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It’s a week since Papua New Guinea (PNG) experienced a massive in the , in the country’s highlands.

More than have been affected by the landslide, including more than 3,300 children. This could mean they’ve been displaced from their homes or are lacking access to basic necessities.

The is still unknown, and estimates have varied, but the figure could be . Estimating deaths in disasters comes with and we may never know the actual number of lives lost.

But even many survivors are likely to be facing serious injuries and illness, with warnings of a significant in the region.

So what are the potential health risks following a landslide? And what can we do to mitigate them?

From injuries to illness

Like many natural disasters, can lead to serious physical harms. Rapidly flowing water and debris can cause injury and death. People may become trapped as the landslide carries buildings, structures and people in an unpredictable manner.

The Enga landslide happened in the middle of the night, which sadly meant most people could not escape in time.

Early after a natural disaster almost always focus on minimising casualties and providing essential and immediate medical care.

Once the situation stabilises, the health situation on the ground may require a to review the potential public health impacts and further determine the needs of the community.

Other natural disasters show us it’s likely there will be an of disease outbreaks after the landslide. This could include water-borne diseases, such as diarrhoea, possibly due to disrupted access to clean drinking water, as well as reduced sanitation and hygiene.

Skin diseases, such as scabies and yaws (a bacterial infection), , which could also lead to outbreaks with close contact in overcrowded settings.

and can also lead to proliferation of mosquitoes and other vectors. This could increase the risk of vector-borne diseases, such as dengue, especially if the disease is already circulating, which is the case in PNG.

PNG is one of the few countries in the Pacific region where . So there could also be a risk of increased cases of malaria (another mosquito-borne disease) in the region.

We could even see a surge in vaccine-preventable diseases. The 2005 tsunami in Aceh, Indonesia, resulted in . While is not spread from person to person, contaminated wounds in people where vaccine coverage is low can result in tetanus cases and deaths.

Aceh also saw after the tsunami due to overcrowding among displaced populations, combined with patchy vaccination coverage.

Health system weaknesses

The risk of infectious diseases outbreaks in PNG stems from some underlying weaknesses in the health system, and . For example, in , it’s estimated that for children under five years old, 41 children die for every 1,000 live births. In , this number is ten times lower, at four deaths per 1,000 live births. Disparities also exist for maternal deaths, and infectious diseases such as HIV.

³Ô¹ÏÍøÕ¾ly, PNG’s immunisation rates are low. For example, in 2023, coverage for the first dose of the measles vaccine for children was . Because measles is so transmissible, should be vaccinated with at least two doses of measles vaccine.

Low vaccination coverage can lead to outbreaks during natural disasters, so PNG may be at risk.

The might also be influenced by the disruption in access to health-care services. This can result in delayed of infections.

Mitigating the risks

A disaster like this will have severe societal and economic impacts that will last for some time. We also know individuals affected by natural disasters can face and .

Beyond providing medical care, local and international agencies are working to offer shelter, clean water and food, and mental health support to affected people.

Over the coming days and weeks, it will be important to closely monitor the health situation in PNG. This will require close coordination between, and leadership from local, national and international agencies.

As primary health care is restored around the affected area, one of the key aspects to preventing outbreaks is to have effective systems in place. These can , enabling a rapid response.

For example, in Fiji after cyclone Winston in 2016, a detected outbreaks of influenza, conjunctivitis and typhoid. This prompted public health responses to prevent further spread of infection.

A rough road

PNG, like the Pacific more broadly, is vulnerable to the due to the geography, rising temperatures and communities living in remote locations.

In the , PNG has experienced storms, droughts, floods, earthquakes, volcanic activity and landslides. We know climate change can increase the risk of .

Places such as PNG are due to their geographical location, terrain and climate.
Landslides are also .

Ultimately the health effects from natural disasters and other emergencies can be minimised through , strengthening the health system, and of climate change. Beyond focusing on helping people in the Enga province, these are the things we should be working towards.

Meru Sheel does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.