Type of post-graduate training needed within Europe

The workshop defined the more important training needs for those directly and indirectly concerned with health, with emphasis on professional health workers and public health engineers in order to keep the topic within manageable proportions.

The workshop was aware that, in relation to disasters within Europe, there are more radical approaches to education for health promotion in disaster situations. For example, emphasis could be placed on training of primary school teachers, of journalists and of those who produce television material, with a view to spreading awareness of the problems to a very wide audience and to the young. There was also a need for those administratively responsible for disaster planning in each country to be more aware of health issues.

The workshop accepted the importance of these routes of communication and was also aware of the importance of social studies of disasters and of work on disaster prevention and and preparedness. All these could, and often did, affect health indirectly. They were not pursued in detail by the workshop because they lay outside the competence of its members and there was a danger of attempting to cover the whole multi-faceted topic and of failing to concentrate adequately to make an impact.

In relation to disasters in developing countries, the ability to intervene on such a broad front is more limited and health professional workers are the main European personnel involved.

It was found convenient to classify the teaching needed by the type of disaster, since more potential students have an orientation primarily towards either the European or the third world scene. Some division was also made between short courses, complete in themselves, and modules for insertion into longer courses; but to some extent these are interchangeable.

The need for some grounding in the subjects at undergraduate level, the need for many more courses for epidemiologists and other trainees, and the concern for nuclear problems, were all accepted but were beyond the scope of this workshop.

In relation to acute disasters, especially in Europe, there was a clear need for modules suited to post-graduate doctors, veterinarians and public health engineers. Nurses, nutritionists and social workers needed either a module or short course depending on whether they were already in a longer post-graduate course.

Specific short courses were needed by various specialist groups, and to illustrate this the workshop drew attention to the need for short courses directed to teachers of veterinary and of human public health, to senior health officials involved in health aspects of disasters, and to accident surgeons whose skills often lead them to be placed in key positions in disasters. There was also a need for a short course to provide an introduction to disaster problems for a variety of health professionals. At this level it was unnecessary to have different courses for different disciplines.

Many courses and all the modules were designed for use at national level. They need replicating in many European countries, even though benefit could be gained from sharing teaching materials. Other short courses, such as for teachers of veterinary public health, or for senior health officials involved in disaster health, were sufficiently specialised that a single course, or few, within Europe would suffice. These topics were specially suitable for courses supported by the Council of Europe.

The overall aim is for all public health specialists to have an understanding of the health problems of disasters. The needs may be illustrated from the veterinary profession.

In the veterinary services of Europe, there is a need for training in disaster work for:

a. those veterinarians working in areas with a high risk of natural disaster;

b. those with a higher probability of being called in to disaster work such as veterinarians employed in the public service and in the military;

c. those with special bilateral twinning arrangements with those working in high risk areas.

In the case of preparation for work in refugee, famine, and other “chronic disaster” problems of developing countries, the needs fall into two clear categories. Firstly, all training courses for professional health workers in such fields as tropical public health and tropical public health engineering need to include a module on refugee health. Secondly, the numerous health workers who go out to refugee situations in the tropics, often under the sponsorship of non-governmental organisations, are in great need of short courses.

Importance of co-ordination in any disaster

The diverse forms of relief in any disaster situation can only be co-ordinated adequately and rapidly if personnel and services are highly organised; the importance of planning delivery of aid, of briefing teams properly and preparing them psychologically for this work cannot be stressed enough. Close liaison with international organisations and a preliminary assessment of local needs by a specially designated person(s) to pinpoint the best forms of intervention is highly desirable. If the trained personnel from the courses proposed are to be utilised adequately, proper organisation is crucial.

Postgraduate training needed within Europe for work in disasters

A. In relation particularly to acute disasters, especially in Europe:

I. Modules for incorporation into longer courses for:

1. courses for doctors studying public health
2. public health engineering courses

II. Short courses for:

3. senior health officials involved in health aspect of disasters
4. accident surgeons
5. teachers of veterinary public health
6. members of the medical and other health professions (introductory)

B. In relation particularly to chronic disaster problems, especially in the third world for:

I. Modules for incorporation into longer courses in

7. tropical medicine and tropical public health
8. tropical public health engineering

II. Short courses for:

9. medical and nursing and other health volunteers

No doubt many other courses and modules are possible, but the small differences from the types described above do not need separate presentation. Also, the persons who may find the above courses useful are likely to include disciplines other than the ones specifically mentioned.

The proposed courses can be found detailed in Appendix III.