1. Children in Disasters Special Populations

2. Issues: Multi-casualty and complex Dealing with primary injuries Rapid identification Protection of separated kids Reunification with legal guardians Minimize secondary injuries

3. Secondary injuries I.Unintentional - Carbon monoxide inhalation - Lacerations - Poisoning II.Intentional - Abduction - Violence - Physical and sexual abuse - Neglect - Maltreatment

4. Background 29 th August, 2005, Hurricane Katrina a Cat.III storm hit New Orleans 4 th Sept., 2005 1600 evacuees (300 children) evacuated (31 hours bus ride) Camp Gauber, Oklahoma National Guard Base Oklahoma Army National Guard Maneuver Training Center (33,000 acre site), Cookson Hills, 60 miles from Tulsa

5. Shelter Series of two storied military barrack buildings 5-6 large room 50 people in each room Pediatric Injury Response Team (PIRT) provided care for child survivors –Child – safety crisis measures set up –Treated patients (dermatitis, asthma, upper respiratory infections, diarrhea, skin or wound infections)

6. Hypothesis tested: A significant number of unregistered children at Camp Gruber were traveling without legal guardians and were on the National Center for Missing and Exploited Children (NCMEC)

7. Problems No standard approach No rapid plan to identify the immediate needs of children separated from parents No registry set up No information collected when they disembarked from the bus Subjected to physical assaults, rape, gang attacks, murder etc.

8. Operation Child-ID: Case reports Early identification of a high risk situation and reunification Reunification of children and parents Child abuse prevention

9. Discussions - ‘Principles’ not ‘Protocols’ Displaced children - quickly reuniting with primary caregivers - Post Traumatic Stress Disorder (PTSD) minimized - Community panic reduced - Immediately register children and prioritize needs - Id’s with photographs and identifying bracelets - Set up a digital data entry system POSSIBLY A CENTRALIZED DATA TRACKING SYSTEM???

10. QUESTIONS?