ORCID Profile
0000-0002-9734-5368
Current Organisation
Government of Western Australia Department of Health
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Publisher: Cambridge University Press (CUP)
Date: 04-2012
DOI: 10.1017/S1049023X12000489
Abstract: It is likely that calls for disaster medical assistance teams (DMATs) will continue in response to international disasters. As part of a national survey, the present study was designed to evaluate leadership issues and use of standards in Australian DMATs. Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. The response rate for this survey was estimated to be approximately 50% (59/118). Most of the personnel had deployed to the Asian Tsunami affected areas. The DMAT members were quite experienced, with 53% (31/59) of personnel in the 45-55 years of age group. Seventy-five percent (44/59) of the respondents were male. Fifty-eight percent (34/59) of the survey participants had significant experience in international disasters, although few felt they had previous experience in disaster management (5%, 3/59). There was unanimous support for a clear command structure (100%, 59/59), with strong support for leadership training for DMAT commanders (85%, 50/59). However only 34% (20/59) felt that their roles were clearly defined pre-deployment, and 59% (35/59) felt that team members could be identified easily. Leadership was identified by two team members as one of the biggest personal hardships faced during their deployment. While no respondents disagreed with the need for meaningful, evidence-based standards to be developed, only 51% (30/59) stated that indicators of effectiveness were used for the deployment. In this study of Australian DMAT members, there was unanimous support for a clear command structure in future deployments, with clearly defined team roles and reporting structures. This should be supported by clear identification of team leaders to assist inter-agency coordination, and by leadership training for DMAT commanders. Members of Australian DMATs would also support the development and implementation of meaningful, evidence-based standards. More work is needed to identify or develop actual standards and the measures of effectiveness to be used, as well as the contents and nature of leadership training. Aitken P, Leggat PA, Robertson AG, Harley H, Speare R, Leclercq MG. Leadership and use of standards by Australian disaster medical assistance teams: results of a national survey of team members. Prehosp Disaster Med. 2012 (2):1-6 .
Publisher: Royal Society of Chemistry (RSC)
Date: 2008
DOI: 10.1039/B713256P
Publisher: Informa UK Limited
Date: 2008
DOI: 10.3134/EHTJ.08.001
Publisher: Cambridge University Press (CUP)
Date: 02-2010
DOI: 10.1017/S1049023X00007585
Abstract: Recent events have heightened awareness of disaster health issues and the need to prepare the health workforce to plan for and respond to major incidents. This has been reinforced at an international level by the World Association for Disaster and Emergency Medicine, which has proposed an international educational framework. The aim of this paper is to outline the development of a national educational framework for disaster health in Australia. The framework was developed on the basis of the literature and the previous experience of members of a National Collaborative for Disaster Health Education and Research. The Collaborative was brought together in a series of workshops and teleconferences, utilizing a modified Delphi technique to finalize the content at each level of the framework and to assign a value to the inclusion of that content at the various levels. The framework identifies seven educational levels along with educational outcomes for each level. The framework also identifies the recommended contents at each level and assigns a rating of depth for each component. The framework is not intended as a detailed curriculum, but rather as a guide for educationalists to develop specific programs at each level. This educational framework will provide an infrastructure around which future educational programs in Disaster Health in Australia may be designed and delivered. It will permit improved articulation for students between the various levels and greater consistency between programs so that operational responders may have a consistent language and operational approach to the management of major events.
Publisher: AMPCo
Date: 2016
DOI: 10.5694/MJA15.00816
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.TMAID.2011.06.004
Abstract: Large scale Australian civilian medical assistance teams were first deployed overseas in 2004. The deployment of small Forward Teams in the early phase of a health disaster response allows for informed decisions on whether, and in what form, to deploy larger medical assistance teams. The prime consideration is to support the capacity of local services to respond to the specific needs of the affected population. In addition, Australian citizens caught up in large numbers in overseas disasters may need health assistance.
Publisher: Cambridge University Press (CUP)
Date: 31-01-2017
DOI: 10.1017/S1049023X16001382
Abstract: Specific knowledge and skills are required, especially in the first 72 hours post-disaster, to bridge the time gap until essential services are restored and Emergency Medical Services (EMS) can focus on in iduals’ needs. This study explores disaster knowledge and preparedness in the first 72 hours as a function of the in idual’s engagement in discussions about disasters, and several other factors (both at personal and community/country level), as well as the entities/organizations perceived by the in idual as being responsible for disaster risk reduction (DRR) education. A prospective, cross-sectional survey of 3,829 final-year high-school students was conducted in nine countries with different levels of disaster risk and economic development. Regression analyses examined the relationship between a 72-hour disaster preparedness composite outcome (ability to make water safe for drinking, knowledge of water potability, home evacuation skill, and improvising a safe room) and a series of independent predictors. Respondents from countries with lower economic development were significantly better prepared for the first 72 hours post-disaster than those from developed countries (OR=767.45 CI=13.75-48,822.94 P =.001). While several independent predictors showed a significant main effect, combined disaster risk education (DRE) efforts, as a partnership between school and local government, had the best predictive value (OR=3.52 CI=1.48-8.41 P =.005). Disaster preparedness in final-year high-school students is significantly better in developing countries. Further improvement requires a convergent effort in aligning the most effective educational policies and actions to best address the in idual’s and the community needs. Codreanu TA , Ngo H , Robertson A , Celenza A . Challenging assumptions: what do we need to address in our disaster risk reduction efforts? Prehosp Disaster Med . 2017 32 ( 2 ): 134 – 147 .
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1111/J.1753-6405.2011.00814.X
Abstract: To assess the impact of airborne lead dust on blood lead levels in residents of Esperance, a regional Western Australian town, with particular reference to preschool children. Following identification of significant airborne lead contamination, residents were notified that a blood lead clinic was available to all, with testing of preschool children encouraged. About 40% (333 children) of the preschool group and about 20% of the remaining population were tested. The main measures were blood lead levels, prevalence of elevated results and comparisons to other Western Australian surveys. In preschoolers, 2.1% (seven children) had blood lead levels exceeding the current 10 μg/dL level of concern. This was not significantly different to two previous community-based surveys elsewhere in Western Australia. However, at a lower cut-off of 5 μg/dL, the prevalence of elevated lead levels was 24.6%, significantly higher than children tested in a previous Western Australian survey. The prevalence of blood lead levels of 10 μg/dL or greater in adults was 1.3% (26 adults), not significantly different from a previous Western Australian survey. The prevalence of preschool children with blood lead levels exceeding the current level of concern was not significantly increased. However, the increased prevalence of children with lead levels at or above 5 μg/dL demonstrates exposure to lead dust pollution. This episode of lead dust contamination highlights the need for strict adherence to environmental controls and effective monitoring processes to ensure the prevention of future events.
Publisher: MDPI AG
Date: 05-02-2019
Abstract: Identification and profiling of current and emerging disaster risks is essential to inform effective disaster risk management practice. Without clear evidence, readiness to accept future threats is low, resulting in decreased ability to detect and anticipate these new threats. A consequential decreased strategic planning for mitigation, adaptation or response results in a lowered resilience capacity. This study aimed to investigate threats to the health and well-being of societies associated with disaster impact in Oceania. The study used a mixed methods approach to profile current and emerging disaster risks in selected countries of Oceania, including small and larger islands. Quantitative analysis of the International Disaster Database (EM-DAT) provided historical background on disaster impact in Oceania from 2000 to 2018. The profile of recorded events was analyzed to describe the current burden of disasters in the Oceania region. A total of 30 key informant interviews with practitioners, policy managers or academics in disaster management in the Oceania region provided first-hand insights into their perceptions of current and emerging threats, and identified opportunities to enhance disaster risk management practice and resilience in Oceania. Qualitative methods were used to analyze these key informant interviews. Using thematic analysis, we identified emerging disaster risk evidence from the data and explored new pathways to support decision-making on resilience building and disaster management. We characterized perceptions of the nature and type of contemporary and emerging disaster risk with potential impacts in Oceania. The study findings captured not only traditional and contemporary risks, such as climate change, but also less obvious ones, such as plastic pollution, rising inequality, uncontrolled urbanization, and food and water insecurity, which were perceived as contributors to current and/or future crises, or as crises themselves. The findings provided insights into how to improve disaster management more effectively, mainly through bottom-up approaches and education to increase risk-ownership and community action, enhanced political will, good governance practices and support of a people-centric approach.
Publisher: Elsevier BV
Date: 12-2003
Publisher: Frontiers Media SA
Date: 03-04-2017
Publisher: Wiley
Date: 30-03-2011
DOI: 10.1111/J.1440-1843.2011.01923.X
Abstract: As the world population expands, an increasing number of people are living in areas which may be threatened by natural disasters. Most of these major natural disasters occur in the Asian region. Pulmonary complications are common following natural disasters and can result from direct insults to the lung or may be indirect, secondary to overcrowding and the collapse in infrastructure and health-care systems which often occur in the aftermath of a disaster. Delivery of health care in disaster situations is challenging and anticipation of the types of clinical and public health problems faced in disaster situations is crucial when preparing disaster responses. In this article we review the pulmonary effects of natural disasters in the immediate setting and in the post-disaster aftermath and we discuss how this could inform planning for future disasters.
Publisher: Informa UK Limited
Date: 2008
DOI: 10.3134/EHTJ.09.004
Publisher: Elsevier BV
Date: 09-2009
DOI: 10.1016/J.TMAID.2009.03.001
Abstract: Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to pre- and post-deployment health care. Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. The response rate for this survey was estimated to be around 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45-55 years age group (31/59). Seventy-six percent of the respondents were male (44/58). Only 42% (25/59) received a medical check prior to departure and only 15% (9/59) received a psychological assessment prior to deployment. Most respondents indicated that both medical and psychological screening of personnel would be desirable. Most DMAT personnel received some vaccinations (83%, 49/59) before departure and most felt that they were adequately immunised. While nearly all DMAT members participated in formal debriefing post-deployment (93%, 55/59), far less received psychological debriefing (44%, 26/59), or a medical examination upon return (10%, 6/59). Three respondents reported experiencing physical ill health resulting in time off work following their return. While only one reportedly experienced any adjustment problems post-deployment that needed time off work, 32% (19/59) found it somewhat difficult to return to work. There were multiple agencies involved in the post-deployment debriefing (formal and psychological) and medical examination process including Emergency Management Australia (EMA), Australian Government, State/Territory Health Departments, District Health services and others. This study of Australian DMAT members suggests that more emphasis should be placed on health of personnel prior to deployment with pre-deployment medical examinations and psychological assessment. Following the return home, and in addition to mission and psychological debriefing, there should be a post-deployment medical examination and ongoing support and follow-up of DMAT members. More research is needed to examine deployment health support issues.
Publisher: Cambridge University Press
Date: 03-05-2010
Publisher: Oxford University Press (OUP)
Date: 08-2011
Abstract: On 16 April 2009, a boat carrying 47 Afghan asylum seekers and 2 Indonesian crew exploded in Australian waters, resulting in mass casualties. Of these casualties, 23 persons who suffered significant burns were transferred to Royal Perth Hospital, Perth, Western Australia. One patient was subsequently shown to be a hepatitis B virus (HBV) carrier at the time of the explosion. Over the following months, 3 other patients received a diagnosis of acute hepatitis B, and an additional 4 patients showed serological evidence of recent HBV infection, including 1 patient who was transferred to another Australian city. Molecular typing determined that the strains from the HBV carrier and the acute and recent case patients formed a closely related cluster, and the investigation suggested that transmission occurred at or around the time of the boat explosion. This is the first report of confirmed transmission of HBV following a disaster, and it reinforces the importance of postexposure prophylaxis for HBV in mass casualty situations.
Publisher: Elsevier BV
Date: 09-2009
DOI: 10.1016/J.TMAID.2009.03.005
Abstract: Disaster medical assistance teams (DMATs) have responded to numerous international disasters in recent years. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to health and safety aspects of actual deployment. Data were collected via an anonymous mailed survey distributed by State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the time of the 2004 South East Asian tsunami disaster. The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45-55 years age group (31/59) and a mean level of clinical experience of 21 years. 76% of the respondents were male (44/58). Once deployed, most felt that their basic health needs were adequately met. Almost all stated there were adequate shelter (95%, 56/59), adequate food (93%, 55/59) and adequate water (97%, 57/59). A clear majority, felt there were adequate toilet facilities (80%, 47/59), adequate shower facilities (64%, 37/59) adequate hand washing facilities (68%, 40/59) and adequate personal protective equipment (69%, 41/59). While most felt that there were adequate security briefings (73%, 43/59), fewer felt that security itself was adequate (64%, 38/59). 30% (18/59) felt that team members could not be easily identified. The optimum shift period was identified as 12h (66%, 39/59) or possibly 8h (22%, 13/59) with the optimum period of overseas deployment as 14-21 days (46%, 27/59). Missing essential items were just as likely to be related to personal comfort (28%) as clinical care (36%) or logistic support (36%). The most frequently nominated personal items recommended were: suitable clothes (49%, 29/59) toiletries (36%, 22/59) mobile phone (24%, 14/59) insect repellent (17%, 10/59) and a camera (14%, 8/59). The most common personal hardship reported during their deployment was being away from home roblems at home (24%, 14/59) however, most felt that their family was adequately informed of their whereabouts and health status (73%, 43/59). This study of Australian DMAT members suggests that, in the field, attention should be given to basics, such as adequate food, water, shelter and personal hygiene as well as appropriate clothing, sunscreen and vector protection. The inclusion of appropriate personal items can be assisted by provision of a minimum suggested personal equipment list, with local conditions and the nature of the deployment being taken into account. A personal survival kit should also be recommended. There should be medical and psychological support for team members themselves, including the provision of a dedicated team member medical cache. Concern for their own health and ability to communicate with family members at home are major issues for deployed team members and need to be addressed in mission planning. This should also recognise security issues, including briefings, evacuation plans and exit strategies. The team members concerns about adequate security and the risk profile of humanitarian intervention in natural disasters compared with complex humanitarian emergencies may help determine future deployment of civilian or defence based teams.
Publisher: Wiley
Date: 04-02-2011
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/AH10901
Abstract: This article reviews the lessons that can be learned by the health sector, in particular, and the public sector, more generally, from the governmental response to pandemic (H1N1) 2009 influenza A (pH1N1) in Australia during 2009. It covers the period from the emergence of the epidemic to the release of the vaccine, and describes a range of impacts on the Western Australian health system, the government sector and the community. There are three main themes considered from a State government agency perspective: how decisions were influenced by prior planning how the decision making and communication processes were intimately linked and the interdependent roles of States and the Commonwealth Government in national programs. We conclude that: (a) communications were generally effective, but need to be improved and better coordinated between the Australian Government, States and general practice (b) decision making was appropriately flexible, but there needs to be better alignment with expert advice, and consideration of the need for a national disease control agency in Australia and (c) national funding arrangements need to fit with the model of state-based service delivery and to support critical workforce needs for surge capacity, as well as stockpile and infrastructure requirements. What is known about the topic? There have been a number of articles on pandemic (H1N1) 2009 influenza in Australia that have provided an overview of the response from a Commonwealth Government perspective, as well as specific aspects of the State response (e.g. virology, impact on intensive care units across Australia, infection control). Victoria, Queensland and NSW have published papers more focussed on epidemiology and an overview of public health actions. What does this paper add? This would be the first in-depth account of the response that both details a broader range of impacts and costs across health and other State government agencies, and also provides a critical reflection on governance, communication and decision making arrangements from the beginning of the pandemic to the start of the vaccination program. What are the implications for practitioners? Practitioners (clinical, public health, and laboratory) would recognise the importance of the workforce and surge capacity issues highlighted in the paper, and the extent to which they were stretched. Addressing these issues is vital to meeting practitioner needs in future pandemic seasons. Policy makers would see the relevance of the observations and analysis to governance arrangements within a Federal system, where the majority of funding is provided from the Commonwealth level, whereas service delivery responsibilities remain with the States and Territories. In particular, the argument to consider a national disease control agency along the lines of the US and UK will be of interest to public health and communicable disease practitioners in all States and Territories, as it would affect how and where policy and expert advice is created and used.
Publisher: SAGE Publications
Date: 07-2012
Abstract: On March 11, 2011, a magnitude 9.0 earthquake occurred off the Sanriku coast of Japan, which resulted in multiple tsunamis. The earthquake and tsunami damaged several nuclear power stations, with the Fukushima Dai-ichi Nuclear Power Plant being the worst affected, which led Japan to declare a State of Nuclear Emergency. As of November 9, 2011, the National Police Agency of Japan reported a death toll of 15 836 people, with 3664 people still reported missing, following the earthquake and tsunami. Australian radiation health advisers were deployed to Tokyo early in the nuclear emergency to assist the Australian Embassy in assessing the radiological threat, to provide risk advice to Embassy staff and Australian citizens in Japan, and to plan for any further deterioration in the nuclear situation. This article explores the challenges of risk assessment, risk communication, and contingency planning for expatriate staff in the worst nuclear incident since Chernobyl, outlines what measures were successful in addressing heightened perceived risks, and identifies areas where further research is required, particularly in a radiological context.
Publisher: Elsevier BV
Date: 12-2015
Abstract: To determine which measures of heatwave have the greatest predictive power for increases in health service utilisation in Perth, Western Australia. Three heatwave formulas were compared, using Poisson or zero-inflated Poisson regression, against the number of presentations to emergency departments from all causes, and the number of inpatient admissions from heat-related causes. The period from July 2006 to June 2013 was included. A series of standardised thresholds were calculated to allow comparison between formulas, in the absence of a gold standard definition of heatwaves. Of the three heatwave formulas, Excess Heat Factor (EHF) produced the most clear dose-response relationship with Emergency Department presentations. The EHF generally predicted periods that resulted in a similar or higher rate of health service utilisation, as compared to the two other formulas, for the thresholds examined. The EHF formula, which considers a period of acclimatisation as well as the maximum and minimum temperature, best predicted periods of greatest health service demand. The strength of the dose-response relationship reinforces the validity of the measure as a predictor of hazardous heatwave intensity. The findings suggest that the EHF formula is well suited for use as a means of activating heatwave plans and identifies the required level of response to extreme heatwave events as well as moderate heatwave events that produce excess health service demand.
Publisher: Cambridge University Press (CUP)
Date: 02-2011
DOI: 10.1017/S1049023X10000087
Abstract: Introduction: Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. Objective: As part of a national survey, the present study was designed to evaluate the education and training of Australian DMATs. Methods: Data were collected via an anonymous, mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Southeast Asia tsunami disaster. Results: The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the tsunami-affected areas. The DMAT members were quite experienced, with 53% of personnel in the 45–55-year age group (31/59). Seventy-six percent of the respondents were male (44/58). While most respondents had not participated in any specific training or educational program, any kind of relevant training was regarded as important in preparing personnel for deployment. The majority of respondents had experience in disasters, ranging from hypothetical exercises (58%, 34/59) to actual military (41%, 24/49) and non-governmental organization (32%, 19/59) deployments. Only 27% of respondents felt that existing training programs had adequately prepared them for deployment. Thirty-four percent of respondents (20/59) indicated that they had not received cultural awareness training prior to deployment, and 42% (25/59) received no communication equipment training. Most respondents felt that DMAT members needed to be able to handle practical aspects of deployments, such as training as a team (68%, 40/59), use of communications equipment (93%, 55/59), ability to erect tents/shelters (90%, 53/59), and use of water purification equipment (86%, 51/59). Most respondents (85%, 50/59) felt leadership training was essential for DMAT commanders. Most (88%, 52/59) agreed that teams need to be adequately trained prior to deployment, and that a specific DMAT training program should be developed (86%, 51/59). Conclusions: This study of Australian DMAT members suggests that more emphasis should be placed on the education and training. Prior planning is required to ensure the success of DMAT deployments and training should include practical aspects of deployment. Leadership training was seen as essential for DMAT commanders, as was team-based training. While any kind of relevant training was regarded as important for preparing personnel for deployment, Australian DMAT members, who generally are a highly experienced group of health professionals, have identified the need for specific DMAT training.
Publisher: Informa UK Limited
Date: 2008
DOI: 10.3134/EHTJ.08.004
Publisher: Cambridge University Press (CUP)
Date: 17-07-2018
DOI: 10.1017/S1049023X18000535
Abstract: The World Association for Disaster and Emergency Medicine (WADEM Madison, Wisconsin USA) is a multi-disciplinary professional association whose mission is the global improvement of prehospital and emergency health care, public health, and disaster health and preparedness. In April 2017, the biennial general meeting of the World Congress for Disaster and Emergency Medicine (WCDEM) endorsed the WADEM Climate Change Position Statement, which was subsequently published in Prehospital and Disaster Medicine in July 2017. This special report examines literature used and reviews the process of development of this Position Statement as a product of WADEM. Cuthbertson J, Archer F, Robertson A. Special report: WADEM climate change position statement. Prehosp Disaster Med. 2018 (4):428–431
Location: No location found
Location: Australia
Location: Australia
No related grants have been discovered for Andrew Robertson.