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NZMAT DIGEST The Official Newsletter for the New Zealand Medical Assistance Team

Issue 14 January 2019

FROM THE DESK OF CHARLES BLANCH

It was fantastic to be part of our sixth domestic Team Member course in December and the capacity and capability of NZMAT continues to grow and it was great round out to the year which included TC Gita deployments, specialist training for NZMAT personnel in Australia, Macao and Geneva and new training such as the domestic BEOC course and further specialist cache procurement completed.

I’ll be starting a two year secondment to the Ministry of Civil Defence & Emergency Management in February to lead the development and implementation of the ‘Fly-In Teams’, one of the key government responses to last year emergency management system review. This small cadre of self-sufficient emergency management, strategic communication and iwi liaison specialists will support and assist controllers in lead agencies with response and early recovery activity. NZ-FIT will be working with the NZMAT leadership team, during the implementation phase especially, as we prepare to respond to domestic disasters and NZMAT has a lot of expertise I hope to draw on so I look forward to maintaining contacts over the next couple of years.

I’m confident that NZMAT will continue to go from strength to strength under the leadership of Martin, Judy, Emma and Paul, supported by our partnership with Counties Manukau DHB and Fire and Emergency New Zealand.

Charles Blanch, Director of

Emergency Management

At the NZMAT Team Member Course March 2013

On NZMAT Deployment Tonga February 2018

At the NZMAT’s WHO EMT Verification August 2017

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ARTICLES in this issue of the NZMAT DIGEST

3 NZMAT Team Member Course 10 Cyclone Season Preparation

4 MoH Leadership Award 11 NZ High Commissions Visits

5 Asia-Pacific INSARAG Exercise 12 NZMAT EMTCC Course

7 NZMAT Personnel – Psychological Assessments 13 Mass Casualty Management

8 NZMAT BEOC 14 Notices

9 AUSMAT Surgical Course 14 NZMAT Contacts

NZMAT Upcoming Events

Month Events

January NZMAT Core Operational Group Meeting

July NZMAT Basic Emergency Obstetric Course

September NZMAT Refresher Course

NZMAT Deployment: Fiji February 2016 Cyclone Winston

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2018 NZMAT TEAM MEMBER COURSE

Words by: JUDY FAIRGRAY

NZMAT Programme Manager, Counties Manukau Health “The realism! The

combination of

theory and

practical was

awesome” Feedback received from one of the course participants

One of the major highlights of the 2018 NZMAT Calendar was welcoming 30 participants at the NZMAT Team Member Course in early December.

A wide range of skills sets were represented on the course, from obstetrics, midwifery, emergency medicine, theatre, rural, and logistics to name a few. This year we were fortunate to have 1 faculty and 4 participants from our neighbors in the Pacific – Tonga, Vanuatu, Cook Islands and Fiji.

Two of our colleagues from The National Critical Care and Response Trauma Centre (NCCTRC) in Darwin also joined the faculty to deliver this intensive five day course, designed to provide participants with exposure to a range of essential techniques and skills to manage successfully when deployed into the field after a sudden onset disaster through a variety of lectures, activities and skills stations.

A variety of topics were covered including an update of the EMT initiative, functions of the Reception & Departure Centre (RDC) & Emergency Medical Team Coordination Centre (EMTCC), deployment & demobilization processes, security & security, camp construction and clinical ethics to name a few.

NZMAT faculty would like to extend our thanks to all guest presenters, external facilitators and all participants for their active and enthusiastic engagement resulting in a fun, interesting and successful course.

2018 NZMAT Team Member Course Participants

Photo Credit: NZMAT

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MINISTRY OF HEALTH LEADERSHIP AWARD

This article was posted on the Ministry of Health’s Intranet site in November 2018.

In recognition of Public Service Day, we’re taking the opportunity to recognize people who are exemplars of the spirit of service and leadership within the Ministry.

Everyone at the Ministry has a leadership role to play. Leadership isn’t about tier or hierarchy, it’s about the way your engage, empower and inspire the people around you.

We’ve used the Public Sector Leadership Success Profile as the basis of the awards. The Leadership Success Profile describes the leadership qualities required of all Public Servants that will transform the experiences of New Zealanders.

22 nominations were received and a winner has been selected for each of the five categories plus the Director-General Award for Public Service

Systems Stewardship Award

This award recognises people who are exemplars of collaboration across the Ministry and/or wider Public or Health Sectors and experts at building strong relationships and delivering results that benefit the wider system.

Martin Buet, Regional Emergency Management Advisor Midlands

Winner: Martin Buet In September 2017, Martin led the successful classification of New Zealand Medical Assistance Team (NZMAT) by the World Health Organization.

Since then, Martin has established a strategic partnership with Ministry of Foreign Affairs and Trade, securing $0.8m of vote overseas development funding to enhance NZMAT cache, clinical training for disaster response and fund the participation of attendees from Small Island Developing States in the Pacific over the next three years.

Martin and the NZMAT clinical director participated in pre-cyclone season briefings and capacity building visits with NZ High Commissions and Ministries of Health in Tonga, Fiji and the Cook Islands with the intent to enhance the effectiveness and speed of humanitarian assistance in a disaster.

NZMAT now has an ongoing invitation on these annual pre-cyclone season missions

Source Credit: Ministry of Health’s Intranet site, 12th

November 2018

Aftermath of a disaster. Photo credit: UMCOR

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2018 INSARAG ASIA-PACIFIC REGIONAL EARTHQUAKE RESPONSE EXERCISE

In June 2018, three NZMAT members, Dr Alan Wright (GP), Helen Polley (RN ICU) and Shane England (Logistician) participated in the International Search and Rescue Advisory Group (INSARAG) Asia Pacific Regional Earthquake Exercise 2018 in Indonesia.

Thoughts on the exercise from HELEN POLLEY

Registered Nurse, Counties Manukau Health

From L to R: Dr Alan Wright, Shane England, Helen Polley

Photo Credit: NZMAT Team

It was a privilege to be invited to attend the INSARAG exercise. I left NZ knowing that between Judy and Emma our team had been supplied with a vast amount of electronic information, we had also received “handy hints & tips” from Lucas Fraser who had attended the 2017 exercise, although we were going into the unknown I felt pretty confident that we had the resources required to represent NZMAT well.

We arrived before the exercise formally began which was beneficial as it gave us time to discuss various experiences and compare resources as we had not met each other previously. This increased our ability to work as an efficient team once the exercise began.

One of the great aspects of the exercise for me was being part of a global community all working towards disaster preparedness. This is only the second INSARAG which has involved Emergency Medical Teams (EMT).

A beneficial addition as I think all teams who are responding, despite their tasking should be aware of other organizations and the infrastructure they are working within. Often, in a real situation these groups are all working from different locations and it can be difficult to gain an insight into all involved.

The learning gleaned from an exercise is understandably different from a real deployment. The time scale is condensed, the heat, smell and human despair is missing & the disaster conveniently has “technical breaks” for meals & home time. Having a condensed time scale meant that it was easier (for me) to grasp the concepts of which organizations supply what information to whom.

The exercise also highlights the importance of having an overseeing body such as the World Health Organization (WHO). In our EMTBOO (Base of Operations) there were 15 teams of different nationalities triaging and treating patients in various earthquake zones. The host country needed to collect & collate all of this data, without WHO providing consistent paperwork which all teams utilized this would have been problematic.

Acronyms!! So many, strange as it may sound, it is really important to know what they all stand for as no one refers to them in full & it is easy to lose the gist of the conversation very quickly. Try these: HEOC, HuMOCC, NEMA, OSOCC, RDC, UCC, UNOCHA, UNDAC, VOSOCC…

A wonderful learning opportunity and experience to see so many (27) nations enthusiastically preparing for disaster (that sounds so wrong!). I was proud to be from NZ because NZMAT was one of the very few “WHO classified” teams there.

Visit the NZMAT Website @ http://www.health.govt.nz/nzmat

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Thoughts on the exercise from ALAN WRIGHT

General Practitioner, Hastings Health Centre

Thank you for the opportunity to attend my first INSARAG meeting on behalf of NZMAT. This was the first time I had met both Helen and Shane and it was clear right from the start that we were a good mix and we quickly established a good team structure. Helen was appointed as the Team Leader.

This was a huge learning curve for me in terms of the operational structure of a disaster response organization and it was very helpful to learn the various (and many) acronyms and where each organisation was placed in terms of the overall structure and chain of command. The simulation exercise (earthquake in central Manila) was well thought out in terms of likely impact both in terms of structures and casualties and the figures that were working with were all extremely realistic and possible.

There was a large amount of inter-agency co-operation and discourse along with some entertaining times especially with our Australian neighbours and colleagues. It was evident very early on that every country attending is in a different stage

Acronyms

HEOC Health Emergency Operational Centre

HuMOCC Health Emergency Operational Centre

RDC Humanitarian–Military Operations Coordination Cell

NEMA Reception and Departure Centre

OSOCC National Emergency Management Agency (Sometimes known as LEMA – Local)

UCC On-Site Operations Coordination Centre

UNOCHA USAR Coordination Cell

UNDAC United Nationals Office for the Coordination of Humanitarian Affairs

Alan Wright participating in the SIMS component of the

INSARAG exercise Photo Credit: NZMAT Team

of development and preparation and while some had apparent large quantities of logistics at their disposal it did not necessarily always translate into seamless and smooth operation. I felt confident being part of the New Zealand team that we are well placed for our Classified level of response capability and that we would able to deploy effectively into this type of disaster.

As with all exercises there are frustrations such as the fact that we were deployed as a Type 1 mobile facility but expected to perform as a Type 1 fixed facility and I don’t think the exercise controllers took maximum advantage of the ability to move us around to test our adaptability to various locations.

I would like to thank NZMAT and MFAT for the opportunity to attend this exercise. I really hope I get deployed with these guys as much of the work in establishing working relationships has already been completed.

Photo on the Right: NZMAT Team with our colleagues from FENZ USAR team who also attended the exercise

Photo Credit: NZMAT Team

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PSYCHOLOGICAL ASSESSMENT TO SUPPORT SAFE & EFFECTIVE TEAM DEPLOYMENTS

Have you completed your Psychological Assessment?

The New Zealand Ministry of Health has contracted Response Psychological in Australia to provide pre and post mission psychological support for deployments. This aligns with arrangements that AUSMAT has also implemented.

This has been commenced as part of maintaining our duty of care to all team members who are eligible for deployment when they are potentially involved in scenarios that may be of a more complex nature than their normal working environment.

The participants on the last team member’s course in 2017 successfully undertook the pilot process as part of their attendance on the course.

The assessment will give a baseline for an individual to assist in the rapid mental health and welfare assessment conducted as part of pre-deployment processes. Your assessment results will be maintained in clinical-confidence by Response Psychological staff within their encrypted database.

All participants are rated against several specific criteria and a simple grading system is used. These ratings will be used by NZMAT to assist in personnel selection and for development purposes in promoting safe and effective teams. There is no ‘pass’ or ‘fail’ criterion for these assessments. The aim of the assessment is to provide NZMAT with an overview of your individual characteristics and predispositions only.

An email was sent to NZMAT personnel in June 2018 regarding this requirement. If you have completed the assessment – thank you! If you have commenced and not completed or not engaged in the process at all, please complete your psychological assessment as soon as possible. It is a pre-requisite for being deployed.

An aerial view of the Baiturrahman mosque which was hit by a tsunami, after a quake in West Palu, Central

Sulawesi, Indonesia, on September 30, 2018. Photo credit ‘The Altantic’

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2018 NZMAT BASIC EMERGENCY OBSTETRIC COURSE

On the 5th & 6th of July 2018, NZMAT held inagural Basic Emergency Obstetric Course (BEOC) in Wellington. Twelve NZMAT personnel attended – 4 doctors, 1 orthopaedic surgeon and 7 registered nurses. The course was facilitated by Kass Jane (Senior Advisor Maternity at the Ministry of Health, midwifery lectuerer and midwife) along with a couple of her colleagues. The purpose of the course was to refresh and up-skill NZMAT clinical staff, regardless of where they work normally, to deliver safe and effective maternal care following a disaster.

Thoughts on the exercise from ANDREA CHAPMAN

Nurse Practitioner – Urgent Care, Medical & Injury Centre, Nelson

I attended the inaurgual NZMAT BEOC course in Wellington. The pre-reading for the course included relevant NZMAT Guidelines and WHO Integrated Management of Pregnancy and Childbirth. Pretty substanital, but doable and really essential, particularly for working out how to successfully naviagate the guidelines in a timely manner.

The course programme was comprehensive – it appeared to be full on midwifery training in a nutshell, condensed into a 2 day training. I do admit to wondering if this would be possible. However, the programme facilitiators were so skillfully accomplished that they kept us all focused and engaged for the entire duration. Their passion, knowledge and good humour made attending the course a real privilege.

The participants had a borad range of prior obstetric experience and I’m certain we all learned new skills or refreshed those that had long been tucked away. There was a series of practical skill stations ranging from normal delivery through to breech, forceps, shoulder dystocia and postpartum haemorrhage. I can proudly announce that many, many dolls were safely delivered!

The course was adeptly aligned to potenital deployment situations and equipment availability. Additionally, it provided an invaluable insight into some other vital components for a successful deployment. Clinical knowledge and ksills are a no-brainer but teamwork, adaptability and resourcefulness are essential to.

As I endeavour to retain a healthy percentage of the essential information imparted, I do fear that the sentence I will certainly never forgot is “has aynone seen my knitted vagina?!”

Faculty and participants – 2018 NZMAT BEOC

Photo credit Judy Fairgray

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2018 AUSMAT SURGICAL COURSE

In August 2018 six NZMAT personnel attended the AUSMAT Surgical Course in Darwin, Australia.

Dr Vaughan Poutawera (Orthopaedic Surgeon), Dr Tony Diprose (Anaesthetist) and RN Emma Brooks (Theatre Nurse) were invited by the National Critical Care and Trauma Response Centre to attend as faculty members. NZMAT sponsored Dr Alan Crowther (Anaesthetist), Dr Ben Wheeler (General Surgeon) and Vili Tuisawana (Theatre Nurse) to attend as participants on the course.

The AUSMAT Surgical Course is held over four days during which participants learn from experts who have worked in disasters, often with limited resources to ensure that correct surgical techniques are used when managing challenging surgical cases post disasters. The course also covers the building and sustaing a field hospital throughout a deployment.

Back Row from L to R: Dr Alan Crowther, Dr Tony Diprose, Dr Ben Wheeler,

Dr Vaughan Poutawera

Front row from L to R: Emma Brooks, Vili Tuisawana

Photo credit: NZMAT Team

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NZMAT Fiji Deployment, February 2016. Photo credit: Dr Chip Gresham

CYCLONE SEASON PREPARATION

Are you prepared?

The 2018 – 2019 cyclone season officially commenced on the 1st October, this is a friendly reminder to do some preparation to ensure you meet all the requirements for deployment. To be eligible for deployment, NZMAT personnel are required to:

Reconfirm with your manager your desire to deploy with NZMAT

Complete the Psychological Testing from Response Psychological Services Ltd.

Confirm your contact details (email and mobile phone number) are current on D4H

­ Please ensure these are how you can be contacted both in and out of hours

Check your required vaccinations are current and updated records have been submitted

Check your passport has at minimum of 6 months before expiry

­ If the expiry will fall below this during the cyclone season, it might be a good time to arrange a new passport

­ Ensure any associated visas are current

To ensure arrangements of your registration within the host country runs smoothly, confirm you have provided a current copy of the following documentation:

­ Current Annual Practicing Certificate / Licence

­ Current professional CV (updated within the last 2 years) – in the NZMAT CV format

­ Relevant professional certificates i.e. degree, diploma etc.

Update your ‘off-call’ status for any period you will be away during the next 6 months

As you are required to carry a hard copy and electronic copy of all required documentation mentioned above if you deploy, it’s a good time to photocopy documentation as well as save onto a USB stick

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NZ HIGH COMMISSION VISITS

Tonga, Fiji & Cook Islands NZ High Commissions Visits 2018

Words by: MARTIN BUET

Regional Emergency Management Advisor (Midlands), MoH

In 2018 the Ministry of Foreign Affairs and Trade invited Dr Emma Lawrey and I to participate with other Government agencies in a series of visits designed to further develop the New Zealand offshore disaster response system.

The visits during July and August (nicely out of the cyclone season) were this year to Tonga,Fiji and the Cook Islands.

The NZ contingent was made up of personnel from MFAT humanitarian response team, MFAT Consular division, Fire and Emergency NZ, Ministry of Civil Defence, NZ Defence Force and ourselves representing health.

The objectives were to undertake training with NZ High Commission staff in each of the High Commissions and in country response partners around potential support from NZ Government to the respective countries if required and requested.

The visits allowed NZMAT and partner agencies to demonstrate their respective capabilities for deployment and also allowed time for opportunities to meet with key in country partners.

These discussions allowed us a better insight into the operating context in each of the three countries. These visits also continue to further develop our knowledge and relationships with health providers in the Pacific Region.

The MFAT funded participation of five Pacific Island attendees at the NZMAT team member course in 2018 is a further example of the continuing relationship building of the Pacific Island nations within health.

Martin Buet from the MoH’s Emergency Management team speaking about preparedness to NZ High Commission staff in Tonga

Photo Credit: NZMAT Facebook page

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NZMAT EMTCC COURSE Words by: DEBBIE WING

Senior Advisor Emergency Management Team, MoH

In September 2018, the Ministry of Health and Counties Manukau DHB hosted the first two day NZMAT Emergency Medical Team Coordination Cell (EMTCC) training and development course in Auckland to upskill experienced NZMAT clinical and allied health staff to support Emergency Medical Team (EMT) coordination, and in particular embed as liaisons with an international team.

The Emergency Medical Team Coordination Cell (EMTCC) would work as part of the Operations function in the National Health Coordination Centre (NHCC) and would coordinate International Emergency Medical Teams that offered assistance or deployed to New Zealand during a national emergency.

The faculty staff were supported by Dr Ian Norton, World Health Organization HQ Geneva EMT secretariat, who gave interesting insights into EMT challenges on the frontline of humanitarian emergencies and ran a workshop on ‘no regrets’ tasking for clinical capacity after a sudden onset disaster.

The training covered EMTCC registration, tasking, logistics management and using information technology, such as HealthEMIS, to capture data and information. A short exercise was conducted at the end of the course to take the participants through registration and acceptance of International Emergency Medical Teams into New Zealand and ongoing support to those teams through embedded liaison officers.

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The NZMAT Kiwi is on the move! Have you seen him around?

The NZMAT KIWI has been spotted on board a plane bound for Australia and somehow he managed to stowaway in Alan Wright’s bag to Indonesia and ventured out to meet AUSMAT colleagues!!

MASS CASUALTY MANAGEMENT

NZMAT Mass Casualty Management on Deployment

Mass casualty management is one scenario that NZMAT personnel could face while on deployment and the WHO minimum standards require teams to not only be able to respond to the disaster but respond effectively to second events such as aftershocks, or transport accidents during the mission that may result in a surge of casualties. To assist personnel, NZMAT has purchased the Mass Casualty Triage – SMART card tag system. We selected the SMART tag system as it is the same system that AUSMAT utilize and NCCTRC is supporting a range of mass casualty training across the pacific region. We therefore felt that utilizing the ames system would provide best flexibility, and continue to support joint deployments as we have done in the past.

SMART Tags system is quick and simple to use and allows personnel to

reprioritize the injured without losing information.

Major Features:

Ability to record vital information about patients

Enhanced tracking with detachable barcoded transport strip

Clear identification of priority

Clearly highlights infected and contaminated patients

What to learn more about mass casualty management?

Major Incident Medical Management and Support (MIMMS) courses teach a systemic approach to disaster medical management.

For more information visit:

http://www.mimms.org.au/

Photo credit: Journal of Emergency Medical

Services 1st

November 2016

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NOTICES

For more information see: http://wadem2019.org/

NZMAT CONTACTS

Judy Fairgray

NZMAT Programme Manager

Pacific Health Development

Counties Manukau DHB

Email: Judy.Fairgray@middlemore.co.nz

Mobile: +64-21-227-4830

Martin Buet

Regional Emergency Management Advisor (Midlands)

NZMAT Project Lead

Emergency Management Team

Ministry of Health

Email: Martin_Buet@moh.govt.nz

Dr Emma Lawrey

NZMAT Clinical Lead

Emergency Medicine Consultant

Auckland City Hospital

Email: emma-b@xtra.co.nz

Paul Callaghan

NZMAT Logistics Lead

Senior Fire Fighter / USAR Technician

Fire and Emergency New Zealand

Email: Paul.Callaghan@fireandemergency.nz

Calling Early Expression of

Interest

NZMAT Basic Emergency Obstetric Course (BEOC) 2019

NZMAT personnel are invited to submit an expression of interest in attending the next NZMAT BEOC course in mid-2019.

Please submit your interest to Judy Fairgray at Judy.Fairgray@middlemore.co.nz