Disaster Preparedness:
Lessons Learned from Cuba
Amelia Muccio
amuccio@njpca.org
Director of Disaster Planning
NEW JERSEY PRIMARY CARE ASSOCIATION
Health in Cuba
• Two fundamental principles
– Equity
– Free access for entire population
• Infant mortality (7.1/1000) among lowest in
world
• Projected life expectancy (75.5) among
highest in world
• Chronic dxs major cause of death
• “We live like the poor but die like the rich.”
Healthcare Structure
1.
2.
3.
4.
Family Doctor (Neighborhood)
Polyclinics (448 in country)
Municipal Hospitals
Provincial Hospitals (tertiary care)
One of the highest ratio of physicians to
population in world (1 doc for every 175
people)
Cuban Education
• 98% of children
attended the end of
secondary school
• 99% literacy rate
• One of world’s
highest literacy rates
Why Cuba?
• Cuba is lauded by United
Nations for having: ‘most
effective and replicable’
disaster preparedness
model.
1. Political will
2. Inter-Organizational
cooperation
3. Effective communication
4. Disaster preparedness
education
Cuba: Effective and Replicable
• “The Cuban way could easily be applied to
other countries with similar economic
conditions, and even in countries with
greater resources that do not manage to
protect their population as well as Cuba
does.” UN ISDR
Cuban Areas of Strength
• Accurate forecasting
– Advance warning and time
• Protecting vulnerable
populations
– Priority
• Disaster education
– Primary and secondary
schools
• Evacuation
– Palatable with perks
• Medical Diplomacy
• Yearly Drill
– Public participates
Cuba’s Disaster Plan
• 1st Pillar: Meteorological Institute
• 2nd Pillar: Civil Defense
• 3rd Pillar: Communication
4 Emergency Phases
1. Informative
2. Alert
3. Alarm
4. Recovery
Disaster Sequence
Event
Alert
Response
Preparedness
Rehabilitation
Mitigation
Reconstruction
Prevention
Accurate Forecasting: Not Your Father’s
Weatherman
• Cuban Meteorological
Institute is the first pillar
of Cuba’s disaster
preparedness
1. 96 hours (early advisory)
2. 72 hours (information
phase)
3. 48 hours (hurricane
watch)
4. 24 hours (hurricane
warning)
U.S. uses 36 and 24 hours
Cuban Methodology
• Cuba does not use a line
in trajectory (cone).
• In Florida, Hurricane
Charley’s trajectory line
was straight thru Tampa.
Sudden change in storm’s
track landed it south and
caught Port Charlotte
completely off guard.
• Early and accurate
reporting
Protecting Vulnerable Populations
• Vulnerability is social
• Those living in fragile conditions suffer disproportionately
therefore they must be a priority not an afterthought
• Groups: pregnant women, children under 7, disabled,
elderly, social or financially stressed…etc.
• Cuban civil defense charts this population by community
(risk assessment) and at the first sign of an emergency,
these people are evacuated and transported to safe
environment
• Farmers also receive special focus (limit financial impact
and loss)
– Accelerated harvest to secure food supply
– Short harvest crop yield in recovery phase
Solidarity
• Disaster assistance not
limited to government
• “Neighborhood
Solidarity” families
take care of neighbors
(provide shelter,
supplies and
assistance)
Disaster Education
• Informed children become informed adults.
• Education is very important in disaster
prevention and preparedness.
• Children in 5th and 6th grade study
geography, meteorology, first aid and CPR.
• Further information in secondary school
(high school).
Disaster Education
• “Commitment to saving human lives our
first priority and this is achieved through
education from an early age about the
dangers associated with hurricanes and how
to prepare in the event of one.”
Disaster Education
Voluntary Evacuation
• People are resistance to evacuation
• Cuba uses innovative steps to appease
people’s worries
– Belongings are stored in secured warehouse
– Pets are welcome at all shelters (Vets)
– All needs are met at shelters (water, food,
medical attention)
• 15% of Cuban population evacuates vs. 2%
United States
Livestock Evacuation
• Farm animals are
evacuated to higher
ground.
• Mitigating loss to
farming and rural
communities
• 10 km inland or 2
meters above sea level
• Significant livestock
loss from Katrina and
Rita
Medical Diplomacy
• How do we improve as human beings?
• Cuba lends healthcare professionals to
humanitarian crises
• i.e. The Henry Reeves Brigade
• International cooperation NOT charity
• Cuba does not have excessive resources but
believes in ‘sharing our daily bread’
• Shared vision & equality of resources
• 63 countries (Post Apartheid South Africa and
Chernobyl)
Henry Reeve Brigade
• Henry Reeve was an American who fought
in Spanish-Cuban war.
• Brigade offered assistance of 1,500
healthcare professionals to Gulf region
immediately after Katrina
• 2,621/3000 went to Pakistan for earthquake
(45 areas)
• Largest foreign assistance campaign
Medical Diplomacy:
Pakistan Earthquake
Yearly Drill: METEOR
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•
•
•
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Yearly disaster preparedness drill
Everyone participates!!!
This includes the public
Drill usually done on Sunday using neighborhood
associations
Families can test their disaster plans
Hotel staff and functional drill for tourists
Issues can be solved prior to real event
Plan-Drill-Revise
Cuban Buzz Word: Political Will
• “Fidel is always there”
• Many Cubans cited
‘political will’ as a
reason and/or cause
for their success in
disasters.
• Fidel assures
confidence and safety
to public.
Why Political Will is Needed?
• “Cuba’s political will prioritizes disaster
preparedness and works together with
citizens to design and implement a
comprehensive risk reduction program.”
Benchmarks of Success
• 124 mph storm—2 million evacuated—
ZERO loss of life
• 100,000 people evacuated safely in 3 hours
• No deaths from electrocution
• Minimal loss to pets and livestock
• Massive volunteer efforts in recovery phase
The Cuban Way
• Emphases public’s role
• Focuses on saving lives
• Connectivity of public,
gov’t and media
• Solid disaster education
• Yearly practice with
METEOR
• Creates empowerment
and equity
• Political will
• Reliable forecasts
• Early Warning