SURGICAL AND REHABILITATION INTERVENTIONS IN RESPONSE TO THE HAITI EARTHQUAKE   Antony Duttine & Dr James Gosney Jr Handic...
Reminder of the Haiti earthquake <ul><li>Richter scale magnitude 7.0 earthquake </li></ul><ul><li>222,570 deaths and 300,5...
Study on the humanitarian response: <ul><li>Aims: </li></ul><ul><li>Review surgical response in relation to amputations </...
Methodology <ul><li>Quantitative data element: </li></ul><ul><ul><li>Statistical data from surgical organizations </li></u...
Findings: Surgery <ul><li>Variation in amputation rates </li></ul><ul><li>Lack/inconsistency of medical record keeping </l...
Findings: Rehab <ul><li>Surgery to rehab limited pathways: </li></ul><ul><ul><li>Community and self referrals </li></ul></...
Implications and conclusions <ul><li>Rehab and surgical sectors showed evidence of excellent practices individually.  BUT ...
The multidisciplinary model
Reality may be more like this…
Questions for the ISPRM… <ul><li>How to advocate and achieve a multidisciplinary approach </li></ul><ul><li>How to ensure ...
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Duttine surgical and rehab interventions in response to the haiti eq crdr.disaster.symp.isprm11

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  • Could be a photo here instead of the description? Msf photo from field team Can be cut out if a shorter presentation. Thought to include a brief intro of the background of media and personal criticism of the resposne.
  • Can provide a brief background to the 2 organizations. Taken from the background sheet: Handicap International http://www.handicap-international.org is an international non- governmental and non-profit organization that is unaffiliated with political parties or religious groups. It is made up of eight sections (national associations) which work together on mobilising resources, co-managing projects and promoting the movement&apos;s principles and activities. Handicap International works to meet the needs and defend the rights of people with disabilities. In countries affected by poverty, disasters and conflicts, our organisation implements prevention, emergency relief and mine-action projects and provides long term development support The Humanitarian and Conflict Response Institute www.hcri.ac.uk is a joint venture between the faculties of humanities and medicine at the University of Manchester inspired by the need to conduct rigorous research and to support postgraduate training on the impact and outcomes of contemporary and historical crises. This programme is driven by a desire to inform and support policy and decision makers, to optimise joint working between partner organisations, and to foster increased accountability within a knowledge gathering framework. Bringing together the disciplines of medicine and the humanities to achieve these aims, the HCRI will facilitate improvements in crisis response on a global scale whilst providing a much needed centre of excellence for all concerned with emergencies and conflicts.
  • This is directly aimed at ISPRM. What will be their role as potentially a bridging link between the surgical and the rehab communities? Can they help in aiding better continuity between the two? There is a practical implication here – all very well idealising about a multidisciplinary decision making approach to each client, but the realities in a disaster are that decisions need to be made rapidly – links with Dr Kohlers thoughts.
  • Duttine surgical and rehab interventions in response to the haiti eq crdr.disaster.symp.isprm11

    1. 1. SURGICAL AND REHABILITATION INTERVENTIONS IN RESPONSE TO THE HAITI EARTHQUAKE Antony Duttine & Dr James Gosney Jr Handicap International San Juan, Puerto Rico 13 th June 2011
    2. 2. Reminder of the Haiti earthquake <ul><li>Richter scale magnitude 7.0 earthquake </li></ul><ul><li>222,570 deaths and 300,572 injuries (OCHA). </li></ul><ul><li>Over 600 agencies responded in first month (PAHO) </li></ul><ul><li>Excessively high amputation rate reported in media – criticisms of response </li></ul>
    3. 3. Study on the humanitarian response: <ul><li>Aims: </li></ul><ul><li>Review surgical response in relation to amputations </li></ul><ul><li>Links to rehabilitation services </li></ul><ul><li>Implications for response to future disasters and responses </li></ul>
    4. 4. Methodology <ul><li>Quantitative data element: </li></ul><ul><ul><li>Statistical data from surgical organizations </li></ul></ul><ul><ul><li>HI/CBM/SEIPH database </li></ul></ul><ul><li>Qualitative data: </li></ul><ul><ul><li>83 semi-structured interviews </li></ul></ul><ul><ul><li>Local interviewer </li></ul></ul>
    5. 5. Findings: Surgery <ul><li>Variation in amputation rates </li></ul><ul><li>Lack/inconsistency of medical record keeping </li></ul><ul><li>Day 2: population rumours </li></ul><ul><li>Day 5: amputation peak </li></ul><ul><li>BUT </li></ul><ul><li>range = <1% to 46% </li></ul>
    6. 6. Findings: Rehab <ul><li>Surgery to rehab limited pathways: </li></ul><ul><ul><li>Community and self referrals </li></ul></ul><ul><li>Amputees only a fraction of total rehab clients: </li></ul><ul><ul><li>Orthotic vs. prosthetic requirements </li></ul></ul><ul><li>Prosthetic “shopping around” </li></ul>
    7. 7. Implications and conclusions <ul><li>Rehab and surgical sectors showed evidence of excellent practices individually. BUT </li></ul><ul><ul><li>Needs to be better coordinated </li></ul></ul><ul><ul><li>Integrated trauma care pathways </li></ul></ul><ul><li>Medical record keeping reinforcement </li></ul><ul><li>Proportionalise not sensationalise </li></ul>
    8. 8. The multidisciplinary model
    9. 9. Reality may be more like this…
    10. 10. Questions for the ISPRM… <ul><li>How to advocate and achieve a multidisciplinary approach </li></ul><ul><li>How to ensure all actors are aware of protocols and standards… </li></ul><ul><li>How to practically facilitate medical communication in the chaos of disaster… </li></ul>
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