What Do We Need to Do for Better Casualty Support in Disasters?

Dear Editor, Statistics show that Iran is one of the main disaster prone countries. 1 In the Bam earthquake alone in De-cember 26, 2003, more than 25000 people died, 50,000 were injured and 100,000 lost their homes. 2 Disaster may happen during any person's life and preparedness is the best way for preventing the dramatic consequences. By sure, implementing proper preparedness for disasters in developing countries with high populations and low resources is difficult. One task for disaster preparedness is to find out the right people to engage in relief operations and to determine how and what tasks they should perform. Despite the allocation of tremendous resources and finances for educating and simulating disaster response situations in many countries, the actual disaster response, even in developed countries has been inadequate and recently there has been renewed emphasis on better planning and research to improve medical responses to sudden and catastrophic events. 3 In Iran, there are many experienced nurses and aid workers working in educational hospitals, with valuable information and experience about aid and casualty support after disasters. Our team interviewed and documented the valuable experiences of more than 20 nurses in Kerman through a qualitative descriptive phenomenology study. The results helped us in understanding the shortcomings of aid and casualty support , and suggesting the proper interventions, educational and technical programs for more effective disaster management in the future. The most frequent topic mentioned in our data were the facts that some caregivers could not cope with the mental and psychological burden and stress of post disaster care. They commented that aid workers should be selected among those who have strong personalities, dedication, energy and physical strength. Other studies have also commented that not all persons can or should be recruited as first line caregivers. 4 The aid workers should be selected in advance and should be trained intensively and frequently in both theoretical and practical aspects of casualty aid through specific well organized educational programs to stay ready and up to date. Our participating nurses, although were experienced but they felt to need the knowledge and practice more about trauma complications and trauma care; and needed frequent workshops, seminars, well organized and well conducted drills and etc. Some commented that untrained volunteers should not enter the circle of aid workers; because they caused chaos and various problems. They suggested clear planning and their duties and scope of responsibility …