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Integration of foreign and local medical staff in a disaster area: the Honduras and El Salvador experiences
call for international aid by the Honduran government after the destruction wrought by Hurricane Mitch in November 1998
Department of International Cooperation of the Israel Ministry of Foreign Affairs sent 2 tons of medical supplies and a 10 member team of medical professionals, including a nurse and specialists in emergency medicine, paediatrics and paediatric critical care, surgery, internal medicine, infectious diseases and family medicine. All volunteered for the 17-day mission

describe the unique Israeli approach to integrating foreign and local medical staff for providing healthcare in disaster areas and to discuss its advantages and disadvantages

novel approach to foreign medical assistance, namely, the integration of international/foreign and local medical teams in the disaster area. In the present case, our team from Israel worked together with the staff of a community hospital in Honduras during the early recovery phase of a hurricane. Our experience highlights several advantages and disadvantages of this method.
  • Solidarity staffing (eg deployments to/from other jurisdictions)
  • Other
  • Physicians - Emergency
  • Physicians - Primary/Family
  • Physicians - Specialists
The Atlantida General Hospital is the main public government-run hospital serving the city of La Ceiba and its suburbs (population 300 000). It is a two-storey, 120 bed, level I facility with a general emergency department, departments of paediatrics, obstetrics and gynaecology, neonatal medicine, internal medicine, and general surgery, and an operating and recovery room. The hospital campus also houses a pharmacy, paediatric immunization clinic and a large outpatient clinic. The hurricane had badly exacerbated the already severe shortages in medical staff, equipment and drugs. Access roads were blocked and supply lines cut. There was no potable/running water as a result of damage to the water and sewage systems, and electricity failures occurred at frequent intervals. The destruction of the entire second floor of the hospital had caused serious overcrowding. In addition, the Honduran army was evacuating patients by helicopter from isolated rural areas to the hospital. The emergency department was very deficient in oxygen and advanced life support equipment, and used sheets for stretchers or beds were being replaced with brown paper.

The permanent staff of the Atlantida Hospital consists of only three paediatricians, two general surgeons, and one or two specialists in internal medicine. There are no physicians trained in emergency medicine, and even under normal circumstances, there is no emergency department director. The work in the emergency department is carried out primarily by interns (eighth year students on an obligatory rotational service) and family physicians. The permanent staff works from 07:00?h to 13:00?h and continues thereafter on an on-call basis only.
  • Emergency Medical Services
  • Hospitals
  • Primary Health Care
On arrival in Tegucigalpa, each member of the team was licensed by the Honduran Ministry of Public Health, and assigned by the Center of Coordination of International Aid to work in a specific area, according to local needs on the one hand and individual
The Israeli team had no available information on local needs, the function of local services, specific diseases/epidemics and the type of medical aid desired.
Research Intervention - outcome data available
Waisman, Y. (2003). Integration of foreign and local medical staff in a disaster area: the Honduras and El Salvador experiences. European Journal of Emergency Medicine, 10(2), 124-129.
Yehezkel Waisman
Schneider Children's Medical Center of Israel Petah Tiqva and the Sckler School of Medicine, Tel Aveiv University
Caribbean, Central, Latin & South America
Israel
English
Published Literature

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