Audrey Stewart-Hinchcliffe | After Hurricane Melissa: Infrastructure and systems impact public health and safety

The mention of infrastructure typically conjures up thoughts of buildings, bridges, roadways and other facilities. However, infrastructure and systems in public health refer to essential services and the capabilities to deliver these services during and after a crisis, such as the devastation caused by Hurricane Melissa.

Among infrastructure for the delivery of public health and safety are human resources, information systems, structures and management capacity, funding, laws, regulations (legs and regs.) and policy guidelines.

Infrastructure and systems provide support for the successful administration of public health and safety measures.

INFRASTRUCTURE ADMINISTRATION

After the hurricane, the public health infrastructure is administered through multi-agency collaboration led by the Ministry of Health and Wellness (MOHW). Coordination of well needed support comes from international and regional agencies such as the Pan American Health Organization (PAHO/WHO), the Caribbean Public Health Agency (CARPHA) and the Caribbean Disaster Emergency Management Agency (CDEMA). The latter provides technical assistance, supplies and coordination of international aid.

The public health system enables monitoring and investigation of health concerns as demonstrated by the reports of leptospirosis and tetanus in parishes severely affected by the hurricane. It also provides public education through press briefings, bulletins and public service announcements (PSA’s), among other interventions.

INFRASTRUCTURE RESTORATION RESOURCE REQUIREMENTS

Rapid post-hurricane assessment is essential as the basis for beginning restoration. This assumes that planning prior to the hurricane laid the foundation for immediate action in its aftermath.

First and foremost would be rapidly assessing damaged health facilities as in the case where Hurricane Melissa laid bare the devastation to facilities mainly in St. Elizabeth, Westmoreland, Hanover, St. James and Trelawny.

Blocked roadways impacting transportation, loss of shelter, and disruptions to utilities including electricity, water, communication, sanitation and lifesaving systems such as medical equipment, medicines, food, shelter and hygiene supplies, can result in the displacement of people.

When taken together, infrastructure needed for public health and safety has been severely compromised or lost due to the hurricane.

Hence, effective restoration relies heavily on human resources, utilities, transportation and communication. Also, the ability to publish and distribute critical alerts on health and safety measures to prevent injury and illness has been severely hampered.

Another important feature of response is logistics for the delivery of supplies which may be required for life-saving interventions. This is where the collaboration of local and international assistance comes together; and reports are that the response via air and sea has been robust, enabled by the rapid restoration of the airports and wharf facilities.

COLLABORATION FOR RESOURCE MOBILISATION

The Ministry of Health and Wellness (MOHW) as the lead agency for public health, wellness and safety guided by pre-existing disaster preparedness response plans, immediately assessed health facilities to determine the extent of damage and to prioritise urgent service delivery.

However, collaboration for health infrastructure resource mobilisation after the hurricane is a multi-sector initiative that includes the government, private sector, international organisations, non-governmental organisations (NGO’s), specialised bodies and community groups. They work in harmony to support restoration of the health infrastructure, for longer term rehabilitation.

With the devastation of the previously stated health facilities – hospitals and health centres – we see the establishment of field hospitals in Black River and Falmouth and at the time of writing, plans are underway for one to be established at Savanna-La-Mar Hospital in Westmoreland.

Support facilities for primary health care are being deployed across various parishes and Minister of Health, the Hon. Christopher Tufton, posits “It is our target to ensure that all type V, IV and III health facilities are providing basic services by Friday, November 21.”

We also see, for example, volunteers repairing the Cornwall Regional Hospital (CRH) in St. James.

Healthcare is a trigger for emotional response, hence there is heightened response in all areas of the infrastructure, including building repairs and maintenance, volunteer human resources, for example, Doctors Without Borders, information systems via Star Link, funding via the National Health Fund, utilities via generator power and water storage, sanitation through the National Solid Waste Management Authority (NSWMA); and the reinforcement of laws and regulations under the Public Health Act.

Infrastructure and systems underpin public health and safety which are essential for speedy economic recovery, by creating a healthy and productive workforce, and boosting labour productivity.

- Dr. M. Audrey Stewart-Hinchcliffe, CD, JP, BA, M.Sc., DBE (h.c.), is the Chairman of Manpower & Maintenance Services (MMS) Limited Group. Email feedback to columns@gleanerjm.com