Rolf Maibach - Cooperation in Humanitarian Disasters – Balancing between cultures

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  • 1. Cooperation in Humanitarian Disasters Rolf Maibach, MD FMH Ped, Ilanz/Switzerland & Deschapelles/Haiti
  • 2. Balancing between cultures
  • 3. EARTHQUAKE IN HAITI 7 M January 12, 2010 WHERE TO GO?
  • 4. Haiti: 10 Mio inhabitants Hôpital Albert Schweitzer Haiti 316’000 killed 400’000 injured 2 Mio displaced >6’000 amputees
  • 5. HÔPITAL ALBERT SCHWEITZER HAITI
  • 6. HÔPITAL ALBERT SCHWEITZER HAITI 1315 injured, 90% open fractures, transported 4-8 hours on trucks
  • 7. Lè ou bezwen, ou dwe pi intèlijan. When you are in need, you must be more intelligent.
  • 8. No telephone available: 80 volunteering surgeons, anesthesiologists, orthopedic surgeons
  • 9. infrastructure, ressources
  • 10. laboratory, blood bank, medicaments
  • 11. external fixations
  • 12. Life goes on Diphtheria
  • 13. PROSTHESIS LAB AT HAS HANGER IVAN R. SABEL FOUNDATION
  • 14. 40 new prosthesis every week! 1500 prosthesis, 5600 follow up
  • 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. MITHA on training with all her four children
  • 17. Smile, whenever you are stressed!
  • 18. Orthopädische Uniklinik Balgrist Zürich Dr. Thomas Böni
  • 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. Too many amputations in Haiti? • Many small organizations without technically skilled personnel and insufficient technical ressources (Swiss army knife is no surgical instrument!)
  • 21. Too many amputations in Haiti? • Many small organizations without technically skilled personnel and insufficient technical ressources • Unethical behaviour? Kick ? Lack of responsibility?
  • 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. Visiting foreign doctor ? Art exposition at the Oloffson Port-au-Prince Haiti November 2011
  • 24. In the the last few years we had several disasters in Haiti. HÔPITAL ALBERT SCHWEITZER played a major role in disaster relief!
  • 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. Cholera
  • 27. Cholera 2010 / 2011
  • 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. Which qualifications are prerequisites for a medical disaster intervention team?
  • 30. Which qualifications are prerequisites for a medical disaster intervention team? 1 Technical competence, speed
  • 31. Which qualifications are prerequisites for a medical disaster intervention team? 1 Technical competence, speed 2 Infrastructure, sufficient ressources
  • 32. Which qualifications are prerequisites for a medical disaster intervention team? 1 Technical competence, speed 2 Infrastructure, sufficient ressources 3 Excellent interpersonal communication
  • 33. COOPERATION=SUCCESS
  • 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. 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. COOPERATION AT EYES LEVEL!
  • 37. COOPERATION AT EYES LEVEL RESPECT
  • 38. REVERENCE FOR LIFE
  • 39. COOPERATION AT EYES LEVEL RESPECT MODESTY
  • 40. COOPERATION AT EYES LEVEL RESPECT MODESTY DETERMINATION
  • 41. DETERMINATION New Medical Director at HAS Dr. Herriot Sannon
  • 42. COOPERATION AT EYES LEVEL RESPECT MODESTY DETERMINATION HUMOR
  • 43. NATHALIE lost a leg, but did not loose her humor !
  • 44. COOPERATION AT EYES LEVEL DETERMINATION RESPECT MODESTY HUMOR LOVE
  • 45. JULIETTE ET FRÉDERIC
  • 46. • Nouveaux jambes, nouveaux amis! • New legs, new friends!
  • 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. CONCLUSION • The first two days everyone has to focus on live saving measures, hopefully in an organized way.
  • 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. 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. Nampwen zamlèt san kase ze. There is no omelet without breaking some eggs.
  • 52. One must make necessary sacrifices to get a desired result. Sometimes it is necessary making unpopular decisions to achieve your goal.
  • 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. Never, ever underestimate local knowlegde
  • 55. LESPWA FÈ VIF Hope gives life
  • 56. MESI ANPIL! MERCI BEAUCOUP! THANK YOU! ENGRAZIEL FETG! VIELEN DANK! www.hopitalalbertschweitzer.org www.hashaiti.org