Pediatrician's Leadership Role: Evaluation of the Needs of Children and Mitigation After Disasters

ABSTRACT

Background: Children are more vulnerable to natural disasters. They depend on adults for protection, prevention, and mitigation of adverse effects. From the preparedness stages to the response and mitigation, the pediatricians can play an important leadership role identifying and prioritizing the immediate and long-term needs of this population and helping to implement strategies to mitigate the impact of natural and anthropogenic disasters on the health and well-being of children and their families. Puerto Rico has experienced multiple challenges during in the last 4 years, including 2 major hurricanes, a prolonged earthquake sequence, and the COVID pandemic, to which pediatricians actively responded collaborating in recovery, mitigation, and preparedness. Methods: The leadership of the Puerto Rico Chapter of the American Academy of Pediatrics (PRAAP) coordinated activities to identify the needs and priorities of infant, children, adolescents, and their families. These activities included visits to the affected communities and matching the needs with healthcare services and basic needs donations. For the need's assessment, in-person visits were performed, to several official and improvised shelters. Pediatricians interviewed families and children and met with government officials and response personnel for the initial assessment and to advocate for children's health. Multiple PRAAP meetings were performed to develop strategies and ideas and coordinate the response. Results: In collaboration with stakeholders, pediatricians helped in the development and implementation of multiple response, recovery, and mitigation strategies. PRAAP established innovative communication venues among its members (including chats and electronic media platforms);conducted and delivered, temporary in-kind pediatric health care clinics in the most affected communities;offered guidance on best practices to groups working on disaster relief and mitigation efforts;offered guidance, and established collaboration with local and federal response agencies;and provided support and opportunities to increase capacity to pediatricians and other healthcare providers. Multiple educational activities were conducted in-person and virtually to clinicians, health and government officials, educators and caretakers and families. In addition, the PRAAP Chapter developed and distributed evidence-based educational materials to facilitate the education process. Some topics addressed include management and prevention of common conditions which may occur living in overcrowded conditions after a disaster, safe sleep, safe infant feeding, use of sunscreen and mosquito repellent in children, injury prevention, management of asthma, infection control and prevention, and the management of stress, among others. These efforts impacted families in all regions of the island. Conclusion: The initiatives of the PRAAP leadership in response to the emergent disasters, helped families with children, community leaders and other collaborators identify critical strategies that contributed to mitigate the challenges. Pediatricians have the knowledge to advocate for children's needs and guide in identifying priorities to address.