Impact 

of Natural Disasters on the 
Health System in Africa
 Outline of Presentation
‰ The emergency situation in Africa
‰ Common emergencies in Africa
ƒ Natural disasters
ƒ Man‐made disasters (complex emergencies)

‰ Key facts about health & emergencies
‰ General impact of disasters on health systems
‰ Public health consequences of natural disasters
ƒ Floods
ƒ Drought

‰ Key conclusions & lessons learned

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 The Emergency Situation in Africa
‰ Emergencies (complex or natural) have become common 
phenomenon globally
‰ A high proportion of these emergencies occur in Africa:
ƒ 56% & 83% of global complex emergencies & epidemics between 1995 & 
2004 occurred in Africa (Spiegel et al)
ƒ Africa is second only to Asia in terms of occurrence of natural disasters 
(Spiegel et al)
‰ Southern Africa is particularly prone to natural disasters
ƒ Floods, cyclones, drought & epidemic outbreaks
‰ In general emergencies negatively impacts on the health & 
nutrition of affected population

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 Common Threats in Southern Africa

‰ Natural Disasters
ƒ Flooding (Namibia, Mozambique, Malawi, Zambia)
ƒ Drought (Madagascar, Zimbabwe, Namibia)
ƒ Cyclones (Madagascar)
‰ Man‐made disasters (complex emergencies)
ƒ Political & inter communal crises (South Africa, Madagascar, 
Zimbabwe)
‰ Other disasters
ƒ Epidemic outbreaks: cholera, VHF, H1N1, 
ƒ HIV/AIDS & TB

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 Key Facts about Health & Emergencies I
‰ Morbidities always pre‐exists in communities prior to 
the occurrence of disasters
‰ Not all natural disasters or emergency have an impact 
on the health system 
‰ Occurrence of health system consequences of 
emergencies depends on many factors (Ivers et al):
ƒ Type of disaster
ƒ Pre‐disaster status of the health system
ƒ Public health situation & disease pattern of the area prior to the crisis
ƒ Impact of the disaster on other sectors such as water, sanitation, shelter
ƒ Population displacement 
ƒ Effectiveness of the response to the disaster
ƒ Socioeconomic status of the area prior to the emergency

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 Key Facts about Health & Emergencies II

‰ Occurrence of public health impact of crises depend 
on other sectors such as protection, shelter, WASH
‰ Some emergencies have direct impact on health while 
some are indirect:
ƒ Direct: earthquakes/conflicts/mines (trauma, lacerations, 
fractures, amputations
ƒ Indirect: floods/droughts/cyclones (epidemic diseases, 
malnutrition, mental health & psychosocial problems, MCH)

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 General Impact of Disasters on Health Systems I
‰ Health workforce
ƒ Illness, disability & death due to hospital acquired infections, injuries & 
violence
ƒ Displacement as a result of insecurity or destruction of living quarters
ƒ Psychological trauma due to illness, death & disability of colleagues &  
displacement 
‰ Health Information Management
ƒ Collapse of health information management systems
ƒ Inability to effectively monitor health performance & status
‰ Medical products, vaccines & technologies
ƒ Looting of medical supplies & equipment
ƒ Breakdown of supply chain management system due to insecurity, poor 
access
ƒ The above results in drug stock‐outs

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 General Impact of Disasters on Health Systems II
‰ Health financing
ƒ Diversion of health resources to other sectors such as defense thus 
resulting in reduced spending on health
ƒ Increased cost of delivering health care 
‰ Leadership & governance
ƒ Breakdown of strategic policy framework for health
ƒ Lack of oversight function (supervision, monitoring & evaluation)
ƒ Inability to enforce health regulations & ensure accountability
‰ Health service delivery
ƒ All of the above results in:
9 Reduced access to health services
9 Poor coverage of public health interventions e.g. immunization
9 Poor quality of available health services
9 Unsafe health care services

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 Public Health Impact of Floods
•Loss of livelihoods &
assets (reduced •Epidemic outbreaks:
Socio access to food) ARI, measles
economi •Increased
•Loss of shelter
c impact malnutrition
•Displacement •Mental & psychosocial
•Erosion of disorders
community social •Increased GBV, STI &
structures & coping HIV
mechanisms •PTSD

•Destruction of health •Reduced access to

care infrastructure healthcare
Effect on Increased
Infrastruct •Disruption of social •Poor outcomes for
Floods services (water chronic diseases morbidity and
ures
supplies, electricity, •Increased maternal & mortality
latrines) child mortality
•Destruction of roads •Electric shock

•Epidemics: AWD,
•Destruction of
cholera, malaria,
sanitation facilities
typhoid
Environme •Lack of clean water •Increased snake bites
ntal •Increased parasites
impact in the environment Waring & Brown

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 A submerged clinic in Namibia…

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 A looted & abandoned health facility in Uganda…

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 Public Health Impact of Drought
•Epidemics: AWD,
Water cholera, typhoid
shortage •Skin diseases
•Eye diseases

Drought •Reduced •Malnutrition

food intake and avitaminosis
Increased
morbidity
•Crop and
failure mortality
•Loss of •Increased
•Loss of purchasing illnesses
livestock •Reduced access
power •Maternal &
to health care
•Increased child health
•Loss of caring risks
food price capacity
•Reduced •Displaceme
access to nt/forced
•Distortion of •Alcholism
food migration community •Increased GBV,
social structures STI & HIV

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 Malnutrition in Madagascar…

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 Summary of public health impact of disasters

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 Key Conclusions & Lessons
‰ Disasters (whether natural or man‐made) almost always 
impact on the health of affected populations ultimately
‰ Most times addressing the social determinants of health 
immediately after a disaster reduces the impact of the 
disaster on the health of populations
‰ Implementation of risk & vulnerability reduction measures 
before, during & after disasters mitigates the health impact 
of disasters
‰ Development & implementation of emergency preparedness 
& response programmes reduces morbidity & mortality 
during disaster
‰ Use of a health‐system‐based approach to emergency 
response ensures effective early recovery of the system

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 References
‰ Spiegel et al; Occurrence & overlap of natural
disasters, complex emergencies & epidemics during the
past decade (1995-2004); Conflict & Health 2007; 1:2
‰ Waring SC; Brown JB: The threat of communicable
diseases following natural disasters: A public health
response; Disaster Management & Response 2005; 3:41-
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‰ Ivers LC; Ryan ET: Infectious diseases of severe
weather-related & flood-related natural disasters; Curr
Opin Infect Dis 19:408-414
‰ International public health systems: diseases,
programmes, systems & policies; chapter 9: complex
humanitarian emergencies

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 Ladies & Gentlemen,
many thanks for your
attention

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