Delivering First-World Medicine in Third-World Disaster Relief and Volunteerism Samir Mehta, MD...
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![Page 1: Delivering First-World Medicine in Third-World Disaster Relief and Volunteerism Samir Mehta, MD University of Pennsylvania.](https://reader037.fdocuments.in/reader037/viewer/2022110210/56649e675503460f94b630d3/html5/thumbnails/1.jpg)
Delivering First-World Medicine in Third-World Disaster Relief
and Volunteerism
Samir Mehta, MDUniversity of Pennsylvania
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Everything I Wish I Knew Before I Left the Country …
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Everything I Wish I Knew Before I Left the Country …
No International Incidents to date …
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Choose Your Own Adventure
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Choose Your Own Adventure
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Volunteerism
• Who are you?– Overseas work– Disaster areas – be ready, credentialing– Organization – OTA, SIGN, FOT, AO, HVO, DMAT
• What can you offer?– Part of the solution
• Infrastructure– At home and abroad
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Tip #1
• Bring a Cell Phone
• Bring a charger (solar)
• Make sure it has international functioning
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Tip #1
• Bring a Cell Phone
• Bring a charger (solar)
• Make sure it has international functioning
• Turn off your roaming!
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What are the local conditions?
Haiti•50% no access to clean water BEFORE QUAKE•50% adults middle school education•GNP 1/5 to 1/7 that of DR•60% unemployment •Subsistence farming
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Haiti …
• The disaster was as much social as geologic
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Why so destructive?
• Poor construction– No codes– Little rebar– Poor concrete
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How Can You Help?
• Decision
• Loved ones– Not alone
• Not Vacation
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Acronyms decoded
• HHS- US Dept. of Health and Human Services• NDMS- National Disaster Medical System• DMAT- Disaster Medical Assistance Team• IMSuRT- International Medical Surgical
Response Team• USAID- US Agency for International
Development• DoD- US Department of Defense
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How does IMSuRT work?
• Multidisciplinary team• Self contained surgical hospital, personnel
support• Equipment loaded on pallets• Driven onto DoD aircraft (C-17)• Deployable within 48 hours
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Disaster Response
• “If you want to go quickly, go alone. If you want to go far, go together”– African proverb
• “…We need to go very far very quickly”– Al Gore
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Private groups
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HSS Team
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HHS Team
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What do you need?
• Permission– Passport– Visa– License– Malpractice
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Transportation
– Air– Ground– Return– Supply chain
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Healthcare (your own)
– Vaccinations (Hep A/B, Typhoid, Tetanus, MMR, DPT)– Malaria prophylaxis– Yellow card– Dengue Fever?– HIV– Tuberculosis (N95 mask)– Leptospirosis– Anthrax– Ebola
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Water
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Tip #2
• Bring self-filtration water kits
• Bring energy bars
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Food
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Shelter
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Protection
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•Crowd control•Aid distribution
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Power
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• You need a lot of stuff• You need to bring it all…
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Spain
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Russia
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Germany
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Puerto Rico
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US Embassy
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EMR
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Real Medical Record
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Evac to USNS Comfort
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Tip #3
• Baby Wipes– Unscented
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Strategic Deployment
• Nine Full Days• 1200 lbs of supplies• 84 surgical procedures
– 76 Earthquake
• ~1000 patient contacts• Implemented systems
– Daily wound rounds– “Sign your site”
• No follow-up
0%
10%
20%
30%
40%
Fracture Infection Soft-tissue
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Hospital Antonio Lenin FonsecaManagua, Nicaragua
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Tip #4
• Know the local politics
• Don’t take things personally
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The Contrast – The “Private Hospital”
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The People
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Wards
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Intensive care
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Emergency
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Equipment
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Medications
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Bringing HUP to Managua
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Teaching
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Tip #5
• Check the State Department Website
• Know where the Embassy is
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Case #1: Injury 3 years ago
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Case #2: Hardware Removal
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Case #3: 19M s/p fall from truck 4wks ago
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Case #4
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Case #5: Machete injury, contralateral BEA
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Case #6: 15F, 4wks old, head injury
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Tip #6
• Leave your Ego at the Door
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2nd Inpatient Tower Under Construction
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Volunteerism
![Page 90: Delivering First-World Medicine in Third-World Disaster Relief and Volunteerism Samir Mehta, MD University of Pennsylvania.](https://reader037.fdocuments.in/reader037/viewer/2022110210/56649e675503460f94b630d3/html5/thumbnails/90.jpg)
Volunteerism
• Not about going somewhere necessarily• Locally or Nationally• Organized Medicine
– OTA– AAOS– AOA– AMA
• Unique Skill Set
![Page 91: Delivering First-World Medicine in Third-World Disaster Relief and Volunteerism Samir Mehta, MD University of Pennsylvania.](https://reader037.fdocuments.in/reader037/viewer/2022110210/56649e675503460f94b630d3/html5/thumbnails/91.jpg)
Volunteerism
• Life Changing
– For Them
– For You