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DISASTER
RECOVERY

Malaria is another disease carried by mosquitoes that infect
populations in areas of natural disasters. In Haiti, it was dif-
ficult to access the incidence of malaria the weeks and
months following the earthquake. There are many reasons
for this. However, the main reasons are that the prevalence
rates of the disease were unknown and given the transient
displaced population post-earthquake, it was difficult to es-
timate the prevalence rate of malaria. Nevertheless, The
Haitian Ministry of Health and Population (MSPP), in col-
laboration with the US Centers for Disease Control and Pre-
vention (CDC) and non-governmental organization (NGO)
partners, established infectious disease surveillance for a va-
riety of conditions, including malaria. They estimated that
20 percent of the population might have been infected with
malaria.
Infectious disease can be devastating in a population.
Consider the great pandemic of 1918. It is estimated that
over 50 million people died from the mass infection of in-
fluenza! World War One started in 1914 and ended in No-
vember 1918 and took the lives of 9 million soldiers. Five
and a half times the number of people were killed by the
great influenza than died in war! Scientists believe the out-
break started in Fort Riely, Kansas in an overcrowded camp
that was an ideal site for the spreading of the disease of a
respiratory virus with 100,000 soldiers in transit every day. ways replace damaged property. One cannot replace a loved one
Then the soldiers were sent to camps all over the USA and eventu- who is the victim of a deadly disease.
ally overseas. The silent heroes in the deadly disease disasters are all of the care-
It is estimated that 10 percent to 20 percent of those who were givers that put their lives at risk to care for patients that present with
infected died. The take away is that infectious disease kills. We now symptoms that can be dangerous for all who come into contact with
live in a very transient world whereby one can go from country to these individuals. Additionally, the epidemiologist that identify the
country with little thought of what airborne disease can do to a source of the disease, the incidence of and prevalence of the disease
population. When traveling overseas, it is not uncommon to sit in a are the CSI folks of deadly and hurtful disease. The next time you
plane for eight or more hours with hundreds of individuals of see them, tell them… “thank you”!
which we have no idea if they have a deadly disease such as Ebola.
Many diseases have an incubation period. Thus one can be infected Alan Preston, MHA, Sc.D., is an independent consultant that helps physi-
and not have any outward symptoms yet infect many people they cians navigate through the difficult regulatory framework and helps them achieve
come into close contact. The pandemic influenza of 1918 may have higher reimbursements from insurance companies; skilled with a tremendous
killed as many as 25 million people in its first 25 weeks alone! background in managed care and Population Health Management, epidemiol-
The next time we think of natural disaster such as hurricanes, ogy, team building, and biostatistics; strong healthcare professional with a Doctor
tornadoes, earthquakes, mudslides, forest fires and alike, we need of Science (Sc.D.) focused on Public Health, Health Services Research from
to think about the lingering disaster that awaits and can be far more Tulane University School of Public Health and Tropical Medicine. Dr. Preston
devastating than any of the aforementioned “natural disasters.” The is involved in risk-sharing contracts, ACOs, Medicare Advantage including
media loves to focus on property damage, and it is compelling to RAP scores, HEDIS, and STAR ratings which helps physicians and health
watch. However, disease can be far more devastating. One can al- plans alike in reducing MLR. Alan@Preston101.com.

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