RESPONDING TO THE PHILIPPINES T YPHOON

Center for the Study of Traumatic Stress
The Center for the Study of Traumatic Stress (CSTS) is part of the Department of Psychiatry, Uniformed Services University of the Health Sciences

Sustaining the Psychological Well-Being ofCaregivers While Caring for Disaster Victims
The magnitude of death andDiagnostic tests (e.g. laboratory
Supporting caregivers and encouraging them
destruction in disasters andor radiographic studies) andthe often difficult nature of theinterventions (e.g. medications
to practice self-care sustains their ability to
medical response require specialor surgeries) that are clinicallyserve victims of disaster.
attention to the needs of healthcare
indicated may not be possible
providers. Supporting caregivers anddue to limited resources. Disasterencouraging them to practice selfvictims may die from illnesses thatcare sustains their ability to serve victims of disaster.
clinicians regard as quite treatable. Some interventions
may take place, but in suboptimal conditions. For
Challenges for the Healthcare Provider in the Postexample, life-saving amputations may need to be
Disaster Environment
performed, even without proper anesthesia. It is difficultfor healthcare providers to inflict pain on patients■■ Ruined and socially unstable areas. Disaster areas(especially children), even if necessary.
are often physically and socially unstable. Accessing
a disaster area to establish a clinical setting can be■■ Unfamiliar and unexpected conditions. Working in adifficult due to disturbances of critical infrastructure
disaster setting often means traveling to an unfamiliar
such as airports, roads and communications. Ensuring
place, usually away from one’s family and other social
the physical safety and security of providers (as well assupports. Accommodations may be rudimentary andpatients) is a top priority, but can be a challenge.
provisions of food and water may be somewhat sparse.
■■ The magnitude of suffering. The suffering of the■■ Psychological stress of healthcare in disaster settings.
large number of people needing assistance, theWhile healthcare providers find the experience ofextreme physical injuries being treated and the almost
assisting in a post-disaster environment gratifying,
unbearable losses that many disaster victims have
many also experience the intense emotions andexperienced can challenge the fortitude of even thethoughts of loss and concern as part of their work. Somemost seasoned healthcare provider and responder.
common reactions include:
Disasters often produce mass physical trauma, and thexx Physical and emotional exhaustion
injuries seen may be more severe or, because of delays
xx Identification with the victims —“It could havein treatment, more complicated than many providers
been my child, my spouse…”
are accustomed to treating. Disfiguring injuries such as
xx Feelings of grief, hopelessness, helplessness, sadness
head/facial trauma or burns can be especially difficultand self-doubt
emotionally. Disasters may result in the deaths or severexx Difficulty sleeping
injuries of children, which can be particularly disturbing
for all involved.
xx Guilt over not being able to do more, or having
resources back home that their patients do not■■ Providing support as well as medical care. Manypatients in the post-disaster setting are distressed andxx Frustration and anger at the healthcare delivery
filled with a range of emotions. They may not havesystemfamily or friends. Healthcare providers often take onextra support roles. This is especially the case when theStrategies for Mitigating Psychological Distress inpatient is a child who is injured and may have lost or
Healthcare Providers
been separated from his/her family.
■■ Communicate. Communicate with colleagues clearly■■ Poorly resourced areas. Post-disaster clinical settingsand in an optimistic manner. Identify mistakes or
are often substandard, and healthcare providers must
deficiencies in a constructive manner and correct
adapt to work in under-resourced environments.
Continued

them. Compliment each other—compliments canbe powerful motivators and stress moderators. Shareyour frustrations and your solutions. Problem solving
is a professional skill that often provides a feeling ofaccomplishment even for small problems.
■■ Monitor basic needs. Be sure to eat, drink and sleep
regularly. Becoming biologically deprived puts you atrisk and may also compromise your ability to care forpatients.
■■ Take a break. Give yourself a rest from tending topatients. Allow yourself to do something unrelated
to the traumatic event that you find comforting, funor relaxing. This might be taking a walk, listening tomusic, reading a book, or talking with a friend. Somepeople may feel guilt if they are not working full-timeor are taking time to enjoy themselves when so manyothers are suffering. Recognize that taking appropriate
rest leads to proper care of patients after your break.
Remember that your family and friends are awaiting
you at home.
■■ Connect. Talk to your colleagues and receive support
from one another. Disasters can isolate people in fear
and anxiety. Tell your story and listen to others’.

■■ Reach out. Contact your loved ones, if possible. They

are an anchor of support outside the disaster area.
Keeping in contact may help them better support you
upon return home.
■■ Understand differences. Some people need to talkwhile others need to be alone. Recognize and respectthese differences in yourself, your patients and yourcolleagues.
■■ Stay updated. Participate in meetings to stay informedof the situation, plans and events.
■■ Check in with yourself. Monitor yourself over time
for any symptoms of depression or stress disorder:
prolonged sadness, difficulty sleeping, intrusive
memories, hopelessness. Seek professional help ifneeded.
■■ Honor your service. Remind yourself that despite
obstacles or frustrations, you are fulfilling a noble
calling—taking care of those most in need. Recognize
your colleagues—either formally or informally—for
their service.

Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences
4301 Jones Bridge Road, Bethesda, MD 20814-4799
Tel: 301-295-2470 | Fax: 301-319-6965
www.CSTSonline.org