In 1998, Hurricanes Georges and Mitch became two of the most devastating natural disasters in decades; Hurricane Mitch is considered to be the worst disaster in Central America in the past 200 years, with tremendous damage to all sectors. Thousands of deaths and missing were reported, and millions were affected. Development in the countries, a difficult process in itself, was seriously threatened by the economic and social damages caused by these disasters.
These disasters led to the activation of the SUMA System initiative.
About Hurricane Georges - 1998 (Category 4)
Damage was recorded along the path of Hurricane Georges. Saint Kitts and Nevis, Antigua and Barbuda, Montserrat, Anguilla, the British Virgin Islands, and Puerto Rico were all affected by this system. However, most of the damage occurred in Saint Kitts and Nevis, Cuba, the Dominican Republic, and Haiti.
About Hurricane Mitch - 1998 (Category 5)
Hurricane Mitch affected most of the population of Honduras and Nicaragua, large parts of Guatemala and El Salvador, and, to a lesser extent, Belize and Costa Rica. The governments reported some 9,000 deaths, 9,000 missing, and millions of affected or homeless. It destroyed or damaged a large part of the health infrastructure, including health centers, hospitals, the vaccine cold chain, and water pipes and sewers.
Activities carried out
Hurricanes Georges and Mitch posed an enormous challenge to PAHO's response capacity. In each case, PAHO/WHO Representatives, assisted by their country-level disaster focal points, the subregional advisers from the Emergency Preparedness Program, and the Organization and other staff, collaborated with national authorities in five principal areas:
- Epidemiological surveillance and control;
- Information for the donor community;
- Needs assessment;
- Implementation of the SUMA system;
- Mobilization of resources.
During the disasters of 1998, surveillance efforts focused on specific diseases considered to pose the greatest public health risk: water and foodborne diseases including cholera, and vector-borne diseases such as malaria and dengue. Leptospirosis surveillance was implemented specifically in Central America.
Since the possibility of secondary outbreaks remains serious, PAHO and UNICEF jointly launched an international appeal for cholera surveillance and control in Central America, to strengthen the country's effort to carry out control measures long overdue before the hurricanes.
The Internet, and particularly the use of electronic mail, became an important part of disaster management in 1998. This contributed to reshaping the traditional relationships among humanitarian actors in terms of the collection and management of data and the production and use of information.
There was a substantial increase in the local use of the Internet for early warning purposes to track the progress of Hurricanes Georges and Mitch and, for a one-month period following Hurricane Mitch, information was also circulated daily, via the Internet. There was a need to streamline the analysis of the data received from the field. By the second week, a special website was created to post epidemiological reports and guidelines prepared by many PAHO technical programs. As a result of these experiences, a permanent mechanism was left in place whereby PAHO’s technical programs maintain contact and present a more speedy and coordinated response to any upcoming disaster situation.
The Internet greatly aided the distribution of information on needs in the wake of these disasters and enabled a fluid dialogue on disaster management issues.
More than 150 PAHO staff (professional and administrative) were permanently assigned to the subregion.
In addition to information management and epidemiological surveillance, PAHO also mobilized experts to provide technical cooperation in drinking water and sanitation; food handling and nutritional surveillance; vector control and use of insecticides; immunizations; assessment of damages; project and proposal preparation; maternal and child health in emergency situations; disaster management; management of supplies; and mental health.
Furthermore, the deployment of technical personnel allowed response activities in the health sector to focus directly on the local level. It also enabled PAHO Headquarters to receive, within the first 24 to 36 hours after the disaster, a rapid evaluation of health sector needs and to communicate this information to the donor community.
Immediately after Mitch, PAHO made US$ 350,000 available from its regular funds to Honduras and Nicaragua to deal with the immediate health problems. These emergency funds were used to procure pharmaceuticals and vaccines, and to support activities such as epidemiological surveillance, control of vector-borne diseases, immediate assistance to victims, etc.
Later, based on the joint damage assessment carried out by PAHO, the Ministries of Health, and UNICEF, PAHO's Director assigned US$ 1 million in additional resources to the countries of Central America for cholera control.
The experience gained in disaster preparedness and decentralization was decisive for a rapid response. Lessons learned about gathering and analyzing epidemiological information, emergency supply management, institutional organization, electronic information management and coordination with other sectors and organizations, rehabilitation, and reconstruction policies, were socialized to strengthen disaster health management at the national level, and within PAHO/WHO.
Implementation of the SUMA System
SUMA, the humanitarian supply management system, was very effective in meeting the challenge of a multicountry disaster. The SUMA system was created by PAHO in 1990, with support from the Government of the Netherlands, to address the management problems caused by a large influx of donations in the wake of major disasters. Under a contract with PAHO following Hurricanes Georges and Mitch, the SUMA system was set up and helped each interested country to achieve transparency and accountability in the supply management process.
Almost 2,000 individuals were trained throughout the Americas in the SUMA system. Some of these volunteers are available within their own country to offer indispensable support and make possible the rapid acceptance of SUMA at the time of a disaster.
Health achievements in Central America: 5 years after Mitch