Development of an ISPRM rapid rehabilitation response capability in support of the WHO FMT (Foreign Medical Team) Initiative James Gosney MD, Jianan Li MD, Andrew Haig MD, Jan Reinhardt, PhD ISPRM – WHO Liaison Sub-committee on Rehabilitation Disaster Relief (CRDR) ISPRM 2013 Disaster Symposium June 19, 2013

FMT Initiative - Humanitarian reform PAHO/WHO Guidelines on the Use of Foreign Field Hospitals Humanitarian Response Review: 'cluster approach' 2004/ Indian Ocean tsunami / Haiti earthquake: unimpressive results Global Health Cluster Technical Consultation on FMTs

FMT Initiative - Global Health Cluster Technical Consultation on FMTs Purpose: to create an improved humanitarian health response Recommendations: create an international register of FMT providers: faster response establish a FMT-WG to monitor progress: technical initiatives (2) o functional classification criteria & minimum standards service delivery for FMTs in sudden onset disaster (SOD) o guidelines for registering & monitoring the FMTs by national authorities of the affected country

FMT Initiative - Classification & registration system FMT functional classification categories Standards (minimum technical & core) FMT registration

FMT Initiative - Functional classification categories Type 1 FMT: Outpatient emergency care Type 2 FMT: Inpatient surgical emergency care Type 3 FMT: Inpatient referral care Additional specialized care teams (ie, burn care, orthoplastic surgery, intensive rehabilitation)

FMT Initiative - 'Rehabilitation' minimum standards of service Type 1 FMT: Outpatient or mobile services provided or referred Type 2 FMT: Out and inpatient services provided or referred Type 3 FMT: Out and inpatient services for complex cases

FMT Initiative - Core standards Register with the lead national authority / international agency Adhere to professional guidelines (ie, staff must be registered to practice in home country & be licensed for work assigned) Ensure that staff are specialists in the field & appropriately trained in SOD injury management in a humanitarian setting

FMT Initiative: Registration & authorization Registration - act of documenting FMT details (ie, services) based on the classification system Authorization - authority to practice as a FMT in a host country & comes from the host government (registration as an FMT does not imply authorization)

FMT Initiative: FMT self-registration form (variables) outpatient capacity (patients/day) inpatient capacity (available beds) surgical capacity (number of surgical procedures / day) length of stay no. of international/local staff time to deploy/be operational services offered (functions/capacities) logistics and support required

ISPRM CRDR: FMT Supporting programs PRM volunteer registry: qualified responders Disability Acute Rehabilitation Team (DART): qualifying training (certification) Scientific papers

ISPRM CRDR: Development strategy Develop supporting programs in line with WHO FMT WG guidance Individual vs FMT response scenario? Progression & optimization criterion? Sponsorship & funding?

Conclusions FMTs play an important role in saving lives, minimizing disability, and alleviating suffering following a SOD Rehabilitation is an important component of the immediate disaster response Development of an ISPRM FMT response capability provides rehabilitation perspective in the disaster response

Acknowledgement Professor Tony Redmond - WHO FMT-WG Chair, ISPRM CRDR member

References Technical Criteria for Classification and Minimum Standards for FMTs (WHO FMT-WG draft) Registering and Monitoring FMTs Arriving in the Aftermath of Sudden Onset Disasters (WHO FMT-WG draft)

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