Management Of Chronic Noncommunicable Diseases After Natural Disasters In The Caribbean: A Scoping Review.

Saria Hassan,Trevor Hassell,Laverne Ragster,Oswald P Adams,Marcella Nunez-Smith,Alyssa Grimshaw,Morgan Buchanan,Mytien Nguyen

doi:10.1377/hlthaff.2020.01119

Abstract

Extreme weather events in the Caribbean region are becoming increasingly severe because of climate change. The region also has high rates of poorly controlled chronic noncommunicable diseases (NCDs), which were responsible for at least 30percent of deaths after two recent hurricanes. We conducted a scoping review of literature published between 1974 and 2020 to understand the burden and management of chronic NCDs in the Caribbean after natural disasters. Of the twenty-nine articles included in this review, most described experiences related to Hurricanes Dorian (2019) and Irma and Maria (2017) and the Haiti earthquake (2010). Challenges included access to medication, acute care services, and appropriate food, as well as communication difficulties and reliance on ad hoc volunteers and outside aid. Mitigating these challenges requires different approaches, including makeshift points of medication dispensing, disease surveillance systems, and chronic disease self-management education programs. Evidence is needed to inform policies to build resilient health systems and integrate NCD management into regional and national disaster preparedness and response plans.

Highlights

Extreme weather events in the Caribbean region are becoming increasingly severe because of climate change
We excluded 821 articles from our study.We assessed the remaining seventy-six articles for eligibility, and of these, forty-seven were excluded
The most common noncommunicable diseases (NCDs) discussed in these studies were diabetes (n = 11), cardiovascular diseases (n = 9), mental health disorders (n = 6), and asthma (n = 5)

Summary

Introduction

Extreme weather events in the Caribbean region are becoming increasingly severe because of climate change. With more than 3,000 lives lost and $280 billion in damage, it was a stark realization of the worsening impact of climate change.[1,2] This was not the first time in recent memory that the Caribbean had suffered a major natural disaster. In November 2010 Hurricane Tomas tore through the western edge of Haiti, adding to the existing devastation.[3] In September 2019 Hurricane Dorian became the strongest storm to hit the Bahamas, with estimated losses totaling $3.4 billion.[4] severe weather events are expected to occur more frequently in many parts of the world, including the Caribbean, because of climate change.[5]

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Discussion

Conclusion