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TheEvolving Role ofRehabilitation
Professionals in Disaster
Management
Peter Skelton, BSc, MSc
Technical Advisor, Handicap...
Top Priority: Preparedness
• We know where disasters are likely to strike!
• Rehabilitation must be integrated into disast...
A Positive Example: Nepal 2015
• EU Project combining
government, UN and non
governmental actors.
• Mapping of governmenta...
New Guidance…
Emergency Medical Teams
• WHO initiative post Haiti
• Minimum Standards
launched in 2013, including
basic rehabilitation
r...
Type 1
Type 2
Type 3
Specialty teams
requiring support within
an FMT level 2 or 3 care
facility or local
secondary or tert...
How
• Highly consultative inter-disciplinary process
• Literature review
• Working group includes PT, P&O, Rehab
Medicine,...
Key Standard: Staff
• At least one rehabilitation professional per
20 beds
• Outpatient facilities should be able to
provi...
Key Standard: Layout and Accessibility
For deployments exceeding 3 weeks, allocation
of a purpose-specific rehabilitation ...
Key Standard: Equipment
Deployment of EMTs with at least the essential
rehabilitation equipment and consumables
• Pragmati...
Key Standard: Reporting
Reporting of patients with notifiable injuries
(spinal cord injury, lower limb amputation and
comp...
Key Standard: Discharge/Referral
• To ensure that referrals for rehabilitation are managed
effectively, the patient and th...
Specialised Cell: Rehabilitation
• Embedded into an EMT or a local facility
• Length of stay minimum of 1 month or
matches...
Step Down Facilities
“An inpatient unit with a mandate to provide
interim care for medically stable patients while
prepari...
Coordination
It is essential that EMTs do not duplicate existing
rehabilitation services but rather integrate with
and est...
Implications
• All Emergency Medical Teams should now offer
early Rehabilitation
• They should also be better linked to lo...
Training
Clinical skills attained
through accredited
education, training,
practice and
licensure
Accredited
competency bas...
Ecuador
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management
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RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management

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RIWC_PARA_A147 the emerging and rapidly evolving role of rehabilitation professionals in disaster management

  1. 1. TheEvolving Role ofRehabilitation Professionals in Disaster Management Peter Skelton, BSc, MSc Technical Advisor, Handicap International and the UK Emergency Medical Team
  2. 2. Top Priority: Preparedness • We know where disasters are likely to strike! • Rehabilitation must be integrated into disaster management plans – including mapping of services, referral mechanisms, use of human resources. • Professionals in high risk countries must be trained in trauma management • Service providers should consider stockpiling of essential rehabilitation equipment
  3. 3. A Positive Example: Nepal 2015 • EU Project combining government, UN and non governmental actors. • Mapping of governmental and non-governmental stakeholders • Rehabilitation integrated into national trauma management guidance and training • Involvement of professional associations (e.g NEPTA) • Equipment stockpiled • Injury and Rehabilitation Sub- cluster then established early to coordinate the response and ensure “Build Back Better” principle applied.
  4. 4. New Guidance…
  5. 5. Emergency Medical Teams • WHO initiative post Haiti • Minimum Standards launched in 2013, including basic rehabilitation requirements • Teams are verified by WHO and requested by the affected country • Already having an impact – Philippines, Nepal, Ecuador…
  6. 6. Type 1 Type 2 Type 3 Specialty teams requiring support within an FMT level 2 or 3 care facility or local secondary or tertiary hospital
  7. 7. How • Highly consultative inter-disciplinary process • Literature review • Working group includes PT, P&O, Rehab Medicine, OT and Nursing • Contributing organisations include MSF, CBM, ICRC, Handicap International, WHO • Reviewed by WHO, EMT leaders and global professional bodies (ISPRM, WFOT, WCPT, ISCOS)
  8. 8. Key Standard: Staff • At least one rehabilitation professional per 20 beds • Outpatient facilities should be able to provide basic rehabilitation care or refer patients to an appropriate EMT or existing local facility.
  9. 9. Key Standard: Layout and Accessibility For deployments exceeding 3 weeks, allocation of a purpose-specific rehabilitation space of at least 12 m2; Recommendations regarding latrines and accessibility.
  10. 10. Key Standard: Equipment Deployment of EMTs with at least the essential rehabilitation equipment and consumables • Pragmatic approach taken considering likely logistical constraints • Self sufficient for first 2 weeks • 6 wheelchairs and 30 pairs of crutches per 20 beds.
  11. 11. Key Standard: Reporting Reporting of patients with notifiable injuries (spinal cord injury, lower limb amputation and complex fracture) to the ministry of health of the host country/coordination cell at stipulated intervals.
  12. 12. Key Standard: Discharge/Referral • To ensure that referrals for rehabilitation are managed effectively, the patient and the referring EMT should both keep a copy of the referral, which should contain the following information, at a minimum: –– required assistive devices provided; –– functional status, including mobility and precautions; and –– requirements for follow-up with the referral team (e.g. for surgical review, removal of an external fixator or follow-up X-ray). • EMTs should keep an updated list of all patients who require rehabilitation follow-up after discharge or after the departure of the EMT and communicate the list to the host ministry of health/coordinating cell as requested.
  13. 13. Specialised Cell: Rehabilitation • Embedded into an EMT or a local facility • Length of stay minimum of 1 month or matches the team deployed into. • Must either bring equipment or demonstrate an agreement for its provision. • Must align their services with local practice and consider service provision after their departure.
  14. 14. Step Down Facilities “An inpatient unit with a mandate to provide interim care for medically stable patients while preparing them for discharge into the community.” • EMT transforms to step down at request of MoH • Includes nursing and rehabilitation • Minimum stay 3 months
  15. 15. Coordination It is essential that EMTs do not duplicate existing rehabilitation services but rather integrate with and establish referral pathways to local service providers, where they exist.
  16. 16. Implications • All Emergency Medical Teams should now offer early Rehabilitation • They should also be better linked to local rehabilitation providers • There should be better data on the number of injuries and rehabilitation needs earlier in the response • Those wishing to travel as a rehabilitation provider must either work for a registered EMT or register as a specialised cell – and meet all the standards – training, equipment, length of stay…
  17. 17. Training Clinical skills attained through accredited education, training, practice and licensure Accredited competency based and culturally sensitive education and training in adapting and adjusting skills in a resource poor setting Accredited education and training in humanitarian core competencies Humanitarian Health Professional
  18. 18. Ecuador

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