In response to the increasing number of disasters involving children in both their home environment and in school, the Kenya Paediatrics Association is taking the lead in rolling out the Pediatrics in Disaster course.
Dr Dan Alaro who is the course director says that the training programme in disaster is focused on the unique physical and psychological needs of children. It increases the participants’ awareness and competence in pediatric disaster planning and response.
“The course is challenging the health workers to take lead in disaster management,” he says.
The Paediatrics in Disaster course is an initiative between the KPA in collaboration with the Ministry of Health and the Centre for Global Health, Colorado School of Public Health and the American Academy of Pediatrics (AAP).
This course has been adapted for use all over the world including in Ghana and Tanzania.
In light of the increasing alerts regarding imminent natural disaster such as the looming El Nino touted as the worst El Nino in 60 years, as well as a series of terror attacks, disaster responses that are tailored to meet the unique needs of children cannot be overemphasized.
According to the KPA, the goal is to train a critical mass of paediatricians, other physicians and health professionals to take an active role in disaster planning and response for their hospitals and communities.
“This course is a first in many ways because it seeks to provide skills not taught in the medical course. Most health professionals are trained for hospital based care which is the precedence the world over,” Dr Alaro observes.
According to the pediatrician, health providers must be taught how to transform a disaster site into a hospital.
Further expounding that medical training “does not include pre-hospital and community based disaster care. Out of the hospital or pre-hospital care is a key component as is the period when the patient is being transported to hospital.”
He says that if each of this scenarios are not managed properly and adequately, the result is increased morbidity and mortality.
This means that the course is strengthening capacities for health professionals to operate at the scene of the disaster, the transportation to hospital itself and within the hospital.
Another important component is the social and emotional response and the need to include psychiatrists and psychologists in disaster preparedness plans.
The course could not have come at a better time since the country is prone to a range of natural disasters, notably drought, floods, landslides and mudslides, earthquakes, wildfires, various epidemics and most recently terror attacks.
Statistics by the international disaster database shows that during the period 1993-2010, a total of 73 natural disaster events including droughts, epidemics, floods and landslides affecting a cumulative total of 48.46 million people translating to an annual average of 2.69 million people.
During the same period, a total of 5,825 people (averaging 323 people annually) died from the impacts of the 73 natural disaster events with drought affecting the highest number of people -about 39.2 million-compared to about 6.9 million affected by epidemics and 2.4 million affected by floods.
On the average, drought episodes affected between three to five million people per event during the period compared to 237,300 by epidemics and 75,600 by flood events.
“This numbers take into account the often forgotten social and emotional trauma which this course intends to address comprehensively,” Dr Alaro explains.
The KPA further states that “in terms of Health emergencies, HIV and Aids are the most well documented disasters in Kenya. To date the pandemic has left a trail of over 1.2 million Aids orphans, an enormous burden on the elderly persons in whose care the orphans are often left and a burden to the economy.”
According to Dr Alaro who has been conceptualising a paediatrics in disaster course for more than ten years, emergency situations lead to the disruption of health programs, destruction of health facilities and to the flight or death of health personnel, which hampers the provision of vital social services.
“Disaster affects vaccination programs as was seen during the post-election violence. So we want to address the needs of newborns, infants, and older children particularly adolescents from ages 11 to 18 years,” he explains.
According to KPA, this will mean going into schools and training teachers, Form Three and Four students as well as standard seven and eight pupils to be prepared for disaster, and repeating this training every two years.
Here, career development will also be part of the training. For sustainability, the plan is also to involve professionals in other areas as role models to provide insights on career development.
But children are not the only vulnerable group, “with time, we shall scale it up to include orphans, pregnant mothers, the fertile (potential to be pregnant), the elderly and those with immune-suppression such as people living with HIV/Aids.”
The course will ride on the existing structures of the Ministry of Health as well as the Kenya Red Cross (the two local partners in the paediatrics in disaster course). He says that The Red Cross has training centres which can be used in the rolling out of the proposed trainings.
The plan is to have training centers in all the 47 counties but immediate plans are to begin rolling out 11 training centers in Kiambu, Mombasa, Garissa, Meru, Machakos, Eldoret, Nakuru, Kakamega, Kisumu, Kisii and Nairobi.
“These areas are a priority for two main reasons, they are highly populated and are a hub of trade with a capacity to mobilise resources,” Dr Alaro explains.
“It is important that this course gets support from the private sector so that it can be sustainable. Public-private partnerships will be key to the survival and success of the pediatrics in disaster course,” he adds.
He says that a training center is basically the main coordinating center when disaster strikes, but it must be supported by other sectors. Currently, Integrity House is the main place for co-coordinating disaster but other players come in to strengthen and support disaster preparedness and management.
Towards this end, paediatricians are not the only ones involved, the plan is to involve all the health professional networks and to even train registered community health workers.
Dr Alaro says that the community health worker is the ear of the medical professions on the ground.
They are the first to detect an Ebola or cholera case, are registered by government and work with the lowest level hospitals, so training them is key.
Over the next two years, there will be an estimated 99 trainings in the eleven regions identified. All the trainees will be certified upon completion of the course.
But even the best laid plans have challenges such as the discrepancy between the national and county governments so it is important that the county fully supports the course.
Budgetary allocation is also key because budgets drive disaster preparedness and responses.
The goal is therefore to have less loss of life, more productive adults because they were adequately supported during a traumatic period in their lives, and to consequently build the country by raising the Gross Domestic Product.
“We are now in a new global development agenda and the issues tackled in the course will create an enabling environment to achieve the new Sustainable Development Goals by involving everyone in the community,” says Dr Alaro.
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