Re-housing, Reconstruction of limbs and Rehabilitation of patients, known as “the 3 R’s Strategy, is the priority for causalties of a disaster.
Disasters are either natural, such as earthquakes, tsunamis and hurricanes, or man made such as armed conflict. Both can happen unexpectedly and MIST is prepared to respond at short notice with medical aid and expertise in limb reconstruction.
Immediate: Days to Weeks
The immediate task for authorities is to initiate evacuation of the victims and send in specialist teams for Search and Rescue.
In the subsequent days, authorities need to establish communications in the affected areas, set up a Field Hospital to deliver urgently required medical care and ensure that the hospitals within the disaster area are structurally sound and suitable for patient care.
The coordinated mobilization of personnel can take days to initiate and the more geographically remote and difficult the terrain, the more challenging this task becomes.The immediate response depends on the Nation’s ‘Emergency Preparedness’, the healthcare infrastructure within that country, it’s economy and geographic location.
For developed countries, the resources and manpower are available to deliver a coordinated immediate response to the initial disaster. This was observed in the response following the tsunami of March 2011 in Japan compared to the Haitian earthquake in April 2010.
Early Response: Weeks to Months
Following a catastrophe, MIST deploys an initial assessment team, with MIST Units on stand-by in their respective countries. After establishing a ‘surgical base’ in the disaster area, teams are sent out on a 2-weekly rotation. The rotation of Units will enable the continuity of patient care which is essential in these initial stages and provide a cycle of fresh team members in order to avoid ‘burn-out’ of field staff.
MIST coordinates with the local hospital and sends specialist Ortho-Plastic teams to address orthopaedic problems encountered from the initial disaster. These include bone and soft tissue injuries, infections, mal-unions and untreated injuries from the initial stage of the disaster, due to the large number of causalities.
A ‘Limb Reconstruction Team’ (LRT) consists of all the personnel needed to run a trauma theatre independently. Each team leader and his team have been briefed on disaster management protocols and all have received training in emergency medical treatments and ATLS training. The medical expertise consists of Orthopaedic surgeons specialising in the Ilizarov technique, Plastic Surgeons and Anaesthetists specialising in pain management.
Late Response: Months to Years
Once the immediate and early phases have been achieved and casualties stabilised and a clear care plan established MIST can develop and agree the ongoing and future needs for the population, medical staff, facility and region to establish a limb reconstruction unit, supported by MIST expertise but staffed locally.
Self-sufficiency within a limb reconstruction unit, hospital, a region, a country with targeted support when needed is the ultimate goal of MIST.
