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Wednesday, December 6, 2023
Courthouse News Service
Wednesday, December 6, 2023 | Back issues
Courthouse News Service Courthouse News Service

Disaster medics warn of infectious disease outbreaks in Hurricane Otis aftermath

Aid groups are doing what they can to mitigate a second wave of deaths due to public health threats, but they lack the most important resource for accomplishing that: government cooperation.

ACAPULCO, Mexico — Floodwater still flowed down storm-scoured slopes to the Pacific a week after Hurricane Otis slammed into Acapulco as one of the strongest to ever make landfall in Mexico. Strips of sheet metal lay strewn about the city like giant windblown ribbons. Smells of sewage and putrescence permeated the muddy streets. 

But the debris the storm left behind — a fetid melange of everything from hotel night tables to the twisted branches of almond trees — had been piled up to make access easier than the week before. 

As the city began to open up to the outside world, one team of disaster physicians rushed to the scene to assess a situation that has been criticized as an insufficient response to the catastrophe on the part of the government. 

They were unfortunately too late to avoid the larger disaster to come. As many as 8,500 people will die of stomach and respiratory infections and vector-borne diseases like dengue in the coming months, according to disaster response experts.

“The second wave [of deaths] will be much worse than the first,” said Giorgio Franyuti, CEO of the emergency aid organization Medical Impact, as afternoon mosquitos began to swarm in a neighborhood of unpaved roads where his team set up a mobile clinic on Tuesday. “It’s going to be a massacre.” 

Floodwater puddles in a working class neighborhood in Acapulco, Mexico, a week after Hurricane Otis made landfall. Disaster medics warned that if not treated with lime, such puddles will breed large amounts of mosquitos, leading to deadly outbreaks of vector-borne diseases like dengue. (Cody Copeland/Courthouse News)

In disasters where sanitary infrastructure like water and garbage collection have been incapacitated, there is always a second round of public health threats that often kill more people than the initial event, Franyuti said. 

The official death toll of Hurricane Otis stands at 46, with 58 missing, but the broad consensus by those who have seen the extent of the storm’s destruction is that the government's figure is a gross undercount. 

People have been forced to gather water from contaminated sources like flood runoff, rivers and puddles, and many are drinking this water and are or will get very sick. Franyuti laments that many will not take his advice to boil the water before drinking it.

Immediate medical attention from civil society groups like his could have significantly diminished the scale of this second wave, but the Mexican military blocked access to Acapulco from the outside world for the first five days after Otis passed.

Mexico's Secretariat of Defense did not respond to questions concerning the purpose of the blockade.

“They’ve already made this situation worse,” Franyuti said. “This can’t be stopped, only mitigated. People are already infected.”

Medics on his team confirmed this. Stomach problems were among the most common complaints they heard at the mobile clinics they set up in working class and rural neighborhoods away from the city’s tourist zones. 

They also saw several cases of skin infections, as some of the patients they saw spent 20 hours or more in chest-high flood water, as well as minor injuries and symptoms of anxiety.

Disaster medics with Medical Impact treat hurricane victims at a pop-up clinic in Yetla, Mexico, a rural community near Acapulco hit hard by Otis, on Nov. 1, 2023. (Cody Copeland/Courthouse News)

Elizabeth Loeza was not in Acapulco when Otis hit. A resident of the state of Nayarit, she came the day after the storm to take care of her mother. She visited the clinic seeking help for headaches, shortness of breath and heart palpitations. 

“It’s so good that they came, because people are cut off from the outside world, there are no services, and they’re sick,” said Loeza, 40, as she waited to see a doctor. 

Along with Direct Relief, a nonprofit that provides organizations with funds, resources and logistics to respond to disasters, Medical Impact is working to mitigate the effects of this second wave by vaccinating against tetanus, flu, streptococcus, meningitis and others . 

But getting these cold chain vaccines, which must be kept between 35.6 and 46.4 degrees Fahrenheit, into an area without electricity and other services is tricky. Medical Impact has a mobile refrigerator for administering these cold chain vaccines, and if they could have gotten into Acapulco sooner, they could have made a significant difference in the second wave.


The Mexican government could cut the estimated death toll in half if it takes immediate action over the next week and a half, Franyuti said. The health department Salud and public health risk agency Cofepris should already be purifying water supplies with colloidal silver and killing off mosquito larvae by putting lime in puddles and other standing water as part of a mitigation strategy.

But they are not doing this, Franyuti said. Neither are they prepared or equipped to adequately respond to this crisis.

Salud and Cofepris did not immediately respond to requests for comment on their mitigation strategies. 

Piles of rubble surround severely damaged high-rise hotels and other structures in Acapulco, Mexico, on Oct. 31, 2023. (Cody Copeland/Courthouse News)

“This disaster is much different from previous ones,” said Franyuti, who has run similar missions after disasters in Guatemala, Colombia, Gaza, Ghana and Mexico. “The government should be here.”

The government is not completely absent in Acapulco and other affected areas. This week Cofepris announced in a press release that it installed first aid stations and conducted health inspections in the city.

The army is keeping order and guarding functioning gas stations. Marines are dispensing potable water on the city’s main tourist avenue. And the National Guard is directing traffic at busy intersections. The federal welfare department is conducting a census of affected homes. 

But Franyuti and others with disaster relief experience have noted a significant difference in the military’s response plan for Otis compared to past events. Security analyst David Saucedo told Courthouse News in a recent interview that budget cuts and personnel distribution have significantly weakened the military’s ability to respond to Otis’ aftermath compared to its capabilities in the past. 

The sheet metal roof of a construction materials warehouse sits twisted around the ruins of the structure that buckled under it in a working class neighborhood of Acapulco after the passage of of Hurricane Otis in late October 2023. (Cody Copeland/Courthouse News)

The elimination in 2021 of a government trust fund for disaster relief allocations also contributed to this weakening, he said. 

Franyuti said the government needs to work hand in hand with civil society to minimize as much as possible the harm they know is coming.

“There is mistrust and wariness between the government and civil society, but we should be working as partners,” he said. 

The response will have to be a yearslong, sustained effort. Along with buildings, infrastructure and services, Otis also wiped out the livelihoods of the principal source of income for Acapulco residents, 80% of whom work in tourism. 

Franyuti and his team have seen what happens when the world’s attention moves on to the next crisis.

“Everyone’s sending help now, but in a month or two, people will forget and those resources will run dry,” said Katia Díaz, a volunteer general practitioner with Medical Impact. 

The trunk of a toppled ceiba tree shorn of most of its branches sits among other debris outside of a hotel on Acapulco's main tourist avenue after the passage of Hurricane Otis in late October 2023. (Cody Copeland/Courthouse News)

In the meantime, Otis’ victims are extremely grateful for the help that is making it through the rubble to get to them.

The pop-up clinic Medical Impact set up on Wednesday was “a ray of hope” for Gladys Izazaga Sánchez and others in Yetla, a rural community northwest of Acapulco that was hit hard by the hurricane. 

“We were totally abandoned, we haven’t seen the government here, all the relief efforts are in Acapulco,” she said after taking a group photo with the team of medics. She herself had pain and inflammation in her shoulder, but it was feeling much better by the time the team left. 

“These are folks who can’t get to a hospital or afford a doctor,” she said, smiling and giving goodbye hugs. “People are happy they came.” 

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Categories / Government, International, Weather

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