Editorial | Clean brigades, please

The authorities’ confirmation of an outbreak of leptospirosis is not, in the circumstances, particularly surprising. Surges in infectious and communicable diseases often happen in the aftermath of natural disasters.

What the Jamaican health official, however, mustn’t allow to happen is for the sharp rise in leptospirosis cases to morph into a public health crisis, or for there to be a surge of other infectious or communicable diseases, including gastrointestinal ones.

That would compound Jamaica’s difficulty in recovering from Hurricane Melissa, the category 5 storm that pummelled western Jamaica a month ago. It left damage estimated at US$10 billion, or over 40 per cent of the island’s GDP, as well as disrupted the lives of over 900,000 people, whose homes were either damaged or destroyed.

Facing a public health crisis would only exacerbate people’s sense of misery.

There are ways for this to be avoided, some of which are already happening, through the delivery of relief, moves to rebuild the health services in the affected parishes and efforts and public education about the transmission of infections.

These strategies, and others, especially changing environments that are friendly to vectors, have to be more aggressively pursued.

Disease outbreaks are when there are more cases of the particular illnesses than would normally be expected in a specific area/community or region during a particular period or season – an excess of the norm.

On Friday, the health minister, Christopher Tufton, reported six suspected deaths from leptospirosis, an infection caused primarily from people coming into contact with a bacteria transmitted through the urine of infected animals. Another 28 cases of the disease were confirmed or suspected between October 30 and November 20, compared to 21 cases, or fewer than one case per month, over the previous 34 months.

COMMON CARRIER

Rats are the most common carrier of the bacteria, which often spreads after floods which spreads the contamination. The rodents are also likely to be in closer proximity to humans.

Previously, the health authorities had noted a number of cases of tetanus (lockjaw), an infection caused when the tetanus bacteria enter the body, often via cuts or puncture wounds caused by rusty implements.

These diseases, and other diseases, tend to occur after disasters like hurricanes because the large amounts of stagnant water left by rainfall provide breeding ground for vectors like the aedes egypti mosquito, which spreads dengue fever, or parasites that cause gastrointestinal infections. It is also a time when disaster victims face a shortage of clean drinking and are without proper sanitation and full health services.

But while the post-catastrophe environment may be conducive for the spread of communicable diseases and other infections, major outbreaks and public health crises aren’t inevitable.

They can be prevented, or contained by robust surveillance and aggressive and preemptive action. Getting relief, such as potable water, basic sanitation facilities and food, to victims quickly are among the things that can be done. Public education, warning people of the public dangers they face and to do and don’ts to avoid them, is also important.

Also a bit of a shaky start, the government is getting on top of these issues, although the scale of the crisis means that there is a lot more to be done.

What, in this newspaper view, has lagged, is a wider clean-up of the physical environment.

In areas where a natural run-off hasn’t yet happened, the authorities may be able to do little about the newly emerged ponds, except for regularly disinfecting against diseases spreading vectors and vermin.

MORE CAN BE DONE

But more can be done to accelerate the removal of the nearly five million tonnes of debris – and the additional amounts that were added since then – that was left by Hurricane Melissa. The piles of garbage are hiding places and breeding grounds for rats and other vermin. They are also sources of injury and infections, the treatment of which places further burden on a weakened and stressed health system.

That is why The Gleaner repeats its call for the mobilisation of garbage removal brigades, as part of a cash-for-work scheme, to accelerate the clean-up effort.

There is the obvious public health value of such a project. But it would also have other critical benefits.

One is a speedier return to a sense of normality in communities and the psychological advantages of this. But perhaps more importantly, it would help to put money into people’s pockets in circumstances where they have lost their livelihoods, and in some cases, self-esteem, because of their inability to independently earn.

Money in people’s pockets would allow them to spend and help to restart commerce in western Jamaica. That would be an advantage to the national economy.