Climate catastrophe in Rio Grande do sul, Brazil: impact of strategic actions in response to flooding

Abstract

Objective

In May 2024, Rio Grande do Sul, Brazil, faced the greatest climate catastrophe in its history when a flood affected approximately 90% of the entire state territory. This study aimed to describe the strategic actions of volunteers gathered by a social institution linked to a private hospital in southern Brazil and their impacts on the affected community.

Methods

Descriptive study, based on the experience of the team at the Instituto Moinhos Social (IMS) - Hospital Moinhos de Vento (Rio Grande do Sul - Brazil), which brought together a group of volunteers to develop actions in response to the flood. Between 05/01/2024 and 07/31/2024, the IMS organized donations of basic items, health care, and monetary donations to recover goods for people affected by the flood.

Results description

The IMS had 583 volunteers working in the phase of receiving, organizing, and distributing donations and 208 health professionals for emergency care, mental health, and telemedicine. In total, approximately 317 thousand basic items were organized and distributed, which benefited almost 100 thousand people; 1044 people received health care; and 490 families received vouchers worth R$2,500 (US$455,66) for the recovery of material goods.

Background

Globally, it is observed that climate change has been worsening environmental changes, including heavy rainfall events [1]. These events, when prolonged and associated with a low functional capacity of natural and artificial drainage systems, can lead to pluvial flooding [2].

Pluvial flooding tends to have a strong impact on urban environments, especially those in situations of social vulnerability, where human and material losses are more evident [2,3,4]. In this sense, the state of Rio Grande do Sul, Brazil, because it has a humid subtropical climate, is particularly susceptible to extreme weather events [5]. Due to its large network of rivers and frequent periods of heavy rainfall, the state has already experienced flooding that has significantly impacted both urban and rural areas [5]. However, in May 2024, the state faced the greatest climate catastrophe in its history, in which a large volume of rain triggered a flood that affected approximately 90% of the entire state territory, resulting in more than 600,000 people being displaced or left homeless [6]. In the health sector, more than 3,000 health facilities were affected [5].

In this scenario, the work of social institutions and civil volunteers was essential in supporting the emergency needs of the affected population, such as food and health care. Thus, the objective of this work is to describe the strategic actions carried out by a group of volunteers brought together by a social institution linked to a private hospital in southern Brazil and their impacts on the affected community.

Methods

This is a descriptive study based on the experience of the team at the Instituto Moinhos Social (IMS), an initiative that consolidates the social actions of the Moinhos de Vento Hospital, located in the city of Porto Alegre - Rio Grande do Sul - Brazil (Fig. 1), in areas relevant to the development of society, especially for the most vulnerable people. During the flood period (01/05/2024–05/30/2024), the IMS organized donations and health care for people in shelters, for the employees of the Moinhos de Vento Hospital itself, and affected residents of the metropolitan region and interior of the state. It is worth noting that at the time of the flood, there was no management or contingency plan for natural disasters. Therefore, the organization and interventions carried out occurred independently of other institutions and in a format that was considered most appropriate for the situation. Post-flood actions became permanent, but for the present study, actions and results will be reported up to the date of 07/31/2024. Figure 2 presents a timeline of the actions developed.

Fig. 1

Map of South America, highlighting Rio Grande do Sul, Brazil (city of Porto Alegre), where the Instituto Moinhos Social - Moinhos de Vento Hospital is located

Fig. 2

Timeline with the main dates of the actions carried out by the Instituto Moinhos Social during the flood in Rio Grande do Sul, Brazil

All interventions were carried out by civilian volunteers, without training in climate disasters, under the organization and supervision of the IMS team. As there was no plan to recruit volunteers to deal with the flooding, the IMS used the following strategies: (1) contacting a previous list of registered volunteers, who had already carried out some activity in different areas from the perspective of health promotion and prevention, but without training to support disasters; (2) providing a link for volunteer registration aimed at employees from any area of ​​the associated Hospital; (3) welcoming volunteers who made a spontaneous search on IMS communication channels, offering to help in any necessary activity.

Concerning donations, the strategies used were: fundraising, a campaign to receive and distribute donations of clothing, blankets, water, food, medicines and hygiene, and cleaning products, partnerships with other hospitals and establishments in Brazil, providing housing for homeless employees of the institution, and providing ready-made meals for lodging in cities in the capital, metropolitan region and interior of the state.

As for health care, the assistance plan for victims took place as follows: making doctors and other health professionals, such as nurses, nursing technicians, and pharmacists available to provide direct care in the shelters. In this context, first aid care was provided, prescriptions were renewed and continuous medication was distributed, referrals were made to health institutions, vital signs and blood pressure were measured, vaccinations were carried out, medicines and hospital supplies were stored and consultations were offered via telemedicine to the general public during the flood period and a mental health clinic was created for employees.

In addition to emergency response, IMS also carried out a monetary donation campaign, which was used to provide vouchers. This resource, made available to both employees and the general public, was intended to help recover material goods, according to family needs, for the reconstruction of their homes damaged during the flood.

The study was conducted following the Declaration of Helsinki. As this is a descriptive study, with the presentation of aggregated data and not personal data, Human Ethics and Consent to Participate declarations are not applicable.

Results

Table 1 presents a summary of interventions carried out by IMS and the number of people who benefited. To carry out the volunteer work, IMS had 583 volunteers working in the stage of receiving, organizing, and distributing donations. For the external community, that is, shelters, distribution centers, family homes, and other accommodations for flood victims, 238,349 items of clothing, blankets, water, food, medicines, hygiene, and cleaning products were donated to 120 associated locations, which benefited 91,490 people who were in a vulnerable situation. In addition, approximately 30 ready-made meals were distributed daily for 1 month to a shelter for people undergoing cancer treatment, and 250 beds were donated to the locations. For the internal community, that is, Hospital employees, approximately 100 employees were sheltered for 20 days in rooms at the hospital, 4,104 received 69 thousand donated items and 1428 employees received 10,033 kg of non-perishable food.

Table 1 Summary of interventions carried out by IMS and number of people benefited

Regarding health care for the population, 208 doctors and other health professionals were assigned to volunteer work throughout May 2024, who attended to approximately 574 people in temporary shelters. Telemedicine consultations for the general public were carried out 700 times. In addition, 80 employees in the mental health clinic benefited from consultations with a volunteer clinical psychologist.

As for monetary donations, the IMS raised 1,400,000 Brazilian reais, which is equivalent to 256,880.73 US dollars (based on the US dollar exchange rate of R$5.45 in Brazil on August 20, 2024). These amounts were distributed through vouchers worth R$2,500 (US$455,66) to 490 families (250 employees and 240 residents of Porto Alegre and the Metropolitan Region).

Discussion

In a climate disaster scenario triggered by a flood, situations such as shortages of drinking water, food, and clothing, as well as damage to basic sanitation, end up becoming a reality for many people, especially the most vulnerable [7]. In this sense, non-profit social service organizations, that is, private organizations that work for a social mission rather than financial gain, which is the case of IMS, play a fundamental role in providing immediate assistance to this population [8]. This immediate assistance involves direct donations of scarce items, as well as emergency shelters or financial support services, and is necessary to contribute to the response to the disaster [8].

Although it is not their primary area of ​​activity, in the circumstances of a natural disaster it is common for this type of organization to adapt its way of working, temporarily or permanently, to meet the needs of the affected community [8]. Therefore, the IMS had to adapt its operational organization structure to provide essential donation items, as well as gather volunteers from the health area or without specific professional skills to provide support in disaster areas.

The work of volunteers is another highlight in environmental emergencies, since, even without experience in the activities carried out, they seek to assist unknown individuals. Often motivated by a sense of altruism, empathy for disaster survivors, and a sense of duty, the impacts of volunteer interventions generated in the assisted community are extremely beneficial, leading to an increase in community resilience, which includes greater social cohesion, greater disaster preparedness, and psychological support, which positively influence the well-being of victims [9]. In this context, it is clear that the support of the volunteers who were gathered by the IMS to provide support to the homeless in the community outside and inside the institution was certainly very positive, as they reached almost 100 thousand people who were directly impacted by the flood, in terms of donations.

Furthermore, the work of health volunteers (doctors, nurses, nursing technicians, and pharmacists) is also vital in crises, as injuries, infectious diseases, and difficulty in accessing health services are direct consequences of flooding [10]. It is common in flood situations for hospitals and other health institutions to be deactivated, causing an overload of patient admissions in those not affected, which creates difficulty in providing emergency and routine medical care for patients with chronic diseases [10,11,12]. Therefore, the provision of health professionals by the Hospital, mobilized by the IMS, was fundamental in caring for the population, as it met all the necessary health demands at that time, offering immediate assistance (first aid), in addition to medication prescriptions, vaccinations, and mental health care. It is important to emphasize that mental health support in situations of destruction caused by climate events is extremely important since the consequences of experiencing such events can include anxiety and mood disorders, acute stress reactions and post-traumatic stress, as well as a reduced sense of identity due to material and human losses [13, 14]. In addition, the impact on mental health is aggravated in people in vulnerable situations, especially in low- and middle-income countries, which is the case of Brazil [13, 15].

It is also worth noting that, in the context of the overload of health institutions, the telemedicine service for the general population, offered by the Hospital and mobilized by the IMS, was extremely significant, as it prevented 700 people from seeking in-person care, relieving the burden on other health institutions. Thus, telehealth and telemedicine, as emerging healthcare technologies, should be further explored in times of public calamity to remotely assist in medical screening and assessment, expanding access to primary and specialized medical care [16].

Conclusion

The challenges in caring for the physical and mental health of people affected by floods are great, and therefore, the collaboration of organizations and volunteers is essential for response and recovery operations after natural disasters. In the face of the situation in the state of Rio Grande do Sul, even without expertise in supporting climate disasters, the IMS played a significant role in the lives of the population assisted. It is important to highlight the need for greater training to deal with future disasters and more studies on the subject to share actions and strategies that can help other affected areas.