Haitian and international responders' and decision-makers' perspectives regarding disability and the response to the 2010 Haiti earthquake

Assessment of healthcare needs on disabled earthquake survivors after the Malatya earthquake

BACKGROUND

The earthquake that occurred in Turkey on February 6, 2023 is considered the biggest disaster of the century, having a major impact on 10 provinces of Turkey. This study might provide the necessary data for healthcare services planning for disabled earthquake survivors according to their needs after the Malatya earthquake.

MATERIALS AND METHOD

This mixed-patterned study was conducted in Malatya between February 17 and 20, 2023, with 30 disabled earthquake survivors. It was a mixed-methods study which involved both qualitative study using a semi-structured interview and quantitative analysis using both the Disability Status Analysis Questionnaire and the Exercise of Self-Care Agency Scale (ESCA).

RESULTS

The study determined four themes: "Accessibility to Assistive Devices," "Establishment of Special Facilities for Disabled Individuals after the Earthquake," "Suitability of Living Areas," and "Accessibility to Campgrounds and Tent Cities." The ESCA mean score of all disabled earthquake survivors was 87.47 ± 13.75 and those with multiple disabilities had lower ESCA scores (P < .05).

CONCLUSION

It was found that disabled earthquake survivors had difficulties in meeting their basic needs after the earthquake. It is considered vital to include disabled individuals and their families in disaster planning and to teach them about these plans.

Identifying and Describing Impact of Disasters on Non-Communicable Diseases: A Systematic Review

BACKGROUND

Patients with non-communicable diseases are vulnerable to disasters. This is a systematic review describing the impact of disasters on non-communicable diseases.

METHODS

A systematic review was conducted using PRISMA standards. Relevant articles published from 1997 to 2019 collected by searching the Scopus, PubMed, Science Direct, databases. We specifically examined reports describing NCDs and including the key words "non-communicable disease and Disasters". NCDs included cardiovascular, respiratory, diabetes, cancer and mental health diseases.

RESULTS

Of the 663 studies identified, only 48 articles met all the eligibility criteria. Most studies have shown the impact of all natural disasters on non-communicable diseases (39.8% n=19). The largest study was the effect of earthquakes on non-communicable diseases (29.2% n=14). For the NCDs targeted by this research, most of the included studies were a combination of four diseases: cardiovascular disease, respiratory disease, diabetes and cancer (44% n=21). Followed by cardiovascular disease (14.6% n=7), chronic respiratory disease (12.5% n=6), diabetes and cancer (6.2% n=3) and mental health (12.5% n=6).

CONCLUSION

The incidence of disasters affects the management of treatment and care for patients with NCDs. Specific measures include a multi-part approach to ensuring that patients with non-communicable diseases have access to life-saving services during and after disasters. The approach of the health system should be expanded from traditional approaches to disasters and requires comprehensive planning of health care by policy makers and health professionals to develop effective strategies to enable patients to access medical, therapeutic and diagnostic services in natural disasters.

Establishing the Status of Patients With Non-Communicable Diseases in Disaster: A Systematic Review

OBJECTIVE

People with NCDs are particularly vulnerable to disasters. This research systematically reviewed reports describing studies on the status of patients with NCDs before, during and after disasters.

METHOD

Relevant articles published from 1997 to 2019 were collected by searching the Scopus, PubMed, and Science Direct databases. We specifically examined reports describing NCDs and including the key words 'Non-Communicable Disease and Disasters.' NCDs include cardiovascular, respiratory, diabetes and cancer diseases.

RESULTS

The review identified 42 relevant articles. Most of the included studies were found to have described the conditions of patients with NCDs after disasters - 14 (13.3%), during disasters - 11 (26.2%), before disasters - 6 (14.3%), within all stages of disasters: before, during and after - 6 (14.3%), only during and after disasters - 4 (9.5%), and includes before and during disasters - 1 (2.4%).

CONCLUSION

NCDs pose major health issues in disasters. Development of strong counter measures against the interruption of treatment, as well as surveillance systems to ascertain medical needs for NCDs are necessary as preparation for future disasters.

Physiotherapy in Haiti: A qualitative study exploring local clinicians' perspectives

BACKGROUND AND PURPOSE

The physiotherapy profession in Haiti has seen many changes since the earthquake in 2010, due to the increased number of Haitians living with permanent impairments. The earthquake sparked a significant humanitarian response. Research shows that the response focused mainly on providing short-term rehabilitation services without sustained efforts to develop sustainable rehabilitation services. A decade later, little is known about the state of the Haitian physiotherapy profession. The purpose of this study was to explore the perspectives of Haitian physiotherapy professionals regarding the current state of the profession in terms of strengths, weaknesses, opportunities and threats.

METHODS

We used a qualitative exploratory descriptive design. This study consisted of two phases: (1) a survey to identify potential interview participants, and identify preliminary themes to be explored in the follow-up interviews, and (2) a series of semi-structured qualitative interviews. We performed a thematic analysis of the interview transcripts.

RESULTS

Four physiotherapists and one rehabilitation technician participated in the interviews. Six interrelated themes emerged, each having a systemic impact on the development of physiotherapy and rehabilitation services in Haiti: (1) physiotherapy as an emerging field, (2) government funding and planning of physiotherapy services, (3) accessibility to physiotherapy services, (4) relationship with doctors, (5) international collaboration, and (6) Haitian physiotherapy associations.

CONCLUSION

This study highlights the ongoing efforts of local physiotherapy associations in advocating for the profession in Haiti, which has become one of the profession's main strengths. The lack of government funding and service planning was considered a significant barrier to overcome, as was the aftermath of the earthquake's emergency response. Future international efforts could focus on supporting local physiotherapy associations and organisations in their endeavours to develop sustainable rehabilitation services.

Pandemic Surveillance and Racialized Subpopulations: Mitigating Vulnerabilities in COVID-19 Apps

Debates about effective responses to the COVID-19 pandemic have emphasized the paramount importance of digital tracing technology in suppressing the disease. So far, discussions about the ethics of this technology have focused on privacy concerns, efficacy, and uptake. However, important issues regarding power imbalances and vulnerability also warrant attention. As demonstrated in other forms of digital surveillance, vulnerable subpopulations pay a higher price for surveillance measures. There is reason to worry that some types of COVID-19 technology might lead to the employment of disproportionate profiling, policing, and criminalization of marginalized groups. It is, thus, of crucial importance to interrogate vulnerability in COVID-19 apps and ensure that the development, implementation, and data use of this surveillance technology avoids exacerbating vulnerability and the risk of harm to surveilled subpopulations, while maintaining the benefits of data collection across the whole population. This paper outlines the major challenges and a set of values that should be taken into account when implementing disease surveillance technology in the pandemic response.

Effects of the Pedernales Earthquake on Ecuador's Health Care System

OBJECTIVE

This study analyzes the effects of the Pedernales earthquake (April 2016) on Ecuador's health care system.

METHODS

A research was carried out in Chone Canton, which combined documentary, quantitative, and qualitative techniques. Epidemiological and service production information taken from official documents was analyzed systematically. In-depth interviews and surveys were conducted with health care program directors and technicians from the Health Centres of the Ministry of Public Health and the users.

RESULTS

Deficiencies in the health care system were already observed in Chone Canton prior to the earthquake mainly due to the lack of doctors, nurses, and hospital beds. According to the interviewees, the health district was not prepared for an emergency like the earthquake. Some buildings fell after the earthquake, and Chone Hospital was disabled. These problems coupled with preventive action failures at the community level led to an increase in diseases after the earthquake.

CONCLUSIONS

The shortage of personnel and physical infrastructure, weaknesses in primary health care in the Ecuadorian health system, the lack of preparation, and limited availability of information on health indicators were the causes of the sharp increase in pre-existing diseases in the area, and of new epidemic outbreaks after the earthquake.

Occupational Therapy in Haiti: A Pilot Study to Identify Intervention Methods Used during Short-Term Medical Missions

Due to the shortage of occupational therapists (OTs) in Haiti and over 800,000 individuals with disabilities, most occupational therapy assessments and interventions are provided by OTs on short-term medical missions (STMMs). Learning which methods OT use to provide assessments and interventions during these STMMs is the first step to understanding how to facilitate follow-up and carry-over for clients and ensure longevity for STMMs in Haiti. This study used a cross-sectional, descriptive design to gather data on methods used by OTs. Thirty-three OTs, who travelled to Haiti on STMMs, completed a 16-question, online survey. The most common method provided by OTs was education to patients, caregivers, and local providers. Training of Haitian rehabilitation technicians was also prevalent. There was an association between the years of the OTs' clinical experience and the effort of OTs to train local providers, but this result was not statistically significant. Further research should be implemented on specific methods that can be used in the absence or shortage of Haitian OTs to ensure follow-up for Haitian clients. The sharing of data regarding OT methods on STMMs will promote evidence-based, client-centered, and cost-effective therapy to enhance effective client outcomes.

Uganda at Glance of 5.7 Magnitude Earthquake: Lessons for Earthquake Risk Reduction

INTRODUCTION

Uganda remains seismically vulnerable to earthquakes, which constitute one of the most deadly naturally triggered disasters in the world. This is not surprising given the country's location in the East African Rift Valley System.

METHOD

This paper draws mainly on the authors' live event experience and some media reports to narratively outline the nature of a sizable earthquake, which measured a magnitude of 5.7 on the Richter scale that struck Uganda and other countries within the Lake Victoria Basin region on 10th September 2016 in the afternoon.

RESULTS

Rakai - a district in central region was the worst affected in Uganda. It witnessed the death of four people; 20 people were admitted to the hospital with injuries; a total of 590 people were affected; and serious structural damages mainly in buildings were reported, leaving many either razed to the ground or left with cracks.

DISCUSSIONS

Although this earthquake was less devastating in terms of injuries and fatalities compared to two previous earthquakes in Uganda, based on the Modified Mercalli Intensity Scale it was still considered to be severe. Therefore, this paper identified some proactive lessons as far as earthquake risk reduction in Uganda is concerned, which among others include: encouraging earthquake-resistant buildings; the safety of essential infrastructure; earthquake early warning systems supported by free global technologies; and the safety of rescue workers along with prioritizing the psychosocial needs of rescue teams. With all this in mind, the September 2016 earthquake should serve as a timely reminder that there is a real need for the proactive ex-ante earthquake preparedness rather than risking an expensive post-ante approach to responding to any future devastating earthquakes in Uganda.

Experience of people with physical disability: Mobility needs during earthquakes

BACKGROUND

People with physical disability are vulnerable in disasters because of their mobility limitations. They are unable to escape from hazards and their needs have been somewhat neglected in planning and relief measures.

AIM

This study aimed to identify the mobility needs of people with physical disability during earthquakes across different provinces of Iran.

MATERIALS AND METHODS

A qualitative study was conducted using 18 semi-structured interviews with participants who had a kind of mobility disability. The participants, across six provinces of Iran who had experienced an earthquake, were selected by purposive sampling in two ways of snowballing and maximum variation in 2017. Data were analyzed thematically assisted by MAXQDA 10 software.

RESULTS

The mobility needs included house and workplace adaptation, spare assistive devices, easy access to vehicles, special facilities for emergency evacuation, adaptation and accessibility of shelters, adapted bathroom and toilet, and transferring by others.

CONCLUSION

By considering needs and experiences of people with physical disability in disaster planning, appropriate interventions can be arranged to promote the level of response in disasters. Such measures can have a significant role in maintaining the lives and health of such people.

The changing health priorities of earthquake response and implications for preparedness: a scoping review

OBJECTIVES

Earthquakes have substantial impacts on mortality in low- and middle-income countries (LMIC). The academic evidence base to support Disaster Risk Reduction activities in LMIC settings is, however, limited. We sought to address this gap by identifying the health and healthcare impacts of earthquakes in LMICs and to identify the implications of these findings for future earthquake preparedness.

STUDY DESIGN

Scoping review.

METHODS

A scoping review was undertaken with systematic searches of indexed databases to identify relevant literature. Key study details, findings, recommendations or lessons learnt were extracted and analysed across individual earthquake events. Findings were categorised by time frame relative to earthquakes and linked to the disaster preparedness cycle, enabling a profile of health and healthcare impacts and implications for future preparedness to be established.

RESULTS

Health services need to prepare for changing health priorities with a shift from initial treatment of earthquake-related injuries to more general health needs occurring within the first few weeks. Preparedness is required to address mental health and rehabilitation needs in the medium to longer term. Inequalities of the impact of earthquakes on health were noted in particular for women, children, the elderly, disabled and rural communities. The need to maintain access to essential services such as reproductive health and preventative health services were identified. Key preparedness actions include identification of appropriate leaders, planning and training of staff. Testing of plans was advocated within the literature with evidence that this is possible in LMIC settings.

CONCLUSIONS

Whilst there are a range of health and healthcare impacts of earthquakes, common themes emerged in different settings and from different earthquake events. Preparedness of healthcare systems is essential and possible, in order to mitigate the adverse health impacts of earthquakes in LMIC settings. Preparedness is needed at the community, organisational and system levels.

The Role of the Occupational Therapist in Disaster Areas: Systematic Review

Background

Disasters are increasingly more frequent events on our planet. During disaster the role of the occupational therapist will require a more specific operative framework within nongovernmental organizations and community health services.

Design

Systematic review.

Objective

The aim of this study is to evaluate the evidence that highlight occupational therapist's role in disaster area through a systematic review.

Materials and Methods

Research on MEDLINE was performed. All articles from 2005 to 2015 concerning rehabilitation and occupational therapy in disaster areas were included.

Results

Ten studies were selected to be included in this review. Four interesting points emerged: the importance of having rehabilitation intervention in postdisaster situations, the necessity to include a rehabilitation team in the early phase of disaster response, the need to provide a method to address the difficult evacuation, and finding the safest method of transport of people with preexisting disabilities and new injuries.

Conclusions

The amount of evidence with respect to specific intervention of the occupational therapist's role in a disaster situation is limited. However some evidence suggests that it could be a good means for reducing the number of medical complications and deaths of persons with preexisting disabilities. The evidences found highlight the necessity to create a multidisciplinary team addressing needs in disasters situation, in which the occupational therapist could certainly contribute.