Floods are the most common natural disaster occurring locally, regionally and internationally, and their frequency and impact are expected to grow in the future due to the effects of climate change. Flooding poses not only immediate concerns and many dangers to human health, but also long-term effects resulting from displacement of families and worsening of living conditions. In the Caribbean, floods may follow periods or episodes of heavy rainfall, or even hurricanes, and may cause a range of problems from traffic disruptions, destruction of properties and crops, to deaths. Faulty constructed and/or blocked drainage certainly aggravate the issues of flooding. Certainly during heavy rainfall here in the Caribbean in recent years there have been numerous videos highlighting areas seriously impacted by flooding.
When a doctor hears a flood warning, apart for ensuring that his office and home are secure, he has to prepare for a variety of health issues in his community that can be associated with flooding, in both the short and long terms.
The immediate health impacts of floods may include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of persons, and loss of health infrastructure including essential drugs and supplies, and access to health care facilities. In the medium-term, infected wounds, complications of injuries, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy.
The risk of water supplies becoming contaminated after a flood is very high, and contaminated water can pose a threat for months. Flood waters may contain chemicals, debris, sewage – both human and animal, and many micro-organisms, including parasites, bacteria and viruses. Diseases like dengue fever and malaria, which are spread by mosquitoes, often increase after floods as the eggs hatch once exposed to water. In addition to the health risks associated with power outages and damaged plumbing, floodwater itself can harbor bacteria and disease-carrying organisms that pose a risk to evacuees, rescue workers, and anyone returning to their homes. Residents should wear gloves and proper protective clothing while doing storm clean-up work and wash any cuts or scrapes thoroughly to prevent infection. Up to date tetanus protection is important.
Vulnerable population groups include children, pregnant women, people with chronic illnesses, elderly people, and persons with physical or mental impairments. Being a good neighbor suggest that adults should consider offering assistance to all vulnerable persons, especially during an emergency. If you still believe in being your neighbors keeper, then whenever possible adults/families/communities/church groups should identify vulnerable individuals and offer them help/shelter/evacuation to deal with any (and every) impending natural disaster.
Effects on people exposed to flood water include:
• Drowning from walking, driving, or being swept away by flood waters;
• Heart attacks, strokes and other acute outcomes;
• injuries from contact with debris and submerged objects in flood water; falling into hidden manholes or wells; suffering injuries while trying to move possessions during floods, or during building collapses, or electrocution;
• Diarrheal illnesses, including cholera, typhoid, and dysentery. Rats and rodents, driven out of their normal living places by flood waters, increase chances that Salmonella, E. coli, leptospirosis or rabies infections may occur. Symptoms may range from mild to moderate, but severe vomiting or diarrhea may result in life-threatening dehydration.
• Lung, skin and eye infections. Some types of infections caused by moulds may only show up weeks or months after the flooding, and can cause some serious illnesses that are difficult to diagnose and treat. While most mould infections are caused by Aspergillus, and may present as persistent respiratory infections or non-healing wounds; because these are uncommon in everyday practice, and require special diagnostic techniques, they may prove challenging to diagnose and treat.
• Stress, anxiety and short or longer-term mental health disorders, including the impacts of displacement;
• Damage to health care infrastructure, leading to a loss of access to essential care, and failure to obtain continuing health care;
• Damage to water and sanitation infrastructure;
• Damage to or destruction of property and vital community facilities;
• Damage to crops;
• Disruption of food supplies;
• Disruption of education, livelihoods and income;
• Stress from dealing with insurance claims and refurbishing properties.
Psychological effects.
Unfortunately severe flooding is associated with a flood of psychological issues, loosely lumped under the Post-Traumatic Stress Disorder (PTSD) syndrome. Even in ideal times, Caribbean communities operate with a shortage of mental health professions to service the needs of their communities. Perhaps ( and not focused specifically on floods) increased efforts should be made to educate the general population on stress and its management; this type of information can hopefully help a few individuals to better cope with the tsunami of stressors that they are likely to encounter in their lives. As far as floods are concerned, these issues do not recede with the flood waters, can last weeks or months, and can cause severe disruption to mental health.
Preparing for floods.
1. Family emergency plans have been shown to be useful in planning for emergencies; these should include information on details such as how and when to turn off the gas, electricity and water; how and when to call the police and fire departments; and how to find emergency numbers. Evacuation routes should also be considered, and assembly points decided on.
2. Know your community’s evacuation route(s) and warning signals, and identify areas prone to flooding or landslides.
3. Ensuring uninterrupted provision of safe drinking water is the most important preventive measure to be implemented following flooding, in order to reduce the risk of outbreaks of water-borne diseases.
4. Promote good hygienic practices and safe food preparation techniques
Do not use flood water to wash dishes, brush teeth or wash and prepare food. Always wash your hands with soap and water if you have been in contact with floodwater.
5. Avoid walking or driving through flooded areas and standing water.
Even the smallest amount of water can bring about significant dangers. You do not know if electrical lines have fallen in the water or hazardous chemicals exist. Cars and people can easily be swept away during a flood.
6. Throw away any food that has come in contact with floodwater.
If your food has touched any floodwater, it is not safe to eat and increases your risk of water-borne diseases.
7. Safely clean your home if it has come in contact with floodwater.
Throw out any items that cannot be washed and cleaned with bleach, such as pillows and mattresses. Clean all walls, floors and other surfaces with soap and water, as well as bleach.
8. Beware mosquitoes. If your home is in an area with stagnant or standing water, use mosquito repellent, following the instructions on the label, and apply it to clothes or skin. Also wear trousers and long-sleeved shirts, and cover beds with mosquito nets when sleeping.
Our current climate trajectory suggests that we will be subject to more frequent and more severe weather-related events, like hurricanes and floods. Big up Noah, who in biblical times established the original blueprint for dealing with floods, and at the same time took care of many of those around him. Noah had the time and resources to build and stockpile the Ark and to put into practice “love thy neighbor as thyself”. If we hope to survive significant flooding, we must develop a plan to keep ourselves, friends, family and neighbors, ‘clean and dry’ from flooding.