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Rau B1, Lopez Villanueva D1, Wladis A1
1International Committee of the Red Cross, Geneva, Switzerland
Background: The International Committee of the Red Cross (ICRC) is operating in conflict zones around the world and responds to the surgical needs of war wounded and people indirectly affected by the conflict through its hospital programme. In 2017 it delivered surgical care in collaboration with an ICRC team in 18 supported structures: 3 in Iraq (including the Mosul offensive), 1 in the Central African Republic, 1 in the Democratic Republic of Congo, 2 in Lebanon, 1 in Mali, 1 in Niger, 1 in Nigeria, 7 in South Sudan and 1 in Yemen. Physiotherapy services were included, which is not yet standard practice of many organisations).
Purpose: The aim of this overview is to present the activities of physiotherapy (PT) within the ICRC supported hospital projects; this will share the knowledge on ICRC PT activities as well as raise awareness of the necessity of such interventions in conflict contexts.
Methods: Data presented was collected through usual monitoring in ICRC supported hospitals including a multidisciplinary team, therefore ethical consent was not necessary. Descriptive statistics was used.
Results: The ICRC physiotherapists function as an integral member of the surgical team. 24'689 patients were admitted in ICRC supported hospitals in 2017 and 136'394 surgeries were performed. Around 10 expatriate physiotherapists were collaborating with local physiotherapists and other hospital team members. Physiotherapists treated 573 amputees, 4339 patients with fractures and 1986 with soft tissues injuries, as well as many other patients with central nervous system or respiratory conditions. As described during the 2015 WCPT Congress, physiotherapists are responsible for the application of Plaster of Paris and have applied 5527 of those in 2017 to mainly patients with lower limb fractures. 38'129 activities related specifically to patients whose fractures are treated by external fixators or skeletal tractions. Amongst other tasks, they are also responsible of managing patients needing mobilisation or functional training. 1043 patients who underwent physiotherapy were referred to outpatient clinics and 681 to physical rehabilitation services. In addition to their clinical role, ICRC physiotherapists also undertake capacity building of local counterparts, help develop reference manuals (e.g. Plaster of Paris and skeletal traction applications) and clinical guidelines (e.g. management of patients with limb fractures), adapt equipment necessary to provide quality services (e.g. for respiratory care or gait training) and ensure that management patients through early physiotherapy activities is understood by all staff members.
Conclusion(s): Physiotherapy constitute a core component of the surgical team in hospitals supported by the ICRC in a conflict setting. The ICRC's references of physiotherapy interventions for people post surgery provide a comprehensive and updated approach in treating war wounded but additional documentation is required. This presentation will inform professionals about key figures of this type of activity and share ICRC's field experience, resources and challenges.
Implications: Actors in the field of physiotherapy in emergency contexts are better collaborating in developing resources to answer best to the needs of the people affected by conflicts. This developmental work is supported by WCPT as well as through the WHO Rehabilitation 2030 initiative.
Keywords: Humanitarian physiotherapy, Disaster, Collaboration
Funding acknowledgements: No funding was received for this work. ICRC has supported this contribution.
Purpose: The aim of this overview is to present the activities of physiotherapy (PT) within the ICRC supported hospital projects; this will share the knowledge on ICRC PT activities as well as raise awareness of the necessity of such interventions in conflict contexts.
Methods: Data presented was collected through usual monitoring in ICRC supported hospitals including a multidisciplinary team, therefore ethical consent was not necessary. Descriptive statistics was used.
Results: The ICRC physiotherapists function as an integral member of the surgical team. 24'689 patients were admitted in ICRC supported hospitals in 2017 and 136'394 surgeries were performed. Around 10 expatriate physiotherapists were collaborating with local physiotherapists and other hospital team members. Physiotherapists treated 573 amputees, 4339 patients with fractures and 1986 with soft tissues injuries, as well as many other patients with central nervous system or respiratory conditions. As described during the 2015 WCPT Congress, physiotherapists are responsible for the application of Plaster of Paris and have applied 5527 of those in 2017 to mainly patients with lower limb fractures. 38'129 activities related specifically to patients whose fractures are treated by external fixators or skeletal tractions. Amongst other tasks, they are also responsible of managing patients needing mobilisation or functional training. 1043 patients who underwent physiotherapy were referred to outpatient clinics and 681 to physical rehabilitation services. In addition to their clinical role, ICRC physiotherapists also undertake capacity building of local counterparts, help develop reference manuals (e.g. Plaster of Paris and skeletal traction applications) and clinical guidelines (e.g. management of patients with limb fractures), adapt equipment necessary to provide quality services (e.g. for respiratory care or gait training) and ensure that management patients through early physiotherapy activities is understood by all staff members.
Conclusion(s): Physiotherapy constitute a core component of the surgical team in hospitals supported by the ICRC in a conflict setting. The ICRC's references of physiotherapy interventions for people post surgery provide a comprehensive and updated approach in treating war wounded but additional documentation is required. This presentation will inform professionals about key figures of this type of activity and share ICRC's field experience, resources and challenges.
Implications: Actors in the field of physiotherapy in emergency contexts are better collaborating in developing resources to answer best to the needs of the people affected by conflicts. This developmental work is supported by WCPT as well as through the WHO Rehabilitation 2030 initiative.
Keywords: Humanitarian physiotherapy, Disaster, Collaboration
Funding acknowledgements: No funding was received for this work. ICRC has supported this contribution.
Topic: Disaster management; Musculoskeletal
Ethics approval required: No
Institution: International Committee of the Red Cross
Ethics committee: Cantonal ethical and research commission guidelienes Geneva, Swizerland
Reason not required: Project data used was collected for project monitoring, no ethical consent was required
All authors, affiliations and abstracts have been published as submitted.
