These Are the Health Crises That Typically Follow Horrific Floods

There are no words to describe the magnitude of the devastation Houston is experiencing in the wake of Hurricane Harvey. Although downgraded to a tropical storm after its initial landfall, Harvey has unleashed torrential downpours that are likely to prove worse than anything America has seen in over 100 years. And Houston is no stranger to catastrophic flooding—in 2001, tropical storm Allison’s wrath left the city with 22 deaths and billions of dollars in damages.

Climate scientists have said that climate change may be making these unwieldy natural disasters more common. And many experts argue that increasing development makes flooding worse. With these players already having contributed to the formation of a perfect storm, all Houstonians can do is brace themselves and try to wait out Harvey’s relentless pounding. But the story of peril does not stop with the end of the rainfall. These days of rain and flooding in Houston will leave the city in shambles for months.

Beyond infrastructure dangers, the survivors of Harvey will likely also face serious health hazards.

As Kristi L. Koenig, M.D., professor emerita of emergency medicine and public health at the University of California, Irvine, tells SELF, the key issues following major flooding events are infrastructure damage, displacement of occupants, spread of infectious diseases, toxic chemical exposures, and often unrecognized mental health consequences.

A large-scale World Health Organization (WHO) study out of Europe investigated these health effects of flooding and found that the two-thirds of flood-related deaths are due to drowning, while the remainder are from trauma, electrocution, carbon monoxide poisoning, fire, or heart attacks. Weakened health care infrastructures during natural disasters make seeking care for these immediate injuries and infectious diseases even more difficult. In the case of Harvey, Houston’s biggest level 1 trauma center, Ben Taub Hospital, is itself being evacuated due to lack of food and flooding.

The need for immediate medical attention aside, basic necessities such as food and clean drinking water become critical for displaced flood survivors, says Koenig. Contamination of drinking water due to failures at water treatment plants and sewage system overloads can lead to outbreaks of diarrheal disease if clean water provisions are not prioritized. Even exposure to flood water itself for prolonged periods of time can lead to health risks—ranging from animal bites and wound infections to electrical and chemical hazards. And, according to Koenig, once the immediate crisis dissipates, the toll of the natural disaster can persist in the form of chronic disease, worsened poverty, and emotional and mental distress.

Fortunately and unfortunately, we have a lot of previous experience with flooding.

In America, the best examples of public health and safety issues following flooding can be found with a quick study of Hurricanes Katrina and Rita in 2005. Katrina led to the deaths of close to 1,000 Louisiana residents, and 80 percent of New Orleans was flooded when the city’s levees failed. Just one month after Katrina’s destruction, Hurricane Rita battered New Orleans with more storm surges. Long-term flood impacts on physical health are not well-studied, but most agree that the impoverished and medically underserved populations are the most vulnerable to potential health hazards post natural disasters.

The most pressing concerns in New Orleans in the immediate aftermath of the Katrina and Rita were mosquito-borne illnesses and a need for clean drinking water. Additionally, complications from untreated chronic diseases such as diabetes, hypertension, and HIV were thought to have increased mortality in the city due to an inability to access basic health care as well as added physical stress from hurricane-related stressors. Regarding concerns about long-term physical health effects related to indoor mold exposure from water-damaged houses, studies ultimately demonstrated no correlation between mold exposure and sensitivity to mold allergens.

The most lingering health hazards for many New Orleans residents in the aftermath of Hurricanes Katrina and Rita were the mental and emotional trauma sustained after surviving the floods. Some of those same residents later faced displacement, poverty, and unemployment. Natural disasters are known to leave many survivors with acute post-traumatic stress disorder (PTSD), so not surprisingly, surveys conducted in post-Katrina census divisions found that the the prevalence of serious mental illnesses had doubled when compared to results from surveys of the same census divisions pre-Katrina. And, notably, flooding in particular has been found to affect people of all ages for prolonged periods of time, with the mental health effects encompassing anxiety and depression in addition to PTSD. A study of Katrina-era New Orleans residents demonstrated that over half of these residents still reported poor mental health 15 months after the hurricane, likely due to hurricane-related stressors.

And what about experiences with health care infrastructure issues? Louisiana State University’s (LSU) New Orleans-based Charity Hospital and Veteran Affairs (VA) Hospital were the most damaged by Katrina’s flooding. LSU’s Charity Hospital provided care to the city’s most vulnerable populations and remains permanently closed. The VA was ultimately rebuilt, but did not open until November 2016, while LSU’s replacement for Charity Hospital, the University Medical Center New Orleans, did not open until August 2015—10 years after Katrina hit New Orleans.

There are resources on the ground—and ways for you to help.

On the ground in Houston right now, first responders and 911 emergency services remain the mainstay for any emergent medical care or evacuation needs. Here are some other resources to know about:

  • For non-emergencies, the numbers for the Houston Coast Guard Command Centers can be found here.
  • If you are in need of shelter, Houston’s local ABC news affiliate site has a list of shelters that is being updated as more information becomes available.
  • For those waiting out the floods in their homes, please be cautious with indoor grills, generators, and gas stoves to prevent carbon monoxide poisoning.
  • If you are unable to access clean water, the Food and Drug Administration (FDA) has water purification methods listed on their website in addition to tips on safe medication use after natural disasters.
  • Healthcare Ready, a partner with other disaster response programs, has mapped out open pharmacies in the Houston area, but before you consider leaving your home for anything, please ensure the roads are safe by consulting the Houston Chronicle’s compilation of flooded streets.
  • For flood victims with diabetes and concerns that they will not be able to properly care for themselves in the aftermath of Harvey, a diabetes emergency plan resource is available here. Additionally, Eli Lilly and Company has donated diabetes medications to Direct Relief’s efforts, and this map shows Direct Relief’s partner health clinics in areas affected by Harvey. And Novo Nordisk is working with AmeriCares to provide diabetes medications to those in need.
  • If you’re not physically in Houston but are able to offer assistance or support, here are a few ways you can help.

Last, but certainly not least, the emotional and mental burden from natural disasters such as Harvey should never be overlooked. Psychological first aid should be made a priority, and FEMA provides resources from the Listen, Protect and Connect (LPC) system on their website. The LPC system provides a framework that can help survivors of natural disasters support one another through difficult times. The Substance Abuse and Mental Health Services Administration (SAMHSA) also has a 24/7 disaster distress helpline for immediate crisis counseling services. Calls or texts to this SAMHSA service will connect those in need with a network of independently operated crisis centers across America, because we truly are in this together.

Farah Naz Khan, M.D., is a physician and a writer. Find her on Twitter @farah287 or her website at FarahNazKhan.com.

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