Medical Relief Research Articles

Review of the domestic utilization of pre-positioned international medical relief equipment in Japan

Review of the domestic utilization of pre-positioned international medical relief equipment in Japan

Deployment of Medical Relief Teams of the Indian Army in the Aftermath of the Nepal Earthquake: Lessons Learned.

In April 2015 a 7.8-magnitude earthquake hit Nepal. As part of relief operations named Operation Maitri, the Indian Armed Forces deployed 3 field hospitals in the disaster zone. Rapid deployment of mobile surgical teams to far-flung, inaccessible areas was done by helicopters. In an operational deployment spanning 1 month, a total of 7532 patients were treated and 105 surgeries were carried out on 83 patients. One-fifth of the patients were less than 18 years of age. One-third of the patients had traumatic injuries directly attributable to the earthquake, whereas the remaining patients were treated for diseases of poor sanitation and hygiene as well as chronic illness that had been neglected owing to the collapse of the local health infrastructure. Cases of traumatic injuries directly related to the earthquake were seen maximally on the 5th day after the index event but tapered off rapidly by the 10th day. Nontraumatic illness required more attention thereafter and a need was felt for separate child health and reproductive health services later in the mission. Although immediate management of injuries and surgical intervention in selected cases was possible, ensuring long-term care and rehabilitation of cases proved problematic. This was especially so for spinal injury cases. Data capturing by a paper-based system was found to be inadequate. The lessons learned from this mission have led to a reimagining of the composition of future relief operations. Apart from mobile surgical teams, on which conventional field hospitals are generally centered, a separate section for preventive medicine and child and maternal services is needed. (Disaster Med Public Health Preparedness. 2017;11:394-398).

Electronic health records system as a catalyst for inter-institutional collaboration in international medical relief work

Electronic health records system as a catalyst for inter-institutional collaboration in international medical relief work

The Rise of the Lord’s Resistance Army: HIV/AIDS or Politics?

The war in northern Uganda, between the Lord‟s Resistance Army (LRA) and the central government which is generally agreed to have started in 1986 and ended in 2006, has attracted many theories as to its origin. While most scholars blame it on marginalisation, discrimination, loss of power by the locals and religious fanaticism which led to acts of terrorism, we assert that one of the underlying causes or perhaps the only leading cause was the emergence of “slim‟ or HIV/AIDS. The other so-called causes could have only been mere triggers of the desperation stemming from this disease which at the time had no known medical relief, unlike today when we have a plethora of medicines which can be applied to its management and to prolong life. The influx of the Ugandan National Resistance Army which led to the setting up of barracks and garrisons in nearly all parts of Acholiland, the setting up of the Local Defence Unit which considerably increased the number of armed personnel in the region as well as forcing people into over-crowded internally displaced camps with little amenities and privacy further exacerbated the spread of HIV/AIDS and in turn public opinion against the National Resistance Movement/Army (NRM/A) government.

Communicating Radiation Risk to the Population of Fukushima.

Radiological specialists from Nagasaki University have served on the medical relief team organized at Fukushima Medical University Hospital (Fukushima City) ever since the accident at the Fukushima Dai-ichi nuclear power plant. Furthermore, we have conducted the radiation crisis communication efforts by spreading correct information on the health effects of radiation as 'advisors on radiation health risk control'. Nagasaki University has been assisting the reconstruction efforts of Kawauchi Village in Fukushima Prefecture, which was the first village to declare that residents could safely return to their homes because radiation doses were found to be at comparatively low levels. In April 2013, Nagasaki University and the Kawauchi government office concluded an agreement concerning comprehensive cooperation toward reconstruction of the village. As a result, we established a satellite facility of the university in the village. In conclusion, training of specialists who can take responsibility for long-term risk communication regarding the health effects of radiation as well as crisis communication in the initial phase of the accident is an essential component of all such recovery efforts. Establishment of a training system for such specialists will be very important both for Japan and other countries worldwide.

Medical relief in Nepal earthquake: Observations and lessons to learn

Abstract not availableSouth East Asia Journal of Public Health Vol.5(2) 2015: 77-78

Retrospection-Simulation-Revision: Approach to the Analysis of the Composition and Characteristics of Medical Waste at a Disaster Relief Site.

A large amount of medical waste is produced during disaster relief, posing a potential hazard to the habitat and the environment. A comprehensive understanding of the composition and characteristics of medical waste that requires management is one of the most basic steps in the development of a plan for medical waste management. Unfortunately, limited reliable information is available in the open literature on the characteristics of the medical waste that is generated at disaster relief sites. This paper discusses the analysis of the composition and characteristics of medical waste at a disaster relief site using the retrospection-simulation-revision method. For this study, we obtained 35 medical relief records of the Wenchuan Earthquake, Sichuan, May 2008 from a field cabin hospital. We first present a retrospective analysis of the relief medical records, and then, we simulate the medical waste generated in the affected areas. We ultimately determine the composition and characteristics of medical waste in the affected areas using untreated medical waste to revise the composition of the simulated medical waste. The results from 35 cases showed that the medical waste generated from disaster relief consists of the following: plastic (43.2%), biomass (26.3%), synthetic fiber (15.3%), rubber (6.6%), liquid (6.6%), inorganic salts (0.3%) and metals (1.7%). The bulk density of medical relief waste is 249 kg/m3, and the moisture content is 44.75%. The data should be provided to assist the collection, segregation, storage, transportation, disposal and contamination control of medical waste in affected areas. In this paper, we wish to introduce this research method of restoring the medical waste generated in disaster relief to readers and researchers. In addition, we hope more disaster relief agencies will become aware of the significance of medical case recording and storing. This may be very important for the environmental evaluation of medical waste in disaster areas, as well as for medical waste management and disposal.

What Kinds of Skills Are Necessary for Physicians Involved in International Disaster Response?

Introduction Physicians are key disaster responders in foreign medical teams (FMTs) that provide medical relief to affected people. However, few studies have examined the skills required for physicians in real, international, disaster-response situations. Problem The objectives of this study were to survey the primary skills required for physicians from a Japanese FMT and to examine whether there were differences in the frequencies of performed skills according to demographic characteristics, previous experience, and dispatch situations to guide future training and certification programs. This cross-sectional survey used a self-administered questionnaire given to 64 physicians with international disaster-response site experience. The questionnaire assessed demographic characteristics (sex, age, years of experience as a physician, affiliation, and specialty), previous experience (domestic disaster-relief experience, international disaster-relief experience, or disaster medicine training experience), and dispatch situation (length of dispatch, post-disaster phase, disaster type, and place of dispatch). In addition, the frequencies of 42 performed skills were assessed via a five-point Likert scale. Descriptive statistics were used to assess the participants' characteristics and total scores as the frequencies of performed skills. Mean scores for surgical skills, health care-related skills, public health skills, and management and coordination skills were compared according to the demographic characteristics, previous experience, and dispatch situations. Fifty-two valid questionnaires (81.3% response rate) were collected. There was a trend toward higher skill scores among those who had more previous international disaster-relief experience (P=.03). The more disaster medicine training experience the participants had, the higher their skill score was (P<.001). Physicians reported involvement in 23 disaster-relief response skills, nine of which were performed frequently. There was a trend toward higher scores for surgical skills, health care-related skills, and management and coordination skills related to more disaster medicine training experience. This study's findings can be used as evidence to boost the frequency of physicians' performed skills by promoting previous experience with international disaster relief and disaster medicine training. Additionally, these results may contribute to enhancing the quality of medical practice in the international disaster relief and disaster training curricula. Noguchi N , Inoue S , Shimanoe C , Shibayama K , Matsunaga H , Tanaka S , Ishibashi A , Shinchi K . What kinds of skills are necessary for physicians involved in international disaster response? Prehosp Disaster Med. 2016;31(4):397-406.

Laboratory Medicine Abroad

![Graphic][1] Doctors Without Borders —it just sounds cool. Not only does the name allude to the organization's purpose of providing medical care abroad, but it also lionizes physicians in a way, suggesting we are capable of transcending boundaries to help those near and far. I always wanted to participate in Doctors Without Borders or a similar international medical program, and I have friends in other subspecialties who seem to have plenty of opportunities to travel abroad on medical relief–type trips. I attributed these opportunities to the fact that interacting with patients on a daily basis lends itself to fieldwork in other countries. As pathologists, we are reliant on resources such equipment, instruments, reagents, and so forth in order to deliver results and render diagnoses. Consequently, our reliance on technology makes providing international support more cumbersome, especially in resource-limited countries, which of course are the ones most in need. Taking on this prohibitory mentality, I sadly resigned myself to a life sans international medical work. Luckily, my view changed once I was asked to participate in a laboratory medicine course for physicians in Sub-Saharan Africa. Under MEPI, African medical schools are strengthening and expanding their curricula. Photo by Richard Lord for Fogarty/NIH In the United States, we are spoiled in that our laboratories, especially … [1]: /embed/inline-graphic-1.gif

End-of-life Care and Beyond

ABSTRACTOne of the challenges of palliative care is to honour the personal wishes of culturally diverse patients while meeting ‘universal medical relief standards’. Diverging perspectives on good care can result in intercultural negotiations, such as those analysed in this paper between Dutch care professionals and immigrant families with a Turkish and Moroccan background. Fewer tensions are apparent during the burial care phase. This paper outlines the experiences of immigrant families and their Dutch care professionals in the transition from palliative care to burial care. Their narratives highlight how undertakers offer burials that follow the funeral rituals practised in their customers’ (predominantly Muslim) home countries and therefore employ bilingual staff to fulfil the specific wishes of the families. Palliative care professionals, on the other hand, tend to follow their Dutch interpretation of ‘universal medical relief standards’. The contrast not only reveals cultural diversity, but also different logics of care; while undertakers follow the logic of the market and the logic of family life, health care professionals tend to follow the logics of professionalism and politics.

Medical Relief Trips...What’s Missing? Exploring Ethical Issues and the Physician-Patient Relationship

"The welcome ceremony alone will leave you breathless as you become inspired by their overwhelming joy at you arrival. Here you will participate with the community and provide much needed medical care. The team will also provide care for the Talibe boys in Theis who go without medical care and are left to face disease on their own (Senegal, 2009)."

“A Greater Earnestness of Purpose and a More Militant Spirit”: Physicians and Medical Relief in 1930s Michigan

The Federal Emergency Relief Act of 1935 promised federal funds for medical relief, and Michigan physicians seized the opportunity to shape the local programs created under FERA. Michigan’s physicians sought to preserve the private medical marketplace through the allocation of public funds to provide medical relief, just as funds were appropriated for food, fuel, and housing. Michigan physicians’ efforts to influence these programs crossed into the professional terrain of relief workers and social work. Physicians were not able to navigate the system unchecked; local officials and relief workers sought limits to medical authority in the interest of protecting public funds, and physicians resisted such efforts. While many of the programs of the New Deal years were hailed as innovative models, most preserved the existing tenets of the medical system while expanding physicians’ market for patients to include relief recipients.

Medical Relief Response by Miyako Public Health Center after the Great East Japan Earthquake and Tsunami, 2011

To improve disaster preparedness, we investigated the response of medical relief activities managed by Iwate Prefectural Miyako Public Health Center during the post-acute phase of the Great East Japan Earthquake and Tsunami on March 11, 2011. The study divided the post-disaster period into three approximate time segments: Period I (time of disaster through late March), Period II (mid-April), and Period III (end of May in Miyako City, early July in Yamada Town). We reviewed records on medical relief activities conducted by medical assistance teams (MATs) in Miyako City and Yamada Town. Miyako Public Health Center had organized a meeting to coordinate medical relief activities from Period I to Period III. According to demand for medical services and recovery from the local medical institutions (LMIs) in the affected area, MATs were deployed and active on evacuation centers in each area assigned. The number of patients examined by MATs in Miyako rose to approximately 250 people per day in Period I and decreased to 100 in Period III. However, in Yamada, the number surged to 700 in Period I, fell to 100 in Period II, and decreased to 50 in Period III. This difference could be partly explained as follows. In Miyako, most evacuees had consulted LMIs which restarted medical services after disaster, and the number of LMIs restarted had already reached 29 (94% of the whole) in Period I. In Yamada, most evacuees who had consulted MATs in Period I had almost moved to LMIs restarted in Period II. During the same time, a division of roles and coordination on medical services provision was conducted, such as MATs mainly in charge of primary emergency triage, in response to the number of LMIs restarted which reached 1 (20%) in Period I and 3 (60%) in Period II. Following Period III, more than 80% of patients in Miyako had been a slight illness, such as need for health guidance, and the number of people who underwent emergency medical transport reached pre-disaster levels in both locations. These results suggest that demand for medical services of evacuees declined to a stable level in an early stage of Period III. Using the above findings, one might justify supporting local medical institutions' recovery earlier. Then, medical relief activities might be finished properly. This study shows useful perspectives in the response of medical relief activities during post-acute phase after disaster and the importance of establishing systems for information management that apply these perspectives.

Islamic Microfinance Model To Reduce Poverty: Pakistan's Case

The most essential element for any Government is to become a welfare state and the constitution of Pakistan gives great importance to promote the social welfare projects in order to alleviate the poverty. The article 37 and 38 of constitution 1973, is the mother source of socio-economic and people welfare policies, explains that state should provide the basic necessities of life like food, clothing, shelter, education, medical relief, suitable job opportunities and reduce the disparities in the sources of earnings. In view of this, Pakistan government introduced different development programmes, schemes and plans for the provision of basic facilities to poor’s. According to the State Bank report 2011, Microfinance has failed to make a major breakthrough in Pakistan in order to become a dynamic participant. The poverty rate in the country, increased from 23.9 to 37.5 percent according to planning Commission (2012). It was also reported that about sixty million people was living below absolute poverty line. The recent disaster of Thar and Chulsitan own speaks loud on the failure of Govt. development programmes and microfinance. As interest is prohibited as per belief of majority of the people, any interest based scheme is not suitable due to being exploitation. Now, there is a great need to bring a religiously acceptable model that will change baggers to donator hand. Islamic finance takes an impressive leap after ongoing economic and financial crises at the national and global levels and is increasingly gaining ground. The present study suggests a practical Islamic microfinance model that can be considered to be more fruitful and productive to alleviate poverty effectively; it explains seven years might be sufficient to reduce poverty from the society at large.

Design of a Reliable Bi-objective Relief Routing Network in the Earthquake Response Phase

One of the most critical issues in areas which have recently faced natural disasters is transportation of both injured people to medical centers and relief commodities to their desired destinations. In such situation, due to disruptions, some routes may lose all or part of their capacities and not be able to accept as much vehicles as before. Consequently, the relief vehicles face difficulties to follow their itinerary. Such critical circumstance calls for finding reliable solutions. This study develops a new bi-objective, multi-mode and multi-commodity model, in which the reliability is taken into account to help managers in making more reliable decisions. To solve this model, the TH method is used in order to find the equivalent single objective model and this new model is exactly solved by coding in GAMS software.

Outcome of laser therapy in patients with anal fissure

In the past decade, several studies have investigated the effect of laser therapy on haemorrhoids, anal fistulas and tumours but few have explored its use in acute anal fissure. Therefore, the present study aimed to evaluate the efficiency of laser therapy in treating acute anal fissure. This clinical trial was conducted on all the patients referred to Valiasr Hospital, Arak, Iran, with acute anal fissure. Patients who were unresponsive to medical treatment and in whom surgery was indicated were divided into two equal-sized groups. Age, medical treatment duration, healing time, pain relief, relapse and indication for reoperation were recorded in all patients. The mean age of the patients and the mean medical treatment duration were significantly different in the two groups. Although there were no significant differences in the mean healing time and response to pain in the first and third months after surgery and laser therapy, by month 6 the mean response to pain was significantly different in the two groups. Frequency of relapse and need for further surgery were not significantly different between the groups. Laser therapy of acute anal fissure is a simple, non-invasive and painless surgical procedure with a low rate of complications. It can be viewed as an effective treatment for patients with anal fissure. However, this procedure has some limitations.

THE FORMALISATION OF SOCIAL ENGAGEMENT IN THE MEDICAL RELIEF NGO: THE EVIDENCE OF MERCY MALAYSIA

Social engagement involves the participation of a group people in undertaking collective activities in social community. The paper aims to examine the formalisation of NGO social engagement to their stakeholders. The MERCY's social engagement is not only focusing on the traditional forms of reports i.e. social reports to the stakeholders but includes the forms of actions including conversation, behavioural explanations and reasonable conduct through negotiation of performance and impact among stakeholders. The social engagement paradigm emphasises on the rights and contracts between two parties (i.e. Accountor and Accountee). The qualitative research is employed by undertaking empirical case study research for MERCY, an international disaster relief NGO that highlight an understanding of social engagement through the power of negotiation. The data are gathered through indepth series of interviews and documentary reviews, which was analysed through thematic analysis. The findings revelas the social "closeness" within the community can be seen from the moral values imperatives that had driven by the trustworthiness and willingness of the people in the community to engage in the volunteering work.

Mainstream disaster health as a policy priority: experiences from Chennai floods and a cross sectional study during disaster relief phase

Background: The months leading to the end of 2015 exposed the pernicious compromise of India’s flood protection mechanism and India’s deep unpreparedness for addressing Disasters and humanitarian emergencies. Chennai was washed out by the annual northeast monsoon during the November-December months of 2015. More than 500 people lost their lives and more than 18 lakh people were displaced and over 22 lakh vehicles were damaged with economic losses ranging from US$7-15 billion, going by popular media estimates. Methods: A cross sectional study was carried out through a convenience sampling n = 400 and subjects coming under different wards in Chennai municipal corporation were administered a questionnaire which was made exclusively for the Chennai floods. The subjects who participated in the study were belonging to the outreach area zones identified by Help Age Chennai Mobile Unit. Help Age India and Help Age Chennai identified in particular worst affected zones due to the floods and provided medical relief. The first author observations while responding to the floods have also been synced into the discussion. Results: The floods in Chennai led to significant depression among the populace where 87.9 % felt depressed (p value<0.009). 332 (83%) felt that Governmental help did not come, and it signals the massive collapse of the Government structure. Public drainage water got mixed with the clean water during the floods and remained that way without adequate chlorination in many areas and 88.2% felt it affected their health (p value <0.001). Conclusions: Great co-ordination needs to be brought and work integrated between the city corporation, public work department, slum clearance board, housing boards and development authority to be able to respond to any catastrophe.

The Formalisation of Social Engagement in the Medical Relief NGO: The Evidence of MERCY Malaysia

The Formalisation of Social Engagement in the Medical Relief NGO: The Evidence of MERCY Malaysia

Activity of a Medical Relief Team from Shizuoka Hospital During the 2016 Kumamoto Earthquake

Activity of a Medical Relief Team from Shizuoka Hospital During the 2016 Kumamoto Earthquake