1. Family Medicine and the International Relief Response
(most photos removed)
AAFP Global Health Meeting
Denver, Colorado
September
Short workshop (60 min.)
Dr. Lynda Redwood-Campbell, MD,CFPC,FCFP,DTMH,MPH
Associate Professor, Department of Family Medicine
McMaster University, Canada

2. Objectives of this session
To increase awareness and discuss the realities of disasters and humanitarian aid response
To discuss potential involvement of Family Physicians/ Family Medicine as part of the international humanitarian response, using the case of Aceh post tsunami as an example.

3. Pottie, Redwood-Campbell, Rouleau, Ouellette, Lemire
Pottie, Redwood-Campbell, Rouleau, Ouellette, Lemire. Canadian Family Physician Nov 2007.

4. True or False?
There is a growing number of natural disasters in the world (or is it the media?)
There is a growing number of technological disasters in the world
There are growing numbers of IDPs in the world
There are more aid worker security incidents in the world than in the past (or is it just being reported?)

5. Issue: Growing natural disasters
More flooding
More famine and political instability

6. Countries affected by floods in 2008

7. Affected by disasters

8. Issue: Growing technological disasters

9. Impact: Staff Security (agencies)
World Health Organization
11 June 2018
Impact: Staff Security (agencies) 9

10. This week headlines….. Reliefweb Monday September ‘Yemen: Children bear brunt of Saada conflict Kenya: El Niño rains could bridge food deficit Thousands flee new Pakistan anti-militant push Somalia: Number of internally displaced tops 1.5 million Death toll from Africa floods touching 70, some 430,000 affected - UN Senegal flare-up displaces 650 people Mali : le CICR assiste des familles touchées par la violence intercommunautaire

11. Increasing focus on relief response by NGOs
More funding for relief response
Concept of relief ‘vs’. development

12. Two important concepts
to understand…….

13. Disasters Affect Development

14. Issue: Needs V Capacities to respond
World Health Organization
11 June 2018
Local and National agencies are first responders - especially natural disasters 14

15. Trends….. Types of disasters Concepts Who’s involved
more natural disasters
more technological disasters
more IDPs
Disasters affect development
International response too slow and sometimes not effective
Relief and development often treated as separate entities
Increasing relief funding
Who’s involved
more NGOs
more NGO workers
more involvement of private
relations with military

16. How can we as family doctors, and the discipline of family medicine contribute in a meaningful way?
ie: what do we have to offer??

17. Case example; Indonesia post tsunami
Huge proliferation of iNGOs in a very short period of time
Some iNGOs have limited experience working in disasters
Many were field surgical hospitals

18. Some questions…..
What types of patients were we seeing in the OPD 9 weeks after the tsunami?
How many were still directly related to the tsunami?
How many people were experiencing some symptoms of depression/PTSD after the tsunami?
Redwood-Campbell, L. Riddez, L. Prehospital and Disaster Medicine Journal. Feb 2006

19. Direct Tsunami-Related Visits
Burns
Wounds
Fractures
Tetanus
Aspiration pneumonias
Direct Tsunami-Related Visits
11.6%
(9 weeks post Tsunami)
Redwood-Campbell, L. Riddez, L. Prehospital and Disaster Medicine Journal. Feb 2006

20. Diagnosis based on body system
Redwood-Campbell, L. Riddez, L. Prehospital and Disaster Medicine Journal. Feb 2006

21. Family Medicine Our contribution? ….towards the MDGs primary care
generalist
chronic disease management
collaboration with public heath
understanding of mental health
holistic care, broad determinants of health
understanding the patient centred method, team player
comfort with uncertainty
Canada- 4 principles of family medicine,
community-based discipline, resource to a defined practice population-needs of individual and community

22. Reforms needed to change PHC
WHR 2008 WHO

23. IFRC field school concept
“skills gap phenomenon”, seen by many international humanitarian organizations- obvious after the 2004 tsunami
Shortage of ‘field’ experienced health professionals to be able to work in increasingly complex emergencies

24. Pottie, Redwood-Campbell, Rouleau, Ouellette, Lemire
Pottie, Redwood-Campbell, Rouleau, Ouellette, Lemire. Canadian Family Physician Nov 2007.

25. How to get involved?
Internationally- incorporate disaster preparedness into your ongoing development projects ex; Aceh- medical school curriculum now has disaster preparedness
Work with well respected organizations who are adept at dealing in disasters
Get appropriate training
Relief and development need to be seen as symbiotic and less antagonistic
Locally-hospital, clinics, local disaster plans
Since 9/11 many more disaster plans
Remember the most vulnerable! Elderly, poor, marginalized communities

26. References
Redwood-Campbell, L. Humanitarian Relief Aid vs development. Should they be so far apart? American Journal of Disaster Medicine 2009; 4:73-75.
Pottie,K. Redwood-Campbell,L. Rouleau, K. Ouellette,V. Lemire,F. Degrees of Engagement: Family Physicians and Global Health. Canadian Family Physician. (CFP) November 2007, Vol 53:
The International Federation field school training initiative. International Federation of Red Cross and Red Crescent Societies.