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Vol. LXII, No. 18
September 3, 2010
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Disease Potential Detected
Pest Expert Team Examines Post-Quake Conditions in Haiti

On the front page...

Trevor Lubbert was advised to expect a war zone. Never having visited a war zone, however, he still was unprepared for his first view of post-earthquake Haiti.

The humidity and heat hit him first. His next impression was of the large throngs of people hailing him and his party at the airport. Crowds of citizens seemingly size up every incoming group for their potential to offer help in the devastated nation.

Continued...


  One of many tent cities where temporary housing has become semi-permanent in post-quake Haiti  
  One of many tent cities where temporary housing has become semi-permanent in post-quake Haiti  

Lubbert, an urban/industrial pest management specialist and board-certified entomologist at NIH, was one of 11 technical experts in the field to visit Haiti recently at the invitation of the National Pest Management Association (NPMA), a non-profit organization that paid all expenses for the trip.

Sweating the Small Stuff

It’s okay to call them the “bug guys” or “critter crew.” They are qualified to look for and deal with every kind of insect—flies and mosquitoes, for instance—as well as cockroaches and rodents.

And lest you think little creatures can’t cause big problems, consider this: According to the NPMA, “cockroaches can spread at least 33 different types of bacteria, 6 kinds of parasitic worms and at least 7 other kinds of human pathogens. Cockroach allergens are also known to trigger asthma attacks, with an increased incidence in children. Mice can carry fleas, mites, ticks and lice on their bodies, while rats urinate on food and support many external parasites. Rodents spread filth, contaminate food and transmit disease…flies are vectors of more than a hundred different types of disease-causing germs.”

Those are just some of the health effects. We won’t go into the structural damage termites can cause.

Acknowledging conditions that could severely hamper the nation’s rebuilding efforts, Haiti’s minister of the environment asked NPMA to gather a delegation to “assess pest management problems and develop a treatment plan to minimize Haitians’ exposure to disease-carrying pests.” The all-volunteer team was accompanied by NPMA’s executive director and two camera operators who documented parts of the experience for NPMA’s blog. Lubbert attended as the only U.S. federal worker and the only pest professional on the team who has experience in pest management for biomedical research/health care settings.

Dr. Sally Rockey is NIH’s new deputy director for extramural research. Dr. Sally Rockey is NIH’s new deputy director for extramural research.

Above:
The NPMA team found evidence of termite infestation in this building’s support beam and roof.

Left:
The first hospital the group visited in Port-au-Prince was a privately operated facility. Many of the city’s buildings, though in stages of unfinished construction, were occupied and in use.

NIH entomologist Trevor Lubbert (top, third from l) was among a delegation of pest management experts invited to visit Haiti to assess whether earthquake-recovery efforts were being impeded by insects, rodents and other pests. Several of the technical experts have since returned on follow-up missions.  
NIH entomologist Trevor Lubbert (top, third from l) was among a delegation of pest management experts invited to visit Haiti to assess whether earthquake-recovery efforts were being impeded by insects, rodents and other pests. Several of the technical experts have since returned on follow-up missions.  

Potential Pest Problems

Moments into the group’s ride into central Port-au-Prince, the country’s capital city and virtual epicenter of the Jan. 12 earthquake, Lubbert saw evidence of the destruction firsthand.

“Even the structures that are still standing show signs of the stress and damage they’ve been through,” he said. “The walls are cracked. There’s no rebar in them.”

In terms of the pest managers’ 3-day mission there, Lubbert and his colleagues also found a lot of potential trouble. At the first hospital—a private medical facility—the group visited, Lubbert immediately spotted a danger sign before they even entered the facility.

“I could see a huge mosquito-breeding body of water on the side of the hospital that continued underneath the structure,” he said. “Sure enough as we approached the area, I saw that the water was teeming with mosquito larvae. In addition, we found filthflies, including houseflies and blowflies, which are known for spreading disease.”

Structural damage of some kind marked most downtown buildings. Many are condemned. A goat meanders through makeshift dump in the city. The delegation witnessed a variety of domestic animals foraging unleashed.
 

Above, l:
Structural damage of some kind marked most downtown buildings. Many are condemned.

Above, r:
A goat meanders through makeshift dump in the city. The delegation witnessed a variety of domestic animals foraging unleashed.

Below:
Blowflies, which are known to show up at the first sign of waste and can cross-contaminate surfaces, were rampant during Lubbert’s visit.

  Blowflies, which are known to show up at the first sign of waste and can cross-contaminate surfaces, were rampant during Lubbert’s visit.

Inside, conditions were just as bad. Windows and doors were without screens and there were holes in the ceiling straight through to the roof, so patients were completely exposed to the damp, humid air as well as any flying or crawling pests.

In addition, unsanitary practices were making conditions worse. Trash and refuse bins contained no plastic liners, so even empty the receptacles harbored germs from previous contents. Bedpans and linens were not being changed regularly, so flies and other winged pests were likely cross-contaminating any surfaces they landed on, including the eyes, noses, mouths and open wounds of patients.

Similarly, biowaste such as needles, syringes and ampules were not being disposed of properly. Lubbert saw such items tossed out an open window onto a makeshift dump site along one of the hospital’s walls. Animals such as goats, pigs and pet dogs were loose, left to wander through the garbage.

“This was the case throughout the city of Port-au-Prince,” said Lubbert.

At nearly every facility the group visited—including two hospitals, a waste transport center and several “tent cities,” where Haitians are living while their city is recovering—serious issues involving bug and rodent control were evident.

“From what we saw, the people definitely have potential for a major epidemic,” Lubbert said.

Suggested Strategies

In response, NPMA pledged to raise at least $250,000 in donations to help empower the Haitian people with information and resources. The organization put together a program for comprehensive pest management strategies that include:

  • Structural fixes. Haitian workers will be engaged to patch holes, seal openings and install screens in building windows and doorways.
  • Sanitation suggestions. The delegation recommended a program of good waste management practices, with such easily adopted solutions as simple plastic bags to line trash receptacles and regular changing and proper disposal of the bags.
  • Cultural reorientation. Haitian government officials and local pest management firm Boucard will help design culturally sensitive and relevant programs to train individuals and groups to sustain the pest management practices.

NPMA will also develop a public awareness campaign on basic pest management strategies that citizens can accomplish easily in their homes, schools and other general environments.

Lubbert and the rest of the group left Haiti energized and motivated to come back for follow- up visits.

“The delegation will return to train people,” Lubbert said. “We want to make it a model for hospitals, schools and other public facilities.” NIHRecord Icon


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