THE ROLE OF THE PHILIPPINE PHYSIATRIST IN A LARGE-SCALE NATURAL DISASTER

THE PARM EXPERIENCE IN TYPHOON HAIYAN

8th International Society of Physical Rehabilitation Medicine World Congress

Cancun, MexicoJune 4, 2014

Ganchoon, FG, Martinez RR, Dy RT, Gosney JE

- typhoon in recorded history with estimated wind gusts of 235 mph and surface pressure measurement of 901.4 mb

- storm recorded at landfall

Highest- intensity of a Category 5 tropical cyclone with sustained winds of 315 kph

(above the 252 kph threshold for a Category 5 hurricane, the highest category on the Saffir-Simpson scale)

- Reference: Meteomedia

Strongest

- storm surge recorded in East Asia of 9.14m due to strong winds, resulting in the majority of deaths due to drowning and catastrophic damage

GUIUAN, EASTERN SAMAR

AFP CENTRAL COMMAND

November 8, 2013First Landfall – Guiuan, Easter SamarPopulation – 47,047 (est)

ANIBONG, TACLOBAN, LEYTE

REUTERS/ROMEO RANOCO

IMPACTSignificant national impact: 6,268 confirmed deaths, 28,689 injured, and 1,061 missing, with 3.4 million families (over 16 million persons) affected in 44 provinces, 57 cities, and 591 municipalities .

Reference: National Disaster Risk Reduction & Management Council (NDRRMC)

PARMPhilippine Academy of Rehabilitation Medicine

Membership: 340 PMR Centers: 412

Chapters

North Luzon (46)

National Capital Region (178)

Visayas (22)

Mindanao (20)

The Role of the Philippine Physiatrist in a Large-Scale Natural Disaster

• Provide descriptive epidemiology of Typhoon Haiyan

• Compare rehabilitation injury data from two affected populations

• Summarize aid missions conducted by PARM members in the primarily-affected Visayas region

• Describe the strategic development of PARM’s disaster rehabilitation program

• Elaborate the potential role of a local physiatrist in a large-scale natural disaster using the example of the Philippine physiatrist in Typhoon Haiyan

O B J E C T I V E S O F T H E S T U DY

Medical Missions Conducted by PARM CARES (Nov 2013 – Feb 2014)

NCR (Manila)Philippine Orthopedic CenterVillamor Airbase

Region VIAntiqueCapizIloiloLakawon IslandNorthern Negros Occidental

Region VIINorthern CebuBantayan Island

Region VIIILeyteOrmoc

23 MISSIONS 31,609 kitsdistributed

7035 patientsserved

PM & R CONDITIONS EVALUATED IN PHILIPPINE ORTHOPEDIC CENTER (POC) (NOV 10, 2013 – DEC 18, 2014)

TABLE 1: PM & R Conditions Evaluated at Philippine Orthopedic Center (POC) (November 10, 2013 - December 18, 2013)

Diagnosis Number Total Percentage of 79 Persons Percentage of 125 Conditions

MSK 73 92% 58%

Fractures 68 86% 54.4%

Upper Limbs 16

Ribs 8

Spine 18

Pelvis 4

Lower Limbs 22

Amputations (Traumatic) 2 2% 1.6%

Other MSK Conditions 3 4% 2.4%

Soft Tissue Injuries 19 24% 15.2%

Wound/Skin Infections 15 19% 12%

Neurological 18 23% 14.4%

TBI 2 2.5% 1.6%

SCI 15 19% 12%

Ulnar Neuropathy 1 1.3% 0.8%

Total 125 125

2 3 R E L I E F & M E D I C A L M I S S I O N S O F

PARM CARES (NOV 10, 2013 – FEB 18, 2014)

TABLE 2: PARM CARES Missions (Nov.10, 2013 – Feb. 18, 2014)

Date Location Mission Team Relief Kits Patients Served

November 10 Brgy Tapilon, Daan, Bantayan; Northern Cebu

PARM(V)/Cebu (40 MDs, AMRO)

500 300

November 12 Brgy (4), Cadiz City; Brgy (4), Sagay City; Northern Negros

PARM(V)/Bacolod (1MD, 30 Volunteers)

3000

November 15-17 Brgy Libertad, Cagbuhangin,Mabato, Linao, Valencia; Ormoc City; Leyte

PARM(V)/Ormoc(3 MDs, 5 nurses, 12 HWs, HELP for Ormoc)

3500 2000 (Brgy Libertad)

November 17-30 Villamor Air Base, Manila; Luzon

PARM National 420

December 28-29 Brgy Marasbaras, RTR; Tacloban, Leyte

PARM CARES (National) ISPRM (12MDs, 30 HWs)

2000 (Brgy Marasbaras, RTR ) 50 (children(ASP , Tacloban)

400

February 17 Tent City, San Jose; Tacloban, Leyte Abuog General Hospital, Abuog; Franciscan Clinic, Baybay; Leyte

PARM( CARES (National)(6 MD, 40HW, ISPRM, PAPA)ISPRM, PFP, PSPO

1300 1085 (basic needs/medical screening survey)16 (P&O evaluations)

February 18 Burauen, LeyteRTR, Tacloban, Leyte

PARM CARES (National)PAPAISRPM, PFP, PSPO

288(basic needs/medical screening survey)283 (344 diagnoses)1 (P&O)

Total Missions 23 31,609 kits distributed

7035 patients served

PARM CARES MEDICAL MISSION TO BURAUEN, LEYTE (FEB 18, 2014)

Essentiall

y Norm

al

Diabete

s

Infections

Cardiova

scular

Pulmonary

Neurology

Musculoske

letal

Gastro

intesti

nal

Miscella

neous

Hematologic

Opthalm

ology Skin

7 4

143

4022 17

62

156 6 4

18

Graph 1. Medical Conditions seen in Burauen, Leyte (100 Days Post-Haiyan)

5%

37%

5%

34%

3%3% 11%

2%

Graph 2. Musculoskeletal Diagnoses

UE DJD

LE DJD

Neck OA

Lumbar OA

Low Back Strain

Fibromyalgia

Myofascial pain

Fracture (Osteoporotic)

Clinical

First Responder

Triage/ER

Inpatient and Outpatient Rehabilitation

Medical Mission Volunteer Provider

Trainer

Physiatrist Roles in Disaster Response

Non-Clinical

Rehabilitation Needs Assessor

Medical Mission Volunteer: leader, coordinator, relief distributor

Trainer

Disaster Rehab Program Developer

Researcher

O U R D E E P E S T G RAT I T U D E T O A L L T H E

DONORS AND VOLUNTEERS

International Society of Physical Rehabilitation Medicine (ISPRM) Japan Association of Rehabilitation Medicine (JARM)Korean Academy of Rehabilitation Medicine (KARM)

Royal College of Physiatrist of Thailand (RCPT) Philippine American Physiatrist Association (PAPA)

World Rehabilitation Fund (WRF) United Auburn Indian Community Tribe (UAICT)

Philippine National Day Association (PNDA)

All Donors and Volunteers

BRIDGING NATIONS AS ONE

THE HUMAN SPIRIT IS STRONGER THAN ANY

DISASTER

MARAMING SALAMAT

(Thank You)

MERON BA KAYONG TANONG?

(Questions?)