A Critical Concern: Pediatrician Self-care After Disasters

As of this writing, health care in the areas impacted by Hurricane Katrina has shifted from emergency to primary care mode. Disasters take a heavy toll not only on victims but also on professionals and volunteers who experience the immediate, short-term, and long- term impact through their patients. The impact may occur because of the helping professional’s effort to empathize with and be compassionate to patients. There is a rich literature that discusses the risks and impact of vicarious traumatization on psychotherapists, rescue workers, and health care providers who work with survivors, including those who have experienced community traumas such as natural disasters, state-sponsored terrorism, torture, mass murder, and acts of war. The psychological impact of working with those who have suffered trauma has been variously referred to as “vicarious traumatization,” “compassion fatigue,” or, more simply, “burnout.” Vicarious traumatization is described as the emotional and psychological reactions that are triggered by the experience of empathic engagement with patients who are survivors of trauma. This reaction is considered an inescapable aspect of trauma work. Community traumas involve multiple threats to and actual losses of life but also can cause the breakdown of social structures such as family, communities, employment, and housing, thereby dealing a blow to the basic structure of social life by damaging connections between people and their sense of community. A large percentage of health care providers had to evacuate their homes and offices after Katrina and lost their livelihoods and sense of community. It is also likely that many experienced the loss of loved ones. As a result, the emotional toll on health care professionals continuing to treat a traumatized and dislocated population is likely to be significant