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Being Both Helpers and Victims: Health Professionals’ Experiences of Working During a Natural Disaster

  • Karin Hugelius (a1) (a2), Annsofie Adolfsson (a1), Per Örtenwall (a3) and Mervyn Gifford (a1)

In November 2013, the Haiyan typhoon hit parts of the Philippines. The typhoon caused severe damage to the medical facilities and many injuries and deaths. Health professionals have a crucial role in the immediate disaster response system, but knowledge of their experiences of working during and in the immediate aftermath of a natural disaster is limited.


The aim of this study was to explore health professionals’ experiences of working during and in the immediate aftermath of a natural disaster.


Eight health professionals were interviewed five months after the disaster. The interviews were analyzed using phenomenological hermeneutic methods.


The main theme, being professional and survivor, described both positive and negative emotions and experiences from being both a helper, as part of the responding organization, and a victim, as part of the surviving but severely affected community. Sub-themes described feelings of strength and confidence, feelings of adjustment and acceptance, feelings of satisfaction, feelings of powerless and fear, feelings of guilt and shame, and feelings of loneliness.


Being a health professional during a natural disaster was a multi-faceted, powerful, and ambiguous experience of being part of the response system at the same time as being a survivor of the disaster. Personal values and altruistic motives as well as social aspects and stress-coping strategies to reach a balance between acceptance and control were important elements of the experience. Based on these findings, implications for disaster training and response strategies are suggested.

Hugelius K , Adolfsson A , Örtenwall P , Gifford M . Being Both Helpers and Victims: Health Professionals’ Experiences of Working During a Natural Disaster. Prehosp Disaster Med. 2017;32(2):117123.

Corresponding author
Correspondence: Karin Hugelius, RN, RNA, MSc School of Health Sciences Örebro University Örebro, Sweden E-mail:
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Conflicts of interest/funding: The study was financed by contributions from Fortifikationsforeningens Forskningsfond (Foundation of Fortification-Related Research) and Orebro County Council Research Committee (Orebro, Sweden).
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1. World Health Organization. Public health risk assessment and interventions – Typhoon Haiyan, Philippines 16 November 2013. philippines_ph_risk_assessment_16November2013.pdf. Accessed August 12, 2015.
2. UN Office for the Coordination of Humanitarian Affairs. Philippines; Typhoon Haiyan. Situation Report No. 20 (as of December 3, 2013). philippines-typhoon-haiyan-situation-report-no-20-3-december-2013. Accessed August 12, 2015.
3. The International Disaster Database. EM-DAT. Center for Research on the Epidemiology of Disasters; 2014. Accessed September 9, 2013.
4. Global Facility for Disaster Reduction and Recovery (GFDRR). Typhoon Yolanda Ongoing Recovery. Recovery Framework Case Study. August 2014. Accessed February 2, 2015.
5. World Health Organization. Typhoon Haiyan (Yolanda), Philippines, External Situation Report, No. 1, November 15, 2013. typhoon_haiyan/media/Sitrep_17Nov2013.pdf?ua=1. Accessed December 4, 2015.
6. Gerdin, M, Clarke, M, Allen, C, et al. Optimal evidence in difficult settings: improving health interventions and decision making in disasters. PLOS Med. 2014;11(4):1-4.
7. Birnbaum, ML, Daily, EK, O’Rourke, AP, Loretti, A. Research and evaluation of the health aspects of disasters, Part II: the disaster health conceptual framework revisited. Prehosp Disaster Med. 2015;30(5):523-538.
8. Katz, CL. “Psychiatric Evaluation.” In: Stoddard F, Padya A, Katz CL, (eds). Disaster Psychiatry: Readiness, Evaluation, and Treatment. September 2012 ed. Washington USA: Group for the Advancement of Psychiatry; 2012.
9. Doocy, S, Dick, A, Daniles, A, Kirsch, TD. The human impact of tropical cyclones: a historical review of events 1980-2009 and systematic literature review. PLOS Curr. 2013;16:5.
10. Stallings, R. “Methodological Issues.” In: Rodriguez H, Quarantelli EL, Dynes RR, (eds). Handbook of Disaster Research. 1st ed. New York, USA: Springer Science; 2007: 55-82.
11. von Schreeb, J. Needs assessments for international humanitarian health assistance in disasters. Theses for doctoral degree. Solna, Sweden: Division of Global Health, Karolinska Intitutet Medical University; 2007.
12. Birnbaum, ML, Daily, EK, O’Rourke, AO, Loretti, A. Research and evaluations of the health aspects of disasters, Part 1: an overview. Prehosp Disaster Med. 2015;30(5):512-538.
13. Brolin, K, Hawajri, O, von Schreeb, J. Foreign Medical Teams in the Philippines after Typhoon Haiyan 2013 - who were they, when did they arrive, and what did they do? PLOS Curr. 2015;5:7.
14. Merin, O, Kreiss, Y, Lin, G, Pras, E, Dagan, D. Collaboration in response to disaster typhoon Yolanda and an integrative model. N Engl J Med. 2014;370(13):1183-1184.
15. Kirsch, T, Sauer, L, Guha Sapir, D. Analysis of the international and US response to the Haiti earthquake: recommendations for change. Disaster Med Public Health Prep. 2012;6(3):200-208.
16. Zhang, L, Liu, X, Li, Y, et al. Emergency medical rescue efforts after a major earthquake: lessons from the 2008 Wenchuan earthquake. Lancet. 2012;2(379):853-861.
17. Berger, W, Coutinho, ES, Figueira, I, et al. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):1001-1011.
18. Gerdin, M, Wladis, A, von Scrheeb, J. Foreign field hospitals after the 2010 Haiti earthquake: how good were we? Emerg Med J. 2013;30(1):1-5.
19. Baack, S, Alfred, D. Nurses’ preparedness and perceived competence in managing disasters. J Nurs Scholarsh. 2013;45(3):281-287.
20. Abolghasemi, H, Radfar, M, Khatami, M, Nia, M, Amid, A, Briggs, S. International medical response to a natural disaster: lessons learned from the Bam Earthquake experience. Prehosp Disaster Med. 2006;21(3):141-217.
21. Baker, ND, Feldman, MS, Lowerson, V. Working through disaster: re-establishing mental health care after Hurricane Katrina. Disaster Med Public Health Prep. 2012;7(3):222-227.
22. Geisz-Everson, MA, Dodd-McCue, D, Bennett, M. Shared experiences of CRNAs who were on duty in New Orleans during Hurricane Katrina. AANA J. 2012;80(3):205-212.
23. Adams, T, Turner, M. Professional responsibilities versus familial responsibilities: an examination of role conflict among first responders during the Hurricane Katrina disaster. J Emerg Manag. 2014;12(1):45-54.
24. Michel, PO. Insatsrelaterad stress hos civil personal- En litteraturöversikt [in Swedish]. (Stress related to operations among civilian personnel; Governmental review of veterans’ health). Veteranutredningen Vol 2, Bilaga 7. 2014.
25. OPSIC-Project. The comprehensive guideline on mental health and psychosocial support (MHPSS) in disaster settings. Accessed March 20, 2016.
26. Hobfoll, S, Watson, P, Bell, C, et al. Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry. 2007;70(4):221-242.
27. Halpern, J, Gurevich, M, Schwartz, B, Brazeau, P. Interventions for critical incident stress in Emergency Medical Services: a qualitative study. Stress & Health. 2009;25(2):139-149.
28. Daily, E, Padjen, P, Birnbaum, M. A review of competences developed for disaster health care providers: limitations of current process and applicability. Prehosp Disaster Med. 2010;25(5):387-395.
29. Lazarus, RS. Coping theory and research: past, present, and future. Psychosom Med. 1993;55(3):234-247.
30. Folkman, S. Personal control and stress and coping processes: a theoretical analysis. J Pers Soc Psychol. 1984;46(4):839-852.
31. Bonanno, GA. Regulatory flexibility: an individual differences perspective on coping and emotion regulation. Perspect Psychol Sci. 2013;8(6):591-612.
32. Hobfoll, SE. Conservation of resources and disaster in cultural context: the caravans and passageways for resources. Psychiatry. 2012;75(3):227-232.
33. Southwick, SM, Bonanno, GA, Masten, AA, Panter- Brick, C, Yehda, R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. 2014;1(5).
34. Norris, FH. Epidemiology of trauma: frequency and impact of different potentially traumatic events on different demographic groups. J Consult Clin Psychol. 1992;60(3):409-418.
35. Bonanno, G, Westphal, M, Mancini, A. Resilience to loss and potential trauma. Review. Annu Rev Clin Psychol. 2011;7(5):11-35.
36. Southwick, SM, Charney, DS. Resilience. The Science of Mastering Life’s Greatest Challenges. First ed. New York USA: Cambridge University Press; 2012.
37. Lindseth, A, Norberg, A. A phenomenological hermeneutical method for researching lived experience. Scand J Caring Sci. 2004;18(2):145-153.
38. Coyne, ITC. Sampling in qualitative research. Purposeful and theoretical sampling: merging or clear boundaries? J Adv Nurs. 1997;26(3):623-630.
39. Ricoeur, P. From explaining to understanding: the model of the text. Meaningful action considered as a text. New Literacy History.” In: Singsuriya P. Nursing researchers’ modification of Ricoeur’s hermeneutic phenomenology. Nurs Inq. 2015;22(4):348-358.
40. Geanellos, R. Exploring Ricoeur’s hermeneutic theory of interpretation as a method of analyzing research texts. Nurs Inq. 2000;7(24):112-119.
41. Charalambous, A, Papadopoulos, R, Beadsmoore, A. Ricoeur’s hermeneutic phenomenology: an implication for nursing research. Scand J Caring Sci. 2008;22(1):637-642.
42. Philippine Council for Health Research and Development. National Ethical Guidelines for Health Research. 2006. Accessed December 4, 2015.
43. Folkman, S, Moskowitz, J. Coping: pitfalls and promise. Annu Rev Psychol. 2004;55(1):745-774.
44. Lazarus, RS. Emotions and interpersonal relationships: toward a person-centered conceptualization of emotions and coping. J Pers. 2006;74(1):9-46.
45. Norris, FH, Stevens, PS, Pfefferbaum, B, Wyche, KF, Pfefferbaum, RL. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. Am J Community Psychol. 2008;41(1-2):127-150.
46. Kaiser, CF, Sattler, DN, Bellak, DR, Dersin, J. A conservation of resources approach to a natural disaster: sense of coherence and psychological distress. J Soc Behav Pers. 1996;11(3):459-476.
47. Slepski, LA. Emergency preparedness and professional competency among health care providers during Hurricanes Katrina and Rita: pilot study results. Disaster Manag Response. 2007;5(4):99-110.
48. Wietsse, AT, Barui, C, Galappatti, A, et al. Mental health and psychosocial support in humanitarian settings; linking practice and research. Lancet. 2011;378(9802):1581-1591.
49. Hugelius, K, Gifford, M, Ortenwall, P, Adolfsson, A. To silence the deafening silence: experiences of the impact of disaster radio for survivor’s wellbeing after a natural disaster. Int Emerg Nurs. 2016;28:8-13.
50. Polit, D, Beck, C. Generalization in quantitate and qualitative research: myths and strategies. Int J Nurs Stud. 2010;47(11):1451-1458.
51. Grimm, A, Hulse, L, Preiss, M, Schmidt, S. Behavioral, emotional, and cognitive response in European disasters: results of survivor interviews. Disasters. 2014;38(1):62-83.
52. Girratano, G, Savage, J, Barcelona-deMendoza, V, Harville, EW. Disaster research: a nursing opportunity. Nurs Inq. 2013;29(3):259-268.
53. Benight, CC, McFarlane, AC. Challenges for disaster research: recommendations for planning and implementing disaster mental health studies. J Loss Trauma. 2007;12(5):419-434.
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Prehospital and Disaster Medicine
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