When Disaster Strikes what is the Role of the Local Primary Healthcare Doctor?

Abstract

Study/Objective: To examine the role of Primary Health Care (PHC) doctors in disasters Background: Research shows that primary health care strengthens population health outcomes across developing/developed nations and disparate health groups. Life expectancy is increased, infant mortality decreased, and access to health care more equitable; a strong element of this is continuity-of care. However, in disasters, this care can be disrupted as PHC doctors are not linked into disaster response, with potential adverse effects on population and individual health in the months to years following the aftermath. Existing disaster,management systems currently focus on local capabilities. PHCdoctors are locals; part of the local community and health care with a unique contribution to offer to patient care during any adversity. Methods: The epidemiology of health consequences of disasters was reviewed. A temporal pattern of the prevalence and incidence of health effects and health deterioration over time emerges. Interviews were conducted with PHC doctors and disaster management experts involved in the November 2010 E.Australian floods, the 2010-2011 Christchurch earthquakes, 2013 NSW bushfires, and the 2014 Sydney Siege, exploring the diversity of roles played by PHC doctors across the PPRR of disasters. Results: Roles that the PHC doctors undertake in disasters varies considerably. Many are spontaneous and unsupported, with few involving planning or preparedness. Key messages from the PHC doctors involved in disasters are consistent across the different disasters. Conclusion: In order to improve the health of people affected by disaster, there is an urgent need to define the role of primary care in existing disaster management systems, using evidence from the literature and experience from the field. Pre-disaster involvement on local disaster planning committees, as well as patient and practice preparedness; during-disaster continuity of-care for the local population; and post-disaster involvement in health surveillance for emerging disease and deterioration of existing health conditions are crucial to strengthen and optimize community health outcomes following disasters. Show more