Disabled Children in Disaster Management

Disabled children have a wide range of impairments, talents, and capacities, which collide with a wide range of circumstances and societal attitudes. The following article discusses disaster management in the context of disabled children. Disaster, disability and its management is discussed in the context of international practices in general and suited to India in particular. The research follows a review of the United States National Commission on Children and Disaster and its extrapolations to India. In addition to this Disaster Medicine as one approach to Disaster Management concerning disabled children has been explored. The research concludes that the understanding of particular issues of Children with disabilities as one stakeholder and their capacity to engage, as well as a shift in mindset and power relations in which children with disabilities contribute to DRR projects, are fundamental to disability-inclusive DRR.

Terrorist Attacks in Western Europe: A Counter-Terrorism Medicine Analysis

Background: The modern concept of terrorism has its roots in the “old continent” of Western Europe, more specifically in France, during the “Reign of Terror” period of the French Revolution. At the time, this form of state terror had a positive connotation: it was a legitimate means of defending the young state. While no single accepted definition of terrorism exists today, it is universally considered an attack on both state and society. The health care impacts of terrorist attacks often extend disproportionally beyond the casualty toll, but the potential for such events to induce mass casualties remains a concern to Disaster Medicine and Counter-Terrorism Medicine (CTM) specialists. Method: Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). The GTD was searched using the internal database search functions for all events which occurred in Western Europe from January 1, 1970 - December 31, 2019. Years 2020 and 2021 were not yet available at the time of the study. Primary weapon type, country where the incident occurred, and number of deaths and injured were collated. Results were exported into an Excel spreadsheet (Microsoft Corp.; Redmond, Washington USA) for analysis. Results: A total of 15,306 events were recorded in Western Europe out of a total of 201,183 events world-wide between the years 1970 and 2019 inclusive. This resulted in a total of 5,548 deaths and 17,187 injuries. Explosives were used as a primary weapon/attack modality in 8,103 attacks, followed by incendiary attacks in 3,050 events and firearm use in 2,955 events. The use of chemical, biological, radiation, and nuclear (CBRN) weapons was rare and only accounted for 47 events. Conclusion: From 1970 through 2019, 9.11% of all terrorist attacks occurred in Western Europe. Compared to global trends of attack methodologies in the same study period, the use of explosives as a primary attack modality in Western Europe was similar (52.94% in Western Europe versus 48.78% Global). Firearm use was comparatively low (19.31% versus 26.77%) and the use of CBRN as an attack modality was rare (0.30% versus 0.20%). The United Kingdom, Spain, and France accounted for over 65% of all terrorist attacks and over 75% of terrorism-related deaths in Western Europe.

How Prepared Are the Health Care Professionals for Disaster Medicine Management? An Insight from Pakistan

Countries need healthcare professionals who are competent first responders with a positive attitude and prepared to deal with catastrophes. The study evaluated the knowledge, attitude, and readiness of the practice of healthcare professionals towards disaster management. A survey was carried out among hospital healthcare professionals using a self-administered validated questionnaire. The questionnaire comprised knowledge, attitude, and readiness to practice items. Descriptive and inferential statistics (Mann–Whitney, Kruskal–Wallis, correlation and regression tests) at alpha = 0.05 were used in the analysis. The mean (SD) score of knowledge was 12.25 (4.27) (range: 3.00 to 20.00), attitude (39.32 ± 9.55; range: 18.00 to 61.00), readiness to practice (32.41 ± 6.69; range: 21.00 to 61.00), and KArP (83.99 ± 12.21; range: 60.00 to 124.00). The average knowledge score was moderate, low attitude score, moderate readiness to practice score, and an average score of overall KArP. Attitude is a significant predictor of readiness to practice (p = 0.000). The levels of knowledge, attitude, and readiness of the practice of healthcare professionals were not satisfactory. The educators and health policymakers should build a robust curriculum in disaster medicine management and preparedness to prepare for the future of competent healthcare professionals for the nation.

Emergency Preparedness and Disaster Response: There’s an App for That 2.0

Introduction: In disaster response, smartphone applications (or apps) are being used by the layperson, emergency first responders, and health care providers to aid in everything from incident reporting to clinical decision making. However, quality apps are often diluted by the overwhelming number of apps that exist for both the lay public and first responders in the Apple iTunes (Apple Inc.; Cupertino, California USA) and Google Play (Google LLC; Mountain View, California USA) stores. Hypothesis/Problem: A systematic review of disaster response apps was originally completed in 2015; a follow-up review was completed here to evaluate trends and explore novel apps. Methods: A search of the Apple iTunes and Google Play stores was performed using the following terms obtained from PubMed (National Center for Biotechnology Information; Bethesda, Maryland USA) Medical Subject Headings Database: Emergency Preparedness; Emergency Responders; Disaster; Disaster Planning; Disaster Medicine; Bioterrorism; Chemical Terrorism; Hazardous Materials; and the Federal Emergency Management Agency (FEMA [Washington, DC USA]). After excluding any unrelated apps, a working list of apps was formed and categorized based on topics. Apps were categorized by intended user (first responders or the public) and sub-categorized by topic for discussion. Sub-categories included News/Information, Reference/Education, Weather/Natural Disasters, Travel/Navigation, and Communication/Reunification. Results: A search of the Apple iTunes store revealed 394 unique apps and was narrowed to 342 based on relevance to the field and availability on the iPhone. A search of the Google Play store yielded 645 unique applications and was narrowed to 634 based on relevance. Of note, 49 apps appeared in both app stores using the search terms. An aggregate 927 apps from the Apple iTunes and Google Play stores were then critically reviewed by the authors. Apps were sub-categorized based on intended audience, layperson or first responder, and sorted into one of five disaster response categories. Two apps were chosen for discussion from each of the five sub-categories. The highest quality apps were determined from each group based on relevance to emergency preparedness and disaster response, rating, and number of reviews. Conclusion: After comparisons with the 2015 article, many new apps have been developed and previously described apps have been updated, highlighting that this is a constantly changing field deserving of continued analysis and research.

Estimating the emergency care workforce in South Africa

Background: Emergency care is viewed as a fundamental human right in South Africa’s constitution. In the public sector, all emergency medical services (EMS) come under the Directorate: Emergency Medical Services and Disaster Medicine at the National Department of Health (NDoH), which provides regulation, policy and oversight guidance to provincial structures.Aim: The aim of the study is to understand the supply and status of human resources for EMS in South Africa.Setting: This research was undertaken for South Africa using the Health Professions Council of South Africa (HPCSA) database from 2002 to 2019.Methods: A retrospective record-based review of the HPCSA database was undertaken to estimate the current registered and future need for emergency care personnel forecasted up to 2030.Results: There are 76% Basic Ambulance Assistants registered with HPCSA. An additional 96 000 personnel will be required in 2030 to maintain the current ratio of 95.9 registered emergency care personnel per 100 000 population. The profile of an emergency care personnel employed in South Africa is likely to be a black male in the age group of 30–39-years, residing in one of the economically better-resourced provinces.Conclusion: It is time that the current educational framework is revised. Policy interventions must be undertaken to avoid future shortages of the trained emergency care personnel within South Africa.

The Imagined Disastrous: West German Civil Defence Between War Preparation and Emergency Management 1950–1990

Histories of civil defence have tended to focus on large-scale endeavours during the early Cold War. In West Germany, however, civil defence became more successful after concepts of ‘total defence’ and accompanying shelter construction programmes were discontinued. From the mid-1960s, officials who had initially spoken of ‘disasters’ to avoid the unpopular term ‘war’ began focusing on less obtrusive, attainable all-hazards measures. Similarly, the majority of German physicians involved in disaster medicine pragmatically imagined scenarios up to, but not exceeding, nuclear reactor meltdowns or isolated nuclear strikes. In the wake of political détente and technical disasters during the 1980s, most critics came to agree that at least some specialised preparation for more extreme scenarios might be warranted and did not necessarily amount to militarisation.

Experience of Applying Telemedicine Technologies in the Work of Voronezh Regional Clinical Center for Disaster Medicine

The purpose of the study is to determine the role of telecommunication technologies in increasing the efficiency of Voronezh Regional Clinical Center for Disaster Medicine. Materials and methods of research. The data contained in analytical reports and other documentation of the Center for 2018-2020 in terms of identifying patterns of their change with the introduction of telecommunications technologies were analyzed. Results of the study and their analysis. Introduction of telemedicine technologies in the work of the Center resulted in increase of volume of rendering of medical care by its specialists. The neurosurgeons were the most demanded specialists, who performed telemedical consultations, which is mostly related to the necessity of performing consultations for the doctors of trauma centers of the II and III levels, engaged in treatment of victims of car accidents. Voronezh Regional Clinical Center for Disaster Medicine plans to further expand the use of telecommunication technologies not only in treating victims of road accidents, but also victims of other man-made and natural emergencies.

Analysis of Organizational Models of Disaster Medicine Service of the Ministry of Health of the Russian Federation at Regional Level

The results of study and analysis of organizational and functional changes in the Disaster Medicine Service of the Ministry of Health of Russia at the regional level, organizational models of the Disaster Medicine Service functioning in the subjects of the Russian Federation are presented. The study was conducted at the All-Russian Center for Disaster Medicine “Zashchita” (since 2015) and at the Federal Center for Disaster Medicine of the National Medical and Surgical Center named after N.I. Pirogov of the Ministry of Health of Russia. The purpose of the study is to analyze organizational models of the Disaster Medicine Service functioning at the regional level. Materials and research methods. The following methods were used in the study: expert evaluation, statistical, analytical, field observation, etc. The method of expert evaluation was applied through questionnaire survey of experts – Russian experts in the field of disaster medicine and emergency medical care. The questionnaires were filled in twice – questionnaire №1 – in 2015 and questionnaire №2 – in 2019-2020; a total of 529 people took part. Questionnaires № 1 and № 2 included questions and provisions relating to organizational models of the Disaster Medicine Service functioning at the regional level and to organizational and functional changes in the Disaster Medicine Service of the subjects. Results of the study and their analysis. The results of the research helped to formulate a number of principle statements on further improvement of the Disaster Medicine Service, including development of organizational structure, implementation of its organizational models at the regional level.