Some of the most vulnerable people during a disaster also are our youngest. Children have difficulty understanding what is happening during a disaster and are less able to cope with the stress that disasters bring. In emergencies – like new diseases or bioterrorism – that require drugs or other medical products, children’s needs may be different than adults. Children may be too young to swallow pills so they would need liquid or nose spray medications, and medical devices would need to fit for their little bodies. ASPR is committed to ensuring all residents – including the youngest – are protected in public health emergencies.
Building partnerships
ASPR and the Administration for Children and Families (ACF) created the Children’s HHS Interagency Leadership in Disasters (CHILD) Working Group in February 2010 to integrate the needs of children into all HHS disaster planning activities and operations, including preparedness, response, and recovery activities.
The needs of children in a disaster can be very different from the needs of adults. The working group focused on seven key areas that impact children’s health in a disaster: 1) behavioral health; 2) medical products; 3) physical health, emergency medical services (EMS), and pediatric transport; 4) child care and child welfare; 5) support for pregnant and breastfeeding women and newborns; 6) children with special health care needs; and 7) enhancing collaboration across government and with non-governmental organizations.
The CHILD Working Group assessed existing capabilities and coordinated across HHS on policies and emergency response. The group made recommendations HHS leaders that would help the department address the health and human services needs of children during and after disasters or other public health emergencies. The activities and accomplishments of the group are summarized in the 2011 Update on Children and Disasters and the 2012-2013 CHILD Report.
ASPR also leads the HHS Preparedness for Pregnant Women Working Group; the Coordinating Council on Women’s Health, part of the HHS Office of Women’s Health, coordinates and supports this working group. Members from across the department provide subject matter expertise and work with programs that reach pregnant women. The working group integrates the needs of pregnant women into all disaster and public health emergency preparedness, response, and recovery activities across HHS.
In 2013, the Pandemic and All-Hazards Preparedness Reauthorization Act established a new National Advisory Committee on Children and Disasters. This advisory committee brings together health care professionals from outside the government who provide expert advice to HHS on the medical and public health needs of children in disasters, such as recommendations on drugs, vaccines, diagnostic tests, and medical devices needed to protect children’s health in emergencies.
Leading change
The Public Health Emergency Medical Countermeasure Enterprise (PHEMCE) established the Pediatric and Obstetric Integrated Program Team to assist HHS with strategies for identifying, developing, acquiring, deploying, and using high priority medical products for children and pregnant women in all public health emergencies. Through the PHEMCE, five federal agencies collaborate to decide what medical products should be developed and purchased to protect children in emergencies, such as plague, inhalational anthrax, influenza, and botulism.
The National Disaster Medical System now deploys pediatric specialists, when needed, as part of traditional medical response teams. The U.S. Public Health Service Commissioned Corps also has pediatric specialists who can deploy on medical teams to provide care in disaster areas. In addition, ASPR partnered with ambulance companies and EMS to craft a national strategy to move hundreds of pediatric patients in a large disaster.
Raising awareness
ASPR and CDC co-led a working through that made sure preparedness was part of Healthy People 2020, HHS’ science-based, 10-year strategy. The working group added 16 new objectives for preparendess, four about preparedness for children needs in disasters. The group used data from CDC, FEMA, and Save the Children to write the objectives. The Healthy People 2020 objectives encourage preparedness activities in schools and child care settings.
Leveraging social media, ASPR hosted Twitter chats at least annually to provide information, resources, and tools that help families protect children, newborns, and pregnant women in disasters. Federal and non-federal partners, including the American Academy of Pediatrics and New York Times best-selling author Heidi Murkoff, joined these events to raise awareness of the health needs of children’s and pregnant women in disasters.
The path forward
In just the last year, the Flint water crisis and Zika have threatened the health of children. ASPR continues to play a critical role in promoting the integration and coordination of children’s health needs in emergencies so that we can better protect health when disaster strikes.
