rolf maibach - cooperation in humanitarian disasters – balancing between cultures

Cooperation in Humanitarian

Disasters

Rolf Maibach, MD FMH Ped, Ilanz/Switzerland & Deschapelles/Haiti

Balancing

between

cultures

EARTHQUAKE IN HAITI 7 M January 12, 2010 WHERE TO GO?

Hôpital Albert Schweitzer Haiti

Haiti: 10 Mio inhabitants

316’000 killed 400’000 injured 2 Mio displaced >6’000 amputees

HÔPITAL ALBERT SCHWEITZER HAITI

HÔPITAL ALBERT SCHWEITZER HAITI1315 injured, 90% open fractures,

transported 4-8 hours on trucks

Lè ou bezwen, ou dwe pi intèlijan.

When you are in need, you must be more intelligent.

No telephone available: 80 volunteering surgeons, anesthesiologists, orthopedic surgeons

infrastructure, ressources

laboratory, blood bank, medicaments

external fixations

Life goes on Diphtheria

PROSTHESIS LAB AT HAS HANGER IVAN R. SABEL

FOUNDATION

40 new prosthesis every week!1500 prosthesis, 5600 follow up

MITHA, 29 y. buried under her house for

several days, amputation of both legs, abandonnend by her husband, her four children being

listed as missing

MITHA on training with all

her four children

Smile, whenever you are stressed!

Orthopädische Uniklinik Balgrist Zürich Dr. Thomas Böni

NAOMIEThe only surviving of a large family in Port-au-

Prince. Surgeon in small team

overwhelmed, did not have time to treat

open fracture.

Too many amputations in

Haiti?

Too many amputations in Haiti?

• Many small organizations without technically skilled personnel and insufficient technical ressources (Swiss army knife is no surgical instrument!)

Too many amputations in Haiti?

• Many small organizations without technically skilled personnel and insufficient technical ressources

• Unethical behaviour? Kick ? Lack of responsibility?

Too many amputations in Haiti?

• Many small orgizations without technically skilled personnel and insufficient technical ressources

• Unethical behaviour? Kick ? Lack of responsibility?

• Absence of any control mechanism, governmental organization.

Visiting foreign doctor ?

Art exposition at the Oloffson

Port-au-PrinceHaiti

November 2011

In the the last few years we had several disasters in Haiti. HÔPITAL

ALBERT SCHWEITZER played a major role in disaster relief!

Other disasters

• August 2008: 4 Hurricanes with inundations (Gonaive/Artibonite)

• Several truck accidents with >50 severely injured people

• End of 2010 and Summer 2011: severe Cholera epidemics, HAS treated more than 7000 patients

Cholera

Cholera 2010 / 2011

It has been widely recognized, that Hôpital Albert Schweitzer Haiti was very successful in

handling these disasters. Why was it so? Which qualifications are prerequisites for succesful

medical and surgical interventions in a disaster

situation?

Which qualifications are prerequisites for a medical disaster intervention team?

Which qualifications are prerequisites for a medical disaster intervention team?

1 Technical competence, speed

Which qualifications are prerequisites for a medical disaster intervention team?

1 Technical competence, speed2 Infrastructure, sufficient ressources

Which qualifications are prerequisites for a medical disaster intervention team?

1 Technical competence, speed2 Infrastructure, sufficient ressources3 Excellent interpersonal communication

COOPERATION=SUCCESS

Which qualifications are prerequisites for a medical disaster intervention team?

1 Technical competence, speed2 Infrastructure, sufficient ressources3 Excellent interpersonal communication4 Cultural adaptability

Which qualifications are prerequisites for a medical disaster intervention team?

1 Technical competence, speed2 Infrastructure, sufficient ressources3 Excellent interpersonal communication4 Cultural adaptability5 Competent leadership – Cooperation at eyes level

COOPERATION AT EYES LEVEL!

COOPERATION AT EYES LEVEL

RESPECT

REVERENCE FOR LIFE

COOPERATION AT EYES LEVEL

RESPECT

MODESTY

COOPERATION AT EYES LEVEL

RESPECT

MODESTY

DETERMINATION

DETERMINATION

New Medical Director at HASDr. Herriot Sannon

COOPERATION AT EYES LEVEL

RESPECT

MODESTY

DETERMINATION

HUMOR

NATHALIE lost a leg, but did not loose her humor !

COOPERATION AT EYES LEVELDETERMINATION

RESPECT

MODESTY

HUMOR

LOVE

JULIETTEET

FRÉDERIC

• Nouveaux jambes, nouveaux amis!

• New legs, new friends!

DAS GLÜCK IST DAS EINZIGE, DAS SICH VERDOPPELT, WENN MAN ES TEILT

THE FORTUNE IS THE ONLY THING THAT DOUBLES, WHEN YOU SHARE IT. A S

CONCLUSION

• The first two days everyone has to focus on live saving measures, hopefully in an organized way.

CONCLUSION• The first two days everyone has to focus on live

saving measures, hopefully in an organized way.

• Thereafter healthcare has to be given first and foremost by institutions or organizations, technically well equipped, being on the ground or with experience on the ground.

•

CONCLUSIONS• The first two days everyone has to focus on live saving

measures, hopefully in an organized way.

• Thereafter healthcare has to be given first and foremost by institutions or organizations, technically, well equipped being on the ground or with experience on the ground.

• NGOs and surgical teams with skilled personnel and

aware of cultural sensitivities may collaborate with these institutions and reinforce them.

•

Nampwen zamlèt san kase ze.

There is no omelet without breaking some eggs.

One must make necessary sacrifices to get a desired

result.

Sometimes it is necessary making unpopular

decisions to achieve your goal.

CONCLUSIONS• The first two days everyone has to focus on live saving measures, hopefully in an organized way.

• Thereafter healthcare has to be given first and foremost by institutions or organizations, technically well equipped, being on the ground or with experience on the ground.

• NGOs and surgical teams with skilled personnel and aware of cultural sensitivities may collaborate with these

institutions and reinforce them.

• Never, ever underestimate local knowledge!

• Never, ever underestimate local knowledge !

•

Never, ever underestimate local knowlegde

LESPWA FÈ VIFHope gives life

MESI ANPIL!MERCI BEAUCOUP!THANK YOU!ENGRAZIEL FETG! VIELEN DANK!

www.hopitalalbertschweitzer.orgwww.hashaiti.org