Effects of the Pedernales Earthquake on Ecuador’s Health Care System

Abstract

Objective: This study analyzes the effects of the Pedernales earthquake (April 2016) on Ecuador’s health care system. Methods: A research was carried out in Chone Canton, which combined documentary, quantitative, and qualitative techniques. Epidemiological and service production information taken from official documents was analyzed systematically. In-depth interviews and surveys were conducted with health care program directors and technicians from the Health Centres of the Ministry of Public Health and the users. Results: Deficiencies in the health care system were already observed in Chone Canton prior to the earthquake mainly due to the lack of doctors, nurses, and hospital beds. According to the interviewees, the health district was not prepared for an emergency like the earthquake. Some buildings fell after the earthquake, and Chone Hospital was disabled. These problems coupled with preventive action failures at the community level led to an increase in diseases after the earthquake. Conclusions: The shortage of personnel and physical infrastructure, weaknesses in primary health care in the Ecuadorian health system, the lack of preparation, and limited availability of information on health indicators were the causes of the sharp increase in pre-existing diseases in the area, and of new epidemic outbreaks after the earthquake.

Preparedness, impacts, and responses of public health emergencies towards health security: qualitative synthesis of evidence

“…Host populations [ 43 ], weak capacity distribution of supplies, unavailability of quality services [ 42 , 44 ], and postponed routine care in PHC [ 33 , 45 ]. Cameroon, Congo, Mali, Nigeria, Iraq, Eastern Medicterrain Region (EMR), Libya, Yemen Constraints in service delivery Lack of trained workforces [ 46 ], failure of coordinated support overburdened hospitals [ 47 ], lack of primary care [ 45 ], high priority of hospitals services [ 48 ], health workforce workload [ 49 , 50 ], an increase of infections [ 15 ], the hotspot of epidemics but blind spot of PHC services [ 28 , 37 ], the spread of Ebola [ 43 ], increase of pre-existing diseases [ 34 ], reduced availability of services [ 45 , 51 ]. Italy, Australia, Brasil, Malawi, SSA, CAR, Ecuador Multiple impacts on building blocks of health systems Inadequacies of service provision [ 47 , 51 , 52 ], isolation, lockdown, restriction [ 53 , 54 ], collateral damage, interruption of service [ 53 , 55 – 58 ], post-disaster disease outbreaks [ 33 , 34 ], shortage of workforce and heavy workload [ 33 , 34 , 47 , 50 , 51 , 55 – 58 ], reliance on short term staff [ 46 ], poor data quality [ 56 ], poor resource coordination and readiness [ 29 , 52 , 59 ], unavailability of digital tools [ ...…”

“…Countries like Cameroon and the CAR had hot spots of emergency outbreaks but lacked PHC services as blind spots of outbreak response [ 28 , 37 ]. New epidemic outbreaks in Ecuador were exacerbated by a lack of preparation, poor information on health indicators, a shortage of resources (personnel and physical infrastructure), poor PHC services, and a sharp increase in pre-existing diseases [ 34 ]. During the pandemic, health systems had the availability of comprehensive services and adaptation to unique demands of resources.…”

“…The COVID-19 pandemic amplified the fragility of existing systems, caused a de facto lockdown and associated collateral damage, and disrupted traditional delivery models in Sub-Saharan Africa and South Africa [ 53 , 55 – 58 ]. Following natural disasters, damage to health infrastructure has contributed to the eruption of post-disaster disease outbreaks in Ecuador and Ebola-affected countries in Africa [ 33 , 34 ].…”

“…Third, there was an impact on the health workforce, including a shortage of clinical workforce; fatigue and stress from heavy workloads, stigma, worries of infection, burnout, grief; and lack of training of junior doctors [ 33 , 34 , 47 , 50 , 51 , 55 – 58 ]. For example, during the COVID-19 pandemic, the Australian health system experienced an acute shortage of health workforce (e.g., nurses) and relied heavily on short-term workforce such as fly-in, fly‐out/drive‐in, drive‐out staff to provide care in the country’s remote regions [ 46 ].…”

Addressing the Urgent Concerns of Disaster-Related Hypertension After the 2023 Turkey Earthquake: Letter to Editor

“…in the Journal of Disaster Medicine and Public Health Preparedness . 3 Similarly, it was observed in the 2023 Turkey earthquake that many people, with or without a history of hypertension, applied to the emergency units of hospitals due to high blood pressure. According to the preliminary results of a study conducted by Gümüştakim et al, 40.3% of the emergency service applicants ( N = 253) who were found to have high blood pressure in the first week after the 2023 Turkish earthquake had no history of hypertension.…”