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Disaster Medicine: Apart surgery
What else?

Tacloban Nov 2013

Olivier Hagon MD
Good or bad way?
Good or bad way?
Explosion of Brazzaville
4 March 2012
Triage !!?
Dead bodies
Forensic…

First Aid

Transport
Reality
Hospital
Haiti 14th January 2010

Triage

Brazzaville April 2012

Surgery

Operating Theater
Anesthesia

Equipment
Consuma...
Primary health cares
Trauma

Non Communicable Diseases

Obstetric

Haiti February 2010

Brazzaville April 2012

Haiti Janu...
Internal Displaced Persons IDP
Shelter

Water/Sanitation

Brazzaville April 2012

Food/nutrition

Haiti February 2010

Bra...
Internal Displaced Persons IDP
Non Food Items

Protection

Haiti January 2010

Mental Health

Brazzaville April 2012

Hait...
Disaster?
Disaster
• “A disaster is sudden, calamitous event that seriously disrupts the
functioning of a community or society and c...
Earthquake
Haiti 2010
Typhoon
Philippines 2013

Leyte island, Ormoc city
Tsunami
Indonesia 2005
War
Gaza strip 2009
Floods
Pakistan 2010
Complex emergencies
• A complex emergency is typically characterized by:
–
–
–
–

Extensive violence and loss of life;
Dis...
Health needs during disaster?
support

substitution

!
Vacuum effect
EVENT

Timeline Disaster
« SIMPLE » EMERGENCY

D2

D4

D7

D14

D21

Search and Rescue
SAR

EVENTS

COMPLEX EMERGENCIES

D...
EVENTS

COMPLEX EMERGENCIES

Security
EVENTS:

Bombings, Air Strikes
Army, Police interventions
Food distributions
Rumors…...
COMPLEX EMERGENCIES

Timeline
Elective Surgery
Emergency Surgery
Children
Adults
Elderly

Complex post operative care

Reh...
COMPLEX EMERGENCIES

Timeline

Medicine (NCD)
Diabetes Mellitus
Hypertension
COPD
Cancer
Malnutrition

Chronic mental dise...
COMPLEX EMERGENCIES

Timeline

Obstetric

Physiological deliveries
Ceasarian sections

Newborn
Breastfeeding
COMPLEX EMERGENCIES

Elective Surgery

Emergency Surgery
Rehabilitation

Medicine (NCD)

Communicable diseases (CD)
Obstre...
EVENTS

COMPLEX EMERGENCIES (Armed conflicts)

Emergency (War) Surgery
COMPLEX EMERGENCIES (Armed conflicts)
COMPLEX EMERGENCY (Armed conflict)

Non Communicable Diseases

Communicable Diseases

Mental Health

Obstetric

Emergency ...
COMPLEX EMERGENCIES

Timeline

Water
Quantity
Quality (water sanitation)
Access

Food
Food distribution
Food security
Brea...
COMPLEXE EMERGENCIES

Elective Surgery

Emergency Surgery
Rehabilitation

Medicine (NCD)

Communicable diseases (CD)
Obstr...


Health
care

Public
health

Non-food items

Water + Sanitation

Nutrition
P. Perrin 2002 ICRC
SURGERY
Elective Surgery

Emergency Surgery

Rehabilitation

Health care

PUBLIC HEALTH
Medicine (NCD)

Public
health

Com...
Amputations
“Increasingly, the responsible humanitarian surgeon will be
required to understand not only surgical principle...
Take home message
Despite the type, the intensity of the disaster

“Life goes on”
God bless you “Madiba”
Olivier Hagon - Disaster Medicine apart from surgery: What else?
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Olivier Hagon - Disaster Medicine apart from surgery: What else?

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2nd Disaster Surgery Workshop Davos 2013

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Transcript of "Olivier Hagon - Disaster Medicine apart from surgery: What else?"

  1. 1. Disaster Medicine: Apart surgery What else? Tacloban Nov 2013 Olivier Hagon MD
  2. 2. Good or bad way?
  3. 3. Good or bad way?
  4. 4. Explosion of Brazzaville 4 March 2012
  5. 5. Triage !!? Dead bodies Forensic… First Aid Transport
  6. 6. Reality
  7. 7. Hospital Haiti 14th January 2010 Triage Brazzaville April 2012 Surgery Operating Theater Anesthesia Equipment Consumables Medicine Nursing cares Physiotherapy
  8. 8. Primary health cares Trauma Non Communicable Diseases Obstetric Haiti February 2010 Brazzaville April 2012 Haiti January 2010
  9. 9. Internal Displaced Persons IDP Shelter Water/Sanitation Brazzaville April 2012 Food/nutrition Haiti February 2010 Brazzaville April 2012
  10. 10. Internal Displaced Persons IDP Non Food Items Protection Haiti January 2010 Mental Health Brazzaville April 2012 Haiti January 2010
  11. 11. Disaster?
  12. 12. Disaster • “A disaster is sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, materiel, and economic or environmental losses that exceed the community’s or society’s ability to cope using its own resources. Though often caused by nature, disaster can have human origins” Vulnerability+ Hazard / Capacity = Disaster Sources: EM-DAT Centre for research on the epidemiology of disaster CRED International Federation Red Cross (IFRC) Website
  13. 13. Earthquake Haiti 2010
  14. 14. Typhoon Philippines 2013 Leyte island, Ormoc city
  15. 15. Tsunami Indonesia 2005
  16. 16. War Gaza strip 2009
  17. 17. Floods Pakistan 2010
  18. 18. Complex emergencies • A complex emergency is typically characterized by: – – – – Extensive violence and loss of life; Displacements of population; Widespread damage to societies and economies; The need for large-scale, multi-faceted humanitarian assistance; – The hindrance or prevention of humanitarian assistance by political and military constraints; – Significant security risks for humanitarian relief workers in some areas. Source: EM-DAT Centre for research on the epidemiology of disaster CRED International Federation Red Cross (IFRC) Website
  19. 19. Health needs during disaster?
  20. 20. support substitution ! Vacuum effect
  21. 21. EVENT Timeline Disaster « SIMPLE » EMERGENCY D2 D4 D7 D14 D21 Search and Rescue SAR EVENTS COMPLEX EMERGENCIES D28
  22. 22. EVENTS COMPLEX EMERGENCIES Security EVENTS: Bombings, Air Strikes Army, Police interventions Food distributions Rumors….
  23. 23. COMPLEX EMERGENCIES Timeline Elective Surgery Emergency Surgery Children Adults Elderly Complex post operative care Rehabilitation Mobilisation Prothesis Orthesis
  24. 24. COMPLEX EMERGENCIES Timeline Medicine (NCD) Diabetes Mellitus Hypertension COPD Cancer Malnutrition Chronic mental diseases Communicable diseases (CD) Tetanus Measles Cholera Malaria … Vaccines Prophylaxis … Mental Health Acute stress disorders PTSD
  25. 25. COMPLEX EMERGENCIES Timeline Obstetric Physiological deliveries Ceasarian sections Newborn Breastfeeding
  26. 26. COMPLEX EMERGENCIES Elective Surgery Emergency Surgery Rehabilitation Medicine (NCD) Communicable diseases (CD) Obstretric Mental Health
  27. 27. EVENTS COMPLEX EMERGENCIES (Armed conflicts) Emergency (War) Surgery
  28. 28. COMPLEX EMERGENCIES (Armed conflicts)
  29. 29. COMPLEX EMERGENCY (Armed conflict) Non Communicable Diseases Communicable Diseases Mental Health Obstetric Emergency (War) Surgery
  30. 30. COMPLEX EMERGENCIES Timeline Water Quantity Quality (water sanitation) Access Food Food distribution Food security Breastfeeding … Shelter Temporary shelter (tarpaulin) Local shelter
  31. 31. COMPLEXE EMERGENCIES Elective Surgery Emergency Surgery Rehabilitation Medicine (NCD) Communicable diseases (CD) Obstretric Mental Health Water Food Shelter
  32. 32.  Health care Public health Non-food items Water + Sanitation Nutrition P. Perrin 2002 ICRC
  33. 33. SURGERY Elective Surgery Emergency Surgery Rehabilitation Health care PUBLIC HEALTH Medicine (NCD) Public health Communicable diseases Obstretric Mental Health WATER-SANITATION-NUTRITION- Non Food Items Non-food items Water Water Nutrition Sanitation Food Shelter P. Perrin 2002 ICRC
  34. 34. Amputations “Increasingly, the responsible humanitarian surgeon will be required to understand not only surgical principles of amputations, but also to be mindful of what lies beyond the operating theatre for each patient” Consensus Statements Regarding the Multidisciplinary Care of Limb Amputation Patients in Disasters or Humanitarian Emergencies: Report of the 2011 Humanitarian Action Summit Surgical Working Group on Amputations Following Disasters or Conflict L. Knowlton and All Prehospital and Disaster Medicine: Vol. 26, No. 6 Dec 2011
  35. 35. Take home message Despite the type, the intensity of the disaster “Life goes on”
  36. 36. God bless you “Madiba”

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