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Landslide in Papua New Guinea raises risk of disease outbreaks and mental health impacts: experts

Disease outbreaks could occur as a result of the devastating landslide in Papua New Guinea, experts say.

A mountainside collapse early Friday buried villages in Enga province, located in the northern region, under rocks, soil and rubble – sweeping away homes, schools and businesses, local authorities said.

Some 670 people are confirmed dead, while the country’s National Disaster Center believes the real death toll could be as high as 2,000, with hundreds of bodies trapped under the rubble.

Public health and infectious disease experts told ABC News that standing water, lack of access to medical care and improper sanitation after a landslide can lead to disease outbreaks. In addition, mental health can be seriously affected, with symptoms persisting for several years after the event.

Infectious diseases spread easily

“In the aftermath of a disaster … usually in the first few days you’re really dealing with injuries, the trauma of being hit by the debris, and those kinds of injuries,” said Jeffrey Schlegelmilch, director of the National Center for Disaster. Preparedness at Columbia University’s Columbia Climate School, told ABC News. “So it’s more of a trauma-oriented response. Then, days and weeks later, comes the emergence of the infectious disease.”

Landslides often create large puddles and standing water and disrupt an area’s infrastructure, resulting in a lack of clean water supply or proper sanitation.

People may drink untreated drinking water or sewage, causing gastrointestinal diseases such as cholera. Meanwhile, standing water can attract mosquitoes and lead to mosquito-borne diseases, such as malaria.

PHOTO: People clear an area at the site of a landslide in Yambali village, Enga province, Papua New Guinea, May 27, 2024.

People clear an area at the site of a landslide in Yambali village, Enga province, Papua New Guinea, May 27, 2024.

Undp Papua New Guinea/via Reuters

Dr. Nathaniel Hupert, an associate professor of population health sciences and medicine at Weill Cornell Medicine in New York City, said the risk of malaria is important because Papua New Guinea has had a resurgence of malaria in the past 10 to 15 years for reasons. that are not fully understood.

In 2020, Papua New Guinea had more than 750,000 reported cases of malaria, the most of any country in the Asia-Pacific region.

“It turns out that, unlike earthquakes, which tend not to be directly linked to increases in malaria, landslides that occur in countries with high malaria rates appear to be linked to large outbreaks of malaria,” he told ABC News. “And this seems to be due to the fact that the landslides are clearing forests and also creating space for water to collect, which the mosquitoes that transmit malaria love. … So one of the things we can probably predict in the future The aftermath of this truly major landslide is that malaria rates will rise.”

Moreover, respiratory illnesses – such as colds, flu and even COVID – can also flare up as people take refuge in congregate settings, where such infections spread easily.

Dr. Amesh Adalja, an infectious disease physician and senior scientist at the Johns Hopkins Center for Health Security in Baltimore, Maryland, told ABC News because Papua New Guinea is in the Southern Hemisphere and is currently entering flu season, so medical providers will need to be alert to rising fallen.

“Some of the most important things will be getting people vaccinated and getting vaccinations,” he said. “But in many cases it will take some time before vaccinations get underway. So it’s really about hygiene, so that could mean wearing masks in communal indoor environments, increasing ventilation in those types of indoor environments – if they can open windows, for example, which keeps the air circulating.”

Indirect effects on people with chronic diseases

While many people are likely to become seriously ill from illnesses directly related to the landslide, experts say there could also be indirect consequences.

Patients suffering from underlying conditions, such as heart disease, diabetes or high blood pressure, may not have access to their doctor or healthcare provider – or hospitals may be offline – because of the landslide.

In addition, patients may not have access to their medications, which could result in a worsening of their condition.

PHOTO: This undated handout photo taken by the UN Development Program and released on May 28, 2024, shows locals digging at the site of a landslide in Mulitaka village in Maip Mulitaka region, Enga province, Papua New Guinea.

This undated handout photo taken by the UN Development Program and released on May 28, 2024, shows locals digging at the site of a landslide in the village of Mulitaka in the Maip Mulitaka region, Enga Province, Papua New Guinea.

UN DEVELOPMENT PROGRAM/AFP via Getty Images

Studies have shown that several natural disasters can worsen chronic conditions and fail to meet pharmaceutical needs. A survey of evacuees who moved to San Antonio, Texas, after Hurricane Katrina in 2005 found that emergency medical pharmacy supplies did not meet the needs of evacuees.

“Anytime there is a serious disruption in a country’s infrastructure, like what happens during a landslide, there will be disruptions in general medical care in a given area,” Adalja said. “The entire healthcare system could be disrupted when there is such a large impact and that will be something that exacerbates all other medical conditions that are not directly related to the landslide but are present in the population.”

He said it will be important for first responders and medical workers to try to fill the gaps in medical care left by the landslide so that people can monitor their chronic conditions and detect undiagnosed chronic conditions .

During a major event such as a landslide, “people think about the acute things, but the chronic things can pile up and put a heavy burden on the health care system in a place like Papua New Guinea,” Adalja said.

Mental health implications

While the physical health consequences of a landslide can be devastating, the mental health consequences can also be severe and long-lasting.

A 2001 study of the effects of the 1998 landslide in the Sarno area of ​​southern Italy found that survivors were 20 times more likely to have post-traumatic stress disorder (PTSD) than members of a control group.

One year after the disaster, 90% of survivors in the study had Criterion B symptoms of PTSD, which are characterized by unwanted, disturbing memories; nightmares; flashbacks; and emotional or physical reactions after experiencing traumatic memories.

A 2022 study of survivors of the 2010 landslide in Bududa, eastern Uganda, found that almost half of participants had PTSD symptoms.

“With this landslide, it’s not just about the immediate loss of life or displacement, but also about recovery,” Hupert said. “So mental health care is really critical, but establishing and integrating into existing primary care the kind of mental health support that may be needed is really going to be something that is – difficult to achieve – but most importantly would in terms of long-term financing and planning. And those effects in many cases exceed the direct consequences of infectious diseases.”

Schlegelmilch explained that the mental health of landslide survivors often develops in a non-linear manner and is not always a steady progression or a downward regression.

PHOTO: In this image from the International Organization for Migration, villagers search through the rubble of a landslide in the village of Yambali in the highlands of Papua New Guinea, May 27, 2024.

In this image from the International Organization for Migration, villagers search through the rubble of a landslide in the village of Yambali in the highlands of Papua New Guinea, May 27, 2024.

Mohamud Omer/AP

He added that, in addition to providing mental health care or medication when needed, offering survivors help to balance their daily routines can be helpful.

Schlegelmilch said that during one of his many trips to natural disaster areas in the U.S., he visited a shelter where mental health workers told him that creating a child-friendly space can improve the mental health of both children and adults.

“I think we cannot underestimate the ability to have a sense of normalcy and create a sense of normalcy for people,” he added.

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