I. HIGHLIGHTS
• There are 4,027 injured, mainly in cities in the provinces of Manabí (Pedernales, Chone, Bahía de Caraquez, Manta and Portoviejo), Guayaquil and Santo Domingo; 2,959 people are in shelters; 231 people are missing and 413 deaths have been reported as of 22:30 on 18 April 2016.
• The most affected provinces are: Manabí, Esmeraldas, Guayas, Santo Domingo, Santa Elena and Los Ríos. The population at the impact area where the earthquake magnitude was highest (MMI scale from VI to VIII) is 2,480,000, according to USGS/PAGER.
• The Chone General Hospital and the Hospital of the Ecuadorian Institute of Social Security (IESS) suffered significant structural damage.
• Suspension and damages to water and sanitation services, and loss of housing are risk factors for the population in affected areas and pose challenges to the health system.
• The Ministry of Health reports that mobilization of Emergency Medical Teams is not required.