Assessing the public health impacts of disasters: A retrospective study of the October 2015 Hindu Kush earthquake in Pakistan

It is well-established that the rate of natural disasters has increased in the last three decades, with millions of people affected. The direct impacts of disasters, including earthquakes, have been monitored and documented; however, only limited information is available on the impact of natural disasters on healthcare institutions and communities. Even less information is available on the different ways in which aftereffects of these events are reflected in global and public health indicators. This study aims to assess and analyze earthquake-related public health impacts on communities and their health service-providing institutions. To this end, we conducted a case study of ten districts hit by the October 2015 Hindu Kush earthquake in Pakistan. We grouped these districts into two groups of five each: Group I include the districts most seriously affected by the earthquake in terms of death toll, number of injured and structural collapses; Group II includes the less-affected districts, which experienced lower mortality and injury rates and less structural damage than those in Group I. We retrieved six years of monthly data from the District Health Information System of the selected districts and analysed it to examine trends of ten indicators in pre- and post-earthquake contexts. Findings from both groups revealed that districts in Group I showed significant variation in trends relating to rates of communicable disease, e.g. tuberculosis and hepatitis C; of vector-borne diseases, e.g. malaria; and of psychological problems such as depression and anxiety. On the other hand, trends in indicators relating to health care services including antenatal care, immunization coverage, and postnatal care remained stable. It can be concluded that earthquakes does impact the health status and utilization of health service services within affected communities.