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Pallets of critical medications and supplies are being prepped in the warehouse for shipment to Jamaica after Hurricane Melissa. (Shannon Hickerson/Direct Relief)
Hurricane Melissa has killed at least 50 people across the Caribbean – a number that’s likely to rise.
But storms like Melissa aren’t deadliest in the short days when they’re active. Instead, it’s in the weeks and sometimes years afterward – when affected communities struggle with a blocked road to the nearest hospital. A contaminated water source, or a local clinic with a missing roof and ruined equipment. Or perhaps a communal refrigerator that held insulin but is now damaged and its contents unsafe.
In coordination with Jamaica’s Ministry of Health and Wellness, Direct Relief’s warehouse and logistics staff are currently packing an urgent shipment of requested medicines and supplies, valued at roughly $1 million wholesale. This shipment supplements aid Direct Relief had already positioned in the region before hurricane season began and medical aid currently on the way – and its purpose is to head off what’s commonly called “the second disaster.”
Hurricane preparedness packs including medications and supplies provided by Direct Relief are distributed in advance of hurricane season in Haiti by local NGO Hope for Haiti. These critical supplies are on the ground and are currently in use in response to Hurricane Melissa. (Photo courtesy of Hope for Haiti)
Research is increasingly proving that this second disaster – a period of months or years after a natural disaster severely damages a community – is deadly. Sixty-four Puerto Ricans were directly killed by Hurricane Maria in 2017. But a groundbreaking 2018 study conducted in the months after found a number of excess deaths above 4,000 – about 70 times the cited death toll. About one-third of those deaths were caused by a lack of access to healthcare, as blocked roads and closed clinics kept people from providers and medicine.
Tropical storms like hurricanes unleash a host of threats into affected communities.
When local water sources are contaminated, water-borne illnesses like cholera become a severe and potentially fatal risk. Digestive ailments like norovirus can spread through contaminated water and food, especially in crowded conditions like shelters. Because both uncontaminated food and drinkable water are in short supply in Jamaica right now, preventing these illnesses and preparing to treat their symptoms will be high priorities.
Pools of standing water quickly become breeding grounds for mosquitoes, especially in warm climates. In the Caribbean, mosquitoes cause vector-borne diseases like dengue, zika, and chikungunya. Because dengue has been on the rise in recent years, it’s a particular concern right now.
Jamaican residents were told to evacuate as Hurricane Melissa makes landfall with extreme winds and catastrophic rain and floods to follow (Photo by Associated Press).
Communities affected by hurricanes have reported a growing need for epinephrine autoinjectors, as people working to clear damage and return to their homes encounter beehives and other potentially deadly allergens. And physical traumas such as injuries occur both during storms and as people work to clear debris and reach help.
2. Lost Medicine and Food
People with non-communicable diseases like diabetes, hypertension, respiratory ailments like COPD, cancer, and kidney disease are at increased risk during and after hurricanes. Medicines are often damaged by the disaster or people are forced to flee without them. The lifesaving treatments used to manage these conditions generally demand consistent, reliable access to care and monitoring.
In addition, contaminated food sources or lost crops can quickly lead to nutritional deficits, with pregnant women and other vulnerable people at higher risk. In Jamaica, Hurricane Melissa has destroyed both food and crops. For people with diabetes, managing the disease with little food or with whatever is available is likewise much more hazardous.
3. Mental Illness
Communities that experience hurricanes experience increased levels of post-traumatic stress, depression, anxiety, and other mental health issues that can continue for more than a decade. Long periods of uncertainty – such as when recovering families struggle to access housing or find employment – can create or prolong psychological distress.
Jamaican communities have experienced extensive damage, while access to water, food, and healthcare has been compromised. Recovery will likely take years. (Photo courtesy of Dennis Abrahams)
A single hurricane can cause widespread impacts, but repeated events compound the effects. Research has demonstrated that survivors of multiple traumatic events are left with worsening mental strain and greater vulnerability to future mental health illness.
4. Damaged Infrastructure
Damaged clinics and hospitals – Jamaica has reported at least five significantly damaged hospitals – can cut off access to care for months. This affects both people needing emergent care, such as for diabetes or a mental health condition, and people who need surgery or specialty care for cancer, kidney disease, and other complex illnesses.
When Hurricane Dorian battered whole islands in the Bahamas in 2019, both primary care clinics and specialty care hospitals were affected. The Covid-19 pandemic, which began the following year, drastically complicated access to care in the Caribbean nation.
But even if clinics and hospitals are open and able to care for patients, blocked roads and landslides can make accessing that care impossible. Puerto Rico, like many other areas of the Caribbean that are vulnerable to hurricanes, has increased its mobile and rural healthcare efforts in the aftermath of Hurricane Maria.
Dr. Josué Segarra Lucena speaks with a patient during a mobile clinic visit. (Photo courtesy of La Fondita de Jesús)
5. Poverty, Displacement, and Struggle
Some of the most lasting consequences of hurricanes are hard to quantify – but they can be deadly. Excess deaths in the years after a hurricane aren’t always easily attributable to it. But when people lose their homes or their livelihoods; when they are displaced from their communities for long periods; when the community as a whole struggles to rebuild or restore services; when contamination and pollution continue to haunt communities, then the number of excess deaths will increase.
First Response
The medical aid being prepared for transport to Jamaica includes a wide variety of requested medicines and supplies. Some of these – including epinephrine auto-injectors, water purification tablets, IV supplies, antibiotics, insect repellent, personal protective equipment, field medic packs for emergency responders working on the ground, and reentry kits for people returning to damaged homes – are designed to prevent emergent conditions common after a disaster.
Many other items, including insulin and blood pressure medications and prenatal vitamins, will help prevent spiraling health emergencies caused by a lack of medications. People with non-communicable diseases like diabetes and hypertension, and pregnant women, are at particularly high risk in the aftermath of a hurricane.
The Jamaican Ministry of Health and Wellness has also requested a range of mental health medications for people affected by Hurricane Melissa, as post-traumatic stress and other mental health conditions pose significant risks to disaster-affected communities. These medications are included in the shipment.
Pallets of critical medications and supplies for Hurricane Melissa relief are loaded for transport. (Shannon Hickerson/Direct Relief)
A second shipment of pediatric insulin and materials for children with Type 1 diabetes is also being prepared by Direct Relief for shipment to Jamaica and awaiting dispatch to the Jamaica Diabetes Association.
Recovery in countries affected by Melissa will likely take years. Direct Relief has strong, active partnerships throughout the Caribbean, and in Jamaica, Haiti, the Dominican Republic, and the Bahamas in particular. The organization has worked for years with regional and local partners to increase resilience and disaster preparedness.
Direct Relief will continue to collaborate with partners, monitor the changing situation, and respond as needed.
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