Ccih 2014-typhoon-haiyan-kosh-wallis

Stories from Typhoon Haiyan: Compassionate Care in Disaster Response


Kosh Wallis, RN, a member of the Samaritan's Purse Disaster Assistance Response Team, describes the organization's response to help people in need after Typhoon Haiyan. She addresses the major challenges and disease threats faced after the typhoon.

Transcript of Ccih 2014-typhoon-haiyan-kosh-wallis

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Stories from Typhoon Haiyan:

Compassionate Care in Disaster Response

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Tropical Cyclones

Damage and deaths related to cyclones are

the result of three major forces:

- High wind speed

- Storm surges

- Secondary flooding

  Storm surges and floods are the

primary causes of death in cyclones

Shannon. Doocey, PhD. “Natural Disasters: An Overview” PowerPoint Presentation. John

Hopkins University, Baltimore, MD. 18 September 2012

Presentation Notes
Storm surge is defined by the National Hurricane Center as “an abnormal rise of water generated by a storm over and above the predicted astronomical tide.” - drowning and trauma related to storm surges and floods are the most common cause of death
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Cyclone Injuries

Injury rates estimated at ~3-5%

  Lacerations, wounds, contusions, blunt trauma,

animal/insect bites, and motor vehicle injuries are the

most common types of injuries reported

Shannon. Doocey, PhD. “Natural Disasters: An Overview” PowerPoint Presentation. John Hopkins University, Baltimore, MD. 18

September 2012

Presentation Notes
  At risks group for injury: - Middle age adults - Males
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Typhoon Haiyan

Mechanism of Action:

195 MPH winds accompanied

by a tremendous storm surge that

“may have been as much as 26.4

feet high” (NASA).


Presentation Notes
Typhoon Yolanda one of the strongest tropical storms on record made landfall in the Philippines causing massive damage Most of the city of Tacloban sits less than 16 feet above sea level. The typhoon made landfall at 6 am Patients described the sound of the storm as a jet engine outside their homes They described the storm surge as a giant whirlpool that forced many onto rooftops and into the 195MPH winds.
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Presentation Notes
50 square miles that looked like this The government reported that 6,000 people lost their lives Thousands more were left without shelter after their homes were destroyed
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Disaster Assistance Response Team (DART)

• DART is the mechanism Samaritan’s Purse uses as it’s initial rapid disaster response mechanism.

• Consists of a team of professionals trained in various disaster relief skills.

• Regardless of the disaster, each DART team coordinates its activities with the affected country, non-governmental organizations and other actors

Presentation Notes
The people on this team are the first people on the ground. The activities of a DART vary, depending on the type, size, and complexity of disaster to which it deploys. The medical component of the DART responds to the type of medical emergency generated by the disaster.
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DART Preparation

• Skills training

• Lectures

• Simulations

• Field experience

Presentation Notes
Previous experience Proven ability to handle extreme environments and living conditions Technical expertise
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Role of Medical Responders:


Presentation Notes
Medical Professional First and foremost responsibility is to address and respond to the health needs of the affected population Varies greatly depending on the disaster and requires a narrow and wide focus. Must address the acute need while simultaneously looking at the patient’s larger environment including shelter, sanitation, and food sources. An example of this is taking the time to have a conversation with a mother and learning she has lost her husband and sons and is now worried about sexual assault in her makeshift tent.     Healer Easy to get caught up in the skills aspect of the medical profession. Dealing with enormous psychological, emotional and spiritual trauma. You have a more intimate relationship with the affected population than most other aid workers. Take the time to connect. Make eye contact, use supportive touch, go the extra mile to provide for basic needs.   Team Member Team unity is essential. Without the support and accountability of your team you will burn out 10x faster. Be aware of your teammates; make sure they are eating, sleeping and resting well. Easy to prioritize yourself last but this is selfish and will result in a compromised response in the end.   Wild Card Trained in a variety of other disaster relief skills including shelter and food distribution, logistics and data collection.
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Role of Medical Responders: HEALER

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Role of Medical Responders: TEAM MEMBER

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Presentation Notes
- Kelly is a perfect example of the Wild Card idea Shelter Program Manager 10,000 tarps distributed over 4 days
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Don’t panic when you hit a roadblock!!! STOP…THINK…then IMPROVISE

Presentation Notes
-Flexibility and resourcefulness are key!
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Typhoon Haiyan Medical DART

Presentation Notes
- 8 medical team members arrived in Tacloban one week after the typhoon - Medical Director coordinated with the local government and other NGO’s for assignment
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Supported Schistosomiasis Research and Control Hospital

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Schistosomiasis Parasitic worm infection

Infection occurs when skin comes in contact with fresh water containing snails that carry shistosomes.

Once in the body, parasites resides in blood vessels where they mature into adult worms.

Females lay eggs which travel to bladder, liver, intestine, spinal cord and brain causing inflammation and scarring.

Presentation Notes
- Global disease – reported Africa, Asia, South America, the Caribbean, and the Middle East WHO reports that 35 million people were treated for Schistosomiasis in 2012 Often occurs in agricultural workers such as rice farmers and children swimming in fresh water
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Mobile Medical Teams

Presentation Notes
Outreach to communities isolated by typhoon damage - Locations chosen by coordinating with local health officials to identify highest need areas - Chronic disease such as hypertension, diabetes and tuberculosis were especially problematic
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Mass Vaccination Campaign

Measles and Polio

Vitamin A

Malnutrition Screening

Presentation Notes
Vaccination programs implemented to address high risk of measles and polio in tent cities for children under 5. Vitamin A supplements also given Children screened for malnutrition via upper arm circumference  
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Typhoon Haiyan Morbidity Data

Presentation Notes
-This is data we collected on reportable conditions by the DOH from November-December 31st. Acute Respiratory Infections Hypertension Open Wounds Skin conditions Asthma Diabetes Acute Watery Diarrhea Other: Schistosomiasis, UTIs,
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Lessons and stories…

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Vulnerability—the extent to which an individual, community, sub group, structure, or service in a

geographic area is likely to be damaged or disrupted by the impact of a particular hazard

*the rationale for compassionate care*

“Strengthening Emergency Response Abilities: SERA Project; Vulnerability Profile” Aheforom Woreda (district), Central Zone, Tigray Region. 2000

Presentation Notes
Displaced people, disrupted health services, disrupted economic status
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Take your time in the moment…


Presentation Notes
-You always have time to connect Be intentional with your eye contact, touch and listening. They may impact your patient more than the medicine you’re giving. Compassionate care is healing. Touch is a buzz word full of liability. Healing touch cannot be overestimated. Use your judgment...know cultural norms. Kelly’s encounter led her to the shelter program Ali visiting the hospital
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Remember your national colleagues…

Presentation Notes
Remember that your national coworkers experienced a recent trauma too Elaine’s story Serve them Listen to them (personal trauma, personal needs – tarps) Ask questions
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“Against the assault of laughter, nothing can stand.” - Mark Twain

Presentation Notes
-My biggest lesson from the Philippines Optimism Our sympathy would have disempowered them When unsure how to react to suffering…follow the local examples
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Presentation Notes
-Human beings are resilient. Believe in the tremendous resilience of the human spirit and have hope!