Gender-based violence and associated health outcomes against internally displaced women after the Haitiearthquake

OBJECTIVES: Limited research following disasters suggests that internally displaced women are disproportionately vulnerable to violence and abuse. The purpose of this study was to investigate gender-based violence (GBV) and health outcomes among Haitian women living in tent cities/camps following the 2010 earthquake. SUBJECTS AND METHODS: Culturally sensitive and language appropriate audio-computer assisted self-interviews (ACASI) of 208 internally displaced women in Port-au-Prince, Haiti, were done. Intimate partner violence, nonpartner violence, sexual abuse and emotional abuse history were collected from 2011–2013. RESULTS: Findings showed high prevalence of physical, psychological and sexual abuse, both before (71.2%) and after (75.0%) the earthquake, primarily perpetrated by boyfriends or husbands. Significantly more mental and physical health problems were reported by abused than non-abused women. The most frequent abusers were boyfriends or ex-boyfriends (38.1%) and husbands or exhusbands(42.3%). In addition, among abused women post-earthquake, post-traumatic stress disorder and suicidal thoughts and attempts increased by 104% and 30%, respectively. CONCLUSIONS: It is essential that disaster healthcare policies and practices include specific attention to intimate partner violence. Post-disaster violence is often a continuation of the same intimate partner violence women encountered before the disaster occurred. Coordinated planning and implementation of much needed culturally tailored interventions are essential to provide a balanced approach to the care of displaced women after natural disasters, with sensitivity to the abusive occurrences many of the women experience, both before and after the disaster.

Nutritional status of children under 5 years of age in three hurricane-affected areas of Honduras

Hurricanes and other natural disasters can produce crop destruction, population displacement, infrastructure damage, and long-term public health consequences that include increased malnitrition among the affected populations. This paper presents the results of anthropometric measurements taken of 295 children under 5 years of age from three regions of Honduras that were affected by Hurricane Mitch, a major storm that struck Central America in the fall of 1998. The children in our study were sampled in three shelters in the capital city of Tegucigalpa; in the resettlement zone of Nueva Choluteca, Choluteca; and in the small urban area of Catacamas, Olancho. Our data indicated that, in comparison to the period before the hurricane, there was an elevated prevalence of wasting in all three of the study areas, and that there were also high levels of underweight in the Tegucigalpa and Nueva Choluteca study areas. There were statistically significant differences between the mean values of malnutrition indicators for Catacamas and those for the Tegucigalpa and Nueva Choluteca settlements. These differences suggest that resettled families were confronting a nutritional crisis in July and August of 1999, some 9 months after the hurricane struck (AU)

Impact of Hurricane Luis on the health services of Antigua and Barbuda

Antigua and Barbuda, located in the Caribbean, was one of the countries most affected by Hurricane Luis in 1995. Electricity, water supply and health facilities were disrupted for several weeks. Inadequate criteria at the design stages, unsound structual design, and lack of maintenance of building components, are some of the reasons that damage was so severe. The main hospitals and 6 health facilities were destroyed and flooded and most of the medical staff had to cope with their own damaged houses. Although the knowledge and materials are available to reduce the losses caused by hurricanes, building codes are not reinforced by laws and preventive maintenance to protect health care facilities from natural hazard damage is not usually budgeted for. The additional cost of making a single or two-storey health facility almost invulnerable to future catastrophe in a hurricane is only 2 percent in initial capital cost and becomes negligible when spread over the life of a building. The effort of UN International Decades for Natural Disasters (IDNDR) directed towards disaster mitigation should be increased over the remainder of the decade to ensure that standards are respected and building codes are mandatory.(AU)

Neural tube defects in Jamaica following Hurricane Gilbert

An increased incidence of obvious live-birth neural tube defects (i.e., spina bifida cystica and encephalocele) occurred in Jamaica 11 to 18 months after Hurricane Gilbert. The conceptions of the affected babies coincided with a rise in megaloblastic change in sickle cell patients, suggesting a wide-spread drop in dietary folate intake. A detailed history was taken from each of the 17 affected mothers (case subjects) and 51 unaffected mothers (matched control subjects). The case subjects reported a significantly lower mean intake of dietary folate in the periconceptional period (154 micograms/day) than did the control subjects (254 micrograms/day). The temporary increase in neural tube defects was associated with a dietary level of folate that fails to protect against neural tube defects under natural conditions. (AU)

An exploration of the hurricane experiences of nine elementary school children of St. Croix, United State Virgin Islands

The purpose of this study was to explore the hurricane experiences of elementary school children of St. Croix, United States Virgin Islands. Measures of effecting positive change by significantly reducing symptomatic behavior resulting from the effects of natural disasters such as Hurricane Hugo were suggested. Qualitative inquiry was utilized, and case studies of children's family situations, school context, hurricane and aftermath experiences, the effects of the hurricane on families and friends, and related issues were presented.(AU)

Effects of a hurricane on growth and morbidity in children from low-income families in Kingston, Jamaica

This is the first report of the effects of a hurricane on children's health and nutritional status in which data were available preceeding and following the event. When Hurricane Gilbert struck Jamaica in 1988, a longitudinal study was in progress in which children's weights and heights were recorded every 2 months and their morbidity histories taken every week. The investigation included 127 stunted (low height-for-age) and 32 non-stunted children aged 23-44 months, living in poor areas of Kingston. The data from the 4 months before and after the hurricane were compared. There was an increase in the occurrence of respiratory symptoms including rapid or difficult breathing (P < 0.04), coughs (P < 0.001) and nasal discharges (P < 0.001) during the first 2-month period after the hurricane. Howerver there was no significant effect on the occurrence of diarrhoea and injuries. Deficits were also found in height gain (P < 0.0001) during the same period. These adverse effects were found in spite of the large amount of food aid received and the aggressive health education programme implemented after the hurricane (AU)

Hurricane Gilbert: its effects on growth and morbidity in at-risk children in Kingston, Jamaica - abstract

Hurricanes strike the various territories of the Caribbean anually, leaving considerable destruction in their wake. Evaluations are normally based on surveillance systems which are implemented afterwards. However, there tend to be no data before the event. Therefore, it is not possible to identify the true effects on children's morbidity and growth. When Hurricane Gilbert struck Jamaica in September 1988, a two-year longitudinal study was in progress which included 127 stunted and 32 non-stunted children living in poor areas of Kingston. At the time of the hurricane, they were aged 23 to 44 months. A complete history of the children's weekly morbidity was recorded while weight and height measurements were taken every two months. These data were available for four months before a six months after the hurricane. Differences were examined, using analyses of variance. The results indicated that there was an increase in the incidence of respiratory diseases, including shortness of breath (p < .04), coughs (p < .001) and nasal discharges (p < .001) during the first two-month period after the hurricane. There was no effect on the incidence of diarrhoea and trauma. Deficits were found in weight gain in the two-month period ending the first two-month period after Hurricane Gilbert (p < .001). It is likely that the deficits in growth were the result of food shortages. Increased overcrowding and movements due to the displacement of families may have been responsible for the increased incidence of respiratory diseases. The absence of the effect on diarrhoea may have been due to the rapid restoration of water supplies in Kingston while the absence of an effect on trauma is surprising. (AU)

A post Hurricane Gilbert increase in neural tube defects in Jamaica, associated with a diet comparatively low in folate, in the periconceptional period - abstract

An increase in obvious live-birth neural tube defects (NTDs), spina bifida cystica and encephalocelle, occurring in Jamaica 11-18 months post-Hurricane Gilbert and periconceptionally coinciding with a rise in megaloblastic change in sickle-cell (SS) patients, was investigated by a retrospective case-control study. A detailed health, environmental and dietary history was done on each of the 17 affected mothers (cases) and 51 controls, matched for 5 variables. The Group I (cases) reported a significantly lower mean score in dietary folate intake in the periconceptional period (154) than Group 2 (controls) (254), p < 0.0001). Trauma was high among the cases, p < 0.0005. There was no association with maternal smoking, alcohol, ganja or other substance abuse, pesticide exposure, intake of previously suspected teratogenic foods, bush teas, pica, sources of drinking water, clinic attendance, environmental or psychosocial stress, hyperemesis, hypertension, spacing of pregnancies, incestuous parenting or previous birth defects. The results show that this NTD increase was associated with maternal diets comparatively low in folate in the periconceptional period. (AU)

Development of the Emergency Medical Services in Barbados - abstract

Pre-hospital and emergency department care have improved immensely over the past 15 years in Barbados. In 1976, a medical unit was formed by the Barbados Regiment to assist primarily as responders in a mass casualty/disaster situation. Within 3 weeks of its existence, it was tested during the Air Cubana crash. Today, if requested, the unit is capable of responding urgently to disasters in neighbouring OECS islands. Previous responses include hurricane David in Dominica - 1979, Hugo in Montserrat - 1988, and the volcanic erruption in St, Vincent - 1980. In 1984, the Emergency Ambulance Service was completely reorganized. Among the staff are 45 EMTs trained to the basic level in pre-hospital care. The service deals with about 1,100 cases monthly, 60 per cent of which originate in the St. Michael area. Response times range from about 10 minutes in St. Michael to about 30 minutes in the most distant Parish of St. Lucy. Improved service offered by the Accident and Emergency Department of the Queen Elizabeth has been the most recent development. In July 1990, a modern 22-bed unit was opened, coinciding with the introduction of a post-graduate course in Accident and Emergency Medicine at the Cave Hill Campus of the UWI. The department is equipped with an X-ray unit and modern commuication devices. A computer tracking system will asist in monitoring patient flow and provide, on a regular basis, statistics necessary for Quality Assurance exercises (AU)

Helminthiasis in Montserrat after the parasite control programme and hurricane Hugo - abstract

The Parasite Control Programme of Montserrat, West Indies, was a child-targeted chemotherapeutic control programme which ran from August 1986 to July 1989. The Programme involved the delivery of a broad spectrum antihelminthic to children (2-15 years old) once every school term. Two months after the end of the Programme, Hurricane Hugo devastated Montserrat on September 17, 1989. The Health Department (Montserrat) felt that the reductions in prevalence and intensity of Trichuris trichiura and Ascaris lumbricoides gained as a result of the Programme would be compromised by the disruption to sanitation and water supply caused by Hugo. In December 1989, a cycle of treatment was therefore administered to the child target group using the same infrastructure and procedure as that used in the Control Programme. The treatment compliance was 97.0 percent of the student population (n=2,125). Six months later, an age-stratified survey was done to assess the level of infection in the population and the age-standardised prevalence of T. trichiura for the overall population. Changes in the age-standardised intensity of both helminths before and after Hugo were recorded for the overall population: for T. trichiura the intensity went from 0.8 to 1.5 epg-faeces, while for A. lumbricoides the intensity rose from 1.2 to 1.7 epg.faeces. The observed rise in the infection levels of the overall population not statistically significant. The changes seen in the prevalence and intensity of both parasites taken from the surveys before and after Hugo were all found to be non-significant. There appeared to have been a non-significant increase in parasitic infection levels 9 months after Hugo to levels seen in the latter part of the Control Programme (AU)