By Roman A. Hayda, MD
Disaster responders are motivated by good intentions that are often fulfilled. However, if safety and security protocols are ignored, the volunteer may become an additional casualty. Instead of helping, they become a burden, increasing the scope of the disaster.
In disaster response, there are three areas of concern for the individual and the team: physical security, physical health, and mental health. All of these must be considered in the preparation phase, response phase, and during recovery.
In terms of physical security, the response team must be able to safely perform triage and care. These should be planned for in advance and maintained during response. For instance, in a natural disaster, care facilities should be located near enough to the disaster to limit transit time, but not so close as to be in danger from the conditions of the disaster. In terror events, security personnel should be made available to assure that medical providers are not placed at undue risk from continued terror actions (second hit) or other threats such as kidnapping.
Physical health of responders is equally important. Prior to the event, personnel should assess their ability to withstand the rigors of disaster response. Stable and controlled medical conditions are not a contraindication to participation, but providers should carry an excess supply of their own medications, as resupply may not be available. Endemic diseases should be considered, and ALL vaccinations should be up to date. When traveling internationally, it is valuable to check websites for suggested vaccinations. During disaster response, appropriate rest, hydration, and nutrition is a critical but often neglected factor for providers. Ignoring them can lead to significant degradation of performance. Anecdotally, an unvaccinated responder to the recent Haiti disaster became seriously ill with COVID-19, in a situation in which advanced care was not possible, risking their own health and degrading the response of the team, who then had to provide care for the individual.
Finally, mental health is critical during and after response due to risk of extremely high stress levels. Providers and leaders must remain cognizant of the potential for severe mental stress both during and after response among themselves and their teammates. Maintaining appropriate rest, nutrition and hygiene is a vital component of prevention, but counseling and mental health support response are critical. Debriefing both during and after the event is an important means of identification and initiation of treatment measures.