As floodwaters continue to recede, communities throughout El Salvador are starting to consider the short and long-term impact of the 1400 milimeters (55 inches) of rain that has fallen in the past week. One of the most immediate issues is public health.
According to Eduardo Espinoza, Viceminister of Health, the most immediate public health concern in El Salvador is the 2,200 community wells contaminated by flooding, which threaten the availability of safe drinking water. The Health Ministry announced yesterday that it is distributing ‘Puriagua,’ a chlorine solution used to disinfect contaminated drinking water. Other organizations are also distributing chlorine-tablets and purified water. Although the wells pose a significant health concern, “the risk of outbreaks can be minimized” through prompt action to identify wells and provide clean drinking water, according to the World Health Organization (WHO).
Flooding can increase the risk of communicable diseases in a number of ways – contaminated water can cause gastrointestinal diseases; floodwater can bring disease-carrying animals such as dogs, rats or mosquitoes into closer contact with humans; direct contact with waste carried by floodwater can cause skin disease; and exposure to weather conditions can lead to respiratory ailments.
The most prevalent health concerns, so far, seem to be respiratory and skin problems, judging by the number of consultations at shelters nationwide. Out of 9,139 health consultations made by October 17th, 2,395 dealt with respiratory problems, primarily among the very young and the elderly. The Health Minister recommended that special care be taken to wrap these vulnerable groups warmly. Another 1,231 consultations dealt with skin problems. However, according to the World Health Organization, neither problem is “epidemic-prone.” 145 consultations dealt with gastrointestinal diseases and diarrhea.
Other “epidemic-prone” diseases are being monitored closely. The Panamerican Health Organization (PAHO) has donated diagnostic kits to monitor the spread of H1N1, dengue, malaria, and a disease called leptospirosis carried by rodents and dogs. Espinoza reported five cases of chicken pox in the Municipality of Cojutepeque, which have been addressed with “isolation measures and antiviral treatment to contain the spread of the disease.” Espinoza also reported six cases of the H1N1 virus under isolation. “So far, there has been no case [of H1N1] in the shelters,” says Espinoza.
Another public health problem is that flooding has damaged 138 health establishments, according to the Health Ministry. As just one example, the PAHO reports that the infrastructure at the Kidney Health Unit in the Lower Lempa has been “completely damaged” by more than two meters of water, “losing the medical equipment vital to treat renal failure.” The organization writes, “This unit treats 350 patients with chronic renal failure, who, currently, have no other alternative.”
Dr. Anne Daul, a fellow with the the George Washington University department of Emergency Medicine, added that flood victims also need to be concerned about the psychological impact from loosing a home or even loved ones. She also warns that major catastrophes such as this can break down the social fabric, which puts women at risk of gender-based violence.
The international community, government officials and local partners must all work together in the coming weeks and months to minimize the impact of the flooding on the health of the people. It will be an issue that we at Voices will be monitoring closely.