By Charles Krin
There are many things to consider when looking to become a disaster volunteer, as I outlined in my previous article. This is also true if you’re at the next stage of the process — deployment.
If you’ve joined up, trained up and have the paid leave time to cover your expenses while you are out in the field, there’s more work still to do. Are your immunizations up to date? Remember that you will be exposed to “unusual” diseases, even if you are only responding here in the United States.
If you are going to go overseas then you will need a passport, and you will have to have your immunization records transcribed to the yellow “immunization record book” that goes with it. U.S. passports may take up to eight weeks to process and, if you did not have the basic military or overseas immunization package in the past, the full immunization series may take a month or more before they are effective.
While the initial response to a major disaster/mass casualty situation will always be a “come as you are” situation for local responders, a more measured response is needed for support coming in from outside the area.
Outside responders have a duty to themselves and to the folks they are supposed to be helping to be properly trained, physically fit and ready to handle living and working under austere circumstances. Without those qualifications, you are more likely to end up as another patient, and a drag on the system, instead of a help.
Under the principle that “Proper Prior Preparation is Paramount in Providing Prompt Relief,” would-be volunteers need to:
• Join an organized group well ahead of time and deploy on one or more “planned” humanitarian missions before trying to deploy for a humanitarian disaster relief effort. A partial listing of established groups is included at the end of this letter.
• Obtain appropriate training and experience to allow them to function in the austere to primitive circumstances involved in humanitarian relief efforts
• Keep their passports and immunizations up to date, including transcribing information to their “yellow book” immunization record if they intend deployment away from their home country
• Be able to camp under primitive conditions (no running water or flush toilets) for at least five days in a row
• Be able to hike a number of miles a day in rough terrain carrying personal equipment and water
• Be able to handle extremes of sun, heat and cold with appropriate clothing
• Have completed the National Incident Management System (NIMS) curriculum so that they are aware of the likely systems, and where they will fit in to the system
• Have the capability to do other jobs on the team besides their primary assignment, including cooking, cleaning, light (non-technical) rescue, communications, documentation, and so forth.
• Understand the use and care of liquid fuel stoves and mantle type lanterns. (Electricity and propane is going to be scarce on the ground.)
• Be willing and able to handle various tasks involving infrastructure building and upkeep: basic carpentry, sewing, plumbing, masonry, small engine and electrical work.
• Other invaluable skills include a conversational faculty with more than one language and an amateur radio license, complete with appropriate portable radio(s), antennas and (solar) recharging gear.
When you deploy, your personal kit needs to include as a minimum:
1. The clothing on your back and boots on your feet
2. Your personal medications
i. Medications should be in original, individual, clearly labeled vials
ii. You will need enough to cover:
1. the expected tour of duty,
2. expected travel time
3. and AT LEAST an additional seven days worth of medications.
3. Your personal grooming kit, including
a. Toiletries
b. Personal sanitation supplies,
c. “Baby wipe” type premoistened novelettes.
4. At least three additional pairs of socks
5. Two additional changes of “wash and wear” clothing
6. Appropriate changes of underwear
7. An extra pair of boots — both pairs should be hiking style with puncture resistant insoles
8. Weather-protective gear appropriate for the location and season
9. Appropriate sleeping gear (sleeping bag, pad, mosquito net, etc.)
10. Personal protective gear (if not provided by your group)
a. A day pack including an integral water bladder (“Camelback” or similar)
b. Two pair of lightweight leather gloves
c. Two pair of impact resistant glasses,
i. one clear and one tinted for sun protection
ii. (two pair of clear glasses if you need prescriptions)
iii. Appropriate contact lenses may be used, but are often discouraged due to hygiene problems.
d. A hard hat with chin strap (even if you are not on a dedicated rescue team)
e. A broad brimmed sun hat with a ventilated crown
f. Hard shell knee pads
Your organization may provide a more inclusive list, or even provide some of the equipment for you.
Charles Krin is a retired Family and Emergency Medicine physician with more than 30 years of experience in the field. Initially trained as an EMT-A in 1976, he spent three years as an air ambulance medic in the US Army, and then attended medical school, graduating in 1987. Residency trained in Family Medicine through one of the programs associated with the Louisiana StateUniversity Medical Center, he spent almost a decade in full time clinical medicine while teaching and working in local emergency rooms on the side.
Moving to full time Emergency Department work in 1999, he continued his interest in teaching EMS personnel at all levels. He was called up in support of Desert Storm in 1991, where he provided medical care while assigned at Ft Hood, Texas. He later participated in the local response to Hurricanes Opal, Katrina and Rita while practicing in Louisiana. Recently retired, he is now taking care of his wife, nine dogs and six cats in the Ozarks. You can contact Charles at krin135@aol.com.
The author wishes to acknowledge the contributions from the many correspondents from the Trauma-List in the development of this article.