When Hurricane Katrina's storm surge breached New Orleans's levees and destroyed thousands of homes, it also devastated sanitation systems, safe drinking water supplies and other measures vital to public health, leaving residents vulnerable to numerous health threats.
In the wake of such disasters, public health workers help fill in the gaps, caring for the victims and rebuilding the systems that safeguard the nation's health. Paramedics, EMTs, nurses and physicians are just the most visible of the varied public health workers who prepare for and respond to hurricanes, floods, fires and other disasters. Infectious disease epidemiologists, environmental health scientists, water quality investigators, sanitation workers and others all play vital roles in restoring communities' mental, physical and environmental health.
Preparing for Disaster
Long before catastrophes occur, public health workers lay the groundwork for an effective response. They identify community resources and establish networks and working relationships among doctors, hospitals and medical facilities, says Dr. Bernard Turnock, MPH, clinical professor of community health sciences at the University of Illinois at Chicago School of Public Health and former director of the Illinois Department of Public Health.
When a disaster looms, public health workers urge citizens to prepare themselves. One way is by encouraging seniors, people with disabilities and the chronically ill to have a week's supply of medication ready to go if evacuation becomes necessary, says Linda Landesman, DrPH, LSW, an adjunct faculty member at the University of Massachusetts at Amherst School of Public Health and Health Sciences.
Once disaster strikes, public health workers engage in a broad range of activities to restore the public health infrastructure, including:
- Water and Food Safety: Engineers, laboratory specialists and health inspectors test local water and food as well as work to restore safe supplies.
- Vector Control: Standing water, garbage and rotting food invite vermin, so keeping disease-carrying rats and mosquitoes under control is vital. Spreading bacteria tablets that kill mosquito larva and spraying pesticides are among the measures that public health workers have implemented in flooded Gulf Coast areas, says Dr. Georges C. Benjamin, executive director of the American Public Health Association.
- Occupational Health: Public health experts ensure workers who will be exposed to hazardous conditions in the disaster zone are outfitted with the appropriate protective equipment.
- Environmental Sampling and Analysis: Environmental specialists, typically biologists or chemists with master's degrees in environmental health sciences, determine the level of contaminants, such as lead, in floodwaters. Houses submerged in lead-contaminated water for prolonged periods become uninhabitable. Following the World Trade Center attacks, for example, public health workers tested dust samples to identify contaminants and issue building clean-up guidelines, Landesman says.
- Disease Surveillance: Public health workers must quickly establish disease-reporting systems to detect increases in infectious diseases and other health problems. In the Gulf Coast area, where much of the healthcare infrastructure was wiped out, medical officials had to set up interim systems to track injuries, gastrointestinal problems and skin rashes. "Nurse epidemiologists and infection-control nurses engage in early identification of diseases and disease patterns," Benjamin says.
Following the September 11 attacks in New York City, where disease-reporting systems remained relatively intact, officials monitored post-disaster health problems by tallying ambulance runs and over-the-counter purchases of diarrhea remedies, as well as by examining records of school and business absences. New York-area hospitals faxed daily reports to a central computer, which then sent a master report to the city health department.
Public health specialists in disaster zones also:
- Work to reestablish healthy sanitation and personal-hygiene procedures.
- Ensure HIV/AIDS screenings continue.
- Maintain contact with substance abusers.
- Act as healthcare extenders so chronically ill people can continue to receive healthcare. In emergencies, nurses, paramedics and EMTs sometimes are allowed to help administer vaccinations to displaced children.
- Process birth and death certificates so families can receive life insurance.
Individual medical professionals as well as teams can volunteer through a variety of organizations: