GeoJournal 26,1 61-64 © 1992 (Jan) by Kluwer Academic Publishers 61 The Impact of Natural Hazards on the Health Sector in the Caribbean*: Implications for Health Sector Planning Collymore, Jeremy McA; University of the West Indies, Department of Geography, Kingston, Jamaica ABSTRACT: In the last decade significant initiatives have been taken in the health sector with the view to better manage and respond to natural disaster emergencies. However, the recent hurricane disasters related to Hugo and Gilbert have highlighted many areas of health sector emergency planning still to be adressed. This paper briefly summarises the impact of recent natural disaster on the health sector in the Caribbean and comments on the performance of the sector during the emergencies. An effort is then made to detail what are the policy and programming issues to be tackled, if desired improvements are to be achieved. Introduction The recent disasters in the Caribbean which were associated with hurricanes Gilbert and Hugo have emphasized in an indelible way, the link between disasters and development. Jamaica, a Caribbean island economy already undergoing severe financial and balance of payment pressures suffered losses to centralised services and natural resources of more than US$ 2 billion as a result of a direct hit by hurricane Gilbert. When hurricane Hugo struck Montserrat on September 16, 1989, it left the 12,000 population with over US$ 200 million in damage. It was then estimated that it would take at least a decade for the island to reach its pre-Hugo state. Similarly, hurricane David in 1979 severely disrupted and set back the economy of Dominica and hurricane Allen in 1980 that of St. Lucia (Collymore 1990). The fact that in an environment prone to the most severe natural hazards known (Tomblin 1981), and with a frequent experience of them (Granger 1987) such massive * The reader may like to see GeoJournal vol. 23, no. 4 (April 1991)on "Caribbean Hurricanes" losses to property and extensive disruption of public services still occurs reflects the fact that decision makers were yet to make the link between disasters and development. For most of our history, disasters have been perceived as separate events requiring rapid response of medical and material aid. The result has been an episode of ineffective and counter-productive responses to the management of disasters, focussed on relief. The recent disasters in the Caribbean, particularly those related to hurricane Gilbert and Hugo have indicated that the region has come a long way in reducing loss of life and injury in hurricane disasters. At the same time, however, it is clear that inadequate attention has been paid to developing and sustaining appropriate contingency planning systems for the health sector and even less to the design of safe structures from which health services can be offered. This paper briefly summarizes the impact of recent disasters in the Caribbean on the health sector and seeks to make comments on the performance of the sector during these emergencies. It also offers some broad guidelines on the necessary systems to be emplaced if better management of disasters by the health sector is to be achieved.