1. THE ROLE OF THE PHILIPPINE PHYSIATRIST IN A LARGE-SCALE NATURAL DISASTER THE PARM EXPERIENCE IN TYPHOON HAIYAN International Society of Physical Rehabilitation Medicine 9th World Congress Maritim Hotel, Berlin, Germany June 19, 2015 Ganchoon, FG, Martinez RR, Gosney JE

2. Highest -intensity of a Category 5 tropical cyclone with sustained winds of 315 kph (above the 252 kph threshold for a Category 5 hurricane, the highest category on the Saffir-Simpson scale) -Reference: Meteomedia -storm surge recorded in East Asia of 9.14m due to strong winds, resulting in the majority of deaths due to drowning and catastrophic damage

3. ANIBONG, TACLOBAN, LEYTE REUTERS/ROMEO RANOCO IMPACT Significant national impact: 6,268 confirmed deaths, 28,689 injured, and 1,061 missing, with 3.4 million families (over 16 million persons) affected in 44 provinces, 57 cities, and 591 municipalities. Reference : National Disaster Risk Reduction & Management Council (NDRRMC)

4. PARM Philippine Academy of Rehabilitation Medicine Membership: 340 PMR Centers: 412 Chapters  North Luzon (46)  National Capital Region (178)  Visayas (22)  Mindanao (20)

6. The Role of the Philippine Physiatrist in a Large-Scale Natural Disaster Provide descriptive epidemiology of Typhoon Haiyan Compare rehabilitation injury data from two affected populations Summarize aid missions conducted by PARM members in the primarily-affected Visayas region Describe the strategic development of PARM’s disaster rehabilitation program Elaborate the potential role of a local physiatrist in a large-scale natural disaster using the example of the Philippine physiatrist in Typhoon Haiyan

7. Medical Missions Conducted by PARM CARES (Nov 2013 – Feb 2015) NCR (Manila) Philippine Orthopedic Center Villamor Airbase Region VI Antique Capiz Iloilo Lakawon Island Northern Negros Occidental Region VII Northern Cebu Bantayan Island Region VIII Leyte Ormoc 31 MISSIONS 31,884 kits distributed 8934 patients served

8. PM & R CONDITIONS EVALUATED IN PHILIPPINE ORTHOPEDIC CENTER (POC) (NOV 10, 2013 – DEC 18, 2014)

9. TABLE 1: PM & R Conditions Evaluated at Philippine Orthopedic Center (POC) (November 10, 2013 - December 18, 2013) DiagnosisNumberTotalPercentage of 79 Persons Percentage of 125 Conditions MSK 7392%58% Fractures 6886%54.4% Upper Limbs16 Ribs8 Spine18 Pelvis4 Lower Limbs22 Amputations (Traumatic) 22%1.6% Other MSK Conditions 34%2.4% Soft Tissue Injuries 1924%15.2% Wound/Skin Infections 1519%12% Neurological 1823%14.4% TBI2 2.5% 1.6% SCI15 19% 12% Ulnar Neuropathy1 1.3% 0.8% Total125

10. PARM CARES MEDICAL MISSION TO BURAUEN, LEYTE (FEB 18, 2014)

12. 31 RELIEF & MEDICAL MISSIONS OF PARM CARES (NOV 10, 2013 – FEB 1, 2015)

13. TABLE 2: PARM CARES Missions (Nov.10, 2013 – Feb. 1, 2015) DateLocationMission TeamRelief KitsPatients Served November 10, 2013 Brgy Tapilon, Daan, Bantayan; Northern Cebu PARM(V)/Cebu (40 MDs, AMRO) 500 300 November 12, 2013 Brgy (4), Cadiz City; Brgy (4), Sagay City; Northern Negros PARM(V)/Bacolod (1MD, 30 Volunteers) 3000 November 15-17, 2013 Brgy Libertad, Cagbuhangin,Mabato, Linao, Valencia; Ormoc City; Leyte PARM(V)/Ormoc (3 MDs, 5 nurses, 12 HWs, HELP for Ormoc) 3500 2000 (Brgy Libertad) November 17-30, 2013 Villamor Air Base, Manila; Luzon PARM National420 December 28-29, 2013 Brgy Marasbaras, RTR; Tacloban, Leyte PARM CARES (National) ISPRM (12MDs, 30 HWs) 2000 (Brgy Marasbaras, RTR ) 50 (children (ASP, Tacloban) 400 February 17, 2014 Tent City, San Jose; Tacloban, Leyte Abuog General Hospital, Abuog; Franciscan Clinic, Baybay; Leyte PARM( CARES (National) (6 MD, 40HW, ISPRM, PAPA) ISPRM, PFP, PSPO 1300 1085 (basic needs/medical screening survey) 16 (P&O evaluations) February 18, 2014 Burauen, Leyte RTR, Tacloban, Leyte PARM CARES (National) PAPA ISRPM, PFP, PSPO 288 (basic needs/medical screening survey) 283 (344 diagnoses) 1 (P&O) June 27, 2014RTR, Tacloban, LeytePARM Cares/ PARM (V) PFP 25 Lower Limb Prostheses (20 BK & 5AK) 24

14. TABLE 2: PARM CARES Missions (Nov.10, 2013 – Feb. 1, 2015) DateLocationMission Team Relief Kits /Mobility Aids Patients Served June 28, 2014 Brgy Abukay Relocation Site, Tacloban PARM Cares/ PARM (V) 250 Clothes and Sleeping Mats 250 families Tacloban City Gym PARM Cares/ PARM (V) 25 Sleeping mats and clothes, 8 wheelchairs, 10 crutches and 10 canes 25 Families for Relief 28 Patients for Mobility Aids July 20, 2015RTR, Tacloban, Leyte PARM Cares/PARM (V), World Rehabilitation Fund PARM CARES Physiatrist in Tacloban received the WRF donated Physical Rehabilitation Equipment and donated it to the 3 hospitals: Remedios Trinidad Romualdez Hospital, Divine Word Hospital and Eastern Visayas Regional Medical Center October 18, 2014 RTR, Tacloban, Philippines PARM Cares/ PARM (V) Buddhist Tzu Chi Foundation, PARM CARES Physical Therapy volunteers 47 Haiyan Amputee Survivors were casted for 50 Lower Limb prostheses 20 PT Volunteeers were trained for casting of amputee stumps and gait training 50 October 19, 2014RTR, Tacloban, Philippines PARM Cares/ PARM (V),PFP, PARM CARES Physical Therapist Volunteers (20) 25 Lower limb prostheses were fitted and distributed 25 October 25, 2014 Estancia, Panay island, Philippines PARM Visayas Roxas/PARM CARES,Balay Mindanao and JDC American Jewish Joint Distribution Committee 16 wheelchairs 16 January 30, 2015 Divine Word Hospital Tacloban, Philippines PARM CARES / PARM (V), Loving Rose Mission. 60 Mobility Aids (50 walkers and 7 crutches and 3 canes) 60 January 31, 2015Remedios Trinidad Romualdez Hospital Tacloban, Philippines PARM CARES / PARM (V) Buddhist Tzu Chi Foundation 50 47

15. TABLE 3: PARM CARES Haiyan Disaster Response Outcome (Nov.10, 2013 – Feb. 1, 2015) Date Nov 2013-Feb 2014Mar 2014-Feb2015Outcome Missions23831 Relief Goods Distributed 31,609 275 31,884 No. of Mobility Aids distributed 0104 (74 wc, 17 Cruthes, 13 Canes) 104 No. of artificial legs distrubuted 075 Patients Served7,0351899 179 (missions) 1720 ( 450 at RTR, 858 at DW, 431 at EVRMC) 8934 No. of Rehabilictation Centers provided with new equipments 03 Rehab Centers 3 Rehab centers repaired and given rehab equipments No of Volunteers trained 024

16. PARM CARES PROJECTS FOR 2015-2016 1. Establishment of a community based rehabilitation center and evacuation center for PWDs in Tacloban by December 2015 2. Establishment of Orthotics and Prosthetics shop at RTR Hospital by Feb 2016. 3. Training of PMRs who are interested in Disaster Rehabilitation at AOSPRM in Cebu on Feb 2016. 4. Establishment of a Local disaster response coordination and training center by Feb 2016.

17. PARM CARES WRF REHAB CENTER PROJECT

18. PARM CARES LEGS FOR LIFE PROGRAM:

19. Clinical  First Responder  Triage/ER  Inpatient and Outpatient Rehabilitation  Medical Mission Volunteer Provider  Trainer Physiatrist Roles in Disaster Response Non-Clinical  Rehabilitation Needs Assessor  Medical Mission Volunteer: leader, coordinator, relief distributor  Trainer  Disaster Rehab Program Developer  Researcher

20. MARAMING SALAMAT (Thank You) MERON BA KAYONG TANONG? (Questions?)