Natural Geological Disasters - Research Proposal Example

no. In the aftermath of an earthquake: Whether or not to use cholera vaccines in combating the disease In most cases, when natural geological disasters happen, most effort is directed towards rescuing the affected people and getting them to areas that are safe from the disaster. Although this is and should be the priority, the safety of the rescued people in terms of health should also be prioritized. This is because, although people may be rescued from the disaster stricken areas, they also face the risk of contracting communicable diseases brought about by overcrowding and poor sanitation. This is particularly the case when dealing with earthquakes and the subsequent communicable diseases, specifically cholera. This discussion aims at examining pertinent issues in relation to earthquakes and methods of combating the ensuing cholera outbreaks. Kouadio et.al states that earthquakes are the second most prevalent form of natural disasters after floods (96). The environmental changes caused by an earthquake often change the relationship between human beings and the microbes around them. For example, fear of earthquakes may cause people to crowd together in one shelter that they deem safer, thus increasing the risk of a cholera outbreak. Apart from deaths related to the collapse of buildings and traumatic injuries, people in areas affected by earthquakes also suffer from communicable diseases occasioned by displacement. Once people are displaced, they tend to overcrowd in shelters thus raising the chances of contracting communicable diseases, such as cholera. According to Jafari et.al natural disasters which are significantly complex in nature, usually increase the chances of communicable diseases outbreaks, thus increasing the mortality and morbidity resulting from these diseases. Since earthquakes may cause disruptions to water supply, for example, through breakage of water pipes and sewage systems, chances are high that the water available for use will be contaminated. However, according to Bissell, Lopez &Burkeholder-Allen, if pathogens are non-existent before an earthquake, the probability that there will be a cholera outbreak is very low. Nonetheless, the pathogen could be introduced by rescue personnel who may come from an infected area, especially if the sanitary systems are not functioning properly. A case in point is that of Haiti which, according to Dhillon & Annunziata, had not had cholera reports in decades, yet the 2010 earthquake brought about high cholera rates in the country. Arguably, the cholera outbreak in Haiti may have originated from the high number of rescue personnel who came to the aid of the earthquake victims. As Katz writes, the cholera in post-earthquake Haiti was almost certainly introduced by UN peacekeepers who went to rescue the earthquake victims (241). The soldiers came from a region in Nepal known as Kathmandu, which was infected by the vibrio cholera (Katz 225). Inexplicably, the soldiers were never tested for the virus and their presence in the poorly sanitized Haiti led to the spread of the disease. Accordingly, Lemonick writes that shelter workers and rescue personnel should be tested for any communicable diseases and be encouraged to receive treatment if the disease is detected (146-148). As a result, of the testing and immunization, the chances of infecting the displaced population are significantly reduced. Medical personnel should be always ready to respond to cholera outbreaks in areas affected by earthquakes, even before the disease actually occurs. There should be adequate investigation, sampling of data, and availability of transportation materials necessary for combating the disease. It is important for medical professionals to have adequate knowledge concerning how to handle cholera outbreaks in areas affected by earthquakes. To curb the spread of cholera, infected people are usually given a hydrating oral solution. However, WHO reports that in most cases, when cholera outbreaks are reported in areas affected by earthquakes, the best and most common method of dealing with the disease is the provision of safe water and sanitation services (12). On the other hand, although not commonly used, the administration of cholera vaccine could also be a solution. According to WHO, this vaccine is not commonly used due to its cost and the difficulties in administration logistics (12). This argument that cholera vaccines cannot be administered to people affected by natural disasters, for this case, earthquakes, has raised a lot of controversy. Some people argue that cholera vaccines should be used, while others are against the use, citing logistical difficulties in the administration of the vaccine. The question, therefore, remains; should cholera vaccines be used to curb the spread of cholera in areas affected by a natural disaster such as an earthquake? And what are the pros and cons of using the vaccines in the said areas? Opponents of the plan to use cholera vaccines in disaster struck areas argue that the administration of the vaccine among such populations is very hard. For example, Seidlein & Deen write that people affected by disasters are very mobile, moving from oneshelter to another and cannot be trusted to take the recommended2-dose, especially considering the time required by the vaccine to generate immunity. In addition, it has been reported that the infrastructure in an area affected by an earthquake is not conducive for the transportation and delivery of vaccines. Moreover, the human resources required for the achievement of such a task are not readily available, thus making the undertaking hard to accomplish. Another matter of concern, according to Wade is whether the cholera vaccine is effective regardless of age, location, and the speed at which immunity is gained (25). For instance, people in under-developed countries have poor nutritional standards, meaning that the immunity speed of the vaccine could be reduced. Poor nutrition coupled with the other effects occasioned by an earthquake would make the cholera vaccine unsuitable in developing countries affected by earthquakes. This conclusion, therefore, begs the question: should there be cholera vaccines that are specific to certain regions of the world, particularly in relation to the economic developmentsof such regions? According to Cyranoski, most actors in the health sector are proposing the use of the vaccine in Haiti, to test the viability of the vaccine and to see whether it can be used in future areas affected by disasters (273). The most rational reason perhaps, for discouraging the use of the cholera vaccine, according to Perlin & Cohen is that the vaccine only gives protection for around three to six months, after which the vaccinated person is again susceptible to infection. In view of that, it is not advisable to use the vaccine to control a cholera outbreak such as that caused by an earthquake, because the effects of the vaccine are not long-term (152). This vaccine should only be used by people travelling to cholera-prone regions for a short period of time, or to rescue personnel involved in rescuing people from natural disasters (Perlin & Cohen 129). Proponents of the cholera vaccine, according to Wiwanitkit hold that a cholera outbreak can be controlled by use of a vaccine (596). Their argument is based on the fact that in 1996, WHO recommended that cholera vaccines be used to control complex emergencies, such as those brought about by earthquakes (ibid). Seidlein & Deen write that the claims that the cost of vaccinating a population afflicted by an earthquake is too highare poor excuses for refusing to give aid to deserving people. Their argument isthatsince cholera mostly occurs in underdeveloped and developing countries, their developed counterparts are not too eager to use vaccines in these countries. It is, therefore, not a case of cost: rather a matter of unwillingness to invest in poor populations that has led to the reluctance to use the cholera vaccines in areas affected by earthquakes, for example Haiti. Considering that vaccination is one of the primary means of preventing the spread of disease, the cholera vaccine should be used whenever necessary, before other measures are taken. Evidently, the immediate effects of an earthquake such as the collapse of buildings and the displacement of people are not the only issues that deserve special attention in as far as dealing with earthquakes is concerned. The occurrence of communicable diseases such as cholera due to overcrowding and poor sanitation is a major contributor to the deaths of many people in areasaffected by earthquakes. From the discussion, it is clear that a region does not have to have a history of the existence of the cholera pathogen in order for cholera to emerge. The pathogen can be introduced by people from outside the region, especially rescue personnel, as in the example of Haiti. Nonetheless, if the proper mechanisms are instituted, the spread of cholera can be checked in such populations. The problem, however, is whether cholera vaccines can be used on populations affected by earthquakes, considering the complexity of the logistics involved in such a measure. It is also questionable whether there exists a global vaccine for cholera or manufacturers would be forced to produce vaccines that are specific to certain regions. On humane grounds though, issues on cost and administration should not hinder the use of those vaccines if they can, in fact, help save lives. If it is anything to go by, in 1996, WHO recommended the use of cholera vaccines in responding to the disease in areas afflicted by earthquakesand other natural disasters. While the debate still rages on, concerning the effectiveness of the cholera vaccines, another earthquake could be looming somewhere and people will not know whether or not the vaccines are viable. Works cited Bissell Richard, Lopez Rene &Burkeholder-Allen, Kelly. Post-Disaster Infectious Disease Management. n.d. Web. 9 July 2013. www.mediccom.org/public/tadmat/training/NDMS/inf_disease.pdf? Cyranoski, David. Cholera Vaccine Plan Splits Experts: Opinion Is Divided Over How To Tackle The Disease In Haiti. Nature, 469:273-274. 2011. Print. Dhillon, Paul and Annunziata Giuseppe.The Haitian Health Cluster Experience: A Comparative Evaluation of the Professional Communication Response to the 2010 Earthquake and the Subsequent Cholera Outbreak. PLOS Current Disasters. 2012. Print. Jafari Najmeh, Shahsanai Armindokht, Memarzadeh Mehrdad, and Loghmani Amir. The Field Hospital Setting In Earthquake.Journal of Research in Medical Sciences.2011; 16.7:956-962. Print. Katz, Jonathan. The Big Truck That Went By: How The World Came To Save Haiti And Left Behind A Disaster. London: Palgrave Macmillan, 2013. Print. Kouadio, Sisdore. Infectious Diseases Following Natural Disasters: Prevention and Control Measures. Expert Reviews of Anti-Infective Therapy, 10.1: 95-104. 2012. Print. Lemonick, David. Epidemics after Natural Disasters. American Journal of Clinical Medicine, 8.3:144-152.2011. Print. Perlin, David and Cohen, Ann. Water-Borne Diseases: Cholera and Dysentery. The Complete Idiot's Guide to Dangerous Diseases and Epidemics. New York: Marie Butler-Knight, 2002. Print. Seidlein Von, Deen Jacqueline. Considerations for Oral Cholera Vaccine Use during Outbreak after Earthquake in Haiti.2010–2011.Emerging Infectious Diseases Journal, 18.7. 2012. Print. Wade, William. Is A Universal, One Dose Cholera Vaccine Possible? The Open Vaccine Journal, 4:18-30. 2011. Print. Wiwanitkit, Viroj. Vaccination in Post-Earthquake Crisis.Human Vaccines, 6.7: 595-596. 2010. Print. World Health Organization. Communicable Diseases Following Natural Disasters: Risk Assessment and Priority Interventions. Programme on Disease Control in Humanitarian Emergencies Communicable Diseases Cluster. 2006. Web. 9 July 2013.http://www.who.int/diseasecontrol_emergencies/en/ Read More