Towards Health Equity in Cuba
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Hurricane Wilma: Living to Tell the Tale

By Conner Gorry

By the Numbers: Hurricane Wilma

People evacuated: 607,542 (over 537,200 with friends or family, the rest in shelters)

Number of shelters: 1,325

Animals moved to higher ground: 413,850

Volunteers mobilized: 103,000

Greatest wind gusts: 86 mph

Greatest sustained winds: 67 mph

Hurricane Wilma was a record breaker and history maker, escalating from a tropical storm to a full-blown Category 5 hurricane in a matter of hours, making it the fastest intensification of any storm on record. By the time it sideswiped Cuba on October 23rd, lashing coastal regions with 20-foot waves that traveled almost a half mile inland, it had mellowed to Category 3 - still powerful enough to rip electrical posts from the ground, send roofs flying and flood some Havana neighborhoods beyond recognition.

Nevertheless, there was zero loss of life on the island, in contrast to other experiences in the region, with 12 dead in Haiti, two in Jamaica, eight on the Yucatán Peninsula and five in Florida. Cuba’s minimal loss of life from this and even stronger storms is by design: internationally recognized as efficient, effective and replicable, the disaster preparedness system in the hurricane-thrashed nation has proven that accurate information given early and often, combined with a series of coordinated measures, can save lives.

A mother and daughter move to higher ground in Havana´s Vedado district during Hurricane Wilma.

Forecasting, Cuban authorities have found, plays a critical role. A full 96 hours before a tropical storm or hurricane is expected to hit the island, the National Forecast Center issues an Early Advisory. This is followed by an Information Phase, 72 hours before, when all media begin special reports on the trajectory and progress of the storm. At this time, the public starts preparing for a possible hurricane strike, taking measures they’ve learned over the years - including storing potable water, stocking up on non-perishable food and securing doors and windows of their homes. At this stage, civil defense officials also begin reviewing and updating disaster plans.

Cuba is one of the few countries that use these Early Advisory and Information Phases as preludes to the Hurricane Watch (48 hours before a strike is expected) and Hurricane Warning (24 hours before). According to Dr. José Rubiera, Director of the National Forecast Center, “by the time we issue the Hurricane Warning, almost everything is in place.”

As the storm rolls in, above-ground electricity is cut when winds reach about 40 miles an hour, preventing electrocution deaths caused by downed wires – a common cause of hurricane-related fatalities. Some Havana residents grumbled that their power was cut too early in slow-moving Wilma’s trajectory, leaving them without electricity for hours before the fiercest winds hit. Nevertheless, they called the precaution itself necessary.  

Evacuate….Or Not

Cuba’s evacuation procedures prioritize vulnerable populations, from pregnant women and the elderly to residents in low-lying villages; and importantly, transportation is provided for all those evacuated. During Wilma for instance, the entire seaside community of Playa Rosario on the southern coast of Havana Province had to be moved to safer ground, so scores of buses were brought in to evacuate the townspeople. Once the storm had blown through, only three of 113 homes were left standing, but no injuries or loss of life were reported.

Evacuations from flooded areaswere carried out by specialist teams in small boats.

In a country heavily dependent on revenue from foreign visitors, evacuation of tourists - during Wilma, over 1,000 were moved inland from seaside hotels and resorts - is also a major component of Cuba’s disaster preparedness plan. MEDICC Review staff witnessed evacuation from one Havana hotel, where evacuees were ushered out and briefed in English and Spanish where they were going and what to expect. Tourism officials estimated that installations affected by the storm would be up and running within a month.

Yet, evacuation ahead of impending disaster is a tricky equation, as no one wants to abandon their home to nature or potential thievery. Like elsewhere, evacuation in Cuba is voluntary. Still, the government provides some innovative services to make it more palatable and practical, including setting aside warehouse space for household valuables like TVs and appliances and guaranteeing safe evacuation and shelter space for pets. Medical attention, food and water are also guaranteed at evacuation shelters.  Yet, some don’t heed the warnings, and simply stay behind - to be evacuated after the storm hits and under more precarious circumstances. 

Although no lives were lost during Wilma’s wrath, many homes were not as fortunate.  Calamitous flooding in coastal areas in Western Cuba brought severe damage, with interminable ocean swells pouring seawater over Havana’s Malecón seaside drive, pounding parts of the Playa, Centro Habana, Habana Vieja and Vedado neighborhoods. When October 24th dawned on the city, the streets ran with knee-high and even shoulder-high water in some places, sparking the evacuation of 31,000 more residents from those areas, many who had to leave their belongings behind, floating in flooded homes. 

Many said despite warnings, they were caught by surprise since flooding like this hadn’t been seen in Havana since the 1993 “Storm of the Century.” A resident of 5th and E Streets in Vedado was frantically moving his valuables to his neighbor’s house on the second floor when a boat came to evacuate him with his wife. “The water came up so fast as we were stowing our things with our neighbor,” he told MEDICC Review shortly after wading to dry ground. “Our three kids are already at a friend’s house, and that’s where we’re headed now. We’ll go back and see the damage when the water recedes,” he said.

One immediate concern for authorities was contaminated drinking water, as result of saltwater-flooded cisterns. Trucks pumping potable water into homes could be seen around Havana the day after the storm, while public health workers emptied saltwater from the compromised cisterns, flushed them with fresh water and treated them with chlorine. Several days later, public health teams returned to test cistern water for contamination.  

Looking a little like Venice - with rescue teams in Zodiacs instead of men paddling gondolas - the streets-turned-canals were cordoned off by police, while authorities coordinated rescue missions. “Some members of our congregation - including old folks - are still in there,” said Pastor Estela Hernández of the William Carey Baptist Church, pointing to the flooded neighborhood beyond the corner of Línea and K Streets where she stood. Pastor Hernández was waiting to see them to safety, and if need be, to the shelter of her Vedado church with other evacuees.        

In some cases, doctors were shuttled into the flooded areas by boat, and the Cuban Red Cross erected a mobile hospital at the intersection of Paseo and Línea Streets. People suffering from asthma stranded in their homes were of particular concern. Doctors on duty at the Camilo Cienfuegos Hospital emergency room in the heart of the flooded neighborhood told MEDICC Review they had seen several asthmatic patients, but few injuries.

For those returning home, the wreckage was heartrending.  “This is very, very hard,” said Enrique Álvarez of the Colón section of Centro Habana, looking upon his apartment, flooded knee-high with flotsam and saltwater. “No one thought the water would come up this far. My neighbor came in and saved some of my things and I’ll salvage what I can,” the filmmaker told MEDICC Review. The full extent of the damage to the city’s buildings will reveal itself over time, since the combination of voluminous water and salt will undermine structures already in disrepair, according to experts.

Storm Lessons

A neighbor from 5th and E Streets is evacuated by boat with his wife and a few belongings. “We’ll go back and see the damage when the water recedes.”

Once the floodwaters receded, the Recovery Phase - dubbed Operation Aurora - of the Cuban disaster management plan was nearing completion, and the cleanup task ahead loomed large. Massive volunteer efforts in the effected areas eased that task, and flood zone residents received boosts with food disbursements, new mattresses, televisions and fans from the government. Doctors and nurse teams meanwhile, went house to house, conducting heath assessments. The work is far from over for disaster planners and health and state authorities, as post-hurricane is the time to analyze storm-provided lessons and fold that knowledge into the overall strategy, to be better prepared next time.

A recent evaluation looked at Hurricane Dennis that hit eastern Cuba last August – taking the lives of 16 people, the number of combined hurricane deaths from 1996-2002 throughout Cuba.  The tough assessment revealed too much of an improvised approach by some Civil Defense coordinators; too little evacuation from vulnerable areas; the use of inadequate buildings for some shelters; and poor provisioning in others.

Undoubtedly, lessons from Hurricane Wilma will focus on the effects of intense flooding; early, efficient evacuation of littoral zones; and different risk management approaches for very slow-moving hurricanes like this one. One lesson, though, has always dictated disaster preparedness strategy in Cuba: the protection of human life is the highest priority.

To learn more about Cuba’s strategy, see MEDICC Review online “Disaster Management in Cuba: Reducing the Risks,” Vol. VI, No. 3, 2004.

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