A “chaotic” situation and a human toll that will continue to “increase”. Ambdilwahedou Soumaila, mayor of Mamoudzou, capital of Mayotte, gave a gloomy inventory this Tuesday, December 17, three days after the passage of Cyclone Chido which ravaged the island this Saturday, December 14. If the official toll shows 22 dead and 1,373 injured, the reality could be even darker. Last Sunday, prefect François-Xavier Bieuville raised the possibility of “hundreds” or even “thousands” of victims. The situation could well get worse in the coming days, as the authorities fear the outbreak of epidemics. The water distribution and sanitation networks are out of service. Unclean water consumed could contain viruses which could lead, in the mildest cases, to gastroenteritis, but also to leptospirosis, typhoid fever, or even cholera. This disease had also affected up to 200 people between February and June.
These serious conditions, which require rapid and extensive treatment, risk being difficult to treat in Mayotte with its ravaged infrastructure. “Twenty-five first medical evacuations of patients in urgent situations” have already been carried out on Monday between Mayotte and Reunion, declared the Minister of Health, Geneviève Darrieussecq. These operations “should continue in the coming days,” she explained. At the same time, a field hospital will be deployed on site. Emergency services will have to respond to the influx of injured people, the risk of disease development, but also tropical heat. These, and the mosquitoes that accompany them, could lead to the arrival of chikungunya or dengue viruses. A nightmarish situation, which Christophe Blanchard knows closely. Currently deputy director of the Kourou hospital center, in Guyana, he was deputy and interim director of that of Mayotte. While stationed in Saint-Martin, he also experienced the pressure of Hurricane Irma on the island’s health system.
L’Express: You experienced Hurricane Irma in Saint-Martin in 2017. Are the scenes of desolation in Mayotte comparable?
Christophe Blanchard: Saint-Martin, Mayotte, it’s the same situation. It looks like a bomb has hit there and everything is razed. It’s not the event itself that’s scary: we hunker down, we wait. But it’s the day after, with the astonishment it brings. In my case, for example, my house exploded. I had to go and live with a colleague. Caregivers in Mayotte are experiencing similar times, or even worse, to the extent that the island is less developed and has less infrastructure. Beyond the caregivers, there will be hundreds of deaths, if not thousands. Dozens of people remained in their unsanitary homes during the cyclone. As we start to collect the metal sheets, we risk finding bodies, unfortunately.
Do you have any specific fears for the Mayotte hospital center?
The hospital was also badly damaged – but it is running. I draw a new parallel with Irma: in Saint-Martin, the caregivers remained on site the night of the hurricane. They didn’t know what happened to their house because they were on duty with me that night. In the early morning, the hospital was able to welcome patients at short notice, because the teams were there. They remained on site to accommodate the flow of patients. The same principle applies to Mayotte, with several difficulties: their emergency service was completely flooded. That of resuscitation, a little too. The care units must be put back into working order very quickly. This obviously involves draining the water, but also caulking the windows to prevent water from re-entering. Next, it will be necessary to determine the most viable operations to perform on patients in current conditions. The first days are always those of system D.
Do you think all precautions were taken before the cyclone arrived?
I think Mayotte is less familiar with the culture of risk than the inhabitants of Saint-Martin were. In 2019, when the first alerts were given on the island about cyclone Belna, no one really panicked, arguing that this type of event generally avoided the island, that Madagascar was acting as a screen and protecting Mayotte. It was true. But all it takes is a cyclone with a trajectory like Chido’s to contradict this reasoning. I think people weren’t sufficiently acculturated to risk among caregivers – and that’s probably even more true in the general population.
Cholera, dengue fever, chikungunya… Is the risk of epidemic significant?
The risk of an epidemic was much greater in Mayotte than in Saint-Martin at the time. But the risk was still present: when we started to make piles to collect the waste, rats and flies were attracted. We will have to pay attention to this health issue. Especially since Mayotte has much more favorable terrain, particularly on the issue of cholera, a disease which has already affected them this year. The water network does not work in their favor. We are talking about an island occupied by unsanitary housing on dozens of hectares. This means networks in poor condition, but also people who do not know – or who cannot do otherwise – and who consume directly from the pipe, without the water having been treated beforehand. These conditions favor the emergence of epidemics.
Add to this that Mayotte is a department with a particularly high density: 320,000 square kilometers for as many inhabitants officially. Some counts claim that there are more than 450,000 people on the island, uncounted because they are undocumented. This data will also complicate the situation. When I was there, I remember long queues from 4 a.m. in front of the Jacaranda health center. About a hundred patients were already waiting outside the doors. It was everyday life, not a natural disaster situation.
What will be the first difficulties for caregivers?
Probably information gathering. Then the coordination of aid. In Mayotte, the hospital center is the heart of the health system. He provides 90% of general care. You should also know that there is only one hospital on the island. The question of childbirth also arises acutely in Mayotte. In Saint-Martin, we had 600 deliveries per year. We had not been faced with the same problem as our colleagues in Mayotte, with women giving birth at home, in very difficult conditions today for some.
Some people, not afraid of being deported because they were undocumented, did not go to the accommodation centers. Do you think that such a barrier still exists, particularly in terms of healthcare today?
Let one thing be clear: the Mayotte hospital treats everyone. It was noted that many people probably did not go to the accommodation centers when the cyclone hit. Several explanations have been put forward, but one simple one must be remembered: the language barrier. Many in Mayotte do not speak French, or not well. There may have been a problem of understanding, which may arise in the coming weeks. However, the hospital is well equipped in this area. A few months ago, a service of translators and interpreters of several dozen people was set up.
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