Transcript Bangladesh FMT (RDR Track: Experience

EARLY DISASTER REHAB RESPONSE :
NEPAL 2015 EQ
LESSONS LEARNT IN THE FIELD
Professor Taslim Uddin,
MBBS, FCPS
Faculty of Medicine: Dept of PMR
BSM Medical University, Dhaka-1000.
Bangladesh
Email: [email protected]
Introduction
FMTs working onsite at the ground
immediately after the disaster have multiple
challenges that needs to be notified for
future reference
Bangladesh FMT Nepal EQ2015 disaster
Rehab Response : in-depth and Challenges
EARLY DISASTER REHAB RESPONSE:
NEPAL 2015 EQ:
Bangladesh FMT Process
• Initial planning , fund raising and FMT
organization
• Process of FMT registration
• International , disaster affected country and local
health center Communication : very promising
and really required
Planning meetings
and Mission needs
assessments
FMT accreditation
by WHO and
MoHP Nepal
Nepal, Ban, India (SAARC countries)
: Geo-location
Bangladesh FMT in Nepal EQ
Dr AMS Maharajan
Dr Jas B Gurung,
Dr Raju Dakhal
Mrs. Sheela G Dakhal
EARLY DISASTER REHAB RESPONSE : NEPAL
2015 EARTHQUAKE
LESSONS LEARNT IN THE FIELD: inputs for Do, and Don’t’s
Huge inputs, links with varied suggestions;
professionals with earlier experiences
Do,s and Don’t,s in the field made easy
access to Nepal Disaster Rehab
FMTs worked in Nepal Earthquake ( A section
of ?128 FMTs)
•
Medical Emergency Response Team (MERT)
• Bangladesh Association of Physical Medicine and Rehabilitation
•
Medical Help World Bharatiya Jain Sanghathan
• Mercy Malaysia
•
•
•
•
•
•
CBM International
Nepal Disaster and Emergency Medicine
Centre for International Studies and Cooperation OATH
Chandrajyoti Integrated Rural Development Society (CIRDS)
Plan International
Chiang Mai University Maharat Hospital
• Royal Melbourne Hospital
•
ChildFund International
… WHO
Musculoskeletal (MSK) and limb injuries
literacy and Human development Index of the
disaster affected community
• Most of the earth quake injuries (70%) both in the
developed and developing countries are involving limbs
and MSK ( Rehab FMT trained in MSK preferred to be deployed in EQ)
• SCI much less in the developed country disasters in the
recent days
References:
doi:
org/10.3920/978-90-8686-806-3_15
1. Orthopedics, October 2000; (23): 10: 1085-87
2.World J Surg. 2014:38(10): pp2543-50
3.MSK injuries following EQ: Published Online: February 11, 2015:
FMT Reporting/ attending
meetings
• FMT keeping records
and daily reporting :
despite of the workloads
and poor internet,
• Attending to other
centers and MoHP for
FMT meetings … roads
,vehicles
Flights were off for days, Less spacious,
damaged Kathmandu airport, waiting hrs to land
the flights and getting the luggage : no second
airport
Nepal EQ 2015: Bangladesh FMT
activities
• Medical consultations indoors and OPDs
• Triaging and facilitating for step down cares preparing to receive
the incoming patients
• Clinical round teaching and Health education
• Online tele-rehab
• Multidisciplinary professional clinical meetings for care, referral
and discharge
• Meetings with local administration facilitating capacity building
• Psychosocial support to the health staff and patients
Patient received with limited/no
information of surgical procedure
Reports on
polythene
X -ray jacket
FMT Personal issues
• Residence : no building without a crack!
Hundreds of aftershocks even in the middle of
night
• Disruptions of electricity, internet problems of
having safe water and food
• Transport : vehicles damaged, drivers injured
working station matters
• Shortage of essential health staffs
• Inadequate hospital beds with rehab equipments
• Shortage of essential supplies like urinary
catheters /dressing material and pain medications
• Limited/lack of lab investigation/imaging tools
with technicians/technologists
Rehabilitation Facilities
• Limited options for referral to other
specialty/step down care / home
discharge/community Rehab
• No centre for “medical rehabilitation
under one roof”
Concerns of Rehab FMTs in
the field: after shocks
Earth quake
Intensity RS
Pakistan 2013 Kashmir
valley :
24 September : 7.7 28 September : 6.8
Nepal 2015 Kathmundu
Valley: ≥1200
25 April, 2015: 7.9 12th June 2015: 7.3
(largest): 100?
Deaths
February 2011 - 6.3
September 2010:
Christchurch
7,1 minimal live
earthquake : 180
loss and injury
NZ 2010, Darfield
After shock
deaths
“The poor to die” and the rich to escape:
Majority of the damaged houses were stone/brick
masonry structures with no seismic detailing,
whereas the most of RC buildings were
undamaged: university of Canterbury Eng Dept
.
Other concerns: Infectious
diseases
One of the eight stool sample collected
tested positive for vibrio cholera (other
centre)
……WHO
Conclusions
• Improvements in Nepal EQ FMT accreditation
compared to previous earthquake Rehab
Disaster Response
• Very useful international linking and
professional inputs in the real time
• We need to be prepared to face the next natural
disasters that going to strike (where / when)
..Taiwan..then??
Acknowledgements
• Dr Jim Goseny for continuous support, Dr Fary
Khan for kind oversee
• Committee for Rehabilitation Disaster Relief
ISPRM
• BAPMR and BSMMU
• SAARC Rehab Forum and Dr Farooq Rathore
• SIRC Nepal
• AOCPRM2016 President Prof Raynald Rey
Recommendations
1. FMT deployed for medical Rehabilitation as an
Early responder needs special attentions and
training on specific areas.
2. A data base of disaster rehab experts who can be
mobilized as FMT on a short notice is required
3. FMT trained in MSK rehab should be
preferred to be deployed in the field as early
Rehab responder
4. Development of working guideline for smooth
functioning of rehab FMT
Ms Valerie : known as the Mother Theresa
of the paralyzed
HE presenting ASCoN Star Award in recognition of her
hard work and dedication to those with spinal cord
injuries everywhere
Welcome Nepal PMR: Nepal EQ is the turning point
like the World War injuries for the PMR in the US/UK
• mmm