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close this bookEpidemiologic Surveillance after Natural Disaster (PAHO - OPS; 1982; 105 pages) [FR] [ES]
close this folderPart 1 : Epidemiologic surveillance and disease control after natural disaster
close this folderChapter 3 : Setting up surveillance systems
View the documentSurveillance of diseases between disasters under normal conditions
View the documentSurveillance sources following disaster
View the documentDiseases to include in the surveillance
View the documentThe collection, interpretation and utilization of data
View the documentProviding feedback to the field from the central level

Providing feedback to the field from the central level

Providing feedback is of particular importance to postdisaster surveillance, insofar as it promotes the cooperation of newly established reporting units and those which did not participate in the preexisting surveillance. Furthermore, many relief workers will not be familiar with the surveillance system and, even when they are, many give higher priority to providing health services than to carrying out daily or weekly surveillance reporting. Efforts to provide feedback will, however, be frustrated by limitations of diagnostic resources, epidemiologic manpower, communications and transport, as well as in obtaining access to existing facilities (e.g., space on helicopters, radio time and duplicating machines).

The situation which necessitates the relief of effort, on the other hand, is a special one in that whatever feedback which can be provided is especially welcome. A disaster is invariably stressful to members of health teams in the field, be they of national or international composition, since they are placed in unfamiliar circumstances. Furthermore, most relief workers have little or no firsthand experience with disaster, and few feel they are adequately trained to cope with either the immediate or potential problems in public health. There is also personal concern about the risk of acquiring a communicable or tropical disease with which they may be unfamiliar. Relief workers are, moreover, particularly conscious of being isolated from one another and of their ignorance of events in adjacent areas. Factors such as these may explain why relief workers are so psychologically vulnerable, and prone to disseminating rumors of outbreaks. It is important to remember that these concerns are also shared by the general public, especially in areas where literacy is high.

These considerations render widespread promulgation of weekly surveillance summaries the cornerstone of surveillance feedback. Because few relief workers have training in epidemiology or significant knowledge of communicable diseases, commentary, informational material and graphics should also accompany the summaries. Duplicating machines or printing presses are available under most circumstances. The epidemiologist may, however, experience difficulty in gaining access to them because of competition with colleagues, and even when there is access there may be no funds for publishing the reports. The airlifting or local purchasing of such equipment may, thus, be more effective forms of relief assistance than is the donation of medical supplies. Innovation may be required for distribution to the field, but distribution usually can be arranged through the system developed for collection of relief deliveries, personal mail to relief workers, and so forth.

The weekly report provides more than feedback to field workers. The epidemiologist should ensure that the weekly report and adequate background information (personal visit or covering note) are circulated to the relief coordinator and other national authorities and local representatives of voluntary agencies. The relief coordinator should be responsible for distributing the report to members of the media and the community.

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