Chandrika Raghavendra Rao M.ch. Paediatric Surgery /MSF Volunteer
Volunteering in a calamity Introduction Disasters and calamities are a part of life since time immemorial. It is very important for any disaster management team/ organisation to be at the site of a disaster within the first 48-72 hours and start the activities. This helps in reducing the mortality and morbidity
Volunteering in a calamity There are Government and non government organisations striving to achieve good results in terms of saving lives, limbs and property of population affected by disasters. A dynamic team and team work is essential in order to achieve satisfactory outcome. The team MUST function like clockwork.
Civil defence medical volunteer There are two essential components of a civil defence team Both the parts are equally important and crucial and can not function without each other. Logistics team and the medical team. Setting up the centre,getting the equipment,supplies &Water sanitation are the responsibilities of the logisticians. Medical team to organise the triage area and the emergency resuscitation room,operation theatre complex and post operative or recovery areas and wards.
O.T. TEAM Darfur, Sudan TEAM
SOUTH SUDAN
Papua New Guinea
HAITI
Haiti - OT
BIHAR FLOODS
BIHAR
CAESARIAN SECTION
CAESARIAN SECTION- TRIPLETS
Civil defence operations a few essentials Emergency preparedness Triage Mass casualty Influx plan Mock drills
Emergency preparedness In MSF there is an Emergency Desk which deals with any new calamities /emergency situations The team comprises of experienced [and temperamentally suitable] logistic and medical team members who will be deployed immediately to set up a facility in an affected area where there is an urgent need for medical care floods, earthquake, conflict [both internally displaced and refugee populations]
Emergency Civil Defence Team A typical field team comprises of logisticians, water and sanitation [WATSAN] experts, Nurses,a medical doctor and a surgeon where needed. Depending on the requirements- a lab technician, an epidemiologist, a pharmacist & a mental health expert. All the team members work under a Project Co ordinator who in turn will be in touch with a Coodination team located at a district level/capital level and at the head quarters.all these teams will be supporting and guiding the field team.
Emergency Preparedness MSF Experience-
Emergency Preparedness The team should have a plan ready in areas where some of the seasonal disasters are predictable- Floods, cyclones earthquake, landslides And medical outbreaks such as cholera, Malaria, Japanese encephalitis.[ebola] Its good to have done a Risk analysis and have a plan of action ready for Industrial accidents [such as the one which happened in NTPC recently],railways accidents, Bridge building/flyover collapse. Even with the plans and protocols BE FLEXIBLE
Emergency Preparedness The guidelines and protocols help with achieving some uniformity in the management and help prevent chaos at the crucial time of need. More over, new members in the team will find it easier to function and are better prepared if they have the guidelines with them to refer to.. It also reduces stress levels considerably. After every disaster or calamity,it is good for the entire team to sit together with the higher authorities and discuss what went right AND more importantly - what went wrong?
Emergency Preparedness If we have Emergency scenarios ready at hand for reference then the whole exercise goes on like a clock work. Always consider Which emergency? In which region? And what is the size of the population affected? And most importantly maintaining accurate data, communication and team work are the keys to success.
Emergency Preparedness Budget and finance the biggest hurdle Human resources a database with all the relevant information about all the volunteers and their availability. Supplies - is it possible to tie up with local pharmaceuticals for supplies in an emergency scenario? Can there be warehouses in different parts of the country for storage of supplies in anticipation? [there should be a list of the supplies including expiry dates for the perishables and it should be pasted on the supplies boxes]
E-Prep In most of the disaster/emergency situations,apart from the medical needs[including Vaccinations]- shelter, safe drinking water,toilets, Nutrition and other essential goods [NFIs] need immediate attention in the acute phase itself. Is it possible to tie up with other agencies to take care of some these issues?
@External Source
War Zone - Vaccination @MSF
E Prep teams Medical and logisitcs Ideally, a team setting out to manage an emergency/disaster situation should be composed of - A team leader, two logisticians [who will look after the supplies] A doctor/surgeon[depending on the type of emergency], a nurse midwife and another nurse. A water sanitation expert. Locally available skilled personnel can be hired to help out and assist.
E Prep team The team described is an absolute minimum requirement. Depending on the emergency and the magnitude of it - we may require a vaccination team [if there is an outbreak we are dealing with or we are anticipating due to the emergency] A lab, technician [with minimum essential investigation tests] A pharmacist A mental health counsellor A community health worker and a Health Educator.
E prep ( Supplies and equipment] As discussed storage/transport facility Ready stock so that no time is wasted. Kits can be kept ready - for example delivery kits Disposable minor surgery kits Dressing sets Orthopedic POP application sets Suture sets caesarian sets [yes! Disaster or not women are always delivering -naturally or by C. section]
Logistics in action
How it works
Giorgio Contessi/MSF
Triage Extremely important part of an emergency set up to save lives and limbs. Triage basically means assigning the order of urgency for patient management or deciding who needs to be managed first[depending on how ill the patients are when dealing with patients in big numbers] This role should be assigned to the most experienced, senior nurse who will be the Triage officer.[ or it can be an experienced senior doctor/anaesthetist]
Triage & Mass casualty Influx The leader of triage will need other nurses, a junior doctor to help if the number of patients reaching the facility are large. Triage area should be set up in such a way that it is very close to the observation area, the make shift operation theatre and the post observation/post operative ward. There should be a separate area to manage the ones who are critical and there is no hope of saving them. Most useful triage system is that of South Africa. Most of the INGOs use a system based on the South African Triage
Triage & mass casualty influx The large Triage area should have a single entry point. It should be able to accommodate at least 40 patients on stretchers lined next to a wall with hooks for IV bag. Triage officer will do a rapid assessment [ using clinical parameters such as patient is conscious,radial pulse felt, breathing [rate above 30 or less] Basic ABC Patients are categorised into - RED [requiring immediate attention - have pneumothorax or a bleeding vessel ORANGE - have fractures or abdominal injury,can be stabilised and can wait for a few hours GREEN minor injuries.require cleaning, dressing,suturing, tetanus injection, oral pain killers and may be antibiotics.
Triage& mass casualties BLACK very critical, will not survive. Patients must be assessed rapidly and assigned an identification number which has to be clipped to a clip board with his/her assessment notes[ preferably on a body diagram ],blank surgical form and a post op notes. At the time of reassessment some patients may move from one category to another.for example a patient from Orange may move to Red or Green. Cleaning staff are essential [ they should have undergone training about hospital waste disposal.
Triage & Mass Casualty plan A psycho social worker to counsel the family members [especially that of the Black category is essential] An adjacent area to the triage should be a small lab where the care takers and friends of the red category will be screened for potential blood donation,if needed. Lastly, its mandatory to take universal precautions.
What is MSF?
Médecins Sans Frontières, is an international medical and humanitarian organisation providing medical care to populations in distress, victims of natural and man-made disasters, and victims of armed conflict, regardless of race, religion or political beliefs.
Who can WORK with us?
WHO WE NEED Medical Profiles General Physicians, Infectious disease specialists(hiv/tb),anesthesiologists,obstetricians/gynae cologists, Paediatricians,Surgeons General / Orthopedic / Plastic,Emergency and trauma specialists, Hospital managers,project co ordinators[medical] Para-medical Profiles Nurses,Epidemiologists, Mental Health Officers, Technicians Non Medical Profiles Logisticians, Watsans, HR Coordinators, Finance Coordinators, Project Coordinators[Log] Lab
What do you GET? Return air ticket from home to mission Accommodation in mission Facilitation of visas and documentation for international travel Vaccinations Monthly salary in your bank account Per diem on missions paid in local currency
What do you get? Full medical and insurance coverage Holidays (One week off every 3 months) Chance to participate in international trainings. To live/work/interact with people from all over the world. To challenge your limits and feel the adventure. Professional gratification like never before. Memories to cherish for a lifetime
How to be part of MSF The MSF Office in New Delhi recruits medical professionals from all over South Asia. If you meet the requirements and would like to volunteer, please go to our website: www.msfindia.in Download the application form and send it along with your CV to the following email address. india.office.hrm@new-delhi.msf.org : +91-9910405492
Thank You