COVID–19 and Gaza: a policy recommendation to establish the Gazan Medical Reserve Corps

This paper serves as a policy recommendation to develop a collaborative public–private interdisciplinary healthcare system known as the Gazan Medical Reserve Corps (Reserves) during the COVID–19 pandemic. Due to the high concentration of educated unemployed in Gaza, the Reserves would draw from recent medical school graduates and unemployed physicians. Although initial funds must be awarded by the government and international community to launch the Reserves, the proposed four evidence–based divisions of the Reserves are designed to make a self-sustaining and financially–sound entity. Our literature review demonstrates that the United Nations, various interest groups, and numerous researchers recommend the work of each of the proposed divisions as necessary aspects of a long–term health sector. The Reserves would work with humanitarian organizations, such as the United Nations Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA) and International Medical Corps (IMC), in cooperation with the World Health Organization (WHO). It is a goal to ultimately transition Gaza out of the need for short–term aid and assistance. The Reserves would also work alongside the local health entities and facilities already present inGaza, such as the medical schools, hospitals, and clinics.

Use of Medical Reserve Corps Volunteers in a Hospital-based Disaster Exercise

IntroductionThe Medical Reserve Corps (MRC) is a national network of community-based volunteer groups created in 2002 by the Office of the United States Surgeon General (Rockville, Maryland USA) to augment the nation’s ability to respond to medical and public health emergencies. However, there is little evidence-based literature available to guide hospitals on the optimal use of medical volunteers and hesitancy on the part of hospitals to use them.Hypothesis/ProblemThis study sought to determine how MRC volunteers can be used in hospital-based disasters through their participation in a full-scale exercise.MethodsA full-scale exercise was designed as a “Disaster Olympics,” in which the Emergency Medicine residents were divided into teams tasked with completing one of the following five challenges: victim decontamination, mass casualty/decontamination tent assembly, patient triage and registration during a disaster, point of distribution (POD) site set-up and operation, and infection control management. A surge of patients potentially exposed to avian influenza was the scenario created for the latter three challenges. Some MRC volunteers were assigned clinical roles. These roles included serving as members of the suit support team for victim decontamination, distributing medications at the POD, and managing infection control. Other MRC volunteers functioned as “victim evaluators,” who portrayed the potential avian influenza victims while simultaneously evaluating various aspects of the disaster response. The MRC volunteers provided feedback on their experience and evaluators provided feedback on the performance of the MRC volunteers using evaluation tools.ResultsTwenty-eight (90%) MRC volunteers reported that they worked well with the residents and hospital staff, felt the exercise was useful, and were assigned clearly defined roles. However, only 21 (67%) reported that their qualifications were assessed prior to role assignment. For those MRC members who functioned as “victim evaluators,” nine identified errors in aspects of the care they received and the disaster response. Of those who evaluated the MRC, nine (90%) felt that the MRC worked well with the residents and hospital staff. Ten (100%) of these evaluators recommended that MRC volunteers participate in future disaster exercises.ConclusionThrough use of a full-scale exercise, this study was able to identify roles for MRC volunteers in a hospital-based disaster. This study also found MRC volunteers to be uniquely qualified to serve as “victim evaluators” in a hospital-based disaster exercise.GistR, DanielP, GrockA, LinC, BryantC, KohlhoffS, RoblinP, ArquillaB. Use of Medical Reserve Corps volunteers in a hospital-based disaster exercise. Prehosp Disaster Med. 2016;31(3):259–262.

Developing Strong Response Capacity: Training Volunteers in the Medical Reserve Corps

ObjectiveThe success of the Medical Reserve Corps (MRC) is dependent on the ability of volunteers to respond in a timely and effective manner. This study aimed to assess the current status of MRC volunteer training and to examine the association between MRC characteristics and provision of training.MethodsThe data for this study were drawn from the 2013 Network Profile Survey of the MRC, which was administered to active MRC unit leaders or designated alternates of 962 units across the country in April to May of 2013.ResultsOver 80% of MRCs had a training plan. Ninety-one percent of MRCs offered one or more training courses to volunteers, and 73% indicated requirements for mandatory training. Approximately 84% of MRC units collaborated with other organizations to conduct trainings. Units with more volunteers (>150) were 3 times as likely to have a plan for volunteer training as were those with fewer volunteers (≤50). Compared to units with a full-time leader, those with leaders who were volunteers were only 0.57 times as likely to have a training plan.ConclusionsAn overwhelming majority of MRC units provide critical training to their volunteers prior to an emergency deployment. To further strengthen the overall MRC capacities, it is important for MRC units to have a training plan tailored to their community needs and features, make full use of available training resources, and collaborate with partner organizations. (Disaster Med Public Health Preparedness. 2014;8:527-532)