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Kathryn Barbara LT, MSC, USN

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Environmental Health Site Assessments in Southeast Asia USNS MERCY (T-AH 19) 2006 Humanitarian Assistance Deployment Kathryn Barbara LT, MSC, USN – PowerPoint PPT presentation

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Title: Kathryn Barbara LT, MSC, USN


1
Environmental Health Site Assessments in
Southeast Asia USNS MERCY (T-AH 19) 2006
Humanitarian Assistance Deployment
Kathryn Barbara LT, MSC, USN Navy Entomology
Center of Excellence Jacksonville, FL
2
MERCY DeploymentMay September 2006
Jolo, RP
Tawi Tawi, RP
Zamboanga, RP
Chittagong, Bangladesh
Simeulue Island, ID
Nias Island, ID
Dili, Timor Leste
Banda Aceh, ID
Kupang, ID
Tarakan, ID
3
USNS MERCY (T-AH 19) Public Health Cell
  • U.S. Navy
  • Forward Deployed Preventive Medicine Unit (FDPMU)
  • 1 Public Health Physician
  • 1 Microbiologist
  • 1 Industrial Health Officer
  • 1 Environmental Health Officers
  • 1 Entomologist
  • 1 Biological Technician
  • 6 Preventive Medicine Technicians
  • U.S. Public Health Service
  • 2 Primary Care Physicians
  • 2 Civil Engineers
  • 2 Environmental Health Officers
  • U.S. Air Force
  • 2 Public Health Officers
  • 4 Physical Health Journeymen
  • U.S. Army
  • 1 Veterinarian
  • 2 Veterinarian Techs

4
FDPMU-6Vector Component Mission
  • Conduct Environmental Health Site Assessments
    (EHSAs) on hospital grounds.
  • Provide vector surveillance and control to host
    nation (when possible).
  • Provide training and education in vector
    identification, surveillance, control to host
    nationals.

5
Common Encounters
  • Filth Flies
  • Improper Waste Management
  • Accumulation
  • Disposal
  • Hazardous Waste
  • Mosquitoes
  • Larvae
  • Adults
  • Force Health Protection

6
Waste Management
  • Trash accumulation

7
Waste Management
  • Trash maintenance
  • Burning
  • Burying

8
Waste Management
  • Biological Waste Disposal

9
Waste Management
  • Biological Waste Disposal

10
Waste Management
  • Trash disposal techniques
  • Patients and staff are often not educated in
    proper disposal practices

11
Waste Management
  • Hazardous Material Disposal

12
Filth Fly ManagementOur Contribution
  • Provided temporary control
  • Methomyl (Blue Streak)
  • Nithiazinine (Quick Strike)
  • Sticky fly paper

13
Filth Fly ManagementOur Contribution
  • Suggested ways to improve solid waste management

14
Mosquitoes
  • Larvae
  • Standing water common (commonly septic water)
  • Artificial containers
  • Open sewers and septic tanks
  • Adults
  • Limited surveillance conducted
  • Landing rates not conducted (inability to RON)
  • Interviews often revealed common disease vectors

15
Mosquitoes
  • Common Issues throughout deployment area
  • Rain water collection
  • artificial containers
  • often used for drinking or wash water

16
Mosquitoes
  • Common Issues throughout deployment area
  • Rain water collection
  • artificial containers
  • often used for drinking water
  • Open sewer systems
  • Culex spp.

17
Mosquitoes
  • Common Issues throughout deployment area
  • Rain water collection
  • artificial containers
  • often used for drinking water
  • Open sewer systems
  • Open or unsecured septic tanks

18
Mosquitoes
  • Common Issues throughout deployment area
  • Rain water collection
  • artificial containers
  • often used for drinking water
  • Open sewer systems
  • Culex spp.
  • Open or unsecured septic tanks
  • Indonesian Style toilets/
  • mandi

19
Mosquitoes
  • Common Issues throughout deployment area
  • Rain water collection
  • artificial containers
  • often used for drinking water
  • Open sewer systems
  • Culex spp.
  • Open or unsecured septic tanks
  • Indonesian Style toilets
  • Open windows or doors

20
Mosquitoes
  • Adults
  • Limited surveillance conducted

21
Mosquitoes
  • Adults
  • Limited surveillance conducted
  • Landing rates not conducted (often unable to RON)

www.collier-mosquito.org/factsheet.asp
22
Mosquitoes
  • Adults
  • Limited surveillance conducted
  • Landing rates not conducted (inability to RON)
  • Interviews often revealed prevalent disease
    vectors
  • Unable to leave secured area around hospital due
    to force protection concerns

23
Mosquito ManagementOur Contribution
  • Larval insecticide applications
  • No adult applications (inability to RON)
  • Donations of larval and adult insecticides
    compatible with host nation equipment
  • Advice on IPM techniques and equipment maintenance

24
Training Activities
  • Requested at nearly every location
  • The most valuable product delivered to the
    countries visited
  • Audiences consisted of
  • Physicians, nurses, mid-wives
  • Medical/ nursing students
  • Sanitarians/ public health workers
  • Non-governmental organization members

25
Training Activities
  • Classes were didactic and/or hands on
  • Class sizes ranged from 5-200 students
  • Topics included
  • Mosquito biology, identification, and control
  • Country specific disease and vector information
  • Integrated pest management
  • Non-chemical pest management

26
Training Activities
  • Development and distribution of educational
    pamphlets and posters

27
Training Activities
28
Overall Effectiveness/Lessons Learned
  • Training of host nation public health personnel
    is a high-impact activity for Preventive Medicine
    as component of humanitarian assistance missions.
  • Preventive Medicine team could have been more
    effective if they had the ability (and security)
    to asses community efforts.
  • Longer duration of visits would be more effective
    for preventive medicine efforts.

29
Overall Effectiveness/Lessons Learned
  • Use of the FDPMU equipment set and personnel is
    appropriate for HA missions.
  • A preventive medicine professional should be a
    part of the advanced party.
  • Remaining overnight is required for effective
    vector control measures.

30
Thank You
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