Preparedness, Response, and Recovery Considerations for Children and Families Workshop Summary (2014) / Chapter Skim
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2 Children and Disasters
2 Children and Disasters
Pages 9-26
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From page 9... ...
This report begins with an overview of the specific impact of disasters on children by Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University. He explained the important differences between lessons learned and lessons acted on, and realistic goals to keep in mind regarding children in these precarious situations.
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For example, during Hurricane Sandy, the New York University Langone Medical Center evacuated neonates from its neonatal intensive care unit. Photographs of people carrying tiny newborn babies down a dark hospital stairwell were front-page news.
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Because the explosion happened after school hours, the middle school students were gone, and although the high school track team was returning to the school from an event, they decided to stop along the way for something to eat, delaying their return to school. Although hundreds of schools are in Oklahoma's "Tornado Alley" (most without appropriate storm cellars or other safe havens)
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Toward this end, the 2010 NCCD report recommends specific actions to be taken to improve preparedness, response, and recovery for children (NCCD, 2010; discussed further by Schonfeld and Dodgen in the next section)
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cut by 35 percent, state and local preparedness programs cut by 62 percent, and the elimination of the Academic and Public Health Preparedness Centers that had been promised a 5-year lifespan.
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Recommendation 1.1 from the report is to "distinguish and comprehensively integrate the needs of children across all inter- and intra-governmental disaster management activities and operations." The recommendation specifies further that children should not be grouped in an "at-risk" category, but should instead be pulled out for separate consideration. Schonfeld listed several examples of how the needs of children are now being considered 1 The National Commission on Children and Disasters was authorized under the Consolidated Appropriations Act of 2008, signed into law by President Bush on December 26, 2007 (P.L.
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But, as noted earlier by Anderson, there is uncertainty on where this committee will live, which reinforces the overall need for centralization for these issues and resources. One gap in integration highlighted by the NCCD was the lack of inclusion of education, child care, juvenile justice, and child welfare systems into disaster planning, training, and exercises.
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Although overall progress toward successful implementation is not yet clear, there are some examples. Schonfeld cited the Crisis Counseling Grant awarded to New Jersey in response to Hurricane Sandy, which includes a community liaison, numerous children's specialists, and an intervention-based program to ensure that children's disaster mental health needs are addressed effectively and efficiently.
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Schonfeld highlighted the NCCD's concern that the country is not yet prepared to accommodate a surge in pediatric emergency medical trauma that may occur during a disaster, although, as of yet, no North American emergency to date has overwhelmed intensive care unit services on a widespread basis since the modern development of the field of critical care. However, planners are not optimistic that this will always be the case, and important progress on Pediatric Emergency Mass Critical Care has been made in recent years (Kissoon, 2011)
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Given that EMS interfaces with so many different federal agencies, creating one federal lead may not solve issues that reach across so many areas. Schonfeld described the commission's call for efforts to "improve the capability of emergency medical services to transport pediatric patients and provide comprehensive pre-hospital pediatric care during daily operations and disasters," and to "develop a national strategy to improve federal pediatric emergency transport and patient care capabilities for disasters." The limited federal and state capability to accommodate a major pediatric surge requiring transport of a large number of pediatric patients is a significant vulnerability.
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Schonfeld cited as an example a recent workshop sponsored by the American Academy of Pediatrics at the Head Start Leadership Institute in Washington, DC. In addition, ACF issued a proposed regulation that would require emergency preparedness and response planning for providers serving children who are receiving child care development fund assistance.
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Unfortunately, Schonfeld said, this is one area where ground has been lost, rather than progress made, and school systems and their students remain unprepared to deal with disasters, whether natural or man-made. Child Welfare and Juvenile Justice The NCCD made several recommendations aimed at ensuring that state and local child welfare agencies, juvenile justice agencies (and their associated court programs)
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HHS PROGRESS IN ADDRESSING CHILDREN'S DISASTER HEALTH NEEDS The NCCD recommendations directed toward HHS fall into four key categories: behavioral health; MCMs; physical health, EMS, and transport; and child care and child welfare. To address these, ACF and the Office of the Assistant Secretary for Preparedness and Response (ASPR)
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Medical Countermeasures (MCMs) Establish an integrated program team to advise the Public Health Emergency Medical Counter Measures Enterprise (PHEMCE)
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Strengthen requirements for pediatric surge capacity within the Health Care Preparedness Program (HPP) and encourage HHS grantees to adopt the Emergency Medical Services for Children (EMSC)
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Public Health Service Commissioned Corps includes psychological first aid in all of its field training activities, and a 6-hour, interactive, online psychological first aid course available through National Child Traumatic Stress Network.7 In 2012, the Substance Abuse and Mental Health Services Administration (SAMHSA) launched the Disaster Distress Helpline (DDH)
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To aid reunification, one outcome of the Pediatric Disaster Preparedness Curriculum Development Conference convened by the National Center for Disaster Medicine and Public Health was an online module, "Tracking and Reunification of Children in Disasters: A Lesson and Reference for Health Professionals."8 The ASPR HPP hosted a technical assistance webinar in June 2013 for HPP grantees and health care coalitions on integrating pediatric disaster management into health care system preparedness and medical surge.9 Approximately 400 people dialed in to participate in the webinar, and the archived webpage received 3,000 visits in the first month it was available. A second webinar focused on pediatrics is scheduled for May 2014 through the HPP at ASPR.
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From page 26... ...
ACF has also trained Head Start executives in preparedness planning. ACF recently collaborated with state and NGO partners via Child Care Task Forces and Coalitions following the Joplin tornadoes and Hurricanes Isaac and Sandy to assess the impacts to systems serving children and to promote children's resilience and recovery.
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