Madagascar - GFDRR

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Damage, Loss, and Needs Assessment for Recovery and Reconstruction: <strong>Madagascar</strong> 49 The extent of the damage to health infrastructure is related to either the intensity of the cyclone as it passed through the country, or to the age or fragile condition (constructed of local materials) of the buildings. The bulk of the damages to hospitals and basic health centers was located in the regions of Analanjirofo, Atsinanana, and Haute Matsiatra (for more details, see Annex 2) This infrastructural damage led to the temporary and even permanent closure of a number of these health centers, thus terminating or disrupting the various basic health services, particularly the treatment of common diseases and diseases covered by control and prevention programs, especially with regard to maternal-child health. Figure 15: Health Station Moreover, disruptions triggered by cyclones and flooding on access roads, coupled with the financial difficulties faced by disasteraffected households, generally resulted in an even more significant reduction in the number of health facilities, which was already low before the disaster. Free health care services had to be provided to the homeless in major cities and to disaster victims in rural areas in the weeks and months following the disaster. Thus, health care was provided to between 180,000 and 300,000 persons by medical teams working at health facilities and with mobile health services, as well as by public facilities and NGOs. Furthermore, in addition to the high levels of rainfall during the season, the cyclones produced environmental conditions favorable to the outbreak of diseases: an increase in the number of areas of stagnant water, thereby providing countless breeding grounds for diseases such as malaria, arboviruses, and schistosomiases; the submersion of latrines and wells or other household water sources, which are thus contaminated by infectious agents, the source of diseases linked to fecal contamination; and atmospheric humidity, which is conducive to diseases of the respiratory tract. Added to these diseases are those linked to overcrowding in temporary housing (shelters) or in host families for the homeless, which apart from acute respiratory infections include skin infections, conjunctivitis, and even sexually transmitted infections.
50 Damage, Loss, and Needs Assessment for Recovery and Reconstruction: <strong>Madagascar</strong> Figure 16: Post disaster health station In anticipation of these epidemic diseases, urgent preventive actions such as child vaccination and Vitamin A distribution, insecticide-treated mosquito net distribution, well disinfection, and IEC campaigns, were carried out by health services at the various levels and supported by international partners and NGOs. These rapid responses to cyclones have, thus far, helped to make epidemic outbreaks a rare occurrence. Figure 17 and Figure 18show the increased incidence of diseases in 2008 as compared to 2007 for two separate districts. Figure 17: Comparison for 2007 and 2008 for the Mahabo Health District Figure 18: Comparison for 2007 and 2008 for the Toamasina 2 Health District
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Madagascar - GFDRR

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