Disaster medicine is a specialization within the medical field that has evolved since the 1980s and combines acute medical care, disaster preparedness, public health, humanitarian services, and pre-hospital emergency medical services.
So what constitutes a disaster? Disasters can come from natural causes, such as fires, earthquakes, hurricanes and tornadoes. Disasters also include mass casualty events such as bombings and shootings. In addition, disasters can be intentional or accidental releases of chemical, biological, radiological or nuclear substances.
Recent incidents where disaster medicine was in action include the COVID-19 pandemic – when many hospitals were over capacity – and the ongoing humanitarian crisis in Ukraine.
Many doctors of all specialties intervene regularly and support disaster relief operations. Emergency physicians specifically gain training in disaster medicine during their residency programs, and they may choose to pursue a fellowship in disaster medicine after medical school.
Disaster medicine works in different contexts
Dr. Jarone Lee, a critical care and emergency medicine physician at Massachusetts General Hospital, is a medical member of a National Disaster Medical Assistance Team. DMATs are part of a rapid-response effort that sends self-sustaining federal medical teams to areas after a disaster. They deploy with doctors, nurses, respiratory therapists and mental health specialists.
“We typically set up a field hospital in a tent and then start treating patients like we would in a hospital emergency department,” says Lee.
“Hurricane Irma in 2017 destroyed hospital and healthcare infrastructure in the Florida Keys,” he recalled. “Shortly after our team was sent in and we set up a field hospital to care for the local population until the local hospital was able to reopen. We treated everything from trauma related to the vaccine disaster. In total, our team was deployed for about three weeks.”
Lee was also deployed to Alaska during one of the COVID-19 surges to support two hospitals overwhelmed with COVID-19 patients.
“I helped care for additional COVID patients who were admitted to the hospital,” he says. “Many of us have stood in for a doctor or nurse so they can get some much-needed rest. We have also helped with their public health operations by staffing COVID vaccination sites across the city and checking patients quarantined at home.”
Disaster telemedicine programs are a new possibility for doctors to help in disasters without leaving their homes. For example, the National Emergency Tele-Critical Care Network was created to support hard-to-reach, critical-access rural hospitals during the pandemic.
“NETCCN has allowed us to support several overwhelmed hospitals across the country with disaster telemedicine,” says Lee.
Lee became involved in disaster relief as a pre-med, when he volunteered with the American Red Cross Disaster Action Team. As a non-clinical volunteer, he helped disaster victims with paperwork, housing, clothing and food.
“I encourage all premeds to get involved — medical training is important but not necessarily necessary,” says Lee. “As physicians, we are a key element but also part of a larger coordinated medical response with multiple team players. For example, many of our DMAT team members are not clinicians. To be effective in an austere disaster environment, we need team members with expertise in leadership, logistics, operations, security, safety and communications.
To apply the lessons he learned from telemedicine to disasters, Lee co-founded Health Tech Without Borders, a global nonprofit that supports telemedicine consultations with Ukrainians. HTWB has supported more than 40,000 telemedicine “visits” since the beginning of Russia’s invasion of Ukraine, in collaboration with the Center for Global Health at Massachusetts General Hospital, the World Health Organization and the Ministry Ukrainian Health, HTWB provides virtual medical education to Ukrainians.
How Premeds can get involved in disaster medicine
Medical students do not need special licenses or training to get involved in disaster medicine efforts. Nonprofits and other organizations will offer training if you need to develop specific skills.
Here are some ways premeds can find disaster medicine opportunities:
- Volunteer in a disaster with nonprofit organizations such as the American Red Cross Disaster Action Team and the Federal Medical Reserve Corps.
- During public health emergencies, your city, county, or state may create a public health body that you can get involved with. Many premeds have volunteered for these groups during the pandemic, conducting contact tracing and answering questions from the public about COVID-19.
- Volunteering abroad during international disasters. Many premeds join through international non-governmental organizations and church trips.
- Consider getting an EMT license or taking a course in emergency management.
Disaster medicine after a disaster in the Philippines
While on my Fulbright Fellowship as a pre-doctor, I was living in Manila, Philippines in 2009 when one of the most devastating typhoons in recorded history – Tropical Storm Ondoy quickly followed by Typhoon Pepeng – hit the area directly. Metro Manila. Eighteen inches of rain fell in 24 hours, causing massive flooding, destruction and hundreds of deaths.
I remember walking outside with floodwaters reaching my chest. Cars floated through the streets as citizens desperately waited on rooftops for help. For days I stayed on high ground, only getting electricity from generators. Once the water levels subsided and it was safe to travel outdoors, I volunteered for disaster relief efforts in my community.
I wanted to help in any way possible. I found ways to help through the Ateneo de Manila University, local governments and health care teams. My first days of volunteering revolved around organizing first aid kits and distributing supplies to medical teams. I also distributed food, water and clothing to citizens whose properties were destroyed in the flood.
Then I started working with local health centers on public health campaign efforts. For anyone injured, we administered tetanus shots. I have also worked with infectious disease physicians to educate the community about infectious diseases, including leptospirosis, diarrheal diseases, and other waterborne diseases.
Over the next several weeks, I participated in municipal and national disaster preparedness meetings and saw the importance of coordinated government planning in the event of a natural disaster.
It was my first experience at the epicenter of a large-scale disaster, and I gleaned more information about the roles of government, public health services and doctors. Although we cannot plan for spontaneous natural disasters, my advice to premeds is to help with whatever tasks are necessary at the time.