International Emergency Medical Teams in the Aftermath of the 2015 Nepal Earthquake

2019 ◽  
Vol 34 (03) ◽  
pp. 260-264 ◽  
Author(s):  
Nieves Amat Camacho ◽  
Khem Karki ◽  
Shiva Subedi ◽  
Johan von Schreeb

AbstractIntroduction:International Emergency Medical Teams’ (I-EMTs) response to disasters has been characterized by a late arrival, an over-focus on trauma care, and a lack of coordination and accountability mechanisms. Analysis of I-EMT performance in past and upcoming disasters is deemed necessary to improve future response.Objective:This study aimed to describe the characteristics, timing, and activities of I-EMTs deployed to the 2015 Nepal earthquake, and to assess their registration and adherence to the World Health Organization Emergency Medical Teams’ (WHO-EMT; Geneva, Switzerland) minimum standards compared to past disasters.Methods:An online literature search was performed and key web sites related to I-EMT deployments were purposively examined. The methodology used is reported following the STARLITE principles. All articles and documents in English containing information about characteristics, timing, and activities of I-EMTs during Nepal 2015 were included in the study. Data were retrieved from selected sources to compile the results following a systematic approach. The findings were validated by the Nepalese focal point for the coordination of I-EMTs after the earthquake.Results:Overall, 137 I-EMTs deployed from 36 countries. They were classified as Type I (65%), Type II (15%), Type III (1%), and specialized cells (19%). Although national teams remained the first responders, two regional I-EMTs arrived within the first 24 hours post-earthquake. According to daily reporting, the activities performed by I-EMTs included 28,372 out-patient consultations (comprising 6,073 trauma cases); 1,499 in-patient admissions; and 440 major surgeries. The activities reported by I-EMTs during their deployment were significantly lower than the capacities they offered at arrival. Over 80% of I-EMTs registered through WHO or national registration mechanisms, but daily reporting of activities by I-EMTs was low. The adherence of I-EMTs to WHO-EMT standards could not be assessed due to lack of data.Conclusion:The I-EMT response to the Nepal earthquake was quicker than in previous disasters, and registration and follow-up of I-EMTs was better. Still, there is need to improve I-EMT coordination, reporting, and quality assurance while strengthening national EMT capacity.Amat Camacho N, Karki K, Subedi S, von Schreeb J. International Emergency Medical Teams in the aftermath of the 2015 Nepal earthquake. Prehosp Disaster Med. 2019;34(3):260–264.

2019 ◽  
Vol 34 (s1) ◽  
pp. s24-s25
Author(s):  
Soichiro Kai

Introduction:Quality assurance of Emergency Medical Teams (EMTs) is a world concern. The World Health Organization (WHO) published an international guideline for EMTs in 2013 and started the global EMT classification, a quality assurance program for EMTs, in 2015. There are 16 classified EMTs in the world as of October 2018. The Association of Southeast Asian Nations (ASEAN) region is a disaster-prone area. Therefore, the need for EMTs is relatively high. However, there is no classified EMT in the ASEAN region. Factors that prevent the global classification of EMTs in the ASEAN region are unknown.Aim:The objective of this study was to analyze the inhibitory factors of the global EMT classification in the ASEAN region.Methods:A questionnaire survey was taken to the 10 national groups of ASEAN countries. Each group consisted of EMT-related personnel. They were 39 participants for the third AMS Training of the ARCH Project held in May 2018. 10 national groups were asked to answer whether governmental EMT of their country is able to meet the criteria for the EMT global classification. The criteria were written in the WHO-provided minimum standard self-assessment checklist for the Type 1 fixed EMT.Results:Among 39 categories in the self-assessment checklist, 5 were the most difficult categories to meet the criteria: [Core Standards] Self-sufficiency, Sanitation, and Waste Management; Indemnity and Malpractice; [Technical Standards] Logistics; EMT Capacity.Discussion:There are some limitations to the study. Non-governmental EMTs were not covered. Participants of the training were not at the official EMT focal point for the global EMT classification. Logistical requirements may be inhibitory factors of the global EMT classification in the ASEAN region.


Author(s):  
Yosuke Takada ◽  
Yasuhiro Otomo ◽  
Khem Bahadur Karki

ABSTRACT Objectives: After the Nepal earthquake in 2015, for the first time, the Emergency Medical Team Coordination Cell (EMTCC) was activated. This study aims to evaluate the emergency medical team (EMT) coordination in the aftermath of the Nepal earthquake in 2015. Methods: This is a retrospective study that (a) describes the coordination process in Nepal, and (b) reviews and analyzes the EMT database in Nepal to classify the EMTs based on the World Health Organization (WHO) EMT classification, an online survey for EMT coordination, and the Geographic Information System-analyzed EMT distribution. Results: We recorded 150 EMTs, which included 29 Type 1-Mobile, 71 Type 1-Fixed, 22 Type 2, 1 Type 3, and 27 specialist cell recorded EMTs including the military team. The EMTs were allocated based on the number of casualties in that area. The Type 1 EMTs were deployed around Type 2 EMTs. Conclusions: The EMT Classification is useful for the effective posting of EMTs. However, the method of onsite multi registration has room for improvement. The WHO should provide an opportunity for EMTCC training for better coordination of disasters.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026746 ◽  
Author(s):  
Anup Uprety ◽  
Akihiko Ozaki ◽  
Asaka Higuchi ◽  
Bikal Ghimire ◽  
Toyoaki Sawano ◽  
...  

ObjectivesLittle is known regarding how natural disasters affect patients with cancer in low-income and middle-income countries. The objective of the present study was to assess the impact of the 2015 Nepal earthquake on the admission of patients with cancer at a core medical institution in Kathmandu.Design, setting and participantsWe considered all 3520 cancer patient admissions to Tribhuvan University Teaching Hospital, from 25 April 2013 to 24 April 2017 (2 years before and 2 years after the earthquake).Outcome measuresThe number of cancer patient admissions was calculated for each month. Using a negative binomial model, we estimated the incidence rate ratio (IRR) for admission numbers each month after the earthquake compared with the pre-earthquake baseline and investigated chronological change.ResultsThe total admission number in the first month after the earthquake was decreased compared with that of the predisaster baseline (IRR=0.66, 95% CI 0.43 to 1.00), which largely reflected decreased admissions of patients from outside of the most disaster-affected districts. From the second month, the admission number consistently exceeded the predisaster baseline for the remaining postdisaster period. In contrast to the month of the disaster, the continuation of increased admissions was most prominent among those from outside of the most affected districts.ConclusionsAfter a transient decrease immediately following the 2015 Nepal earthquake, there was a long-term increase in cancer patient admissions in a core hospital in Kathmandu. These changes were seen most prominently in patients from outside the most disaster affected areas.


2019 ◽  
Vol 34 (s1) ◽  
pp. s25-s26
Author(s):  
Hai Hu

Introduction:Currently, Technical Advisors of the World Health Organization’s (WHO) Emergency Medical Teams (EMT) Secretariat are conducting standardized verification work for international emergency medical teams in various countries and organizations. However, a uniform and standard training course for an International EMT is lacking.Aim:To design a training course model based on knowledge structure, teaching, and evaluation methods for an International EMT.Methods:The first and second level catalogue defined as chapters and sections for the International EMT training curriculum were drafted based on literature and summaries of fragmentary experience. The teaching syllabus with the method of teaching and evaluation was initially outlined. The expert consultation form was designed and validated. Experts from International EMTs from various countries were consulted and investigated. The Delphi method was used, and the chapters and sections were adjusted and weighed according to experts’ advice through the Analytic Hierarchy Process. The teaching and evaluation methods for each knowledge module were obtained based on suggestions from experts.Results:A total of 25 experts were consulted. By 2 rounds of consultation with a Kendall coordination coefficient W value of 0.210 and chi-square value of 78.61 (p<0.05), consensus about the knowledge structure for the curriculum was achieved, which consisted of 6 chapters: (1) introduction of International EMT, (2) Disaster medicine, (3) Global health, (4) Care in austere condition, (5) Medical technology, (6) Field training, with the weights of 0.1415, 0.1584, 0.1536, 0.1827, 0.1728, and 0.1909, respectively, and 32 sections. Teaching methods for different knowledge modules were determined, which included lecture, demonstration, discussion, drills, and tabletop simulation. The evaluation methods were affirmed via a quiz, written examination, skill test, and teamwork test assessed by intra-group and inter-group evaluation.Discussions:Through scientific investigation of experts from International EMTs, a training course model for International EMT was established.


2018 ◽  
Vol 33 (3) ◽  
pp. 335-338 ◽  
Author(s):  
Anthony Albina ◽  
Laura Archer ◽  
Marlène Boivin ◽  
Hilarie Cranmer ◽  
Kirsten Johnson ◽  
...  

AbstractThe World Health Organization’s (WHO; Geneva, Switzerland) Emergency Medical Team (EMT) Initiative created guidelines which define the basic procedures to be followed by personnel and teams, as well as the critical points to discuss before deploying a field hospital. However, to date, there is no formal standardized training program established for EMTs before deployment. Recognizing that the World Association of Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) Congress brings together a diverse group of key stakeholders, a pre-Congress workshop was organized to seek out collective expertise and to identify key EMT training competencies for the future development of training programs and protocols. The future of EMT training should include standardization of curriculum and the recognition or accreditation of selected training programs. The outputs of this pre-WADEM Congress workshop provide an initial contribution to the EMT Training Working Group, as this group works on mapping training, competencies, and curriculum. Common EMT training themes that were identified as fundamental during the pre-Congress workshop include: the ability to adapt one’s professional skills to low-resource settings; context-specific training, including the ability to serve the needs of the affected population in natural disasters; training together as a multi-disciplinary EMT prior to deployment; and the value of simulation in training.AlbinaA, ArcherL, BoivinM, CranmerH, JohnsonK, KrishnarajG, ManeshiA, OddyL, Redwood-CampbellL, RussellR. International Emergency Medical Teams training workshop special report. Prehosp Disaster Med. 2018;33(3):335–338.


2008 ◽  
Vol 101 (5) ◽  
pp. 712-714 ◽  
Author(s):  
E. Leusveld ◽  
S. Kleijn ◽  
V.A.W.M. Umans

Author(s):  
Moran Bodas ◽  
Kobi Peleg ◽  
Bruria Adini ◽  
Luca Ragazzoni

Abstract In spite of their good intentions, Emergency Medical Teams (EMTs) were relatively disorganized for many years. To enhance the efficient provision of EMT’s field team work, the Training for Emergency Medical Teams and European Medical Corps (TEAMS) project was established. The purpose of this study was to assess the effectiveness and quality of the TEAMS training package in 2 pilot training programs in Germany and Turkey. A total of 19 German and 29 Turkish participants completed the TEAMS training package. Participants were asked to complete a set of questionnaires designed to assess self-efficacy, team work, and quality of training. The results suggest an improvement for both teams’ self-efficacy and team work. The self-efficacy scale improved from 3.912 (± 0.655 SD) prior to training to 4.580 (± 0.369 SD) after training (out of 5). Team work improved from 3.085 (± 0.591 SD) to 3.556 (± 0.339 SD) (out of 4). The overall mean score of the quality of the training scale was 4.443 (± 0.671 SD) (out of 5). In conclusion, The TEAMS Training Package for Emergency Medical Teams has been demonstrated to be effective in promoting EMT team work capacities, and it is considered by its users to be a useful and appropriate tool for addressing their perceived needs.


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