El sector de la salud frente a los desastres y el cambio climático en Cuba
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Mesa Ridel, G., González García, J., Reyes Fernández, M. C., Cintra Cala, D., Ferreiro Rodríguez, Y., & Betancourt Lavastida, J. E. (2018). El sector de la salud frente a los desastres y el cambio climático en Cuba [Journal articles]. https://iris.paho.org/handle/10665.2/34898
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2018
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[RESUMEN]. Por su impacto sobre la salud humana y su capacidad para generar daños, los desastres son uno de los problemas globales que más preocupan a la comunidad internacional. Sin embargo, y pese a los esfuerzos realizados por numerosos sistemas de salud, aún no se ofrece la atención necesaria a la reducción de vulnerabilidades y la falta de estrategias que eviten o minimicen los riesgos. Por estar ubicada Cuba en una zona de peligro permanente de desastres, su sector de la salud ha logrado acumular una notable experiencia en cuanto a la gestión correctiva de los riesgos y el aseguramiento de escenarios futuros menos riesgosos, con la activa participación de la comunidad y un proceso planificado y organizado para enfrentar el impacto del cambio climático. En este trabajo se resumen algunas de estas experiencias y se describen los peligros, las vulnerabilidades y los riesgos de desastres en Cuba, su Sistema de Defensa Civil, y la planificación y la organización en el sector de la salud para la reducción de desastres, así como los principales efectos y desafíos del cambio climático en el sistema de salud. Las lecciones aprendidas y las buenas prácticas ratifican el papel determinante de los recursos humanos para reducir las vulnerabilidades; el mayor desafío es evitar o minimizar los riesgos, avanzar en la investigación y la preparación de los profesionales ante el cambio climático, y optimizar la organización de los sistemas y los servicios de salud del país.
[ABSTRACT]. Due to its impact on human health and its capacity to cause damage, disasters are one of the global problems that most concern the international community. However, and in spite of the efforts made by many health systems, the reduction of vulnerabilities and the lack of strategies to avoid or minimize risks have not received enough attention yet. As Cuba is located in an area of permanent danger of disasters, its health sector has accumulated considerable experience in the management of risks and in the assurance of less risky future scenarios, with active participation of the community and a planned and organized process to address the impact of climate change. This paper summarizes some of these experiences and describes the dangers, vulnerabilities, and risks of disasters in Cuba, its Civil Defense System, and planning and organization in the health sector for disaster reduction, as well as the main effects and challenges of climate change in the health system. Lessons learned and good practices support the key role of human resources to reduce vulnerabilities; the greatest challenges are to avoid or minimize risks, to advance research, to train professionals for climate change, and to optimize the organization of health systems and services in the country.
[RESUMO]. Devido ao seu impacto na saúde humana e na sua capacidade de causar danos, os desastres são um dos problemas globais mais preocupantes para a comunidade internacional. No entanto, e apesar dos esforços feitos por numerosos sistemas de saúde, a atenção necessária ainda não foi oferecida para a redução de vulnerabilidades e a falta de estratégias que evitem ou minimizem os riscos. Como Cuba está localizada em uma área de permanente perigo de desastres, seu setor de saúde acumulou uma experiência considerável no gerenciamento de riscos e na garantia de cenários futuros menos arriscados, com a participação ativa da comunidade e um processo planejado e organizado para enfrentar o impacto das mudanças climáticas. Este artigo resume algumas dessas experiências e descreve os perigos, vulnerabilidades e riscos de desastres em Cuba, seu Sistema de Defesa Civil e planejamento e organização no setor da saúde para a redução de desastres, bem como os principais efeitos e desafios das mudanças climáticas no sistema de saúde. As lições aprendidas e as boas práticas ratificam o papel determinante dos recursos humanos para reduzir vulnerabilidades; o maior desafio é evitar ou minimizar riscos, avançar pesquisa, preparar profissionais para mudanças climáticas e otimizar a organização de sistemas e serviços de saúde no país.
[ABSTRACT]. Due to its impact on human health and its capacity to cause damage, disasters are one of the global problems that most concern the international community. However, and in spite of the efforts made by many health systems, the reduction of vulnerabilities and the lack of strategies to avoid or minimize risks have not received enough attention yet. As Cuba is located in an area of permanent danger of disasters, its health sector has accumulated considerable experience in the management of risks and in the assurance of less risky future scenarios, with active participation of the community and a planned and organized process to address the impact of climate change. This paper summarizes some of these experiences and describes the dangers, vulnerabilities, and risks of disasters in Cuba, its Civil Defense System, and planning and organization in the health sector for disaster reduction, as well as the main effects and challenges of climate change in the health system. Lessons learned and good practices support the key role of human resources to reduce vulnerabilities; the greatest challenges are to avoid or minimize risks, to advance research, to train professionals for climate change, and to optimize the organization of health systems and services in the country.
[RESUMO]. Devido ao seu impacto na saúde humana e na sua capacidade de causar danos, os desastres são um dos problemas globais mais preocupantes para a comunidade internacional. No entanto, e apesar dos esforços feitos por numerosos sistemas de saúde, a atenção necessária ainda não foi oferecida para a redução de vulnerabilidades e a falta de estratégias que evitem ou minimizem os riscos. Como Cuba está localizada em uma área de permanente perigo de desastres, seu setor de saúde acumulou uma experiência considerável no gerenciamento de riscos e na garantia de cenários futuros menos arriscados, com a participação ativa da comunidade e um processo planejado e organizado para enfrentar o impacto das mudanças climáticas. Este artigo resume algumas dessas experiências e descreve os perigos, vulnerabilidades e riscos de desastres em Cuba, seu Sistema de Defesa Civil e planejamento e organização no setor da saúde para a redução de desastres, bem como os principais efeitos e desafios das mudanças climáticas no sistema de saúde. As lições aprendidas e as boas práticas ratificam o papel determinante dos recursos humanos para reduzir vulnerabilidades; o maior desafio é evitar ou minimizar riscos, avançar pesquisa, preparar profissionais para mudanças climáticas e otimizar a organização de sistemas e serviços de saúde no país.
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Mesa Ridel G, González García J, Reyes Fernández MC, Cintra Cala D, Ferreiro Rodríguez Y, Betancourt Lavastida JE. El sector de la salud frente a los desastres y el cambio climático en Cuba. Rev Panam Salud Publica. 2018;42:e24. https://doi.org/10.26633/RPSP.2018.24
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Item El sistema de salud en Cuba: avances y desafíos(2018)[RESUMEN]. Este número de la Revista Panamericana de Salud Pública dedicado al sistema de salud en Cuba aborda los logros, los desafíos y las lecciones aprendidas en temáticas como el desarrollo del modelo de atención médica; la prevención y el control de enfermedades no transmisibles; la capacidad de respuesta frente a las enfermedades transmisibles; la experiencia en inmunización; la salud maternoinfantil; la formación de capital humano para la salud; el afrontamiento del envejecimiento demográfico; la salud y su relación con los desastres y el cambio climático; las consideraciones económicas sobre la salud pública y la salud universal; la ciencia y la innovación tecnológica en salud; y la aplicación de la eSalud. EDITORIALES: Cuba hacia la Salud Universal; Experiencias y lecciones desde Cuba en el camino a la Salud Universal en las Américas; Transformaciones en el sistema de salud en Cuba y estrategias actuales para su consolidación y sostenibilidad. ARTÍCULOS: Enfermedades no transmisibles: factores de riesgo y acciones para su prevención y control en Cuba; Atención a la salud maternoinfantil en Cuba: logros y desafíos; Calidad de las estadísticas de mortalidad materna en Cuba, 2013; Experiencia cubana en inmunización, 1962-2016; Capacidad de respuesta y desafíos del sistema de salud cubano frente a las enfermedades transmisibles; Enfoques, evolución y afrontamiento del envejecimiento demográfi co en Cuba; El Programa del Médico y Enfermera de la Familia: desarrollo del modelo de atención médica en Cuba; Formación del capital humano para la salud en Cuba; Consideraciones económicas sobre la salud pública cubana y su relación con la salud universal; El sector de la salud frente a los desastres y el cambio climático en Cuba; Ciencia e innovación tecnológica en la salud en Cuba: resultados en problemas seleccionados; Aplicación de la eSalud en el contexto cubano.Item Excess mortality associated with extreme heat in Rio de Janeiro, Brazil, 2023(2025-07-28)[ABSTRACT]. Objective: To determine the excess mortality associated with the November 2023 extreme heat wave in Rio de Janeiro, Brazil, with temperatures reaching 42°C. Methods: Using the excess heat factor (EHF) to characterize the heat wave, this study identified elevated excess mortality across various disease categories, including symptoms and abnormal clinical findings, nervous system disorders, mental health conditions, and genitourinary diseases, diverging from typical heat-related mortality patterns. Results: This event resulted in an estimated excess mortality of 1 392 individuals in a short period, disproportionately affecting older adults and women, with a significant number of deaths occurring at home. The findings underscore the complexity of heat wave impacts and highlight gaps in health care access, risk perception, and clinical management. Conclusions: Heat waves are increasingly recognized as a significant public health threat, exacerbated by climate change, with profound impacts on morbidity and mortality. The study emphasizes the urgent need for comprehensive heat alert and response systems, intersectoral action plans, and public education to mitigate the effects of extreme heat. Furthermore, it calls for adaptive strategies in urban planning, housing, and public health policies to address the growing frequency and intensity of heat waves in the context of climate change. As Brazil faces escalating challenges from rising temperatures, particularly in urban centers, coordinated multisectoral efforts are essential to protect vulnerable populations and reduce heat-related mortality in the future.Item Ensuring health equity during the COVID-19 pandemic: the role of public health infrastructure(2020)[ABSTRACT]. The COVID-19 pandemic has significantly stressed public health systems around the world and exposed the gaps in health care for underserved and vulnerable populations. In the context of the social determinants of health, focusing on health system preparedness is paramount for protecting the health of all of society. Faced with old threats (e.g., re-emergence of measles), disruptive new technologies (e.g., electronic cigarettes), increased challenges (e.g. drug-resistant organisms), and new threats (e.g., the current pandemic, climate change, politicized misinformation), our health systems must be robust and resilient. The response must include those who now suffer disproportionately—the poor and the vulnerable. Current World Health Organization priorities call for infrastructures capable of detecting, monitoring, and responding to health emergencies, such as COVID-19, and the health impacts of climate change in the context of health for all. Health care infrastructure can be better prepared and more equitable if systems are strengthened by building on core competencies and following the recommendations made for leadership, stakeholder involvement, accreditation, data collection, and funding resources. Ensuring health equity in a pandemic requires robust and resilient public health infrastructure during normal times.Item Carbon pollution increases health inequities: lessons in resilience from the most vulnerable(2016)Climate change is a social justice as well as an environmental issue. The magnitude and pattern of changes in weather and climate variables are creating differential exposures, vulnerabilities, and health risks that increase stress on health systems while exacerbating existing and creating new health inequities. Examples from national and local health adaptation projects highlight that developing partnerships across sectors and levels are critical for building climate- resilient health systems and communities. Strengthening current and implementing new health interventions, such as using environmental information to develop early warning systems, can be effective in protecting the most vulnerable. However, not all projected risks of climate change can be avoided by climate policies and programs, so health system strengthening is also critical. Applying a health inequity lens can reduce current vulnerabilities while building resilience to longer-term climate change. Taking inequities into account is critical if societies are to effectively prepare for and manage the challenges ahead.Item Un análisis cualitativo de las políticas de preparación en salud en Chile(2023)[RESUMEN]. Objetivo. Analizar las políticas de preparación en salud en Chile, e identificar sus fortalezas y debilidades. No hay hasta la fecha otros estudios que analicen las políticas de preparación en el país. Métodos. Se llevó a cabo una revisión documental y entrevistas semiestructuradas con expertos en prepara- ción y respuesta a emergencias para identificar el marco normativo, los actores principales, y las fortalezas y debilidades de las políticas de preparación en salud. Resultados. Se encontraron 103 normas y se entrevistó a 7 personas expertas en preparación. Las normas revisadas y las entrevistas demuestran que Chile se encuentra en un momento de transición entre el antiguo Sistema Nacional de Protección Civil y el nuevo Sistema Nacional de Prevención y Respuesta ante Desas- tres. Solo tres normas tenían relación directa con salud, pero la normativa de preparación prevé el abordaje de cualquier amenaza desde un conjunto de actores multidisciplinario. Los expertos valoraron de manera positiva el sistema chileno, si bien hubo consenso en algunas debilidades que deben corregirse. La principal fortaleza es la experiencia en respuesta a desastres, así como sus mecanismos de coordinación. Las princi- pales deficiencias se detectaron en la comunicación de riesgo, la mitigación, la preparación y evaluación, y los recursos humanos. Conclusiones. Chile cuenta con un marco normativo sólido con una perspectiva multiamenaza y un conjunto de instituciones multisectoral. El nuevo Sistema Nacional de Prevención y Respuesta ante Desastres debe apoyarse en sus fortalezas para corregir las debilidades que limitan su capacidad de preparación y respuesta ante emergencias.