Research conducted by the Centre for Research on Health Care in Disasters

A disaster is defined by a lack of resources - a lack of staff, lack of skill, lack of material and lack of time. Our research concerns the challenge of how we, despite the lack of resources, can provide optimal health services. On this page we present our current research. At the moment we conduct research in four areas: moral stress, needs assessment, management of conflict injuries and health system resilience.
Professor Johan von Schreeb is in overall charge of the research conducted.

Needs assessments:

Needs assessments in disasters

Summary

To plan relief activities following a disaster the following needs assessment information is needed: The context in which the disaster struck? What was the socioeconomic situation before the disaster? What resources are available and how was the pre-disaster situation for the population?

Our previous research findings highlight the lack of a “system” among disaster response agencies to make use of needs assessment data. Relief is sent based on “experience” and “feeling” rather than on objective needs assessment.  Our focus has changed towards developing methods and approaches of estimating needs and risk following disasters, rather than how to collect the data on ground. We have created and tested a model to estimate and compare the severity of disasters, and our work now focuses on predicting the severity of disasters using the model of indicators we developed earlier.

Objectives

  • To map existing models of severity assessment models used in complex disasters and earthquakes
  • To evaluate the extent to which the mapped severity models can estimate the number of people affected and killed by earthquakes and floods
  • Based the first objectives, to define a model for estimating the severity and level of needs in different types of disasters
  • Moreover, to explore contextual and conceptual aspects of needs assessments and how their results may influence the international humanitarian health assistance response in disaster situations

Anneli Eriksson

Research Specialist
Photo: Getty Images

Moral stress:

Ethical challenges in disasters

Summary

The resource scarcity that defines disasters brings with it moral challenges beyond those in normal healthcare settings. In disaster response situations, health care staff will be in new, often threatening, situations where they will need to make difficult decisions to prioritise among overwhelming needs. Available professional ethical guidelines are of limited use as they do not sufficiently capture the complexity of disasters and the pressure responders are working under.

Our research aims to better understand what determinants are crucial to moral stress and what can be done to prevent illness and suffering.

Objectives

  • To identify and categorise moral challenges in disaster response
  • To explore how and to what extent these challenges affect wellbeing among responders
  • To systematically develop education materials to prepare responders
  • To assess the extent that a preparatory education improves the preparedness and the capacity of responders to handle moral stress

Management of conflict injuries: 

Local negative pressure therapy for gunshot and explosion wounds

Summary

Wounds caused by gunshots and explosions often have difficulty healing because of extensive tissue damage and contamination. Current management practices are based on experience treating military personnel, but these skills may not necessarily be transferable to a civilian context. Research is needed to enable evidence-based management of traumatic injuries and evaluate the use of new therapies.

Our research concerns local negative pressure therapy, which is a relatively new technology that primarily aims to reduce infections and shorten healing time. We performed a randomised controlled study in close vicinity to active conflicts to evaluate if the Vaccum Assisted Closure (VAC) treatment improved wound healing and reduced infection complications of limb injuries. The results of this study showed no significant benefit, which provides support for evidence-based management of patients with traumatic injuries. More studies regarding improved management of conflict injuries are underway.

Objectives

  • To assess pre-hospital trauma mortality in conflict situations and examine to what extent it is possible to reduce this
  • To evaluate the efficacy and safety of local negative pressure treatment of explosion and gunshot wounds

Epidemiology of conflict-related trauma in contemporary armed conflicts

Summary

Armed conflicts constitute a significant public health problem, and the advent of asymmetric warfare tactics creates unique and new challenges to health care organisations providing trauma care in conflicts.

Our retrospective studies analyse the epidemiology of presentations to civilian hospital close to ongoing conflicts in Afghanistan and Iraq and assess different aspects of their management.

Andreas Älgå

Affiliated to research

Health system resilience:

Towards health systems resilience to extreme weather events: managing health needs during floods in Cambodia

Summary

Extreme weather events like floods are expected to become more common as climate change continues, putting health at risk. Knowledge on what health needs is expected after such events is needed for health systems to be able to provide health services. Resilient health systems have the capacity to maintain their functions and change when experiencing events like floods which enables them to continue delivering essential health services.

Our research aims to assess the effects of flooding on health and the capacity of the public health system to manage health needs during floods in Cambodia, with a view to identifying capacities that foster health systems resilience to extreme weather events.