Heavy rainy season in Latin America and the Caribbean could cause significant outbreaks

تم النشر: 4 يوليه 2014 5:23 CET

By: Enrique Jair Guevara, IFRC, Panama.

With the onset of the hurricane season many countries in Latin America and the Caribbean face an increase of rainfall in their national territories. While these rains can cause flooding, property damage, and even loss of life, the stagnant water also presents another major threat. When the rains ceases, the water remains, and where the water remains there is an increased risk of an outbreak.

Year after year National Societies fulfill their auxiliary role to national  to the authorities, carry  a number of activities, programmes and projects to address public health issues  help change attitudes and save lives. In recent interventions in Honduras as Nicaragua, as well as the Caribbean in St. Vincent and the Grenadines, the Red Cross has been responding to dengue and chikungunya outbreaks.

At present, countries in Latin America and the Caribbean, are under the looming threat of outbreaks exacerbated by the lack of access to health services, lack of access to water services, lack of adequate sanitation and hygiene, and lack of public education to reduce risks. These  challenges come to a head in the Dominican Republic.

We recently had the opportunity to speak with Leonardo Arias, Health Coordinator of the Dominican Red Cross and Lina Villa, Emergency Health Delegate of the Pan-American Disaster Response Unit of the International Federation of Red Cross and Red Crescent Societies, who help shed some light on what is happening.

EG: What is the context of the emergency?

LA: During the epidemiological week (EW) 22 we had 20,382 new suspected cases of chikungunya, for a cumulative total of 77,320 cases across the country, equivalent to an incidence rate of 745 cases per 100,000 people. 88% (12,013 of 13,299) of the cases came from six provinces, mostly from San Cristobal 28% (3,864), Santo Domingo 21% (2,802), San Pedro de Macorís 17% (2273), Distrito Nacional 12% (1,572), Independencia 5% (685) and Hato Mayor 5% (683).

LV: Since last year we have been monitoring possible outbreak of diseases like dengue and now the chikungunya virus in Latin America and the Caribbean. In the specific case of the Dominican Republic, the population is facing a rapid spread of cases of this virus.

EG: What is the biggest concern in terms of public health?

LA: One of the biggest problems faced is that with more than 500,000 people are contracted the virus, which can overwhelm the health care system overrunning health centers where there will likely be a shortage of the medication used to treat patients, not to mention the increase risk for vulnerable groups such as: pregnant women, infants, children under 1 year, people with immune deficiencies, among others. Moreover, the risk is greater considering the disease can spread internationally, since there is a high level of tourism in the country.

Absenteeism at the work place is also a key concern for the Ministry of Public Health, but given the mortality low mortality rate, what is threatening in this case is that the pain caused by the disease is extremely debilitating which could have an impact on the economy.

LV: At the regional level, we are greatly concerned by the rapid spread of this type of vector borne disease in several countries, as Leonardo has mentioned. I am particularly concerned by silence on this emergency, as there has been very little said  and little visibility in the media. Also concerning is the evidence in some communities that there is a lack of knowledge about this new virus in the Americas, beliefs and myths that limit their perception of control and ability to prevent the disease. This leads to an important public health problem especially considering the chronicity of chikungunya. Moreover in the case of chikungunya the joint pain can last for years to the point of becoming disabling. This results in a much longer process of recovery and a significantly stronger impact on the lives of those affected.

EG: Are these epidemic threats recurrent in the Dominican Republic?

LA: Yes they are recurrent. The Dominican Republic is a country endemic to Dengue, Malaria, and Cholera. We have a lot of experience in responding to these events and we know the work we need to do in order to reduce risks before there is an emergency or when there is an imminent emergency.

EG: What is the risk in urban areas?

LA: Urban areas have a higher risk as this is where most of the population lives. We should note that there are many communities with environmental and sanitation conditions that are very poor and with little access to basic services which enhances the proliferation of the vector and therefore the transmission of the disease.

EG: What is the risk to the rural areas?

LA: The limited access to proper water services, sanitation and hygiene, as well as health services, education and information place rural populations in a vulnerable position. Therefore it is important that through our volunteers, we continue training people within the community to support prevention activities,  raise awareness, change behavior and save lives.

EG: How has this situation developed?

LA: Focusing on the issue of the chikungunya fever, this is the first experience, but we have faced similar situations caused by vector-borne diseases such as dengue, malaria, and leptospirosis.

EG: What is  the Red Cross doing to address this situation?

LA: The Dominican Red Cross has activated rapid response health teams in the most affected communities to assess the current situation. We prepare a progress report to raise awareness of the current situation in the country. The psychosocial support team have been developing activities in the province of San Cristobal where the disease has spread and has had a major impact causing stress to the affected communities. Different subsidiaries have implemented their plan of action, aligning with the contingency plan epidemic control prepared by the Department of Community Health Headquarters. We have encouraged affiliates to use the methodology of Community Based Health and First Aid (CBHFA) in the formation of brigades focused on raising changes towards healthy behavior.

EG: Why is community involvement essential to fight epidemics?

LA: Community participation is important because the population had no previous experience with the fever caused by the chikungunya virus. Through health promotion and prevention we can work together to change to healthy behaviours and save more lives. We have worked together with the Ministry of Public Health supporting their public health awareness campaigns and activities.  

The Dominican Red Cross will continue its coordination with national authorities to contribute to the implementation of measures to reduce the incidence of vector-borne diseases. The  Pan-American Disaster Response Unit  will continue to monitor the situation  so as to provide the necessary assistance.

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