The Role of Family Physicians in Disaster Response Mitchell W. Duininck, MD, FAAFP

2 Activity Disclaimer ACTIVITY DISCLAIMER It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity.

Disaster Defined Definition of a Disaster : An event causing widespread chaos, destruction, and distress which frequently overwhelms the ability of the local population to deal with; a complex humanitarian catastrophe

Types of Disasters Natural – floods, hurricanes, earthquakes, tornadoes, volcanoes, climate shifts Manmade – war, genocide, bombings, terrorism, bioterrorism, chemical terrorism Travel – airlines, trains, mass transit, ships Disease – infectious agents

High Risk Locations Developing Countries - poor roads, poor communications, poor health care, low literacy rates and education, etc. Densely Populated Areas Mountainous Regions – earthquakes, etc. Coastal Regions – hurricanes, tsunamis, flooding, etc. Politically Unstable Regions

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Why Go? We have been given much and have much to share Relieve pain and suffering Bring hope Lead by example Support others responding to the need

Why Not Go? Too expensive Too dangerous Too difficult-physically, emotionally, etc. Inadequately trained and prepared Needs are too great/overwhelming Inconvenient - job, family, etc.

Why Family Medicine? Broadly trained medical specialists: –Musculoskeletal problems/trauma –Infectious disease –GYN, obstetrics –GI, pulmonary, cardiac, etc. –Etc. Comfortable with all ages Treat male and female 13

Why Family Medicine? Medical and procedural diagnostic and therapeutic skills Comfortable working in low resource settings; outpatient clinics and hospitals Behavioral medicine skills Community health and public health skills 14

Why Family Medicine? Servant leadership and group dynamics; team building skills Creative thinkers and problem solvers Good communicators, team players Trained in multi-tasking Skilled in crisis management and decision- making 15

Opportunities Temporary medical clinics Working in IDP(refugee) camps Working in local medical facilities Community surveys of medical needs Community reconciliation

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Preparation Physical, emotional, psychological, intellectual and spiritual Previous international medicine experience vital Financially prepared, current passport Local national partners to collaborate with – transportation, translators, food, housing, security, etc.

Preparation Appropriate team members Home-based support team Knowledge of local customs, language, politics, climate, economics, etc. Medical knowledge and training

Preparation BLS/CPR/ACLS ATLS BDLS/ADLS/CDLS First Responder/First Aid/Emergency Responder – Red Cross Wilderness Survival Course

Pitfalls Not well prepared physically, mentally, medically, spiritually Dysfunctional team members Going solo Partners/family not supportive Interactions with other organizations

Organizations UNHCR(United Nations High Commission for Refugees) UNICEF(United Nations International Children's Emergency Fund) WHO(World Health Organization) USAID(United States Agency for International Development) Red Cross

Organizations Doctors Without Borders Oxfam Salvation Army World Vision Samaritan’s Purse Military

Keys to Success Being well prepared; team structure Working with likeminded organizations Incredible flexibility and unity of team Daily personal and team debriefing and self-care

Keys to Success Committed support team Cross-cultural and interpersonal communication skills Re-entry planning and support

Summary If not now – when? If not us – who? Tremendous needs and opportunities! Significant challenges! For to whom much is given, of him much is required. (Luke 12:48)