Baseline Report: Provision of Emergency Health, WASH and Protection Services to Disaster-Affected Populations in Grand Bahama

The Category 5 hurricane caused widespread destruction, leaving an estimated 76,278 people affected, with at least 52 deaths and over 1,500 missing. The storm's impact on the health care system was severe, with health clinics destroyed and medical professionals and a large segment of the population leaving the island. The International Medical Corps (IMC) deployed a Rapid Response Team to Grand Bahama, including clinical and support staff, to conduct rapid needs assessments, deploy supplies, and meet urgent health care needs. The team provided essential and urgent health care services, with a focus on reaching vulnerable populations, including children, pregnant and lactating women, older adults, persons with disabilities, and internally displaced persons. Mental health and WASH activities were also complemented. The IMC identified the need to support the population of Grand Bahama with a health, WASH, and mental health response. Under the Health Sector, IMC selected six health facilities, including the Rand Memorial Hospital at Freeport, to launch an aggressive clinical and community health strategy. An average of three volunteer doctors, nine nurses, and one trained pharmacist provided clinical and community-based health care services to these selected health facilities and their catchment areas. The health care system in Grand Bahama had been severely impacted by the hurricane, with medical professionals and a large segment of the population leaving the island. The Bahama Health Service had developed a mature health care system for its entire population, but it suffered as a result of the hurricane. The system has a disease surveillance system in place, which is still largely functional. Health care professionals, including doctors, nurses, and pharmacists, are well-trained, with some having received training abroad. The people of Grand Bahama are generally literate and comply with municipal and health policies. However, there has never been a policy or practice of developing a cadre of Community Health Workers (CHWs) on the island. The health authorities disseminate health and related messages and alerts or warnings through the radio, print media, and social media, which they claim is an effective approach. The pharmacy staff at the health clinics use an electronic ordering system to ensure adequate quantities of medicines and medical supplies are available. This system is linked to the Bahamas National Drug Agency (BNDA), which dispatches drugs and supplies to the clinics. The IMC has a large number of medicines, supplies, and equipment in its stock, which it received as Gifts in Kind (GIK) from donors. These items are being distributed to the clinics and will soon be streamlined for distribution through BNDA in Freeport. The key challenges identified in the aftermath of Hurricane Dorian on WASH access, quality, and quantity include a shortage of potable water, lack of safe sanitation facilities, and poor hygienic conditions. The Grand Bahama utility company has started to restore the water supply system, but the water quality is still a concern, with high levels of salinity and free residual chlorine not meeting World Health Organization (WHO) standards. Several people have returned to their communities, where they face a lack of toilets and waste management concerns, including medical waste from the Rand Memorial Hospital and clinics.