International healthcare responses to man-made
or natural disasters should be co-ordinated and planned to enable
the people affected to receive the aid they need, delegates at the
Annual Meeting of the Royal College of Psychiatrists heard this
week.
Professor Rachel Jenkins, director of the
World Health Organisation (WHO) Collaborating Centre at the
Institute of Psychiatry, London, one of an international network of
centres carrying out work in support of WHO programmes, said lone
healthcare professionals who took it upon themselves to volunteer
their skills outside a co-ordinated plan can do more harm than
good.
Prof Jenkins recalled occasions when Western
healthcare staff have turned up unexpectedly in disaster zones. She
said: “If the whole world jets in, it’s mayhem. Volunteer from
other countries must be prepared to be co-ordinated by the lead
agencies in charge, normally the Ministry of Health and the WHO
country office.”
Such co-ordination is necessary to guard
against duplication, to ensure help reaches the remotest villages,
and to strengthen local facilities so they do not collapse when
donor money is withdrawn.
International medical teams should liaise
closely with local governments and organisations to help to train,
supervise and support front-line health workers. They should link
up with nurses, health visitors, social workers and teachers, as
well as volunteers, the army and frontline workers to ensure that
post-disaster recovery programmes are effective.
Functioning primary care and mental health
services are vital in all populations, but Prof Jenkins said
Kashmir was particularly disadvantaged in the aftermath of the
earthquake in 2005 because it had previously had very sparse health
services in the affected region. This made post-earthquake efforts
even more challenging, but the army and WHO combined to deliver an
effective response.
In addition, Prof Jenkins said it must be
remember that, following disasters, as well as dealing with the
normal psychological responses to trauma, healthcare workers have
to cope with people who have pre-existing mental disorders and the
loss of health, social and educational infrastructure.
Professor David Alexander, a psychologist and
Director of the Aberdeen Centre for Trauma Research, called for
mental health professionals carrying out research in the aftermath
of disasters, to conduct their research sensitively.
Researchers must be sensitive to culture. Giving examples, he
said that researchers should be conversant with the politics of the
country involved and be aware that national and local governments
are sometimes at odds with each other. Researchers should also
employ cultural advisers to give them guidance on how best to
conduct their queries. “People in different countries express
emotional distress in different ways. Some might not be able to
read, so there is no point in handing out questionnaires,”
Professor Alexander said.
For further information, please contact Liz Fox or Deborah
Hart in the Communications Department.
Telephone: 020 7235 2351 Extensions. 6298 or 6127
References:
The Annual Meeting of the Royal College of Psychiatrists, Imperial College, London, 1 – 4 July 2008