The aftermath of a disaster - recovery following the volcanic eruptions in Montserrat - Poster abstract

ABSTRACT

OBJECTIVE: To analyse the adverse health effects following the major volcanic eruptions in Monsterrat and describe how the recovery process has dealt with these problems. DESIGN AND METHODS: The records of the health clinics were analysed for information on diseases resulting from volcanic activity. The official records of the Health Department were reviewed for evidence of the recovery process and its effects on health services. RESULTS: Direct effects included trauma - 19 fatalities and 10 severe burns following one pryroclastic surge; respiratory - an immediate exacerbation of symptoms in known asthmatics and a small increase in attendances at clinics during the early stages of the eruption. Subsequent analysis found no increase in respiratory disease following ash falls and no differences in clinic attendances comparing a clinic in a high risk area with one in lower ash areas. A survey of police staff exposed to high levels of ash found no impairment of respiratory function. Indirect effects included mental illness. There was no increase in the incidence of new illness but problems occurred because of disruption of support structures. Post traumatic stress syndrome was widely reported anecdotally but there are no survey data to support this impression. Health infrastructure was gradually restored by converting a school into a temporary hospital, refurbishing health clinics and recruiting and training staff. The Disaster Preparedness Team was strengthened. These improvements, and the setting up of an embryonic Health Information System permitted better analysis of records. A system of clinical audit had resulted in better treatment of patients. CONCLUSIONS: The major eruptions of the volcano in Monsterrat between 1995 to 1999 caused a number of health problems. These were made more difficult to contain by mass relocation of the population, closure of clinics and transfer of rudimentary clinics in north of the island. The Health Department is now in an advanced state of recovery following the crisis and many of the health problems are being resolved.(AU)