To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: epidemiology of injury and disability, impact on health and rehabilitation systems, and the assessment and measurement of disability.
Qualitative literature review
deaths and affected by year and region deaths in earthquake deaths and affected in Asia
Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with preexisting disabilities are more likely to die in a natural disaster.
Additional development of health-related rehabilitation following natural disaster is urgently required.
To better understand the perceptions of responders and decision-makers regarding disability and efforts to address the needs of PWD following the 2010 earthquake.
Qualitative study
persons involved in the national and international first aid associations; 11 women; 13 men
Participants identified PWD as being among the most vulnerable individuals following the earthquake. Though some forms of disability received considerable attention in aid efforts, the needs of other PWD did not. Several factors were identified as challenges for efforts to address the needs of PWD including lack of coordination and information sharing, the involvement of multiple aid sectors, perceptions that this should be the responsibility of specialized organizations, and the need to prioritize limited resources.
There have been several efforts to promote best practices and develop guidelines to better address the needs of PWD in disasters; significant obstacles remain to the implementation of disaster preparedness, relief, and reconstruction that is inclusive of PWD and responsive to their needs.
Khan et al. [3], 2015, Archives of Physical Medicine and Rehabilitation
To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected.
Systematic review
studies (2 randomized controlled trials, 8 observational studies) participants; age 9–76, mostly women
There are some evidence for the rehabilitation short and long-term improvement in terms of functional activity, psychological symptom, and participation. More attention must be paid to the rescue of preexisting disabilities.
The findings highlight the need to incorporate medical rehabilitation into response planning and disaster management for future natural catastrophes. Access to rehabilitation and investment in sustainable infrastructure and education are crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness, and outcome measurement in such settings.
To summarize epidemiological and scientific research on spinal cord injury (SCI) populations from three severe earthquakes (EQs) in rehabilitation resource-scarce settings; summarize SCI rehabilitation services by local and foreign providers; and provide implications including research gaps for a supporting global scientific research agenda.
Narrative literature review
studies (4, 2005 Pakistan earthquake; 4, 2008 China earthquake; and 3, 2010 Haiti earthquake)
The range of long-term disabilities is more than death’s range. Sometimes the rescue operation of SCI patients is not accurate; therefore the clinical picture is made worse.
A global disaster research agenda for SCI in EQs in rehabilitation resource-scarce settings is needed to strengthen the evidence base for improvement of clinical management and outcomes for SCI EQ survivors.
Liu et al. [10], 2012, Journal of Rehabilitation Medicine
To provide descriptive epidemiology and assess the activities of 10 rehabilitation- related organizations.
Descriptive
10 rehabilitation-related organizations
10-RRO provided relief activities at 3 shelters. Support activities included prevention of immobilization, daily life support, environmental improvement, and transition to temporary housing. The questionnaire survey revealed poor preparedness, satisfactory initial response and support activities, and problems of data collection and advocacy.
The disaster was characterized by minimal trauma and a great need for preventing immobilization. There is an urgent need to develop such a manual to improve preparedness and enhance capability of first aid team to cope with disasters.
Landry et al. [11], 2010, Disability and Rehabilitation
To underline the role of rehabilitation during and after Haiti earthquake
Report
Undefined
There is a remarkable increment of permanent disabilities caused also by attempt of rescues. For this reason there is a tremendous need of rehabilitation services.
The events have raised awareness of the importance of rehabilitation services and highlighted the need to incorporate rehabilitation into response planning for future humanitarian catastrophes.
Most survivors 82% had decreased ROM and 23.5%. Muscle force 72.2% had also restricted ADL capacities. With time the ADL capacities of female patients increased compared to the male patients.
Fractures were the main issue among the injured. Many patients had decreased ROM, ADL capacities, and muscle force; this highlights that physician, involved in rehabilitation, should pay great attention to muscle force exercises, joint mobilization, and occupational therapy during the early phase after disaster.
Rathore et al. [13], 2008, Archives of Physical Medicine and Rehabilitation
To sum up the interventions, the gaps, and the needs emerged the day after the 2005 earthquake in Pakistan.
Report
The ratio of males to females injured 1 : 1.3 Mean age 28, 16.5% less than 18 y; 89% paraplegia cases
Spinal trauma is a surgical emergency that requires specialized care in the initial immobilization and transport of a patient. Unfortunately, after the earthquake, there was usually such little care taken in transporting patients with a suspected or diagnosed SCI. Many physicians involved in the care of SCI patients were unaware of the ASIA system and its worksheet documentation. This resulted in errors in the diagnosis of complete and incomplete SCI.
There is a need to increase disaster preparedness and have a tangible disaster management plan in place and periodic disaster drills. Trauma management in disasters and the correct SCI evacuation, immobilization, and transport protocols should be taught during the training of emergency relief workers, ambulance officers, army medical staff, resident surgeons, and emergency physicians. Rescue units trained in methods to avoid and minimize spinal injuries should be established.
Rathore et al. [4], 2012, Archives of Physical Medicine and Rehabilitation
To stimulate development of research and practice in the emerging discipline of disaster rehabilitation within organizations that provide medical rehabilitation services during the postdisaster emergency response.
Report
Undefined
Medical rehabilitation is an urgent, essential emergency medical service in disasters and not restricted to the intermediate and long-term care settings. Emergency rehabilitation services should only be provided by trained, credentialed professionals to ensure practice accountability and proper standards of care. Nonqualified personnel, although well intentioned, should provide care only in the event of extreme emergency and under strict supervision.
Evidence on the effectiveness of disaster rehabilitation interventions is presented; indeed these services can reduce morbidity and improve functional results and survival.
