Pediatric Care in Disasters

Disasters in Germany and France: An Analysis of the Emergency Events Database From a Pediatric Perspective

“…40 Rothstein reviewed strategies of pediatric care in disasters and proposed top 10 priorities in the emergency phase of a catastrophe (ie, initial assessment, measles immunization, water and sanitation, food and nutrition planning, shelter and site planning, health care in emergency phase, control of communicable diseases and epidemics, public health surveillance, human resources and training, and coordination). 41 Likewise, one should keep in mind that the seven sins of humanitarian medicine (ie, leaving a mess behind, failing to match technology to local needs, failure of NGOs to cooperate with each other, failing to have a follow-up plan, allowing politics or training to trump service, going where we are not wanted or needed, and doing the right thing for the wrong reason) are to be avoided. 41,42 This implies that the preventive and interventional approach toward pediatric care in disaster situations should be timely, transparent, coordinated and sustained, and ideally be data-driven.…”

Pediatricians and Global Health: Opportunities and Considerations for Meaningful Engagement

“…22,23 Earthquakes, floods, environmental changes, famine, and conflict all alter how children receive routine and emergency medical care. 24 Children in disaster settings may experience trauma, disease outbreaks, psychological or behavioral disturbances caused by separation from their families, and exploitation. 25,26 Such overtly highneed situations attract volunteers whose efforts, if not coordinated, can be duplicative, fragmented, and burdensome.…”

Pediatric Emergency Care in Disaster-Affected Areas: A Firsthand Perspective after Typhoons Bopha and Haiyan in the Philippines

“…Because external (nonlocal) emergency responders are often poorly versed in care of tropical and, to the resourcerich provider's eyes, "atypical" diseases, coordination with local health care providers and ministries of health is essential, albeit sometimes difficult, owing to disruptions inherent to disaster environments. 23 This was found to be an effective model for our teams in the Philippines, where external providers worked closely hand-in-hand with local Filipino pediatricians and primary care providers to administer care, particularly to patients with diseases such as leptospirosis, dengue fever, and tetanus, the management of which external providers were less familiar with. This cooperative team approach also allowed for better integration of local culture and language during patient care, preventing consumption of spare resources and manpower and preventing some of the problems seen with exclusively foreign medical teams in other disaster situations reported in the literature.…”

“…Local governments and NGOs need to consider what happens when external providers leave, what occurs when donated resources fade away, who is responsible for long-term care of patients operated on during an emergency, and who will care for patients newly burdened with posttraumatic stress disorder and exacerbations of preexisting conditions, among many other complex issues. 23 FMTs and DMATs must consider that there are significant ethical implications of providing care for limited time periods and then creating a "departure vacuum" for follow-up care in a region or community. These are difficult issues with complex answers and limited solutions.…”