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Posts Tagged ‘Flood’

Psychological support in disasters is public health’s business

Posted in Uncategorized, tagged , , , , , , on February 14, 2014| 2 Comments »

  • by Dr Anne Eyre
  • Trauma Training

I recently met a Director of Public Health. We were both in the lunch queue at a conference which was focusing on civil contingencies, the needs of people in disasters and organisational structures for addressing local resilience.

As we queued I asked her about provision of psychological (trauma) support services in her area for addressing the needs of people in the event of a major emergency. She replied, somewhat curtly, that she did not know: it was not her responsibility she said; it was not her budget. I was told I obviously hadn’t read the Health and Social Care Act, 2012.

Somewhat bemused, I sought reassurance. Perhaps I had misunderstood; she was not suggesting that psychological support services are not to do with public health? Sadly, I did not get that reassurance.

Just to be clear I went away and re-read the Act, and also the Department of Health’s guidance on the roles and responsibilities of Directors of Public Health in Local Government. This says that, among other things, Directors of Public Health (DPH) should offer leadership, expertise and advice on a range of issues, from emergency preparedness through to improving local people’s health and concerns around access to health services.

With regard to health emergency, preparedness resilience and response (EPRR) the role of Local Authorities, via their DPH, is to:

  • Provide leadership for the public health system within their local authority area;
  • Take steps to ensure that plans are in place to protect the health of their populations, and
  • Fulfill the responsibilities of a Category 1 responder under the Civil Contingencies Act.

This is encapsulated in the Emergency Preparedness Framework 2013 (NHS Commissioning Board, 2013).

At a time of tight budgetary constraint, and pressures on all those working within our public services, keeping trauma support and other mental health services on the agenda remains a formidable challenge in ordinary time, let alone in the context of major emergencies and disasters.

Perhaps this helps to explain why psychological support services, and indeed broader aspects of humanitarian assistance, remain the poor relation when it comes to emergency planning, response and longer term recovery in so many areas of the country. But these are integral aspects of public health, and not just in the event of disasters.

It is a worrying thought that our sense of health responsibility could become limited only to those activities over which we have direct budgetary control. Directors of Public Health in particular have a key role to play in delivering real improvements in local health in today’s health system. They are corporately and professionally accountable; with such seniority comes responsibility.

The challenge and expectation on all those who lead on health-related initiatives before, during and after emergencies, is that they will think holistically about people, across phases of disaster, beyond rigid organisational structures and within a multiagency framework in responding to the needs of their communities. For a long time this idea has been encapsulated in the concept of integrated emergency management and it is integral to so many of our organisational philosophies today.

I think it is important that we never forget that public health is about people and that responding to disasters – before, during and after they strike – is about helping and supporting people, including through the provision of robust public mental health services. This is not to say it is easy, and not to acknowledge that addressing mental health and other needs in today’s world of limited budgets and organisational structures can be difficult. However the challenge to those in leadership positions, and indeed all of us, is to work with and through these, not be constrained by them.

The public and those we serve will help ground us in this. Try telling those affected by the recent floods, or any other disaster for that matter, that public health in emergencies is not to do with psychological support.

References

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Heatwaves, Floods and Natural Disasters: How do we need to prepare and adapt?

Posted in Climate change, Disaster relief, Health Inequalities, tagged , , , , , on July 14, 2010| Leave a Comment »

By Matthew Kilgour

What are the difficulties encountered when planning for and responding to natural disasters and adverse weather conditions in the UK?  This was the topic of discussion at the FPH Annual Conference session on Wednesday 7 July,  featuring contributions from Lucy Reynolds from the London School of Hygiene and Tropical Medicine, Wayne Elliott, Head of the Health Programme at the Met Office, Shona Arora, NHS Director of Public Health for Gloucestershire, and Andy Wapling, NHS Head of Emergency Response for London.

The three key environmental factors affecting UK emergency planning and response were outlined as excessive cold, heat and flooding.  All the speakers were keen to point out that the implications of these factors stretch beyond immediate and physical dangers, and stressed the need to understand the social and mental health implications of events like floods or heatwaves. Andrew Wapling, discussed the need to conflate the public health and emergency response agendas saying, “the quicker an effective response is mounted, the lesser the impact on individuals.“  He cited early response to disasters as a key determinant in minimising longer-term implications.   He also stressed the need to identify critical infrastructure and the events that could potentially ground services and impede response.

Shona Arora discussed her involvement with the response to 2007’s flooding in Tewkesbury, Gloucestershire. The flooding heavily disrupted day-to-day patterns of life, and vulnerable individuals and groups like the poor, the elderly or those with learning difficulties did not, in many cases, have access to the information or resources to protect themselves.  Lucy Renolds stressed this same issue in her closing remarks by saying, “it is always the poorest communities who are affected the worst”.  Large percentages of individuals affected by the flooding did not have sufficient insurance, and many were left without access to serviceable kitchens.  Ms Arora admitted that the evidence base for pre-empting eventualities like these was thin, and placed emphasis on the need to address this factor.

Lucy Reynolds highlighted the key role that mass media can play in information sharing and raising public awareness in response to disasters.  She stressed the need for reliable communications networks when dealing with disaster relief, as public phone network can become overloaded and unreliable.  The need for effective and reliable communication between departments was emphasised repeatedly throughout the session. Wayne Elliott from the Met Office said that “unless you communicate at the right time, and in the right manner, nothing will get done.”

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Copenhagen Climate Change Summit – A public health view from the UK

Posted in Climate change, tagged , , , , on December 4, 2009| Leave a Comment »

By Jenny Griffiths

The UK will stage its biggest ever demonstration in support of action on climate change – The Wave – just before the United Nations conference commences.  To help to ensure that the health voice is heard loud and clear, health professionals will meet on Saturday 5th December to hear inspirational speakers and share ideas before joining the main event, walking to Parliament, demanding a healthier, low carbon society for ourselves and future generations.

The increasingly unstable climate has been affecting health in the UK for some years: the 2003 heatwave and the 2007 floods being the most dramatic examples.  The fight is on to avoid the tipping point of two degrees of global warming, beyond which catastrophic impacts around the world could trigger food and water shortages, ecosystem and associated economic collapse and mass migrations.  This is a public health crisis: we have only 5-10 years to stabilise greenhouse gas emissions, which rose by a third globally in the last decade.

A growing movement of health professionals is leading the way to a healthy, positive future.  As the Faculty’s Peder Clark notes in his post of 27 November, there is increasingly strong evidence that what is good for the climate is also good for health.  There are many inspirational examples of public health action:

  • Directors of Public Health are taking the lead in explaining to their populations that climate change is a major health issue; see for example Dr Paul Edmondson-Jones’ 2007 Annual Report which was entirely focused on environmental issues
  • Public health staff are involved with community development initiatives, such as Transition Towns which are creating self-supporting, healthy, resilient communities – for example Angela Raffle, who made a presentation at the FPH conference in Scarborough
  • Primary care trusts are working effectively with local authorities to plan and design healthy, sustainable communities – CABE’s recent publication “Future health: sustainable places for health and well-being” has examples
  • Many health organisations have joined the 10:10 campaign to reduce carbon emissions by 10% in 2010 – most health organisations are reducing their consumption of energy from buildings and travel, as well as developing adaptation strategies to cope with heatwaves, floods and energy crises
  • The Sustainable Development Commission and the NHS Sustainable Development Unit have recently launched the new Good Corporate Citizenship Assessment Model to support progress on sustainable development

We have, of course, yet to reach the critical mass of public commitment to resolute action.  A recent Times poll suggested that over 40 % of the population are still in denial that climate change is happening now and is caused by our lifestyles; and it is likely that the Copenhagen summit will not deliver legally binding commitments.

But the health community can be ready with a powerful non-pharmaceutical prescription for post-Copenhagen depression: a public health movement for healthy, sustainable, low-carbon communities.  It is the most important public health movement of our lifetime, its underlying aim being no less than to secure the future for the human species.

Change will be difficult because we are deeply addicted to carbon-dependent ways of living.  But a low-carbon life rewards us with a health dividend: an improved quality of life replacing a focus on materialistic standards of living.

And in public health we have decades of experience to draw on in how to help people to overcome the most intractable behavioural challenges, through an effective combination of policy and practice.

We know what to do.

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