Fujita Sawa

Kanbara Sakiko

Ngatu Nlandu Roger

Nojima Sayumi

Takezaki Kumiko

Yamada Satoru

Ngatu, Nlandu Roger

Kanbara, Sakiko

Takezaki, Kumiko

Yamada, Satoru

Fujita, Sawa

Nojima, Sayumi

University of Kochi Repository for Academic Resources / 高知県立大学学術情報リポジトリ

IntroductionWith the introduction of the principles oftriage during the Napoleonic wars of 1799-1815, the term emergency medicine started tobe used１). Currently, the term is commonly usedin relation to efforts to address health careissues within humanitarian crises２). Outbreaksof infectious diseases (cholera, shigellosis,tuberculosis, measles…) and trauma resultingfrom natural disasters and war in the nineteenthand twentieth centuries have inspired the necessityfor a global medical response beyond nationalborders. To deal with such catastrophes, nationalheath policy makers and international institutionshave created state-based and non-governmentalorganizations so as to limit or eradicateepidemics and take care of disaster-affectedpopulations. On a global scale, the UnitedNations High Commissioner for Refugees (UN-HCR), the World Health Organization (WHO),the Office for the Coordination of HumanitarianAffairs (OCHA) and other international organizations(International Relief Committee, IRC; MedecinsSans Frontieres, MSF/DWB; Medecins du Monde,CARE, OXFAM, Red Cross/CICR etc…) are playinga critical role in responding to humanitariandisasters worldwide.― 156 ―Value of Disaster-oriented Educational Programfor Health Care ProfessionalsNlandu Roger NGATU＊ Sakiko KANBARA＊＊ Kumiko TAKEZAKI＊＊Satoru YAMADA＊＊ Sawa FUJITA＊＊ Sayumi NOJIMA＊＊Lately, a growing number of severe and complex humanitarian crises such as earthquake, tsunami, flood, fire,hurricane, armed conflicts and epidemics have been occurring in different regions of the planet earth,causing hundreds or even thousands cases of injury, mental disorders, outbreaks of air and water bornecommunicable and non-communicable disease epidemics and deaths. To deal with such humanitarian crises,national heath policy makers and international health institutions have created state-based agencies and non-governmental organizations to deal with disaster's consequences and take care of disaster-affected populations.This article highlights the importance of a special disaster-oriented graduate medical and nursing educationprogram for catastrophe preparedness. Natural disasters are often unpreventable; however, risk reductionstrategies with involvement of governmental and non-governmental bodies, health care providers, the media andat-risk population may help mitigate its physical and psychological impacts. Enhancing the skills of healthcare and social relief workers in the way to deal with disaster-related issues and improving communicationbetween and within organizations involved in disaster interventions are really critical for the success ofevery humanitarian crisis management operation. Thus, preparedness of disaster health care providers isindispensable for a prompt and efficient disaster response. The classic education and training given atundergraduate levels are obviously not well adapted to the psychological environment surrounding disastersand might limit care givers' capacity to provide fast and adequate emergency relief to affected populations.There is a crucial need to train health care professionals whose major competency would be to respond todisaster-related socio-medical issues.								＊Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Japan.＊＊Faculty of Nursing, University of Kochi, Kochi, Japan.高知女子大学看護学会誌 VOL.38, NO.２, pp156～160 2013Since the last century, a growing number of humanitariancatastrophes-earthquake, tsunami, flood, fire,hurricane and typhoon, armed conflicts- havebeen occurring at different sites on the planetearth, causing hundreds or even thousands casesof injuries and other musculoskeletal disorders,outbreaks of air and water borne illnesses,communicable and non-communicable diseases anddeaths. Disaster nursing, as well as disastermedicine, involves preparedness and readinessto promptly and efficiently respond to communityneeds during and after a natural or man-madedisaster that might be beyond local healthsystem's capacity to deal with. This impliesthe necessity for national health policy makersto envisage providing a program that trainshealth care providers with appropriate skillsand ready to intervene in time of humanitariancrisis.Disaster response:Are national health systems well prepared？A glance to recent natural disasters both indeveloped and developing countries shows thatthere is still much to do in terms of disasterpreparedness, rescue, medical and social relieffor affected populations and risk communication.Recently, the hurricane Sandy that particularlydamaged the city of New York has left morethan 90 of the inhabitants dead and a lot ofinfrastructure damages, despite early warningson the imminent catastrophe and possible damagesit might cause.During the past decade, considerable publicinvestment has been made in standardizing commandand communication assuring appropriate and rapidsupply chains in the United States, for example.Obviously, recovery from large-scale disastersis invariably a prolonged and complex challengethat is poorly understood and difficult toaccomplish３). Another evidence of insufficiencyof disaster preparedness can be seen in the“triple Tohoku-Fukushima disaster”(earthquake,tsunami and nuclear explosion) on 11 March2011 in Japan. Though much effort has been donein terms of preparedness for future humanitariancrises in Japan since the great Hanshin-Awajiearthquake that occurred on 17 January 1995 inKobe, most of tsunami victims in the Tohokuregion could not benefit of health care reliefservices and food supply ２ to ３ days after thedisaster. This supposes that the level and impactof the catastrophe might have been beyond thenation's preparedness efforts and responsecapacity, suggesting the necessity to improve thedisaster management system for early reliefand efficient coordination of humanitarianinterventions.高知女子大学看護学会誌第38巻第２号 (2013)― 157 ― 	 !"#$%&'Currently, there are a number of hot spotsin Africa where armed conflicts are claimingthousands of lives, causing millions of refugeesand displaced populations; governments are oftenpowerless to face the humanitarian crises,whilst international organizations are low torespond. In central African region, the ongoing“Congo war”has already claimed more than６million lives of innocent people since 1998,mostly women and children, with more than445,000 refugees in neighbor countries and2.5 million of internally displaced populations(IDPs) left in forest and savanna without enoughsupport and with no hope for ending theirmisery. This“economic war”is reported to bethe deadliest one since the World War２ (StephenLewis, 2007)４).Similarly, thousands of Malian and Somalianrefugees in neighboring countries (Mauritania,Burkina Faso, Kenya...) have been striving tosurvive for months without any assistance.These facts highlight the lack of preparednessof local governmental agencies and regionalorganizations to protect and provide necessaryrelief to populations in need.In 2010, an earthquake of magnitude 7.0 occurredin Haiti which devastated the country, leavingapproximately 230,000 people dead and injuredmore than 300,000 of inhabitants. It has beenreported that about two million Haitians wereleft homeless without consistent relief in theaftermath５).There are a lot of things to learn from thosepast and current disasters so that disasterresponse and intervention strategies could getimproved. Enhancing the skills of health careproviders in the way to deal with disaster-related health and social issues and improvingcommunication between and within organizationsinvolved in interventions are really criticalfor the success of every humanitarian crisismanagement operation.― 158 ―									 		 !"	 		#$!#%			!%!#&!'()*#+		,	,		,			,$-	,				.							!		,		,,	 	+&	/!0%/!0 %			Ａ ＣＢ ＤMore natural disasters expectedin a near futureIn Japan, the imminent great Nankai earthquakeis predicted to occur in a near future; it isonly one of the natural catastrophes to befaced sooner or later in the country. Recently,Asia pacific region and Latin America have beenone of the world regions the most affected bynatural disasters such as earthquake, tsunamiand flood. There is a possibility of occurrenceof such events in the coming years.Given the ecological consequences of climatechange, extreme weather events, increase of sealevel, melting of glaciers in oceans wouldinevitably lead to flood disasters that willaffect vulnerable population across the planet６);and, follo-wing the flood, outbreaks of epidemicdiseases, depression and post traumatic stressdisorder (PTSD)will, as usual, occur and willrequire appropriate disaster response. MichaelCharness, an American researcher, declared inthe midst of hurricanes Katrina ruins, that hewas overwhelmed by the number and volume ofmental health problems arising from this disaster７).If the current trend of climate change is notreversed, we can expect the burden of disastersto increase as a result６).Limits of classic medical/nursing educationcurriculum and the necessity ofa disaster-oriented training programIt is true that natural disasters are oftenunpreventable; however, disaster risk reductionstrategies with involvement of governmentalagencies, the media and at-risk population mayhelp mitigate its physical and psychologicalimpacts２).A good coordination and communication systembetween disaster responders are certainly animportant component of a successful disasterresponse; but they are not sufficient by themselves.Preparedness and competence of disaster healthcare providers are indispensable for an efficientmedical humanitarian response.The classical education and training given atundergraduate levels are not always adaptedto the psychological environment surroundingdisasters, particularly those with large scaleconsequences, as they involve a person toperson relation between a care giver and apatient in a hospital, a setting equipped withnecessary materials needed to administratehealth care. In contrast to the classic education,disaster health care response implies dealingwith a group of affected individuals or apopulation mostly at sites with limitationsin terms of materials, personnel, even competencesand under working conditions that are unfamiliarto neophytes.Due to the relatively high frequency of bothnatural and man-made disasters occurrence andfor efficiency purpose, the nursing personnelinvolved in relief interventions should beadequately prepared. That is very important asnurses come in contact, in disaster-affectedsites, with people of different ethnic, educationaland traditional or cultural backgrounds, nationalitiesand sensitivity.ConclusionMany scientists are predicting the occurrenceof natural disasters of great intensity andmagnitude in a near future. However, lessonsfrom past humanitarian crises show an insufficientpreparedness and a poor disaster managementpolicy in many regions of the world. Theserealities suggest the necessity for a disaster-oriented discipline in the field of nursing andmedicine, as there is a crucial need to trainhealth care professionals whose major competencyis to respond to disaster-related socio-medicalissues.As stated by Aunice Reed８) , helping nursesbecome formally trained for disaster equipsthem with a universal code or method for them高知女子大学看護学会誌第38巻第２号 (2013)― 159 ―to adhere to, no matter the environments. Italso gives them much more confidence in theirability to lead and organize large groups ofpeople in frantic situations and times. Aspart of the first-response front, nurses arethen better able to effectively assist andease overwhelmed medical teams. So in essence,nurses can save many lives.AcknowledgmentsThe authors thank Mr Yuji Takeuchi, Ms MayumiOki, Ms Yukiko Nakaie, Mr Masanori Osaki and MsLee Hyeon Ju from the faculty of nursing,University of Kochi, for their wonderful support.Reference１. Mitchell GA. A brief history of triage.	~~2008;2(Suppl 1)：S4-S6.２. Macintyre AC, Barbera JA, Brewster P. Healthcare emergency management：establishingthe science of managing mass casualty andmass effect incidents. 	~~2009；3 (Suppl 1)：S52-S58.３. Abramson DM, Redlener I. Hurricane Sandy:Lessons learned, again. 	~~2012；6(4)：328-9.４. Lewis S. Calls for a new UN initiative toend sexual violence in the eastern regionof the Democratic Republic of the Congo(DRC). Accessible at URL：http：//www.wunrn.com/news/2007/10_07/10_01_07/100707_congo.htm５. Walk RM, Donahue TF, Stockinger Z et al.Haitian earthquake relief：disaster responseaboard the USNS comfort. 	~~2012；6：370-377)６. Crabtree A. Climate change and mental healthfollowing flood disasters in developingcountries, A review of the epidemiologicalliterature：What do we know, what is beingrecommended？ 2012；2012：21-30.７. Singer E. Mental health research emergesfrom hurricane ruin. 	2005;11：1127.８. Reed A. About disaster Nursing. Availableat URL：http://www.ehow.com/about_4571887_disaster-nursing.html#ixzz208GHAT75(Accessed on 20 March 2013).― 160 ―

Value of Disaster-oriented Educational Program for Health Care Professionals

https://u-kochi.repo.nii.ac.jp/?action=repository_action_common_download&item_id=211&item_no=1&attribute_id=22&file_no=1

Value of Disaster-oriented Educational Program for Health Care Professionals

Abstract

Similar works

Full text

Available Versions

University of Kochi Repository for Academic Resources / 高知県立大学学術情報リポジトリ