When everyday is an emergency
Friday, 10 April 2009
THIS year's World Health Day, April 7, called for making health facilities safer and more capable of dealing with emergency situations at all times. Bangladesh, being a geographically vulnerable piece of land, packed with largely powerless people, and prone to all kinds of natural and man-made disasters, the theme here can hardly be over emphasised. In fact, its meaning and scope goes far beyond the avowed intent of the World Health Organisation (WHO)-designated health-day slogan -- 'Save Lives Make Hospitals Safe in Emergencies.'
Under this slogan, whenever the need arises, Bangladesh's Health and Family Welfare Ministry is to be given prompt technical support for better case management. Enhancement of the government's response capacities, through various WHO-GOB collaborative programmes, is also high on the priority list of the UN body. People in low-income countries like Bangladesh are said to be at least four times more likely to die from extreme natural disasters than the rich world's people. This is not unexpected, given the fragility of the poor in terms of physical strength and stamina, though in spirit Bangladesh's people at least remain unbeatable in their legendary resilience.
For Bangladesh, with one of the world's highest maternal mortality rates and other negative indices pertaining to general health, virtually everyday is an emergency, even though the more dramatic and spectacular instances like super cyclones Sidr or Gorky, terrible tornadoes and tidal bores, devouring floods and erosions make more news than the silent emergencies caused by day-to-day malnourishment, poor sanitation and poor management of scarce resources.
This daily emergency however can never trivialise the magnitude of the health problems generated by major disasters. Nine of the world's top ten countries for disaster-related deaths due to weather-related phenomena like floods and cyclones belong to Asia and Bangladesh is one of the worst affected. In November 2007, Sidr alone killed some ten thousand people and injured thousands more, according to reports. Government figures put the number of affected to as many as eight million and, it is estimated that about 71 per cent of the health facilities in the periphery of the storm were badly damaged. The economic toll and human suffering from extreme natural disasters are enormous.
It is, therefore, important to invest in health infrastructure that can withstand hazards, not only to be able to safely serve people immediately but also to have systems in place to ensure continuity of care. A health facility's actual value is said to lie in its non-structural elements, including mechanical, electrical and communications equipment as well as storage and water-heating provisions. It is often damage to these that turns an otherwise good health infrastructure into a mere brick building. WHO information kits claim that only about one per cent of a hospital's budget is needed to have these non-structural elements in place, but this one per cent can protect 90 per cent of the hospital's value.
Unfortunately, a culture of poor management and maintenance in Bangladesh's government-run facilities can be the undoing of even the best health facilities available. This must, and can be overcome through continuous training of personnel in the use and upkeep of essential equipment. It is an imperative if existing facilities and newly established ones are to remain safe and operable whenever needed. A participatory approach to meeting emergency health needs, whereby the community, particularly the youth, comes forward spontaneously, can work wonders. Mercifully, Bangladesh has no dearth of such volunteerism.
Programmes for year-round preparedness in emergency health care could grow out of such volunteerism and brigades of barefoot doctors, so to say, that could be created, if the energy and urge is channelled sustainably. The non-so-spontaneous members of the student community could perhaps be drawn into such voluntary programmes also for their own mental health and to build wider support for community health care.
Under this slogan, whenever the need arises, Bangladesh's Health and Family Welfare Ministry is to be given prompt technical support for better case management. Enhancement of the government's response capacities, through various WHO-GOB collaborative programmes, is also high on the priority list of the UN body. People in low-income countries like Bangladesh are said to be at least four times more likely to die from extreme natural disasters than the rich world's people. This is not unexpected, given the fragility of the poor in terms of physical strength and stamina, though in spirit Bangladesh's people at least remain unbeatable in their legendary resilience.
For Bangladesh, with one of the world's highest maternal mortality rates and other negative indices pertaining to general health, virtually everyday is an emergency, even though the more dramatic and spectacular instances like super cyclones Sidr or Gorky, terrible tornadoes and tidal bores, devouring floods and erosions make more news than the silent emergencies caused by day-to-day malnourishment, poor sanitation and poor management of scarce resources.
This daily emergency however can never trivialise the magnitude of the health problems generated by major disasters. Nine of the world's top ten countries for disaster-related deaths due to weather-related phenomena like floods and cyclones belong to Asia and Bangladesh is one of the worst affected. In November 2007, Sidr alone killed some ten thousand people and injured thousands more, according to reports. Government figures put the number of affected to as many as eight million and, it is estimated that about 71 per cent of the health facilities in the periphery of the storm were badly damaged. The economic toll and human suffering from extreme natural disasters are enormous.
It is, therefore, important to invest in health infrastructure that can withstand hazards, not only to be able to safely serve people immediately but also to have systems in place to ensure continuity of care. A health facility's actual value is said to lie in its non-structural elements, including mechanical, electrical and communications equipment as well as storage and water-heating provisions. It is often damage to these that turns an otherwise good health infrastructure into a mere brick building. WHO information kits claim that only about one per cent of a hospital's budget is needed to have these non-structural elements in place, but this one per cent can protect 90 per cent of the hospital's value.
Unfortunately, a culture of poor management and maintenance in Bangladesh's government-run facilities can be the undoing of even the best health facilities available. This must, and can be overcome through continuous training of personnel in the use and upkeep of essential equipment. It is an imperative if existing facilities and newly established ones are to remain safe and operable whenever needed. A participatory approach to meeting emergency health needs, whereby the community, particularly the youth, comes forward spontaneously, can work wonders. Mercifully, Bangladesh has no dearth of such volunteerism.
Programmes for year-round preparedness in emergency health care could grow out of such volunteerism and brigades of barefoot doctors, so to say, that could be created, if the energy and urge is channelled sustainably. The non-so-spontaneous members of the student community could perhaps be drawn into such voluntary programmes also for their own mental health and to build wider support for community health care.