Abstract
The West Coast of Aotearoa is classified as rural or remote rural (1). The Alpine Fault traverses the entirety of the 600km region and has a 75% chance of rupture causing a magnitude 8.1 earthquake within the next 60 years, codenamed by civil defence as ‘AF8’ (2). Primary health teams play a significant role in disaster response.
Methods
The first stage of research included a narrative literature review, focussing on Alpine Fault disaster modelling and disaster preparedness or response for rural/remote primary care teams in Australia and Aotearoa.
The second stage of the research involved semi-structured interviews with current general practitioners on the West Coast. Interviews took place via Zoom; data was transcribed, anonymised and considered using content analysis.
Ethics approval was attained through the UoO, approval 25/1319. Ngai Tahu Research Committee consultation was undertaken. Informed consent was attained from all participants.
Results
Literature review included 11 papers. Key findings included:
- The role of the GP in educating patients about preparedness, particularly regarding medication access (3).
- Establishing staff and personal response plans (4).
- Coordination within the organisation and inter-agency (3), including cultural (4).
- Addressing the practicalities of business continuity (5).
Three virtual semi-structured interviews were undertaken. All participants were general practitioners, who were currently practising in central Greymouth (R1) at practices funded by Te Whatu Ora. One participant attended weekly clinics in a more remote location.
Overall, participants revealed a general sense of not being fully prepared. The essential points considered:
- GPs were aware that plans for disaster management had been made, but they were unsure of the details and how it may relate to them.
- GPs sought clarity regarding their role in disaster response.
Discussion
Literature findings regarding business continuity practicalities were mentioned in interviews; however, participants felt that the information had not "flowed through to…frontline staff."
Interviewees noted uncertainty regarding staff organisation and their role in disaster response. This was a feature of literature findings. Concerns regarded the GP’s responsibility to the practice versus family, access to clinics, and communication amongst professionals. This was particularly relevant given the geography and facilities of the West Coast.
There was little mention of the GPs role in educating patients prior to disaster. Literature revealed that patient education regarding medication, vaccination, infection control, use of grab bags and access to resources would be beneficial. However, interviewees displayed agreement that the West Coast population is generally resilient, resourceful, and has a strong sense of community.
The key limitations of this paper included sample size (n=3) and participant characteristics. Because the interviews were conducted with practitioners working at the same R1, publicly funded/ TWO clinic, information may not represent views across the wider West Coast region.
Results from semi-structured interviews have revealed two key points for further exploration : dissemination of disaster preparedness actions to GPs, and role clarification for the GP in disaster.
Conclusions
The topography of the West Coast region and proximity to the Alpine Fault makes it vulnerable to devastation following an AF8 event.
Analysis of literature revealed four themes: patient education, personal preparedness, business continuity, and coordination and integration. Many of these points were mentioned by participants in semi-structured interviews. These revealed a general sense of a need for further disaster preparedness, particularly related to disseminating plans to clinicians, and clarification of the general practitioner’s role in disaster.