Taal Volcano Eruption: When The Lava Hits the Fan

On January 12, 2020, the Taal volcano erupted resulted in an ash cloud that is carried over several kilometers downwind. Based on ongoing observations, there is still a danger of an imminent and more significant eruption

This article presents the effects of substantial volcanic eruptions on health care.

Geophysical Problems of Volcanic Eruptions

1. Earthquakes and heavy ashfall can make roads impassable.
2. Bridges can get destroyed by lahat and earthquakes.
3. Ashfall on the roofs of clinics, hospitals, churches, school gyms, and evacuation centers can collapse due to the weight.
4. With rain, the weight of the ash gets more substantial. This makes road clearing harder.
5. Ashfall is electrically conductive when wet. This creates electrocution hazards if fallen power lines are still live. Transmission lines can carry up to 700,000 volts.
6. Rain-soaked ash short circuit transformers and cause power failures.
7. The ash can clog engine filters and destroy the machinery of generators rendering back-up power useless.
8. The ash can clog the air filters and ruin engines. This includes ambulances and heavy pieces of machinery like bulldozers that will be needed for rescue and road clearing.
9. Electrical storms from the ash clouds can hamper communications like radio and cell phones. Ambulances need contact from their dispatchers where to go and to contact hospitals to give a report.
10. Freshwater and sewage facilities cannot operate without power or generators. Water filters will be clogged, and sewage water will mix with freshwater producing undrinkable water.
11. Ground movements can break the water and sewage pipes, mixing both contents.

Effects On the Health Care Delivery System

1. Health care facilities will become inaccessible because of impassable roads and bridges.
2. Electrical disruption and busted generators render all critical equipment useless like the refrigerators for medicines, intravenous pumps, nebulizers, ventilators, and dialysis machines.
3. The absence of clean running water will make basic hygiene like handwashing difficult.
4. Failure of the sewage system will lead to nonfunctioning toilets.
5. Dialysis machines cannot be used if there is no water.
6. Health care workers will not be able to report for work. Those who stay behind can only work for so long. They have families too.
7. Medicines that need refrigeration like insulin will expire earlier.
8. The blood bank needs functioning refrigerators to preserve blood.
9. Elective surgeries will be canceled
10. Emergency surgeries will be done in less ideal conditions using flashlights and instruments boiled in hot water.  Provided that there is the staff.
11. Suction machines to clear the operating field will not work.
12. The same challenges exist with obstetrical deliveries. It becomes more difficult if an emergency cesarian section is needed.
13. The equipment to provide intensive care to a newborn will be useless if there is no power.
14. Delivery trucks will not be able to bring oxygen tanks.
15. Hospitals rely on a supply system to be well-stocked with food, intravenous fluids, and critical medicines.

Pre-emptive Solutions:

Evacuation

Obey evacuation orders by the authorities while the roads are passable.  The following are the priority.

1. Pregnant mothers, babies, and children
2. Elderly
3. Dialysis patients
4. Patients who need refrigerated medicines like diabetics on insulin.
5. People with chronic illnesses like chronic lung diseases and heart failure.
6. Asthmatic patients.
7. Patients who are already on intensive care support in the hospitals may need to be transferred.

Heed the Warnings

In December 2019, the White Volcano in New Zealand erupted without warning. The same happened with Mount  Ontake Volcano in Japan in 2014. Many tourists died.

Presently, the Taal volcano has the “courtesy” to give a warning of an impending eruption.  The Alert Level is at 4, which means an imminent eruption is possible in hours or days.

It is better to heed the warnings and evacuate. One thing I have learned about natural disasters is that nature doesn’t care who it kills.

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References:

1. Hogan, and Burstein, J. Disaster Medicine. First edition, Lippincott and Wilkins, 2002.
2. Baxter, P J et al. “Preventive health measures in volcanic eruptions.” American journal of public health vol. 76,3 Suppl (1986): 84-90. doi:10.2105/ajph.76.suppl.84
3. Tayag JC, Punongbayan RS. Volcanic disaster mitigation in the Philippines: experience from Mt. Pinatubo. Disasters. 1994 Mar;18(1):1-15. PMID: 8044638
4. TAAL VOLCANO BULLETIN 23 January 2020 8:00 A.M.

Image Credit:

Taal Volcano image from Philvolcs website

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