Disaster-related fatalities among US citizens traveling abroad.

OBJECTIVE: To describe the locations and risk of death associated with natural disaster fatalities for US citizens traveling abroad. DESIGN, SETTING, AND PARTICIPANTS: A retrospective database review of US citizen disaster deaths occurring worldwide. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Information on fatalities due to disasters was abstracted from the US Department of State Web site reporting deaths of US citizens abroad by non-natural causes from October 2002 through June 2012. The main outcome measures were the frequency of disaster deaths and countries where disasters occurred. Descriptive statistics and rates were used to evaluate the study data. RESULTS: There were 7,963 total non-natural deaths of US citizens traveling abroad during the study period. Of these, 163 (2.0 percent) were disaster-related deaths, involving 19 disaster events in 15 countries. Only two disaster-related events resulted in more than two deaths of US travelers-the 2010 earthquake in Haiti causing 121 fatalities (74.2 percent of disaster deaths), and the 2004 tsunami in Thailand causing 22 fatalities (13.5 percent of disaster deaths). The approximate annual mean death rate for US citizen travelers as a result of disaster events is 0.27 deaths/1 million travelers, compared with 1.4 deaths/1 million residents due to disaster annually within the United States. CONCLUSIONS: The risk of disaster-related fatality is low for US citizens traveling abroad. Although disaster-related death among travelers is unpredictable, during a period of almost 10 years, there was only one reported death due to disaster in the five countries most frequently visited by US travelers. Further investigation may identify population-, seasonal-, country-, or location-specific risks from which prevention strategies can be developed.

Emergency medical training for health promoters in Central and South America / Entrenamiento médico en urgencias para promotores de salud de América Central y América del Sur

Los promotores de salud, las parteras y otros proveedores de cuidados médicos básicos trabajan en comunidades locales de todo el mundo para mejorar y facilitar la atención sanitaria. No hay suficiente información que describa los programas educacionales dirigidos a mejorar los conocimientos y las habilidades de los promotores de salud y sobre su impacto sanitario a largo plazo. Muchas iniciativas educacionales dirigidas a los promotores de salud consisten en intervenciones aisladas que permiten evaluar sus conocimientos inmediatamente después de la intervención, pero no miden los progresos a largo plazo en la base de conocimientos o la atención sanitaria. La Alianza Pediátrica Global -una organización sin ánimo de lucro basada en los EE.UU. que trabaja con personal médico y sanitario local- creó un programa educacional para promotores sanitarios y parteras en Ecuador, Guatemala, México y Nicaragua con un enfoque centrado en reducir la mortalidad materna e infantil y en mejorar la atención primaria y de urgencias. En este artículo se describen estas iniciativas educacionales diseñadas para mejorar las habilidades de los promotores de salud y las parteras mediante un entrenamiento médico avanzado y sostenible, ajustadas a las necesidades específicas de cada comunidad.

Emergency medical training for health promoters in Central and South America

Underserved regions in the developing world are challenging areas to provide emergency medical care. As populations in these often remote or isolated districts may have minimal access to regular health care, contacts with medical providers are frequently episodic and driven by an acute condition. Health promoters—practitioners who provide basic medical care and promote public health in numerous countries across Central and South America, Asia and Africa—help to fill this void. Typically, health promoters are certified through a formal training program in their country and come from the same population as the clients they serve, which helps them form a link between their community and the dominant health care system in the region (1-2). Access to health and social services in regions served by health promoters is usually minimal, resulting in high morbidity and mortality associated with preventable diseases. Health promoters strive to improve the overall health of these communities by supplementing and improving the curative, preventive, and promotional aspects of the existing health system.