Children and Disaster

The American Red Cross (ARC) self-reports post-disaster efforts annually, potentially biased for public image. The lack of formal reviews of ARC interventions' social impacts further exacerbates the issue. This scoping review aims to address both issues by summarizing and evaluating the social impact of ARC's national disaster interventions. As a secondary objective, this review will also provide important information to guide ARC and other organizations in truly fulfilling their missions. The inclusion criteria involve participants of all age groups, marginalized communities, displaced individuals, and ARC disaster responders. Opinionated statements, except for anecdotes, were excluded. This review involves all United States (US) areas that have been affected by disasters and required assistance from ARC. With no search limits, all evidence was searched on PubMed from July to August 2023. Two stages of screening were conducted by two independent reviewers: title/abstract screening and full-text screening. During each stage, each paper underwent a quality assessment. Disagreements in each stage were resolved before proceeding to the next stage. Through 22 academic papers, the review outlines key themes in ARC comprehensive interventions on disaster preparedness and on-site disaster interventions. However, research gaps were found in ARC recovery interventions, especially their impact on evacuees. This investigation found that ARC makes general efforts to address the needs of communities they assist before, during, and after disasters. Because the results suggest that ARC is moving in the correct direction in reducing the nationwide harm disasters cause, ARC's social impact on studied populations is mostly positive.

The level of emergency preparedness considered adequate for hospitals prior to the events of 9/11 is no longer sufficient. To analyze and improve emergency preparedness in Navy healthcare facilities, the US Navy Medical Department has established the Disaster Preparedness, Vulnerability Analysis, Training and Exercise (DVATEX, pronounced ‘dee-va-tex’) program. The four-stage program includes a hospital or clinic self-assessment, a site visit to each Navy hospital and clinic (during which a team of emergency preparedness experts trains staff, performs a vulnerability analysis, and conducts an exercise of the facility’s emergency management plan), development of an after-action report, and ongoing support to improve preparedness (Figure 1). In its first year, the DVATEX program has been successful in identifying hospital vulnerabilities, applying remedies, and developing long-term plans to improve preparedness.

Background: Empowering and improving the preparedness of DMATs plays a vital role in the effectiveness of the medical relief process. Integrated training of rapid response teams is a significant goal to promote coordination in the response phase. Determining educational requirements is an essential prerequisite for developing educational programs. Objectives: This study was conducted to determine the training requirements of Disaster Medical Assistant Teams (DMATs) in Iran. Methods: This mixed methods study was conducted in 3 steps. In the first step, the roles and duties of DMATs were identified using a narrative review. Then, training requirements were determined using a focused group discussion method. Finally, the three-round Delphi survey was used to finalize the study's findings in the third step. Results: Using a narrative review of the texts from 2428 articles, 15 addressed the roles and duties of DMATs and were included in the study as final texts. The roles and duties of the health, treatment, and support teams, as well as the team managers and seniors, were identified. In the second step, based on expert opinions in FGD, 105 specific and 16 general training requirements were found. The findings of this step were entered into the Delphi for finalization. Finally, the training requirements of DMAT members were determined. These requirements are divided into specific and general requirements. Conclusion: DMATs are an integral part of disaster response operations, and their actions can play a vital role in the success of disaster response. On the other hand, DMAT members usually work individually in healthcare jobs and join each other as a team, depending on emergency conditions. Therefore, they need continuous training to perform their duties. The findings of this study can be a starting point for the training program of DMATs because, in addition to showing the roles and duties of the teams and sub-teams in disasters, it specifies the necessary skills and training requirements of the members.

Years of categorical funding have led to fragmented service delivery systems related to children and families. States have had to devise mechanisms to coordinate the variety of funding streams which finance the array of children's programs. Creation of a single focal point for children's policy at the national level is recommended. Attempts to consolidate oversight and administration of programs related to children have resulted in the creation of the Administration for Children and Families (ACF), but some children's programs are administered outside of ACF. In addition, an array of Congressional committees has oversight over children's programs. There is no system in place to coordinate program policy or research funding. State efforts to overcome the lack of coordination include Maryland's Children's Cabinet and Indiana's Step Ahead Panel. The mission of the Federal Interagency Coordinating Council (FICC), which was formally established to coordinate federal programs and policies for children with disabilities, could be modified to consider policies and programs related to all children and families. Membership of the FICC could be expanded to include the business community and private foundations, and the expanded FICC could report to a newly created Office for Children in the White House. The FICC could be charged with drafting a National Policy for Children. Broadening the focus of the FICC would provide an opportunity for children and families to benefit from true interagency collaboration at the federal level for all child and family services. (JDD)

Chairman Gregg, Senator Byrd, and distinguished members of the Homeland Security Subcommittee of the Senate Committee on Appropriations, it is a privilege to appear before you today to testify on this subject of national importance. Your leadership on preparedness issues related to bioterrorism and pandemic influenza in particular is both crucial and commendable. While our federal, state and local governments as well as the private sector and healthcare community, have taken steps in the right direction, our level of preparedness remains a work in progress and it is not yet where it needs to be. Five years ago, the Senate Committee on Foreign Relations invited me to testify on the threat of bioterrorism and how we, as a nation, might best organize and marshal our resources so as to meet that threat and combat the spread of infectious diseases. At the time, I suggested that the country was “at a crossroads” and that, “[w]hile credit must be given where it is due, the time has come fo...

High-quality pediatric emergency care can be provided only through the collaborative efforts of many health care professionals and child advocates working together throughout a continuum of care that extends from prevention and the medical home to prehospital care, to emergency department stabilization, to critical care and rehabilitation, and finally to a return to care in the medical home. At times, the office of the pediatric primary care provider will serve as the entry site into the emergency care system, which comprises out-of-hospital emergency medical services personnel, emergency department nurses and physicians, and other emergency and critical care providers. Recognizing the important role of pediatric primary care providers in the emergency care system for children and understanding the capabilities and limitations of that system are essential if pediatric primary care providers are to offer the best chance at intact survival for every child who is brought to the office ...

In the fall of 2008, a group of eight graduate students and two faculty members from the Department of Sociology at Colorado State University conducted an evaluation of the Church of the Brethren's Children's Disaster Services (CDS) program for training volunteers to assume roles as responders to disaster situations. The project was carried out in the context of a graduate seminar in evaluation research that met weekly for class sessions. In this report, we outline the major research questions and our methods and then describe ...

The Northridge earthquake of 1994 displaced almost 10,000 families and destroyed major transportation infrastructure within Southern California, and Hurricane Katrina created the largest national housing crisis since the Dust Bowl of 1930, destroying over 300,000 homes and leaving over one million people seeking shelter. Numerous smaller disasters each year such as tornados, costal or inland flooding, and less severe earthquakes also destroy homes and displace families, although on a much smaller scale. Arranging housing for disaster victims ranks as a top priority after the immediate needs for food and medical care are met. This task becomes more challenging as families are displaced for a longer period of time due to increases in costs, government involvement, and expectations of the victims. In early 2009, FEMA released the first-ever National Disaster Housing Strategy which calls for improved planning and outlines the key principles and policies guiding disaster sheltering, interim housing, and restoration of permanent housing. While all three housing problems are very difficult, the provision of adequate temporary or interim housing is perhaps the most challenging. A few researchers have addressed the issue of optimal allocation of temporary housing, but have focused primarily on the first part of the problem which focuses on the selection of adequate capacity from among available interim housing alternatives. The second part of the problem, which consists of recommending housing alternatives to individual families from the pool of temporary housing units selected in phase one such that educational, healthcare, and socioeconomic needs are met, has not yet been addressed to the best of our knowledge. We propose a decision support system for assigning families to housing units which addresses these needs. We develop a benchmark integer programming model for developing a balanced housing plan, and then use the model to evaluate three heuristics which could be practically applied with our system. We use a prototypical example to illustrate the model and evaluate the heuristics, and to demonstrate their appropriateness for the development of realistic real-time housing recommendations.

The National Disaster Medical System (NDMS) Pilot Program was authorized by Congress to improve the interoperability, capabilities, and capacity of the NDMS. To develop a roadmap for planning and research, the mixed-methods Military-Civilian NDMS Interoperability Study (MCNIS) was conducted in 2020-2021. The initial qualitative phase of the study identified critical themes for improvement: (1) coordination, collaboration, and communication; (2) funding and incentives to increase private sector preparedness; (3) staffing capacity and competencies; (4) clinical and support surge capacity; (5) training, education, and exercises between federal and private sector partners; and (6) metrics, benchmarks, and modeling to track NDMS performance. These qualitative findings were subsequently refined, validated, and prioritized through a quantitative survey. Expert respondents ranked 64 statements based on weaknesses and opportunities identified during the qualitative phase. Data were collected using Likert scales, and multivariate proportions and confidence intervals were estimated to compare and prioritize each statement's level of support. Pairwise tests were conducted for each item-to-item pair to determine statistically significant differences. The survey results corroborated the earlier qualitative findings, with all weaknesses and opportunities ranked as important by a majority of respondents. Survey results also pointed to specific priorities for interventions within the 6 previously identified themes. As with the qualitative study, the survey found that the most common weaknesses and opportunities were related to coordination, collaboration, and communication, especially regarding information technology and planning at the federal and regional levels. These priority interventions are now being developed, implemented, and validated at 5 pilot partner sites.

The media have provided detailed accounts and vivid illustrations of the damage and destruction that Hurricane Katrina left in its wake after slamming into the Gulf Coast of the U.S. on August 29, 2005. Some of this coverage focused specifically on children. The public was informed, for example, that more than 130,000 children were displaced in New Orleans alone (Kantrowitz and Breslau 2005). According to the National Center for Missing and Exploited Children, as of October 1, 2005, there were still 2,646 children reported as missing.2 Typically, media reports about children were “human interest” stories, offering tales of tragic losses or celebrating happy reunions with re-found family members, with video clips and photos providing visual testimony.
One month after the disaster, with the stage of emergency assistance over, attention shifted to the reconstruction of the environments—including children’s places—that had been devastated by the hurricane and subsequent flooding. However important physical places are in children’s daily lives and development, this brief contribution to CYE concerns itself with the place of children in a cultural and political sense. The portrayal of children in Katrina’s aftermath has emphasized their vulnerability and their dependence on adults. This perspective, we suggest, reflects a wider societal paradigm that frames what is upheld as the proper place of children and youth in U.S. society. We argue that the reconstruction of children’s environments on the Gulf Coast must be based on an alternative paradigm that recognizes the right and capacity of children to participate in matters affecting their lives.

he 2009 H1N1 influenza pandemic provided a realworld exercise that revealed the strengths and weaknesses of the public health system in response to a major infectious disease outbreak. Because children were disproportionately affected, a review of lessons learned offered opportunities to improve future planning. The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) implemented various strategies to address the needs of children during the pandemic-these efforts illustrate that strategic partnerships can improve preparedness. Pediatricians faced many challenges throughout the pandemic. Clinicians universally reported being overwhelmed by the high volume of patients, numerous questions from various audiences, and "information overload" (ie, many messages and rapidly changing advice). A significant difficulty was helping the public understand when to seek treatment, so that health care systems were not inundated with questions and visits from patients who did not have symptoms of an influenza-like illness (ILI) or were not at higher risk of complications if infected. Pandemics can evolve rapidly, so developing strategic alliances and effective communication systems is advantageous. This is especially important when considering children, as they constitute about one-quarter of the US population and require special planning in an emergency or disaster. 1,2 WARNING, CHILDREN AT RISK The AAP and the Trust for America's Health identified that children were at increased risk during an influenza pandemic and recommended specific actions to address children's needs. 3 A National Commission on Children and Disasters was appointed in 2008 to examine and assess the needs of children in relation to the preparation for, response to, and recovery from all hazards, including major disasters and emergencies. In 2010, the commission delivered its final report to the president and Congress. 2 The report cited gaps in disaster preparedness and called for the development of a national strategy to ensure that children are protected before, during, and after a public health emergency. The commission encouraged government agencies and nongovernmental organizations to consider children a distinct population in disaster planning, and to include pediatric experts in all planning efforts.