Disaster Responses 'Should Be Better Planned'

International healthcare responses to man-made or natural disasters should be co-ordinated and planned to enable the people affected to receive the aid they need, the conference heard this week.



Professor Rachel Jenkins, director of the World Health Organisation (WHO) Collaborating Centre at the Institute of Psychiatry, London, one of an international network of centres carrying out work in support of WHO programmes, said lone healthcare professionals who took it upon themselves to volunteer their skills outside a co-ordinated plan can do more harm than good.



Prof Jenkins recalled occasions when Western healthcare staff have turned up unexpectedly in disaster zones. She said: "If the whole world jets in, it's mayhem. Volunteer from other countries must be prepared to be co-ordinated by the lead agencies in charge, normally the Ministry of Health and the WHO country office."




Such co-ordination is necessary to guard against duplication, to ensure help reaches the remotest villages, and to strengthen local facilities so they do not collapse when donor money is withdrawn.



International medical teams should liaise closely with local governments and organisations to help to train, supervise and support front-line health workers. They should link up with nurses, health visitors, social workers and teachers, as well as volunteers, the army and frontline workers to ensure that post-disaster recovery programmes are effective.




Functioning primary care and mental health services are vital in all populations, but Prof Jenkins said Kashmir was particularly disadvantaged in the aftermath of the earthquake in 2005 because it had previously had very sparse health services in the affected region. This made post-earthquake efforts even more challenging, but the army and WHO combined to deliver an effective response.



In addition, Prof Jenkins said it must be remember that, following disasters, as well as dealing with the normal psychological responses to trauma, healthcare workers have to cope with people who have pre-existing mental disorders and the loss of health, social and educational infrastructure.



Professor David Alexander, a psychologist and Director of the Aberdeen Centre for Trauma Research, called for mental health professionals carrying out research in the aftermath of disasters, to conduct their research sensitively.



Researchers must be sensitive to culture. Giving examples, he said that researchers should be conversant with the politics of the country involved and be aware that national and local governments are sometimes at odds with each other. Researchers should also employ cultural advisers to give them guidance on how best to conduct their queries. "People in different countries express emotional distress in different ways. Some might not be able to read, so there is no point in handing out questionnaires," Professor Alexander said.



Reference



The Annual Meeting of the Royal College of Psychiatrists, Imperial College, London,
1 - 4 July 2008




Royal College of Psychiatrists