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Being Both Helpers and Victims: Health Professionals’ Experiences of Working During a Natural Disaster

Published online by Cambridge University Press:  03 January 2017

Karin Hugelius ,
Annsofie Adolfsson ,
Per Örtenwall  and
Mervyn Gifford
Karin Hugelius*
Affiliation:
School of Health Sciences, Örebro University, Örebro, Sweden Karlskoga Hospital, Örebro Region County Council, Karlskoga, Sweden
Annsofie Adolfsson
Affiliation:
School of Health Sciences, Örebro University, Örebro, Sweden
Per Örtenwall
Affiliation:
Sahlgrenska Akademin, Gothenburg University, Gothenburg, Sweden
Mervyn Gifford
Affiliation:
School of Health Sciences, Örebro University, Örebro, Sweden
*
Correspondence: Karin Hugelius, RN, RNA, MSc School of Health Sciences Örebro University Örebro, Sweden E-mail: karin.hugelius@oru.se
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Abstract

Background

In November 2013, the Haiyan typhoon hit parts of the Philippines. The typhoon caused severe damage to the medical facilities and many injuries and deaths. Health professionals have a crucial role in the immediate disaster response system, but knowledge of their experiences of working during and in the immediate aftermath of a natural disaster is limited.

Aim

The aim of this study was to explore health professionals’ experiences of working during and in the immediate aftermath of a natural disaster.

Method

Eight health professionals were interviewed five months after the disaster. The interviews were analyzed using phenomenological hermeneutic methods.

Results

The main theme, being professional and survivor, described both positive and negative emotions and experiences from being both a helper, as part of the responding organization, and a victim, as part of the surviving but severely affected community. Sub-themes described feelings of strength and confidence, feelings of adjustment and acceptance, feelings of satisfaction, feelings of powerless and fear, feelings of guilt and shame, and feelings of loneliness.

Conclusion

Being a health professional during a natural disaster was a multi-faceted, powerful, and ambiguous experience of being part of the response system at the same time as being a survivor of the disaster. Personal values and altruistic motives as well as social aspects and stress-coping strategies to reach a balance between acceptance and control were important elements of the experience. Based on these findings, implications for disaster training and response strategies are suggested.

HugeliusK, AdolfssonA, ÖrtenwallP, GiffordM. Being Both Helpers and Victims: Health Professionals’ Experiences of Working During a Natural Disaster. Prehosp Disaster Med. 2017;32(2):117–123.

Keywords

disaster medicinedisastershealth professionalsphenomenological hermeneutic methodrelief work
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 2 , April 2017 , pp. 117 - 123
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest/funding: The study was financed by contributions from Fortifikationsforeningens Forskningsfond (Foundation of Fortification-Related Research) and Orebro County Council Research Committee (Orebro, Sweden).

References

1. World Health Organization. Public health risk assessment and interventions – Typhoon Haiyan, Philippines 16 November 2013. http://www.who.int/hac/crises/phl/sitreps/ philippines_ph_risk_assessment_16November2013.pdf. Accessed August 12, 2015.Google Scholar
2. UN Office for the Coordination of Humanitarian Affairs. Philippines; Typhoon Haiyan. Situation Report No. 20 (as of December 3, 2013). http://reliefweb.int/report/philippines/ philippines-typhoon-haiyan-situation-report-no-20-3-december-2013. Accessed August 12, 2015.Google Scholar
3. The International Disaster Database. EM-DAT. Center for Research on the Epidemiology of Disasters; 2014. http://www.emdat.be/. Accessed September 9, 2013.Google Scholar
4. Global Facility for Disaster Reduction and Recovery (GFDRR). Typhoon Yolanda Ongoing Recovery. Recovery Framework Case Study. August 2014. http://reliefweb.int/report/philippines/philippines-typhoon-yolanda-ongoing-recovery-recovery-framework-case-study-august. Accessed February 2, 2015.Google Scholar
5. World Health Organization. Typhoon Haiyan (Yolanda), Philippines, External Situation Report, No. 1, November 15, 2013. http://www.wpro.who.int/philippines/ typhoon_haiyan/media/Sitrep_17Nov2013.pdf?ua=1. Accessed December 4, 2015.Google Scholar
6. Gerdin, M, Clarke, M, Allen, C, et al. Optimal evidence in difficult settings: improving health interventions and decision making in disasters. PLOS Med. 2014;11(4):1-4.Google Scholar
7. Birnbaum, ML, Daily, EK, O’Rourke, AP, Loretti, A. Research and evaluation of the health aspects of disasters, Part II: the disaster health conceptual framework revisited. Prehosp Disaster Med. 2015;30(5):523-538.Google Scholar
8. Katz, CL. “Psychiatric Evaluation.” In: Stoddard F, Padya A, Katz CL, (eds). Disaster Psychiatry: Readiness, Evaluation, and Treatment. September 2012 ed. Washington USA: Group for the Advancement of Psychiatry; 2012.Google Scholar
9. Doocy, S, Dick, A, Daniles, A, Kirsch, TD. The human impact of tropical cyclones: a historical review of events 1980-2009 and systematic literature review. PLOS Curr. 2013;16:5.Google Scholar
10. Stallings, R. “Methodological Issues.” In: Rodriguez H, Quarantelli EL, Dynes RR, (eds). Handbook of Disaster Research. 1st ed. New York, USA: Springer Science; 2007: 55-82.CrossRefGoogle Scholar
11. von Schreeb, J. Needs assessments for international humanitarian health assistance in disasters. Theses for doctoral degree. Solna, Sweden: Division of Global Health, Karolinska Intitutet Medical University; 2007.Google Scholar
12. Birnbaum, ML, Daily, EK, O’Rourke, AO, Loretti, A. Research and evaluations of the health aspects of disasters, Part 1: an overview. Prehosp Disaster Med. 2015;30(5):512-538.Google Scholar
13. Brolin, K, Hawajri, O, von Schreeb, J. Foreign Medical Teams in the Philippines after Typhoon Haiyan 2013 - who were they, when did they arrive, and what did they do? PLOS Curr. 2015;5:7.Google Scholar
14. Merin, O, Kreiss, Y, Lin, G, Pras, E, Dagan, D. Collaboration in response to disaster typhoon Yolanda and an integrative model. N Engl J Med. 2014;370(13):1183-1184.Google Scholar
15. Kirsch, T, Sauer, L, Guha Sapir, D. Analysis of the international and US response to the Haiti earthquake: recommendations for change. Disaster Med Public Health Prep. 2012;6(3):200-208.Google Scholar
16. Zhang, L, Liu, X, Li, Y, et al. Emergency medical rescue efforts after a major earthquake: lessons from the 2008 Wenchuan earthquake. Lancet. 2012;2(379):853-861.Google Scholar
17. Berger, W, Coutinho, ES, Figueira, I, et al. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):1001-1011.Google Scholar
18. Gerdin, M, Wladis, A, von Scrheeb, J. Foreign field hospitals after the 2010 Haiti earthquake: how good were we? Emerg Med J. 2013;30(1):1-5.Google Scholar
19. Baack, S, Alfred, D. Nurses’ preparedness and perceived competence in managing disasters. J Nurs Scholarsh. 2013;45(3):281-287.Google Scholar
20. Abolghasemi, H, Radfar, M, Khatami, M, Nia, M, Amid, A, Briggs, S. International medical response to a natural disaster: lessons learned from the Bam Earthquake experience. Prehosp Disaster Med. 2006;21(3):141-217.Google Scholar
21. Baker, ND, Feldman, MS, Lowerson, V. Working through disaster: re-establishing mental health care after Hurricane Katrina. Disaster Med Public Health Prep. 2012;7(3):222-227.Google Scholar
22. Geisz-Everson, MA, Dodd-McCue, D, Bennett, M. Shared experiences of CRNAs who were on duty in New Orleans during Hurricane Katrina. AANA J. 2012;80(3):205-212.Google Scholar
23. Adams, T, Turner, M. Professional responsibilities versus familial responsibilities: an examination of role conflict among first responders during the Hurricane Katrina disaster. J Emerg Manag. 2014;12(1):45-54.CrossRefGoogle ScholarPubMed
24. Michel, PO. Insatsrelaterad stress hos civil personal- En litteraturöversikt [in Swedish]. (Stress related to operations among civilian personnel; Governmental review of veterans’ health). Veteranutredningen Vol 2, Bilaga 7. 2014.Google Scholar
25. OPSIC-Project. The comprehensive guideline on mental health and psychosocial support (MHPSS) in disaster settings. http://opsic.eu/wp-content/uploads/2015/06/OPSIC-Comprehensive-guideline-FINAL-June-2015.pdf. Accessed March 20, 2016.Google Scholar
26. Hobfoll, S, Watson, P, Bell, C, et al. Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry. 2007;70(4):221-242.Google Scholar
27. Halpern, J, Gurevich, M, Schwartz, B, Brazeau, P. Interventions for critical incident stress in Emergency Medical Services: a qualitative study. Stress & Health. 2009;25(2):139-149.CrossRefGoogle Scholar
28. Daily, E, Padjen, P, Birnbaum, M. A review of competences developed for disaster health care providers: limitations of current process and applicability. Prehosp Disaster Med. 2010;25(5):387-395.CrossRefGoogle Scholar
29. Lazarus, RS. Coping theory and research: past, present, and future. Psychosom Med. 1993;55(3):234-247.Google Scholar
30. Folkman, S. Personal control and stress and coping processes: a theoretical analysis. J Pers Soc Psychol. 1984;46(4):839-852.Google Scholar
31. Bonanno, GA. Regulatory flexibility: an individual differences perspective on coping and emotion regulation. Perspect Psychol Sci. 2013;8(6):591-612.Google Scholar
32. Hobfoll, SE. Conservation of resources and disaster in cultural context: the caravans and passageways for resources. Psychiatry. 2012;75(3):227-232.Google Scholar
33. Southwick, SM, Bonanno, GA, Masten, AA, Panter- Brick, C, Yehda, R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. 2014;1(5).Google Scholar
34. Norris, FH. Epidemiology of trauma: frequency and impact of different potentially traumatic events on different demographic groups. J Consult Clin Psychol. 1992;60(3):409-418.CrossRefGoogle ScholarPubMed
35. Bonanno, G, Westphal, M, Mancini, A. Resilience to loss and potential trauma. Review. Annu Rev Clin Psychol. 2011;7(5):11-35.Google Scholar
36. Southwick, SM, Charney, DS. Resilience. The Science of Mastering Life’s Greatest Challenges. First ed. New York USA: Cambridge University Press; 2012.Google Scholar
37. Lindseth, A, Norberg, A. A phenomenological hermeneutical method for researching lived experience. Scand J Caring Sci. 2004;18(2):145-153.Google Scholar
38. Coyne, ITC. Sampling in qualitative research. Purposeful and theoretical sampling: merging or clear boundaries? J Adv Nurs. 1997;26(3):623-630.Google Scholar
39. Ricoeur, P. From explaining to understanding: the model of the text. Meaningful action considered as a text. New Literacy History.” In: Singsuriya P. Nursing researchers’ modification of Ricoeur’s hermeneutic phenomenology. Nurs Inq. 2015;22(4):348-358.Google Scholar
40. Geanellos, R. Exploring Ricoeur’s hermeneutic theory of interpretation as a method of analyzing research texts. Nurs Inq. 2000;7(24):112-119.Google Scholar
41. Charalambous, A, Papadopoulos, R, Beadsmoore, A. Ricoeur’s hermeneutic phenomenology: an implication for nursing research. Scand J Caring Sci. 2008;22(1):637-642.Google Scholar
42. Philippine Council for Health Research and Development. National Ethical Guidelines for Health Research. 2006. www.pchrd.dost.gov.ph/. Accessed December 4, 2015.Google Scholar
43. Folkman, S, Moskowitz, J. Coping: pitfalls and promise. Annu Rev Psychol. 2004;55(1):745-774.Google Scholar
44. Lazarus, RS. Emotions and interpersonal relationships: toward a person-centered conceptualization of emotions and coping. J Pers. 2006;74(1):9-46.Google Scholar
45. Norris, FH, Stevens, PS, Pfefferbaum, B, Wyche, KF, Pfefferbaum, RL. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. Am J Community Psychol. 2008;41(1-2):127-150.Google Scholar
46. Kaiser, CF, Sattler, DN, Bellak, DR, Dersin, J. A conservation of resources approach to a natural disaster: sense of coherence and psychological distress. J Soc Behav Pers. 1996;11(3):459-476.Google Scholar
47. Slepski, LA. Emergency preparedness and professional competency among health care providers during Hurricanes Katrina and Rita: pilot study results. Disaster Manag Response. 2007;5(4):99-110.Google Scholar
48. Wietsse, AT, Barui, C, Galappatti, A, et al. Mental health and psychosocial support in humanitarian settings; linking practice and research. Lancet. 2011;378(9802):1581-1591.Google Scholar
49. Hugelius, K, Gifford, M, Ortenwall, P, Adolfsson, A. To silence the deafening silence: experiences of the impact of disaster radio for survivor’s wellbeing after a natural disaster. Int Emerg Nurs. 2016;28:8-13.Google Scholar
50. Polit, D, Beck, C. Generalization in quantitate and qualitative research: myths and strategies. Int J Nurs Stud. 2010;47(11):1451-1458.Google Scholar
51. Grimm, A, Hulse, L, Preiss, M, Schmidt, S. Behavioral, emotional, and cognitive response in European disasters: results of survivor interviews. Disasters. 2014;38(1):62-83.CrossRefGoogle ScholarPubMed
52. Girratano, G, Savage, J, Barcelona-deMendoza, V, Harville, EW. Disaster research: a nursing opportunity. Nurs Inq. 2013;29(3):259-268.Google Scholar
53. Benight, CC, McFarlane, AC. Challenges for disaster research: recommendations for planning and implementing disaster mental health studies. J Loss Trauma. 2007;12(5):419-434.Google Scholar