Wiley H. Mosley

EAST BENGAL CYCLONE OF NOVEMBER, 1970: EPIDEMIOLOGICAL APPROACH TO DISASTER ASSESSMENT

Abstract Two medical relief assessments were carried out in the southern coastal region of East Bengal affected by the cyclone and tidal bore of November, 1970. The first, a rapid 18-site survey, documented the adequacy of existing water supplies and absence of significant post-cyclone morbidity or exceptional levels of epidemic diseases. The second, wider in scope, was done 2 months later, between Feb. 10 and March 4, 1971. Seventy-nine unions in the nine most affected thanas were visited, and 2973 families, comprising 1·4% of the areas population, were studied. Age-specific cyclone mortality ranged from highs of 29% and 20% in the 0-4-year and 70+ age-groups, respectively, to a low of 6% in 35-39-year-olds. Females fared worse than males in all but the youngest age-groups. Mean mortality was 16·5%, representing a minimum of 224,000 deaths. More than 180,000 homes were destroyed by the cyclone, and at the time of the survey 600,000 people were still without adequate shelter. Although post-cyclone morbidity, mortality, and nutritional status compared favourably with a control area, 1,000,000 people were still dependent on outside food relief for survival. At least 123,000 draft animals and 127,000 ploughs were needed before the region could begin to regain agricultural self-sufficiency. The surveys prove the value of early on-the-spot assessments in getting an accurate picture of requirements in disaster areas.

The effect of fecundity on fertility in rural East Pakistan (Bangladesh).

To determine levels of fecundity--the biological capacity for reproduction-- in various population segments and the effect of the fecundity levels on fertility rates 30155 ever-married women in the Matlab thana area of East Pakistan were interviewed on fecundity in early 1968 as part of a cholera eradication program. Fecundity was defined as some current or recent state of pregnancy or regular menstruation for at least 6 months. This is an admittedly rough definition with one of the problems involved among others being that only female fecundity is studied without regard for infertility in the husband. Fertility statistics were taken from official public health records. 70% of the sample were found to be fecund and as expected fecundity shows an inverse relationship with age except in the very young woman. Women who were living with their husband and who had larger families showed higher fecundity rates than others. Subfecundity was found to reduce the total fertility rate by approximately 0.8 births per woman especially in women at the extremes of the age spectrum where their contribution to total fertility is lowest. The major impact of subfecundity upon fertility was found to occur in the larger family sizes. Estimations of family size based on fecundity and female mortality rates are concluded to be more realistic than the total fertility rate.