Extending a Helping Hand: A Comparison of Israel Defense Forces Medical Corps Humanitarian Aid Field Hospitals.

BACKGROUND: During the past 6 years the Israel Defense Forces Medical Corps (IDF-MC) deployed three humanitarian delegation field hospitals (HDFHs) in disaster zones around the globe: Haiti (2010), the Philippines (2013), and Nepal (2015). OBJECTIVES: To compare the activity of these HDFHs and the characteristics of the patients they served. METHODS: This retrospective study was based on the HDFHs' operation logs and patients medical records. The study population included both the staff who participated and the patients who were treated in any of the three HDFHs. RESULTS: The Philippine HDFH was a "hybrid" type, i.e., it was integrated with a local hospital. Both the Haitian and the Nepali HDFHs were the "stand-alone" type, i.e., were completely autonomic in resources and in function. The Nepali HDFH had a larger staff, departed from Israel 4 hours earlier and was active 7 hours earlier as compared to the Haitian one. In total, 5465 patients, 55% of them female, were treated in the three HDFHs. In Haiti, Nepal and the Philippines, disaster-related injuries accounted for 66%, 26% and 2% of the cases, respectively. Disaster-related injuries presented mainly in the first days of the HDFHs' activity. CONCLUSIONS: The next HDFH should be planned to care for a significant proportion of routine medical illnesses. The IDF-MC continuous learning process will enable future HDFHs to save more lives as we "extend a helping hand" to foreign populations in crisis.

La asistencia médica al Ejército Auxiliar del Alto Perú en la batalla de Tucumán: en el bicentenario de la batalla

El propósito de este estudio fue investigar el comportamiento del servicio de sanidad militar durante la batalla de Tucumán. El 28 de abril de 1812, Belgrano, General en Jefe del Ejército del Alto Perú, le manifestaba al gobierno: ôcuento con 1.500 hombres en el ejército, pero la mitad de ellos están enfermosö. Los médicos del Ejército no tenían experiencia en la organización del servicio de sanidad ni tampoco en el tratamiento de los heridos. Los recursos médicos disponibles también fueron muy pobres. (AU)

The purpose of this study was to investigate the actions of the military health service during Tucuman battle. In april 28 of 1812, Belgrano, General in chief of the Army, tell to the government: ôHave 1500 soldiers in the Army, but half of them are sickö. The physicians of the Army had no experience in the administration of the health service and iin the treatment of the casualties. The medical resources also was poors. (AU)

La asistencia médica al Ejército Auxiliar del Alto Perú en la batalla de Tucumán / Medical assistance to the Auxiliary Army of the Upper Peru in the battle of Tucumán

El propósito de este estudio fue investigar el comportamiento del servicio de sanidad militar durante la batalla de Tucumán. El 28 de abril de 1812, Belgrano, General en Jefe del Ejército del Alto Perú, le manifestaba al gobierno: “cuento con 1.500 hombres en el ejército, pero la mitad de ellos están enfermos”. Los médicos del Ejército no tenían experiencia en la organización del servicio de sanidad ni tampoco en el tratamiento de los heridos. Los recursos médicos disponibles también fueron muy pobres.

The purpose of this study was to investigate the actions of the military health service during Tucuman battle. In april 28 of 1812, Belgrano, General in chief of the Army, tell to the government: “Have 1500 soldiers in the Army, but half of them are sick”. The physicians of the Army had no experience in the administration of the health service and iin the treatment of the casualties. The medical resources also was poors.

Orthopaedic management in a mega mass casualty situation. The Israel Defence Forces Field Hospital in Haiti following the January 2010 earthquake.

Following the January 2010 earthquake in Haiti, the Israel Defence Forces (IDF) established a field hospital in Port au Prince. The hospital started operating 89 h after the earthquake. We describe the experience of the orthopaedic department in a field hospital operating in an extreme mass casualty situation. The hospital contained 4 operating table and 72 hospitalization beds. The orthopaedic department included 8 orthopaedic surgeons and 3 residents. 1111 patients were treated in the hospital, 1041 of them had adequate records for inclusion. 684 patients were admitted due to trauma with a total of 841 injuries. 320 patients sustained 360 fractures, 18 had joint dislocations and 22 patients were admitted after amputations. 207 patients suffered 315 soft tissue injuries. 221 patients were operated on under general or regional anaesthesia. External fixation was used for stabilization of 48 adult femoral shaft fractures, 24 open tibial fractures and 1 open humeral fracture. All none femoral closed fractures were treated non-operatively. 18 joint reductions and 23 amputations were performed. Appropriate planning, training, operational versatility, and adjustment of therapeutic guidelines according to a constantly changing situation, enabled us to deliver optimal care to the maximal number of patients, in an overwhelming mass trauma situation.

Experiencias aportadas por los médicos militares cubanos en las guerras por la independencia del siglo XIX / Experience contributed by the Cuban military physicians during the independence wars in the 19th century

Se exponen algunas experiencias de la organización de la Sanidad Militar y del ejercicio de la medicina militar cubana en el siglo XIX. Se realizó una revisión bibliográfica para la obtención de los datos. Se pone de manifiesto cómo los cubanos en las guerras contra el colonialismo español establecieron las bases reglamentarias para la Sanidad Militar. En la Guerra de los Diez Años (1868-1878) no se logró una óptima organización de la Sanidad Militar, pero las experiencias alcanzadas fueron el cimiento para la creación del Cuerpo de Sanidad Militar en la Guerra del 95. La labor de los cirujanos cubanos en la Guerra del 95 fue testimoniada con rigor científico por el Coronel Médico Enrique Núñez de Villavicencio y Palomino, presentada en la Sociedad de Estudios Clínicos de La Habana y publicada en 1889 en los Archivos de la Sociedad de Estudios Clínicos de La Habana. Se puede afirmar que el meritorio desempeño de los cubanos en el ejercicio de la medicina en condiciones de campaña en las guerras por la independencia de Cuba en el siglo XIX ofrece interesantes experiencias para la medicina militar contemporánea.

Some experience about the organization of the military health system and the practice of military medicine in Cuba in the 19th century were presented. A literature review was made to collect data about this topic. The way in which the Cubans set the regulatory basis for the military health system during the independence wars was put forward. In the Ten-Year War 1868-1878, optimal organization of the military health system was not accomplished, but accumulated experience laid the foundations for the creation of the Military Health Corps in 1895 Independence War. The work of Cuban surgeons in this last war was scientifically documented by Medical Colonel Enrique Núñez de Villavicencio y Palomino, submitted to the Society of Clinical Studies in Havana and published in the Archives of the Society of Clinical Studies of Havana in 1889. It may be said that the meritorious performance of the Cuban physicians under the independence war conditions in the 19th century offer some interesting pieces of experience for the contemporary military medicine.

Rapid response to a case of mumps: implications for preventing transmission at a medical research facility / Respuesta rápida a un caso de paperas: implicaciones para la prevención del contagio en una instalación de investigación biomédica

OBJECTIVE: To prevent transmission among the staff and potentially among the non-human primate (NHP) colony at the U.S. Naval Medical Research Center Detachment in Peru, where an active case of mumps was discovered in a senior laboratory technician in Sep 03, 2007. MATERIAL AND METHODS: Subjects at the research facility were interviewed and potentially susceptible contacts were tested for mumps IgG. RESULTS: In total, 81 out of 106 staff members (76 percent) had close contact with the case. Only 6/81 (7 percent) had MMR, 33 (41 percent) reported having had mumps, and 8 of 45 (18 percent) of the potentially susceptible individuals did not have immunity (IgG > 20.0). All the susceptible, exposed individuals received MMR vaccine. There were no secondary cases and access to the NHP colony was restricted. DISCUSSION: Immediate and thorough investigation and occupational health response were imperative in preventing secondary cases of mumps among humans and NHP.

OBJETIVO: Prevenir el contagio de parotiditis al personal y potencialmente a la colonia de primates no humanos (PNH), tras detectarse un caso en el personal técnico de laboratorio en el Centro de Investigación de Enfermedades de la Marina de los EUA (NMRCD). MATERIAL Y MÉTODOS: El personal fue entrevistado y se hizo una prueba de IgG para parotiditis a los contactos potencialmente susceptibles. RESULTADOS: En total, 81 de 106 miembros del personal tuvo contacto cercano con el caso. Sólo 6/81 (7 por ciento) tenían vacuna y 33 (41 por ciento) reportaron haber tenido parotiditis, y 8 de 45 (18 por ciento) de los susceptibles potenciales no tenían inmunidad (IgG > 20.0). Todos los susceptibles expuestos fueron vacunados y no hubo casos secundarios. Se restringió el acceso a la colonia de PNH. CONCLUSIÓN: La investigación inmediata y la respuesta de salud ocupacional fue imperativa para prevenir casos secundarios de parotiditis en el personal y los NHP.

Rapid response to a case of mumps: implications for preventing transmission at a medical research facility.

OBJECTIVE: To prevent transmission among the staff and potentially among the non-human primate (NHP) colony at the U.S. Naval Medical Research Center Detachment in Peru, where an active case of mumps was discovered in a senior laboratory technician in Sep 03, 2007. MATERIAL AND METHODS: Subjects at the research facility were interviewed and potentially susceptible contacts were tested for mumps IgG. RESULTS: In total, 81 out of 106 staff members (76%) had close contact with the case. Only 6/81 (7%) had MMR, 33 (41%) reported having had mumps, and 8 of 45 (18%) of the potentially susceptible individuals did not have immunity (IgG > 20.0). All the susceptible, exposed individuals received MMR vaccine. There were no secondary cases and access to the NHP colony was restricted. DISCUSSION: Immediate and thorough investigation and occupational health response were imperative in preventing secondary cases of mumps among humans and NHP.

Medical support for Pershing's Punitive Expedition in Mexico, 1916-1917.

Pershing's Punitive Expedition had adequate medical support despite deliberately limited in-theater resources. The few casualties did not strain the inadequate number of forward providers. Preventive medicine was highly successful due to significant medical and command emphasis. New technologies were useful and helped minimize the medical footprint. National Guard troops mobilized to support the Expedition had troublesome medical readiness rates.

Civil affairs augmentation of Special Forces units greatly enhance MEDRETE impact.

Medical readiness education and training exercises (MEDRETEs) provide acute, primary, and preventative medicine services to populations in countries other than the United States. MEDRETEs provide training in deployment, redeployment, austere environment medicine, supply, security, and defense for our active duty and reserve component personnel. MEDRETEs also improve public relations, advance U.S. foreign policy, and build confidence in the partner nation services. This article documents the great increase in ability to see multiple patients provided when a Special Forces unit is augmented by assistance from Civil Affairs attachments.

A comparative cost analysis of an integrated military telemental health-care service.

The National Naval Medical Center, Bethesda, Maryland, integrated telemental health care into its primary behavioral health-care outreach service in 1998. To date, there have been over 1,800 telemental health visits, and the service encounters approximately 100 visits per month at this time. The objective of this study was to compare and contrast the costs to the beneficiary, the medical system, and the military organization as a whole via one of the four methods currently employed to access mental health care from remotely located military medical clinics. The four methods include local access via the military's civilian health maintenance organization (HMO) network, patient travel to the military treatment facility, military mental health specialists' travel to the remote clinic (circuit riding) and TeleMental Healthcare (TMH). Interactive video conferencing, phone, electronic mail, and facsimile were used to provide telemental health care from a military treatment facility to a remote military medical clinic. The costs of health-care services, equipment, patient travel, lost work time, and communications were tabulated and evaluated. While the purpose of providing telemental healthcare services was to improve access to mental health care for our beneficiaries at remote military medical clinics, it became apparent that this could be done at comparable or reduced costs.

Urology/urogynecology medical readiness training exercise: experience for the military surgeon.

A medical readiness training exercise was conducted in conjunction with Task Force Bravo in Honduras during July and August 2000. Surgical teams from Madigan Army Medical Center performed 46 major pelvic reconstructive surgical procedures and treated more than 300 patients. The mission was an exceptional training opportunity for Army Medical Department personnel, who performed complex surgical procedures with limited logistical support under austere surgical conditions. Team members gained invaluable experience in mobilization preparedness and tested their predeployment training and resourcefulness while providing needed services to the people of the host nation.

Utilization of military support in the response to hurricane Marilyn: implications for future military-civilian cooperation.

INTRODUCTION: The past decade has been a period of evolution for the Federal disaster response system within the United States. Two domestic hurricanes were pivotal events that influenced the methods used for organizing Federal disaster assistance. The lessons of Hurricane Hugo (1989) and Hurricane Andrew (1992) were incorporated into the successful response to Hurricane Marilyn in the U.S. Virgin Islands in 1995. Following each of these storms, the Department of Defense was a major component of the response by the health sector. Despite progress in many areas, lack of clear communication between military and civilian managers and confusion among those requesting Department of Defense health resources may remain as obstacles to rapid response. METHODS: This discussion is based on an unpublished case report utilizing interviews with military and civilian managers involved in the Hurricane Marilyn response. RESULTS: The findings suggest that out-of-channel pathways normally utilized in the warning and emergency phase of the response remained operational after more formal civilian-military communication pathways and local assessment capability had been established. CONCLUSION: It is concluded that delays may be avoided if the system in place was to make all active pathways for the request and validation of military resources visible to the designated Federal managers located within the area of operations.

The dermatologist in military operations.

The military dermatologist has a specific and significant role in military operations--in time of war as well as in peace. Many dermatologists are unfamiliar with the impact that our specialty and cutaneous disease has upon the ability of the military to fulfill the missions, duties, and responsibilities assigned by our government. This article highlights a few of the recent or ongoing types of military operations in which our specialty plays a prominent part.

Para la vida: aprender a salvar / For life: learn to save

El tema de la salud boliviana de acuerdo a la necesidad de la población. La salud de las familias bolivianas es difundida y aplicada por las Fuerzas Armadas. El enfoque enmarca la alimentación de la madre y el niño, la salud Materno-Infantil esta constituye 6 mensajes para evitar la desnutrición del niño; además de ello enfoca el desarrollo infantil enmarcada en 8 mensajes básicos de salud. La vacuna es uno de las actividades preventivas enunciada en 4 mensajes. Otras enfermedades infecciosas para su prevención

Aseguramiento médico en guerra irregular / Medical insurance in the irregular war

Se hace un recuento histórico de algunos hechos relevantes en una guerrilla, durante una guerra de liberación nacional; se destacan lasparticularidades de esta lucha según su fase nómada, seminómada o de columnas guerrilleras establecidas, en que la estabilidad y el dominio de la región liberada permite mayor organización de la sanidad. Se exponen algunos testimonios referidos al cumplimiento de una misión internacionalista

The formation and application of an overseas mental health crisis intervention team, Part I: Formation.

The creation of an overseas mental health crisis intervention team is described. The authors discuss the unique aspects of an overseas low intensity conflict environment and the importance of immediate mental health responses to disaster situations in such theaters. Key elements in the formation of the team are the use of local resources, command endorsement, and an emphasis on education of commanders and team members. Examples are cited of other military response team deployments. The authors present their experience in Panama as a model for other providers in similar environments.