Defining Therapeutic Persistence in Children during Disaster Relief Missions.

Scenario TH Dutch

Scenario TH English

Scenario TH Español

Children, women and the elderly are the most vulnerable populations in the event of a natural disaster. When empathic, ethical, sociological and demographical arguments are filtered out, there is no "economic" reason to give children an intensive care treatment during large disasters. 

Children can and will not contribute in the immediate rehabilitation and reconstruction of the country; instead the medical treatment will cost a lot of money and efforts that otherwise can be spend to rebuild the nation. 

There are no solid arguments to motivate the instauration of pediatric intensive care facilities in large disaster areas. But recent (Asian Tsunami 2004) retrospective studies show that men (fathers and husbands), families and even entire communities suffer shorter periods from traumatic stress disorders when their children and women could be saved. 

When they suffer shorter periods of anxiety, psychosis, panic attacks and lethargy, they will mobilize and assist the Western rehabilitation teams sooner. A local population that gets involved sooner in rehabilitation could perhaps lead to sooner withdrawal of foreign and highly expensive support.

This study looks for arguments among professionals interested in the matter of pediatric medical assistance during natural disasters. Especially "what" do we define as pediatric critical care in disaster settings, "how far" would we go and for "how long". 

For that purpose 21 scenarios have been edited, describing a disaster scene where "you" are involved in disaster medical assistance. We are not looking for answers on the medical treatment, we are looking for your attitude towards the proposed treatment and especially the consequences of the treatment per scenario. 
For that purpose you are asked to fill in a score.

As in real time situations we ask you not to think and overthink each scenario. Respond spontaneously. Imagine that you are far away from home, communication with home is scarce, you are tired, you feel dirty and you have seen a lot. You are with people you barely know and with them you have to discuss what to do and how far to go. 

Again: respond spontaneously. In that way it should not take you more than 20-30 minutes to fill in the scores. In the meantime you learn on natural disasters that actually happened (and always can strike again) or that are expected to happen within ? years.

If the number of respondents is large enough to perform statistical analysis, we can report on this inquiry. As there is little research on disaster assistance, this study could report on "how far, how long" we believe we have to go with kids in disaster areas. 

Consequently these attitudes can be compared with the content of a generic health kit: can you go "that far, that long" with what the WHO provides during a disaster? 

Finally: from the first data we already collected, we observe different "profiles" among the respondents. This prematurely suggests that scenarios perhaps could help in "profiling" the candidates of a disaster medical assistance team. Matching profiles in remote areas are probably in the best interest of both the patients and the disaster medical assistance team.

Instructions to participate to this survey:

1) Allow yourself just enough time to reflect on the different scenarios as if you were at a very hectic and abroad disaster site, where decisions are taken "in a blink of an eye". That way, filling in this survey will take about 10-20 minutes of your time.

2) Click on the Scenario of your choice (Dutch, English or Spanish). Save and rename the document with your own name. Fill in the survey.  Send this word document as an e-mail attachment to: dirk.danschutter@vub.ac.be. 

Thank you and enjoy it. 

Dirk Danschutter, MSc (Nursing), CCP, CCNS