Disaster Preparedness: Lessons Learned from Cuba

1. Disaster Preparedness: Lessons Learned from Cuba Amelia Muccio amuccio@njpca.org Director of Disaster Planning NEW JERSEY PRIMARY CARE ASSOCIATION

2. Health in Cuba • Two fundamental principles • Equity • Free access for entire population • Infant mortality (7.1/1000) among lowest in world • Projected life expectancy (75.5) among highest in world • Chronic dxs major cause of death • “We live like the poor but die like the rich.”

3. Healthcare Structure • Family Doctor (Neighborhood) • Polyclinics (448 in country) • Municipal Hospitals • Provincial Hospitals (tertiary care) One of the highest ratio of physicians to population in world (1 doc for every 175 people)

4. Cuban Education • 98% of children attended the end of secondary school • 99% literacy rate • One of world’s highest literacy rates

5. Why Cuba? • Cuba is lauded by United Nations for having: ‘most effective and replicable’ disaster preparedness model. • Political will • Inter-Organizational cooperation • Effective communication • Disaster preparedness education

6. Cuba: Effective and Replicable • “The Cuban way could easily be applied to other countries with similar economic conditions, and even in countries with greater resources that do not manage to protect their population as well as Cuba does.” UN ISDR

7. Cuban Areas of Strength • Accurate forecasting • Advance warning and time • Protecting vulnerable populations • Priority • Disaster education • Primary and secondary schools • Evacuation • Palatable with perks • Medical Diplomacy • Yearly Drill • Public participates

8. Cuba’s Disaster Plan • 1st Pillar: Meteorological Institute • 2nd Pillar: Civil Defense • 3rd Pillar: Communication 4 Emergency Phases • Informative • Alert • Alarm • Recovery

9. Disaster Sequence

10. Accurate Forecasting: Not Your Father’s Weatherman • Cuban Meteorological Institute is the first pillar of Cuba’s disaster preparedness • 96 hours (early advisory) • 72 hours (information phase) • 48 hours (hurricane watch) • 24 hours (hurricane warning) U.S. uses 36 and 24 hours

11. Cuban Methodology • Cuba does not use a line in trajectory (cone). • In Florida, Hurricane Charley’s trajectory line was straight thru Tampa. Sudden change in storm’s track landed it south and caught Port Charlotte completely off guard. • Early and accurate reporting

12. Protecting Vulnerable Populations • Vulnerability is social • Those living in fragile conditions suffer disproportionately therefore they must be a priority not an afterthought • Groups: pregnant women, children under 7, disabled, elderly, social or financially stressed…etc. • Cuban civil defense charts this population by community (risk assessment) and at the first sign of an emergency, these people are evacuated and transported to safe environment • Farmers also receive special focus (limit financial impact and loss) • Accelerated harvest to secure food supply • Short harvest crop yield in recovery phase

13. Solidarity • Disaster assistance not limited to government • “Neighborhood Solidarity” families take care of neighbors (provide shelter, supplies and assistance)

14. Disaster Education • Informed children become informed adults. • Education is very important in disaster prevention and preparedness. • Children in 5th and 6th grade study geography, meteorology, first aid and CPR. • Further information in secondary school (high school).

15. Disaster Education • “Commitment to saving human lives our first priority and this is achieved through education from an early age about the dangers associated with hurricanes and how to prepare in the event of one.”

16. Disaster Education

17. Voluntary Evacuation • People are resistance to evacuation • Cuba uses innovative steps to appease people’s worries • Belongings are stored in secured warehouse • Pets are welcome at all shelters (Vets) • All needs are met at shelters (water, food, medical attention) • 15% of Cuban population evacuates vs. 2% United States

18. Livestock Evacuation • Farm animals are evacuated to higher ground. • Mitigating loss to farming and rural communities • 10 km inland or 2 meters above sea level • Significant livestock loss from Katrina and Rita

19. Medical Diplomacy • How do we improve as human beings? • Cuba lends healthcare professionals to humanitarian crises • i.e. The Henry Reeves Brigade • International cooperation NOT charity • Cuba does not have excessive resources but believes in ‘sharing our daily bread’ • Shared vision & equality of resources • 63 countries (Post Apartheid South Africa and Chernobyl)

20. Henry Reeve Brigade • Henry Reeve was an American who fought in Spanish-Cuban war. • Brigade offered assistance of 1,500 healthcare professionals to Gulf region immediately after Katrina • 2,621/3000 went to Pakistan for earthquake (45 areas) • Largest foreign assistance campaign

21. Medical Diplomacy:Pakistan Earthquake

22. Yearly Drill: METEOR • Yearly disaster preparedness drill • Everyone participates!!! • This includes the public • Drill usually done on Sunday using neighborhood associations • Families can test their disaster plans • Hotel staff and functional drill for tourists • Issues can be solved prior to real event • Plan-Drill-Revise

23. Cuban Buzz Word: Political Will • “Fidel is always there” • Many Cubans cited ‘political will’ as a reason and/or cause for their success in disasters. • Fidel assures confidence and safety to public.

24. Why Political Will is Needed? • “Cuba’s political will prioritizes disaster preparedness and works together with citizens to design and implement a comprehensive risk reduction program.”

25. Benchmarks of Success • 124 mph storm—2 million evacuated—ZERO loss of life • 100,000 people evacuated safely in 3 hours • No deaths from electrocution • Minimal loss to pets and livestock • Massive volunteer efforts in recovery phase

26. The Cuban Way • Emphases public’s role • Focuses on saving lives • Connectivity of public, gov’t and media • Solid disaster education • Yearly practice with METEOR • Creates empowerment and equity • Political will • Reliable forecasts • Early Warning