Atendimento psicossocial nos serviços de proteção social especial do SUAS / Psychosocial care in the special social protection services of SUAS / Atención psicosocial en los servicios de protección social especial del Sistema Único de Asistencia Social (SUAS)

Documentos normativos determinam que serviços de Proteção Social Especial (PSE) do Sistema Único de Assistência Social (SUAS) devem oferecer atendimento psicossocial às(aos) usuárias(os). No entanto, não especificam que atendimento é esse, que tipo de atividades ele inclui, porque ele caracteriza principalmente serviços da PSE ou o que o diferencia das outras atividades desenvolvidas pelas equipes desses serviços. Diante disso, neste artigo, buscamos responder às seguintes questões: como profissionais que atuam nas equipes técnicas ou na gestão de serviços de proteção social especial do município de São Paulo compreendem a noção de "atendimento psicossocial"? E como essa noção é convertida em práticas concretas de intervenção? Para respondê-las, realizamos uma pesquisa bibliográfica e documental, bem como fizemos 10 entrevistas semiestruturadas com profissionais da PSE. As entrevistas e documentos analisados indicam a polissemia da expressão atendimento psicossocial. Ora ela refere-se a determinadas práticas ou ações que fazem parte do cotidiano dos serviços do SUAS; ora a um aspecto ou uma visão que norteia o trabalho. Indicam, ainda, que tal forma de atendimento é caracterizada, entre outras coisas, por sua interdisciplinaridade, pela importância que dá ao contexto e ao território e por não ser equivalente à clínica psicoterápica tradicional.(AU)

Regulatory documents determine that Special Social Protection (PSE) services of the Unified Social Assistance System (SUAS) must offer psychosocial support to its users. However, they do not specify which support, what type of activities it includes, why it mainly characterizes PSE services or what differentiates it from other activities developed by teams in these services. Given this, in this article, we seek to answer the following questions: how do professionals working in the technical teams or in the management of special social protection services in the municipality of São Paulo understand the notion of "psychosocial support"? And how is this notion converted into concrete intervention practices? To answer them, we conducted a bibliographic and documentary research, as well as 10 semi-structured interviews with professionals from PSE services. The interviews and documents analyzed indicate the polysemy of the expression psychosocial support. At times, it refers to certain practices or actions that are part of the daily routine of SUAS services; at other times, it refers to an aspect or vision that guides the work. They also indicate that this form of support is characterized, among other things, by its interdisciplinary nature, by the importance given to context and territory and by not being equivalent to the traditional psychotherapeutic clinic.(AU)

Los documentos normativos determinan que los servicios de Protección Social Especial (PSE) del Sistema Único de Asistencia Social (SUAS) deben ofrecer atención psicosocial a los usuarios. Sin embargo, no especifican en qué consiste esta atención, qué tipo de actividades incluye, por qué caracteriza principalmente a los servicios de PSE o qué lo diferencia de otras actividades desarrolladas por los equipos de estos servicios. Teniendo esto en cuenta, en este artículo buscamos responder a las siguientes preguntas: ¿Qué piensan sobre la noción de "atención psicosocial" los profesionales que trabajan en los equipos técnicos o en la gestión de los servicios de protección social especial en el municipio de São Paulo? ¿Y cómo convierten esta noción en prácticas concretas de intervención? Para responderlas, realizamos una investigación bibliográfica y documental, así como diez entrevistas semiestructuradas con profesionales de la PSE. Las entrevistas y los documentos analizados indican la polisemia de la expresión atención psicosocial. A veces, se refiere a ciertas prácticas o acciones que forman parte de la rutina diaria de los servicios del SUAS; otras veces, a un aspecto o visión que guía el trabajo. También esta forma de atención se caracteriza, entre otras cosas, por su interdisciplinariedad, por la importancia que se da al contexto y al territorio, y por no ser equivalente a la clínica psicoterapéutica tradicional.(AU)

Haïti: tremblement de terre. Rapport de Situation nº 1 - 22 aout 2021 / Haiti: earthquake. Situation Report n ° 1 - August 22, 2021

Après qu'un puissant séisme de magnitude 7,2 et une dépression tropicale aient frappé Haïti les 14 et 17 août derniers, ne faisant qu'aggraver la misère et le dénuement causés par une intensification des déplacements liés aux gangs, une insécurité alimentaire chronique et des chocs climatiques récurrents, les besoins humanitaires augmentent rapidement, dépassant la vitesse à laquelle les autorités nationales et les partenaires humanitaires peuvent atteindre les populations touchées. Le passage de la dépression tropicale Grace n'a fait qu'aggraver les conditions sur le terrain après le tremblement de terre, en déversant des pluies extrêmement fortes dans les mêmes régions du sud du pays qui ont subi l'impact du tremblement de terre quelques jours plus tôt et en retardant le déploiement rapide des évaluations sectorielles et l'acheminement de l'aide humanitaire vitale. Alors que le département du Sud-Est a été largement épargné par les conséquences du séisme dévastateur, les pluies diluviennes de Grace ont déclenché des inondations dans le département qui ont touché des centaines de foyers, générant des besoins concurrents issus de crises qui se superposent. Au 21 août, le bilan s'élevait à 2 207 morts, 12 268 blessés et 344 disparus. Ces chiffres augmentent d'heure en heure, car les équipes de recherche et de sauvetage ont de plus en plus de mal à trouver des survivants. Alors que le nombre de personnes gravement blessées ne cesse d'augmenter, la capacité de réaction du système de santé, déjà limitée, est de plus en plus mise à l'épreuve. Beaucoup de celles et ceux qui ont eu la chance de s'en sortir vivants se retrouvent maintenant sans abri, sans accès à l'eau potable et à l'assainissement, et plus exposés aux violences et aux abus, y compris aux violences basées sur le genre (VBG), car l'environnement de protection reste précaire. Selon la Direction générale de la protection civile (DGPC), 650 000 personnes ont besoin d'une aide humanitaire d'urgence dans les trois départements les plus touchés (Sud, Grand'Anse et Nippes). L'agriculture et les moyens de subsistance qui y sont liés ont été durement frappés dans les zones sinistrées, ce qui risque d'aggraver la sécurité alimentaire dans un pays où 4,4 millions de personnes, soit près de 40 % de la population, souffraient déjà d'insécurité alimentaire aiguë. Certaines des zones les plus touchées, comme le département des Nippes, ont déjà été confrontées aux conséquences négatives des sécheresses cycliques et de l'érosion des sols ces dernières années, ce qui a probablement poussé de nombreuses personnes à recourir à des mécanismes d'adaptation négatifs, car elles n'ont pas la capacité de faire face à la dernière crise.

Haiti: earthquake situation. Report nº 2 - 26 August 2021

Nearly two weeks after a 7.2-magnitude earthquake rocked south-western Haiti, humanitarian assistance has begun reaching some of the hardest-to-reach areas, where the most vulnerable are still unable to meet their urgent need for food, basic sanitation and hygiene and life-saving health services. In some remote rural areas, response personnel and relief supplies have yet to reach those most in need. The compounded impacts of the earthquake and Tropical Depression Grace have greatly exacerbated pre-existing needs. The UN System in Haiti estimates 650,000 people are in need of emergency humanitarian assistance, a concerning figure considering that 634,000 people across the three most affected departments ­ Grand'Anse, Nippes and Sud ­ already needed multi-sectoral humanitarian assistance before the quake. As of the latest updates issued on 25 August, the Haitian Civil Protection General Directorate (DGPC) reported 2,207 deaths,12,268 injured and 320 missing. By 22 August, search-and-rescue crews had extracted 24 missing people from the rubble, including 4 children, who were airlifted to Camp-Perrin to receive emergency medical assistance. In the Sud Department, aftershocks continue almost two weeks after the initial quake on 14 August, creating widespread panic among the affected population. Some people whose homes are still standing in affected areas are choosing to sleep in the streets in fear that the structures may collapse at any moment.

Flash appeal Haiti - 2021

Le 14 août à 8h30, heure locale, un séisme de magnitude 7,2 a frappé la côte sud-ouest d'Haïti, causant des dommages à grande échelle dans toute la péninsule sud du pays. Le puissant séisme de 10 km de profondeur s'est produit à 13 km au sud-est de PetitTrou- de-Nippes, dans le département des Nippes, une région déjà dévastée par l'ouragan Matthew en 2016. Deux jours seulement après le séisme, la dépression tropicale Grace a déversé des pluies extrêmement fortes dans le sud d'Haïti, provoquant des inondations dans les mêmes zones touchées par le séisme.

Flash appeal summary: Haiti earthquake

Humanitarian needs are rapidly growing in the aftermath of the 7.2 magnitude earthquake that struck south-west Haiti on 14 August 2021, badly affecting the departments of Grand'Anse, Nippes and Sud. The earthquake's devastating impact, while considered less catastrophic than the 2010 earthquake that left more than 220,000 people dead and 1.5 million injured, was later compounded with heavy rains from tropical depression Grace on 17 August. Overall, official reports indicate more than 2,200 deaths and more than 12,000 people injured. The consecutive impacts damaged or destroyed more than 130,000 homes, rendering thousands homeless and in urgent need of assistance.

Flash appeal Haiti: earthquake - August 2021

On 14 August at 8:30 am local time, a 7.2 magnitude earthquake struck the south-western coast of Haiti causing large-scale damage across the country's southern peninsula. The powerful 10 km deep earthquake occurred 13km southeast of Petit-Troude-Nippes, in the department of Nippes, the same region devastated by Hurricane Matthew in 2016. Only two days after the quake, Tropical Depression Grace dumped extremely heavy rains in southern Haiti, causing flooding in the same quake-affected areas. Despite being much less catastrophic than the 2010 earthquake which left more than 220,000 people dead and 1.5 million injured, the impact of the 14 August earthquake has been devastating. According to the latest reports issued by the Haitian Civil Protection on 21 August, the death toll has now surpassed 2,200 with more than 12,200 people injured. Almost 53,000 homes have been destroyed and more than 77,000 have sustained damage. About 800,000 people have been affected and an estimated 650,000 people ­ 40 per cent of the 1.6 million people living in the affected departments ­ are in need of emergency humanitarian assistance. The back-to-back disasters are exacerbating preexisting vulnerabilities. At the time of the disaster, Haiti is still reeling from the 7 July assassination of President Jovenel Moïse and still facing an escalation in gang violence since June that has affected 1.5 million people, with at least 19,000 displaced in the metropolitan area of Port-au-Prince. The compounded effects of an ongoing political crisis, socio-economic challenges, food insecurity and gang violence continue to greatly worsen an already precarious humanitarian situation. Some 4.4 million people, or nearly 46 per cent of the population, face acute food insecurity, including 1.2 million who are in emergency levels (IPC 4) and 3.2 million people at crisis levels (IPC Phase 3). An estimated 217,000 children suffer from moderateto-severe acute malnutrition.

Haiti earthquake: situation report 4 - 23 August 2021

As a result of the 7.2 magnitude earthquake on August 14, 2021, according to Haiti's Civil Protection agency (DGPC), 2,207 people have died, 12,268 people were injured, and 320 are missing. In the most affected departments ­ Sud, Grand'Anse and Nippes ­ around 53,000 houses were destroyed and more than 77,000 damaged. Rapid assessments reported 59 health facilities affected in Grand'Anse, Nippes and Sud Departments: 27 severely damaged and 32 slightly damaged. In the affected departments, health sector evaluators are carrying out assessments to gather data on injured patients (hospitalizations, types of injuries and demographics) and the degree of damage to health facilities and needs. Logistics and security challenges continue limiting the delivery of supplies, deployment of personnel to affected areas and the transfer of patients to hospitals that are not overwhelmed. Health sector needs include: medical personnel, medicines, supplies and stock management, mental health and psychosocial support initiatives, implementation of preventive and control measures for communicable diseases, WASH operations in health facilities and shelters, rehabilitation of injured patients, among others

Impactos físicos e psicológicos na população de Brumadinho após rompimento da barragem de rejeitos / Physical and psychological impacts on the population of Brumadinho after rupture of the tailings dam

Objetivo: Esta revisão sistemática busca identificar os fatores que podem impactar na saúde das vítimas do rompimento da barragem, em especial aqueles riscos surgidos ou incrementados com a ruptura da barragem de rejeitos em Brumadinho. Fontes de Dados: Bases de dados informatizadas, Pubmed, Scopus e Web of Science nos idiomas Português e Inglês, restringindo-se a publicações nos últimos cinco anos. Critérios de inclusão: estudos que abordem aspectos relacionados à saúde dos envolvidos na ruptura da barragem de Brumadinho. Foram excluídos estudos que abordassem qualquer tema que escapasse desse escopo. Síntese dos Dados: Foram identificadas um total de 157 publicações. Excluíram-se 127 pelo título, por serem duplicatas e pelos critérios de exclusão. Analisou-se 30 integralmente, restando 19(63,3%). Resultados: Por meio dos critérios de elegibilidade dessa revisão foram encontrados artigos sobre as consequências do achado de metais pesados nas águas dos rios, como o favorecimento de genes multirresistentes e o comprometimento de fonte de água potável. Também foram descritos os impactos na saúde mental em Brumadinho, pois nota-se que a população está sujeita a efeitos psicológicos traumáticos secundários a desastres ambientais. Por meio dessa busca foi identificado que ainda há a necessidade de novos estudos sobre os impactos da mudança da morfologia hídrica e social para a saúde desses indivíduos. Conclusão:Alguns poucos impactos diretos e indiretos já estão descritos na literatura de forma incipiente, de forma que ações de mitigação são necessárias para dirimir os impactos já observados.

Abstract: This systematic review seeks to identify the factors that may impact on the health of the victims of the dam rupture, especially those risks arising or increased with the rupture of the tailings dam in Brumadinho. Data Sources: Computerized databases, Pubmed, Scopus and Web of Science in Portuguese and English, restricted to publications from the last five years. Inclusion criteria: studies that address aspects related to the health of those involved in the Brumadinho dam rupture. Studies that addressed any topic that fell outside this scope were excluded. Summary of Data: A total of 157 publications were identified. 127 were excluded by title, because they are duplicates and by exclusion criteria. 30 were analyzed in full and, of these, only 19 (63,3%) were eligible. Results: Through the eligibility criteria of this review, articles were found on the consequences of the finding of heavy metals in river waters, such as the favoring of multidrug-resistant genes and the impairment of drinking water sources. The impacts on mental health in Brumadinho were also described, it is noted that the population is subject to traumatic psychological effects secondary to environmental disasters. Through this search, it was identified that there is still a need for further studies on the impacts of changing water and social morphology on the health of these individuals. Conclusion: Direct and indirect impacts are shown and that actions are fundamental for their mitigation.

Tropical cyclone Fani-perspective from the trauma and emergency department of an affected tertiary hospital / 中华创伤杂志(英文版)

PURPOSE@#To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster.@*METHODS@#A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated.@*RESULTS@#Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7-53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14-28), 7.84 (7.841-7.841), and 97.4 (91.6-98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure.@*CONCLUSION@#In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.

Changes in smoking behavior among victims after the great East Japan earthquake and tsunami

BACKGROUND@#In areas affected by the tsunami of the great East Japan Earthquake, smoking behavior may have deteriorated due to high stress and drastic changes in living environment. Surveys were conducted to reveal changes in smoking behaviors among victims.@*METHODS@#A population-based random-sample home-visit interview survey of victims in Iwate and Miyagi Prefectures affected by the tsunami disaster was conducted in 2012 (n = 1978), while a population-based nationwide survey was conducted in 2013 (n = 1082). A panel survey in 2014 was conducted with respondents of the 2012 survey (n = 930). Multiple logistic regression analysis was performed to reveal factors related to smoking status after the disaster.@*RESULTS@#There was high smoking prevalence of both sexes in the tsunami disaster area (current smoking rate in coastal area, 50.0% for male, 21.4% for female; inland area, 34.7% for male, 7.6% for female). Low prevalence of male quitters was observed (quitter rate in coastal area, 20.8% for male, 8.0% for female; inland area, 23.4% for male, 5.5% for female). The prevalence of nicotine-dependent people assessed by FTND (Fagerström Test for Nicotine Dependence) in the coastal area was also higher than in the inland area or other areas of Japan. Smoking behavior among victims worsened after the disaster and did not improve 3 years from the disaster. Post-disaster factors related to smoking were living in coastal area, complete destruction of house, and living in temporary housing.@*CONCLUSIONS@#Smoking prevalence and the level of nicotine dependence of tsunami victims were still high even 3 years after the disaster. It is important to emphasize measures for smoking control in the disaster areas for an extended time period.

Utilidad de expedientes odontológicos disponibles en Costa Rica en el año 2018 para la identificación de víctimas de desastres según el protocolo de INTERPOL / Utility of dental records available in Costa Rica in 2018 for the identification of disaster victims according to the INTERPOL protocols

Resumen Introducción: La identificación por métodos odontológicos ha demostrado su efectividad desde hace mucho tiempo, pero en los últimos años ha tenido un rol determinante en la identificación de víctimas de desastres masivos y en crímenes de lesa humanidad. Uno de los factores determinantes para efectuar una identificación positiva es la calidad de la información antemortem. La presente investigación tuvo como fin establecer la calidad de la información recopilada en los expedientes odontológicos durante el año 2018 en Costa Rica con respecto a la información contemplada en los protocolos de INTERPOL. Materiales y métodos: Estudio descriptivo de corte transversal, en el que se realizó un cuestionario basado en la información solicitada en los formularios antemortem y postmortem de INTERPOL para identificación de víctimas de desastres (DVI). Se realizó una cuestionario piloto y se aplicó a 10 odontólogos, posteriormente se realizó un cuestionario final calibrado, vía electrónica a través del Colegio de Cirujanos Dentistas de Costa Rica mediante la plataforma Google Docs; los resultados fueron analizados mediante las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. El procesamiento estadístico de los datos se realizó en la base de datos llamada SPSS versión 17.0 y en Excel. Resultados: En total fueron respondidos 573 cuestionarios de los cuales el 76% son mujeres; la distribución es independiente de la edad(p=0,161). Un 90,2% de los odontólogos generalmente elaboran un expediente clínico odontológico para sus pacientes, un 8,4% a veces no lo hace y un 1.4% no siempre lo realiza. El 69% de los entrevistados indican que la información que recopila en el expediente clínico odontológico si puede ser útil para la identificación de una persona, 19% indica que no sabe que esta información puede ser utilizada para identificación y un 12% indica que no es útil. Conclusiones: El expediente clínico odontológico es de extrema utilidad para colaborar en el proceso de identificación de víctimas mortales, sin embargo existe una gran cantidad de información no odontológica que puede ser recopilada por los odontólogos para facilitar la identificación de seres humanos.

Abstract Introduction: The identification by dental methods has proven its effectiveness for a long time, but in recent years it has played a determining role in the identification of victims of mass disasters and crimes against humanity. One of the determining factors for positive identification is the quality of antemortem information. The purpose of the present investigation was to establish the quality of the information collected in the dental records during the year 2018 in Costa Rica with respect to the information contemplated in the INTERPOL protocols. Materials and methods: Descriptive cross-sectional study, in which a questionnaire was conducted based on the information requested in the INTERPOL antemortem and postmortem forms for identification of disaster victims (DVI). A pilot questionnaire was carried out and applied to 10 dentists, later a calibrated final questionnaire was done electronically through the College of Dental Surgeons of Costa Rica in the Google Docs platform; the results were analyzed by means of frequency distributions, crossing of variables, comparison of means based on analysis of variance. The minimum confidence level for the comparisons was 95%. The statistical processing of the data was done in the database called SPSS version 17.0 and in Excel. Results: A total of 573 questionnaires were answered, of which 76% are women; the distribution is independent of age (p = 0.161). 90.2% of dentists generally elaborate a dental clinical record for their patients, 8.4% sometimes do not and 1.4% do not always do it. 69% of the interviewees indicate that the information that they collect in the dental clinical file can be useful for the identification of a person, 19% indicate that they do not know that this information can be used for identification and 12% indicate that it is not Useful. Conclusions: The dental clinical file is extremely useful to collaborate in the process of identification of fatalities, however there is a large amount of non-dental information that can be collected by dentists to facilitate the identification of human beings.

Psychological Responses among Humidifier Disinfectant Disaster Victims and Their Families

To substantiate psychological symptoms following humidifier disinfectant (HD) disasters, counseling records of 26 victims and 92 family members of victims (45 were bereaved) were analyzed retrospectively. Among the victims, 34.6% had Clinical Global Impression-Severity scores of over 4, which meant they were moderately ill. While anxiety/fear and depression with respiratory symptoms were frequently observed in victims and family members, chronic psychological distress such as alcohol/smoking abuse and insomnia was relatively high in bereaved family members. In conclusion, it is important to provide mental health support for victims and their families, focusing on the characteristic symptoms of each group as well as monetary compensation.

"Among dead and wounded": mapping, characterization and analysis of fires with victims in Recife's metropolitan zone / "Entre mortos e feridos": mapeamento, caracterização e análise dos incêndios com vítimas na região metropolitana do Recife / "Entre muertos y heridos": cartografía, caracterización y análisis de los incendios con víctimas en la zona metropolitana de Recife

This article presents the mapping and analysis of fires with dead and wounded people in the Metropolitan Region of Recife (MRR) served by the Firefighters Department from 2013 to 2016. There was an average rate of 1 death per million inhabitants, similar to countries such as Singapore and Vietnam. The weighted number of fires per wounded or dead person results in rates of 0.5 and 1.7 per 100 recorded fires, respectively. These numbers are concerning, especially when compared to rates from other regions in the world. The victims of fires in MRR were shown to generally not be a perceivable problem in terms of common sense, yet they are real and require accurate analysis and effective measures.

Este artigo apresenta o mapeamento e a análise de incêndios com mortes e feridos na Região Metropolitana do Recife ­ RMR, atendidos pelo Corpo de Bombeiros, no período de 2013 a 2016. Verificou-se uma taxa média de 1 morte por milhão de habitantes, semelhante a países como Singapura e Vietnam. Quando se pondera a quantidade de incêndios para que haja um ferido ou morto, as taxas se apresentam respectivamente em 0,5 e 1,7 por 100 incêndios registrados ­ sendo estes números preocupantes, principalmente quando comparados com taxas de outras regiões no mundo. Conclui-se que as vítimas de incêndios na Região (RMR) são um problema silente ao senso comum, mas real e que exige análise acurada e providências efetivas.

Este artículo presenta la cartografía y análisis de incendios con muertes y heridos en la Zona Metropolitana de Recife (ZMR), atendidos por el Cuerpo de Bomberos, en el período de 2013 a 2016. Se ha verificado un promedio de 1 muerte por millón de habitantes, semejante a países como Singapur y Vietnam. Cuando se examina la cantidad de incendios para que haya un herido o muerto, los promedios se presentan respectivamente de 0,5 y 1,7 por 100 incendios registrados, lo cual es preocupante, principalmente en comparación con los promedios de otras regiones del mundo. Se concluye que las víctimas de incendios en la ZMR son un problema silencioso y real, lo que exige un análisis cuidadoso y diligencias efectivas.

Disasters and the disaster medicine

The definition of a disaster varies across research institutions, although it is generally regarded as a sudden event that demands more resources than the community can offer. Disaster medicine originates from military medicine. It is a new field of medicine that has much in common with emergency medicine, but focuses more on disaster management, targeting populations. It plays a key role both in the pre-event period by helping with disaster preparedness and in the event of a disaster by providing disaster medical services, including on-scene emergency life-saving interventions, thereby contributing to a decrease in the preventable mortality rate. Triage is a system used to sort mass disaster victims according to severity, enabling resources to be allocated, distributed, and utilized more efficiently. During disasters, a hospital should respond to the surge in patients in accordance with the standards and principles of disaster medicine by activating its emergency operation plan, converting the usual medical system into the emergency system, and putting disaster response teams into operation. Disaster medicine is the key discipline for all aspects of preparedness and response to conventional disasters, and even to chemical, biological, radiological, nuclear, and explosive events.

Disaster medical response system in Korea

Disasters have frequently been a problem in Korea. Many initiatives have been carried out to mitigate this problem and to respond to disasters properly. The National Medical Emergency Center organized the Disaster Medical Response Center, which operates 24 hours a day. Regional emergency medical centers were designated as hospitals that receive disaster victims. Along with the designated disaster hospitals, the Ministry of Health and Welfare, city and district governments, and community health centers were all assigned standard roles to carry out in case of disasters. Disaster medical assistance teams were developed to respond to disaster events in their regions. This system has enabled a more rapid and systematic response to disaster events, and has standardized disaster-related medical equipment and vehicles to ensure the proper treatment of disaster victims. Although many valuable systems have been developed to respond to disasters, practical training within each institution and community-wide team training are still lacking; therefore, the government needs to further develop and support such programs.

Indonesian nurses' perception of disaster management preparedness / 中华创伤杂志(英文版)

PURPOSE@#Using a quantitative approach, this study aims to assess Indonesian nurses' perception of their knowledge, skills, and preparedness regarding disaster management.@*METHODS@#This study was a descriptive comparison in design. The research samples are Indonesian nurses working in medical services and educational institutions. The variables of nurses' preparedness to cope with disaster victims were measured using the Disaster Preparedness Evaluation Tool (DPET), which was electronically distributed to all nurses in Indonesia. Data were analyzed using a statistical descriptive one-way Analysis of Variance (ANOVA) and t-test with a significance level of 95%.@*RESULTS@#In total, 1341 Indonesian nurses completed this survey. The average scores of preparedness to cope with disasters, the ability to recover from disaster, and evaluation of disaster victims were 3.13, 2.53, and 2.46, respectively. In general, nurses surveyed in this study are less prepared for disaster management, and do not understand their roles both during the phase of disaster preparedness, and when coping with a post-disaster situation.@*CONCLUSION@#Nurses' preparedness and understanding of their roles in coping with disasters are still low in Indonesia. Therefore, their capacity in preparedness, responses, recovery, and evaluation of disasters needs improvement through continuing education. The efforts needed are significant due to potential disasters in Indonesia and adequate nurses resources.

Factors associated with Quality of Life among Disaster Victims: An Analysis of the 3(rd) Nationwide Panel Survey of Disaster Victims

PURPOSE: The purpose of this study is to assess socio-demographic, disaster-related, physical health-related, psychological, and social factors that may adversely affect disaster victims' QoL (Quality of Life). METHODS: A cross sectional study was designed by using the secondary data. From the 3rd Disaster Victims Panel Survey (2012~2017), a total of 1,659 data were analyzed by using descriptive statistics including frequency, percentage, t-test, ANOVA, and multivariate linear regression. RESULTS: Older people with lower health status lacking financial resources prior to a disaster were more at risk of low levels of QoL. Lower levels of perceived health status, resilience, and QoL were reported by disaster exposed individuals, while their depression was higher than the depression in the control group of disaster unexposed ones. Resilience, social and material supports were positively associated with QoL whereas depression and PTSD (Post-Traumatic Stress Disorders) were negatively associated. CONCLUSION: These findings suggest that psychological symptoms and loss due to disasters can have adverse impacts on the QoL of disaster victims in accordance with their prior socio-demographic background. They also indicate that targeted post-disaster community nursing intervention should be considered a means of increased social support as well as physical and mental health care for disaster victims.

Towards a safer Bajhang

The pages that follow present an earthquake scenario for the district of Bajhang, Nepal. It tells the story of three people, and what happens to them and their families during a plausible but hypothetical earthquake. This is not a prediction. This story, and the study upon which it is based, are intended as an example of what may happen if a major earthquake strikes Bajhang in the near future. Bajhang will always face a risk of earthquakes. The Main Himalayan Thrust fault, which underlies much of Nepal, is the source for potentially very damaging earthquakes. The last very large earthquake in this region occurred in BS 1562 / 1505 AD. 1 Another earthquake could occur any time, because strain has been increasing on the fault ever since. This scenario shows the consequences of such an event, and the knowledge can be used to plan for safer outcomes. The story incorporates insights from professionals around the world who study earthquake effects, research on historic earthquakes, and documented experiences from the 2015 Gorkha earthquake. The consequences are based on standard methods that engineers and scientists use to estimate the shaking, damage and human impact a given earthquake may cause. The scenario earthquake strikes on a weekday in May at 1:35 PM. Across the district, adults are working, and children are on recess at school. Measuring magnitude 7.8, the earthquake originates approximately 100 kilometers northwest of Jayaprithivi on the Main Himalayan Thrust fault. It is not the worst earthquake that could happen, but it causes serious losses and suffering. Shaking throughout Bajhang and most of Sudurpashchim Pradesh is very strong, causing the consequences explained in this narrative: casualties, damaged buildings, landslides, fire, isolation, loss of power and water, and economic hardship.

Campus displacement experiences of the University of the Philippines students and teachers affected by Typhoon Haiyan: Perceived needs for mental health and psychosocial support

@#<p style="text-align: justify;"><b>BACKGROUND:</b> Typhoon Haiyan made landfall over the Visayas Region in 2013, affecting 15 million people. At least 4 million people were displaced, including hundreds of University of the Philippines students and teachers who had to deal with the consequences of such displacement not only on their personal lives but also on their academic lives.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study explored the experiences and needs of students and teachers of the University of the Philippines Visayas Tacloban College (UP VTC), University of the Philippines Manila School of Health Sciences (UPM SHS), and University of the Philippines Diliman (UPD) who were either directly affected by Typhoon Haiyan or served as responders to the typhoon survivors. The study specifically looked at experiences of displacement in an academic setting, from the perspective of those who were academically displaced and those who hosted them.</p><p style="text-align: justify;"><strong>METHODS:</strong> A qualitative descriptive study was designed involving a total of 17 student and teacher survivors and responders (ten survivors or survivor-responders and seven responders), who were purposively sampled and participated in an online open-ended questionnaire that elicited narrative experiences post-Typhoon Haiyan. Archived group process notes during the Haiyan response were also included as data. Qualitative thematic analysis was used to identify salient themes among and within groups.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Salient themes of student and teacher survivors, survivor-responders, (i.e. survivors who also had the additional role of being responders for others), and responders that emerged included: (1) provision of basic needs (food, water, safety) including academic resources, (2) lack of deliberate psychosocial processing of the disaster experience for both survivor and responder, (3) unequal access to help, (4) communication and organizational problems, and (5) victimhood.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Student and teacher survivors and survivor-responders cited needs that go beyond basic survival needs that require a more contextual approach. Given the university context of student and teacher survivors, survivor-responders, and responders, recommendations included the need for (1) efficient dissemination of existing postdisaster school policies and programs to increase access to address communication and organizational issues, (2) equal access to school-based basic, financial, educational, and psychological support and services, and (3) proper sensitivity training for host students, teachers, and staff to decrease experiences of victimhood and discrimination.</p>

Decision Making Regarding Key Elements of Korean Disaster Psychiatric Assistance Teams Using the Analytic Hierarchy Process

OBJECTIVE: The purpose of this study was to determine the key components of Korean disaster psychiatric assistant teams (K-DPATs), to set up new mental health service providing system for the disaster victims. METHODS: We conducted an analytic hierarchy process (AHP) involving disaster mental health experts, using a pairwise comparison questionnaire to compare the relative importance of the key components of the Korean disaster mental health response system. In total, 41 experts completed the first online survey; of these, 36 completed the second survey. Ten experts participated in panel meetings and discussed the results of the survey and AHP process. RESULTS: It was agreed that K-DPATs should be independent of the existing mental health system (70.1%), funding for K-DPATs should be provided by the Ministry of Public Safety, and the system should be managed by the Ministry of Health (65.8%). Experts shared the view that K-DPAT leaders would be suitable key decision makers for all types of disaster, with the exception of those involving infectious diseases. CONCLUSION: K-DPAT, a new model for disaster mental health response systems could improve the insufficiency of the current system, address problems such as fragmentation, and fulfill disaster victims’ unmet need for early professional intervention.