Just before noon on 25 April 2015, a violent 7.8-magnitude earthquake rocked Nepal, killing almost 9,000 people and injuring more than 23,000. Hundreds of aftershocks followed. Entire villages were razed, destroying communities and leaving hundreds of thousands of people homeless. Relief quickly began pouring in from countries around the world, in the form of supplies, equipment, and humanitarian aid workers.
As is often the case after a devastating natural disaster, the brave people who arrived to provide aid were themselves at risk for illness and injury. Doctors, nurses, and other health professionals traveling to provide care for victims after a natural disaster must carefully plan and prepare to stay healthy and safe while providing lifesaving care under extreme circumstances. Without adequate preparation, humanitarian aid workers may not be able to effectively care for those in need or may unintentionally place additional strain on local services.
First, aid workers must realistically assess their fitness level for this work, as well as safeguard their own health while they travel. Aid workers must be in excellent physical health to work in a stressful and demanding environment. Health care facilities are often strained beyond capacity in a natural disaster, and aid workers who become sick or injured will divert limited resources (or may not be able to get care at all). Travel health and medical evacuation insurance should be a strong consideration for aid workers in disaster zones, should they need to be evacuated to a facility where definitive care is available.
Aid workers must be resilient, flexible, and able to improvise. In Nepal, landslides obliterated road access to many remote villages, and workers and supplies had to be delivered by helicopter. Stories abound of aid workers that had to insert a catheter by candlelight or suture wounds with only a little iodine to sterilize instruments.
Pretravel research, care, and preparation are essential for aid workers going to disaster zones. They should be up-to-date on all routine vaccines and receive any travel vaccines recommended for the destination. Malaria prophylaxis is recommended for some destinations, and people going to high altitudes should consider prophylaxis against altitude illness. Aid workers can research these and other travel health recommendations on the CDC Travelers’ Health website.
Aid workers should also prepare a travel health kit that is more extensive than a typical kit. It will most likely need to include supplies or equipment to disinfect water, since safe water is often unavailable after a disaster. It may also need to include gloves, gowns, and goggles if sufficient personal protective equipment will not be available at the disaster site. Aid workers may also wish to carry a supply of calorie-dense, non-perishable food in case of emergency. Those who require medication for a preexisting condition should bring an ample supply, taking into account the possibility of travel delays.
Finally, mental health is an underappreciated aspect of providing care in a disaster zone. Providers often work long hours in extreme conditions and are exposed to profound suffering. These experiences can lead to depression, posttraumatic stress disorder, and anxiety. Before deploying, aid workers should think about coping strategies; after deploying, they should stay in touch with a support network of friends and family as much as possible. Those who have witnessed mass casualties may wish to consider counseling after they return.
Nepal is rebuilding, but the road to recovery will be long and challenging. The Nepalese people are committed to restoring their communities and lives, and the contributions of humanitarian aid workers are essential to this recovery.
Featured image credit: “USAID DART Searches Collapsed Structure in Bhaktapur, Nepal” by the U.S. Department of State. Public domain via Flickr.