Disasters throughout history have had a significant impact on the numbers, health status, and lifestyle of populations and communities. These disasters lead to displacement, death, severe injuries requiring extensive treatment, increased risk of communicable or infectious diseases, damage to health facilities, damage to the water systems, food shortage, and other population movements. Rwanda was heavily affected by torrential rains on May 2 and 3. The rains caused landslides and flooding in the Western, Southern and Northern provinces of the country, primarily in the districts of Ngororero, Rubavu, Nyabihu, Rutsiro, Karongi, Gakenke, Burera, Musanze, Gicumbi, and Nyamagabe. The fundamental problem with disasters such as flooding, which also makes them so likely to cause public health emergencies, is that these events displace a significant number of people and cause conditions that often do not meet basic subsistence standards. In a natural disaster, basic health and medical infrastructure are usually broken or eliminated, and fundamental resources such as food, shelter, and clean water, will likely be affected or missing. Natural disasters can have significant public health consequences that extend beyond the immediate impact of the event itself. They often result in the displacement of communities and the overcrowding of temporary shelters or internally displaced camps. These overcrowded conditions, combined with limited or interrupted access to healthcare and hygiene facilities, create a fertile ground for the transmission of communicable diseases. The proximity among individuals facilitates the spread of waterborne diseases like cholera, typhoid fever, dysentery, influenza, other respiratory diseases, and many others. Additionally, the psychological impact of natural disasters can lead to increased stress, anxiety, and mental health disorders among affected populations, further exacerbating public health challenges. Many scientists believe that the primary role of public health institutions in disasters is to control potential infectious disease outbreaks after the disaster. While it’s true that the potential for disease outbreaks exists after natural disasters, the disease of concern usually already exists in the population before the natural disaster. Natural disasters typically do not introduce new diseases into an area but rather amplify and exacerbate existing or underlying health challenges. For example, if an area already had cases of malaria in the community, the stagnant water and disrupted mosquito control efforts following a flood can result in a surge of mosquito-borne disease transmission. Public health institutions must recognise the existing disease burden in the affected population and tailor their response accordingly. This includes implementing appropriate surveillance systems, providing targeted medical interventions, ensuring access to essential medications, and conducting preventive measures such as vaccinations and health education. By addressing pre-existing diseases in the population, public health efforts can effectively mitigate the risk of disease outbreaks during and after natural disasters. In a few cases, diseases can emerge as new to a community following an outbreak triggered by a natural disaster such as a spill over from animals to humans. Healthcare institutions play a critical role in preparing for outbreaks that may occur after natural disasters. To effectively respond to potential health challenges, these institutions should undertake several key actions like establishing robust disaster response plans that specifically address the potential for disease outbreaks. These plans should include clear protocols for surveillance, early detection, and rapid response to infectious diseases. Adequate resources, personnel, and logistics should be identified and allocated to ensure a prompt and effective response. They should also collaborate with relevant stakeholders, including sub-national health facilities, international organisations, and other humanitarian agencies. Partnerships with these entities enable coordinated efforts, resource sharing, and the implementation of comprehensive response strategies. Training and capacity-building programmes should be conducted to enhance the skills and preparedness of healthcare workers and other personnel involved in outbreak response. Prioritising the pre-positioning of essential medical supplies, including medications, vaccines, diagnostic tools, and personal protective equipment, in disaster-prone areas ensures the availability of necessary resources during the critical early stages of an outbreak. Stockpiles should be regularly monitored, maintained, and replenished to support immediate response efforts. It’s also crucial that the public is given clear and accurate information about the potential risks, preventive measures, and available health services. This allows the community to take necessary precautions but also to seek medical care when needed. It takes a coordinated effort from government agencies, humanitarian groups, emergency management organisations, and healthcare professionals to address the public health effects of natural disasters. The effects of natural disasters on public health can be lessened with the help of prevention measures, early warning systems, a strong healthcare system, and public awareness campaigns. Dr Vincent Mutabazi is an applied epidemiologist Twitter: @VkneeM
