( By A Working Guide (WHO - OMS, 1989) )

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Chapter 4. Action by the local health personnel Post-disaster health problems and the organization of the local health personnel

After the emergency treatment phase, in addition to the need to resume routine health activities, problems arise that are specific to the post-disaster period:

· possible complications and sequelae of injuries, fractures, cuts and burns,

· the possibility that poor sanitary and living conditions may favour the recrudescence and spread of diseases already present in the area,

· the psychological suffering and disquiet that affect individuals and diminish the community’s power of recuperation.

The local health workers must organize themselves to take on these new problems as part of their activities, which include:

· the running of the health centre or local hospital and provision of routine care,

· the disease-monitoring system,

· health education,

· the resumption of health programmes in progress before the disaster (vaccinations, maternal and child health, control of tuberculosis, malaria, diarrhoeal diseases, malnutrition and other health problems, depending on the circumstances),

· activities to alleviate psychological suffering and disquiet.

Most of these activities require intimate involvement with the community. This can be ensured only by the local personnel organizing their work on the basis of support from volunteers and the persons in charge of the family groupings. In this context the local branches of the Red Cross can make a contribution by providing well-organized volunteers, already trained. In all their activities the local health personnel should try to obtain help from the community while reserving for themselves tasks that specifically require professional skills. This requires considerable efforts to coordinate and train volunteers. The local personnel must keep in touch with the intermediate-level authorities, from whom, on the basis of the estimated number of people to be cared for and the types of intervention needed, they can request the assistance and the supplies they require:

· medicaments,

· articles of medical consumption,

· visits to the disaster area by specialists (surgeons, orthopaedists, rehabilitation experts, etc.),

· liaison with suitably equipped hospitals to which they can send cases which cannot be dealt with on the spot,

· means of communication and transport,

· general supplies for the health centre or hospital (blankets, linen, food, fuel, tools, cleaning products, etc.).

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