Andrea Mygrants Discussion Board Post for NUR 340 Week 7- Submitted 10/8/13 In January 2010, a devastating earthquake

hit the country of Haiti. Providing immediate medical services to injured people and searching for trapped individuals grabbed much of the news coverage after the incident. Knowing what you know about environmental health, communicable diseases and risk of infections, what are some of the major concerns about the health of the citizens of Haiti following the earthquake? According to the World Health Organization (WHO), the first and primary need after an earthquake would be for trauma management. People may have suffered crush injuries, electrocutions, toxic dust inhalation, environmental exposure (hypo or hyperthermia), fractures, and open wounds. The response for this would need to be immediate as, Survival in entrapment rarely lasts longer than 48 hours: 85-95% of persons rescued alive from collapsed buildings are rescued in the first 24-48 hours after the earthquake. (WHO, 2013) Needs for survivors would be concentrated on meeting basic survival needs for potable water, shelter, and food. List some of the possible health related problems you would look for as a public/community nurse. After the initial first few days, needs for the survivors would become more complex. A community nurse helping in this situation would have to start looking at what resources are available to meet continued basic needs. In addition to the need for potable water, adequate sanitation would have to be secured to ensure that water sources do not become contaminated. According to Harkness and DeMarco, Improper disposal of human waste can create health problems from direct contact with the waste or can contaminate drinking water supplies... Improper disposal of trash can also encourage pests, which can carry diseases and may expose people to contaminants that leach out of the trash. (Harkness & DeMarco, 2012) Public health officials actually failed the Haitians in this respect. According to an article written by Rick Gladstone in the New York Times, a cholera epidemic which spread throughout Haiti after the earthquake which, has killed more than 8,300 Haitians and sickened more than 650,000, may have been brought to the island by Nepalese relief workers and spread by way of improper sanitation from the Nepalese base camp into a main river. (Gladstone, 2013)

Once water and sanitation has been secured, a public health nurse would then be concerned with shelter. The Haitians were placed in refugee camps consisting of tents, which many of them still live in to this day. One of the complicating factors with securing more permanent shelter has been the fact that even before the earthquake, many buildings were poorly constructed. This is due to the fact that Haiti is one of the poorest nations on earth. Neither the people, nor their government has the means to build safe earthquake resistant buildings. Unfortunately for the people of Haiti, the solution to their housing problem is mired in financial and political difficulty. The next most important need for the Haitians after the earthquake is for adequate food and nutrition. This is complicated by the fact that Haiti is an island, and so much of the food relief they need must be either flown in or sent by ship. Being a small island nation, they also only have limited airports and shipping ports, which may have also been damaged in the earthquake. Once food is available, there also needs to be thought about how the people will be able to prepare it. With no electricity and scarce resources for cooking wood, special consideration needs to be given to food that does not need to be cooked, and/or group and public cooking spaces. After initial needs for water, sanitation, shelter, and food are met, a public health nurse would then begin to look at what other needs the community may have. Are there safety concerns? There were many reports following the earthquake about violence and rape in the refugee camps. Are there psychological or psychiatric needs that are not met? Posttraumatic stress syndrome can certainly have debilitating effects on people. Are there schools or safe places for children to play? What methods of communication are available to the people in the refugee camps? What do you think a public health/community nurses involvement would have been? I think that public health nurses would play a key role in the response after any natural disaster. Public health nurses are uniquely equipped with the skills to assess a community as a whole and identify their priority needs. If the earthquake had happened in the United States how may these health concerns have been different or similar? Had this disaster happened in the United States, I believe that the initial needs and problems would be very much the same. Regardless of where an

earthquake happens, the injury patterns and need for search and rescue are the same. Once past the first 24-48 hours though I think there would be a drastic difference in the response. I attribute this mostly because 1) The US is not an island so there would be multiple routes for getting supplies into the effected area 2) The US is a wealthy nation and has a much greater ability to mobilize and provide resources 3) We have become much more aware of the need for emergency preparedness after the terrorists attacks on September 2011. Not only is our government more ready and trained to deal with disasters, but also even private citizens are much more aware of the need for disaster pre-planning 4) our infrastructure is much more modern and capable of handling natural disasters. While there is no such thing as an earthquake proof building, we do have building codes in place for earthquake prone areas that make buildings much more safe should an earthquake happen. Had this been in place in Haiti it would have immediately lessened the amount of casualties and injuries. Resources Gladstone, R. (2013, October 8). Rights advocates suing U.N. over the spread of cholera in Haiti. The New York Times. Retrieved from http://www.nytimes.com/2013/10/09/world/americas/rightsadvocates-suing-un-over-the-spread-of-cholera-in-haiti.html?_r=0 Harkness, G.A., & DeMarco, R.F. (2012). Community and public health nursing practice: evidence for practice. Philadelphia: Wolters Kluwer/Lippincott, Williams & Wilkins World Health Organization (WHO). (2013). Earthquakes - technical hazard sheet - natural disaster profile. Retrieved from http://www.who.int/hac/techguidance/ems/earthquakes/en