Emergency Medicine & Emergency Medical Supply Management System Dr. Bipin Verma WHO /SEARO
Emergency Medicine and Emergency Medical Supply Management System <ul><li>Health Sector Emergency Supply Needs </li></ul><ul><li>Emergency Supply Management System </li></ul><ul><li>Emergency Supply Management Tools </li></ul>
Short-term Public Health Impact of Natural Disasters Common Common RARE (May occur in heavily damaged urban areas) POPULATION MOVEMENTS Common Common RARE (may occur due to factors other than shortage of food) FOOD SCARCITY Potential problem in all major disasters (probability rises with overcrowding and deteriorating sanitation) COMMUNI-CABLE DISEASES RISKS FEW FEW MODERATE TOO-MANY INJURIES Needing ICU FEW MANY FEW MANY DEATHS FLOOD TIDAL WAVE HIGH WINDS EARTH QUAKE HEALTH IMPACT
Source: DHS Gujarat Thousands Year 1987 Disease Pattern 1987 Draught - Gujarat 0 1 2 3 4 5 6 Sep Oct Nov Dec Water Borne Respiratory Nut. Deficiency Skin
Types of Injuries (30.9.93 to 6.10.93 - 4:00 PM) Analysis of Hospital Statistics ( Latur Earthquake ) <ul><li>Pvt. Medical Camp, Latur </li></ul><ul><li>Maharashtra Instt. Of Medical Sciences and Research (Pvt. Med. Coll.) Latur </li></ul>Hospitals 24.12 109 0.44 2 (Brach. Plexus) 0.66 3 Nerve Inj. 0.88 4 Head Injury 0.88 4 Abd. Inj. 1.11 5 Chest Injury 1.99 9 Paraplegia 2.21 18 Clavicle fracture 3.32 15 Spinal Inj. 3.98 18 Multi. fracture 4.28 19 L. Limb Inj. 4.42 28 U. Limb Inj. Percent Totals Indoor admission
Casualties Treated within first 10 days (MH – Bhuj, Gujarat)
IMPACT Community resources Community Survival and health needs Community Needs after Sudden Onset Disaster Time Other Needs
Tsunami-damaged government health facility including local medical supply stores (Sri Lanka) 34 TOTAL 02 Regional Drug Stores 09 MOH Offices 01 DPDHS Offices 04 Central Dispensaries 15 Small Hospitals 03 Major Hospitals
<ul><li>MSD storage capacity was constrained. Special bottleneck in shipping and receiving area due to lack of space. </li></ul><ul><li>Many RMSD/Institution stores at or near full capacity, which was further aggravated by emergency Tsunami shipments and donations. </li></ul><ul><li>Warehouse conditions at some locations needed considerable improvement (facilities, temperature, shelving, organization). Some stores were set up in hospital rooms or in tents. </li></ul><ul><li>Batch traceability and shelf life monitoring were not adequate at MSD and periphery facilities due to lack of physical storage capacity, manual book keeping and/or lack of appropriate procedures. </li></ul><ul><li>Proper cold storage capacity (cold rooms) is needed at many locations, currently using multiple household refrigerators without proper monitoring and backup systems. </li></ul>Post-tsunami Scenario (Sri Lanka)
Observations <ul><li>Inventory Control System though adequate at Colombo, but programming was needed to include periphery stores, and warehouses. </li></ul><ul><li>General lack of written procedures and manuals. </li></ul><ul><li>Outside of Colombo, the entire supply chain was paper based. </li></ul><ul><li>Limited number of computers, computer software and expertise available at RMSD/Institutions. </li></ul><ul><li>Very limited internet/e-mail access. Limited data communication capabilities between periphery and Colombo. </li></ul><ul><li>No Local Area Networks available at DPDHS and institutions. </li></ul>Post-tsunami Scenario (Sri Lanka)
Emergency Medical Supply Strategies <ul><li>Reduce inflow of donation (Need-based donation) </li></ul><ul><li>Meeting adequate & appropriate supply needs in time through improved Supply Management System & Networking amongst warehouses and user institutions. </li></ul><ul><li>Appropriate stock-piling of life-saving medicines and equipment. </li></ul>
SUMA Guide-lines for Humanitarian Assistance in Disaster Situations Emergency Medical Supply Needs WHO initiatives Need-based donation Improve Supply Management System <ul><li>New Emergency Health Kits </li></ul><ul><li>Stockpiling </li></ul>
WHO’s Humanitarian Advocacy <ul><li>Emergency Supply Related Documents: </li></ul><ul><li>New Emergency Health Kits. </li></ul><ul><li>Guideline for health care donation (pdf 170kb). </li></ul><ul><li>Guideline for safe disposal of unwanted pharmaceuticals in and after </li></ul><ul><li>emergencies. </li></ul><ul><li>Guidelines for drug donations (pdf 72kb) </li></ul>[email_address] http://www.who.int/hac http://www.paho.org/disasters
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