Article

Do pandemic preparedness planning systems ignore critical community- and local-level operational challenges?

Harvard Humanitarian Initiative, Harvard University, USA.
Disaster Medicine and Public Health Preparedness (Impact Factor: 1.14). 03/2010; 4(1):24-9. DOI: 10.1097/DMP.0b013e3181cb4193
Source: PubMed
0 Bookmarks
 · 
76 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The US Department of Defense continues to deploy military assets for disaster relief and humanitarian actions around the world. These missions, carried out through geographically located Combatant Commands, represent an evolving role the US military is taking in health diplomacy, designed to enhance disaster preparedness and response capability. Oceania is a unique case, with most island nations experiencing "acute-on-chronic" environmental stresses defined by acute disaster events on top of the consequences of climate change. In all Pacific Island nation-states and territories, the symptoms of this process are seen in both short- and long-term health concerns and a deteriorating public health infrastructure. These factors tend to build on each other. To date, the US military's response to Oceania primarily has been to provide short-term humanitarian projects as part of Pacific Command humanitarian civic assistance missions, such as the annual Pacific Partnership, without necessarily improving local capacity or leaving behind relevant risk-reduction strategies. This report describes the assessment and implications on public health of large-scale humanitarian missions conducted by the US Navy in Oceania. Future opportunities will require the Department of Defense and its Combatant Commands to show meaningful strategies to implement ongoing, long-term, humanitarian activities that will build sustainable, host nation health system capacity and partnerships. This report recommends a community-centric approach that would better assist island nations in reducing disaster risk throughout the traditional disaster management cycle and defines a potential and crucial role of Department of Defense's assets and resources to be a more meaningful partner in disaster risk reduction and community capacity building. Reaves EJ , Termini M , Burkle FM Jr. Reshaping US Navy Pacific response in mitigating disaster risk in South Pacific Island nations: adopting community-based disaster cycle management. Prehosp Disaster Med. 2014;29(1):1-9 .
    Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation 12/2013; DOI:10.1017/S1049023X13009138
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background:Planning for mass critical care in resource poor or constrained settings (developing or undeveloped countries) has been largely ignored despite their large populations that are prone to suffer disproportionately from natural disasters. Addressing mass critical care in these settings has the potential to help vast numbers of people and also to inform planning for better-resourced areas. Methodology:The Resource Poor Settings panel developed 5 key question domains; defining the term resource poor and using the traditional phases of disaster (mitigation/preparedness/response/recovery), literature searches were conducted to identify evidence on which to answer the key questions in these areas. Given a lack of data upon which to develop evidenced-based recommendations, expert-opinion suggestions were developed and consensus was achieved using a modified Delphi process. Results:The 5 key questions were then separated as follows: definition, infrastructure and capacity building, resources, response, and reconstitution/recovery of host nation critical care capabilities and research. Addressing these questions led the panel to offer 33 suggestions. Due to the large number of suggestions the results have been separated into two sections, part I: Infrastructure/Capacity in this manuscript, and part II, Response/Recovery/Research in the accompanying manuscript. Conclusions:Lack of, or presence of, rudimentary Intensive Care Unit resources and limited capacity to enhance services further challenge resource poor and constrained settings. Hence, capacity building entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is needed to mount a surge response. Moreover, planning should include when to disengage and how the host nation can provide capacity beyond the mass casualty care event.
    Chest 08/2014; 146(4). DOI:10.1378/chest.14-0744 · 7.13 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Planning for mass critical care in resource-poor and constrained settings has been largely ignored, despite large, densely crowded populations who are prone to suffer disproportionately from natural disasters. As a result, disaster response has been suboptimal and in many instances hampered by lack of planning, education and training, information, and communication. METHODS: The Resource-Poor Settings panel developed five key question domains; defining the term resource poor and using the traditional phases of the disaster cycle (mitigation/preparedness/response/recovery). Literature searches were conducted to identify evidence to answer the key questions in these areas. Given a lack of data on which to develop evidence-based recommendations, expert-opinion suggestions were developed, and consensus was achieved using a modified Delphi process. RESULTS: The five key questions were as follows: definition, capacity building and mitigation, what resources can we bring to bear to assist/surge, response, and reconstitution and recovery of host nation critical care capabilities. Addressing these led the panel to off er 33 suggestions. Because of the large number of suggestions, the results have been separated into two sections: part I, Infrastructure/Capacity in the accompanying article, and part II, Response/Recovery/Research in this article. CONCLUSIONS: A lack of rudimentary ICU resources and capacity to enhance services plagues resource-poor or constrained settings. Capacity building therefore entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is oft en needed to mount a surge response. Moreover, the disengagement of these responding groups and host country recovery require active planning. Future improvements in all phases require active research activities. CHEST 2014; 146 (4_Suppl): e168S-e177S
    Chest 08/2014; 146(4). DOI:10.1378/chest.14-0745 · 7.13 Impact Factor

Full-text

Download
11 Downloads
Available from
Nov 1, 2014