rolf maibach - cooperation in humanitarian disasters – balancing between cultures
TRANSCRIPT
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