampage over 18 districts and how many villages we do not know. Nor shall we ever know the number of deaths.
   Long before this, in 1970, we were struck by more severe hurricane and tidal surge in almost the same area of the eastern coast. Bhola was worst affected.
   Mourning apart, we need to face the reality. The reality is: More of the Sidr is going to visit us in future. We cannot stop them anyway. We are weaker than the God’s nature. We can only try and stop the intensity of damages and loss of lives.
   Cyclone and disaster management has by now become one of the biggest research areas in the world. With the drastic change in the climate behaviour scientists and experts are more involved in getting the state-of-the-art alerting system at work.
   By now the people working in these areas should identify that only effective instrument can help us forecast better and minimise the damage and the loss of lives and properties. And this should be a continuous process.
   We should also realize that no apparatus can read the actual velocity of the wind that is going to strike, the actual height of the waves that is going to draw you away and cannot foresee the extent of damage it is going to cause. Therefore, we can only focus on the warning system and take timely measures to evacuate the vulnerable community of the coastal belts before the expected time of impending danger.
   The regular exercise of warning and taking preventive measures during the crisis hours will give people plenty of time to undertake various procedures, such as, issuing warnings, taking ships and vessels to safer areas, hoisting danger signals, evacuating people right from the edge of waters of the sea and guiding people to the storm shelters.
   Let us not forget the families of the hurricane which comes and strikes us every now and then with different names and faces. They will keep coming until the end of the world. We need to have national motivation, awareness, and preventive and rehabilitation programs round the year in those vulnerable areas instead of having seminars and round tables in the cooled rooms with club sandwiches and hot coffee.

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