Keeping disaster workers from becoming victims
In the wake of a disaster, one might assume it is the victims who have the greatest need for counseling. But in reality, the experiences of the helping professions show it is the responders—those who confront the grueling realities—who need it most.
Organizers of the educational program on disaster management at the AVMA Annual Convention in Nashville have chosen mental health for responders as the theme for a daylong session Tuesday, July 16 (6 CE credits available). On Wednesday, attention will shift to the response of veterinarians in terrorist attacks (3 CE credits). The morning program will feature veterinarians who worked at ground zero and investigated anthrax on Capitol Hill. A lunchtime session Sunday, July 14, will explore newly funded research projects on the health of search-and-rescue dogs.
The AVMA and the American Academy on Veterinary Disaster Medicine jointly sponsor the disaster management program.
Dr. John R. Herbold, the Public and Corporate Section manager for the AVMA Convention Management and Program Committee, said, "We had a program last year on bioterrorism and the big picture of public health and governmental agency planning. But now, after 9-11, we have gone to hands-on veterinary medicine at the scene in response to the terrorist attack."
The educational program has grown, Dr. Herbold said, as more and more veterinarians have become aware of the ways they can respond. Establishment of the AVMA Veterinary Medical Assistance Teams has shown "everyday practitioners" how the disaster response community functions, he added. "You have to be aware of how the VMATs function, what their structure is, and their command and control systems, and you have to become part of a team. You can't just go in by yourself. You need to be part of the planning process."
As a program coordinator for Dr. Herbold, Dr. Sebastian Heath has arranged the disaster management sessions. Dr. Heath is disaster management consultant and vice president of the AAVDM. He said the theme of mental health of responders was chosen at the AVMA Annual Convention last July in Boston, not because of Sept. 11.
Very often, responders become extremely stressed after working in a devastated area and returning home to people who don't relate well to the experience, Dr. Heath said. It stands in stark contrast to a community affected by disaster, where there is an esprit de corps about getting through a common misfortune together.
On Tuesday, the first speaker will be Sam D. Bernard, PhD, of the International Foundation for Critical Incident Stress. "This foundation trains the people who respond to emergencies such as airline crashes and those who have to investigate horrible crime scenes," Dr. Heath noted.
In his talk on critical incident stress management, Dr. Bernard will outline what you need to think of before you go to a disaster site. "It's a real privilege to have Sam Bernard come," Dr. Heath said. "He's a prominent mental health professional who also headed up mental health teams at ground zero."
Susan E. Hamilton, PhD, will discuss the mental health services of the American Red Cross, an organization that has a memorandum of understanding with the AVMA and AVMF. The Red Cross is federally mandated to respond to airline crashes, through an agreement with the National Transportation Safety Board to provide mental health counseling for the friends and families of airline crash victims. The AVMA and the American Red Cross also have an agreement to work together in disasters.
Two speakers from Michigan State University will address stress in farming families. Lillian Phenice, PhD, and Robert Griffore, PhD, will share their research on how depopulation of cattle herds because of tuberculosis affects farming families from a mental health standpoint, and how these families cope.
"Tuberculosis is our American equivalent of the British killing an FMD-infected herd," Dr. Heath said. "That's an area we should pay more attention to—understanding the emotional toll on farmers and veterinarians, to help us if we ever have to face [a depopulation] situation."
During his presentation, Dr. Bernard will talk about the strong scientific evidence that people who work in stressful environments and don't get proper counseling are more likely to drop out of their profession early. This theme ties in with what Susan Phillips-Cohen, DSW, of the Animal Medical Center in New York will discuss about stress management in veterinary practice.
Dr. Heath said, "There's been a lot of talk over the last couple of decades on how to deal with grief and bereavement in clients when they lose a pet, but there's been virtually no talk about the need for mental health counseling to help veterinarians and veterinary technicians deal with this stress. Dr. Cohen will talk about how we may be losing some veterinary technicians because they can't handle the stress of euthanasia. That is very similar to what might happen in a disaster."
Two veterinarians will speak about an area of special interest—research facility biosecurity. According to Dr. Heath, the federal government invests $14 billion in biological research every year, and we don't have a lot of expertise in disaster preparedness for biological research facilities.
You will find the disaster management program of interest if:
• You are concerned about coping with stress in disasters and in the workplace
• You want to hear the inside story about veterinarians who responded to the Sept. 11 attacks
• You are interested in the health of search-and-rescue dogs and their value as sentinels of human health events
But even more is at stake than the capital invested in research. "Biological research is what keeps us ahead of many countries in the world," Dr. Heath said. "To think that we could lose some of our transgenic species of our unique models of human disease would be disastrous."
Dr. Catherine Vogelweid of Indiana University will accent the importance of research facilities having disaster preparedness plans tailored to their unique needs. She will describe the comprehensive plan she has developed for the research facilities at Indiana University/Purdue University medical school at Indianapolis.
Research facilities have a long track record of being attacked by animal extremists, but natural disasters also pose a threat. Dr. Robert E. Faith of Baylor College of Medicine will talk about recovery efforts following Tropical Storm Allison. What happens to your research animals if you flood?
For the Wednesday program, Dr. Heath was guided by two goals. First was showing why veterinarian involvement through the VMATs was essential to the effective response to terrorism after Sept. 11. Drs. Barry N. Kellogg and Mary Ann McBride will talk about VMATs at ground zero. "What this program will tell us is that being part of a formal team is the best way to be prepared for these extraordinary events," Dr. Heath said. "I hope this program will inspire people to think about forming new VMATs, because the master plan is to have more."
His second goal was to address other aspects in which veterinarians were essential, such as through the local veterinary associations, providing critical logistic support. Dr. Marc A. Franz from the Long Island VMA will talk about local organized veterinary medicine at ground zero. Gerald Lauber, EdD, of the Suffolk County ASPCA will give an overview of local human society involvement at ground zero.
The final speaker will further exemplify the skills that qualify veterinarians to be involved in so many specialized areas of biosecurity. Dr. Bethany Grohs is an epidemiologist with the Environmental Protection Agency who helped sterilize the Hart building on Capitol Hill after it was contaminated with anthrax (see story, page 731).
Something is missing from the program, however. Both Drs. Herbold and Heath regret that they were unable to line up any of the practitioners who were indirectly affected by the World Trade Center attack. The economic impact on them was so great they could not afford to take the day off to be on the program. Some of their practices were in the security zone and inaccessible. In other cases, business was down because clients did not want to come in for elective services.
Dr. Herbold arranged the lunchtime session Sunday, July 14, which will focus on projects funded by the American Kennel Club Canine Health Foundation that support research on the health of search-and-rescue dogs (see story, page 731). "We have virtually no information on potential respiratory health hazards for search-and-rescue dogs," Dr. Herbold said. "One of the values of the World Trade Center [experience] is the number of dogs that participated. If we follow them over time, we will see whether they have any adverse consequences from that environment.
"It's also becoming an issue in human medicine as to whether some of these responders were exposed to particulates or other noxious gases that we weren't aware of. The dogs might be better sentinels for environmental exposure, because they're certainly close to their work and without respiratory protection."
Over the past two years, the AVMA/AAVDM disaster management program has become one of the top 10 in terms of AVMA program offerings. This is the 10th year disaster management has been part of the AVMA educational program. From 1983-1991, the AAVDM provided Continuing Education in disaster management as an allied group. Dr. Heath said, "Having disaster management on the AVMA educational program has made a huge difference in our level of preparedness within the profession. These programs have been instrumental in our understanding of the essential roles that veterinarians play in disasters."