Disaster and then Disease

By Elizabeth Batt

The International Federation of Red Cross and Red Crescent Societies, describes a natural disaster as a “sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, material, and economic or environmental losses that exceed the community’s or society’s ability to cope using its own resources.”

The earthquake in Haiti that occurred on January 12, 2010, caused death and destruction, the extent of which has yet to be realized. Sadly, Haiti’s problems might be only just beginning. Often following the initial aftermath of any natural disaster there follows a second wave of deaths, caused by disease.

Types of Disease Prevalent in the Aftermath of a Natural Disaster
When a natural disaster strikes to the extent that it did in Haiti, the infrastructure of a country is decimated. Fresh water supplies, sewage disposal and power is destroyed or severely interrupted. What remains is often contaminated, initiating a vicious cycle that cultivates communicable diseases. In a third world country like Haiti, where resources are already stretched thin and immunizations are not standard practice, the loss of life is certain to be much higher because they’re simply not equipped to deal with an incident of this magnitude.

The study, “Management of dead bodies in disaster situations.” PAHO; 2004, indicates that little threat for communicative disease outbreak is posed by actual human remains. The threat comes from the survivors themselves, the destruction of their surroundings and an inevitable crowding situation caused by displacement. Without a continuous fresh water supply, survivors are forced to drink polluted water just to stay alive. Aided by the lack of adequate sanitary conditions, these pollutants are ingested and then defecated back into the water source. It becomes a breeding ground for communicable diseases.

Water-related Diseases
Water-related diseases include infectious diarrhea or norovirus, salmonella and cholera. Noroviruses are transmitted through the fecal-oral route after the ingestion of contaminated food and water. Once infected, a person-to-person transmission can occur. Noroviruses cause diarrhea and vomiting that without adequate sanitization amenities, continue to perpetuate.

Salmonella is often referred to as food poisoning. It causes the same symptoms as norovirus and can be present in almost any type of food. Salmonella is transmitted through infected feces that come into contact with a food source. People can become carriers of salmonella, transmitting the disease for life.

Cholera, transmitted by the fecal-oral route has an extremely brief incubation period of just 2-5 days. It can cause acute diarrhea, dehydration and kidney failure. Of all water-related diseases, cholera is perhaps the most insidious and can kill an adult within hours.

Crowding-related Diseases
The three most common crowding-related diseases are meningitis, measles and acute respiratory failure (ARF). Meningitis causes an inflammation of the membranes surrounding the brain and spinal cord and can lead to permanent neurological damage. Measles is a highly contagious viral disease that can cause seizures and coma. The complications of measles can include blindness and brain inflammation. ARF has a high morbidity rate of 50-70% in both children and adults. Caused by inadequate gas exchange, oxygen levels drop and carbon dioxide levels rise. An effect of displacement, over-crowding issues and poor nutrition, ARF is a major cause of death.

Vectorborne Diseases
Vectorborne diseases are caused by “vectors” such as mosquitoes that carry malaria. Earthquakes and other natural disasters can change a habitat, as evidenced in Saenz R, Bissell RA, Paniagua F. "Post-disaster malaria in Costa Rica." Prehospital Disaster Med. 1995;10:154–60. This change in habitat can create conditions that are ripe for breeding, causing an upsurge in outbreaks of malaria. Children are particularly at risk of contracting malaria, a virus that in its most dangerous form, can affect the brain and kidneys. Dengue, also carried by mosquitoes, can develop into dengue haemorrhagic fever. The spread of dengue can be directly related to inadequate solid waste disposal and water storage. Without treatment, fatality rates can exceed 20%.

Haiti's challenges are far from over and despite aid being sent to this ravaged country, the death toll as it stands now, is certain to rise.

Teen Suicide Risk Factors: Parents Are Too Often Clueless

By Nancy Shute

Suicide is the third leading cause of death among teenagers, and it's a tragedy that can be prevented. Given that almost 15 percent of high school students say they've seriously considered suicide in the past year, parents and friends need to know how to recognize when a teenager is in trouble and how to help.

Parents can be clueless when it comes to recognizing suicide risk factors, or at least more clueless than teens. In a new survey of teenagers and parents in Chicago and in the Kansas City, Kan., area, which appears online in Pediatrics, both parents and teenagers said that teen suicide was a problem, but not in their community. Alas, teen suicide is a universal problem; no area is immune.

The teenagers correctly said that drug and alcohol use was a big risk factor for suicide, with some even noting that drinking and drug use could be a form of self-medication or self-harm. By contrast, many of the parents shrugged off substance abuse as acceptable adolescent behavior. As one parent told the researchers: "Some parents smoke pot with their kids or allow their kids to drink."

Both teenagers and parents said that guns should be kept away from a suicidal teen. But since parents said they didn't think they could determine when a teenager was suicidal, parents should routinely lock up firearms, the researchers suggest. That makes sense. Firearms are used in 43.1 percent of teen suicides, according to 2006 data, while suffocation or hanging accounts for 44.9 percent.

The good news: Both parents and teenagers in this small survey (66 teenagers and 30 parents) said they'd like more help learning how to know when someone is at risk of committing suicide and what to do. Schools and pediatricians should be able to help, but we can all become better educated through reliable resources on the Web. These authoritative sites list typical signs of suicide risk, and they also provide questions a parent or a friend can ask a teenager to find out if he is considering killing himself. Here are good places to start:

The American Academy of Child and Adolescent Psychiatry lists signs and symptoms of suicidal thinking, such as saying things like "I won't be a problem for you much longer."

The American Academy of Pediatrics urges parents to ask the child directly about suicide. "Getting the word out in the open may help your teenager think someone has heard his cries for help."

The National Suicide Prevention Lifeline provides free advice to someone considering suicide, as well as to friends and relatives, at 800-273-TALK.

The National Alliance on Mental Illness's teenage suicide page makes the point that talking with someone about suicide will not "give them the idea." "Bringing up the question of suicide and discussing it without showing shock or disapproval is one of the most helpful things you can do," the NAMI site says. "This openness shows that you are taking the individual seriously and responding to the severity of his or her distress."

Crime Scene Cleanup: What It Involves

A crime scene cleanup service is not without its complications. Crime scene cleaning encompasses restoring the crime scene to its original state. When a crime is usually discovered, crime scene cleaners are not called until after officers of the law, like the crime scene investigators, have done their jobs first and have given the go ahead for the cleaners to come in. If you intend to hire a crime scene cleanup company, you must make sure that they are well equipped and fit right to get the job done. A crime scene presents challenging conditions.

The Use Of Protective Gears:
Crime scenes can very well involve the use of hazardous or deadly substances. For safety reasons then, it has become imperative that crime scene cleaners use protective clothing, in addition to protective tools and gadgets. You must see to it that they have all the necessary protective gears and gadgets. The protective clothing can consist of disposable gloves and suits. A disposable gear is preferred nowadays since it offers the best protection against contamination. You use it one time and get rid of it. That way, the dangers of contamination is virtually brought down to zero percent. Protective clothing extends to respirators and the use of heavy-duty industrial or chemical-spill protective boots.

Among the gadgets that a crime scene cleaning company must have are special brushes, special sprayers, and wet vacuum. These special tools ensure added protection against getting into contact with the hazard could very well be present in the crime scene. There is large, special equipment such as a mounted steam injection tool that is designed to sanitize dried up biohazard materials such as scattered flesh and brain. You would also need to check if they have the specialized tank for chemical treatments and industrial strength waste containers to collect biohazard waste.

Of course, any crime scene clean up must have the usual cleaning supplies common to all cleaning service companies. There are the buckets, mops, brushes and spray bottles. For cleaning products, you should check if they use industrial cleaning products. A crime scene cleaning company must have these on their lists:

1 - Disinfectants including hydrogen peroxide and bleaches - The kinds that the hospitals used are commonly acceptable.

2 - Enzyme solvers for cleaning blood stains. It also kills viruses and bacteria.

3 - Odor removers such as foggers, ozone machines, and deodorizers

4 - Handy tools for breaking and extending such as saws, sledgehammers, and ladders

Established crime scene operators also equip themselves with cameras and take pictures of the crime scene before commencing work which. The pictures taken may prove useful for legal matters and insurance purposes. You never know which.

Needless to say, a specially fitted form of transportation and proper waste disposal is also needed. These requirements are specific. As you can imagine, crime scene cleaning is in a different category on its own. A home cleaning or janitorial service company may not be able to cope up with the demands of a crime scene. A crime scene cleanup service requires many special gears and tools that a home cleaning or a janitorial service company does not usually have or does not require. Crime scene cleaning if not done correctly can expose the public to untold hazards.

What Else To Look For In A Crime Scene Cleanup Company
You may also want to hire a company that has established itself. An experienced company with a strong reputation is always a plus but it could be expensive too. You will do well to balance your needs with what is your budget. There are several companies that offer specific prices such as for death scene clean up categories and suicide clean up categories. Most companies own a website and have round the clock customer service as receptionists.

When looking for a suitable crime scene cleaning service, among the first things you need to do is to scout for price quotes. Crime scene cleanup services usually provide quote after they have examined the crime scene and then they give you a definite quote. Factors that are usually considered include the number of personnel that will be needed to get the job done. It also includes the amount of time that might be needed. The nature and amount of the waste materials that need to be disposed will also be factored in. You can be sure that the more sophisticated equipments needed the more expensive it will get.

Crime Scene Cleanup And Your Insurance
For homeowners, the best approach is always to make sure that crime scene cleanup services clauses and provisions are written down on the contracts or policies. The inclusion of crime cleanup services clauses is very common and has become standard clause in most homeowner’s policy. Make sure that you are covered for this unforeseen event. Make sure that your policy directs the crime scene cleaning company to transact directly with the homeowner insurance company. A crime scene cleaning service is usually a standard clause in many homeowners’ insurance clause. These companies often do the paperwork in behalf of clients.

If for some reason you do not have such coverage by any policies relating to crime scene cleanup on your home, there are ways to keep your expenses controlled.

Finding the right company can be very taxing, especially that you have to deal with the emotional stress stemming from the crime itself, especially with a crime scene involving death.

There are many crime scene cleanup companies in operation nowadays. There are reliable professionals that you can hire and prices are relatively competitive. As of recently, crime-scene cleanup services can cost up to $600 for an hour of their service. A homicide case alone involving a single room and a huge amount of blood can cost about $1,000 to $3,000.

In recent years, crime scene cleaning has come to be known as, "Crime and Trauma Scene Decontamination or CTS. Basically, CTS is a special form of crime scene cleaning focusing on decontamination of the crime scene from hazardous substances such as those resulting from violent crimes or those involving chemical contaminations such as methamphetamine labs or anthrax production. This type of service is particularly common when violent crimes are committed in a home. It is rare that the residents move out of the home after it has become a scene of a crime. Most often, the residents just opt to have it cleaned up. That is why, it is very important to hire the best crime scene cleaning company out there. The place needs to be totally free from contamination of any kind. You have to make sure that the company is able to remove all traces of the violent crime that took place. This includes cleaning biohazards that are sometimes invisible to the untrained eye.

Legally speaking, federal laws state that all bodily fluids are deemed biohazards and you should make sure that the cleanup service company you hire understands this and includes it in the cleanup. These things appear as blood or tissue splattered on a crime scene. You must be able to hire a company that is equipped with special knowledge to safely handle biohazard materials. The company must have the knowledge what to search for in any give biohazard crime scene. For instance, the company should be able to tell clues such that if there is a bloodstain the size of a thumbnail on a carpet, you can bet that there is about a huge bloodstain underneath. Federal and State laws have their own laws in terms of transport and disposal of biohazard waste. Make sure that the company you hire has all the permits necessary.

It will also be a huge plus if you could hire people who not only has the special trainings but also who have the nature to be sympathetic. If you are close to the victim and have the cleaning done at the behest of the victim’s relatives, it would matter that the cleaners tread the site with some level of respect. It is a common site that family members and loved ones are often there at scene. In general, when looking for a suitable crime scene cleaners, you would take into considerations the kind of situation that the crimes scene presents and the demands that it require. Crime scene cleaning companies handle a wide variety of crime scenes and prices may vary from one to the other crime scene and one to the other company.

Each type of scene requires its own particular demands not only to make the crime scene look clean and neat on the surface but to make it germ free, and clean inside and to make it free from all deadly and infectious substances. The cleanup cost for biohazards may vary depending on degree of the bio hazard(s) on the scene. There may even be a category that changes the cleanup pricing which usually involves decomposing bodies and carcasses. Likewise, a cleanup of chemical hazards vary, depending on the amount of chemical hazards as well as the grades i.e. how hazardous the substance is in terms of human contact. Prices are also determined by the number of hours and personnel that it would to get the crime scene cleaned. In addition, the "gross factor" from crime scene involving death and gore needs to be taken under consideration regarding the chemicals that will be used as opposed to those crimes' that do not have gore involved.