Patient being evacuated from Rand Memorial Hospital in the city of Freeport, Grand Bahama, in a United States Navy helicopter.
Hurricane Dorian, a category 5 storm, and the strongest on record in northwestern Bahamas, made landfall on 1 September at Elbow Cay (Grand Abaco) .
The 295-kilometer-an-hour winds, high surf, and intense rain and flooding caused by the hurricane had devastating consequences for water and communications systems and, most importantly, for health facilities, significantly affecting care and provision of services to the population. Before, during, and after the emergency, the Pan American Health Organization (PAHO) deployed its Disaster Response Team, providing 20 experts on support, logistics, civil-military coordination, information management, epidemiological surveillance, mental health, incident management, and water and sanitation.
As of 20 September, Dorian is estimated to have caused over US$7 billion in property damage, including damage to thousands of dwellings. Some 76,000 people were affected, with 1,889 housed in ten shelters. The death toll has risen to 52, but the figure is expected to increase as waters recede. The fate of at least 1,300 missing people will become known as places that have been impossible to reach become accessible, and as search and rescue operations continue. In New Providence, 8,000 people were evacuated, and 2,000 remain in shelters.
Massive flooding and the foreseeable damage to water, sanitation, and health infrastructure are currently the priority of the government of Bahamas and PAHO technical assistance. The population is at serious risk of diseases transmitted by unsafe water, as well as and vector-borne diseases such as dengue and malaria.
According to reports from health facilities, four of the 12 clinics on Grand Bahama are in operation, while one is partly functional, four not functional, and three destroyed. Seven of the eight clinics on Abaco are functional. Although one clinic was destroyed, it continues to provide services at a nearby beach home.
The Rand Memorial Hospital on Grand Bahama suffered a serious loss of equipment and supplies and required not only a major cleaning but also complete disinfection after the flood. Seventy nurses and three emergency physicians work at the hospital.
“Our priority concerns are to reestablish access to essential health services and ensure uninterrupted delivery of medical care, to guarantee water quality in the affected communities and at the health centers, and to restore proper hygiene and sanitation," said Ciro Ugarte, Director of the PAHO Health Emergencies Department. He explained that an international appeal for US$3.5 million has been issued, US$1.3 million of which is earmarked to reestablish the delivery of medical care; US$500,000 for surveillance, detection, and management of disease outbreaks; US$800,000 for access to safe water, emergency sanitation, and vector control; and US$671,000 for information management, coordination of humanitarian assistance, and response to the most urgent needs that may arise.
Manuel Cruz, an architect with the PAHO/WHO Regional Response Team, inspecting the Fox Town Community Clinic, accompanied by the clinic’s managers.
Health workers have had difficulty reaching their units and have made extraordinary efforts to meet the high demand for health services. As part of the response effort, facilities were obtained for surgeons, anesthesiologists, pathologists, midwives, family doctors, psychiatrists, and emergency nurses working in shifts. Psychological support has been required for these workers, as well as lodging.
Health workers in New Providence—the most populous island in Bahamas—and on other unaffected islands were waiting to be transported to Grand Bahama and Abaco to relieve professionals exhausted after days of intense work. Only emergency services were functioning at Princess Margaret Hospital in New Providence.
In addition, a medical information and coordination cell was established in the disaster zone. Among its activities, it activated several emergency medical teams (EMTs): Samaritan Purse (a type 2 EMT), located near Rand Memorial Hospital; Rubicon (a type 1 mobile EMT), deployed on Harbour Island; Heart to Heart International (a type 2 EMT) on Treasure Cay and at Marsh Harbour; and Humanity First (a type 1 fixed EMT) at Marsh Harbour.
The coordination and care work of the United Nations system, principally under PAHO responsibility, are working in close collaboration with the Ministry of Health of Bahamas, the National Emergency Management Agency (NEMA), the Caribbean Disaster Emergency Management Agency (CDEMA), the Caribbean Public Health Agency (CARPHA), and other actors such as the Multinational Caribbean Coordination Cell (MNCCC), which includes CDEMA and military personnel from the Netherlands, Canada, Britain, and the United States, along with the Royal Bahamas Defence Force.
A doctor from the Samaritan's Purse EMT cares for an infant at the group's field unit. The EMT was supporting Rand Memorial Hospital in Free Port, Grand Bahama, that was affected by floods caused by Hurricane Dorian.