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At least 217 records · Page 12Linked to original sources
PubMed1981

Handling the emotional response to disaster: the case for American Red Cross/community mental health collaboration.

This paper presents the theory, rationale, and a working model for integrating professional resources at the time of a disaster. Red Cross and community mental health agencies have worked for too long in parallel. A collaborative approach to meeting the emotional needs of disaster victims makes optimal use of indigenous resources; provides skill and knowledge normally lacking in each agency alone; and helps provide, through early intervention, a preventive factor to thwart long term community distress. Options for maintenance of readiness, local or regional adaptation and piloting are also discussed.

Adjustment Disorders↗
PubMed2004

Rights, standards and quality in a complex humanitarian space: is Sphere the right tool?

The Sphere Project (consisting of both the Humanitarian Charter and Minimum Standards for Disaster Response) has made prominent contributions to the debates, thinking and work on the quality of assistance and accountability of aid agencies. However, since its inception in 1997, several agencies expressed concerns regarding Sphere's approach, many of which were confirmed by the Sphere evaluation (2002/3). The present article restates these concerns, and addresses more fundamental issues regarding Sphere's cornerstone. It questions the validity of Sphere's rights-based approach, which consists of a tenuous link between the rights of affected populations and standards for technical interventions. Sphere is founded on "the right to assistance", although this right does not exist in international law. Its elaboration would entail solving several complex legal and political issues, which Sphere fails to address. This article also questions the validity and usefulness of universal standards for technical performance in helping relief agencies provide adapted assistance to disaster-affected populations, in line with their mandates and principles. It suggests that Sphere's approach and content largely reflect the concerns, priorities and values of technical professionals in Northern agencies, leaving limited space to genuine "participation" by affected populations and partners from the South.

Altruism↗
PubMedDate not supplied

Fred C. Cuny Memorial Continuing Education Series. Lesson 10: group dynamics in disasters: managing work groups.

Groups are assigned or formed to perform tasks that one person cannot accomplish alone. This lesson describes the classification of work groups, group unity, leadership, motivation, recognition, conflict resolution, and remediation associated with managing groups and their activities. Advantages associated with group process include 1) the generation of better ideas, 2) ability to assume greater risks; make fewer errors; 3) the capacity for greater knowledge and 4) information, and for some problems, production of better decisions. Groups may be formal or informal. Formal groups may be organic, task-directed, or committees. Informal groups arise when it becomes obvious that a group will work better or may be formed by a discipline within the organization or through friendships. The size of the group its status within the organization, the goals established, and the dependence of the members on the group all may affect the cohesiveness of the group. Leadership of the group must keep the group focused on the objectives and enhancement of the efficiency of its operation and the quality of the decisions made by the group. Motivation of a group often is more difficult than is that for individuals and generally positive inducements work better than do negative measures such as coercion and reprimands. Roles are often informal and conferred by the group collectively. Often norms are established within groups that help the group deal with conflict. Inadequate performance within a formal group may require changes in the leadership, removal of a member or clique within the group, reduction of group size, and/or dissolution of the group. Understanding the dynamics of groups is an essential skill required of good managers.

Goals↗
PubMed1998

Cool ground for aid providers: towards better security management in aid agencies.

Although full statistics are lacking, there is an impression that aid personnel are increasingly at risk from random, criminal and even at times targeted violence. The argument here is that the current tendency to reduce an agency's vulnerability mainly through the use of protective procedures and devices may be necessary but is insufficient. Better practice in the management of security is an urgent need. Reducing vulnerability to attack is only one approach; deterring the threat of violence by counter-threat, or seeking increased acceptance for the agency's work and presence are two other approaches. Major skill development is required in the areas of conflict analysis and monitoring, threat assessment and incident analysis, since together these form the basis for appropriate security management. Improved analysis can then inform a conscious choice about which mixture of approaches is most appropriate in a specific context. The paper explores in some detail the factors that influence acceptance, but not the methods and basic principles in the use of counter-threat.

Humans↗
PubMed2001

[Hygiene is not cleanliness. For a new definition of hygiene promotion in emergency humanitarian aid].

Following the Kosovo crisis, this paper questions the contents of hygiene kits to be distributed to refugees, the definition of hygiene and the hygiene promotion practises in emergency aid work. Hygiene promotion cannot be reduced to cleanness promotion. We have to consider refugees' psychosocial needs and trauma as well as the problems of refugees settlement as a community and of community mobilisation to conceive programmes meeting population's needs and demands. Hygiene promotion should include systematic attempts to implement community services by volunteer refugees. One has to be careful also that the financial mechanisms of aid do not pervert programmation.

Africa↗
PubMed2004

The medical mission in NATO operations.

Medical support during crisis response operations should follow state-of-the-art standards of medicine, but at the same time to take into account more difficult conditions for medical care providing. The results of treatment of patients during crisis response operations should lead to results as close as possible to peacetime treatment. Multinationality has been working well in the Sipovo Multinational Integrated Medical Unit (MIMU) in Bosnia and Herzegovina until now. The mutual co-operation of nations results in a reduction in terms of personnel and material for all participants. It allows efficient use of resources and could be a model for Role 3 care in other hospitals. It has proven to be greater than the sum of its parts. The MIMU concept can be considered a cornerstone that guarantees the required continuity and stability.

Hospitals, Military↗
PubMed2002

[Care for refugees in sanctuary--a challenge for the health services].

BACKGROUND: When the first sanctuaries for asylum seekers were established in 1993, psychological consequences were a concern and an interview study was started. MATERIAL AND METHODS: The study focused on the refugees' background, physical and psychological reactions, the children's situation, coping strategies and post-traumatic effects, and whether the church-asylants got adequate care from the health services. Twenty former and present church asylants and the same number of helpers with various backgrounds were interviewed. RESULTS: The reasons for seeking sanctuary in the church were fear for one's life, lack of future opportunities, and refusal of asylum. Uncertainty was the most difficult aspect of their plight. All 20 asylants reported headaches, insomnia, sadness, suicidal thoughts and restlessness. In a small minority suffering from severe psychiatric disturbances, previous experience of trauma, were predominant. Education, training, work, social contact and health assistance were organized to cope with the situation. Basic hopes, a wish to help children and family, and experience of friendship and solidarity were the most important motivational factors for keeping up morale. INTERPRETATION: The study shows that church asylants who take an active role, receive emotional support, and have good health services available are protected psychologically during their stay in the sanctuary, possibly also in the long term.

Adaptation, Psychological↗
PubMed1992

Psychological responses of rescue workers: fire fighters and trauma.

The psychological responses of two groups of fire fighters were examined following the performance of rescue work. Four types of responses were reported: identification with the victims, feelings of helplessness and guilt, fear of the unknown, and physiological reactions. Stress was found to be mediated by availability of social support, type of leadership, level of training, and use of rituals. Implications of these findings for preventive intervention measures are discussed.

Accidents, Aviation↗
PubMed2006

Literature review: Afghanistan women's health crisis, health service delivery, and ethical issues for international aid.

The literature indicates that the health of women in Afghanistan is poor. In 1997 maternal mortality in Afghanistan was one of the worst in the world. Difficulties in establishing health services revolve around fundamentalist Islamic ideas and ongoing violence within Afghanistan. The literature holds advice on key behaviours for health professionals who may chose to work in Afghanistan. The literature also identifies the local level action that is occurring as the issue of women's health is recognised. Humanitarian assistance has been provided, with international aid agencies having to weigh the ethical responsibilities they hold and one agency tragically facing the violent loss of its own staff. Easy answers are not in the literature, merely an opportunity to understand, consider, and take action about what is facing women in Afghanistan and those who try to help.

Afghanistan↗
PubMed2007

Contextual empowerment: the impact of Health Brigade involvement on the women of Miraflor, Nicaragua.

This qualitative, descriptive study investigated how working with Health Brigades influenced a sense of empowerment and a resultant shifting of gender-power relationships for women in a rural Nicaraguan community. A convenience sample of 10 women aged 18 to 65 years who had worked with the Brigades were interviewed. Open and axial coding were used to determine core categories and theoretical concepts. From this emerged a grounded theory of contextual empowerment. Key findings included that within this collectivist culture, the concept of contextual empowerment includes psychosocial and structural dimensions. Implications for nursing practice include the impact of unintentional role modeling.

Adult↗
PubMed2000

Similarity of prior trauma exposure as a determinant of chronic stress responding to an airline disaster.

The cumulative effects of trauma were examined in 108 workers at the site of a major air disaster at 4 time points over a year following the crash. The influence of trauma history on chronic distress and physiological arousal associated with the crash were examined. Stress levels were expected to differ on the basis of the similarity of prior trauma exposure to work at the crash site. Prior traumatic exposure that was "dissimilar" to this type of work was associated with greater vulnerability to crash-related stress, that is, more distress and crash-related intrusions during the year following the crash. Accumulation of a variety of different traumatic experiences appeared to sensitize workers to the new stressor and to perpetuate chronic stress. Understanding the role of trauma history is important for improving intervention efforts aimed at alleviating stress following a trauma.

Accidents, Aviation↗
PubMed2006

Lessons in posttraumatic stress disorder from the past: Venezuela floods and Nairobi bombing.

Identification and treatment of posttraumatic stress disorder (PTSD) are important following a disaster. Insights into how these aims can be achieved may be obtained from previous disasters. This article describes mental health initiatives following the 1999 flooding in Vargas State, Venezuela, and the 1998 U.S. Embassy bombing in Nairobi, Kenya. Following the Vargas State floods, a specialist mental health center devoted to the diagnosis, treatment, and follow-up of PTSD was established. Awareness and acceptance of the clinic was promoted by media campaigns and community-based activities. After 18 months, approximately 5000 people had been screened, of whom 62% were diagnosed with PTSD and treated. Moreover, the clinic's activities had expanded to include treatment of other medical conditions and assistance with nonmedical needs. Following the Nairobi bombing, a mass media campaign was initiated to create awareness of PTSD symptoms and help victims come to terms with their experience. This campaign was found to be well received and helpful. In addition, counselors were trained to support people living or working close to the blast. These examples show that mental health initiatives are feasible after a disaster and highlight a number of issues: (1) The intervention should be tailored to the needs of the target population; (2) Communication should be simple and appropriate; (3) Community-based activities are valuable in promoting awareness and acceptance of mental health initiatives; (4) Reducing the stigma often associated with mental health problems is important; and (5) The mass media can be helpful in promoting awareness of mental health issues following major trauma.

Community Mental Health Centers↗
PubMedDate not supplied

[Validation of an evaluation guide for healthcare training programs in the field of humanitarian efforts].

The training of healthcare professionals working in the field of humanitarian action is of fundamental importance but there have been few procedures for assessing the training programs. A specific guide was produced for the evaluation of healthcare training programs. It uses a three-pronged approach to improve the training of healthcare personnel, encouraging educators to take a fresh look at the way in which they work. The guide seeks to improve the efficiency of training by evaluating programs. The guide was tested on four training programs conducted by three non-governmental organizations in three countries: Handicap International in Cambodia and Mozambique, Médecins Sans Frontières in Cambodia and Action Nord Sud in Brazil. Questionnaires, guides and appraisals were analyzed, and the results suggested that the guide was valid, reproducible and easy to use. However, it is vital to provide external educational assistance during evaluation, to promote the implementation of decisions, thereby improving training practices.

Attitude of Health Personnel↗
PubMed1995

On a front line.

Like the patients, doctors in Sarajevo depend largely on humanitarian aid; everyone in the public sector has worked without pay for almost three years. The hospital is on a front line; yet the psychiatric department continues to function, even conducting large scale studies of psychosocial aspects of war in Bosnia-Hercegovina. The type of inpatient morbidity and treatment patterns have changed. A plethora of psychosocial rehabilitation programmes has emerged, including counselling, drop in centres, and attending to special needs of elderly people, schoolchildren, and women. The most prominent psychological symptoms were exhaustion at the prospect of a third winter of war and bewilderment at the Western stereotype of Bosnians as Muslim fundamentalists.

Bosnia and Herzegovina↗
PubMed2004

Information support for the ambulant health worker.

Health workers are trained to work in information-rich environments. Nineteen medical students evaluated 2700 patients in four villages in Kenya where there was no power or phone. A model of information support included personal digital assistants (PDA), electronic medical records (EMR), satellite telecommunications, medical software, and solar power. The students promptly found the advantages of PDA over paper. By using software for decision support and interacting with the EMR data for medical expertise, very few live telemedicine consults were needed. The cost of this information support was only US 0.28 dollars per patient visit. We conclude information resources can be provided in remote environments at reasonable cost.

Attitude to Computers↗
PubMed2000

The role of the pharmacist in humanitarian aid in Bosnia-Herzegovina: the experience of Pharmaciens Sans Frontières.

BACKGROUND: Founded in 1985, Pharmaciens Sans Frontières (PSF) is a nongovemmental organization of pharmacists involved in humanitarian aid. PSF relied on approximately 100 expatriates in 1998, which included 50 pharmacists distributed throughout 24 missions (i.e., 14 emergency, 7 development, 3 assessment). It is necessary to add 200-250 local staff to this group. OBJECTIVE: To describe PSF's mission in Bosnia-Herzegovina from 1992 to 1999 and to define the pharmacist's impact in the supply of medicines and the development of pharmaceutical care and services. RESULTS: In April 1992, at the beginning of Sarajevo's siege, PSF sent a small team of three volunteer pharmacists to Bosnia-Herzegovina. The objective of the emergency phase (1992-1995) was to set up a massive supply program of essential medicines and medical and biologic materials and to implement a distribution system based on existing health centers. The signing of the Dayton peace agreement and a progressive return to peace and stability marked the beginning of the postemergency phase (1995-1997). This phase pursued previous objectives of establishing a distribution network and added the implementation of logistic centers. PSF widened its involvement to medical laboratory analysis, production of medicines, disposal of expired medications sent during the conflict, and the implementation of a national center for quality control. Currently, the development phase's (1998-1999) objective is to provide adequate support for the reorganization of pharmaceutical care and services by establishing pharmacy work groups and developing and maintaining good relationships with the international community and Bosnia-Herzegovina pharmacists. CONCLUSIONS: Humanitarian aid is essential in major conflicts, as seen in the case of Bosnia-Herzegovina. Although it is difficult to evaluate the impact of the distribution network implemented by PSF, it allowed for a better provisioning of medications to the general population. PSF played an important role in such cases. In fact, PSF provides its pharmaceutical expertise to these embattled areas not only by offering financial support to the logistics or supplying of medications, but by offering professional support to the organization/reorganization of the pharmaceutical practice.

Bosnia and Herzegovina↗
PubMed1996

Medical supplies donated to hospitals in Bosnia and Croatia, 1994-1995. Report of a survey evaluating humanitarian aid in war.

OBJECTIVE: To evaluate access to and distribution and quality of medical supplies donated by humanitarian aid organizations to hospitals and health services during the war in Bosnia and Croatia. DESIGN: Retrospective survey of 68 representatives of hospitals and field hospitals regularly caring for inpatients between May 1994 and April 1995. SETTING: Three study areas: the Republic and Federation of Bosnia-Herzegovina, Republika Srpska (part of Bosnia-Herzegovina controlled by Bosnian Serbs), and Republika Srpska Krajina (part of Croatia controlled by Croatian Serbs during the study period). PARTICIPANTS: Of 68 hospital representatives, 44 completed the survey (65% response rate). Respondents did not include representatives from 11 hospitals and field hospitals that could not be contacted because of operational obstacles resulting from the ongoing war. RESULTS: Lack of supplies was reported as an important limitation by 62% (26/42) of respondents, followed by lack of staff and security, physical isolation, and lack of infrastructure. Antibiotics were mentioned by 76% (32/42) of respondents as the unavailable drug or item most urgently needed. The majority of drug and medical supplies used to treat patients had been supplied by 5 humanitarian aid organizations. The frequency with which respondents mentioned their ¿own means¿ (eg, from the ministry of health or respective municipalities) was relatively low (9%), reflecting the high degree of dependency on humanitarian aid. All respondents rated the quality of donated supplies and the working relationship with the donating organization as ¿very good¿ or ¿satisfactory¿; 93% 41/44) of respondents indicated that the donated supplies were appropriate. Six of 44 respondents preferred to receive supplies as part of assembled kits; 70% (31/44) preferred to receive such assistance as loose supplies according to demand. CONCLUSION: During war, access and security are beyond the control of humanitarian agencies. Assistance coordination, however, must be provided. Although a consensus on policies and objectives between different humanitarian organizations is difficult to reach, satisfactory complementarity can be achieved. The systematic and continuous gathering of information at the recipient and user level, beginning at the early phase of the conflict, is recommended to maintain appropriate assistance.

Bosnia and Herzegovina↗
PubMed2001

NGO initiatives in risk reduction: an overview.

NGOs appear to be well placed to play a significant role in natural disaster mitigation and preparedness (DMP), working, as they do, with poorer and marginalised groups in society. However, there is little information on the scale or nature of NGO DMP activities. This paper reports the findings of a study seeking to address that gap. It confirms that NGOs are involved in a diverse range of DMP activities but that a number of them are not labelled as such. Moreover, evidence of the demonstrable quality and benefits of DMP involvement is poor. The paper concludes that a number of problems need to be overcome before DMP can be satisfactorily mainstreamed into NGO development and post-disaster rehabilitation programmes. However, there are some early indications of momentum for change.

Developing Countries↗