Preventive Medicine in Humanitarian Emergencies

5. Post-Disaster Intervention Priorities

5.3. Preventive medicine roles of pediatricians following a disaster in their community

Pediatricians, whether in public or private service, can assist disaster recovery in their communities in many ways. These need not be limited to simply seeing children in consultation; with adequate preparation, pediatricians and other physicians and nurses can fill many important roles, from assisting with search and rescue efforts to conducting population surveys. Their effectiveness will largely depend on personal preparation and their integration into community pre-disaster planning strategies (Box 11)

Box 11: The pediatricians’ role in preventive medicine

Before a disaster: not limiting themselves to direct patient care
Evaluations after the disaster:
- Nutritional evaluation
- Children’s requirements
Collaboration in disease surveillance:
- Design of surveillance systems keeping children in mind
- Collaboration in the collection and analysis of data

Children form a large proportion of the population and because children are one of the most vulnerable groups during a disaster, it makes sense to have pediatricians serve as leaders in disaster response and preparedness programs. Drills should involve children as mock victims, and should represent the ages and numbers representative of the population at large. Advance planning for meeting children’s special nutritional, psychological, and developmental needs will likely happen only if pediatricians are involved in every aspect of disaster planning. By teaching other health workers, such as nurses, general practice doctors, and lay community health workers, pediatricians can disseminate their knowledge of children’s special needs throughout the disaster response community.

Drills should involve children as mock victims, and represent the ages and numbers that are representative of the population at large.

Pediatricians in private practice may need to go out of their way to meet with public health, military, and other governmental officials to offer their services in pre-disaster planning. Waiting to act “ad hoc” after a disaster strikes is a recipe for wasted effort and represents an inability to make a meaningful impact on community recovery.

Even if pediatricians work primarily in their traditional capacity of clinical consultation, they may still have a significant role to play in preventive medicine by making sure that a functioning surveillance cycle is in place. Crucial points of the cycle would include establishing an adequate patient logbook or record that captures important disease data and stratifies data to specific age and sex groups. This is where the surveillance cycle begins, with clinicians seeing individual patients. If they do not capture this data, public health decisions will be based on speculation, not facts.

Next, pediatricians can ensure that individual patient data are shared with public health authorities in a timely fashion, which will allow analysis and quick response to rapidly emerging public health needs. Pediatricians who handle their own preliminary data analysis by reviewing patient logbooks on a daily basis and looking at disease incidence data in terms of rates will allow quicker and more effective interventions and recommendations for resource allocation. Finally, by developing and maintaining effective communication with public health leaders, pediatricians can ensure that wise decisions are made regarding the care of children in their communities.