HEALTH-EFFECTS OF THE 1991 BANGLADESH CYCLONE - REPORT OF A UNICEF EVALUATION TEAM

To assess the impact on health of the cyclone and tidal wave that stru ck the southern coast of Bangladesh on the evening of 29 April 1991, a team of health professionals visited cyclone affected areas from 4-27 June, 1991. Team members met with health workers and officials of the Government of Bangladesh and with staff from non-governmental organiz ations, and conducted field surveys in two severely affected areas. Mo rtality among the 135 households surveyed (pre-cyclone population 1, 1 23) was 14 per cent. At highest risk of deaths were children of less t han 10 years (26 per cent mortality) and women of more than 40 (31 per cent mortality). Almost all deaths occurred as a result of drowning f rom the tidal wave that accompanied the cyclone. Although 95 per cent of the population surveyed had received warning of the cyclone four or more hours before it struck, the 300 existing cyclone shelters had ca pacity for only 450,000 of the 5,000,000 people affected by the cyclon e. Deaths following the cyclone were few. Diarrhea caused by Vibrio ch olerae and Shigella dysenteria type 1, both of which are endemic in Ba ngladesh, occurred in the post-cyclone period. Reports by the national Diarrhea Surveillance System of large increases in diarrheal incidenc e following the cyclone were difficult to assess because of inconsiste ncies in pre- and post-cyclone reporting methods. No increase in other infectious diseases was identified. Although water availability had b een a major concern following the cyclone, the tubewell system was fun ctioning well in the area that was surveyed. Distribution of relief as sistance by the Government of Bangladesh and by non-governmental organ izations was good, with 95 per cent of families surveyed receiving foo d aid within five days of the cyclone. The major health effect of this cyclone was acute deaths due to drowning. Preventing deaths during fu ture cyclones will require increasing accessible shelter.