Events of recent years have highlighted the importance of planning and preparing for the continuity of health care services in the event of any type of emergency or disaster. Providing health care services to mobile underserved populations, like migrant farmworkers poses a host of challenges to service providers under the best of circumstances, including isolated rural work and home locations, group housing, mobility, limited English proficiency, cultural factors, transportation, documentation status, and poverty. The significance of these factors is undoubtedly magnified under emergency circumstances. The Clinician's Role
Clinicians can serve a role in helping patients to avoid disruption of their health care needs in an emergency by discussing safety and other prevention measures with them. In particular, those whose well-being is dependent on medications or medical equipment should be encouraged to have a personal emergency plan with important contact information and options for securing needed supplies and care.
Since emergencies are by their very nature unpredictable, the appropriate response for health centers will vary depending on the duration, scope, severity, and nature of the emergency.
Clinicians are trained to manage medical emergencies by establishing clearly defined roles and functions for the members of the health care team, using triage systems, establishing a safe and efficient care environment, reassuring patients through clear communication, and providing treatment swiftly and according to urgency and degree of need. These same principles and skills need to be utilized in emergency or disaster settings, and require planning and practice to function effectively in a time of need.
Migrant Population Emergency Care Plan
Protocols which focus on the ability to prioritize needs and to be able to function with limited human and material resources must be developed, and adequate time for training and drills must be allocated.
Critical issues for clinicians to consider in planning for the care of migrant populations in an emergency include:
The need to establish back-up systems for energy generation, documentation, communication, and other clinical operations; Identification and location of high risk patients such as those with disabilities, chronic illnesses, and those who are culturally, linguistically, and geographically isolated; Inclusion of outreach staff and promotores in planning—they can be critical partners in preparing, educating, locating, and transporting patients in need; Training of staff on clinical aspects of possible emergencies relevant to the migrant population or the geographic setting such as pesticide exposure, weather-related emergencies, and disease epidemics; Collaboration with other service providers in planning for continuity of services and clinical supplies; The need to advocate for an immigrant population that may be fearful of accessing needed services in an emergency. Resources
While there are a growing number of resources for both clinicians and administrators to assist in providing services in an emergency situation, there are few resources directed at the unique needs of mobile populations.
Migrant Clinicians Network recommends a number of resources within this website and elsewhere:
A promotor/a curriculum entitled, “ Emergency Preparedness,” in Migrant Health Promotion’s Camp Health Aide Manual at Relevant tools, protocols and sample emergency plans posted on the MCN website created by MHP Salud and Health Outreach Partners. Sample emergency management plans. Emergency care policies.
For additional technical assistance in planning for the clinical aspects of emergency preparedness, please contact Migrant Clinicians Network at 1.800.825.8205, or email Candace Kugel, CRNP, CNM, Specialist in Clinical Systems and Women’s Health at