Hurricane Dorian Is Long Gone, But Its Effects Still Sting in the Bahamas: Public Health Watch

“This storm, this savaging disaster.”

The above are lines from the poet W.H. Auden, and while they were used figuratively to describe the political unrest in Europe in the 1930s and 1940s, they could just as easily be applied literally to the collateral damage wrought by hurricanes and tropical storms here in the Western Hemisphere. The most recent example, of course, being Hurricane Dorian, which sadly laid waste to much of the Bahamas.

According to a situation report issued by the Pan-American Health Organization (PAHO) and the World Health Organization (WHO), as of September 20^th, the storm has claimed 52 lives, with 1300 individuals still missing—more than 3 weeks since it made landfall. However, it’s the toll the hurricane has taken on the popular tourist destination’s public health infrastructure that is arguably just as alarming, given that it could lead to more problems down the line.

“While many have received humanitarian assistance, identifying vulnerable and isolated communities in the affected areas for outreach and access to health services, medical care, and support remains a challenge,” the PAHO/WHO report states. “Debris removal, waste management, and identifying storage and management strategies on the islands remain a priority as well. The damage on electrical infrastructure on the islands has increased demand for fuel for generators… [R]egarding health pathologies… it is important to continue strengthening the surveillance systems in place… so that there is a timely and effective system for monitoring and identifying health threats.”

As the PAHO/WHO report notes, Hurricane Dorian made initial landfall on September 1^st as a Category 5 hurricane with sustained winds of 185 mph, before making a second landfall at Grand Bahama a few hours later, at essentially the same intensity. Notably, the storm “stalled” over the island for more than 2 days, with devastating effect, owing to “prolonged exposure to extreme hurricane-force winds, storm surges, flooding, and intense rainfall.”

As a result, on Grand Bahama, for example, only 4 of the 12 public health clinics are reported operational, as of September 20^th, per the PAHO/WHO report, with 3 totally destroyed. The need to get some or all of these facilities up and running as soon as possible is obviously a priority, particularly as the not-at-all-surprising reports of the post-storm spread infectious diseases come to light (think: cholera in Haiti in 2010).

PAHO/WHO have received reports of multiple cases of conjunctivitis at 1 public health clinic, while 3 cases of gastroenteritis have been confirmed in Grand Bahama. As of September 18^th, 1 case of dengue fever has been reported (notably, PAHO has distributed more than 200 mosquito nets to date). Multiple skin infections have been confirmed at 1 clinic in Grand Bahama.

In an effort to prevent the spread of vector-borne infections in the aftermath of Hurricane Dorian, PAHO/WHO have initiated vector control assessments at local shelters and “identified those at high or low risk for vector activities.”

The report adds, “Breeding sites, once identified, will be managed accordingly at each shelter location and experts are working on creating buffer zones between potential breeding sites and the shelters.”

Among the most significant post-storm actions by PAHO and WHO on the islands, though, has been the application of the WASH (water, sanitation, and hygiene) protocol. In general, water assessments are ongoing, and there remains an urgent need for hygiene kits and potable water. As of this writing, PAHO is overseeing a water distribution plan in the Abaco Islands, as well as ensuring access to water testing kits and “disinfection tablets.”

“Coordination is ongoing among many partners to set up distribution systems to population centers, shelters, and displaced people in Abaco and Grand Bahama,” the PAHO/WHO report states. “Several water treatment plants and distribution equipment have arrived to the affected islands and their location is being mapped by the Pacific Disaster Center. UNICEF is leading water distribution plan in Grand Bahama. Overall, the population… need urgent attention to ensure food, shelter, fuel access for power, WASH measures, early recovery activities such as debris clearance and building repair, and environmental health interventions.”

Indeed, though the storm eventually passed, it left a path of destruction in its wake. And, sadly, there’s nothing poetic about that.