Rehabilitation of vulnerable groups in emergencies and disasters: A systematic review

Abstract

BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters. METHODS:The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The key words "recovery", "rehabilitation", "reconstruction", "transformation", "transition", "emergency", "disaster", "crisis", "hazard", "catastrophe", "tragedy", "mass casualty incident", "women", "female", "children", "pediatric", "disable", "handicap", "elder", "old" and "vulnerable" were used in combination with Boolean operators OR and AND. ISI Web of Science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar were searched. RESULTS:In this study a total of 11 928 articles were considered and 25 articles were selected for fi nal review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-fi ve studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and economic. CONCLUSION:The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health fi eld managers better implement standard rehabilitation activities for vulnerable groups.

Health-Related Rehabilitation after the 2008 Great Wenchuan Earthquake in China: A Ten Year Retrospective Systematic Review

“…The interventions were also effective in treating and reducing the survivors' PTSD symptoms like anxiety and depression, and also in enhancing their psychological resilience [35,36,38,39]. These findings are consistent with previous results from a broad systematic literature review and meta-analysis studies that similarly explored the different rehabilitation interventions, services and outcomes in post-earthquake settings, and those following other disasters within and outside China [2,[13][14][15]43,44,[48][49][50][51][52]. Encouragingly, some of the HRR programs after the 2008 Wenchuan earthquake, such as physical and physiological rehabilitation, commenced within the first 5 months after the earthquake, which is commendable and helped to ameliorate long-term impacts such as injuries and PTSD from turning into acute problems for survivors that would prevent them from returning to normal life.…”

“…Earthquakes, like any other disasters, are traumatic events and they result in a range of physical, mental and psychological health consequences [2,8,[12][13][14][15]43,[50][51][52]56]. Indeed, this is attested to in the results of six studies in our systematic review [35][36][37][38][39]41]-which showed a high prevalence of PTSD among the different groups of survivors of the 2008 Wenchuan earthquake.…”

“…Another pertinent consideration for HRR in the post-earthquake scenario is the need to promote and strengthen the interventions that target specific groups of people within the general community affected-which may be more vulnerable and at greater risk of negative outcomes than others [50]. The most vulnerable groups in disasters and emergencies are identified to include physically or mentally disabled persons (blind, with cognitive disorders or with mobility limitations), elderly persons, women, children, adolescents, ethnic minorities, prisoners, homeless persons, illiterate persons and the economically impoverished [2,10,14,28,50,51]. These groups corroborate with examples that our systematic review identified in some of the included studies, such as the females who were exposed to a higher risk of PTSD [17], illiterate amputees [20], childhood survivors, those with hyperarousal symptoms [37] and the adolescents who lost their parents [38].…”

“…This can lead to the disregarding of the special needs of some vulnerable groups, like mobility and hearing aids, daily medications and special or preferred food diets, especially in the response phase. As a result, this can aggravate health-related effects and other risks among the victims, such as PTSD and MDD, isolation and loneliness, drug or alcohol abuse, loss of dignity and sense of guilt, doubt, distress and intense fear, vertigo, insomnia, psychoses or even suicidal ideation [15,50]. Besides, negative outcomes from some rehabilitation interventions can be achieved if the needs of vulnerable groups are not adequately addressed.…”

Prioritization of factors related to mental health of women during an earthquake: A qualitative study

“…[7] In a study on the earthquake in Lorestan Province, Iran, which was performed using a focus group discussion (FGD), it was concluded that women encountered socioeconomic needs, loss of assets, insecurity, and fertility problems. [8] A qualitative study carried out through consultation with scholars, highlighted issues including basic living and security needs, social and status development, access to facilities and values, awareness of rights, and participation in policy-making and the community for women in disasters. [9] In a group discussion with 35 experts in a qualitative study, issues like water, shelter, security, respect, suitable communication, awareness, and employment were introduced as the requirements of earthquake survivors.…”