Disaster, stress and the doctor.

Man is unable to control for the ever-present potential of disaster. In the past practices and procedures have been developed to minimize physical risk and maximize personal safety. However, there has been little awareness of, or attention to, the stress to those involved in the care-giving process to the victims. Medical care-givers are at the forefront of post-disaster intervention. It is necessary to provide training and support for doctors engaged in post-disaster work, especially with regard to the psychosocial consequences for patients, relatives, and the medical team as a group and as individuals. Pre-disaster preparation is suggested as a situational moderator in the prevention or management of extreme strain in medical and paramedical staff. Specifically, social support in the form of team-building and supervisory support and debriefing, use of personality hardiness concepts in selection and training of staff, and general emergency preparedness should form part of a disaster preparation plan. Medical social workers and psychologists can play an important role as facilitators in disaster preparation. The importance of education and increasing awareness of disaster effects on the health team is emphasized.