What you need to know to be a disaster response medic

By Jason Friesen

Disasters are called “disasters” for a reason – everything’s fallen apart, and whatever hasn’t likely won’t be working as it should. And while there are few medical professionals who are more naturally prepared to provide emergency medical services in austere, non-clinical environments than paramedics, many find it hard to get the experience they need to become proven assets on response teams when the disaster strikes.

Disaster response team roster spots are few and far between, and there’s rarely much advanced warning for the biggest catastrophes, so being able to get to the right place at the right time can prove difficult. Even for the more entrepreneurial paramedics who go to great lengths to deploy to the most catastrophic events, it often turns out that by the time they arrive, it’s too late to be of much help – the dust has already settled, and the crisis has evolved to public health-oriented problems, reducing the need for paramedics.

This has been my experience on several occasions and I know how frustrating it can be. Here are a few things that can help you get deployed when a disaster strikes.

Be honest about your intentions and expectations

Before you sign up, be transparent about why you want to go and what you hope to get out of it. “I just want to help” is a feeling, not a plan. Being honest about your intentions and expectations will undoubtedly help you prepare for the potentially extreme demands that are going to be made of you.

For example, very few disaster response positions are paid so money can’t be your motivator. Additionally, your flexibility, patience and ability to adapt will always be challenged, and depending on where you’re willing to go, the people and communities you’ll be serving will likely be foreign to you in both culture and economic class, potentially making whatever challenges you’re already facing more uncomfortable and confusing.

If you understand your motivations and manage your own expectations you’ll be less likely to find yourself feeling disappointed when everything’s fallen apart and nothing works like it should. More importantly, you’ll never feel like nobody’s thankful for all that you’ve done to come and help.

Short-term vs. long-term efforts

Most disaster response organizations are either focused on response before the dust settles or the long-term recovery after. The immediate response phase generally lasts for a few days.

As paramedics, the response phase is where we’re most naturally inclined to get involved, though an increasing number of organizations like my own, Trek Medics International, are focused on long-term efforts to develop local EMS systems after the dust settles.

The team’s makeup may be the same, but the difference in focus can be distinct: An organization like Team Rubicon can utilize paramedics to set up field communications and provide direct care in the short-term, Trek Medics’ long-term work focuses on training local first responders and connecting them to our dispatching software through international mobile phone services, like Twilio.  In both cases, paramedics can help relieve overwhelmed emergency services in meaningful ways, so being aware of the difference in goals and approaches can help guide your decision-making.

DIY disaster response

There’s a third type of disaster-related response, sometimes referred to as “disaster tourism”, or “the second disaster” [1]. Given the record levels of funding now flowing into disaster response (and the dubious results it’s producing) coupled with the difficulties paramedics have in finding opportunities with established response organizations, it’s probably worth understanding this type of response [2].

When I went to Haiti shortly after the 2010 earthquake, I met a gentleman who had done a lot of fundraising for a health care organization and had come to see what the organization’s work was accomplishing. As we drove past the central market where the pungent fumes from days-old food rotting mixed with fumes from days-old corpses still buried under the rubble, the gentleman had what can best be described as his disaster tourism epiphany. He realized he was simply unprepared and under-equipped to offer anything that could outweigh the potential costs of having him being there with nothing to do.

Even for people like myself who had worked in impoverished countries, the sheer destruction of that earthquake was overwhelming, not to mention the poverty, but unlike him, I was able to go to work when we arrived at our destination, and put my focus elsewhere. He couldn’t. And just hours after arriving, he left to go back to the U.S. That was probably the most honest and brave thing he could have done.

What is needed?

Throwing yourself into a disaster response effort for the sake of being there is similar to donating old clothes to disaster efforts: Once the rain comes, everything turns into a wet rag and it all starts to stink. Having a real understanding of how your skills can meet local needs helps you keep perspective if the chaos becomes overwhelming.

Whatever it is you can offer, make sure it’s needed first, and you’re not doing it for purely selfish reasons. The most effective organizations in disaster response and recovery are aware of what they can and can’t do, as well as what they will and won’t do. Look for those organizations.

Remember that the need for paramedic-level emergency medical skills in most disasters often passes within days, and showing up after that window closes often puts paramedics into roles that are more focused on clinical care or triage. Or, medics may find themselves doing station-type chores, like moving supplies, distributing tents, or removing debris.

You may not want to go through all of the trouble of deploying simply to do those types of work, and your frustration at not being able to do what you think you do best, in a foreign culture or land under stressful conditions, may lead to negative experiences for you, your team, and the locals you’re serving. You may also have taken the place of someone who could’ve been more helpful.

Columbia University’s National Center for Disaster Preparedness (NCDP) provides many resources that can help you get an accurate assessment of needs in domestic emergencies. “The most important thing you can do is to go with a credible organization that’s affiliated with the local structure,” advises Jeff Schlegelmilch, managing director for strategy and operations, NCDP. “People want shortcuts and want to do something for the sake of doing something, but that isn’t always in the best interest of those affected by the disaster.”

Onward and upward

I hope this isn’t too discouraging; I sincerely believe there are few professionals more well-suited to provide medical care in disaster settings than paramedics. There are few people more willing and better prepared to pack their bags and get on the road on a moment’s notice, and be of real use in strange and less-than-ideal situations.

But these are disasters after all, and just like local EMS protocols, once you leave your system, everything can change. If you’re interested in international response, and you haven’t heard of the U.N. Cluster System, or you aren’t aware of the Sphere Project’s minimum standards in humanitarian response, or any number of other international disaster response frameworks (whether you think they work or not) you should take the time to learn more or you’re liable to do harm. There’s actually some evidence to prove it, too.

Here’s a list of organizations that may have opportunities for disaster-related deployments requiring EMS skills:

Domestic teams and resources

• National Disaster Medical System (NDMS)
• National Center for Disaster Preparedness (Columbia University)
• Community Emergency Response Team (FEMA)
• The Medical Reserve Corps
• Team Rubicon
• Local / State Red Cross

International organizations and resources

• United Nations Office for the Coordination of Humanitarian Affairs (OCHA)
• U.S. Office for Foreign Disaster Assistance (OFDA)
• U.S. Agency for International Development (USAID)
• ReliefWeb.int to see up-to-date news about international humanitarian emergencies
• International Medical Corps has applications for paramedic-qualified positions
• EMPARCT Northwest offers training in disaster response; and Project Hope (VA) regularly takes medical volunteers on medical missions
• Devex and the Thomson Reuters Foundation often have long-term development job opportunities in post-disaster locations for EMS-related professionals
• If you have little experience in international and humanitarian aid, Idealist.org is a good place to get started with smaller, community-based organizations

About the author

Jason Friesen, MPH, EMT-P is a licensed paramedic and the founder of Trek Medics International, a nonprofit organization that develops emergency medical systems in communities that don’t have them, and recipients of a Global Impact Award seed grant from Google.org. Friesen has worked for large and small nongovernmental organizations on three continents and received his master’s degree in public health from Columbia University while commuting to school from Haiti.

References

1. Haiti Disaster Tourism – A Medical Shame
2. How the Red Cross Raised Half a Billion Dollars for Haiti and Built Six Homes

This article was originally posted Sept. 30, 2015. It has been updated.