USC Medical Student Christine Raj Contributes to FEMA Report on Child Disaster Preparedness

How are children’s lives impacted by disasters and how prepared are we at addressing their needs?

In order to assess the current landscape of pediatric disaster preparedness, Christine Raj, a fifth year student in the joint Doctor of Medicine / Master of Public Health (MD/MPH) program at Keck School of Medicine of USC, co-authored a chapter on child disaster preparedness in a Federal Emergency Management Agency (FEMA) funded report. The publication titled: ‘Current and Emerging Trends in the Management of International Disasters’ featured Raj’s chapter where she conducted a scoping review on ‘Pediatric Priorities Through the Disaster Management Cycle: Integrating Children’s Needs in Mitigation, Preparedness, Response and Recovery.’

“Our main goal was to identify gaps in addressing children’s needs during disasters. We found several areas in need of improvement, but very few recommendations on how to address these concerns,” says Raj, who graduates from USC this spring.

Read her interview below to learn more about her findings and their implications in the wellbeing of children.

What sparked your interest in disaster preparedness?
While pursuing my bachelors’ degree at UC Berkely, I became an emergency medical technician (EMT) through a student-run organization that served the campus. We trained in disaster preparedness as part of The Office of the Medical Reserve Corps—and I really enjoyed it! Later at USC while I was pursuing my Master of Public Health degree, I decided to enroll in Dr. Rita Burke’s class on PM 567: Public Health Disaster Management and Response. The course provided an opportunity to learn more about the broader aspects of disaster preparedness, building on my previous foundation. I chose a project specifically focused on pediatric preparedness and collaborated with Project:Camp, a nonprofit organization that provides care for children, and relief for families impacted by disasters.

Why is it important to focus on children as their own category?
Children have separate needs from other people. Often, we think of children as just mini adults, but it’s important to realize that their physiological and mental health needs are different. For instance, some resources are too large and don’t consider the size of a child or sometimes children have special needs and require extra accommodations. Overall, children require care givers for their needs to be met, so providing resources is not enough to address their needs if they do not have someone responsible to take care of them. When it comes to children, there is more oversight required in planning and more factors to consider about their wellbeing.

Can you discuss your findings published in the FEMA funded report?
Through a collaborative effort from Project:Camp, The Resiliency Initiative, and Dr. Burke, we conducted a literature review evaluating 161 articles to determine the landscape of pediatric preparedness based on the disaster cycle: mitigation, preparedness, response, and recovery. Through this exercise, we found several areas in need of improvement. First, when it came to mitigation, we found that during disasters, children with special needs were at an increased risk because they had more requirements to achieving wellbeing. Overall, there was a lack of tailored disaster plans for children especially those with access and functional needs. We also found there was insufficient training and educational resources to support kids.

With reference to preparedness: there was a lack of comprehensive disaster plans that specifically focused on children and a lack of training for childcare providers to help them feel better prepared during disasters. In terms of disaster response, there was a need for improved shelter and evacuation procedures, particularly among children with special needs—given that there were significant accommodation challenges during emergencies. Lastly, the road to recovery for children was particularly challenging. This was heightened in low- and middle-income countries where barriers included access to resources and healthcare, as well as unequal aid distribution.

What were your recommendations?
First, a greater emphasis should be placed on safeguarding children during disasters through increased pediatric preparedness funding and a more equitable distribution of resources to populations with the greatest need. Next, more options and solutions are needed for children with disabilities and special needs. This was recommended because they were often forgotten and yet they had extra needs which were frequently overlooked. For example, for children who use wheelchairs, housing with flights of stairs make those options inaccessible to them during an already difficult time. Similarly, children on the spectrum may not fare well in the commotion that comes in the aftermath of a disaster.

On a global level, there needs to be more focus on international disaster management where communities are integrated into the recovery process. While humanitarian aid is important, it needs to be actually helpful and not a temporary fix, so that if the aid is discontinued, the communities are not back to where they started.

Can you share one example of a resource that is beneficial for pediatric preparedness?
The organization I worked with Project:Camp, focuses on childcare after disasters and works to provide a safe space for children. This helps to give them some sort of routine in their day after a major disruption. At the same time, parents are given time to deal with the tough situation they are facing without having to worry about childcare—which is expensive. They can focus on finding housing and clothing, dealing with insurance claims, and other recovery activities, while their children are cared for.

What would you say is the outlook when it comes to pediatric preparedness?
You find that disasters get immediate attention when they occur and as more time passes, there is less focus. We tend to forget about the importance of the measures put in place to mitigate the next disaster. It is for this reason that implementation flaws of future strategies should be prioritized before the next disaster strikes. Also, more research is needed on different aspects of child disaster preparedness especially on topics where we did not find much literature to begin with. This will help us to understand how to support the vast needs of children during disasters.

In addition to Ray, other authors of the report include Rita V. Burke, PhD, MPH, from the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California; Lorraine Schneider, MSc, from The Resiliency Initiative; and Mikey Latner and Ozzie Baron from Project:Camp

In addition to Ray, other authors of the report include Rita V. Burke, PhD, MPH, from the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California; Lorraine Schneider, MSc, from The Resiliency Initiative; and Mikey Latner and Ozzie Baron from Project:Camp