Health and safety aspects of deployment of Australian Disaster Medical Assistance Team members: Results of a national survey
The authors wish to dedicate this research to the thousands of people affected by the South East Asian tsunami and Yogyakarta earthquake.
Received 19 March 2009; accepted 24 March 2009. published online 08 May 2009.
Summary
Background
Disaster medical assistance teams (DMATs) have responded to numerous international disasters in recent years. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to health and safety aspects of actual deployment.
Methods
Data were collected via an anonymous mailed survey distributed by State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the time of the 2004 South East Asian tsunami disaster.
Results
The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45–55 years age group (31/59) and a mean level of clinical experience of 21 years. 76% of the respondents were male (44/58). Once deployed, most felt that their basic health needs were adequately met. Almost all stated there were adequate shelter (95%, 56/59), adequate food (93%, 55/59) and adequate water (97%, 57/59). A clear majority, felt there were adequate toilet facilities (80%, 47/59), adequate shower facilities (64%, 37/59); adequate hand washing facilities (68%, 40/59) and adequate personal protective equipment (69%, 41/59). While most felt that there were adequate security briefings (73%, 43/59), fewer felt that security itself was adequate (64%, 38/59). 30% (18/59) felt that team members could not be easily identified. The optimum shift period was identified as 12h (66%, 39/59) or possibly 8h (22%, 13/59) with the optimum period of overseas deployment as 14–21 days (46%, 27/59). Missing essential items were just as likely to be related to personal comfort (28%) as clinical care (36%) or logistic support (36%). The most frequently nominated personal items recommended were: suitable clothes (49%, 29/59); toiletries (36%, 22/59); mobile phone (24%, 14/59); insect repellent (17%, 10/59) and a camera (14%, 8/59). The most common personal hardship reported during their deployment was being away from home/problems at home (24%, 14/59); however, most felt that their family was adequately informed of their whereabouts and health status (73%, 43/59).
Conclusions
This study of Australian DMAT members suggests that, in the field, attention should be given to basics, such as adequate food, water, shelter and personal hygiene as well as appropriate clothing, sunscreen and vector protection. The inclusion of appropriate personal items can be assisted by provision of a minimum suggested personal equipment list, with local conditions and the nature of the deployment being taken into account. A personal survival kit should also be recommended. There should be medical and psychological support for team members themselves, including the provision of a dedicated team member medical cache. Concern for their own health and ability to communicate with family members at home are major issues for deployed team members and need to be addressed in mission planning. This should also recognise security issues, including briefings, evacuation plans and exit strategies. The team members concerns about adequate security and the risk profile of humanitarian intervention in natural disasters compared with complex humanitarian emergencies may help determine future deployment of civilian or defence based teams.
aAnton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, Australia
bEmergency Department, The Townsville Hospital, Townsville, Queensland, Australia
cPublic Health Division, Department of Health, Perth, Western Australia, Australia
dDepartment of Health, Perth, Western Australia, Australia
Corresponding author. School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, 4811, Australia. Tel.: +61 7 47816108; fax: +61 7 47815254.
ABSTRACT