Abstract

When health care providers rushed to assist after the September 11 attacks, they were neither prepared nor cognizant of the risk of serious respiratory ailments or blood cancer they were exposed to. When community members and nurses traveled to Haiti after the 2010 earthquake, many were not prepared for life in a makeshift camp without potable water and the risk of dengue fever. In the aftermath of hurricane Katrina in 2005, emergency staff brought in from around the country were not adequately prepared to deal with anger over racial inequity. As health care and emergency workers, we have a strong commitment to helping when the need arises, and often we are put into the position of not only providing care but also managing or organizing the large numbers of volunteers, government institutions, and community members who also desire to help. We may have the experience or education to triage patients or to provide emergency care for the injured, but we may not have the skills to organize a camp of 50 workers or to negotiate with the military or paramilitary to give us access to the injured in the field. Wemay not have the background that allows us to understand the negotiation, compromise, and mediation skills necessary to convince a warden to allow us access to prisoners in order to evaluate living conditions. We often are under prepared to ensure our own safety. We are more concerned with aiding the injured than with adequately protecting our own health. There is a clear need for training through simulation. Humanitarian organizations provide health care, supplies, and training in zones of conflict around the world. This work is necessary but not without risks. If they are not managed and trained appropriately, aid organizations can cause more disruption, more conflict, and more injuries to the aid workers or the communities they serve. In an environment that includes rebel forces and corrupt

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