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UM Public Health Experts Weigh in on Hurricane Dorian's Impact on The Bahamas

After major storms, disease outbreaks and other devastating events, experts in the University of Miami Miller School of Medicine's Department of Public Health Sciences have played a significant role in identifying the short- and long-term needs of those affected and have been instrumental in researching the all-around impacts of disaster.

After Hurricane Dorian – the strongest hurricane to ever make landfall in the Bahamas in early September – public health leaders, students, faculty and staff from the Miller School's Department of Public Health Sciences held a brainstorming session to discuss the deteriorating situation, potential relief efforts, and gather ideas on the various impacts of the storm. Medical needs, displacement, environmental concerns, mass migration, and mental health were topics of discussion.

“In the past, our faculty and students have assessed the quality of water, sediment, and air before and after Hurricane Maria in Puerto Rico, specifically in the Guanica Bay,” said Viviana Horigian, M.D., M.H.A., associate professor and director of public health education in the department.

Seated at the gateway to Latin America and the Caribbean, UM plays a unique role in aiding countries in the Americas.

At the brainstorming session, Elizabeth Greig, M.D., an internist, emergency response expert and an M.P.H. candidate in the department, shared information on the current conditions in the Bahamas, as she visited the island various times with a UM team to make needs assessments. She has also been working with Barth Green, M.D., executive dean for global health and community service, chairman and co-founder of The Miami Project to Cure Paralysis, and professor of neurological surgery at the Miller School.

Dr. Greig, who is also an assistant professor of medicine at the Miller School and medical director of UHealth on Fisher Island, said that there is a lot of work to be done in terms of infrastructure and that some of the islands have had major population shifts, such as the Grand Bahamas and the most impacted Abaco islands. Nassau, the capital of the island, for example, is seeing a greater number of people from these islands. People are also dispersing to other islands and the numbers in shelters and temporary housing is increasing.

Dr. Greig also emphasized that the department would play in integral role in UM’s response efforts, as the faculty, students, and staff have diverse expertise and experience in disaster research and response from previous storms.

James Shultz, Ph.D., voluntary professor of public health, recently visited the Bahamas with Dr. Greig and the UM team to assess needs, specifically in six shelters, four of which were disaster shelters.

Having written various papers on the aftermath of hurricanes in small island developing states, Dr. Schultz's expertise came into play as the team focused on various issues, including climate change, the mental health needs in affected islands, population health, the well-being of families currently sheltered in Nassau. The team also assessed threats of excess mortality for elderly, frail, and special medical needs patients, as well as on broader determinants of population health.

At the brainstorming session, attendees shared their experience on the public health issues from their work in other countries.

“We target those with chronic conditions, like HIV, hypertension, diabetes, and cancer," said Hermes Florez, M.D., Ph.D., M.P.H., professor of public health sciences, who has previously organized a series of missions in Colombia, where many Venezuelans have migrated.

"It is important to address their needs, as well as the needs of pregnant women, but it is important to first coordinate with the government on the efforts that have already been initiated, as we did with Venezuela and Colombia,” said Dr. Florez, who worked in partnership with MedGlobal, a medical non-profit that works to provide health care for vulnerable populations.

Attendees also talked about their work in mental health, displacement, infrastructure, and the environment outside of the United States. A lot of these topics were based on ways the department has helped islands in the past, specifically in Puerto Rico after Hurricane Maria.

Seth Schwartz, Ph.D., professor of public health and director of the Ph.D. in Prevention Science and Community Health Program, and students in the program, for example, look forward to helping Bahamians with the knowledge and skills that they have acquired through conducting research in Puerto Rico. They have previously studied the effects of acculturation – the process of retaining their cultural heritage and/or adopting a new culture – and mental health effects of Puerto Rican survivors of Hurricane Maria.

Currently, he is continuing to investigate the effects of stress and trauma on families and their adolescent children after the hurricane, such as alcohol misuse and mental health conditions. He is also examining the effects of unplanned relocation to South and Central Florida and of cultural-related stress on youth and their parents. The goal is to ultimately focus on intervention development.

“In populations like those in the Bahamas, who are a lot more conservative, it is very important to consider family roles. In Miami, we saw a lot more discrimination and Puerto Rican families who went through acculturation and substance abuse issues,” said Carolina Scaramutti, M.P.H., first-year candidate in the Ph.D. in Prevention Science and Community Health program.

Scaramutti, who works on Dr. Schwartz's team, also added that approximately 56 percent of families develop alcohol use due to acculturation. As many people go through withdrawal, this can affect family functioning, especially adolescents.

Saskia Vos, M.P.H., a third-year Ph.D. in Prevention Science and Community Health candidate, added that knowing the effects of acculturation from previous research, “would be powerful to help them in achieving this goal.”

As the session came to a finish, Dr. Horigian reminded everyone that, “We as UM can coordinate to help in the best way that we can.”

Written by Amanda Torres
Published on October 2, 2019