Nepal: A potential public health crisis looming: What is to be done?

Abstract

The tragedy of the recent earthquake in Nepal and surrounding areas is monumental in terms of loss of life and property damage. However, there is a potential public health crisis that looms large in the face of recent events. Nepal actually has a good national public health system; and, I have many colleagues through LinkedIn hat serve in Nepal and the surrounding areas. I have lost contact with them; and I am very concerned about them personally. But, I am also concerned about the disruption of public health services in the disaster area itself and the potential hazards that can result from those services being unavailable due to the conditions there now. However, there is another potential crisis looming on the horizon based on reports recently coming from the affected area regarding disrupted services, potentially contaminated food and water supplies; and dead bodies not yet recovered from the rubble. My concerns now as a public health professional is the potential for a pandemic disease outbreak that not only would wreak havoc on the immediate area but also spread to distant areas as survivors and relief workers exit the disaster area and head to unaffected civilization taking diseases with them. This happened to South Florida after the Haiti earthquake when relief workers, many from Florida, came back to Florida carrying infectious diseases with them. Also, survivors made their way to Florida where many of them may have had family; and, they too brought disease. My concern now in addition to recovery and rescue is that all nationalities begin a major effort toward surveillance, detection, and interdiction (quarantine) of these potential pandemic diseases that seem to follow closely after a major disaster. The risks now are biohazard risks to any country within air travel distance from Nepal and of course, Nepal itself must protect itself from follow on deaths from contaminated water borne diseases. They now need international assistance and vigilance to prevent a potential pandemic attack on other nations that are receiving now survivors and relief workers returning from the disaster area who may be potentially infected by their proximate contact with these disaster created plagues. Certainly, international global public health services need to consider recommending to their governments; including the government of Nepal, that quarantine is an essential protection to prevent the spread of disease. Recently, I watched the President of Liberia being interviewed by BBC America and the reporter asked him if he could go back in time; what would he have done differently in the first days of the Ebola outbreak in his country? His answer was quarantine to prevent the spread of the disease to so many of his fellow countrymen. Ibelieve that we need to see an early response in Nepal; quarantine and provide medical treatment in place rather than to risk the potential for a pandemic attack to other countries.