INTRODUCTION

Public Health Emergencies

The term “public health emergencies” denotes disasters that adversely impact the public health system and its protective infrastructure (water, sanitation, shelter, food, and health) thus resulting in both direct and indirect consequences to the health of a population. When this protective threshold is destroyed, overwhelmed, not recovered or maintained, or denied to populations through political violence, war, conflict, or other disasters, classic consequences, all preventable, emerge. Outbreaks of communicable disease, food shortages leading to undernutrition and eventual malnutrition inevitably result in worsening vulnerability and insecurity, population displacement, loss of livelihoods, and poverty.

Public health emergencies occur more often in developing countries where public health infrastructure, adequate numbers of health sector workers, and basic medications and equipment are lacking or nonexistent. An exception occurs in developed countries when urban environments become more populous and dense, commonly with migrants experiencing low socioeconomic status and increased vulnerability. Urban occupancy for the disadvantaged is often limited to unfavorable disaster-prone areas with poor or absent infrastructure. Such a combination of factors results in high risk for a major public health emergency to occur if additional essential infrastructure loss were to occur with an earthquake or tsunami. Similar public health emergencies happen whenever the protective public health cover is breached in large-scale disasters such as Hurricane Katrina and the Indian Ocean tsunami. Two years after Hurricane Katrina, a 47% increase in mortality was reported in New Orleans.