disaster epidemiology in the republic of macedonia prof. d-r elisaveta stikova md, phd medical...
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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!
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