In the wake of a natural disaster, death is not uncommon. Although communicable diseases do occur after hurricanes, death is more so caused by blunt trauma, crush-related injuries, or drowning.1 For example, during Hurricane Katrina, three hundred eighty-seven victims drowned, two hundred forty-six people sustained trauma or injuries severe enough to cause their deaths, and two hundred twenty-six victims had no specific cause of death. For those who had injury-related causes of death, six died from heat exposure, four unintentionally from firearms, two from homicide, four from suicide, three from gas poisoning, and one from electrocution. In total, Hurricane Katrina caused nine hundred eighty-six unfortunate deaths.2
Though the number of immediate deaths caused by Hurricane Katrina is astonishing, even more people perished after she had finished running through her full course. However, if the hurricane itself is not fully responsible for the loss of life, it must be attributed to another factor. Although most people correctly believe that, following natural disasters, there is an increased risk of infectious disease outbreaks, they often believe that it is higher than it truly is. In large part, this misconception is due to exaggeration by the media. The media works to cause unnecessary panic, confusion, and sometimes health-related actions within the population.3
Another false belief is that dead bodies cause disease. Actually, the main cause of disease is population displacement because it leads to other issues such as contaminated water and overcrowding which results in increased contact with infected individuals. Water may become contaminated if a hurricane destroys the sanitation and sewage systems which is extremely hazardous. Contaminated water is especially hazardous after natural disasters because various illnesses can develop from exposure to it.1
According to the Centers for Disease Control and Prevention (CDC), the diseases which can spread after disasters like hurricanes are “cholera, diarrhea, Hepatitis A, Hepatitis E, leptospirosis, parasitic diseases (eg, amebiasis [Entamoeba histolytica], cryptosporidiosis, cyclosporiasis, and giardiasis), rotavirus, shigellosis, and typhoid fever.”4 The factors which could influence the risk of infection of disease include availability of clean water, sanitation and sewage systems, degree of crowding, pre-existing health conditions of the population, immunity to illness, and access to healthcare.1
Population displacement is problematic because it increases the risk of infectious disease outbreaks. Population displacement causes people to move around and crowd places which have taken the least amount of damage during a hurricane. Gastroenteritis, also known as the stomach flu, resulted heavily after Hurricane Katrina in over a thousand evacuees. In overcrowded settings, noroviruses like gastroenteritis are easily spread.5 Acute respiratory infections (ARI) are another major cause of illness and death among displaced populations because of close proximity to other individuals.
People tend to overcrowd certain areas causing population displacement
Hurricane Katrina was not the only natural disaster to see an increase in the spread of infectious diseases. After Hurricane Mitch (1998), the occurrence of ARI increased by four times in Nicaragua.1 The condition of illnesses like tuberculosis can be worsened because of population displacement and reduced access to healthcare. Following Hurricane Katrina though, an emphasis was placed on finding new cases of tuberculosis and continue treatment of the known ones.3 Not only does population displacement allow communicable diseases to spread more easily, but it also causes sudden population influxes in certain areas which leads to unsanitary living conditions.
If people consume unsanitary water, they could contract any number of diseases, including meningitis, cholera, Salmonella, E. coli, and other diarrheal infections. Those directly affected by Hurricane Katrina suffered from diarrhea, tuberculosis, norovirus, Salmonella, cholera.1 In fact, the CDC received reports of the occurrence of diarrheal disease from groups of individuals in evacuation centers in Louisiana, Mississippi, Tennessee, and Texas.4 Hurricane Jeanne forced the people of Haiti to deal with meningitis and he people of Central America had to endure cholera as a result of Hurricane Mitch.6 It is clear that following hurricanes, clean water is difficult to find.
The flooding that results from the occurrence of a hurricane, has hazardous effects such as vector-borne diseases and mold. Standing water can lead to the accumulation of carriers of Malaria and the West Nile virus in the surrounding area.6 The flooding that occurred because of Hurricane Flora led to an outbreak of over seventy-five thousand cases of Malaria.5 Mold is another issue that results from flooding. Hurricane Katrina left eighty percent of New Orleans, Louisiana submerged in water.4 Therefore, it is not shocking that visible mold growth was found in forty-five percent of homes inspected after Hurricane Katrina. The indoor air levels of mold were elevated meaning there was more airborne mold, and more reason for concern about respiratory health.5
The extent of flooding after Hurricane Katrina
Physical damage and health concerns are not the only danger presented to us by hurricanes. By not actively preparing for and dealing with hurricanes, we put everyone already potentially in danger into an even greater risk for trauma. Across cultures, natural disasters greatly affect distributions of people in many different ways. After massive storms like that of Hurricane Katrina, we often find legions of studies conducted to find all the ways in which a population is affected. It has been found that being exposed to disease as well as the innumerable ethical dilemmas that come with attempting to solve such a large-scale problem, can have severe and lasting impacts on the culture of the region affected.
Culture is defined through material and non-material things, and hurricanes often destroy these things and leave behind unparallelled destruction in their wake. Factors that can influence cultural and psychological well-being include time taken to return to normal life, the extent of damage done by the natural disaster, and effectiveness or ineffectiveness of help received. Often times these cultural effects are different between races of people, such as in New Orleans when Hurricane Katrina hit in 2005. You can see the disproportionate suffering is clearly attributed to the “economic and social stratification that was present in New Orleans before Hurricane Katrina that became magnified after the storm.”7
Culture is incredibly important when considering the normative experience of families in America. It is the moral backbone that our nation is founded on, the glue that holds societies together. Without culture, there would be no common connection between people in the same geographical area, or even connections between people of potentially similar upbringings or backgrounds. In the instances involving natural disasters, culture can be deeply affected through the devastation of homes and personal items, as well as the natural social order in towns and urban areas. Often natural disasters destroy deeply personal items that cannot be replaced, which impacts the owners of the personal items extremely upset or angry for losing such a deeply personal keepsake.
Hurricane Katrina brought tremendous loss upon people and left them forever changed
The great losses suffered by the people of New Orleans “exacerbated the uses of substance dependence, psychiatric disorders, child molestation, domestic violence, and other relational difficulties.7 News coverage also highlighted the social stratification in New Orleans during the aftermath of Katrina, and served to differentiate the vulnerable African-American poor from the rest of the population through media coverage of welfare dependency, crime, and familial dysfunction rather than focusing on the real issues at hand- the lack of disaster relief coming in to New Orleans.8
The elderly and children are often disproportionately affected when considering the rest of the population in the area of displacement and damage to property. These losses were also seen to cause a spike in rates of PTSD and general psychic morbidity among the elderly affected.9 Following Hurricane Katrina, there was a rate of PTSD among children as high as 62.5% who remained in the affected area. There were also similar rates of comorbid disorders such as oppositional defiant disorder and separation anxiety disorder.9 The impact of national disasters culturally can be shown through the destruction of property, social order, and high rates of PTSD and other relational difficulties. National disasters also affect other areas of life as well.
Having a thorough and clear understanding of the numerical and social impacts of natural disasters, one must wonder what can we do to make a difference? To make a true and effective difference, we can look at what we have and have not been doing in the past and hold those that dropped the ball accountable. In order to find those accountable, we must answer the question, what is the responsibility of the government when it comes to its people?
Specifically, in relation to hurricanes and other natural disasters, the responsibilities of the government are delegated to a specific government agency known as FEMA. The mission statement of FEMA or the Federal Emergency Management Agency is “Helping people before, during, and after disasters” according to their official website.10 Founded in 1988 with the responsibility of coordinating relief efforts after the declaration of an emergency, “It is designed to bring an orderly and systemic means of federal natural disaster assistance for state and local governments in carrying out their responsibilities to aid citizens.”10 (FEMA Website). Essentially, it is the responsibility of FEMA to ensure that people are properly evacuated, resources and aid are administered effectively, and in the aftermath of the storm, those displaced are safely removed from the area.
FEMA workers helping with hurricane recovery
As we already know, in the aftermath of a storm the chances for an epidemic of airborne and waterborne illnesses increase exponentially. Hurricanes bring colossal surges of water that typically stand for days if not weeks in homes in roads inhabited by countless people. Along with this water comes a myriad of dangers and conditions that can only exacerbate already deplorable conditions. It is vital that agencies such as FEMA fulfill their duty in order to get people out of dangerous and or contaminated environments and with resources one would vitally need after such a storm.
In the documentary titled, “When The Levees Broke”, Spike Lee (2006) recounts the numerous tragedies suffered by those caught in the wrath of Hurricane Katrina.11 Survivors recount stories of going days in shelters without electricity, plumbing, or medication for the sick and elderly. These are the stories of people that evacuated to shelters and people that stayed home to brave the storm because they did not have the resources to evacuate or relocate alike. Specifically, in part three of the documentary a few children explain that their mother passed away from a lack of compressed oxygen while waiting days for aid.11 What this shows, is people clearly died as a direct result of not having access to the proper resources in the aftermath of the storm.
The failures of FEMA are not isolated simply to Hurricane Katrina, most recently in 2017, category 5 Hurricane Maria ravaged Puerto Rico in a storm that considered one of the worst to ever hit the Caribbean islands on record. Keeping FEMA’s mission statement in mind, as well as the fact the agency had 9 years to learn specifically from events in Katrina (as well as the numerous disaster in between), one would expect FEMA to have been fully staffed and trained with resources in place for Hurricane Maria. In the year and a half since the catastrophic storm, we have learned that over three thousand people died as a result of Hurricane Maria12, it took nearly a year for power to be restored to the entirety of Puerto Rico13, and twenty-thousand pallets of fresh bottled water sat spoiling in the hot sun waiting to be distributed as countless Puerto Ricans had no access to running water.14
While Hurricane Katrina was neither the first nor last hurricane to hit the US, we can learn from this and others in order to prepare in the most effective ways possible and ensure the least amount of loss of life as we can. There were increases in mortality of forty-seven percent15 and sixty-two percent16 increase were found in New Orleans and Puerto Rico respectively. What this demonstrates is the failures of our government have real life or death implications for hundreds of thousands if not millions of people. Studies found that in both Hurricanes Katrina and Maria there were extreme increases in overall mortality.
Every single day millions of people count on the idea that in the event of a natural disaster or emergency, they can depend on the government for information and resources. It is not simply the obligation but the stated duty of the federal government and FEMA to take care of its people in their most desperate times of need. Without the effective distribution and management of aid and resources by FEMA, countless people will find themselves in contaminated environments with little to no access to clean water or vital medications.
- Watson, John , Michelle Gayer, and Maire A. Connolly. “Epidemics after Natural
Disasters.” Emerging Infectious Diseases January 2007.
- Brunkard, Joan, Gonza Namulanda, and Raoult Ratard. “Hurricane Katrina Deaths,
Louisiana, 2005.” Disaster Medicine and Public Health Preparedness 2, no. 04
- Kouadio, Isidore , Syed Aljunid, Taro Kamigaki, Karen Hammad, and Hitoshi Oshitani. “Infectious Diseases following Natural Disasters: Prevention and Control Measures.” Expert Review of Anti-infective Therapy 10 (January 10, 2014): 95-104. https://www.tandfonline.com/doi/abs/10.1586/eri.11.155.
- Ligon, B. Lee. “Infectious Diseases That Pose Specific Challenges After Natural Disasters: A Review.” Seminars in Pediatric Infectious Diseases 17, no. 1 (January 2006): 36-45. https://www.sciencedirect.com/science/article/pii/S1045187006000033.
- Ivers, Louise , and Edward T. Ryan. “Infectious Diseases of Severe Weather-related and Flood-related Natural Disasters.” Current Opinion in Infectious Diseases 19 (October 2006): 408-14. https://oce.ovid.com/article/00001432-200610000-00003/HTML.
- Spiegel, Paul , Phuoc Le, Mija-Tesse Ververs, and Peter Salama. “Occurrence and Overlap of Natural Disasters, Complex Emergencies and Epidemics during the past Decade (1995–2004).” Conflict and Health, March 01, 2007. https://conflictandhealth.biomedcentral.com/articles/10.1186/1752-1505-1-2.
- Holiday, Bertha G. Hurricane Katrina: A Multicultural Disaster, (American Psychological Association), March 2006. apa.org/pi/oema/resources/communique/2006/03/katrina-special-section.pdf.
- Mann, Nicole and Victoria Pass, The Cultural Visualization of Hurricane Katrina (University of Rochester), 2011. www.rochester.edu/in_visible_culture/Issue_16/articles/mann and pass/mann_pass_intro.html.
- Jogia, J. et al, Culture and the Psychological Impacts of Natural Disasters: Implications for Disaster Management and Disaster Mental Health (The Built and Human Review volume 7), 2014. research.aston.ac.uk/portal/files/14837549/Culture_and_the_psychological_impacts_of_natural_disasters.pdf.
- About the Agency. (n.d.). Retrieved from https://www.fema.gov/about-agency
- Lee, S., Pollard, S., Nagin, R., Penn, S., Sharpton, A., Marsalis, W., Belafonte, H., … HBO Video (Firm). (2006). When the Levees Broke: A Requiem in Four Acts. New York: HBO Video.
- Fink, S. (2018, August 28). Nearly a Year After Hurricane Maria, Puerto Rico Revises Death Toll to 2,975. Retrieved from https://www.nytimes.com/2018/08/28/us/puerto-rico-hurricane-maria-deaths.html
- Sullivan, E. (2018, August 15). Nearly A Year After Maria, Puerto Rico Officials Claim Power Is Totally Restored. Retrieved from https://www.npr.org/2018/08/15/638739819/nearly-a-year-after-maria-puerto-rico-officials-claim-power-totally-restored
- Weir, B. (2018, September 20). 20,000 pallets of bottled water left in Puerto Rico. Retrieved from https://www.cnn.com/2018/09/12/us/puerto-rico-bottled-water-dump-weir/index.html
- Stephens, K. U., Grew, D., Chin, K., Kadetz, P., & Greenough, P. G. (07/2007). Excess mortality in the aftermath of hurricane katrina: A preliminary report. doi:10.1097/DMP.0b013e3180691856
- Kishore, N., M.P.H., Marqués, D., PhD, Mahmud, A., PhD., Kiang, M. V., M.P.H., Rodriguez, I., B.A., Fuller, Arlan,J.D., M.A., . . . Buckee, C. O., D.Phil. (2018). Mortality in puerto rico after hurricane maria. The New England Journal of Medicine, 379(2), 162-170. doi:http://dx.doi.org.libproxy.lib.unc.edu/10.1056/NEJMsa1803972