Cultural & Ethical Issues Disaster Medicine in a Foreign
Land
Slide 2
Cultural & Ethical Issues Objectives Preparation Cultural
limitations Gender effects Language barriers N Engl J Med. 2010 Mar
11; 362(10): e34.
Slide 3
Cultural & Ethical Issues Language barriers Professional
interpreters optimal
Slide 4
Cultural & Ethical Issues Language barrier Clinical
situation Availability Patient preference Language gap
Slide 5
Cultural & Ethical Issues Gender bias Women highest
mortality Not taught to swim Clothing restricts motion Cannot leave
home without male Asia Pacific Forum on Women, Law and Development
(APWLD)
Slide 6
Cultural & Ethical Issues Gender bias Women poorest medical
care Males restrict mobility and contacts Women maintain household
Asia Pacific Forum on Women, Law and Development (APWLD
Slide 7
Cultural & Ethical Issues Preparation Stay tuned to World
News Hurricanes Wars Famine
Slide 8
Cultural & Ethical Issues Preparation Earthquakes &
Tsunamis demand an immediate response making you dependent on your
group
Slide 9
Cultural & Ethical Issues Preparation Hurricanes Wars
Famine Time to study Central Intelligence Agency
Slide 10
Cultural & Ethical Issues Preparation Hurricanes Wars
Famine Time to study U.S. Department of State
Slide 11
Cultural & Ethical Issues Preparation Hurricanes Wars
Famine Time to study
Slide 12
Cultural & Ethical Issues Preparation Hurricanes Wars
Famine Time to study Most important Call
Slide 13
Cultural & Ethical Issues Haiti, Disaster Medicine: the
Tale of Two Earthquakes National Geograhic
Slide 14
Cultural & Ethical Issues Haiti, Disaster Medicine: the
Tale of Two Earthquakes Google Earth
Slide 15
Cultural & Ethical Issues Haiti before the quake Geography
and culture http://svs.gsfc.nasa.gov/vis/a000000/a002600/a00 2640/
Wunderground.com
Slide 16
Cultural & Ethical Issues Haiti before the quake Geography
and culture Population & location
Slide 17
Cultural & Ethical Issues Haiti before the quake Geography
and culture Population & location Law & order
wikipedia
Slide 18
Cultural & Ethical Issues 1994 before LA quake Geography
& culture Wunderground.com
Slide 19
Cultural & Ethical Issues After the quakes neighbors
Wunderground.com
Slide 20
Cultural & Ethical Issues After the quakes Neighbors 2011
Los Angeles County Fire Department
Slide 21
Cultural & Ethical Issues After the quakes Neighbors Search
& Rescue USAID_IMAGES' photostream 2011 Los Angeles County Fire
Department
Slide 22
Cultural & Ethical Issues After the quakes Neighbors Search
& Rescue Trauma Care U.S. Coast Guard
www.gettingprepared.info
Slide 23
Cultural & Ethical Issues Medicine after a Disaster
Principles Cannot do the best for each individual victim Do the
best for the largest number of victims
http://www.agenciabrasil.gov.br/media/imagens/2010/01/1
4/14.01.10RP5967.jpg/view
Slide 24
Cultural & Ethical Issues Medicine after a Disaster
Principles Cannot do the best for each individual victim Do the
best for the largest number of victims Fink S. (2010). Doctors Face
Ethical Decisions in Haiti. Retrieved from:
http://www.thweorld.org/2010/02/doctors-face-
ethical-decisions-in-haiti/
Slide 25
Cultural & Ethical Issues Medicine after a Disaster
Principles Cannot do the best for each individual victim Do the
best for the largest number of victims Do what can be sustained
locally Ann Intern Med. 2010 Jun 1; 152(11); 733-7.
Slide 26
Cultural & Ethical Issues Historic Twist Antisepsis
Orthopaedics in an Austere Environment
Slide 27
Cultural & Ethical Issues Open Wound care
Slide 28
Cultural & Ethical Issues Lack of Fluoro
Slide 29
Cultural & Ethical Issues Lack of records Lack of follow
up
Slide 30
Cultural & Ethical Issues Women are at a disadvantage
before and during a disaster Professional interpreters facilitate
medical care everywhere Limit your surgical goals to match
environment, culture, materiel and personnel to prevent further
dysfunction World history and geography are great hobby
