Wildfires are large, uncontrolled and
destructive fires that spread quickly over woodland, brush or an area of combustible
vegetation, mostly in rural regions. Depending on the
kind of vegetation involved, wildfires may also be referred to as forest fires,
grassland fires, bush fires, brush fires, urban fires or wildland fires. Wildfires
could happen in most
parts of the world except places like the Antarctica. Fire
is always seen as a good servant and a terrible master; in the case of
wildfires, it evolves from being not just a terrible servant but an enraged god
causing loads of destruction to life, properties, environment and natural resources.
Wildfires can occur naturally and
spontaneously due to factors like lightning and heat- extremely dry heat waves
can produce enough heat to spark a wildfire. Dry weather and drought convert
green vegetation into dry, flammable fuel; strong winds spread fire quickly
over the land and warm temperatures encourage combustion. Additionally, humans
also contribute to this disaster either accidentally or deliberately through
campfires, careless cigarettes disposal, burning etc. According to the national
interagency fire center,
human beings cause about sixty one thousand eight hundred and fifty two (61,852)
fires yearly.
Wildfires can burn hundreds to
millions of acres of land at rapid speeds consuming everything on its path from
trees to animals and humans. The largest single fire ever recorded was that of
the 2003 Siberian Taiga fires- 27 million Acres of land engulfed in flames and
about 47 people died, emissions from the fire equaled the emission cuts
promised by the European Union under the Kyoto protocol. The scars caused by
this fire are still seen in present day environmental studies on ozone depletion.
Some
countries like Canada and Australia have accepted wildfires as an integral
component in shaping their forests. Their ecological system has developed
symbiosis with the fire which in turn affects the air quality and landscape.
Wildfires and industrial activities result in the release of greenhouse gases
which increase the level of heat through the depletion of the ozone layer- the heat
in turn increases the rate to which the wildfires can occur. This causal sequence explains the increased frequency
of fires around the amazon basin as well as the recent California fire
outbreaks.
The war on climate change is far from ending if the
problems of wildfires are not properly addressed. Wildfires pose immediate and serious
public health threats to individuals living around the region and also to
everyone on planet earth- there are already increased reports of respiratory
diseases among Brazilian children.Wildfire prevention
starts from different agencies that cover restrictions but ultimately depends
on the behavior of the general public. In order to stop and reduce the rate or
frequency of wildfires, regulating bodies need to be vigilant and enact the
necessary laws and policies important in tackling this issue. Data of previous
fire incidents should be continuously reviewed and compared with the weather
forecast to recognize dangerous patterns so as to know how to manage them
effectively. People living in fire susceptible areas should be well educated
and constantly informed through various means of communication about any slight
change in their environment. Programs like firewise, community wildfire
protection plan and fire
adapted communities are
plans that work
to protect people, properties and natural resources by emphasizing forest fire
readiness and creating fire resistant community designs. These and more
regulations will help in preventing and containing wildfires as well as minimizing
spreads and damage to the environment.
Health care workers are often at increased risks of
infections due to their immediate work environment. The potential risk to their
health is an important public health issue that is particularly neglected in many
developing countries. The 2006 World Health Report-Working Together for Health
reported a severe health workforce crisis In fifty-seven (57) countries- most
of them in Africa and Asia. In Nigeria for example, during the 2014 Ebola
outbreak, Dr Stella Adadevoh and some other health care workers lost her lives
while trying to prevent Ebola spread from Port Harcourt to Lagos and other
parts of the country- sadly without receiving a national honour or credit for their
efforts and bravery. It is a costly price for health workers to lose their
lives in the course of their service but unfortunately, the list of healthcare
workers that have lost their lives in a similar fashion is unending. There are
various kinds of hazards to which health workers are exposed-they include, Biological
hazards which is a group of hazards including infectious agents like Ebola
mentioned above, HBV, HIV etc. Other forms of hazards can be physical hazards,
chemical hazards and psychosocial hazards.
Biological hazards such as infectious agents pose serious risk to the
lives of every health care personnel. These workers may be exposed through
inhalation, contact with bodily fluids and more importantly, needle stick
injuries. In fact, the WHO global burden of disease from sharps injuries to
health-care workers showed that 37% of the hepatitis B among health workers was
the result of occupational exposure. Sometimes, these are due to either mistakes
from the health worker or poor disposal of wastes.
Health workers are also affected by physical hazards including fire and
radiation as well as work related violence just like industrial workers. Fire
hazards have been reduced due to widespread public health measures but there
are still risks of harmful radiation exposure as radiation is a part of
diagnostic medicine. Work related violence is a common problem in developing
countries- studies have shown that over 90% health workers especially nurses,
have been abused physically or verbally.
Chemical hazards from toxic substances used in routine
medical practice mostly result in injury unlike biological hazards that can
lead to death. Also, allergy from latex gloves is an important form of chemical
hazard. Similar to biological hazards, they can also be due to mistakes from
the health worker and poor disposal of wastes. Finally, there are psychosocial
hazards that affect the mental health of health workers. These are mostly due
to very long work time leading to physical and emotional exhaustion, low pay in
developing countries and stress induced illnesses such as hypertension. These
emotional hazards inflict invisible wounds that reduce the efficiency and
efficacy of health workers. This is then reflected in the poor quality of care
and health systems experienced by the public at large.
The WHO and other international health organisations continue
to advocate for better occupational health through practices like use of post
exposure prophylaxis, vaccination of health workers, increase in wages and trainings
to prevent occupational hazards and its consequences in the health care system.
According to World Health Organization (WHO), healthcare associated
infections (HCAIs)constitute a significant public health burden with about 15%
of hospitalized patients affected- leading to an increase in morbidity, mortality
and healthcare costs. Also known as nosocomial infections, healthcare
associated infections are regarded as infections that occur within 48 hours of
hospital admission, 3 days of discharge or 30 days of an operation. HCAIs pose
serious problems because the organisms implicated are usually drug resistant, the
most common ones being methicillin resistant staphylococcus aureus (MRSA) and
multi-drug resistant gram negative bacteria.
Given to the presence of several risk factors, intensive care unit (ICU)
patients are by far the most affected group by nosocomial infections. The risk
factors associated with HCAIs include:
- Health status: Since most patients are exposed to
similar conditions, the current health status and immunity of a patient
determines the risk of infection of particular patients. Some vulnerable
and immune-compromised patients may be malnourished or elderly.
- Invasive procedures: Some hospital procedures,
especially surgery, involves the use of materials like catheters, lines
and drains which when left for a long time can serve as a nidus for
infection
- Treatment: Some treatment modalities can pose
risk to infection e.g. blood transfusion, hemo-dialysis and immunosuppressive
treatments
- Poor and unhygienic hospital practices: Poor
sanitation and improper disposal of hazardous healthcare wastes can expose
patients to infectious pathogens. Also, healthcare workers could play a
role as vectors of infectious agents when they fail to take standard
precautions.
Perhaps, the most important historical guide on
addressing HCAIs was by the Hungarian physician- Ignaz Semmelweiz, who
demonstrated that hand washing drastically reduced the incidence of puerperal
fever in childbearing women. Even though his teachings were not accepted by
physicians at that time, it laid the foundation for antisepsis. Till today, regular
and proper hand washing remains the single most important measure in infection
control. Proper hand washing should involve the use of alcohol disinfectants or
medicated soap after removal of jewellery like watches, rings and should not be
replaced with gloving. Hospitals should provide more wash sinks and easier to
use disinfectants like sprays to encourage regular hand washing. To improve
hygiene in general, healthcare facilities should provide enough personal
protective materials such as overalls, gloves and nose masks which must not be
reused. Also, healthcare workers must endeavour to engage in regular daily
cleaning of stethoscopes with alcohol and observing complete aseptic procedure
in invasive procedures to reduce the risk of infection.
In addition, it is pertinent that the healthcare
system ensures enlightenment of caregivers and students alike on the importance
of standard precautions of everyday practice in reduction of nosocomial infections.
Also, there must be proper disposal of hazardous healthcare wastes which can
harbour dangerous infectious organisms that are drug resistant. The related
problem of antimicrobial resistance can then be reduced by good antimicrobial
stewardship.
Global Health Security
is defined as actions required to reduce the health hazards and impacts of
acute public health events that endanger the health of populations living
across geographical regions. GHSA pursues a multi-sectoral approach to strengthen global and
national capacity to prevent, detect, and respond to human and animal
infectious disease threats, whether occurring naturally, accidentally or
deliberately spread. Global health security emphasizes the
current framework for global preparedness and response to emerging infectious
diseases. The Global Health Security Agenda (GHSA) which is a partnership
between governments was launched in 2014 with the aim to make the world safe
from infectious disease threats. The governments involved in the Global Health
Security Agenda focused on strengthening their countries’ capacities for the detection,
response and prevention of health problems and threats. More than 70%
of the world remains underprepared to prevent, detect, and respond to a public
health emergency.
Through the GHSA, the
Center for Disease Control and Prevention (CDC) works with countries to
strengthen public health systems and contain outbreaks at their source, before
they evolve into regional epidemics or global pandemics. Public health threats,
health emergencies, and infectious diseases do not recognize or respect boundaries;
therefore, effective and functional public health systems in all countries
reduce the risk of health threats. Protecting the world from infectious disease
threats requires that national governments share the responsibility of serving
those most in need, regardless of where they live. All countries have a
responsibility to keep their people safe because collective international
public health action can build a safer future for humanity. In the context of
public health emergencies, GHSA has received both financial and political
support from several international organizations and about 50 countries. Unfortunately,
global health security is mostly focused on protecting high-income countries from
pandemics originating from low- and middle-income countries such as Ebola
virus, Marburg, Zika virus, dengue, chikungunya, Rift Valley and Lassa fevers.
Values such as
respect for human rights and solidarity, as well as focus on the prevention of
future outbreaks rather than emphasis on disease containment to protect
national security, must be incorporated by GHSA. Such values are consistent
with the motives of many people who provide health services in public health
emergencies. Health security agendas should aim to build resilience to future
outbreaks of infectious diseases, and require a long-term systems approach based
on surveillance and national health system strengthening. To ensure that GHSA
is a fundamental part of the national policy of every country, political
attention, financial support and coordination between national ministries is necessary.
Additionally, all countries need to have the laboratory, trained workforce,
surveillance, and emergency response team to prevent, detect, and respond to
disease threats. Only when these accomplishments are realized can we truly be
on the road to global health security for infectious diseases.