APPNA, NCHD et al. Review Post-Disaster Health Care Systems


A view of the conference

Rawalpindi, Pakistan: The Association of Pakistan Physicians of North America (APPNA), in collaboration with the Rawalpindi Medical College, the National Commission for Human Development (NCHD), and the Aga Khan University took an important step in defining the long-term strategy of disaster management in Pakistan. The premier association of doctors held a two-day conference in Rawalpindi on December 22-23 to deliberate on the important subject.
While APPNA members and people of Pakistani continue to work and focus on the immediate and intermediate needs of the October 8 earthquake disaster, it is critical to look at the strength and weaknesses of the current health care system response toward a disaster of this nature and magnititude. Dr. Saud Anwar, cair of the Scientific Committee of the conference, described the concourse as the first organized step towards enhancing the current health care system to be better equipped for the later phases of the current challenge and future disasters. The conference title was “Post Disaster Health Care Systems in Pakistan: A National And International Challenge.”
The conference attracted a wide variety of experts with experience and knowledge of disaster preparedness and building of health care systems. The various organizations, institutions, disaster groups, and stakeholders represented in the conference along with APPNA included representatives of the Government of Pakistan, Rawalpindi Medical College, National Commission for Human Development, Aga Khan University, Higher Education Commission, Pakistan Society of Emergency Medicine, Pakistan Medical and Dental Council, Pakistan Medical Association, Pakistan Islamic Medical Association, Ayub Medical College, Punjab Emergency and Ambulance Services, Rescue 1122, and the Pakistan Army to name just a few.
Besides there were a good number of foreign participants affiliated with prestigious institutions like the Johns Hopkins University, Harvard Medical School, USAID, Save the Children, Rush University Medical Center, University of Connecticut, Arizona Department of Health Services, American College of Surgeons, WHO Collaborating Centre, Center for Public Health Preparedness and Disaster Response, American Medical Association, Ephesus Emergency Medicine Training and Research Center Izmir, Turkey.
The conference discussed four broad topics, namely:
a) Focus and plans for rebuilding acute health care system post disaster (including an effective and efficient national emergency medical system)
b) Developing health care personnel proficient in disaster management (including improved education of nurses, emergency medical technicians, and doctors to have improved knowledge and preparedness of disaster management along with making emergency and disaster management as a separate training faculty and specialty in Pakistan)
c) Increasing knowledge and understanding of psychiatric and rehabilitative dimensions of disaster along with the health care of internally displaced people and women and children issues resulting from disasters.
d) Enhancing the existing district development system including a need based health care system for providing disaster support.
The conference included main sessions and presentations by various experts followed by four strategic planning sessions (as mentioned above). The expert spent time in discussing ways of inducting changes to enhance the current systems.
Dr. James James, Director of American Medical Association Center for Public Health Preparedness and Disaster Response, mentioned how impressed he was with the level of organization and commitment of the organizers. He commented on the excellent quality of presentations and focus of different presenters. Dr. James Fowler, who has extensive experience in setting up disaster management systems in Turkey, evaluated plans for higher education in Emergency Medicine with Dr. Junaid Razzak of the Aga Khan University and mentioned that the current planned curriculum for Emergency Medicine residency appears better than the one in Turkey. He however mentioned that the success of the disaster and health care systems depended on the commitment of the government and its ability to collaborate and communicate with the civil society and concerned institutes. Dr. Mussadik, Principal of RMC, mentioned that it was time to change the curriculum of the medical schools to start focusing on disaster-related education and training. Dr. Rashid Joom, representing the PMDC, joined in the stimulating deliberations wholeheartedly.
Dr. Stephanie Rosborough from Harvard Medical School and Harvard Humanitarian Initiative agreed with the proposals and suggestions and added that strengthened primary health care systems act as a very important buffer to help sustain any disaster management. She spoke on the health care issues of the internally displaced populations.
The disaster conference will lead to set of general and specific recommendations which will serve as guidelines for a future disaster plan. The conference will serve as a guide for the stakeholders to work with, and to be better prepared to deal with disaster.
Dr. Saud Anwar summarized the discussion and views of the conference participants which emphasized the principles of commitment, communication, collaboration, coordination, continued planning and capacity building. He stated that this initiative should mark the beginning of an era of preventive approach and safety and preparedness culture. Need for a multi-prong, top-down and bottom-up approach was stressed with focus on hazard risk and hazard mapping plans along with improvement in the pre-hospital level of care with specific focus on a volunteer based national movement, and strengthening of the primary health care model as a backbone followed by a nationwide trained and appropriately equipped EMS services. The two models of EMS services were discussed with focus on each model’s strength and weaknesses.
An increase in both horizontal and vertical growth of the system was stressed. Dr. Anwar further stated the need to strengthen the hospital emergency level of care, with a focus on re-evaluating medical and nursing education. An important and critical need for paramedic and EMT (emergency medical technicians) was stressed. Special focus on the vulnerable populations, internally displaced people, and understanding and appropriate implementation for the psychiatric and rehabilitative dimensions of disaster were also reviewed. A group discussion was held between multiple groups currently involved in the physical and mental rehabilitative activities following the current disaster.
The recommendations and the disaster conference declaration were read by APPNA's President-elect, Dr. Abdul Piracha on behalf of Dr. Hussain Malik. Dr. Raza Bokhari, the conference chair thanked all the collaborators and participants and especially Dr. Muhammed Umar, Professor of Medicine at RMC and Dr. Saud Anwar for their role in organizing the conference.



Editor: Akhtar M. Faruqui
2004 . All Rights Reserved.