Situation, target, plan…

28 Jan

Disaster physicians: Dr. Victor Matos, Dr. Alejandro Baez, Dr. Juan Rodriguez SCCM Disaster Field Team: Dr. M.J. Reed, Dr. Marie Baldisseri, Dr. Randy Wax, Dr. Dana Braner, Gervaise Nicklas, Province of Ontario Emergency Medical Assistance Team: Dr. Bruce Sawadsky

The SCCM Disaster Field Team met today with multiple representatives from different disaster-related organizations in the Dominican Republic, including the Pan American Health Organization, Project HOPE and the DR Ministry of Health. Dr. Lucas, Director of Special Services for the Public Health System in the DR, provided an overview of the current ICU bed capacity in the public hospital system in country. 75% of the population in the DR relies on the public hospital system for care. There are a limited and inadequate number of ICU beds in the public health system at varying states of readiness meant to serve a population of 7.5 million on the island. It was agreed that there was a need to increase bed capacity for patients with or at risk of critical illness within the DR public hospital system. ICU bed occupancy and availability will be added to the daily briefing for leadership in the Ministry of Health. A patient tracking system is being evaluated in a pilot project to see if better real time situational awareness can be improved to better allocate resources and move patients to the right place at the right time.

Evaluation of the process for caring for patients, moving patients from makeshift health facilities to more definitive care, was conducted. After mapping out a very complicated existing system, attempts were made to simplify the command and control structure for critical care resources in the country with advice from the groups. Three regions in the country will be targeted for efforts to increase ICU capacity to better serve patients in hard hit areas. Need for additional work in clarifying the referral process and transport system was identified.

Working together to move patients back in as a storm approaches. Fearing another quake Hatians had built a tent city at the steps of the Jimani Clinic.

The SCCM team has moved from initial reconnaissance activities to assisting with brainstorming solutions along with the leading organizations on the ground to improve efficiency of the critical care system.

“Swallow your egos…this is the REAL world"

As the staff on the front lines in Jimani so eloquently stated, “Swallow your egos…this is the REAL world”. This sentiment was seen at the strategic and leadership level as well. The team was impressed with the willingness of the different organizations to work together in a constructive and creative manner to make a difference.

Be Sociable, Share!

5 Responses

H. Stephen Fletcher, M.D.

January 28th, 2010 at 11:02 pm
1

SCCM members are also involved with other specialists including general surgeons, orthopedists and nurses with Hopital Sacre Coeur in Milot, Haiti approximately 70 miles north of Port au Prince. I just returned from a week at the hospital. In 2 days last week from Monday to Wednesday we expanded the hospital from 2 operating rooms with 70 beds to 4 operating rooms and 300 beds. It is fully staffed and functioning well. We are in the network with the Navy and CoastGuard as is the Comfort, aircraft carriers Vinson and Bush and other Navy and Coast Guard Ships. We receive a dozen or so helicopters per day with 40 + patients. For further info you can contact Peter Kelly, M.D. at LPPJS@aol.com or http://CRUDEM.org
MJ Reed

January 30th, 2010 at 4:29 am
2

At all levels during our time here, we heard about the excellent care at Hopital Sacre Coeur. The information is operational details but unfortunately not details of personnel. Your efforts there are impressive to do such wonderful care under extreme conditions. We will pass your personal infomation to the team here in DR working PAHO and the government as knowing who the dedicated volunteers are is important. I encourage all SCCM to use this blog to tell of your experiences as many return. This way we all learn and we know who you are. Thank you for your dedication.
Richard Reed MD FACS FS

January 30th, 2010 at 4:37 pm
3

Great job!
Wish I was with you
Watch your 6
Louisdon Pierre MD FAAP

February 2nd, 2010 at 11:54 pm
4

I am a Haitian born pediatric intensivist practicing in Brooklyn NY (SCCM member). We left New York for Haiti on January 14. Our team arrived at Carrefour Diquini Hospital on Friday January 15 and began performing surgery almost immediately in a makeshift tent set up as the operating room. The team had 3 general surgeons one pediatric nurse a pediatric intensivist and one internist. We were able to quickly penetrate the barriers to the island because of a 10 year history of medical missions to Milot. (www.OMATmission.org). We crossed the border in the north then made our first stop at Hopital Sacre coeur. There was no communication with Port-au-Prince at that time so we personally delivered a memo to the American embassy in the hope that patients would be airlifted to Milot. We are greatly pleased to know that hundreds of patients are able to be cared for in this manner. In fact, 140 patients had already been airlifted by January 20.

The Hospital at Diquini was fully operational however, entry into the facility only began the following Monday. With expertise in deep sedation I facilitated many amputations and fasciotomies and debridements. during the first two days we worked in extreme conditions until more supplies made its way from the airport. It is said that this was perhaps on of the first hospital that began performing life saving surgeries. This is a well run institution within the network of the Adventist Health International, also affiliated with the Loma Linda University. I think that this is a great setting for implementation of a FCCS and PFCCS course and I am hoping to help set-up a PICU on this university campus where I was raised. We are planning a second trip to Diquini in March and later in June in the heart of Carrefour, close to the epicenter of this shocking earthquake.
Randy Wax

February 4th, 2010 at 1:56 pm
5

Dr. Pierre, this is a great success story. Congratulations on your great work. Please keep in touch with our team, there will be great need for FCCS/PFCCS/FDM in helping to build critical care infrastructure in Haiti and the DR. We hope that you can help us establish PFCCS there. You may have seen the announcement by e-mail blast about establishing fundraising efforts to support the SCCM courses in Haiti and the DR. I think the education efforts are so important, eventually the international aid will fade and Haiti will need help to regain independent medical infrastructure.