從水患對健康的影響談家庭醫學中災難醫學的訓練內容：南臺灣某醫學中心的經驗

The Impact of the Floods on Health and the Need for Disaster Medicine Training in Family Medicine in Taiwan

一如日常的執業，每當災難發生時，基層醫師總是站在社區的第一線，處理災難中送達的病患。因此，應該如何於災難時適切的反應和如何與其他機構協調合作，減少社區的損失，促進民眾健康，是基層醫師必須學習的內容之一。依據統計，美國國內的自然災害75%源自於颶風和水患。台灣也是如此，颱風和水災是台灣最常見的自然災害。由於氣候暖化，全球暴風雨發生的頻率和洪災可能持續升高，因此家庭醫師對於水災帶來健康的影響和處置，應該具有基本的認識。雖然目前國內家庭醫學住院醫師訓練尚無相關災難醫學之要求，但美國於2003年即訂定了相關課程之指引，並於2010年做了最新修訂。該修訂雖然仍然缺少充分的實證依據，本文仍然引用該災難醫學訓練之指引及其實證探討，做為國內家庭醫學教育之參考。

As those who see patients daily, family physicians are always at the front lines serving those injured in disasters. Therefore, primary care physicians must know how to respond effectively and cooperate appropriately with other organizations so as to minimize community loss and promote civil health in disasters. Just as tropical storms and floods comprise 75% of natural disasters in the United States, typhoons and floods are also the commonest natural disasters in Taiwan. Recent weather cycles may indicate an increase in the frequency of storms and sequential floods. Therefore, Taiwan family physicians must understand the impact of floods on health and how to manage the related disaster conditions. While family medicine training in Taiwan currently has no requirements for disaster medicine training, curriculum guidelines were developed in 2003 in the United States (revised 2010). We herein introduce these guidelines, although with limited outcome-based evidence, as a reference for developing disaster medicine training as a part of family medicine education in Taiwan.