Victims of the Victorian bushfires can benefit from lessons learned through previous disasters, according to an editorial in the Medical Journal of Australia.
Alexander McFarlane, Professor of Psychiatry at the Centre for Military and Veterans' Health at the University of Adelaide, and Beverley Raphael, Professor of Psychological Medicine at the Australian National University, say contemporary Australian research, drawing on the experience of victims of previous disasters, should help shape the care provided.
"The willingness of victims of previous Australian disasters to participate in disaster research has resulted in the capture of many lessons ... This knowledge needs to be used in the coming months so that the lessons already learned do not have to be rediscovered, as is too often the case after disasters. Future studies should build on what we already know.
"Studies, mainly by Australian researchers, have shown that the most important early responses involve protecting and comforting those most directly affected, linking them to loved ones and sources of support, and ensuring assessment and follow-up," the authors say.
"A crucial issue is the central role of the GP in the provision of post-disaster services, as shown in a study of ... victims of the 1983 Ash Wednesday bushfires.
"Local communities have a preference for their GP's services in the post-disaster period, but they are also likely to need access to community recovery services for practical assistance and resources. Where possible, such services provided after the fires in Victoria should be linked to local clinics to facilitate access to health care."
The editorial says caring for bereaved patients in the early stages requires allowing them to talk about their loved ones, and helping them through disaster victim identification and other formal processes.
"A lesson from the Ash Wednesday fires is that victims often delay seeking care for at least 18 months, despite experiencing considerable suffering. When they do present to GPs, it is often with physical symptoms, and the significance of these is missed.
The authors suggest that one possible approach in the aftermath of the Victorian fires is for GPs in affected areas to screen all presenting patients for depression, post-traumatic stress disorder and alcohol misuse.
"Clinical guidelines demonstrate that this approach leads to better outcomes if the screening is linked to adequate clinical services.
The authors also suggest members of the emergency services are deserving of particular attention because of the prolonged intensity of their exposure to the disaster.
"The community owes them a special duty of care."