duttine surgical and rehab interventions in response to the haiti eq crdr.disaster.symp.isprm11
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SURGICAL AND REHABILITATION INTERVENTIONS IN RESPONSE TO THE HAITI EARTHQUAKE
Antony Duttine & Dr James Gosney JrHandicap InternationalSan Juan, Puerto Rico 13th June 2011
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Reminder of the Haiti earthquake• Richter scale magnitude
7.0 earthquake
• 222,570 deaths and 300,572 injuries (OCHA).
• Over 600 agencies responded in first month (PAHO)
Excessively high amputation rate reported in media – criticisms of response
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Study on the humanitarian response:
Aims:
•Review surgical response in relation to amputations
•Links to rehabilitation services
•Implications for response to future disasters and responses
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Methodology
• Quantitative data element:• Statistical data from surgical
organizations• HI/CBM/SEIPH database
• Qualitative data:• 83 semi-structured
interviews• Local interviewer
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Findings: Surgery
• Variation in amputation rates
• Lack/inconsistency of medical record keeping
• Day 2: population rumours
• Day 5: amputation peak
BUT
range = <1% to 46%
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Findings: Rehab
• Surgery to rehab limited pathways:• Community and self referrals
• Amputees only a fraction of total rehab clients:• Orthotic vs. prosthetic
requirements
• Prosthetic “shopping around”
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Implications and conclusions
•Rehab and surgical sectors showed evidence of excellent practices individually. BUT
• Needs to be better coordinated• Integrated trauma care pathways
•Medical record keeping reinforcement
•Proportionalise not sensationalise
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Questions for the ISPRM…
• How to advocate and achieve a multidisciplinary approach
• How to ensure all actors are aware of protocols and standards…
• How to practically facilitate medical communication in the chaos of disaster…