Health Problems while Working as a Volunteer or Humanitarian Aid Worker in Post-Earthquake Nepal

Abstract

Introduction: Volunteers and humanitarian aid workers working in disaster struck areas of the world are a vulnerable group of travelers. Nepal saw an influx of these humanitarian aid workers following earthquakes in April and May 2015. 
 Methods: This was a descriptive cross-sectional study conducted at CIWEC Hospital located in Kathmandu. A questionnaire was given to all volunteers and aid workers who arrived at the hospital for evaluation of health related problems and agreed to be part of the study.
 Results: Ninety-five volunteers were enrolled in the study. Among these, 65 (68%) were female and 30 (32%) were male. The immunizations received before travel were Hepatitis A 82 (86%), Hepatitis B 82 (86%), Typhoid 70 (73%), Rabies 38 (40%), Japanese Encephalitis 34 (36%), Influenza within last one year 23 (24%), measles 48 (51%), Cholera 34 (36%),Tetanus within 10 years 71 (75%) and Varicella 38 (40%). Forty-four (45%) of travelers carried medication for treatment of Traveler’s Diarrhea (TD) which included Ciprofloxacin, Azithromycin, Loperamide and others like Metronidazole and Charcoal. The common illnesses encountered were gastrointestinal, skin problems , injury and musculoskeletal problems, respiratory problems, genitourinary problems, cardiovascular, psychological problems, syncope, and miscellaneous.
 Conclusions: Traveler’s Diarrhea and dermatological problems were the most common health related problems. Volunteers were not properly prepared for self-treatment and pre-travel preparation was sub-optimal. Important pre travel health advice will decrease the incidence of health problems in this group.

A 36-Hour Unplugged Full-Scale Exercise: Closing the Gaps in Interagency Collaboration between the Disaster Medical Assistance Team and Urban Search and Rescue Team in Disaster Preparedness in Taiwan

“…Nurthen and Jung [ 22 ] reported on fatalities in the Peace Corps during 1986–2003; the major cause of death was unintentional injury (67%), and half of these injuries were caused by motor vehicle accidents. Another study of health problems in a group of volunteers or humanitarian aid workers in post-earthquake Nepal showed that 53 (56%) had gastrointestinal illness, 14 (15%) had skin diseases, and 7 (8%) had injury/musculoskeletal problems [ 23 ]. However, these issues were rarely mentioned in the full-scale exercise.…”

The Impact of Earthquakes on Public Health: A Narrative Review of Infectious Diseases in the Post-Disaster Period Aiming to Disaster Risk Reduction

“…Upper respiratory tract infections were observed quite frequently in the short-term period after disasters induced by earthquakes generated in several continents, including North America (the 1994 Northridge [ 68 , 69 ], 2001 El Salvador [ 70 , 71 ], and 2010 Haiti earthquakes [ 72 , 73 , 74 , 75 , 76 , 77 ], Europe (the 2009 L’Aquila earthquake [ 78 ] and 2014 Cephalonia Island earthquakes [ 79 ]), and Asia (the 1995 Kobe [ 80 ], 1999 Chi-Chi [ 81 , 82 ], 2003 Bam [ 83 , 84 ], 2004 Sumatra-Andaman [ 85 ], 2005 Kashmir [ 86 , 87 ], 2009 Sumatra [ 88 ], 2009 Samoa [ 85 ], 2011 Tōhoku [ 85 , 89 ], 2013 Lushan [ 90 , 91 ], 2013 Bohol [ 92 , 93 ], 2015 Gorkha [ 94 , 95 , 96 , 97 , 98 , 99 ] and 2016 Kumamoto earthquakes [ 100 ]) ( Figure 2 ). Most of the earthquake-affected people lived in overcrowded evacuation shelters, with inadequate air ventilation, unsafe drinking water, and poor personal hygiene being among the possible predisposing factors of contracting respiratory infectious diseases [ 70 , 71 , 72 , 80 , 81 , 82 ,…”

“…Common problems recorded among volunteers included traveler’s diarrhea and skin problems. It was found that the volunteers were not adequately prepared for the situations they were likely to face, suggesting that proper information and advice on health issues before acting to the affected area can help reduce the incidence of health problems among this particular group [ 97 ]. An assessment of morbidity among Israeli rescue team personnel in Nepal after the earthquake revealed that gastrointestinal complaints were by far the most common and significant morbidity (accompanied by diarrhea 44%, vomiting 22%, and fever 10%), followed by respiratory problems (16%) [ 94 ].…”