UK-Med, supported by the Department for International Development, recently provided a team of clinicians to work alongside the Ministry of Health on Ebola preparedness in Rwanda, planning for the possibility of cross-border Ebola cases from Democratic Republic of Congo (DRC).
The Ebola outbreak – the world’s second worst ever – has seen over 2,750 cases in the east of the DRC since it started in August last year. In the last six months, the number of cases has increased dramatically and continues to do so.
The team was invited to observe live simulation exercises run by the World Health Organisation and Ministry of Health, that provided valuable learning opportunities for local healthcare workers in managing a case of Ebola if a patient were to arrive at a general hospital. All members of the UK-Med team have worked inside Ebola Treatment Centres and are experienced in the continuation of vital non-Ebola healthcare services, and ways to mitigate the risk of infection to healthcare workers and other patients at facilities.
In March 2019, Cyclone Idai hit Mozambique, with its centre in Sofala, Inhambane, Zambezia, and Manica. A state of emergency was declared by the president on the 19th March and a request for international assistance was made. Many of the health facilities within the five main affected districts of Biera, Nhmantanda, Dondo, Buzi and Muanza, had experienced either partial damage or were totally destroyed as result of either the cyclone or flood.
UK-Med deployed to Mozambique as part of the DFID assessment support team with other partners from the UK EMT partnership. Team members were seconded into roles to support the World Health Organisation and Ministry of Health with the coordination of the health response.
UK-Med supported the UK Emergency Medical Team response to an outbreak of diphtheria spreading through Rohingya refugee camps in Bangladesh.
Over a million Rohingya refugees have fled violence in Myanmar in successive waves of displacement since the early 1990s. The latest exodus began in August 2017, when violence broke out in Myanmar’s Rakhine State, driving more than 723,000 to seek refuge in Bangladesh. The vast majority reaching Bangladesh were women and children, with more than 40% under the age of 12.
Haphazard development of the camps resulted in overcrowded conditions with poor sanitation facilities, factors which contributed to the spread of the infectious respiratory disease.
At the request of the Government of Bangladesh and the World Health Organisation, the UK Emergency Medical Team deployed a clinical team in two waves to support the existing response, with the first wave flying out on 28th December 2017. Hundreds of thousands of refugees remain the the camps, living in harsh conditions.
Members of the register deployed to Kathmandu in response to the earthquake in Nepal in April 2015. Working with Save the Children and Handicap International, UK-Med supported the deployment of two trauma specialist teams. This was followed by spinal injury specialist cells that combined medical, rehabilitation and nursing staff to provide surge support to a Spinal Injury Centre.
The UK was at the forefront of the response to the Ebola Virus Disease (EVD) outbreak in Sierra Leone. The UK Ebola Response Programme provided assistance to control the epidemic by supporting in-country frontline health workers and underpinning a fractured health system in Sierra Leone. The UK’s aim was to deliver high-quality patient care and support the national healthcare workers during the crisis, under the most challenging conditions.
UK-Med worked with the Department for International Development (DFID), Department of Health, NHS England and International NGOs to recruit NHS volunteers through its International Emergency Medical Register (UKIEMR for Ebola) to work in a number of DFID funded Ebola Treatment Centres in Sierra Leone. We also trained and prepared vital standby teams to be ready to deploy if required through to the close of the programme in November 2015. This programme was funded with UK Aid from the UK government.
In August 2014, UK-Med sent a surgical team to treat the victims of the renewed conflict in Gaza. The team treated wounded civilians and helped to establish a community-based rehabilitation programme for the longer term management of injuries.
UK-Med and Handicap International supported a rehabilitation and nursing specialist cell to provide training and follow-up care for those with complex burns, amputations and spinal injury. As part of this six month rehabilitation programme, treatment was delivered in patients’ homes and family members were trained in on-going care.
In a combined response with Save the Children and Handicap International, UK-Med deployed a team of twenty-one clinicians as part of the UK National response to Typhoon Haiyan. A public health team was dispatched to work in support of the WHO in Manila, a specialist surgical cell augmented the Australian Medical Assistance Team (AUSMAT) field hospital in Tacloban and emergency and primary care teams were deployed to the remote islands supported logistically by the Royal Navy.
Following the success of the UK Ebola Response Programme, for which UK-Med provided trained clinicians, UK-Med was given a grant from DFID to develop its clinician register and on-call teams programme. In December 2016, UK-Med was verified for Type 1 and Type 2 teams by the World Health Organisation as part of its Emergency Medical Teams Initiative.
The earthquake in Haiti in 2010 was a turning point for humanitarian response, and also for UK-Med. In January 2010, members of UK-Med were deployed on behalf of the Department for International Development (DFID) to respond to the devastating earthquake in Haiti. The team worked alongside Merlin, GOAL and BAPRAS surgeons. This multi-agency team led the UK surgical response to the earthquake, predominantly performing limb salvage surgery. A rolling rota of surgeons, anaesthetists and emergency physicians and nurses saw over 70 medical personnel rotating through the field hospital. Over 600 major operations were carried out and over 7000 patients were treated in a three and a half month period.
In the months that followed UK-Med, Humanity and Inclusion and HCRI collaborated to produce a qualitative and quantitative study of the surgical and rehabilitation response to the earthquake. (Tony Redmond et al. (2011) A Qualitative and Quantitative Study of the Surgical and Rehabilitation Response to the Earthquake in Haiti Pre-hospital and Disaster Medicine.)
Haiti was a turning point. The international community was forced to re-think its response to international emergencies and look to ensure that responders were always professional, prepared, well-trained and fully accountable. UK-Med has always promoted and worked in full support of this approach.
UK-Med clinicians were deployed on behalf of the UK government, in response to the magnitude 8.0 earthquake that struck the Wenchuan area of Sichuan province, China on 12 May 2008. The team arrived in country three days after the primary shock, initially working in Mianyang hospital, close to the epicentre. The core team comprised of a plastic reconstructive surgeon and two orthopaedic surgeons supported by two emergency physicians, an emergency nurse consultant and an epidemiologist. Anaesthetic support was provided by local anaesthetists. In collaboration with Chinese colleagues the team reviewed over 50 cases.
UK-Med subsequently delivered emergency medicine and spinal cord injury rehabilitation training programmes in China as well as supporting Chinese health care workers coming to the UK for further training. The charity remains engaged with professionals in China to help improve disaster preparedness and responses.
UK-Med also provided advice on the aid requirements after the earthquake at the end of February 2010 in Chile, which reached 8.8 on the Richter scale.
Throughout the siege of Sarajevo (Bosnia and Herzegovina, 1992-1995), UK-Med organised surgical teams to work in the Sarajevo trauma centre, supporting local staff in their management of war injuries.
Following the 1995 eruption of the Pico Volcano on the island of Fogo (Cape Verde Islands, 1995) the evacuation onto another island, Sao Vicente, where cholera was present, led to an outbreak. The subsequent cholera epidemic was managed by UK-Med with a core team of volunteers working in rotation in support of the local health services over a nine month period.