Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
What to Expect After a Natural Disaster
Sichuan earthquake rescue workers carrying an injured person. In light of the widespread media coverage of natural disasters, such as the earthquake in Haiti and the tsunami in Japan, the public and medical professionals are aware of the anticipated immediate medical needs in these kinds of emergencies. However, it is less well known that after the initial management of life- and limb-threatening injuries, there may be an enormous need to provide care to persons with chronic illnesses. This is because they are displaced from their homes, become exposed to adverse environmental and socioeconomic hardships, lose access to healthcare, are deprived of their sources of medications, and so forth.
Some of my colleagues were allowed to enter Japan after the tsunami, and their observations agree with this assessment, which was also confirmed in a recent paper, “Chronic health needs immediately after natural disasters in middle-income countries: the case of the 2008 Sichuan, China earthquake,” authored by Emily Chan and Jackie Kim (Eur J Emerg Med 2011;18:111-114). The authors considered physical, social and public health preparedness.
Their findings confirmed what has been reported from Japan. Particularly if there is a large population of seniors, chronic medical problems abound. Furthermore, immunizations against diseases such as tetanus, pertussis (whooping cough), and diphtheria may be lacking. If patients require significant ongoing attention, such as dialysis for kidney failure or advanced wound care for chronic problems, then the disruptions associated with large catastrophic events may pose very significant health risks that soon become as life threatening as a crushed limb.
Lack of medications is something for which advance plans can be made. Most individuals, however, are unable to plan well for disaster situations—the cost may be prohibitive, drugs expire, etc. Stockpiling essential medications takes sophisticated planning and financial resources.
In the first few days after a large disaster, the focus is on the obviously injured and ill persons who seek care. After that, the recovery phase involves creating or re-creating a system that can accommodate more of the day-to-day needs of the population than issues attributable to the disaster, unless there is an intervening epidemic, such as cholera.
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