Gendered dimensions of disaster care: Critical distinctions in female psychosocial needs, triage, pain assessment, and care

Abstract

Objective: This research highlights and identifies some critical distinctions in female disaster care including the following: socially constructed gender risk factors; gender and posttraumatic stress; women and pain (presentation and sensitivity); and postdisaster support and services, especially in the arenas of obstetrics and gynecology (breastfeeding, menstruation, contraception, rape, and sexually transmitted disease [STDs]). The research also includes a brief, anonymous survey of 50 adult female Hurricane Katrina evacuees which queried women on their usage of postdisaster health and counseling services.Conclusions: Our literature review shows a pattern of gender differentiation in all areas of the disaster process—in preparedness, response, physical and psychological impact, risk perception and exposure, recovery, and reconstruction. Some research highlights include: six disaster gender risk factors affecting vulnerability, impact and exposure; heightened risks and differing clinical manifestations of posttraumatic stress disorder and pain presentation; “pregnancy status” triage screening; as well gender-sensitive supplies and services (private breastfeeding and obstetrics and gynecology (OB/GYN) exam areas, birth control, feminine hygiene, and prenatal nutrition advocacy). The results of the small voluntary survey are presented that supports the contention that many gender-sensitive services were needed in posthurricane Katrina clinical settings, but were inadequate or nonexistent.This research not only identified issues, but emphasized feasible interventions, which could significantly reduce pain, suffering, and long-term postdisaster care costs. The research’s most important conclusions are the current dearth of gender-disaggregated disaster data, as well as the tremendous need for disaster healthcare planners and providers to take a more cognizant and proactive approach to gender-specific care in triage, psychosocial needs assessment, medical care, and advocacy.