Health Problems while Working as a Volunteer or Humanitarian Aid Worker in Post-Earthquake Nepal
DOI:
https://doi.org/10.31729/jnma.3630Abstract
Introduction: Volunteers and humanitarian aid workers working in disaster struck areas of the world are a vulnerable group of travelers. Nepal saw an influx of these humanitarian aid workers following earthquakes in April and May 2015.
Methods: This was a descriptive cross-sectional study conducted at CIWEC Hospital located in Kathmandu. A questionnaire was given to all volunteers and aid workers who arrived at the hospital for evaluation of health related problems and agreed to be part of the study.
Results: Ninety-five volunteers were enrolled in the study. Among these, 65 (68%) were female and 30 (32%) were male. The immunizations received before travel were Hepatitis A 82 (86%), Hepatitis B 82 (86%), Typhoid 70 (73%), Rabies 38 (40%), Japanese Encephalitis 34 (36%), Influenza within last one year 23 (24%), measles 48 (51%), Cholera 34 (36%),Tetanus within 10 years 71 (75%) and Varicella 38 (40%). Forty-four (45%) of travelers carried medication for treatment of Traveler’s Diarrhea (TD) which included Ciprofloxacin, Azithromycin, Loperamide and others like Metronidazole and Charcoal. The common illnesses encountered were gastrointestinal, skin problems , injury and musculoskeletal problems, respiratory problems, genitourinary problems, cardiovascular, psychological problems, syncope, and miscellaneous.
Conclusions: Traveler’s Diarrhea and dermatological problems were the most common health related problems. Volunteers were not properly prepared for self-treatment and pre-travel preparation was sub-optimal. Important pre travel health advice will decrease the incidence of health problems in this group.
References
1. Shrestha KG. BYE-BYE EQ2015,11:56AM. Nepalese Journal on Geoinformatics. May / June 2015 AD;14:1-3. [Full Text]
2. Adhikari LB, Gautam UP, Koirala BP, Bhattarai M, Kandel T, Gupta RM, et al. The aftershock sequence of the 2015 April 25 Gorkha–Nepal earthquake. Geophysical Journal International. 2015;203(3):2119-24. [Full Text | DOI ]
3. Adhikari B, Mishra SR, Raut S. Rebuilding Earthquake Struck Nepal through Community Engagement. Frontiers in public health. 2016;4:121. [Full Text | DOI]
4. Merchant RM, Leigh JE, Lurie N. Health care volunteers and disaster response--first, be prepared. The New England journal of medicine. 2010;362(10):872-3. [Pubmed | Full Text | DOI]
5. Sharma DC. Nepal earthquake exposes gaps in disaster preparedness. The Lancet. 2015;385(9980):1819-20.[PubMed | Full Text | DOI]
6. Sultan Al-Shaqsi RG, Sarah Lovell, David McBride, Ammar Al-Kashmiri,, Al-Harthy A. Challenges of the New Zealand healthcare disaster preparedness prior to the Canterbury earthquakes: a qualitative analysis. Journal of the New Zealand Medical Association. 5 March 2013,;126 No 1371.[Full Text]
7. Whittaker J, McLennan B, Handmer J. A review of informal volunteerism in emergencies and disasters: Definition, opportunities and challenges. International Journal of Disaster Risk Reduction. 2015;13:358-68.[Full Text | DOI ]
8. Flegel K, MacDonald N, Hebert PC. Volunteering overseas made easy. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2010;182(14):1493.[Full Text | DOI ]
9. Errett NA, Barnett DJ, Thompson CB, Tosatto R, Austin B, Schaffzin S, et al. Assessment of medical reserve corps volunteers' emergency response willingness using a threat- and efficacy-based model. Biosecurity and bioterrorism : biodefense strategy, practice, and science. 2013;11(1):29-40. [ Full Text | DOI ]
10. Shlim DR, Schwartz E, Eaton M. Clinical Importance of Salmonella Paratyphi A Infection to Enteric Fever in Nepal. Journal of travel medicine. 1995;2(3):165-8. [ Full Text | DOI ]
11. Scott RM, Pandey P, Shlim DR, Khin Saw Aye M. Etiology of enterically-transmitted hepatitis among foreigners in Nepal. Southeast Asian J Trop Med Public Health. 2009;40(4):731-7. [ Pub Med ]
12. Zuckerman JN. Hepatitis E and the traveller. Travel Med Infect Dis. 2003;1(2):73-6.[ Pub Med | DOI ]
13. Schwartz E, Shlim DR, Eaton M, Jenks N, Houston R. The effect of oral and parenteral typhoid vaccination on the rate of infection with Salmonella typhi and Salmonella paratyphi A among foreigners in Nepal. Arch Intern Med. 1990;150(2):349-51. [ PubMed | Full Text | DOI ]
14. Abhilasha Karkey AA, Buddha Basnyat, Stephen Baker. Kathmandu, Nepal: Still an enteric fever capital of the world. J Infect Developing Countries 2008;2(6):461-5. [ PubMed | Full Text | DOI ]
15. Gautret P, Harvey K, Pandey P, Lim PL, Leder K, Piyaphanee W, et al. Animal-associated exposure to rabies virus among travelers, 1997-2012. Emerging infectious diseases. 2015;21(4):569-77. [ PubMed | Full Text | DOI ]
16. Pandey P, Shlim DR, Cave W, Springer MF. Risk of possible exposure to rabies among tourists and foreign residents in Nepal. Journal of travel medicine. 2002;9(3):127-31. [PubMed | Full Text ]
17. Boggild AK, Costiniuk C, Kain KC, Pandey P. Environmental hazards in Nepal: altitude illness, environmental exposures, injuries, and bites in travelers and expatriates. Journal of travel medicine. 2007;14(6):361-8. [ PubMed | Full Text | DOI]
18. Dixit SM, Johura FT, Manandhar S, Sadique A, Rajbhandari RM, Mannan SB, et al. Cholera outbreaks (2012) in three districts of Nepal reveal clonal transmission of multi-drug resistant Vibrio cholerae O1. BMC Infect Dis. 2014;14:392. [PubMed | Full Text | DOI]
19. Pandey P. Letter from Nepal, August 12, 2015--Cholera in post-earthquake Kathmandu. Travel Med Infect Dis. 2015;13(5):425. [PubMed | Full Text | DOI]
20. Murphy H, Pandey P. Pathogens for travelers' diarrhea in Nepal and resistance patterns. Curr Infect Dis Rep. 2012;14(3):238-45. [PubMed | Full Text | DOI]
21. Zimmerman MD, Scott RM, Vaughn DW, Rajbhandari S, Nisalak A, Shrestha MP. Short report: an outbreak of Japanese encephalitis in Kathmandu, Nepal. The American journal of tropical medicine and hygiene. 1997;57(3):283-4. [PubMed | Full Text | DOI]
22. Partridge J, Ghimire P, Sedai T, Bista MB, Banerjee M. Endemic Japanese encephalitis in the Kathmandu valley, Nepal. The American journal of tropical medicine and hygiene. 2007;77(6):1146-9.[PubMed | Full Text ]
23. Lagarde S, Lagier JC, Charrel R, Querat G, Vanhomwegen J, Despres P, et al. Japanese encephalitis in a French traveler to Nepal. Journal of neurovirology. 2014;20(1):99-102. [PubMed | Full Text | DOI]
24. Shlim DR HC RR, Scott RM, Pandy P, Echeverria P. . Persistent high risk of diarrhea among foreigners in Nepal during the first 2 years of residence. Clinical Infectious Diseases. 1999;29:613-16. [ Full Text ]
25. Greenwood Z, Black J, Weld L, O'Brien D, Leder K, Von Sonnenburg F, et al. Gastrointestinal infection among international travelers globally. Journal of travel medicine. 2008;15(4):221-8. [PubMed | Full Text | DOI ]
26. Lachish T, Bar A, Alalouf H, Merin O, Schwartz E. Morbidity among the Israeli Defense Force response team during Nepal, post-earthquake mission, 2015. Journal of travel medicine. 2017;24(2):taw083-taw. [PubMed | Full Text | DOI ]
27. Pandey P, Bodhidatta L, Lewis M, Murphy H, Shlim DR, Cave W, et al. Travelers' diarrhea in Nepal: an update on the pathogens and antibiotic resistance. Journal of travel medicine. 2011;18(2):102-8. [PubMed | Full Text | DOI ]
28. H.A. Murphy LB, C. Mason , B. Swierczewski, S. Shakya , A. Pokhrel , P. Pandey. Increasing Resistance in Diarrheal Pathogens among Travelers to Nepal. In: Conference of the International Society of Travel Medicine ; 2015 May 24-28;Quebec City, Canada: CISTM; 2015. Abstract nr 4.4.[ Full Text ]
29. Cave W, Pandey P, Osrin D, Shlim DR. Chemoprophylaxis use and the risk of malaria in travelers to Nepal. Journal of travel medicine. 2003;10(2):100-5.[PubMed | Full Text | DOI ]
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