Professionalizing medical care after disasters

In a large-scale disaster, when tens of thousands of people need medical help quickly, doctors and nurses with limited resources must make on-the-spot decisions about who should receive care and how much. To help health workers navigate these often difficult decisions, experts in disaster care are creating guidelines and training for how best to provide aid after natural disasters, in war zones, or in other tragedies.

Given problems that surfaced in recent disasters—such as poor triage of acute wounds after the 2010 earthquake in Haiti, which led to ongoing health issues among survivors—disaster-relief experts at Harvard T.H. Chan School of Public Health say that recognized guidelines and best practices are crucial to help relief workers deliver the greatest good to the greatest number of people.

Disasters require a population-based approach to health care delivery, said ethicist Nir Eyal, associate professor of global health and population at Harvard Chan School, in the Autumn 2016 issue of Harvard Medicine magazine. But that can be difficult for Western-trained doctors and nurses accustomed to providing personalized care, said Jennifer Leaning, François-Xavier Bagnoud Professor of the Practice of Health and Human Rights and director of the FXB Center for Health and Human Rights. “Keeping your focus on both the individual and the population at the same time is disorienting—and troubling,” she said.

Training can help, said Michael VanRooyen, director of the Harvard Humanitarian Initiative.