The aftermath of a disaster. Recovery following the volcanic eruptions in Montserrat, West Indies.

The people of Montserrat have experienced serious volcanic eruptions since the middle of 1995. These resulted in the evacuation of the capital town Plymouth in 1997. An exclusion zone was declared and two-thirds of the original population of 10,324 migrated abroad. The remainder was left to initiate the recovery process. This paper reviews the action taken to maintain and then restore the health services and the health of the people. The recovery process is now well advanced and is following a characteristic pattern described as the Post Disaster Recovery Scenario. A new hospital was set up in the North of the island and the four remaining clinics refurbished. The health service was restored to a reasonable standard by the end of 2000. A Disaster Preparedness Team is kept on full alert to deal with any emergencies. The disaster caused serious disruption to the health services and to the way of life of the people. It had a number of adverse health effects which included immediate harm to respiratory health followed by other more serious problems such as mental illness, poor nutrition and violence. These were due to the disruption caused by resettlement, overcrowding, breakdown of family life and economic hardship. The lessons learned may be of benefit to countries experiencing similar events in the future.

The aftermath of a disaster. Recovery following the volcanic eruptions in Montserrat, West Indies

The people of Montserrat have experienced serious volcanic eruptions since the middle of 1995. These resulted in the evacuation of the capital town Plymouth in 1997. An exclusion zone was declared and two-thirds of the original population of 10,324 migrated abroad. The remainder was left to initiate the recovery process. This paper reviews the action taken to maintain and then restore the health services and the health of the people. The recovery process is now well advanced and is following a characteristic pattern described as the Post Disaster Recovery Scenario. A new hospital was set up in the North of the island and the four remaining clinics refurbished. The health service was restored to a reasonable standard by the end of 2000. A Disaster Preparedness Team is kept on full alert to deal with any emergencies. The disaster caused serious disruption to the health services and to the way of life of the people. It had a number of adverse health effects which included immediate harm to respiratory health followed by other more serious problems such as mental illness, poor nutrition and violence. These were due to the disruption caused by resettlement, overcrowding, breakdown of family life and economic hardship. The lessons learned may be of benefit to countries experiencing similar events in the future

The aftermath of a disaster - recovery following the volcanic eruptions in Montserrat - Poster abstract

OBJECTIVE: To analyse the adverse health effects following the major volcanic eruptions in Monsterrat and describe how the recovery process has dealt with these problems. DESIGN AND METHODS: The records of the health clinics were analysed for information on diseases resulting from volcanic activity. The official records of the Health Department were reviewed for evidence of the recovery process and its effects on health services. RESULTS: Direct effects included trauma - 19 fatalities and 10 severe burns following one pryroclastic surge; respiratory - an immediate exacerbation of symptoms in known asthmatics and a small increase in attendances at clinics during the early stages of the eruption. Subsequent analysis found no increase in respiratory disease following ash falls and no differences in clinic attendances comparing a clinic in a high risk area with one in lower ash areas. A survey of police staff exposed to high levels of ash found no impairment of respiratory function. Indirect effects included mental illness. There was no increase in the incidence of new illness but problems occurred because of disruption of support structures. Post traumatic stress syndrome was widely reported anecdotally but there are no survey data to support this impression. Health infrastructure was gradually restored by converting a school into a temporary hospital, refurbishing health clinics and recruiting and training staff. The Disaster Preparedness Team was strengthened. These improvements, and the setting up of an embryonic Health Information System permitted better analysis of records. A system of clinical audit had resulted in better treatment of patients. CONCLUSIONS: The major eruptions of the volcano in Monsterrat between 1995 to 1999 caused a number of health problems. These were made more difficult to contain by mass relocation of the population, closure of clinics and transfer of rudimentary clinics in north of the island. The Health Department is now in an advanced state of recovery following the crisis and many of the health problems are being resolved.(AU)

Do we pay too dearly for our sport and leisure activities? An investigation into fatalities as a result of sporting and leisure activities in England and Wales, 1982-1988.

Analysis of deaths from sports and leisure activities in England and Wales during 1982-88 found that horse riding (98 deaths), air sports (92 deaths), motor sports (86 deaths) and mountaineering (74 deaths) were the most hazardous activities. The most hazardous activity for children was horse riding (19 deaths). The commonest activities resulting in drowning in adults were swimming (128 deaths) and fishing (82 deaths). The main drowning deaths in children followed swimming (24 deaths). When exposure was taken into account, mountaineering, motor sports and horseriding were found to be the most hazardous activities. Mountaineering was one hundred times more dangerous than ball games or water sports. We can expect an increase in sport and leisure accidents in the next few years. Strict control, sensible safety precautions and adequate training are paramount if we are to see any improvement.

Geographical and social variations in mortality due to childhood accidents in England and Wales 1975-1984.

An analysis was made of the death rates from accidents in children aged 0-14 by health districts in England and Wales during the five year periods 1974-79 and 1980-84. Death rates were generally higher in the north and west of England and lower in the south and east. Rates were higher in urban areas than in rural areas. There was a more than five-fold difference between the highest and lowest rates by districts during both periods. There was a very strong correlation with social deprivation. Greater efforts are required to reduce unnecessary deaths and disability from childhood accidents. The lessons already learned in many parts of the world must now be put into much wider use and practice in the United Kingdom.