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Skelton P.1
1Handicap International, London, United Kingdom
Background: Early rehabilitation is increasingly recognised as having a vital role in disaster response teams, but until recently, rehabilitation professionals were rarely included in Emergency Medical Teams. This paper will outline the process, from 2013 onwards, of integrating rehabilitation professionals into the UK Emergency Medical Team, which culminated in the development, with WHO, of global guidance on rehabilitation in Emergency Medical Teams, and in December 2016, with the launch of the first ever WHO verified "Rehabilitation Specialist Cell," a rehabilitation team trained and equipped to rapidly deploy to international disasters.
Purpose: In the past, large disasters such as the 2010 Haiti earthquake have shown that in many low and middle income countries, national rehabilitation capability is often not sufficient to manage the number of people injured. With the notable exception of some Non-Governmental Organisations, most emergency medical teams also only included rehabilitation as an afterthought, or sometimes not at all. This left a significant gap in early rehabilitation, meaning many patients risked being discharged without any input, and would often be lost to follow up in the aftermath of the disaster.
Methods: Beginning in 2013, Handicap International were approached to integrate rehabilitation professionals into the UK Emergency Medical Team. This included adding equipment to the team, developing protocols, and recruiting and training physiotherapists and occupational therapists to work in disaster settings.
Results: By 2016, over 100 Rehabilitation Professionals had been trained, and an open access clinical guide and a WCPT report on rehabilitation in disasters were published.
Between 2013 and 2016, Rehabilitation Professionals from the UK Emergency Medical Team have responded successfully to disasters in the Philippines, Gaza and Nepal. In each instance, the rehabilitation component of the team has played a central role in the response.
Following the Nepal earthquake, where the UK team worked with WHO and the Ministry of Health and Population to coordinate the overall rehabilitation response, Handicap International have worked collaboratively with representatives from MSF, CBM and the ICRC to support WHO in developing a minimum standard for rehabilitation for emergency medical teams. This represents a critical step forward in ensuring rehabilitation is included in emergency medical responses. It also establishes, for the first time, what a dedicated emergency rehabilitation team should constitute, and sets standards for the verification of such teams.
In December 2016, the UK Emergency Medical Team became the first team to register and verify a dedicated Rehabilitation "Specialist Cell".
Conclusion(s): Rehabilitation Professionals are now established as a core part of the medical humanitarian response system.
Implications: Rehabilitation professionals interested in responding internationally to disasters must register with Emergency Medical Teams (including specialist cells) that are appropriately verified by WHO and be trained appropriately.
The importance of multidisciplinary training and preparation for disaster response is highlighted.
Significantly, while the WHO program has begun to address the inclusion of rehabilitation professionals in Emergency Medical Teams, the preparedness of appropriate rehabilitation capacity in disaster prone countries, and the inclusion of rehabilitation capability in local and national disaster management plans remains an area where significant progress still needs to be made.
Funding acknowledgements: The UK Emergency Medical Team is funded by the UK Government´s Department for International Development.
Topic: Disaster management
Ethics approval: As a descriptive study, no ethical approval was required.
All authors, affiliations and abstracts have been published as submitted.
