“Cyclone Aila and It’s Impact on Health Care System:A Case Study on Gabura Union, Shyamnagar Upazila, Satkhira”

‘Health Centred Disaster Risk Reduction: a New Agenda for a New Era’.

Dealing with Disasters ConferenceSeptember 2015

Presented by :Sheikh Mohammad Abdur Rahman

Deputy DirectorImplementation Monitoring and Evaluation Division (IMED), Ministry of Planning , The People’s Republic of Bangladesh

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Brief introduction of my Job Place • My job place is Implementation Monitoring and Evaluation Division, Ministry of

Planning. • I work there as Deputy Director. • The major function of this division and as well as my responsibilities are as follows:

• Monitoring and Evaluation of the implementation of development projects included in the Annual Development Programme.

• Collection and compilation of project-wise data for preparing quarterly, annual and periodical progress reports for information of the President, Prime Minister, NEC, ECNEC, Ministries and other concerned.

• Rendering such advisory or consultancy services to Ministries/Agencies concerned on implementation of projects as and when necessary.

• Field inspection of projects for on the spot verification of implementation status and such other Co-ordination works as may be necessary for the removal of implementation problems, if any, with the assistance of related Ministries/Agencies.

• Submission of project inspection reports to the President, Prime Minister and Ministers concerned when attention at such levels are considered necessary.

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Geographic Location of Bangladesh Bangladesh‘s geographical location and land characteristics make it one of the most climatically vulnerable countries in the world (World Bank, 2011).

With a population of 157 million people (WPDS, 2013), at least 70% of the population live in regions at risk of floods and 26% in regions at risk of cyclones (Cash et al, 2013).

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Some Historic Events of Cyclone in Bangladesh

Year Type of hazard Proportion (%) of total region or population affected (n)

Height of storm surge

(m)

Deaths (n)

1970 Bhola Cyclone - 6-10 225000-500000

1985 Cyclone 1.68 million 3-4.6 11000

1991 Cyclone Gorky 4.56 million 6-7.6 138000

2007 Cyclone Sidr 18.3 million 4.5-6.1 3300

2009 Cyclone Aila 3.9 million 2-3 190

Source: Cash et al (2013)

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About Cyclone Aila

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On 23 May 2009, the category 1 cyclone Aila, took shape and hit South-Western coastal region on 25 May 2009.

The sustained wind speed of the Cyclone Aila was about 65-75 mph (74 mph is the lowest threshold for Cat-1 hurricane).

Affected and estimated 3.90 million people in 11 coastal districts of the Bangladesh (ActionAid et al., 2009).

District Upazila Worst Affected Unions

Most Affected

Family

Most Affected

People

Dead and

Missing

Household Damaged

Satkhira Shyamnagar Gabura 6,007 30,034 24 100%Padmapukur 4,432 22,163 10 100%

Burigoalini 4,289 26,810 5 80%Atulia 4,621 28,879   50%

Assasuni Protapnagar 3,750 15,000 1 100%

Sreeula 2,250 9,000   80%Khazra 2,000 8,000   70%Baradal 1,875 7,500   50%

Khulna Dacope Kamarkhola 3,200 16,000 4 90%

Sutarkhali 8,000 40,000   100%

Tildanga 8,000 24,000   80%Banisanta 2,800 14,000   60%

Koira Uttar Betkashi 4,050 8,000 1 100%

Dakhin Betkashi 5,000 15,000 47 100%

Moharajpur 5,000 20,500   80%Koira Sadar 6,204 25,000 5 50%

Maheshwaripur 5,000 20,000   70%  Total   76,478 329,886    

Massive destruction at Satkhira and Khulna districts caused by Aila

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Map of Gabura surrounded by Kholpetua and Kopataska rivers specifying with four mouza, health clinic, drinking water source (PSF), roads, market, canals, settlements and others

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Extent of the impact of Cyclone Aila in Khulna and Sathkira districts

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Schematic Presentation on Different Facets of Impact Caused by Aila

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Level Type of facility Type of service Total No. of

facilities

Total beds

Upazilla Upazila health complex (50-bed) Hospital 268 13400Upazila health complex (31-bed) Hospital 145 4495Upazila health complex (20-bed) Hospital 1 20Upazila health complex (10-bed) Hospital 11 110

Subtotal of Upazila health complexes 425 1802531-bed hospital Hospital 5 13530-bed hospital Hospital 1 30

Subtotal of hospitals outside health complexes

6 165

Trauma center (20-bed) Hospital 5 100Total of upazila-level hospitals 436 18290

Union 20-bed hospital Hospital 18 36010-bed hospital Hospital 13 130

Subtotal of union-level hospitals 31 490Union subcenter Outpatient only 1275 -Union health and family welfare center

Outpatient only 87 -

Subtotal of union outpatient centers 1362 -Total of union level facilities 1393 490

Ward Community Clinic Outpatient only 12527 -Grand total of hospitals (upazila and below) 467 -Grand total of health facilities (upazila and below)

14356 18780Primary Health Care run by Directorate General of Health Services at the upazilla level and belowSlide-8

Types of facility from national to the ward level, with managerial hierarchy

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Objectives of the study

• To make a clear comparison about health care system of Gabura union before and after Aila;

• to analyze the situation of the villagers of Gabura in times of disaster and the needs and problems that arose due to the disaster;

• to examine the weakness of the health care services provided by both GOs and NGOs agencies working for affected villagers of Gabura and

• To push forward some recommendations so that remedial as well as rehabilitative measures in terms of health and education could be initiated to redress the vulnerability of the affected people.

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Materials and Methods

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Study Design: The Schematic Presentation of Different Steps Followed

Data CollectionData Collection

Data analysis, appraisal and assessment

Data analysis, appraisal and assessment

Study Output

Collection of secondary data from different issues of the daily, monthly and quarterly newspapers, published and unpublished research reports, articles and various relevant web site.

Collection of secondary data from different issues of the daily, monthly and quarterly newspapers, published and unpublished research reports, articles and various relevant web site.

Supported by :

Focus Group Discussion & Case Study

Supported by :

Focus Group Discussion & Case Study

Collection of primary data through personal interview with the Aila affected inhabitants, traditional birth attendants, village doctors, community leaders, NGO officials, Shyamnagar upazila statistics and health officer.

Collection of primary data through personal interview with the Aila affected inhabitants, traditional birth attendants, village doctors, community leaders, NGO officials, Shyamnagar upazila statistics and health officer.

A view of FGD session conducted in an indigenous way by the researcher with Aila affected male inhabitants in front of Maddho Khalishabunia mosque (situated at Maddho Khalishabunia village)

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Findings of the study.

House of a permanent residence Jhupri of the migrants’ family living on the embankment

Slide-17Affected hand of the victims by the tiger Tiger victims with the researcher

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Findings of the studyIn terms of magnitude diseases placed Gabura in the following ranks:

Water-borne diseases - 1st Position (100%)Cardiovascular diseases - 2nd Position (68%)Kidney problem - 3rd Position (54%)High blood pressure/Hypertension - 4th Position (43%)Gynecological problem - 5th Position (36%)Eclampsia - 6th Position (32%)

Researcher at village doctor (VD) chamber Researcher with Kabiraj Proshanto

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Water sealed toilet of a permanent residence

Non-sanitary toilet of a migrated residence

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Homemade harvested rain water tank

Piped water system

PSF water system

Homemade harvested rain water tank

A harvested rain water tank seen to be functioning

Water point of a Piped water system

Findings of the studyIn order to ensure remedy of the diseases the facts are as follows:

•The doctor is available only once a week only for a couple of hour.

•Bad road infrastructure due to Aila it is difficult on the part of the local people to rush for medical services provided by the four Community Clinics (CCs) specially at the rainy season.

•The villagers usually take basic health care services from 38 village doctors or paramedics of Gabura. •Village Doctors have their own medicine shop with low quality medicines.•Respondents are taking services from Untrained Traditional Birth Attendants and Kabirajs’ even knowing that they are not qualified enough to prescribe any scientific treatment. •No health and nutrition related education or campaigning found in the study area.

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Front view of Friendship water purification system

Partial image of Friendship water purification system

PSF system installed by OXFAM seen to be non-functioning

Front view of Friendship water purification system

Partial image of Friendship water purification system

A harvested rain water tank seen to be non-functioning

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Embankment are rebuilt for last five years within this way

Damaged portion of the embankment which is still in risk

Embankment and river are almost on the same height in this location

Only pond that was full of pure water even after more than one year of Aila

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Signboard of some NGO’s which are exists only in the signboard

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Concluding Remarks

• This particular study was confined to a union only. • The scope for the study was very much limited. • The findings of this study should, at best, be considered as

indicative rather than exhaustive. • This micro study will pave the way to take many macro studies

in this particular area. • With this study and future research, a nation-wide programs

of action could be commissioned aiming at complete rehabilitation of the people (suffering from natural disaster like Aila on regular interval specially health, nutrition and relevant education) living in coastal regions would be viable and sustainable.

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Researcher with ‘Sheikh Ameer Hossain’ who helps a lot to discover Aila affected Gabura union and assist to communicate all through the respondents

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Thanks for your patience hearing

Do you have any query?

Please……………….Contact:

Sheikh Mohammad Abdur RahmanDeputy Director

Implementation Monitoring and Evaluation Division (IMED), Ministry of Planning , The People’s Republic of Bangladesh

Cell No. +8801819260139E-mail: tinturet@gmail.com

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