Simulating Disaster to Train Humanitarians

The 30 faculty, staff, and students who signed up for the “three-day field experience” taking place this weekend at the School of Nursing and Health Studies don’t know what they are getting into, but they have been forewarned to prepare for disaster.

From left, Dr. Elizabeth Greig, Dr. Antonia Eyssallenne, and Dr. Susana Barroso-Fernandez.
From left, Dr. Elizabeth Greig, Dr. Antonia Eyssallenne, and Dr. Susana Barroso-Fernandez.

Exactly what kind is a secret, but sometime Friday morning havoc and misery will reign somewhere overseas, and the participants in the University of Miami’s inaugural humanitarian disaster response course many from the Miller School of Medicine  will rapidly deploy, carrying only the essentials they’ll need to live outdoors, without a proper bed or meal, and with limited electricity, plumbing, and air-conditioning for a few weeks.

They won’t really be away that long or travel very far. They’ll never even leave the Coral Gables campus. But immersed in life-like scenarios created by Humanitarian U, an international organization dedicated to professionalizing the humanitarian workforce, they’ll learn whether they have the right stuff to act with cool heads and little sleep in a shattered world with infinite needs and unrelenting emergencies.

“It will be very intense, very stressful, and very realistic,” said pediatrician and internist Antonia Eyssallenne, M.D., Ph.D., an assistant professor at the Miller School of Medicine, who spearheaded the training course sponsored by the School of Nursing and Health Studies (SONHS) and the Miller School’s Gordon Center for Research in Medical Education and Global Institute for Community Health and Development.

“They know they need to show up with a change of clothes and the expectation that they’re sleeping outside, and not getting a shower for a few days,” said internist Elizabeth Greig, M.D., another Miller School assistant professor and the medical director of UHealth on Fisher Island, who helped organize the course.

“We all want to help, but how uncomfortable are you willing and able to be to help?” said Susana Barroso-Fernandez, Ph.D., R.N., assistant professor of clinical, who directs SONHS’ simulation hospital special projects, and also helped organize the exercise. “It’s better to find out now, than when you land in chaos in the middle of nowhere.”

Operated by Humanitarian U faculty with a cadre of role-playing volunteers, the life-like simulations that will turn SONHS’ grounds and its Simulation Hospital into a chaotic disaster zone is the first of its kind to be held on a college campus. But Drs. Eyssallenne, Greig, and Barroso-Fernandez hope it won’t be the last, a hope that took root after Haiti’s devastating 2010 earthquake.

Well aware that Miami’s location makes it an ideal hub for responding to disasters that are undoubtedly looming on the horizon, their goal is for UM to offer its own version of Humanitarian U’s training course every year to nursing, medical, and public health students, and residents who are driven, but not necessarily prepared, to assist. In addition to the simulations, the course includes extensive online modules that are completed in advance.

“Not only are we subject to disasters, like hurricanes, but we have easy access to where they occur in our hemisphere,” Dr. Eyssallenne said. “So we want to make sure people who respond are going not just with good hearts and intentions, but with proper training and a good understanding of already established procedures and policies.” Drs. Eyssallenne and Greig know a bit about responding to an overseas calamity. Both had worked on primary care projects in Haiti, and each assumed a critical role in UM’s unprecedented response to the earthquake that killed and maimed hundreds of thousands of people there.

At the time, Dr. Eyssallenne was the chief medicine-pediatrics resident in UM/Jackson’s Internal Medicine-Pediatrics Residency program, which she now leads, and about to head to Haiti’s north coast to work on a family planning project. Instead, she joined a small team of trauma specialists who, led by UM neurosurgeon Barth Green, M.D., the co-founder of Project Medishare for Haiti, were treating survivors in a pair of cargo tents at the edge of the airport in the Haitian capital.

Remaining in her parents’ homeland for nearly a month, Dr. Eyssallenne helped set up a triage system when the makeshift emergency clinic moved into the 240-bed trauma hospital that the Global Institute and Project Medishare opened in four tents just nine days after the temblor.

Dr. Greig, who at the time was a fourth-year medical student weeks away from her wedding, had just written a trauma and disaster plan for Haiti. Knowing the impoverished nation would be mired in unimaginable misery, she left her medical rotations and wedding plans behind, arriving in Port-au-Prince just in time to coordinate patient transfers and care at the new tent hospital, a job she held for nearly a month before leaving briefly to get married.

Unbeknownst to Dr. Greig and Dr. Eyssallenne at the time, Humanitarian U’s CEO, emergency physician Kirsten Johnson, also served in Haiti with Harvard University after the earthquake, and was among the veteran emergency responders who viewed the response by inexperienced do-gooders as being almost as calamitous as the temblor.

“This is the hard data: for 90 percent of the people who responded, it was their first time working in the field,” said Dr. Johnson, who founded Humanitarian U a year later. “Most were under the age of 30 and they had no training. So the disaster was magnified because there was a real lack of coordination, and people on the ground didn’t know what they were doing.”

Since then, Dr. Johnson said, the United Nations’ World Health Organization began requiring members of emergency medical teams to have relevant training, a precedent that led to the push to professionalize and, more recently, certify the humanitarian workforce.

A year after Dr. Johnson founded Humanitarian U to provide that training and certification, Dr. Eyssallenne took the Canada-based organization’s two-week course, which among many things teaches participants how to assess needs, distribute food and aid, analyze data, handle celebrities and media, participate in U.N. meetings, and prepare budgets and service plans for targeted populations.

The course concluded with a three-day simulation that, just as UM’s will, condensed a few weeks of time into 72 intense hours that tested not only what the participants learned, but how they withstood the pressure.

“It was amazing and I knew we had to have it at UM,” Dr. Eyssallenne said. “The assumption is every disaster is different, and you can’t prepare for it, but that’s not true. We don’t have to reinvent the wheel. There are procedures and protocols that we can and should know in advance.”

For her part, Dr. Johnson is more than happy that Humanitarian U also will be training UM’s trainers to begin delivering her organization’s course themselves. As she notes, the world cannot have too many professional humanitarian responders.

“Unfortunately, we’re only going to see an increase in disasters and humanitarian emergencies, largely due to climate, but also forced and economic migration, war, and who knows what,” Dr. Johnson said. “And there’s too much at stake to have an ad hoc response.”

Gianna Falise, one of seven undergraduates who signed up for the course, is grateful for what she called “an amazing opportunity.” Halfway through SONHS one-year Accelerated Bachelor of Science in Nursing program, she hopes to pursue a career in disaster management and, having experienced SONHS’ hospital-based simulations, she knows there is no better way to learn.

“I am so excited I can’t stop talking about it,” she said. “For me, it’s kind of a stepping-stone to my future.”

Tags: disaster response, Dr. Antonia Eyssallenne, Dr. Elizabeth Greig, Miller School of Medicine, School of Nursing and Health Studies