Experts warn that outbreaks of disease could occur in the aftermath of the devastating landslide in Papua New Guinea. The collapse of a mountainside in the Enga province on Friday resulted in the burial of villages under rock, soil, and rubble, causing significant destruction to homes, schools, and businesses. Local authorities report that the confirmed death toll stands at around 670, but the true number of fatalities could be much higher, potentially reaching 2,000. Rescue efforts are hindered by the presence of numerous bodies trapped under debris.
Health experts specializing in population health and infectious diseases have expressed concerns about the post-landslide conditions. They explain that standing water, limited access to medical care, and inadequate sanitation can create an environment conducive to disease outbreaks. Furthermore, the mental health of survivors can be severely affected, with symptoms persisting for years after the event.
The risk of infectious diseases spreading is particularly high in such circumstances.
According to Jeffrey Schlegelmilch, director of the National Center for Disaster Preparedness at Columbia Climate School at Columbia University, in the immediate aftermath of a disaster, the focus is primarily on treating injuries and addressing trauma caused by debris. However, as time goes on, the emergence of infectious diseases becomes a concern.
Landslides can result in extensive pooling of water and disrupt infrastructure, leading to a lack of clean water and proper sanitation. This can result in people consuming untreated or sewage-contaminated water, which can cause gastrointestinal illnesses like cholera. Additionally, standing water can attract mosquitoes and contribute to the spread of mosquito-borne diseases such as malaria.
Dr. Nathaniel Hupert, an associate professor at Weill Cornell Medicine in New York City, emphasized the significance of the malaria risk in Papua New Guinea. Over the past decade or so, the country has experienced a resurgence of malaria, with the exact reasons behind this phenomenon still not fully comprehended.
In 2020, Papua New Guinea reported over 750,000 cases of malaria, surpassing all other countries in the Asia-Pacific region.
According to an interview with ABC News, landslides in countries with high malaria rates are associated with significant outbreaks of the disease. Unlike earthquakes, landslides clear away forests and create spaces for water pooling, which mosquitoes carrying malaria thrive in. Therefore, it is likely that malaria rates will increase after a large landslide occurs. In addition, respiratory diseases like the common cold, flu, and even COVID-19 can also emerge as people seek shelter in crowded areas where infections can easily spread.
According to Dr. Amesh Adalja, an infectious disease physician and senior scholar at Johns Hopkins Center for Health Security, Papua New Guinea is entering its flu season due to its location in the southern hemisphere. As a result, medical workers need to be vigilant for a rise in cases. To prevent the spread of the flu, it is important for people to get vaccinated. However, vaccinations may take some time to take effect. Therefore, practicing good hygiene, such as wearing masks in crowded indoor spaces and increasing ventilation, is crucial. These measures can help keep the air circulating and reduce the risk of infection. Additionally, it is important to consider the indirect effects of the flu on individuals with chronic diseases.
Experts warn that the impact of a landslide goes beyond direct physical harm. In addition to those who may suffer severe illnesses directly from the landslide, individuals with preexisting conditions like heart disease, diabetes, or high blood pressure may face difficulties in seeking medical help. The landslide could disrupt access to healthcare providers or render hospitals inoperable. Moreover, patients may find it challenging to obtain their medications, potentially exacerbating their existing conditions. Previous studies have demonstrated that natural disasters can worsen chronic illnesses and create gaps in pharmaceutical supplies. For instance, research conducted on Hurricane Katrina evacuees relocated to San Antonio, Texas, in 2005 revealed a significant discrepancy between the medical relief pharmacy supplies and the actual needs of the evacuees.
According to Adalja, when a country experiences a significant disruption in its infrastructure, like a landslide, it inevitably affects the overall medical care in the affected area. This disruption can worsen existing medical conditions that are not directly related to the landslide but are prevalent among the population.
Adalja emphasized the importance of aid workers and medical staff stepping in to address the gaps in medical care caused by the landslide. This is crucial for people to continue managing their chronic conditions and for the identification of undiagnosed chronic conditions.
While people often focus on the immediate effects of a major event like a landslide, Adalja highlighted the cumulative impact of chronic conditions on the healthcare system in places like Papua New Guinea.
Additionally, the mental health implications of such a disaster should not be overlooked.
The impacts of a landslide go beyond physical health and can have severe and long-lasting effects on mental health as well. A study conducted in 2001 examined the aftermath of a landslide in the Sarno area of southern Italy in 1998 and discovered that survivors were 20 times more likely to develop post-traumatic stress disorder (PTSD) compared to a control group. One year after the disaster, 90% of the survivors in the study exhibited criterion B symptoms of PTSD, including distressing memories, nightmares, flashbacks, and emotional or physical reactions triggered by traumatic reminders. Another study conducted in 2022 on survivors of the 2010 landslide in Bududa, eastern Uganda, revealed that nearly half of the participants displayed symptoms of PTSD.
According to Hupert, the aftermath of a landslide involves more than just the immediate loss of life and displacement. The recovery process is crucial, and emergency mental health support is essential. However, it is also important to establish and integrate long-term mental health support into existing primary care systems. This can be challenging but is vital for sustained funding and planning. In many cases, the effects of a landslide extend beyond the immediate impacts of the event itself.
Schlegelmilch explained that the mental health of landslide survivors does not always follow a linear progression. It can fluctuate and may not always improve or decline steadily. In addition to providing counseling or medication when necessary, it is beneficial to assist survivors in maintaining a balanced daily routine.
During his numerous visits to natural disaster areas in the United States, Schlegelmilch mentioned that he had visited a shelter. Mental health professionals at the shelter informed him that establishing a child-friendly environment can have a positive impact on the mental well-being of both children and adults.
Schlegelmilch emphasized the importance of providing a sense of normalcy for individuals affected by disasters, stating, “We should not overlook the power of fostering a feeling of normality.”