Lessons Learned from a Medical Response Team 45 Days Post-Hurricane Maria in Puerto Rico

2019 ◽  
pp. 1-6
Author(s):  
Jessica M. Gordon ◽  
Deidre Orriola ◽  
Mary Unangst ◽  
Federico Gordon ◽  
Yazmin E Rodriguez Vellon
Keyword(s):  
Public Health ◽  
Puerto Rico ◽  
Lived Experience ◽  
Natural Disaster ◽  
Public Health Intervention ◽  
Living Conditions ◽  
Lessons Learned ◽  
Medical Response ◽  
Field Note ◽  
Home Visitations

AbstractIntroduction:Describe the lived experience of a grassroots, nongovernmental disaster medical team (DMT) through a research lens and share practical lessons learned based on the DMT’s experience to support and inform future response teams.Method:Forty-five days after Hurricane Maria, a nongovernmental DMT provided primary medical care by means of community-based pop-up clinics and home visitations in 5 different areas of Puerto Rico. Observational data, photo images, and debriefing notes were collected and documented in the response team’s daily activity log. Field notes were coded using a descriptive coding method and then categorized into 2 domains specific to public health and medical diagnosis.Results:Medical aid was provided to nearly 300 (N = 296) residents. Field note observations identified exhaustion related to living conditions and the exacerbation of underlying conditions, such as reactive airway diseases, diabetes, hypertension, and depression due to the compounding effects of multiple post-disaster triggers. During home visitations, feelings of sadness and helplessness were identified secondary to natural disaster trauma and current living conditions.Conclusion:Our nongovernmental DMT displayed similar characteristics demonstrated by federal DMTs post-natural disaster. Several strategic lessons learned emerged from the public health intervention important to future nongovernmental DMTs.

Lessons Learned from a Medical Response Team 45 Days Post Hurricane Maria in Puerto Rico

2019 ◽  
Vol 14 (1) ◽  
pp. 28-33
Author(s):  
Jessica M. Gordon ◽  
Deidre Orriola ◽  
Mary Unangst ◽  
Federico Gordon ◽  
Yazmin E. Rodriguez Vellon
Keyword(s):  
Public Health ◽  
Puerto Rico ◽  
Lived Experience ◽  
Natural Disaster ◽  
Public Health Intervention ◽  
Living Conditions ◽  
Lessons Learned ◽  
Medical Response ◽  
Field Note ◽  
Home Visitations

ABSTRACTObjective:Describe the lived experience of a grassroots, non-governmental disaster medical team (DMT) through a research lens and share practical lessons learned, based on the DMT’s experience to support and inform future response teams.Methods:Forty-five days after Hurricane Maria, a non-governmental DMT provided primary medical care via community based pop-up clinics and home visitations in 5 different areas of Puerto Rico. Observational data, photo images, and debriefing notes were collected and documented in the response team’s daily activity log. Field notes were coded using a descriptive coding method and then categorized into 2 domains specific to public health and medical diagnosis.Results:Medical aid was provided to nearly 300 (N = 296) residents. Field note observations identified exhaustion related to living conditions and the exacerbation of underlying conditions such as reactive airway diseases, diabetes, hypertension, and depression due to the compounding effects of multiple post-disaster triggers. During home visitations, feelings of sadness and helplessness were identified secondary to natural disaster trauma and current living conditions.Conclusion:Our non-governmental DMT displayed similar characteristics demonstrated by federal DMTs post natural disaster. A number of strategic lessons learned emerged from the public health intervention important to future non-governmental DMTs.

Measuring the Efficacy of a Pilot Public Health Intervention for Engaging Communities of Puerto Rico to Rapidly Write Hurricane Protection Plans

2020 ◽  
pp. 1-10
Author(s):  
Mark E. Keim ◽  
Laura A. Runnels ◽  
Alexander P. Lovallo ◽  
Margarita Pagan Medina ◽  
Eduardo Roman Rosa ◽  
...  
Keyword(s):  
Public Health ◽  
Puerto Rico ◽  
User Satisfaction ◽  
National Guard ◽  
Rapid Development ◽  
Public Health Intervention ◽  
Health Intervention ◽  
Project Work ◽  
Community Members ◽  
Community Based

Abstract Objective: The efficacy is measured for a public health intervention related to community-based planning for population protection measures (PPMs; ie, shelter-in-place and evacuation). Design: This is a mixed (qualitative and quantitative) prospective study of intervention efficacy, measured in terms of usability related to effectiveness, efficiency, satisfaction, and degree of community engagement. Setting: Two municipalities in the Commonwealth of Puerto Rico are included. Participants: Community members consisting of individuals; traditional leaders; federal, territorial, and municipal emergency managers; municipal mayors; National Guard; territorial departments of education, health, housing, public works, and transportation; health care; police; Emergency Medical Services; faith-based organizations; nongovernmental organizations (NGOs); and the private sector. Intervention: The intervention included four community convenings: one for risk communication; two for plan-writing; and one tabletop exercise (TTX). This study analyzed data collected from the project work plan; participant rosters; participant surveys; workshop outputs; and focus group interviews. Main Outcome Measures: Efficacy was measured in terms of ISO 9241-11, an international standard for usability that includes effectiveness, efficiency, user satisfaction, and “freedom from risk” among users. Degree of engagement was considered an indicator of “freedom from risk,” measurable through workshop attendance. Results: Two separate communities drafted and exercised ~60-page-long population protection plans, each within 14.5 hours. Plan-writing workshops completed 100% of plan objectives and activities. Efficiency rates were nearly the same in both communities. Interviews and surveys indicated high degrees of community satisfaction. Engagement was consistent among community members and variable among governmental officials. Conclusions: Frontline communities have successfully demonstrated the ability to understand the environmental health hazards in their own community; rapidly write consensus-based plans for PPMs; participate in an objective-based TTX; and perform these activities in a bi-lingual setting. This intervention appears to be efficacious for public use in the rapid development of community-based PPMs.

Sustainability of the Impact of a Public Health Intervention: Lessons Learned From the Laval Walking Clubs Experience

2005 ◽  
Vol 6 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Minh-Nguyêt Nguyên ◽  
Lise Gauvin ◽  
Irène Martineau ◽  
Richard Grignon
Keyword(s):  
Public Health ◽  
Public Health Intervention ◽  
Health Intervention ◽  
Lessons Learned ◽  
The Impact

“Operation Helping Hands”: Massachusetts' Health and Medical Response to Hurricane Katrina

2010 ◽  
Vol 25 (1) ◽  
pp. 80-86 ◽  
Author(s):  
Suzanne Condon ◽  
Elena Savoia ◽  
Rebecca Orfaly Cadigan ◽  
Marya Getchell ◽  
Jonathan L. Burstein ◽  
...  
Keyword(s):  
Public Health ◽  
Conceptual Framework ◽  
Hurricane Katrina ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Medical Response ◽  
Health Goal ◽  
Public Health Goal ◽  
Control And Prevention ◽  
Massachusetts History

AbstractIntroduction:As Hurricane Katrina bore down on New Orleans in August 2005, the city's mandatory evacuation prompted the exodus of an estimated 80% of its 485,000 residents. According to estimates from the US Centers for Disease Control and Prevention (CDC), at least 18 states subsequently hosted >200,000 evacuees.Hypothesis/Problem:In this case study, “Operation Helping Hands” (OHH), the Massachusetts health and medical response in assisting Hurricane Katrina evacuees is described. Operation Helping Hands represents the largest medical response to evacuees in recent Massachusetts history.Methods:The data describing OHH were derived from a series of structured interviews conducted with two leading public health officials directing planning efforts, and a sample of first responders with oversight ofoperations at the evacuation site. Also, a literature review was conducted to identify similar experiences, common challenges, and lessons learned.Results:Activities and services were provided in the following areas: (1) administration and management;(2) medical and mental health; (3) public health; and (4) social support. This study adds to the knowledge base for future evacuation and shelter planning, and presents a conceptual framework that could be used by other researchers and practitioners to describe the process and out comes of similar operations.Conclusions:This study provides a description of the planning and implementation efforts of the largest medical evacuee experience in recent Massachusetts history, an effort that involved multiple agencies and partners. The conceptual framework can inform future evacuation and shelter initiatives at the state and national levels, and promotes the overarching public health goal of the highest attainable standard of health for all.

scholarly journals The Experiences and Perceptions of Health-Care Workers During the COVID-19 Pandemic in Muscat, Oman: A Qualitative Study

2020 ◽  
Vol 11 ◽  
pp. 215013272096751
Author(s):  
Thamra Al Ghafri ◽  
Fatma Al Ajmi ◽  
Huda Anwar ◽  
Lamya Al Balushi ◽  
Zainab Al Balushi ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Health Care Workers ◽  
Lessons Learned ◽  
Group Discussions ◽  
Medical Response ◽  
Primary Health ◽  
Care Workers

Introduction Predominantly, studies on COVID-19 report quantitative data that often miss the social implications and other determinants of health. The objective of this study was to explore the experiences and perceptions of health care workers (HCWs) in primary health care in the management of COVID-19 with respect to medical response experiences, socio-cultural and religious reforms, psychological impressions, and lessons learned. Methods This was a qualitative study using an empirical phenomenological approach. Six focus group discussions were conducted across various stakeholders working frontline in the management of COVID-19 (managerial, public health/field/community and primary care health centers). They participated in semi-structured, in-depth group discussions from 11th to 20th May 2020. All discussions were audio-recorded, transcribed verbatim and analyzed using thematic analysis. Results Forty participants were involved in this study. Three themes emerged related to the medical response experiences, including the rapid re-structuring of the PHC services, use of technology and challenges of working on COVID-19. Perceptions on the socio-cultural and religious reforms included changes in social and religious norms, and anticipated gaps in accessing health care among the vulnerable groups (elderly, expatriates, and individuals with low economic status). Perceptions on psychological disturbances were themed as consequences of social distancing, management of dead bodies, exhaustion among the health care workers, and risk of exposure. Finally, lessons learned were centered around building on the existing epidemiological and public health capacities, improving access to health care and overcoming resistance to change. Most participants labelled their experience in COVID-19 as an “experience of wisdom” in which learning was a continuous process. Conclusion This qualitative study amongst primary HCWs revealed certain aspects of response to COVID-19 in Muscat, Oman. Results has unfolded various aspects of COVID-19. The situation was perceived by primary HCWs as a new experience that challenged the primary health care; enforced the utilization of public health/epidemiological skills, and linked to unfavorable socio-religious and psychological events.

Lessons Learned From Hurricane Maria: Pharmacists’ Perspective

2018 ◽  
Vol 52 (5) ◽  
pp. 493-494 ◽  
Author(s):  
Kyle Melin ◽  
Wanda T. Maldonado ◽  
Angel López-Candales
Keyword(s):  
Health Care ◽  
Puerto Rico ◽  
Patient Care ◽  
Natural Disaster ◽  
Chronic Conditions ◽  
Health Care Services ◽  
Lessons Learned ◽  
Community Pharmacies ◽  
Care Services ◽  
Demand For Health

The destruction in Puerto Rico following Hurricane Maria brought an increased demand for health care services while severely limiting the health care system’s ability to provide patient care. Immediately following the hurricane, countless patients found themselves in a situation without their medications for both acute and chronic conditions. Many of these patients turned first to community pharmacies for access to their medications. In this letter, we describe the response of pharmacists to the needs of their communities following the natural disaster, Hurricane Maria, and summarize some lessons learned from the experience that may be useful in future disaster planning.

scholarly journals (A24) An Disaster Education Framework to Bridge Natural Disaster Medical Response and Primary Care Development in Developing Countries

2011 ◽  
Vol 26 (S1) ◽  
pp. s7-s7
Author(s):  
E.Y.Y. Chan ◽  
S.Y. Wong ◽  
S.M. Griffiths ◽  
C.A. Graham
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Natural Disaster ◽  
Disaster Mitigation ◽  
Academic Training ◽  
Public Health Response ◽  
Humanitarian Emergency ◽  
Emergency Relief ◽  
Medical Response ◽  
Academic Researchers

IntroductionNatural disasters cannot be prevented but their human impact can be mitigated. Effective medical and public health mitigation and responses require multidisciplinary efforts and appropriate training. Whilst Asia is currently ranked as the most natural disaster prone area globally, limited disaster medical and public health response training opportunities are available in the region. Our paper reports efforts to identify the training gaps and ways to fill them to prepare frontline practitioners and academic researchers in disaster and medical humanitarian emergency relief efforts in Asia.MethodsGrounded on the disciplinary principles of academic training in public health, emergency & disaster medicine and primary care, our paper reviews the current disaster related academic training offered in these disciplines and maps out the training and knowledge gaps in disaster mitigation and response for frontline practitioners and academic researchers. We suggest ways to fill such gaps.ResultsA two-dimensional (clinical versus non-clinical), three-tier education training framework (Entrant level, Continuous medical education needs and Expertise level) is developed. Experiences and key training needs in Asia are highlighted.ConclusionThe proposed framework identifies areas for comprehensive training for medical and public health practitioners who are interested to engage in medical disaster relief. The proposed framework also aims to strengthen mitigation and response capacities in health systems.

scholarly journals “I took it off most of the time 'cause I felt comfortable”: unmasking, trusted others, and lessons learned from a coronavirus disease 2019 reinfection: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jacinda K. Dariotis ◽  
Stephanie M. Sloane ◽  
Rebecca Lee Smith
Keyword(s):  
Public Health ◽  
Severe Acute Respiratory Syndrome ◽  
Lived Experience ◽  
Physical Symptoms ◽  
Lessons Learned ◽  
Preventive Behaviors ◽  
Symptomatic Infection ◽  
Initial Infection ◽  
Negative Results

Abstract Background Severe acute respiratory syndrome coronavirus 2 reinfection prevalence is unknown. It is essential to understand reinfection symptoms and, importantly, the lived experience. Case presentation Case study design is the best method for understanding this contemporary pandemic and rare occurrence of reinfections. A 19-year-old White Non-Hispanic woman presented with presumed severe acute respiratory syndrome coronavirus 2 reinfection 6 weeks after initially mild symptomatic infection and consistent repeat negative results. Real-time reverse-transcription polymerase chain reaction from saliva was used for detection. Twice-weekly saliva samples were collected (a) before initial infection, (b) resumed on day 10 after initial infection until reinfection was detected, and (c) resumed on day 10 post-reinfection. A 1.5-hour virtual interview was conducted, transcribed, and independently analyzed by two researchers. Four themes emerged: (1) perceived invincibility or inevitability and subsequent immunity increases risk of transmission via inconsistent preventive behaviors; (2) normalcy desires, trusted others, and implicit social pressures to not wear masks and distance increase one’s coronavirus disease 2019 risk; (3) physical symptoms are more severe with reinfection compared with first infection; and (4) mental health sequelae (trauma and stigma) are more severe and enduring than physical health outcomes. Conclusions Unmasked social interactions contradicting public health recommendations were rationalized by social circle members with heavy reliance on feeling asymptomatic, lacking a positive test (testing negative or not testing), or attributing symptoms to allergies. Stigma of testing positive and consequences of not conforming to social group behaviors is overwhelming and creates pressure to take risks. This case study provides insights and lessons learned relevant for public health messaging and continued preventive behaviors.

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