ministry of defence malaysian armed malaysia forces …

Colonel Mohd Adlan Adnan1

Chief Pharmacist, Tuanku Mizan Armed Forces Hospital

MINISTRY OF DEFENCE

MALAYSIA MALAYSIAN ARMED

FORCES HEALTH

SERVICES

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Co-Author:

Brigadier General Dato’ Dr A Halim Hj Basari2

Director of Pharmacy, MAF Health Services Division

Objectives

Introduction – Disaster, Malaysian Medical Team

Pharmacy Activities

Statistics

Challenges

Recommendations

Conclusion

Outline

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• To document common diseases after water-

based disaster.

• To list essential medications supplied.

• To share experience during the Humanitarian

Emergency Disaster Response (HEDR)

mission.

Objectives

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8th November 2013.

The deadliest typhoon ever to hit Philippines.

The worst typhoon in the world with record winds approaching > 300km/hour followed by a deadly Tsunami with water levels reaching above 20 feet height.

Claimed more than 6000 lives.

Damages estimated at USD 14.5 billion.

More than 30 countries provided various aid.

Introduction 1

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AFTERMATH OF THE HAIYAN SUPER TYPHOON TACLOBAN PHILIPINES

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Mission Module The Malaysian Government (National Security Council) had

deployed the following teams to provide the mission

objective;

Introduction 2

- Ministry of Defence

- Ministry of Health

- Malaysian SMART (Special

Malaysian Disaster Assistance &

Rescue Team)

- Puncak Niaga Holdings Berhad

(PNHB)

- Various NGO’s

- Total of 51 pax

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4 x Emergency Physician (1 x ATM dan 3 x MOH),

4 x Medical Officer (ATM),

1 x Pharmacist (ATM),

1 x Medical Officer Assistant (MOH),

1 x Nurse (MOH) &

7 x Paramedics (ATM)

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MALAYSIAN MEDICAL TEAM COMPOSITION

Malaysian Medical Team Activities

Mobile outreach clinics.

Static Forward Hospital

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Forward Medical Team Outreach Clinic - Carigara

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Forward Medical Team Outreach Clinic – Tanauen

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Foot Doctor Clinic in Tacloban City

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Pre Deployment

Planning prior to deployment to determine list of medical

supplies to bring.

Preparing Load Manifest of medical supplies to meet

transporting requirement of Royal Malaysian Air Force

(RMAF).

Vaccinate troops.

Pharmacy Activities

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During Deployment

Managing store of medical

supplies by considering

climate factor.

Distributing and replenishing

medical supplies for the

operation of static medical

base clinics and mobile

outreach clinics on daily basis.

Dispensing & counselling of

medicine during outreach

clinics.

Pharmacy Activities

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During Deployment (cont)

Spending times with traumatized patients as part of

psychological therapy.

Helping team to manage public health issues such as

sanitation and minimize vector-borne disease risk

Keeping troops healthy.

Pharmacy Activities

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During Deployment (cont)

Working with other volunteer pharmacists, local &

foreign NGOs and local health authority.

Communicating with the International Pharmaceutical

Federation (FIP) and the Philippine Pharmacists

Association.

Preparing handing over of medical supplies to local

health authority before end of mission.

Post Deployment

Prepare reports and statistics.

Pharmacy Activities

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• Providing clean and safe drinking water to

survivors.

• Malaysian invented Field Water

Purification System patented as JERNIH,

• An innovative product resulted from a

collaboration between MAF and PNHB.

• JERNIH produces 3,000 liters of drinking

water per day.

• JERNIH was then donated to the Local

Government Unit of Carigara.

Extended Role of Pharmacist

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Challenges

• Language barrier - elderly

patients.

• Access to needy area movement

to do outreach clinics.

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Challenges

• Heavy rainstorm & very extreme

weather (hot and humid) affects medicine storage area at

the medical base.

affects medicine during outreach

clinics.

Challenges

• Not a comfy environment.

• No hot shower, no electricity, no internet.

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-

5,000.00

10,000.00

15,000.00

20,000.00

25,000.00

30,000.00

35,000.00

40,000.00

45,000.00

ATM KKM 1MDB

15,171.79

44,693.48

13,382.40

2,338.48

4,540.60

80.00

UBAT

BPPB

VALUE (RM)

0

10

20

30

40

50

60

70

ATM KKM 1MDB

59

67

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18

12

2

UBAT

BPPB

VOLUME

169 medicines & 32 medical supplies Medicines = RM73K

Medical Supplies = RM7K

Statistics

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Value by Pharmacological Class (RM)

NO. MEDICINE NAME PACKING QUANTITY

NEEDED FOR 1500 PT

1 Acriflavine 0.4% Lotion Bot Of 1L 100

2 Calamine Cream Tube Of 25gm 400

3 Chloramphenicol 1% Eye Ointment 5gm Pkt Of 25 Tube 150

4 Chlorpheniramine Maleate 2 mg/5 ml Syrup Btl Of 60ml 400

5 Cloxacillin Sodium 250 mg Capsule Box Of 1000's 10

6 Diclofenac Sodium 50 mg Tablet Box Of 1000's 10

7 Diphenhydramine HCl Expectorant Bot Of 90ml 2000

8 Hydrocortisone 1% Cream Tube Of 15gm 200

9 Methyl Salicylate 25% Cream Tube 30gm 300

10 Multivitamin Syrup (Children) Bot Of 120ml 1000

11 Multivitamin Tablet (Adult) Box Of 60's 60

12 Neomycin 0.5% Cream Tube Of 15gm 400

13 Paracetamol 120 mg/5 ml Syrup Bot Of 100 ml 800

14 Salbutamol 2 mg Tablet Pkt Of 1000's 2

15 Salbutamol 2 mg/5 ml Syrup Bot Of 100ml 400

NO. MEDICAL SUPPLY NAME PACKING QUANTITY

NEEDED FOR 1500 PT

1 Gauze Sterile Size 7.5cm x 7.5cm x 12 ply BOX OF 20'S (PKT OF 5'S)

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2 Sampul Ubat Size (50mmx80mm) 1 KG 1

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Top Most Used Medicines And Medical Supplies

N = 2015

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Patients Treated By Age Group

54%

14%

10%

10%

6% 4%

2%

0%

Clinical Spectrum of Disease

RESPIRATORY

WOUND/INJURY

GASTROINTESTINALTRACTSKIN

MUSCULOSKELETAL

CARDIOVASCULAR

EYE

EAR, NOSE & THROAT

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• Pallets are vital to protect boxes from direct contact with

water during rainstorm.

• Transparent waterproof containers are needed to

transport medicines for mobile outreach clinics.

Recommendations

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• Usage of close system with well air-conditioned tentage

can further protect medicines from high temperature

and rainstorm.

Recommendations

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Medications

Medications catered for the most

common disease spectrum based

upon the nature of the disaster

(Resp, Skin, GI).

Limit supplies of medications that

are not most commonly required.

Equipment

Mobile equipment that would be

easily assembled and dissembled

as well as light weight to ease

transport & mobility.

Recommendations

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Conclusions

Deployment of MMT to Tacloban has successfully

achieved its objectives.

Needs of pharmaceutical support depend on:

• nature of disaster,

• socioeconomics status,

• geographical location,

• climate.

Such predictions would be necessary in the preparation

phase of medical teams for performing medical

humanitarian missions, especially in the aim of providing

primary public health care.

Pharmacists should be the best persons to look into

pharmacologistics matter.

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THANK YOU FOR

YOUR ATTENTION

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