Rolf Maibach - Cooperation in Humanitarian Disasters – Balancing between cultures

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Rolf Maibach - Cooperation in Humanitarian Disasters – Balancing between cultures

  1. 1. Cooperation in Humanitarian Disasters Rolf Maibach, MD FMH Ped, Ilanz/Switzerland & Deschapelles/Haiti
  2. 2. Balancing between cultures
  3. 3. EARTHQUAKE IN HAITI 7 M January 12, 2010 WHERE TO GO?
  4. 4. Haiti: 10 Mio inhabitants Hôpital Albert Schweitzer Haiti 316’000 killed 400’000 injured 2 Mio displaced >6’000 amputees
  5. 5. HÔPITAL ALBERT SCHWEITZER HAITI
  6. 6. HÔPITAL ALBERT SCHWEITZER HAITI 1315 injured, 90% open fractures, transported 4-8 hours on trucks
  7. 7. Lè ou bezwen, ou dwe pi intèlijan. When you are in need, you must be more intelligent.
  8. 8. No telephone available: 80 volunteering surgeons, anesthesiologists, orthopedic surgeons
  9. 9. infrastructure, ressources
  10. 10. laboratory, blood bank, medicaments
  11. 11. external fixations
  12. 12. Life goes on Diphtheria
  13. 13. PROSTHESIS LAB AT HAS HANGER IVAN R. SABEL FOUNDATION
  14. 14. 40 new prosthesis every week! 1500 prosthesis, 5600 follow up
  15. 15. MITHA, 29 y. buried under her house for several days, amputation of both legs, abandonnend by her husband, her four children being listed as missing
  16. 16. MITHA on training with all her four children
  17. 17. Smile, whenever you are stressed!
  18. 18. Orthopädische Uniklinik Balgrist Zürich Dr. Thomas Böni
  19. 19. NAOMIE The only surviving of a large family in Port-au-Prince. Surgeon in small team overwhelmed, did not have time to treat open fracture. Too many amputations in Haiti?
  20. 20. Too many amputations in Haiti? • Many small organizations without technically skilled personnel and insufficient technical ressources (Swiss army knife is no surgical instrument!)
  21. 21. Too many amputations in Haiti? • Many small organizations without technically skilled personnel and insufficient technical ressources • Unethical behaviour? Kick ? Lack of responsibility?
  22. 22. Too many amputations in Haiti? • Many small orgizations without technically skilled personnel and insufficient technical ressources • Unethical behaviour? Kick ? Lack of responsibility? • Absence of any control mechanism, governmental organization.
  23. 23. Visiting foreign doctor ? Art exposition at the Oloffson Port-au-Prince Haiti November 2011
  24. 24. In the the last few years we had several disasters in Haiti. HÔPITAL ALBERT SCHWEITZER played a major role in disaster relief!
  25. 25. Other disasters • August 2008: 4 Hurricanes with inundations (Gonaive/Artibonite) • Several truck accidents with >50 severely injured people • End of 2010 and Summer 2011: severe Cholera epidemics, HAS treated more than 7000 patients
  26. 26. Cholera
  27. 27. Cholera 2010 / 2011
  28. 28. It has been widely recognized, that Hôpital Albert Schweitzer Haiti was very successful in handling these disasters. Why was it so? Which qualifications are prerequisites for succesful medical and surgical interventions in a disaster situation?
  29. 29. Which qualifications are prerequisites for a medical disaster intervention team?
  30. 30. Which qualifications are prerequisites for a medical disaster intervention team? 1 Technical competence, speed
  31. 31. Which qualifications are prerequisites for a medical disaster intervention team? 1 Technical competence, speed 2 Infrastructure, sufficient ressources
  32. 32. Which qualifications are prerequisites for a medical disaster intervention team? 1 Technical competence, speed 2 Infrastructure, sufficient ressources 3 Excellent interpersonal communication
  33. 33. COOPERATION=SUCCESS
  34. 34. Which qualifications are prerequisites for a medical disaster intervention team? 1 2 3 4 Technical competence, speed Infrastructure, sufficient ressources Excellent interpersonal communication Cultural adaptability
  35. 35. Which qualifications are prerequisites for a medical disaster intervention team? 1 2 3 4 5 Technical competence, speed Infrastructure, sufficient ressources Excellent interpersonal communication Cultural adaptability Competent leadership – Cooperation at eyes level
  36. 36. COOPERATION AT EYES LEVEL!
  37. 37. COOPERATION AT EYES LEVEL RESPECT
  38. 38. REVERENCE FOR LIFE
  39. 39. COOPERATION AT EYES LEVEL RESPECT MODESTY
  40. 40. COOPERATION AT EYES LEVEL RESPECT MODESTY DETERMINATION
  41. 41. DETERMINATION New Medical Director at HAS Dr. Herriot Sannon
  42. 42. COOPERATION AT EYES LEVEL RESPECT MODESTY DETERMINATION HUMOR
  43. 43. NATHALIE lost a leg, but did not loose her humor !
  44. 44. COOPERATION AT EYES LEVEL DETERMINATION RESPECT MODESTY HUMOR LOVE
  45. 45. JULIETTE ET FRÉDERIC
  46. 46. • Nouveaux jambes, nouveaux amis! • New legs, new friends!
  47. 47. DAS GLÜCK IST DAS EINZIGE, DAS SICH VERDOPPELT, WENN MAN ES TEILT THE FORTUNE IS THE ONLY THING THAT DOUBLES, WHEN YOU SHARE IT. A S
  48. 48. CONCLUSION • The first two days everyone has to focus on live saving measures, hopefully in an organized way.
  49. 49. CONCLUSION • The first two days everyone has to focus on live saving measures, hopefully in an organized way. • Thereafter healthcare has to be given first and foremost by institutions or organizations, technically well equipped, being on the ground or with experience on the ground. •
  50. 50. CONCLUSIONS • The first two days everyone has to focus on live saving measures, hopefully in an organized way. • Thereafter healthcare has to be given first and foremost by institutions or organizations, technically, well equipped being on the ground or with experience on the ground. • NGOs and surgical teams with skilled personnel and aware of cultural sensitivities may collaborate with these institutions and reinforce them. •
  51. 51. Nampwen zamlèt san kase ze. There is no omelet without breaking some eggs.
  52. 52. One must make necessary sacrifices to get a desired result. Sometimes it is necessary making unpopular decisions to achieve your goal.
  53. 53. CONCLUSIONS • The first two days everyone has to focus on live saving measures, hopefully in an organized way. • Thereafter healthcare has to be given first and foremost by institutions or organizations, technically well equipped, being on the ground or with experience on the ground. • NGOs and surgical teams with skilled personnel and aware of cultural sensitivities may collaborate with these institutions and reinforce them. • Never, ever underestimate local knowledge!
  54. 54. Never, ever underestimate local knowlegde
  55. 55. LESPWA FÈ VIF Hope gives life
  56. 56. MESI ANPIL! MERCI BEAUCOUP! THANK YOU! ENGRAZIEL FETG! VIELEN DANK! www.hopitalalbertschweitzer.org www.hashaiti.org

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