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PubMed2006

Assisting older victims of disasters: roles and responsibilities for social workers.

The tumultuous catastrophic tragedies of the Oklahoma bombing in 1995 and September 11, 2001 attacks on the World Trade Center and Pentagon have caused urgency for the profession of social work to be ready to respond to unexpected crises whether directed to an individual, group, or nation. While there has always been the possibility of tragedies in the U.S. caused by nature (so-called "acts of God") or the spontaneous or planned acts of criminals or the deranged, the increased awareness of catastrophes includes, as never before, disasters that are perpetrated by terrorist acts from within or outside of the U.S. The creation of the Department of Homeland Security, in 2003, underscores the need for awareness and for preparation on the part of the nation. Based upon its skills and values, social workers have significant roles to play in the face of potential and actual disasters; yet, gerontological social workers have additional responsibilities for addressing the needs of older persons. It is the purpose of this article to provide an overview of issues to be considered by social workers, in general, and gerontological social workers, in particular, with regard to preparation for possible disasters and the consequences from such catastrophes that affect older persons.

Age Factors↗
PubMed1999

How pediatricians can respond to the psychosocial implications of disasters. American Academy of Pediatrics. Committee on Psychosocial Aspects of Child and Family Health, 1998-1999.

Natural and human-caused disasters, violence with weapons, and terrorist acts have touched directly the lives of thousands of families with children in the United States.1 Media coverage of disasters has brought images of floods, hurricanes, and airplane crashes into the living rooms of most American families, with limited censorship for vulnerable young children. Therefore, children may be exposed to disastrous events in ways that previous generations never or rarely experienced. Pediatricians should serve as important resources to the community in preparing for disasters, as well as acting in its behalf during and after such events.

Child↗
PubMedDate not supplied

An integrated program to train local health care providers to meet post-disaster mental health needs.

This paper describes a post-disaster mental health training program developed by the International Section of the Department of Psychiatry at Dalhousie University (Halifax, Canada) and delivered in Grenada after Hurricane Ivan struck the country in September 2004. This train-the-trainer program used an integrated community health model to help local health care providers develop the necessary skills for the identification and evidenced-based treatment of mental disorders occurring after a natural disaster. The approach also provided for ongoing, sustainable mental health care delivered in the community setting, as advocated by the World Health Organization and the Pan American Health Organization. This approach is in contrast to the largely ineffective and costly vertical whole-population psychosocial counseling activities that have often been used in the Caribbean following natural disasters.

Caribbean Region↗
PubMed2003

The veterinary surgeon in natural disasters: Italian legislation in force.

Law No. 225/1992 established a National Service of Civil Protection, with the important role of 'safeguarding life, goods, settlements and the environment from damage deriving from natural disasters, catastrophes and calamities' (art. 1). This law arranges civil protection as a co-ordinated system of responsibilities administrated by the state, local and public authorities, the world of science, charitable organisations, the professional orders and other institutions, and the private sector (art. 6). The President of the Republic's Decree No. 66/1981 'Regulation for the application of Law No. 996/1970, containing norms for relief and assistance to populations hit by natural disasters--Civil Protection' mentions veterinary surgeons among the people that are called upon to intervene. In fact, in natural disasters the intervention of the veterinary surgeon is of great importance. The authors examine these laws and other legislation relating to the National Service of Civil Protection.

Animals↗
PubMedDate not supplied

Impact of mobile clinical analyzers on disaster medicine: a lesson from crush syndrome in the 1995 Hanshin-Awaji earthquake.

The Great Hanshin-Awaji earthquake caused many people to develop crush syndrome. Analysis of these patients revealed that the severity is not related to their hemodynamics but to hematocrit, base deficits, and potassium concentrations soon after their extrications. In the disaster site, these parameters can only be measured using whole-blood samples by mobile instruments. The present study was made to evaluate the possibility of uses of a mobile measuring device, ABL77, for the triage of crush syndrome patients in disaster sites. Heparin-added blood samples and serum samples were collected from patients admitted to Senshu Critical Care Medical Center. Blood gases, electrolytes, and hematocrit of the heparin-added blood samples were measured using ABL77 and compared with those measured using the stationary device ABL725. Potassium concentrations of the heparin-added blood samples measured by the ABL77 were compared with those of the serum samples measured by the stationary EA06T. Significant correlations were observed between the measurements. We conclude that the ABL77 was satisfactorily compatible with stationary devices in the hospital. Medical institutions should have simplified, mobile measuring devices as a precaution against disasters, so that they can get ready to take appropriate action promptly.

Ambulances↗
PubMed2004

[Determinant factors of community-based disaster preparedness: a case study of flood prone area].

This study examined the determinants of willingness to participate in a community-based disaster preparedness scheme. The theory of reasoned action (Ajzen & Fishbein, 1977, 1980; Fishbein & Ajzen, 1975) was applied as a basic model and was complemented by the factor of concern about disaster. A structural equation modeling was performed to validate this model. The hypothetical model was supported for the data from the residents (N = 3 036) of an area with a high risk of flood damage. It was clarified that the subjective norm and concern about flood positively contributed to the intention of participating in a community-based disaster preparedness scheme. The perceived cost of preparedness was the inhibitory factor of participating in such a scheme.

Adult↗
PubMed1990

Disaster imminent--Hurricane Hugo.

Response to a disaster situation depends upon the type of circumstances presented. In situations where the disaster is the type that affects the hospital as well as a wide surrounding area directly, the hospital and pharmacy itself may be called upon to continue functioning for some period of time without outside assistance. The ability to function for prolonged periods of time requires the staff to focus on the job at hand and the administrative staff to provide security, compassion, and flexibility. Plans for a disaster of the nature of a hurricane require that attention be paid to staffing, medication inventories, supplies, and services being rendered. Recognition of the singular position occupied by a hospital in the community and the expectations of the local population require that hospitals and the pharmacy department have the ability to respond appropriately.

Disaster Planning↗
PubMed1990

A disaster's effects on material management operations.

No one should ever have to encounter a disaster of the magnitude of Avianca flight 052, Hurricane Hugo, or the San Francisco earthquake of 1989. However, we all learn about the appropriate preparation and response that is necessary for managing a disaster effectively after these events. The importance of material management functions in providing the resources for the implementation of direct patient care is often neglected, and recognition is rarely given to these heroes in a disaster situation.

Accidents, Aviation↗
PubMedDate not supplied

The local Red Cross in time of disaster: characteristics and conditions of organizational effectiveness during the Loma Prieta earthquake and central Texas floods.

This discussion demonstrates that three interrelated activities should improve volunteer organizations' disaster capabilities. These factors include improved disaster planning, learning from related experiences, and improving interorganizational networks. These three activities can dramatically improve the local chapter's emergency response. Networking ought to be the first priority. Through the development of both formal and informal contacts, planning and experience potential become enhances. Without the support and involvement of volunteer organizations, an effective community-wide disaster response would be difficult, if not impossible.

California↗
PubMed1994

Patient care during natural disasters.

Delivering health care requires careful coordination on normal workdays, but during a natural disaster, the organization's planning and management can be sorely tested. The most crucial aspect to consider during a natural disaster is patient care; plans have to prepare for such an event in advance. In this article, the author discusses how some HMOs around the country have coped with providing care for patients during natural disasters and offers some key strategies for successful patient care delivery.

Delivery of Health Care↗
PubMed1997

Disaster planning: meeting the challenge of 'killer' tornadoes.

In many areas of the country, tornadoes represent a major concern for hospitals in preparing disaster plans. Like all such plans, the hope is that they will not have to be put to use. But last spring, in areas of Arkansas and Texas, damage and casualties from twisters made national headlines and put the disaster plans of a number of hospitals to the test. For example, as part of the country's worst tornado outbreak since March 1994, twisters that tore through Arkansas from southwest to northeast on the afternoon of Saturday, March 1, killed 25 and injured hundreds. The tornadoes left a path of damaged buildings and downed trees more than 200 miles long. Three persons died in the Little Rock suburb of College Station. Warning sirens and TV and radio broadcasts a few minutes before the tornadoes hit were able to give area residents time to take cover, reducing the number of casualties. On May 27, tornadoes that hit three central Texas counties killed 32 people and left hundreds homeless. The small town of Jarrell was flattened by winds of up to 270 mph. In Cedar Park, about 20 miles south of Jarrell, a grocery store was demolished and a nearby shopping center had roofs torn off. Fortunately, there were relatively few injuries. In the area immediately around Jarrell, hospitals reported 33 casualties treated. The small number of injuries may have been the result of a large number of deaths, one official speculated. In this report, we'll give details on how nine hospitals in the affected areas dealt with tornado emergencies and how their disaster plans were carried out.

Arkansas↗
PubMedDate not supplied

After the flood. A strategic primary health care plan for homeless and migrant populations during an environmental disaster.

An environmental crisis, such as a flood, can significantly affect health care delivery and services in a community. Environmental disasters can be particularly devastating to already vulnerable populations such as the homeless and migrants, who, because of social, political, and economic constraints, experience special health care needs. In 1993, after Iowa experienced the worst flood in its history, President Clinton declared the entire state a federal disaster area. Later, the Iowa Department of Public Health received a federal grant to evaluate the health care delivered during the flood and develop a strategic plan to enhance primary health care for the homeless and migrant populations during future environmental disasters. The plan was based on data obtained during and after the flood in three critical areas--communication, health care delivery, and community. These areas were themes that emerged from a series of interviews with representatives from health care agencies and clients themselves. Each theme became the focus of specific, comprehensive recommendations and strategies to meet the daily challenges of the homeless and migrants, as well as to enhance the delivery of primary health care services in the future.

Disaster Planning↗
PubMed1999

Small but mighty. In the face of an impending natural disaster, you need a great plan, an electronic patient record and community cooperation.

UNLABELLED: Englewood Community Hospital, a small, acute-care facility in the Gulf Coast area of South Florida PROBLEM: Hurricane Georges forced the staff and administrators of Englewood Community Hospital to evacuate patients and provide emergency care for the community. SOLUTION: A comprehensive disaster plan. RESULTS: Englewood staff discovered they were well-prepared for patient evacuation in times of threatening natural disasters. The MEDITECH clinical data repository allowed no disruption in access to the patients' history or current clinical profile. KEY TO SUCCESS: "Englewood Community Hospital's comprehensive, well thought-out disaster plan covered critical issues such as staffing, reimbursement, documentation, and most importantly, continuity of care during the move to another hospital."

Community-Institutional Relations↗
PubMed2001

Warning: are you prepared to lose your ED after a natural disaster?

Natural catastrophes that can lead to loss of the ED itself are often overlooked in disaster plans and drills. Plans should address evacuation of patients, including transportation and equipment to take, and drills should include these scenarios. You should have alternatives to cope with loss of power and communications, such as oxygen-powered backup generators. To prepare for a deluge of individuals coming to the ED after a disaster, decide how to utilize volunteers, and limit access by using disaster identification vests. New Environment of Care standards from the Joint Commission on Accreditation of Healthcare Organizations require you to perform a hazard and vulnerability analysis.

California↗
PubMedDate not supplied

Understanding community psychosocial needs after disasters: implications for mental health services.

The psychosocial impact of disasters has attracted increasing attention. There is little consensus, however, about what priorities should be pursued in relation to mental health interventions, with most controversy surrounding the relevance of traumatic stress to mental health. The present overview suggests that acute traumatic stress may be a normative response to life threat which tends to subside once conditions of safety are established. At the same time, there is a residual minority of survivors who will continue to experience chronic posttraumatic stress disorder (PTSD) and their needs can be easily overlooked. The ADAPT model offers an expanded perspective on the psychosocial systems undermined by disasters, encompassing threats to safety and security; interpersonal bonds; systems of justice; roles and identities; and institutions that promote meaning and coherence. Social reconstruction programs that are effective in repairing these systems maximize the capacity of communities and individuals to recover spontaneously from various forms of stress. Within that broad recovery context, clinical mental health services can focus specifically on those psychologically disturbed persons who are at greatest survival risk. Only a minority of persons with acute traumatic stress fall into that category, the remainder comprising those with severe behavioural disturbances arising from psychosis, organic brain disorders, severe mood disorders and epilepsy. Establishing mental health services that are community-based, family-focused and culturally sensitive in the post-emergency phase can create a model that helps shape future mental health policy for countries recovering from disaster.

Community Mental Health Services↗
PubMedDate not supplied

Preparing for the next natural disaster: learning from Katrina.

Hurricane Katrina exposed the nation's ongoing vulnerability to large-scale losses from natural disasters. The catastrophic loss of life and property has lead people to question why the United States is not better prepared for such disasters. In this Issue Brief, a leading expert on decision processes and low probability events discusses the reasons why people do not take protective measures voluntarily. In addition, he suggests ways to reduce losses through a disaster management plan that includes well-enforced building codes and land-use policies, insurance incentives, and long-term loans.

Building Codes↗
PubMed1996

Strategic disaster preparedness and response: implications for military medicine under joint command.

With the end of the Cold War, renewed emphasis has been placed on humanitarian assistance such as disaster relief, refugee management, and humanitarian intervention during conflicts by the military forces of all nations. The role of the military in humanitarian assistance has been the subject of much recent debate, as the ability of the United States to mount an effective emergency response is linked to our nation's strategic policy and planning. This article describes and broadens the understanding of the evolving concepts of strategic disaster management and the role of Joint Military Commands in providing disaster relief. Examples of strategic humanitarian relief operations are discussed.

Disaster Planning↗
PubMedDate not supplied

Community perception about disaster preparedness and response programme in four states of India.

It is well felt that community participation, local planning, development of self reliance and manpower resource within the community itself can strengthen the effort of disaster preparedness and response. The present study was intended to bring out the salient features about perception and opinion of community leaders and community members about existing preparedness programme and appropriateness of mitigatory exercise against flood disaster in four eastern states of India viz. West Bengal, Bihar, Assam and Orissa. Many snags at the implementation level, in terms of co-ordination, directives, logistics and knowledge gap were noted, which should be dealt with due care for successful disaster preparedness programme.

Community Participation↗