Transcript Human health at Risk: The Case of Cholera in Peru

Human health at Risk:
The Case of Cholera in Peru
Ross Edgeworth
Disaster & Development Centre
The Impact of Cholera
PERU
Peru at a Glance
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60% of population (7 million) live in poverty
14% liv60% of population (7 million) live in poverty
14% live in extreme poverty
Urban population 71%
10% without adequate water or sanitation
Lima, 7 million serviced by water supply designed for
230,000
• Existing supplies overstretched leading to sewage
contamination
Cholera in Peru
Reported January 1991
12,000 cases by mid-February
Spread to neighbouring countries by March
End of 1991: 400,000 cases, 4,000 deaths
Cause and Susceptibility
• Cause…? Disputed, most likely transported from China
• Original source of outbreak: most polluted town in Peru
• Rapid population growth– exceeding infrastructure
capacity
• External influence? Structural adjustment: Poverty
increased 11%, access to drinking water declined from
72% - 24%,
• Govt expenditure on public health fell 0.23% GDP –
0.04%, Govt expenditure on disease prevention fell $77
million - $2 million
Cause and Susceptibility
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Sewage
is released
directly beneath
houses, which are
often on stilts
Tidal flow (twice per
day) corresponds
with toilet flushing
People play, wash…
Cause and Susceptibility
• Global climatic changes responsible?
• Cholera bacteria lives in the environment
• El Niño current warmer in 1991, more vibrios
in aquatic environment which infect people
who drink water or eat fish or shellfish feeding
on the vibrios
Consequences of the Epidemic
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Global dimensions – fishing industry (56,000)
Ill fated Health Minister (pun intended)
Border closures
Tourist Industry lost $150 million (1991)
Shrimp exports declined $270 million
Overall loses at $770 million
For countries already struggling to provide basic
public health outbreak further undermined
capacity of governments to address underlying
causes of epidemic in long term