Czaicki Adam Edward, Fabrigas Gloria, Gocotano Allison, Hall Julie Lyn
Office of the WHO Representative in the Philippines, Sta Cruz, Manila, Philippines .
Mayor Alfred's Social Action Health Service Unit (MASA), Tacloban City, Philippines .
Western Pac Surveill Response J. 2015 Nov 6;6 Suppl 1(Suppl 1):96-101. doi: 10.5365/WPSAR.2015.6.2.HYN_016. eCollection 2015 Oct-Dec.
Evidence on alcohol use following disasters is scarce. After Typhoon Haiyan in the Philippines we wanted to determine whether there were alcohol-related problems among the disaster survivors and to strengthen the appropriate local health service support in Tacloban City.
Tacloban City is a highly urbanized city that was one of the areas worst hit by Typhoon Haiyan. Prior to Haiyan there was very little support for people with alcohol problems, and the rehabilitation facility was located about 40 km away.
A pilot community-based alcohol intervention programme was conducted that included: assessment of the extent of alcohol problems in the community and health-care workers baseline knowledge and skills; training of health-care workers on primary care alcohol intervention provision; and community outreach with post-training supervision.
The alcohol screening found 26 (22%) of those attending health care facilities would benefit from some form of alcohol intervention. Health-care workers knowledge on basic alcohol intervention was low. This was strengthened during the training, and at outreach clinics the trained health-care workers were able to identify people with alcohol problems and provide them with treatment plans.
We learnt that there was a problem with alcohol in Tacloban City and that it was possible to run an alcohol intervention programme in the community using minimal resources. Addressing alcohol-related issues in the community is an important public health intervention. While there is a need for policies and guidelines at the national level, a community-based intervention is possible to establish with referral mechanism to specialized care. Training modules for such programs can be further developed and institutionalized.
关于灾难后饮酒情况的证据很少。在菲律宾遭遇台风海燕后,我们想确定灾难幸存者中是否存在与酒精相关的问题,并加强塔克洛班市当地适当的卫生服务支持。
塔克洛班市是一个高度城市化的城市,是受台风海燕影响最严重的地区之一。在海燕来袭之前,对有酒精问题的人几乎没有支持,康复设施位于约40公里外。
开展了一项基于社区的酒精干预试点项目,包括:评估社区中酒精问题的程度以及医护人员的基线知识和技能;对医护人员进行初级保健酒精干预提供方面的培训;以及在培训后监督下进行社区外展活动。
酒精筛查发现,在前往医疗机构就诊的人群中,有26人(22%)将从某种形式的酒精干预中受益。医护人员对基本酒精干预的知识水平较低。在培训过程中这一情况得到了加强,在社区外展诊所,经过培训的医护人员能够识别出有酒精问题的人,并为他们提供治疗方案。
我们了解到塔克洛班市存在酒精问题,并且利用最少的资源在社区开展酒精干预项目是可行的。解决社区中与酒精相关的问题是一项重要的公共卫生干预措施。虽然国家层面需要政策和指导方针,但通过建立转介到专科护理的机制,基于社区的干预是可以建立起来的。此类项目的培训模块可以进一步开发并制度化。