The Health Burden of Hurricanes And Other Natural Disasters.

By Dr. C. Farquharson-Deveaux, MD 

Hurricane season in The Bahamas runs from June 1st to November 30th.  For the most part Bahamians have been lucky overall in escaping the brunt of most major hurricanes of the Atlantic. 

However, a few islands namely Eleuthera, Grand Bahama and Abaco have suffered some damage in the past few years.  This year it is projected that eight (8) hurricanes will develop and four (4) of them will be major.  With changes in climate because of global warming, this prediction could be quite accurate.  For the most part hurricanes tend to be more frequent and stronger when the oceans are much warmer, and we have already been experiencing some intensely hot days which are expected to continue.

Bahamians tend to be quite laid back when it comes to preparing for hurricane season.  This is partly due to our escaping so many storms in our most recent past, and also because we somehow feel a two to three day warning is more than sufficient.  This may be adequate for the physical preparation of securing buildings, stocking up on food and water, or relocating to more suitable shelters.  However, what about the mental and emotional preparation we tend not to think about.  Yes we are all pretty aware of the immediate physical affects of a hurricane or flooding, the more common being acute gastroenteritis from contaminated food and water, or physical injuries from fallen trees and debris.  On the other hand, people can be significantly traumatized and experience a sense of helplessness and horror when they either experience a life altering event or believe that they [or their family] are under threat of serious injury or death as before or during a hurricane.  Hurricanes can also cause great destruction to property and businesses and can result in loss of jobs and income thereby threatening personal survival or the ability to support family and maintain previous standard of living.  If a person is not prepared for such a turn of event, this can be emotionally and psychologically devastating.

Psychological aspects of disasters can have a mild, transient or a severe, long term affect on overall health. The more mild psychological distress can include difficulty concentrating, confusion, unwanted thoughts or memories [of the storm], irritability, distrust or withdrawal from daily activities.  Some persons may experience physical symptoms such as headache, tension, tiredness, change in appetite and sleep patterns, uncontrollable shaking, palpitations and gastrointestinal upset like stomach pains and diarrhea.  For most people these start immediately and can get better within weeks to months.  However, they can last for up to one year.  Improvement is normally associated with how quickly the person starts to feel secure and is once again able to start meeting their basic needs and responsibilities.  

The more severe mental problems may also begin immediately, and can include depression, post-traumatic stress disorder and other anxiety disorders.  There may also be an increase in the use of alcohol or drug abuse and domestic or violence against others.  These tend to be more long-lasting and also more difficult to identify and subsequently treat.  Psychological health problems can also result in worsening chronic health conditions like diabetes, heart disease and hypertension as persons may begin to neglect their personal physical health.

There are several things that can affect how a person will respond before, during and after a hurricane.  A person's age, income and social support are a few very important factors.  For example children tend to show emotional distress to significant changes while middle-age adults experience psychological and physical problems when a disaster makes it impossible to meet responsibilities.  Older adults most often show physical and mental health problems when pre-existing limited income, poor health and social support causes inability to effectively cope.  Persons who already have a mental or psychological problem will also be more likely to have worsening of these symptoms when faced with disaster or uncertain circumstances.  It is therefore imperative that preparation and recovery from hurricanes also involve developing the ability to mentally cope and also to ensure that adequate family, social and financial supports are in place beforehand. 

Successful coping involves being flexible, thinking creatively, being willing to try new things, working cooperatively with others, being action oriented and having the ability to tolerate frustration or tolerate strong emotions.  Persons should also educate themselves on social and family support systems available in their area or island.  For example, knowing where appropriate shelters are located, securing a safe place for themselves and their family to weather the storm, having adequate cash in hand for emergencies, knowing where and how to access appropriate medical care, having or being able to secure sufficient savings [to cover at least 3 months of expenses] in case there is loss of income, having access to suitable living arrangements post hurricane in the event there is damage or destruction of home/property and being willing to live at a reduced standard of living or reduced income while recuperating from losses.  Other things that can be done to help cope include keeping to usual routines as much as possible, taking the time to resolve daily conflicts so they do not add to your stress, finding ways to relax, turning to family, friends and minister for support and openly discussing your experiences and feelings with them, recognizing that you can't control everything and seek appropriate trained help whenever necessary.  It is also extremely important to never neglect the effect traumatic events may have on our children.  Children are extremely sensitive to changes and we need to make sure they are made to feel safe and secure as soon as possible.  Let your child know that it is okay to feel upset when something bad or scary happens, encourage them to express their feelings and thoughts, without making judgments and help them to return to daily routines.

If you or someone you know may be experiencing changes related to a previous storm [or traumatic event] then seek appropriate healthcare with a medical professional.  By doing this you can get your life back on track and also learn how to deal with future storms that are inevitable in all of our lives.