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First responders are working frantically to rescue and treat those affected by the earthquake that hit Haiti on Tuesday. To help them stay safe and healthy during these efforts, JEMS asked editorial board members toxicologist Robin B. McFee, DO, MPH, FACPM, FAACT and infection control expert Katherine H. West, BMS, MED, CIC for a personal-care checklist for responders who might have long assignments in unsanitary conditions in tropical locations, such as Haiti.
McFee warns that Haiti is home to a many of endemic illnesses, including malaria, HIV, dengue, hepatitis, tuberculosis and brucellosis. She reminds rescuers to wear appropriate personal protective equipment (PPE) and to not bathe in still water, such as streams or ponds, or sleep directly on the ground.
She also suggests shaking off bed linens before getting in them, keeping clean clothes in sealed bags, pre-treating clothes with insect repellant and covering the skin. And although it might be obvious, rescuers can act as each others' safety officers, checking for ticks, insects and the effects of the environment and carnage on fellow rescuers.
Also make sure to have the ability to contact an expert in the type of medicine or medical issues for which you will be deployed, for example tropical medicine expertise or toxicologists. Also consider reading the Centers for Disease Control Yellow Book, which details infectious diseases by region and preventive measures.
West says to remember that if you're dispatched to the location with a team, you'll more than likely be given everything you can take with you. However, while the list below is not exclusive, the items might help you stay safe and healthy so you can continue to help others.
Things You'll Need
- Bug repellent
- Boots
- Matches
- Mosquito netting: Use when sleeping
- Old newspaper
- PPE
- Powder: Use in really hot conditions to absorb sweat.
- Soap: Bar soap is fine. But with a water shortage, bath wipes are also desirable.
- Vaccinations/Immunizations: Make sure these are up-to-date before you leave.
- Vinegar: This is a good disinfectant.
- Water: Drink lots of it. Hydration is critical, especially in tropicalenvironments.
Things to Consider
- Food/water precautions: Boil water. Boil and cook food. Do not eat anything that's raw and rinsed.
- Water will be at a premium for drinking and bathing, but frequent handwashing, showers (when possible) and clean towels, along with appropriate prophylaxis and using foodborne and respiratory precautions, should reduce the risk.
- Thoroughly rinse off boots when arriving at sleep zone to avoid cross-contaminating the clean zone.
Resources
Haiti -- HHS Relief and Support Activities
CDC -- Public Health Issues and Priorities for the Haiti Earthquake
