KATHMANDU, Sept 8: Realizing that disasters and emergencies have claimed a significant number of lives in the South-East Asia region, the health ministers from World Health Organization´s (WHO) 11 member states in the region on Tuesday committed themselves to making health facilities more resilient by adopting the Kathmandu Declaration on Protecting Health Facilities from Disasters.
Records show that around 750,000 lives in the region were lost due to disasters and emergencies including the Gujarat earthquake in India in 2001, earthquake and tsunami in Indonesia in 2004 and cyclone Nargis in Myanmar in 2008 between 1998 and 2009, accounting for 61.6% of all global deaths due to natural disasters.
"A health facility that can withstand a disaster and continue to function can be the difference between life and death," the declaration adopted at the conclusion of the 27th Health Minister´s Meeting in Kathmandu stated.
The ministers and health experts felt critically injured people need immediate medical attention after natural disasters like earthquakes, tsunamis, floods and cyclones. If health facilities, medical equipment and health staff themselves succumb to the impact of the disaster, it deals a double blow to an already suffering community.
WHO representative to Nepal Dr Alex Andjaparidze had on Monday warned that only 25% of health facilities in Nepal can survive an earthquake of more than 7.2 Richter scale.
The Gujarat earthquake in 2001 had destroyed 3,812 health facilities leading to the collapse of the health infrastructure in the Kutch district. Similarly, the earthquake and tsunami in 2004 damaged 61% of health facilities in Indonesia´s Aceh Province, killed 7% of its workforce and 30% of its midwives rendering Aceh´s primary care, maternal health and neonatal care incapacitated.
Likewise, Cyclone Nargis destroyed or damaged more than half of all health facilities in the Ayeyarwady and Yangon divisions of Myanmar.
The difference in cost of building a safe and an unsafe hospital is negligible, and that investment can save a lot of lives and fund during emergency situations, the experts concuded. Interventions such as hazard resistant designs, adherence to building codes, preparedness planning and mock drills can all reduce the risk of physical and functional collapse of the health facility during a disaster. Even existing facilities should be made safer through reinforcement of structures, they stressed.
Diarrhea leading cause of child death
Diarrhea is the second leading cause of child mortality in the region behind pneumonia killing 50 children under age of five years every hour in the region.
"Diarrhea and acute respiratory infections are the biggest killers of children under five in South-East Asia. Diarrhea is also seriously under reported in the region. There is a need to focus on diarrhea and pneumonia in national health programs", said Dr Samlee Plianbangchang, WHO Regional Director for South-East Asia.
A child under five suffers around three episodes of acute diarrhea per year in the region, the experts claimed during the 62nd Session of the WHO Regional Committee for South-East Asia. In some South-East Asian countries, it could be as high as 12 episodes per child per year.
An adequate supply of safe water and improved sanitation as well as community, household and good personal hygiene practices is a must to control the menace. The experts suggested exclusive breastfeeding up to six months of age, frequent hand-washing, proper nutrition, timely immunizations and improved case management with early oral rehydration therapy and zinc at both community and facility levels to lessen diarrhea related deaths.
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