Disaster Epidemiology in the Republic of Macedonia

Prof. D-r Elisaveta Stikova MD, PhD

Medical Faculty, National Public Health Institute

Disaster Epidemiology in the Republic of Macedonia

Learning objectives To explain the theory of disaster occurrence To present the most relevant characteristics of

disasters in the country by: Affected population (victims), Economic damage lost, Frequency of occurrence (trend)

To evaluate epidemiological characteristics using common indicators (annual average incidence of disasters and disaster ranking),

To explain how these indicators could be used for risk assessment and comparison among the countries from the region

Disaster Epidemiology in the Republic of Macedonia

Elisaveta Stikova Present position

1991-Present, Professor, University “Ss. Cyril and Methodius”, Medical faculty, Skopje, Macedonia (courses taught: Occupational Health, Public Health, Medical Ecology, Hygiene

1994 – Present, Director and Advisor, National Public Health Institute, Skopje, Macedonia

2009 – Fulbright Visiting Scholar, Pittsburg University, Graduate School of Public Health – New Educational Pathway for Global Public Heath Security

VULNERABILITY

DISASTER

THREATS

Age and gender Poverty InfrastructuresFood securityHealth CareEducationEnvironment

Emergency response

Epidemics Natural DisastersTechnological disasterCHBR terrorismHumanitarian crises

CAPACITY BUILDING

DEVELOPMENT PLANNING

Preparedness Planning

Policies, Laws and By-laws

Awareness & Partnership

Operational Systems

Human Recourses

Early Warning Systems

Contingency planning

26

54

229

105

Occurence

16312

4597

24517

29559

Damages*

Legend:

Geophysical

Meteorological

Climatological

Hydrological

177932428

8052520125118723980280

Victims

Natural Disasters by Groups and Impact, 2007

Macedonia

48,8 %

China Rep.

120 117 437

India

38 145 269

Lesotho

19,4%

Zimbabwe

18%

Bangladesh

14,4%

Zambia

12,8%

Dominica

10,5%

China Rep

9,1%

Bolivia

8,4%

Belize6,4%

Bangladesh

22 935 841

Zimbabwe

2 117 207

Philippines

2 023 221

Mexico

1 858 058

Pakistan

1 653 622

Veit Nam

1 647 928

Columbia

1 613 736

Zambia

1 553 536

Swaziland

35,4%

Geophysical

Climatological

Hydrological

Meteorologic

120 100 80 60 40 20 10 20 30 40 50

10 top countries by victims/1000000 in 2007

Legend:

Bulgaria Romania

United Kingdom

Macedonia

SpainGrece

GermanyFrance Russia

Austria Italy Croatia Slovenia UkraineSerbiaPoland Albania

Belgium SlovakiaCanary Is.Montenegro

Moldavia Rep.

Czech Rep.

Netherlands Hungary

Occurence

Victims per 1000

inhabitant

Victims

Switzerland

7

6

5

1

2

3

4

488

62

6

10 100 1000 10000 100 000 1 000 000 10 000 000

Disasters in Europe by Victims/100000 Inhabitant

EM-DAT: The OFDA/CRED International Disaster Database – www.emdat.be

Disaster Profile of the Republic of Macedonia

EM-DAT: The OFDA/CRED International Disaster Database – www.emdat.be

EM-DAT: The OFDA/CRED International Disaster Database – www.emdat.be

Disaster Profile of the Republic of Macedonia

Epidemics in the Region 2000 -2009

Start End CountryLocatio

nType Sub Type Name

Killed

Tot.

Affected

00/07/2002 00/07/2002 Albania Gjinokastr

u Epidemic Unknown 226

29/08/2000 29/0082000

Bosnia-Hercegovenia

Tensaj Epidemic Viral Infectious Diseases

Acute hepatitis A 400

12/03/2003 20/04/2003 Italy Epidemic Viral Infectious

DiseasesAcute respiratory syndrome (SARS) 4

00/06/2002 00/06/2002 Italy Campania Epidemic Viral Infectious

Diseases 3 9997

30/11/2002 30/11/2002

R.MacedoniaKuman

ovoEpidemic Unknown 200

01/11/2001 06/02/2002

Serbia Montenegr

Lypjan, Ferizaj,

Prishtin…Epidemic

Bacterial Infectious Diseases

Tularemia 170

26/03/2003 26/03/2003 Spain Epidemic Viral Infectious

DiseasesAcute respiratory syndrome (SARS) 1

01/07/2001 18/07/2001 Spain Murcia Epidemic

Bacterial Infectious Diseases

Legionellosis 2 751

Created on: Mar-31-2009. Data version: v12.07

Extreme

Temperature

Flood

Drought

Epidemic

Transport

Accident

Wildfire

Windstorm

6%6%

6%6%

19%13%

44%Total number of natural hazardsPoly. (Total number of natural hazards)

1989

-199

3

1994

-199

8

1999

-200

3

2004

-200

60

1

2

3

4

5

6

7

Nu

mb

er

of

even

ts

Distribution of Different Hazards and Trends – R. Macedonia, 1989-2006

Dro

ug

ht

Ep

idem

ic Extr

em

e

tem

pera

ture

Flo

od

Tra

nsp

ort

Accid

en

t

Wild

fire

Win

dsto

rm

Nu

mb

er

of

death

s

Nu

mb

er

of

even

ts

Total deaths

Total events250

200

150

100

50

0

8

7

6

5

4

3

2

1

Hazard Incidence and Number of Deaths,Each Hazard- R. Macedonia, 1989-2006

Hazard Incidence and Total Number of Victims, Each Hazard - R. Macedonia, 1989-2006

Dro

ug

ht

Ep

idem

ic Extr

em

e

tem

pera

tu re

Flo

od

Tra

nsp

ort

Accid

en

t

Wild

fire

Win

dsto

rm

Nu

mb

er

of

vic

tim

s

Nu

mb

er

of

even

ts

Total victims

Total events

120000

100000

80000

60000

40000

20000

0

8

7

6

5

4

3

2

1

Dro

ug

ht

Ep

idem

ic Extr

em

e

tem

pera

ture

Flo

od

Tra

nsp

ort

Accid

en

t

Wild

fire

Win

dsto

rm

Econ

om

ic loss (

million

U

SD

) Nu

mb

er

of

even

ts

Total economic loss Total events

400

350

300

250

200

150

100

50

0

8

7

6

5

4

3

2

1

Hazard Incidence and Economic Lost due to All Hazard - R. Macedonia, 1989-2006

Total economic damages reported (2003 US$ million)

Total number of hazards (natural and technology)

1989

-199

3

1994

-199

8

1999

-200

3

2004

-200

60

50

100

150200

250

300

350

400

0

1

2

3

4

5

6

7

8

Data Source: EM-DAT: The OFDA/CRED International Disaster Database

Econ

om

ic loss (

million

U

SD

) Nu

mb

er

of

even

ts

Total Number of Hazards and Economic Losses – R. Macedonia, 1989-2006

Country

Annual average incidence of major hazards

Drought EarthquakeFlood

relatedWind

storm

Techno-

logy related

Albania 0.12 0.09 0.24 0.06 0.06

Bosnia and Herzegovina

0.17 X 0.28 0.17 0.17

Bulgaria 0.21 0.15 0.27 0.15 0.15

Croatia 0.28 0.06 0.22 0.17 0.17

Macedonia 0.17 X 0.22 0.11 0.11

Serbia and Montenegro

0.17 0.06 0.50 0.56 0.56

Source: Annual average incidence and death computed using EM-DAT, exposed population UNDP

Annual Average Disaster Incidence and Major Hazards

CountryAnnual average of deaths due to all

hazards

Exposed population

Drought Earthquake Floods

Albania 7.82 NA 155,688 131,704

Bosnia and Herzegovina

3.72 71397 NA NA

Bulgaria 6.64 325,406 NA 275,537

Croatia 8.61 NA 30,928 108,929

Macedonia 13.39 NA NA 17,784

Serbia and Montenegro

10.00 NA NA 321,934

Source: Annual average incidence and death computed using EM-DAT, exposed population UNDP

Disaster Vulnerability and Major Hazards

Disaster Impact Ranking

CountryDisaster

ranking

Disaster

impact

ranking

Cumulative

rank

Albania 10 5 9

Bosnia and Herzegovina 3 6 5

Bulgaria 5 8 7

Croatia 9 5 8

Republic of Macedonia 4 4 4

Moldova 8 3 6

Romania 2 2 2

Serbia 7 5 3

Montenegro 7 5 3

Slovenia 6 7 10

Turkey 1 1 1

Risk assessment

Country 1 2 3 4 5

Albania S N S N N

BiH N N N N S

Bulgaria N N N N S

Croatia S S N N S

Macedonia N N N N N

Country 1 2 3 4 5

Albania N N S S G

BiH N N U N S

Bulgaria N N S N S

Croatia N N S N S

Macedonia N N S S S

Emergency preparedness1. Emergency response planning2. Exercises3. Public awareness4. Communication & information management systems5. Technical emergency Response capacity

Institutional capacity building1. Decentralized emergency management system2. Sommunity participation3. Legislative framework4. Training, education & knowledge sharing5. International cooperation

Risk mitigation investments1. Warning and monitoring systems2. Hazard mapping and land-use planning3. Code refinement and enforcement4. Hazard-specific risk mitigation

Catastrophe risk financing1. Ex-ante funding arrangements2. Catastrophe insurance pool3. Reserve funds4. Contingent capital facility

Country 1 2 3 4

Albania N N N S

BiH N N N N

Bulgaria N N N N

Croatia S N N N

Macedonia S S N S

Country 1 2 3 4

Albania N N N N

BiH N N N N

Bulgaria N N N N

Croatia N U N N

Macedonia N N N N

G Good

S Satisfactory

N Needs improvement/not available

U Under construction

Is Disaster Preventable?

Nobody died of “disaster” People died of simple to treat and easy

recognized conditions Health consequences of disasters are

potentially catastrophic and preventable The preparedness is crucial!