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El Salvador - GFDRR

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II. POPULATION AND AFFECTED AREAS | 63<br />

B.2.4 Health Sector<br />

a) Background<br />

The natural event of November 2009 struck <strong>El</strong> <strong>Salvador</strong> which already ranked has having the secondhighest<br />

percentage of total population at high risk of death due to multiple disasters. 29<br />

With regard to health status, the country is undergoing an epidemiological transition, with an increase<br />

in deaths from non-transmissible diseases and a reduction in the relative number of infectious diseases.<br />

Most of the demand for health services continues to be for illnesses of mothers and children, especially<br />

respiratory illnesses and diarrhea, which are closely related to the provision of drinking water, hygiene<br />

conditions and lifestyles. It is estimated that over 50% of demand for ambulatory care may be met at firstlevel<br />

facilities such as health units.<br />

<strong>El</strong> <strong>Salvador</strong>’s public health system is of a mixed and organized nature in the public subsector, composed<br />

of the Ministry of Public Health and Social Assistance (Ministerio de Salud Pública y Asistencia<br />

Social -MSPAS), the <strong>Salvador</strong>an Institute of Social Security (Instituto <strong>Salvador</strong>eño del Seguro Social -ISSS),<br />

Teachers’ Well-being (Bienestar Magisterial -BM), Military Health (Sanidad Militar -SM) and the <strong>Salvador</strong>an<br />

Institute for Comprehensive Rehabilitation (Instituto <strong>Salvador</strong>eño de Rehabilitación Integral -ISRI) assigned<br />

to MSPAS; and the private subsector. It is estimated that 41% of the population lacks access to health<br />

services and over 50% has insufficient access due to economic and geographic barriers or to deficient<br />

infrastructure (PAHO 2004).<br />

Despite the limitations of the country’s health sector, associated with structural and financial aspects,<br />

the national government, through the Ministry of Public Health and Social Assistance, the <strong>Salvador</strong>an Institute<br />

of Social Security and other organizations, responded in a timely manner to the emergency. Added<br />

to this was the collaboration of foreign governments and of national and international cooperation agencies.<br />

All were mobilized to address the most urgent health needs.<br />

As part of the emergency response, efforts were conducted to care for the wounded, and to treat cases<br />

of diarrhea and acute respiratory illnesses, dermatological and mental health problems, which were part of<br />

what was expected, considering the nature of the event and the country’s epidemiological profile.<br />

Despite the damages and environmental conditions, health services remained operating at all times,<br />

and public health care coverage was expanded through the strengthening of capacities in the disaster<br />

zone.<br />

b) Effects of the Disaster<br />

b.1) Effects on Health Services<br />

Damages have been reported in eight health facilities, 2.8% of those existing in the affected departments.<br />

Most of them are located in the peri-urban zone of the city of San <strong>Salvador</strong>, where five of them suffered<br />

29<br />

Natural Disaster Hotspot Study, World Bank.

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