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Cultural & Ethical Issues Disaster Medicine in a Foreign Land.

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Presentation on theme: "Cultural & Ethical Issues Disaster Medicine in a Foreign Land."— Presentation transcript:

1 Cultural & Ethical Issues Disaster Medicine in a Foreign Land

2 Cultural & Ethical Issues  Objectives  Preparation  Cultural limitations  Gender effects  Language barriers N Engl J Med. 2010 Mar 11; 362(10): e34.

3 Cultural & Ethical Issues  Language barriers  Professional interpreters optimal

4 Cultural & Ethical Issues  Language barrier  Clinical situation  Availability  Patient preference  Language gap

5 Cultural & Ethical Issues  Gender bias  Women highest mortality  Not taught to swim  Clothing restricts motion  Cannot leave home without male Asia Pacific Forum on Women, Law and Development (APWLD)

6 Cultural & Ethical Issues  Gender bias  Women poorest medical care  Males restrict mobility and contacts  Women maintain household Asia Pacific Forum on Women, Law and Development (APWLD

7 Cultural & Ethical Issues  Preparation  Stay tuned to World News  Hurricanes  Wars  Famine

8 Cultural & Ethical Issues  Preparation  Earthquakes & Tsunamis  demand an immediate response making you dependent on your group

9 Cultural & Ethical Issues  Preparation  Hurricanes  Wars  Famine  Time to study Central Intelligence Agency

10 Cultural & Ethical Issues  Preparation  Hurricanes  Wars  Famine  Time to study U.S. Department of State

11 Cultural & Ethical Issues  Preparation  Hurricanes  Wars  Famine  Time to study

12 Cultural & Ethical Issues  Preparation  Hurricanes  Wars  Famine  Time to study  Most important  Call

13 Cultural & Ethical Issues Haiti, Disaster Medicine: the Tale of Two Earthquakes National Geograhic

14 Cultural & Ethical Issues Haiti, Disaster Medicine: the Tale of Two Earthquakes Google Earth

15 Cultural & Ethical Issues  Haiti before the quake  Geography and culture http://svs.gsfc.nasa.gov/vis/a000000/a002600/a00 2640/ Wunderground.com

16 Cultural & Ethical Issues  Haiti before the quake  Geography and culture  Population & location

17 Cultural & Ethical Issues  Haiti before the quake  Geography and culture  Population & location  Law & order wikipedia

18 Cultural & Ethical Issues  1994 before LA quake  Geography & culture Wunderground.com

19 Cultural & Ethical Issues  After the quakes  neighbors Wunderground.com

20 Cultural & Ethical Issues  After the quakes  Neighbors © 2011 Los Angeles County Fire Department

21 Cultural & Ethical Issues  After the quakes  Neighbors  Search & Rescue USAID_IMAGES' photostream © 2011 Los Angeles County Fire Department

22 Cultural & Ethical Issues  After the quakes  Neighbors  Search & Rescue  Trauma Care U.S. Coast Guard www.gettingprepared.info

23 Cultural & Ethical Issues  Medicine after a Disaster  Principles  Cannot do the best for each individual victim  Do the best for the largest number of victims http://www.agenciabrasil.gov.br/media/imagens/2010/01/1 4/14.01.10RP5967.jpg/view

24 Cultural & Ethical Issues  Medicine after a Disaster  Principles  Cannot do the best for each individual victim  Do the best for the largest number of victims Fink S. (2010). Doctors Face Ethical Decisions in Haiti. Retrieved from: http://www.thweorld.org/2010/02/doctors-face- ethical-decisions-in-haiti/

25 Cultural & Ethical Issues  Medicine after a Disaster  Principles  Cannot do the best for each individual victim  Do the best for the largest number of victims  Do what can be sustained locally Ann Intern Med. 2010 Jun 1; 152(11); 733-7.

26 Cultural & Ethical Issues  Historic Twist  Antisepsis Orthopaedics in an Austere Environment

27 Cultural & Ethical Issues  Open Wound care

28 Cultural & Ethical Issues  Lack of Fluoro

29 Cultural & Ethical Issues  Lack of records  Lack of follow up

30 Cultural & Ethical Issues  Women are at a disadvantage before and during a disaster  Professional interpreters facilitate medical care everywhere  Limit your surgical goals to match environment, culture, materiel and personnel to prevent further dysfunction  World history and geography are great hobby


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