Heavy rainfall led to tragic floods and mudslides in Venezuela during the month of December. The meteorological phenomena involved included: 1) the movement of a cloud line, produced by a frontal system, on the northern coastal area of the country, 2) a high diffluence produced by an anticyclonic dorsal that sustained the mass ascent, and 3) the orography (coastal mountain range) where the humid air rose. As a result, the level of precipitation reached 1,207 mm between the 1st and the 18th of December, with 381 mm on the 15th of December, and 410 mm on the 16th. According to the available data, the daily, monthly and yearly historical records were broken during those days. The average precipitation for a month of December was 57 mm, and the maximum precipitation ever reached was 221 mm in 1985. The average yearly precipitation in Venezuela was 523 mm, and the maximum ever observed was 961 mm of rain in 1951. Therefore, the level of rain was more than twice the yearly average, and 20% more than the worst floods ever registered, which occurred 48 years ago (1951).

The strong rains caused landslides in the mountains that surround the capital, producing floods and alluvions accompanied by rocks and mud, dragging everything in their way and causing heavy damage in eleven states. The most affected states were Vargas, Miranda, Distrito Federal (Caracas), Falcón, Anzoátegui, Nueva Esparta, Zulia and Sucre (see map). In these states, the rains produced mud slides, floods, overflowing of rivers and dams, and the collapse of the principal channels of communication, as well as drainage and water supply networks.

The Venezuelan government, through the Civil Defense, has officially recorded 349 dead as of the 31st of December, however, technically justified estimations put the death toll at a much higher level. Information from the Ministry of Exterior Relations at the same time mentioned between 10 and 20,000 deaths. Official figures indicate a total of 419,222 people affected by the disaster, which left 85,380 people injured and 2,545 missing, while 81,137 dwellings were damaged and 26,147 completely destroyed.

The affected people were evacuated from the danger zone and relocated in shelters, which resulted in the creation of 360 shelters in 14 states, where 53,629 people have been lodged. For better surveillance and control after the disaster, Venezuelan health authorities launched a daily syndromic notification system in those shelters. The sheltered population mainly presented diarrheal, respiratory and viral symptoms (characterized only by fever and overall discomfort).

The Venezuelan epidemiological surveillance system has also intensified the compulsory reporting of communicable diseases in the rest of the affected population and continued with the immediate reporting of diseases. The epidemiological surveillance of routinely observed diseases showed a risk of:

- Malaria: the trend of the disease was ascending in the country until the disaster occurred. There is a risk of increase in the number of cases, considering risk factors such as heavy rainfall, the formation on large lakes and the displacement of population to affected areas as a consequence of the disaster.

- Dengue: this disease was present in all the Venezuelan states, with a majority of cases in Zulia, Falcón and Distrito Federal, which were all affected by the rains.

- Cholera: the State of Sucre presented the majority of cases before the December events, with more than 60% of all cases, and was one of the most affected by the disaster.

- Leptospirosis: the majority of cases has been concentrated in Distrito Federal, Aragua and Carabobo for the last 5 years.

- Yellow fever: there are 3 sources of yellow fever activities in the country: the areas of Lago de Maracaibo in Zulia; San Camilo Barinas; and Guyana. There are risks of outbreaks, as the population is being displaced towards these areas.

In view of the above, the Ministry of Health is maintaining a strict surveillance of these diseases in order to avoid outbreaks or epidemics, which could start and spread easily due to the country’s sanitary conditions after the disaster. It should be noted that health situation rooms have been crea-ted in the most affected states as well as at the national level, to facilitate the flow of information necessary for decision-making.

In terms of environmental sanitation, close to 600,000 people were left without water supply at the national level, making the lack of safe water the most important problem in Venezuela after the disaster. The most critical states are Vargas and Miranda where, according to official data, at least 60% of the water supply systems were damaged.

Repairs observed so far show that Hidroven, with the support of the Ministry of the Environment and Health and Social Development, is reestablishing water supply systems at a fast pace. Indeed, a few weeks after the floods occurred, water services have been partially or totally restored in 8 of the 11 affected states, leaving a decreasing number of people without this vital service. Nevertheless, a lot remains to be done in the most affected states, where almost all installations suffered important damage.

Similarly, the level of wastewater is preoccupying, since a large majority of sewerage systems were damaged, which suggests that there won’t be an adequate canalization system to support the water service once it is reestablished. Actions that are being carried out include the reestablishment of the sewerage and rain drainage systems, as well as the construction or rehabilitation of pumping stations for underwater outfalls.

Another emerging problem is the adequate management of solid waste, since the municipal dumps in all flooded areas remain incapacitated. As a result, the waste is creating environmental health problems and in light of the situation, a plan of action has been developed, with broad community parti-cipation, in order to minimize the health and environmental hazards (such as the presence of vectors and rodent reservoirs of diseases). Specific actions include the superficial burial of the waste, as well as its incineration.

Health services were also severely affected in the 8 states involved in the tragedy. According to the information provided by the Ministry of Health and Social Development, 29% (9/31) of hospitals and 36% (251/687) of ambulatory services were damaged in the affected areas. In the state of Vargas, the most stricken by the floods, all the hospitals and 72% of all ambulatory services were damaged, lea-ving the population without health services for several weeks. With great effort and the support of civil, military, national and international volunteers, the Ministry of Health was able to provide primary care through temporary emergency posts and mobile units.

The Pan American Health Organization has closely supported Venezuela since the beginning of the tragedy, through different areas of technical cooperation established with the country, and has mobilized financial and technical resources at the national and international level. In response to the disaster, PAHO/WHO is providing technical cooperation in the following areas: epidemiological surveillance, health services, environmental health, food protestion, support in the coordination and management of humanitarian supply, information, education and communication.

Since the emergency situation started in Venezuela in the middle of December, PAHO/WHO has been facilitating the coordination and communication between the national institutions’ authorities and the international community, in the areas related to health. At the request of the Ministry of Health, the Organization has played a key role in coordina-ting actions and donations, in order to strengthen national efforts with international support and avoid duplication of humanitarian assistance. In the PAHO/WHO local office, a responsible party was assigned to each priority area, and experts from other countries of the Americas were mobilized, both national employees and staff from the Organization. The local office was also reinforced by administrators with expertise in supply management and informatics in order to ensure a more efficient flow of goods and services.

The International Community has supported Venezuela during the state of emergency, and has responded generously, with financial and human resources and materials. So far, a total of approximately US$ 25,000,000 was received from governments, international organizations, individual donations, non-governmental organizations, banks and private companies.