|Year : 2017 | Volume
| Issue : 2 | Page : 46-48
Health impact of chennai floods 2015: Observations in a medical relief camp
Nancy Angeline, Suguna Anbazhagan, A Surekha, Sushil Joseph, Pretesh R Kiran
Department of Community Health, St. John's Medical College, Bengaluru, Karnataka, India
|Date of Web Publication||31-Aug-2017|
Department of Community Health, St. John's Medical College, Bengaluru - 560 034, Karnataka
Source of Support: None, Conflict of Interest: None
Background: During the year 2015, Chennai and the South Indian coast experienced devastating floods due to unprecedented rains. Indiscriminate damage to housing, communication and transport networks, and health facilities ensued affecting the lives of thousands of people. Objective: To assess the morbidity profile of patients attending the medical camps conducted at Chennai during the postflood period. Methodology: In our study, the investigators with their health team conducted camps in Thiruvallur - one of the worst affected districts during the floods between November and December 2015. Data were collected regarding age, gender, and presenting health problems. Total number of patients seen in camps was 5633. Results: It was observed that among people who came to the camp, common health problems were as follows - 46.84% had acute respiratory tract infections, 24.87% with acute gastroenteritis, 18.6% had fever, and 14.41% with skin problems. Conclusion: Due to provision of safe drinking water and epidemic prevention measures, epidemic outbreaks have been averted. However, strengthening of existing health care systems is required to handle the burden of acute gastrointestinal and respiratory infections during disasters such as floods.
Keywords: Chennai flood, disaster, health impact
|How to cite this article:|
Angeline N, Anbazhagan S, Surekha A, Joseph S, Kiran PR. Health impact of chennai floods 2015: Observations in a medical relief camp. Int J Health Syst Disaster Manage 2017;5:46-8
|How to cite this URL:|
Angeline N, Anbazhagan S, Surekha A, Joseph S, Kiran PR. Health impact of chennai floods 2015: Observations in a medical relief camp. Int J Health Syst Disaster Manage [serial online] 2017 [cited 2017 Oct 20];5:46-8. Available from: http://www.ijhsdm.org/text.asp?2017/5/2/46/213887
| Introduction|| |
Chennai is the capital city of Tamil Nadu, India. It is located on the eastern coast of South India. It is bound by the Bay of Bengal in the east, and it has an average elevation of 6.7 m from the mean sea level. During the Northwest Monsoon 2015, Chennai and other parts of South Indian coast experienced devastation caused by floods.
Floods are the most common type of disasters globally and have caused 53,000 deaths worldwide in the last decade. The negative impacts of flooding are loss of life and property. Disruption in availability of clean water, transportation, and communication can affect human health. Even though flooding cannot be avoided, the impact of floods can be mitigated.
The immediate health impacts of floods are drowning, injuries, hypothermia, and unknown bites. These impacts are aggravated by loss of health workers and damage to health infrastructure. In the medium term, complications of injuries, infections, psychiatric morbidities, communicable diseases, and starvation result. Long-term health effects of floods are chronic diseases, psychiatric comorbidities, poverty, and malnutrition.
The damages incurred during the South Indian floods in the previous years include lack of access to essential services such as water, loss of power and communication, disrupted transportation, and stagnation of water causing increase in mosquito breeding.
Disease outbreaks following floods are more common in areas of inadequate sanitation, overcrowding, and displacement. Diarrheal diseases caused by Vibrio cholera, enterotoxigenic Escherichia More Details coli, and enteric fever are common. Hepatitis A and E can spread by feco-oral route. Leptospirosis can be transmitted by direct contact with contaminated water. Overcrowding can spread respiratory infections due to displacement. Tetanus is not transmitted person-to-person, but contaminated wounds can cause the illness in areas where vaccination coverage is low. Short-term health effects due to flooding have been studied, but long-term effects are currently not well understood. Mortality rates are observed to increase by up to 50% in the first year of postfloods. Floods vary markedly in their character and size and the devastation caused is influenced by the size and vulnerability of the population affected. The effects of floods will be different in high-income countries as compared to low-income countries.
During the Chennai floods, several private and government health facilities were flooded and their services could not be provided to the needy. Inadequate supply of drugs due to disruption of transportation resulted due to the floods. This hampered the distribution of drugs for communicable and noncommunicable diseases. The emotional and psychological consequences were high due to loss of belongings, houses, and family members. It is important to assess the health impact of floods in this region since knowledge of it could facilitate health planning during disasters.
In our study, we aimed to assess the morbidity profile of patients attending the medical camps conducted at Chennai during the postflood period.
| Methodology|| |
Medical camps were conducted in two revenue blocks in Thiruvallur district, namely, Minjur and Pulal. Thiruvallur district is one of the worst affected districts during the South Indian floods-2015 along with Kancheepuram and Chennai. Minjur is a periurban area with an average elevation of 11 m above the sea level. It is situated around 25 km from Chennai city. An extreme high-intensity rainfall occurred over these regions from November 27, 2015, to December 4, 2015, causing floods. Incessant rains, global warming, rapid urbanization, and poor drainage system in these areas observed to have contributed to flooding.
A total of 24 camps were conducted in Thiruvallur district of Tamil Nadu. Data were obtained on the age, sex, and presenting complaints from the camp attendees. Data were entered in EpiData and analyzed in SPSS version 17.0. SPSS Inc. Released 2008. SPSS Statistics for Windows, (Chicago, SPSS Inc).
The camps were organized from December 13, 2015, to December 17, 2015.
| Results|| |
Total number of patients seen in camps was 5633. Total number of health problems identified among people who came to the camp was 8053.
A total of 1980 males and 3653 females attended the camp. Of all the presenting health problems of those who attended the camps, 1401 (24.87%) was acute gastroenteritis, 2639 (46.84%) was acute respiratory tract infections, 1048 (18.6%) was fever, and 812 (14.41%) was skin problems as seen in [Table 1].
Most of the persons who attended the medical camp belonged to the female sex (64.84%), with males comprising only 35.16% of the camp attendees. This could be attributed to the fact that the camp was conducted during the working hours of the male population and most females were homemakers.
Adults aged 19–59 years formed the most common age group attending the medical relief camps. Hence, the morbidities among them are apparently high in our data. It can be observed that from the age-wise distribution of morbidities, acute respiratory tract infections were more common than acute gastroenteritis.
| Discussion|| |
From our study, it has been observed that most of the patients attending medical relief camps during floods belong to the age group of 19–59 years. This constitutes the working age population. Morbidities resulting from floods in this population could severely affect the economy of the affected regions.
The common manifestations in the medical camps conducted in South Indian floods were acute respiratory infections, acute gastroenteritis, fevers, skin problems, and miscellaneous problems such as musculoskeletal pain. Similar pattern of illnesses was prevalent during the Pakistan flood 2010 where acute respiratory infections, skin diseases, acute diarrhea, and suspected malaria were the most common disease presentations. None of the patients presented with symptoms suggestive of leptospirosis (high fever jaundice, muscular pains, and hemorrhagic manifestations) or cholera (watery, loose stools with vomiting). None of the patients who attended the camps had any symptom requiring imminent hospital admission. However, symptoms suggestive of leptospirosis were observed during the floods in 2005 at Mumbai. None of the children in our camps presented with jaundice suggestive of hepatitis. However, during the Uttarakhand floods during 2013, high prevalence of hepatitis A was observed among children due to contaminated water. The practice of disinfection of drinking water by doubling the dose of chlorine, use of bleaching powder for disinfection of surfaces, and availability of medicine and health workforce in the health facilities during the floods in Tamil Nadu could have averted these epidemics.
In our study, 24.87% had acute gastroenteritis, 46.84% had acute respiratory tract infections, 18.6% had fever, and 14.41% had skin problems. These findings were slightly different as compared to the study done among medical camp attendees of the Pakistan floods in 2010, where 30% had acute gastroenteritis, 21% had respiratory tract infections, and 4% had suspected malaria. Similarly, during the Pakistan floods in 2010, skin problems such as dermatitis, fungal infections, and scabies were commonly observed due to the poor hygiene, overcrowding, dermal contact with contaminated water.
In a study done by Fernandes et al., during the Chennai floods 2015, 88.2% of the study participants felt that drinking water was contaminated with drainage water, causing ill health effects. In our campsites, all the patients reported availability of clean drinking water during and after floods due to the desalination plant in the Minjur Block and the provision of bottled drinking water by flood relief agencies.
From very recent experience from California floods 2017, it is evident that building on existing dam safety program, funding is needed to assess and upgrade the state's dams, spillways, and outlet works and update many flood operation manuals. Such funding should be sustained since dam safety and periodic upgrades are not one-time expenses.
| Conclusion|| |
In our study, we provided care only to the acutely ill patients. Patients with noncommunicable diseases such as diabetes also visited the camps for medicine despite us not stocking drugs for noncommunicable diseases. This could be attributed to the failure of the existing health system in provision of routine health care due to the floods.
Further studies should be done to assess the long-term impact of floods on health such as mental health problems, noncommunicable diseases, and nutritional problems.
We thank Camillian Task Force, Caritas, India, and St Johns medical college hospital, Bangalore for their organization of these camps.
Financial support and sponsorship
The study was supported by Camillian Task Force, India, and Caritas, India, for their organization of these camps.
Conflicts of interest
There are no conflicts of interest.
| References|| |
Lavanya AK. Urban flood management – A case study of Chennai city. Arch Res 2012;2:115-21.
Du W, FitzGerald GJ, Clark M, Hou XY. Health impacts of floods. Prehosp Disaster Med 2010;25:265-72.
Suriya S, Mudgal BV, Nelliyat P. Flood damage assessment of an urban area in Chennai, India, part I: Methodology. Nat Hazards 2011;62:149-67.
Alderman K, Turner LR, Tong S. Floods and human health: A systematic review. Environ Int 2012;47:37-47.
Watson JT, Gayer M, Connolly MA. Epidemics after natural disasters. Emerg Infect Dis 2007;13:1-5.
Ahern M, Kovats RS, Wilkinson P, Few R, Matthies F. Global health impacts of floods: Epidemiologic evidence. Epidemiol Rev 2005;27:36-46.
Gaitonde R, Gopichandran V. The Chennai floods of 2015 and the health system response. Indian J Med Ethics 2016;1:71-5.
Shabir O. A summary case report on the health impacts and response to the Pakistan floods of 2010. PLoS Curr 2013;5. pii: Ecurrents.dis.cc7bd532ce252c1b740c39a2a827993f.
Kshirsagar NA, Shinde RR, Mehta S. Floods in Mumbai: Impact of public health service by hospital staff and medical students. J Postgrad Med 2006;52:312-4.
] [Full text]
Pal S, Juyal D, Sharma M, Kotian S, Negi V, Sharma N. An outbreak of hepatitis A virus among children in a flood rescue camp: A post-disaster catastrophe. Indian J Med Microbiol 2016;34:233-6.
] [Full text]
Fernandes E, Borah H, Shetty S. Mainstream disaster health as a policy priority: Experiences from Chennai floods and a cross sectional study during disaster relief phase. Int J Community Med Public Health 2016;1589-92.