Monash University Disaster Resilience Initiative, Clayton, Melbourne, Victoria, Australia.
College of Health, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand.
Prehosp Disaster Med. 2020 Oct;35(5):574-578. doi: 10.1017/S1049023X2000093X. Epub 2020 Jul 16.
Volcanoes cause a wide range of hazardous phenomena. Close to volcanic vents, hazards can be highly dangerous and destructive and include pyroclastic flows and surges, ballistic projectiles, lava flows, lahars, thick ashfalls, and gas and aerosol emissions. Direct health impacts include trauma, burns, and exacerbation of respiratory diseases. Far-reaching volcanic hazards include volcanic ashfalls, gas and aerosol dispersion, and lahars. Within Oceania, the island arc countries of Papua New Guinea (PNG), the Solomon Islands, Vanuatu, Tonga, and New Zealand are the most at-risk from volcanic activity. Since 1500ad, approximately 10,000 lives have been lost due to volcanic activity across Oceania, with 39 lives lost since 2000. While volcano monitoring and surveillance save lives, residual risks remain from small, sudden, unheralded eruptions, such as the December 9, 2019 eruption of Whakaari/White Island volcano, New Zealand which has a death toll of 21 at the time of writing. Widespread volcanic ashfalls can affect the habitability of downwind communities by contaminating water supplies, damaging crops and buildings, and degrading indoor and outdoor air quality, as well as disrupting transport and communication networks and access to health services. While the fatality rate due to volcanic eruptions may be low, far greater numbers of people may be affected by volcanic activity with approximately 100,000 people in PNG and Vanuatu displaced since 2000. It is challenging to manage health impacts for displaced people, particularly in low-income countries where events such as eruptions occur against a background of low, variable vaccination rates, high prevalence of infectious diseases, poor sanitation infrastructure, and poor nutritional status. As a case study, the 2017-2018 eruption of Ambae volcano, Vanuatu caused no casualties but triggered two separate mandatory off-island evacuations of the entire population of approximately 11,700 people. On the neighboring island of Santo, a health disaster response was coordinated by local government and provided acute care when evacuees arrived. Involving primary care clinicians in this setting enhanced local capacity for health care provision and allowed for an improved understanding of the impact of displacement on evacuee communities.
火山会引发多种危险现象。在靠近火山口的地方，危险可能极具破坏性和致命性，包括火山碎屑流和涌浪、抛射物、熔岩流、泥流、厚厚的火山灰降尘、气体和气溶胶排放。直接的健康影响包括创伤、烧伤和呼吸道疾病恶化。影响范围更广的火山灾害包括火山灰降尘、气体和气溶胶扩散以及泥流。在大洋洲，巴布亚新几内亚（PNG）、所罗门群岛、瓦努阿图、汤加和新西兰等岛屿弧国家面临的火山活动风险最大。自 1500 年以来，由于大洋洲的火山活动，约有 1 万人丧生，自 2000 年以来有 39 人丧生。虽然火山监测和监视可以拯救生命，但仍存在来自小型、突然、无预警喷发的残余风险，例如 2019 年 12 月 9 日新西兰怀特岛火山喷发，截至撰写本文时，该火山喷发已造成 21 人死亡。广泛的火山灰降尘会通过污染水源、破坏庄稼和建筑物以及降低室内和室外空气质量，以及破坏交通和通信网络以及获得卫生服务，影响下风区社区的宜居性。虽然火山爆发造成的死亡率可能较低，但由于火山活动而受影响的人数可能更多，自 2000 年以来，巴布亚新几内亚和瓦努阿图约有 10 万人流离失所。对于流离失所者，管理健康影响具有挑战性，特别是在低收入国家，在这些国家，诸如喷发等事件发生的背景是疫苗接种率低且波动大、传染病高发、卫生基础设施差和营养状况不佳。作为一个案例研究，2017-2018 年瓦努阿图安巴火山喷发没有造成人员伤亡，但引发了两次将大约 11700 名居民全部撤离该岛的单独行动。在邻近的圣岛，当地政府协调了一次卫生灾难应对行动，为抵达的撤离者提供了急性护理。在这种情况下，让初级保健临床医生参与进来，增强了当地提供医疗服务的能力，并使人们更好地了解流离失所对撤离者社区的影响。
