The organization of medical services, will depend on the type of the disaster, its magnitude, and its location. The structure of the system of health existing in the country and in the region should be taken into account so that the available resources are used advantage of well, before requesting reinforcements.
Minimum standards of organization and coordination between the health workers relief and the political authorities in the country need to be observed.
The main assistance centers in normal condition and during a disaster, will be even more important because the demand that is generated requires a response which is prompt and greater to that of custom.
During a disaster, assistance centers should continue to look after in-patients, routine pathology, in addition to the injured by the disaster, and intervene in the actions of prevention of future risks and of public health in general.
In normal times, it is ideal that the medical services, as well as the rest of the activities, have a general detailed emergency plan according to activity, which can be activated during the disaster, to save time in the response.
During a disaster the operation of the formal organic structure of the system of health and of the services, is suspended automatically and is replaced by a functional organization, made up of working teams in different areas:
The relief of the victims, care of the injured, management of the corpses, all these actions integrated in the command or local authority.
Field hospitals, if necessary, when infrastructure is loading (see: "Field hospitals in cases of disaster").
In the health facilities: each hospital center should designer emergency committee, that becomes the functional structure, with:
teams of care to people both within the hospital and in the centers assigned, refugees of area, field hospitals etc.;
Diagnostic support services (clinical laboratory, blood banks, radiology, pathology or morgue, pharmacy, social work and volunteer personnel, included the community, Red Cross and NGOs).
administrative support: maintenance, communications; transport of the victims and of the personnel; feeding of the personnel and patients; statistics, for information to the central committee; supplies; safety; laundry; sterilization; petty cash or emergency treasury.
Appointment of a national coordination of medical services, joining the national committee of management of the disaster.
- The medical services are part of the health workers team.
- Care of the situation should be obtained with the personnel of the country, supported in the local volunteer personnel.
- It is very important to have adequate and timely information on the existing situation, as well as to provide information on the services in a timely fashion.
- Medical services are not limited to the task of care of the victims. Public health actions also are part of the responsibilities of the medical services.
What to do?
- Set up expeditious organization, integrated in the national committee.
- The representative of medical organization should be part of the team of evaluation of the damages and of the immediate needs.
- Make a rational and efficient use of the existing resources.
- Request or accept assistance of international personnel when the need is determined.
- International personnel should be required to be self-reliant in main needs of: transport, meals, lodging; they should contribute drugs to the population that will serve; they should speak the local language and should be installed according to needs in agreed areas.
What not to do?
- Do not accept international assistance in the form of unnecessary medical brigades.
- Do not accept medical brigades that are not self-reliant.
- Do not accept donations of drugs, equipment, or other resources that are not necessary.
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