Developing a Nuclear Global Health Workforce Amid the Increasing Threat of a Nuclear Crisis

Abstract

This study argues that any nuclear weapon exchange or major nuclear plant meltdown, in the categories of human systems failure and conflict-based crises, will immediately provoke an unprecedented public health emergency of international concern. Notwithstanding nuclear triage and management plans and technical monitoring standards within the International Atomic Energy Agency and the World Health Organization (WHO), the capacity to rapidly deploy a robust professional workforce with the internal coordination and collaboration capabilities required for large-scale nuclear crises is profoundly lacking. A similar dilemma, evident in the early stages of the Ebola epidemic, was eventually managed by using worldwide infectious disease experts from the Global Outbreak Alert and Response Network and multiple multidisciplinary WHOsupported foreign medical teams. This success has led the WHO to propose the development of a Global Health Workforce. A strategic format is proposed for nuclear preparedness and response that builds and expands on the current model for infectious disease outbreak currently under consideration. This study proposes the inclusion of a nuclear global health workforce under the technical expertise of the International Atomic Energy Agency and WHO's Radiation Emergency Medical Preparedness and Assistance Network leadership and supported by the International Health Regulations Treaty. Rationales are set forth for the development, structure, and function of a nuclear workforce based on health outcomes research that define the unique health, health systems, and public health challenges of a nuclear crisis. Recent research supports that life-saving opportunities are possible, but only if a rapidly deployed and robust multidisciplinary response component exists. (Disaster Med Public Health Preparedness. 2016;10:129-144)

Triage and the Lost Art of Decoding Vital Signs: Restoring Physiologically Based Triage Skills in Complex Humanitarian Emergencies

“…60,61 This has prompted consideration for the development and training of a nuclear global health workforce capacity patterned after current WHO Emergency Medical Teams in place or being developed by many countries nationally and internationally for large-scale, sudden-onset natural disasters and public health emergencies of international concern (PHEICs). 62 Research suggests that following a nuclear detonation in a major city with a vast geographical footprint there could be need of "25 to 75 such triage points or more" proposing that a "lower-tech approach" that includes physiological-based triage, combined with field biodosimetry readings, could save many lives. 63,64 Coleman and colleagues emphasize the criticality of triage in resource-poor settings where extensive preplanning is needed, stating in 2016 that "an understanding of the requirements for biodosimetry, triage and treatment decisions, and massive public health and medical response informs and modifies the over-all large-scale operational response."…”

Justification for a Nuclear Global Health Workforce: multidisciplinary analysis of risk, survivability & preparedness, with emphasis on the triage management of thermal burns

“…Rather than moving toward a “nuclear free world” the U.S. finds itself embarking on a $1 trillion nuclear weapons “modernization program” to counter increasing Russian provocations [ 6 ]. Every other nuclear power worldwide has either increased the size of their arsenal or modernized it [ 3 ]. While there has been an overall decline in the number of nuclear weapons worldwide, the steady expansion of nuclear stockpiles to more national states (including highly aggressive and arguably unstable ones), the continuous modernization of arsenals and a concurrent decline in regional stability, especially in the South Asian subcontinent, provides an increasingly dangerous flashpoint for nuclear war.…”

“…Post-Ebola appeals for a World Health Organization (WHO) led global health workforce resulted in 2014 of the development of country-supported international and national emergency medical teams (EMTs) for rapid and sustained response to sudden onset natural disasters (SoDs), public health emergencies of international concern (PHEICs) and conflict-related complex humanitarian emergencies (CHEs) [ 2 ]. In 2015, amid the increasing risk of a nuclear crisis with unmitigated and shared components of both CHEs and PHEICs, Burkle and Dallas argued for the inclusion within the WHO agenda of a nuclear global health workforce capacity and operational framework [ 3 ].…”

The World Health Organization Global Health Emergency Workforce: What Role Will the United States Play?

“…This should be a two-tier system with those trained for local and national response having extra levels of training and preparation to be ready for international deployment (similar to existing Japanese, Australian, and US urban search and rescue teams), especially in resource-poor settings and with the increasing potential for nuclear catastrophes. 5 Unfortunately, the Global Health Cluster approach to compliance and management of disparate NGOs and their capability to analyze crucial health outcome data has fallen short and has been openly criticized for its lack of "formal decisionmaking mechanisms or mandates," leaving many disasterprone countries to disapprove of the system. 6 EMTs and the crisis events they would be mobilized for are not at all similar to the daily bread-and-butter health NGO activities they are known for (primarily Type 1) and which will always be available in the prolonged recovery and rehabilitation phases of any crisis.…”