Injury toll following the 1997 Maccabiah Games bridge collapse: implications of major disasters for sports medicine teams

Medical and Psychosocial Needs of Olympic and Pan American Athletes after the 2010 Earthquake in Haiti: An Opportunity to Promote Resilience Through Sports Medicine and Public Diplomacy

Introduction

On January 12, 2010, a magnitude 7.0 earthquake devastated Haiti. Data regarding the prevalence of medical and psychosocial needs after the earthquake is scarce, complicating informed targeting of aid. The effects of the earthquake on athletes, as they differ from the general population, are especially unclear. The Center for Disaster Resilience (Boston, Massachusetts USA) and the Disaster Medicine Section at Harvard Medical School (Boston, Massachusetts USA) have partnered with Child in Hand to care for athletes training for the Pan American and Olympic games in Haiti, as well as for children from the general population. This report presents preliminary epidemiologic data illustrating the burden of medical and psychosocial needs of Haitian athletes and the general population after the earthquake of 2010.

Methods

The study was a cross-sectional, comparative study conducted a year after the earthquake. The study group comprised 104 athletes, aged 12-18 years, enrolled from the National Sports Center in Haiti. The control group (N = 104) from the general population was age- and gender-matched from orphanages and schools in and around Port-au-Prince, Haiti. Medical teams assessed illness based on history and physicals. Psychosocial teams utilized the Child Psychosocial Distress Screener (CPDS). Two-proportion z tests and two-sample t tests were used to compare the proportions of medical illnesses, mean CPDS scores, and proportion of CPDS scores indicating treatment.

Results

The most prevalent medical condition in athletes was musculoskeletal pain, which was more common than in controls (49% versus 2.9%). All other medical conditions were more common in the controls than athletes: abdominal pain (28.8% versus 4.8%); headache (22.1% versus 5.8%); fever (15.4% versus 1%); and malnutrition (18.3% versus 1.9%). In contrast, there was no significant difference in mean psychosocial scores and the proportion of scores indicating treatment between athletes and controls.

Conclusion

Elite athletes in Haiti have a low prevalence of most medical conditions after the disaster, suggesting that they may be protected from risk factors affecting the general population. However, athletes have a higher prevalence of musculoskeletal ailments and were not protected from psychosocial distress. This presents an opportunity for sports medicine physicians and mental health providers to engage in efforts to rebuild Haiti on an individual level by providing targeted care to athletes, and on a larger scale, by supporting international sports competition, which enhances human capital and facilitates public diplomacy.

YimES, MacyRD, CiottoneG. Medical and psychosocial needs of Olympic and Pan American athletes after the 2010 earthquake in Haiti: an opportunity to promote resilience through sports medicine and public diplomacy. Prehosp Disaster Med. 2014;29(3):1-5.

Preliminary investigation into the role of physiotherapists in disaster response

INTRODUCTION

Increasingly, disasters and disaster response have become prominent issues in recent years. Despite their involvement, there have been almost no investigations into the roles of physiotherapists in emergency disaster responses. Additionally, physiotherapists are not employed in emergency disaster response by many of the principal non-governmental organizations supplying such care, although they are included in military responses in the United States and United Kingdom, and in Disaster Medical Assistance Teams in the US. This paper, based on a small qualitative study, focuses on the potential role and nature of input of physiotherapists in disaster response.

METHODS

A qualitative approach was chosen due to the emergent nature of the phenomenon. Four physiotherapists, all of whom had been involved in some type of disaster response, agreed to participate. Semi-structured telephone interviews were used to explore participants' experiences following disaster response, and to gain ideas about future roles for physiotherapists. Interviews were recorded, transcribed, and later analyzed using coding and categorization of data.

RESULTS

Four main themes emerged: (1) descriptions of disasters; (2) current roles of the physiotherapist; (3) future roles of physiotherapists; and (4) overcoming barriers. Although all four physiotherapists had been ill-prepared for disaster response, they took on multiple roles, primarily in organization and treatment. However, participants identified several barriers to future involvement, including organizational and professional barriers, and gave suggestions for overcoming these.

CONCLUSIONS

The participants had participated in disaster response, but in ill-defined roles, indicating a need for a greater understanding of disaster response among the physiotherapy community and by organizations supplying such care. The findings of this study have implications for such organizations in terms of employing skilled physiotherapists in order to improve disaster response. In future disasters, physiotherapy will be of benefit in treating and preventing rescue worker injury and treating musculoskeletal, critical, respiratory, and burn patients.