The impact of natural disasters on healthcare and surgical services in low- and middle-income countries

Disaster preparedness and kidney health in children

Disasters pose significant risks to vulnerable populations, particularly children with chronic health conditions such as kidney disease. This paper explores the unique challenges faced by children with kidney disease during and after disasters, focusing on disruptions to essential medical services such as dialysis, access to clean water, and maintenance medications. The vulnerability of these children is further amplified in low-resource settings, where disaster preparedness is often lacking. We present strategies for improving disaster preparedness, including early dialysis initiation, patient and family education, and securing reliable access to medical supplies and treatment facilities. Ensuring the resilience of health systems and comprehensive disaster planning are crucial to safeguarding the health of this at-risk population during emergency situations.

Challenges and Strategies in Maintaining Continuity of Care for Chronic Disease Patients by Emergency Nurses During Disasters

AIM

This study aimed to explore the challenges emergency nurses face in providing continuity of care for chronic disease patients during disasters in the Northern Region of Saudi Arabia and the strategies they employ to overcome these challenges.

BACKGROUND

Emergency nurses play a pivotal role in disaster response, particularly in managing care for patients with chronic diseases. Resource shortages, communication breakdowns, and patient displacement frequently disrupt care continuity during disasters, exacerbating health risks for vulnerable populations.

INTRODUCTION

Ensuring consistent care for chronic disease patients during disasters is critical for mitigating negative health outcomes. Disruptions caused by disasters highlight the need for strategies that support emergency nurses in maintaining care standards under resource-limited and high-stress conditions.

METHODS

A qualitative descriptive study was conducted using semistructured interviews with 14 emergency nurses from a general hospital in the Northern Region of Saudi Arabia. Thematic analysis, adhering to COREQ guidelines, was applied to identify key challenges and solutions.

RESULTS OR FINDINGS

Three key themes were identified: resource limitations, communication barriers, and patient displacement. Nurses reported challenges such as shortages of essential medications, disruptions in communication networks, and difficulties in maintaining continuity of care for displaced patients. To mitigate these challenges, they employed strategies including improvisation, enhanced communication protocols, and resilience-building practices.

DISCUSSION

The findings highlight the critical role of emergency nurses in disaster response and the necessity of adaptive practices. Addressing resource scarcity, fostering robust communication systems, and supporting nurse well-being are essential to maintaining care quality during disasters.

CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Emergency nurses require robust support systems to maintain care continuity during disasters. Policymakers should integrate disaster preparedness into healthcare frameworks by enhancing resource allocation, developing resilient communication infrastructure, and providing targeted training programs. These measures can improve nurse capacity, optimize patient outcomes, and strengthen health systems' disaster response capabilities.

Insights on Health Burden, Needs, and Prevention Strategies After the Flood Catastrophe in Southern Brazil

Brazil has experienced a significant increase in climate emergencies and environmental disasters. Rio Grande do Sul (RS), the southern state of the country, shows an annual rise in climate, hydrological, and meteorological disasters, underscoring its vulnerability to extreme events and the urgent need for proactive mitigation and adaptation strategies. Despite this growing concern, the literature has provided limited focus on the specific public health demands arising from these disasters, particularly regarding prevention. This debate article highlights the short-, medium-, and long-term health needs following the recent floods in RS, integrating disaster prevention science to enhance preventive actions. Floods have profound mental health and behavioral consequences, including increased rates of post-traumatic stress disorder, depression, and anxiety, particularly among displaced individuals and first responders. This analysis uses the RS case to illustrate a multi-tiered prevention approach-spanning primary, secondary, tertiary and quaternary measures-while presenting a model that could be adapted to similar vulnerable regions worldwide. By emphasizing early detection, strategic resource allocation, and evidence-based interventions, the findings highlight the importance of structured responses in minimizing health risks, bolstering community resilience, and preventing health deterioration in climate-vulnerable regions.

The Impact of Climate Change on Cancer Surgery and Healthcare Delivery: A Review of Environmental and Surgical Challenges

PURPOSE

More than 10 million annual global cancer deaths are exacerbated by the impact of climate change and environmental determinants of health. This brief report provides a summary of and mitigating recommendations for the complex intersection between climate change and surgical cancer care.

METHODS

A review of scientific literature from the last 10 years was conducted to assess the current impact of climate change on cancer care with a focus on surgical interventions. Studies with an impact score of 6 or higher and the keywords of climate change, extreme weather, cancer care, and surgery were reviewed. After removing duplicates and excluded studies, 30 studies remained and were reviewed by two reviewers.

RESULTS

Climate-related factors impacting surgical care result in a myriad of healthcare impacts, including disruption of services, impact on patient outcomes and survival, as well as an overburdening of hospital and surgical services.

CONCLUSION

Climate change, including extreme weather events, threatens cancer surgical care and delivery by exacerbating comorbidities, disrupting healthcare systems, and increasing disparities in cancer care. Climate change is a burgeoning threat to global health, cancer care, patients, and communities.

Climate change and cardiovascular risk

PURPOSE OF REVIEW

This review explores the complex relationship between climate change and cardiovascular health. It examines the mechanisms through which climate change impacts cardiovascular risk, highlights recent findings on regional trends, and discusses mitigation strategies.

RECENT FINDINGS

Climate change significantly contributes to cardiovascular morbidity and mortality through mechanisms such as temperature extremes, air pollution, and food insecurity. Heatwaves increase risks of dehydration, electrolyte imbalance, and acute cardiovascular events, while cold spells exacerbate myocardial stress and pollution-related cardiovascular risks. Air pollution, including fine particulate matter (PM2.5), induces systemic inflammation, endothelial dysfunction, and atherosclerosis. Emerging data highlight regional variations, with urbanization exacerbating risks in Asia-Pacific and Middle Eastern populations, while extreme heat and cold challenge resilience in Europe and Latin America. Studies also link socioeconomic stress from climate-induced displacement and resource shortages to chronic cardiovascular conditions. Notably, urban greening and air quality regulations demonstrate potential for reducing cardiovascular risks.

SUMMARY

Climate change amplifies cardiovascular risks through diverse mechanisms, disproportionately affecting vulnerable populations. Targeted strategies, including public health campaigns, sustainable urban planning, and technological innovations, can mitigate these risks. Advances in generative artificial intelligence and big data analytics offer opportunities to tailor interventions and enhance predictive modeling. A multidisciplinary approach integrating public health, environmental science, and clinical expertise is critical to addressing these challenges. Urgent action is required to mitigate the long-term cardiovascular impacts of climate change and foster resilient health systems globally.

The impact of diurnal temperature range on the risk of hospitalizations in a low-income setting: the case of the Central Coast of Vietnam

The study aims to evaluate the effects of diurnal temperature range (DTR) on all causes, cardiovascular and respiratory conditions in the Central Coast of Vietnam, a tropical, low-income region with high DTR exposure but limited research. Daily hospital admission data from the largest hospitals in three provinces were analyzed alongside meteorological data. A time-series analysis using a generalized linear distributed lag model was conducted to examine the non-linear DTR-hospitalization association. A random-effect meta-analysis using restricted maximum likelihood was performed to calculate the pooled effects across three provinces. Stratified analyses by gender, age, season and natural disaster occurrence were conducted to identify vulnerable subpopulations. The multi-province pooled effects indicated that a 1 °C increase in DTR raised the risk of hospitalizations for all causes and respiratory diseases by 1.5% [1.2-1.8%] and 0.5% [0.0-1.0%], at lag 0-6 days. The effects of DTR on cardiovascular diseases, as well as those stratified by subgroups, were not statistically significant. Additionally, DTR had a greater adverse effect during the dry season and in the presence of natural disaster. Females and the elderly were slightly more susceptible to respiratory admissions, while males and younger individuals had a higher risk of all-cause admissions due to greater DTR effects. DTR was an independent risk factor for the exacerbation of all and specific causes, particularly among the susceptible subgroups. The findings suggested that it is necessary to take preventive measures to protect these at-risk populations from the adverse effects of extreme DTR exposure.

Assessing the ripple effects of natural disasters on healthcare systems: a narrative review

PURPOSE OF REVIEW

Natural disasters are on the rise, driven by shifts in climatic patterns largely attributed to human-induced climate change. This relentless march of climate change intensifies the frequency and severity of these disasters, heightening the vulnerability of communities and causing significant harm to both lives and socio-economic systems. Healthcare services are particularly strained during extreme weather events, with impacts felt not only on infrastructure but also on patient care.

RECENT FINDINGS

This narrative review explored the overarching impact of natural disasters on healthcare infrastructure. We delved into how these disasters impact diverse health conditions, the healthcare systems of low and middle-income countries (LMICs), the psychological toll on both clinicians and survivors, and the ramifications for end-of-life care.

SUMMARY

Natural disasters significantly impact healthcare, especially in LMICs due to their limited resources. Patients with cancer or chronic diseases struggle to access care following a natural disaster. Those in need for palliative care experience delay due to shortages in medical resources. Psychological consequences like posttraumatic stress disorder on disaster survivors and healthcare providers highlight the need for mental health support. Addressing challenges requires proactive disaster preparedness policies and urgent public policy initiatives are needed for optimal disaster response.

Natural disasters, livelihood, and healthcare challenges of the people of a riverine island in Bangladesh: A mixed-method exploration

BACKGROUND

Bangladesh's islands, because of their geographical location, frequently encounter crises like floods and river erosion, which pose significant threats to the residents' well-being and livelihoods. To delve into the effects of these disasters on livelihood and healthcare challenges, a mixed-method study was undertaken in a riverine-island near a major river of Bangladesh.

METHODOLOGY

Between February 15th and February 28th, 2023, a cross-sectional study was conducted on an island in Bangladesh. The quantitative method involved conducting a survey of 442 households, with a total of 2921 participants. Additionally, 10 in-depth interviews and 10 key-informant interviews were conducted using semi-structured guidelines. Qualitative interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic analysis. Triangulation was employed in this study through the integration of qualitative and quantitative analysis, resulting in the presentation of findings that offer an in-depth comprehension of the phenomenon being investigated.

RESULTS

River erosions and floods are common and recurring natural disasters that significantly impact the lives of the riverine island inhabitants. These disasters often disrupted their livelihoods, forced many residents to endure substandard living conditions or relocated during flood events. The island faced a low diagnostic prevalence of chronic diseases (e.g., 5.1% of adults were hypertension and 2.5% are diabetes) because of the absence of diagnostic facilities and a shortage of certified doctors. A significant number of chronic illness people in the community turned to alternative medicine sources (39.3%) such as homeopathy, Kabiraj, and Ayurvedic medicine, especially it gets increased during periods of natural disasters. Moreover, reproductive aged women revealed that 79.4% of them gave birth at home, with 6.0% of these home deliveries resulting in miscarriage or infant death. The destruction of crops, unstable job opportunities, an inadequate educational system, and a deficient healthcare delivery system exacerbated the hardships faced by the population affected by these disasters.

CONCLUSION

The failure to seek treatment for chronic diseases and undiagnosed diseases is a significant health issue among the aging adults on the island. Island residents face the challenge of establishing effective prevention strategies for the well-being of older adults especially at the period of natural disasters. It is crucial for the government and non-governmental organizations (NGOs) to collaborate to prevent the negative effects of floods and river erosions. This should include efforts to enhance the quality of education, healthcare services, job opportunities, and financial assistance for rebuilding homes.

Disaster after disaster: the outbreak of infectious diseases in Pakistan in the wake of 2022 floods

In June 2022, Pakistan witnessed catastrophic floods, affecting millions of people. The ensuing epidemics of cholera, cryptosporidiosis, rotavirus infections, generalized diarrhoea, typhoid and paratyphoid fevers, as well as the frequency of vector-borne diseases including malaria and dengue fever, are studied in this investigation. It also explores the latest outbreak of poliomyelitis and the frequency of respiratory diseases such COVID-19, diphtheria, and tuberculosis, as well as how floods have contributed to skin and eye problems. The report also describes the obstacles governments must overcome in order to manage these health emergencies and offers possible solutions for reducing the effects of ongoing and anticipated epidemics. This flood emphasizes the pressing need for international action and acts as an alarming indicator of the significant impact of climate change. It emphasizes how crucial it is to have effective flood response and preparation strategies in developing nations that are vulnerable to natural disasters.

The Impact of Climate Change and Extreme Weather Conditions on Cardiovascular Health and Acute Cardiovascular Diseases

Climate change is widely recognized as one of the most significant challenges facing our planet and human civilization. Human activities such as the burning of fossil fuels, deforestation, and industrial processes release greenhouse gases into the atmosphere, leading to a warming of the Earth's climate. The relationship between climate change and cardiovascular (CV) health, mediated by air pollution and increased ambient temperatures, is complex and very heterogeneous. The main mechanisms underlying the pathogenesis of CV disease at extreme temperatures involve several regulatory pathways, including temperature-sympathetic reactivity, the cold-activated renin-angiotensin system, dehydration, extreme temperature-induced electrolyte imbalances, and heat stroke-induced systemic inflammatory responses. The interplay of these mechanisms may vary based on individual factors, environmental conditions, and an overall health background. The net outcome is a significant increase in CV mortality and a higher incidence of hypertension, type II diabetes mellitus, acute myocardial infarction (AMI), heart failure, and cardiac arrhythmias. Patients with pre-existing CV disorders may be more vulnerable to the effects of global warming and extreme temperatures. There is an urgent need for a comprehensive intervention that spans from the individual level to a systemic or global approach to effectively address this existential problem. Future programs aimed at reducing CV and environmental burdens should require cross-disciplinary collaboration involving physicians, researchers, public health workers, political scientists, legislators, and national leaders to mitigate the effects of climate change.

Determinants of Disaster Competencies Among Jordanian Nurses in Public Hospitals

Introduction

In the last decade, disasters increased by 60% worldwide. These occurrences have resulted in approximately two million deaths and 4.2 million injuries and left 33 million people homeless. Nurses are part of the front-line response team and should be critical during disasters. For nurses to respond competently, they must have the knowledge and skills to provide comprehensive and holistic care to the populations affected by disasters.

Objectives

This study aims to assess the level of competencies among nurses providing disaster care and identify their predictors.

Method

A descriptive correlation design was utilized to measure and predict nursing competencies in providing care to individuals amid disasters. An electronic form of disaster response competencies assessment survey was distributed to 400 nurses working at three public hospitals in the central region of Jordan.

Results

Jordanian nurses reported a moderate level of competencies in providing care for individuals. Furthermore, multiple regression analysis revealed that disaster training, disaster education, sex, and real disaster experience significantly predict nurses' competencies.

Conclusion

With the increasing frequency of disasters, nurses should be adequately prepared to respond to disasters competently to relieve the negative consequences of these events on the affected individuals.