Feng Zijian on possible post-disaster health emergencies -- china.org.cn

“Major epidemics always follow major disasters”. How can we prevent this pattern from being repeated in China? In case of a post-disaster health emergency, what kind of emergency response mechanism does China have? How can we ensure food security in disaster areas? Feng Zijian, director of the Chinese Center for Disease Control and Prevention, spoke to China.org.cn about these issues.

Feng Zijian, director of the Chinese Center for Disease Control and Prevention

China.org.cn: We have seen what the earthquake did to Sichuan. But apart from the direct effects of the disaster, what else could follow? Would you please talk a little bit about that?

Feng Zijian: Secondary disasters can follow after every natural disaster, and have huge effects on public health. The earthquake has destroyed large numbers of buildings and many residents have had to be resettled. If relief efforts don’t arrive in time, they have to live in the open. Even when resettled, their living conditions might be quite poor for a time. People may have to live communally in public buildings such as gymnasiums, as we saw on TV a few days ago. Living conditions may be much worse than they are accustomed to. Additionally, temporary disruptions to food and water supplies may exacerbate the situation.

There is another problem. Just as the natural disaster destroyed human dwellings, it has also disrupted the habitats of wild animals, particularly rats and mice. They may come into closer than normal contact with people. Many people are living in tents in the open air, where they are especially vulnerable to diseases carried by rats and mice.

Moreover, temporary accommodation may not have proper sanitary equipment, and human excrement and garbage is a problem. We need to set up temporary toilets. If we do not, the uncontrolled discharge of garbage and feces will damage both the environment and human health.

To add one more point, the disaster has damaged people psychologically, and this lowers their immunity. Such a cluster of problems might cause food poisoning. Infectious diseases transmitted by food as well as respiratory diseases can spread very quickly in crowded environments. Even simple contact with animals could cause infections. In Sichuan, as temperatures rise, an increasing number of mosquitoes will bring a heightened risk of infectious disease.

China.org.cn: Since the health issues are so pressing, what kind of emergency mechanisms have been established to deal with them?

Feng Zijian: China has suffered from a number of disasters in the recent past. So we have attached great importance to planning for post-disaster health emergencies. We have developed a series of health emergency plans for different disaster scenarios, comprising advance arrangements, preparation, and plans for post-disaster health emergency work. Therefore, in the face of various kinds of natural disasters, we can deal with public health issues in an orderly and effective way.

The poor environment in Sichuan has added to the difficulty of rescue work. Towns are surrounded by mountains. The earthquake blocked roads and cut communications. People hit by the disaster are spread over wide, remote areas. All these conditions increase the difficulty of the public health response. In the initial phase, the priority is to treat the injured and rescue those trapped under buildings. Rescue work has been going on for six days. Now we need to take action to prevent a series of post-disaster public health issues. This is a crucial responsibility for health departments and government at all levels.

We need to take the following steps immediately. Firstly, properly resettle people in disaster areas and thoroughly check their accommodation. Secondly, ensure supplies of food and water. Thirdly, ensure the food and water is safe. Fourthly, set up sanitary services at the accommodation sites as soon as possible. Garbage and feces must be effectively disposed of to prevent risks to health and the environment.

Right now the most urgent task is to deal with the bodies of the deceased. Normally, they would be cremated but this is impossible in the present situation because of the numbers involved. We have to bury these bodies after making the necessary arrangements. Moreover, we need to disinfect the environment. Unchecked water must be disinfected before drinking. We need to carry out disinfection and insecticidal work to control mosquitoes. We also have to control the population of rats and mice to cut down their contact with people.

What’s more, we must immediately set up a disease surveillance system. Through surveillance, public health problems can be detected early so we can respond immediately to minimize the damage. Public health professionals have to go into each disaster area, each district, each town, each village, even each block, to assess water quality. We need to assess the background health environment as well as people’s medical needs.

We must pay particular attention to the vulnerable, children, the elderly, and pregnant women since they are physically more susceptible. All these are measures we are currently taking to deal with public health issues.

China.org.cn: There is a huge demand for food, water and medicine in disaster areas, but the public are being advised not to donate such things. Is that due to worries about food safety?

Feng Zijian: I’m not so clear about the issue of food donations. But to take food safety into consideration, it might create hidden dangers if donated items are not well supervised. The reason is clear: Food, unlike other items, cannot be kept fresh for long periods.

China.org.cn: What measures should be taken to strengthen food safety in quake-hit areas?

Feng Zijian: Professional staff should give technical advice on food sanitation, disposal and sanitary supervision. They should teach people how to ensure that food distributed by the government is healthy and safe. Food should be prepared properly before eating. We must make every effort to ensure food is healthy and safe in the current circumstances.

China.org.cn: You mentioned that people should be directed to eat in a healthy manner, but many of the earthquake survivors haven’t eaten for a long time and are very hungry. Do you think they will take safety into consideration when eating?

Feng Zijian: People won’t consider health problems when they are hungry, which means ensuring people’s minimum food requirements are met is of vital significance. We will appoint people specifically to carry out public information work. For safety reasons food should be cooked before eating. But sometimes it is difficult to do this because of living conditions in disaster-hit areas.

China.org.cn: I think your point is that in disaster-hit areas, sometimes it is difficult to cook food. So would you please give some suggestion on how to make full use of the limited food available?

Feng Zijian: In my opinion, the most important thing is to restore the food supply chain, which means disaster-relief departments, local government and other bodies should try their best to guarantee the supply of food.

China.org.cn: The quake has cost tens of thousands of lives; how to dispose of the bodies is an issue of general concern. How should we deal with the bodies? Would you please tell us what sterilization and protection methods should be adopted?

Feng Zijian: Bodies of people killed in earthquakes are different from those who died of illness. People are usually crushed by falling buildings. In principle, such bodies do not require sterilization. But we should take some measures to deal with decomposing bodies. Our experts have already given some advice on this issue.

For the time being, normal practice will be to bury the bodies. They should be buried 1.5 meters above the underground water level so as to avoid polluting water sources.

China.org.cn: I think it is very necessary for survivors to increase their awareness of public health issues. Do you have any suggestions on this?

Feng Zijian: After a disaster, when living conditions are poor, personal hygiene and self care become particularly important. Sichuan Province has done a lot of work distributing printed materials on these issues. The Chinese Center for Disease Control and Prevention has also sent simple information material to quake-hit areas. In addition, the center has dispatched medical teams to resettlement points and quake-hit villages to direct disease prevention work, help victims with personal hygiene, and check the safety of food and drinking water.

(China.org.cn by Wang Wei and Xiang Bin, May 18, 2008)