September 12, 2018

Disaster Rehabilitation Committee: Role and future agenda

By Fary Khan, Bhasker Amatya1,2

1. Disaster Rehabilitation Committee, ISPRM
2. Department of Rehabilitation Medicine, Royal Melbourne Hospital, & University of Melbourne, Parkville, Victoria, Australia.

The Disaster Rehabilitation Committee (DRC) (previously known as the Committee on Rehabilitation Disaster Relief) is an ISPRM Committee founded at the 5th ISPRM World Congress (Istanbul, Turkey, 2009), which contributes to the society’s humanitarian agenda to advocate for Physical and Rehabilitation Medicine (PRM) perspective in minimizing disability, optimizing function and health-related quality of life of persons who sustain traumatic injury and those with pre-existing disability in a natural or man-made disasters. Formerly part of the ISPRM WHO Liaison Committee, the DRC collaborates with the Liaison Committee on WHO disaster-related disability initiatives. Consistent with ISPRM goals, the DRC goals advance the global disaster rehabilitation community of practice, which include (but not limited to):

  • support ISPRM member National Society response to disasters;
  • provide education and training resources on rehabilitation disaster management;
  • host disaster rehabilitation programming at ISPRM congresses and other professional meetings;
  • provide expert PRM consultation to WHO and other rehabilitation disaster management stakeholders;
  • partner with WHO, other international rehabilitation professional societies, and other organizations to advance global disaster rehabilitation policy and practice;
  • and perform and facilitate disaster rehabilitation research.

The DRC and committee members have been actively involved in various activities during past and recent disasters, specifically providing care to the disaster victims on ground; providing clinical guidance through online consultation (remote teleconferencing) and also on-site consultation; facilitate online donations through the ISPRM website and collaborated with other national organisations for knowledge sharing and dissemination. The Committee members were also directly involved in the WHO Emergency Medical Team (EMT) initiatives and assisted in development of and/or providing guidance/consultation(s) in preparation of various guidelines and protocols including: Classification and Minimum Standards for Foreign Medical Teams in Sudden Onset Disasters (WHO); Emergency Medical Teams: Minimum Technical Standards and Recommendations for rehabilitation (WHO); Rehabilitation in Health Systems (WHO) and others.

The DRC recognises that building and strengthening rehabilitation capacity through education and training in the Low- and Middle-Income countries (LMICs) is of paramount importance in developing a skilled work-force, improving service provision and awareness of rehabilitation. This type of initiative not only benefits effective planning and comprehensive management of disasters, but also helps to develop and/or upskill a skilled and sustainable rehabilitation workforce for deployment in future disasters. One such example is the Royal Melbourne Hospital Rehabilitation Flying Faculty comprising interdisciplinary rehabilitation professionals (majority DRC members), visiting various LMICs as independent experts to run organized intensive rehabilitation educational workshops and capacity building programmes tailored to host requirements, including disaster rehabilitation capacity (in countries such as Madagascar, Nepal, Mongolia, Nigeria, Morocco, Pakistan, Thailand).

 

Since its establishment,  the DRC has been regularly hosting symposia, workshops and special sessions on disaster rehabilitation at the ISPRM World Congresses (annually); World Congress of Neurorehabilitation (joint session with ISPRM held in 10th world congress in February in Mumbai, India); Asia-Oceanian Conference of Physical & Rehabilitation Medicine; Annual Scientific Meeting of the national congresses. The committee members have researched independently and also collaborated on original scientific research resulting in presentations in various conferences/meetings (over 50 in last 5 years) and publications of over 50 manuscripts in various academic journals. The committee has conducted various workshops for early researchers at the ISPRM congresses and provided expert opinion on recommendations for future research in injury and physical rehabilitation for the humanitarian catastrophes.

The DRC currently comprises ‘Disaster Preparedness, Response & Recovery’, ‘Education & Training’, ‘Meetings’, ‘Research’, ‘Communications’, and ‘Finances’  Workgroups led by respective coordinators to enact its action plan. In addition, this year 10 Specific Working Groups (SWGs) have been set up for a period of 2 years, to oversee the ‘DRC Action Plan’, which includes:  Evidence- based Guidelines for traumatic brain injury (TBI) in disaster settings (accepted for publication in JISPRM); Systematic Review of International TBI Guidelines and applicability to Disaster settings (under editorial review at Archives of Physical and Rehabilitation Medicine); managing TBI Complications in Disaster Settings; setting up educational on-line training module for TBI in disaster settings; Disaster-Preparedness Skill- Survey for rehabilitation physicians with RMSANZ (currently ongoing); establish Rehabilitation Physician Disaster Training and Deployment Registry for Asia-Pacific Region (complementary process to the WHO); humanitarian assistance for displaced persons/refugees; Education Guidelines and Training for Rehabilitation in Disasters; DRC Outreach in Africa; DRC Education platform TBI, multiple trauma, burns , fractures etc.; Conflict zone, Humanitarian conflicts  report; develop Acute Trauma Education Module (Chengdu Centre); Hospital preparedness for disasters survey for Nurses and; Spinal cord injury (SCI)- International Spinal Cord Society (ISCoS) International Classification of Functioning, Disability and Health (ICF) assessment tool for disaster settings; preparation of specific ISPRM Action Plan for disasters; collaboration with other organisations (NGOs and INGOs); regular updates in the ISPRM news and views quarterly report and website; sorting funding opportunities for the DRC; and Operational Guidelines Working Group for other major injuries (such as musculoskeletal, burns etc.).

In recent years, many countries have recognized the importance of disaster planning, preparedness and management initiatives, and disaster management capacity.  Unfortunately, major disparities and gaps amongst countries exist, and those with a high disaster-risk tend to have low coping capacity and a large population vulnerable to natural calamities living in more exposed areas.  Disaster response plans and services are generally inadequate or absent in many disaster-prone countries, and few have access to rehabilitation. The strategic objective of the DRC is to advocate for Physical and Rehabilitation Medicine perspective in minimizing disability and optimizing functioning and health-related quality of life for disaster victims. The current developments in disaster rehabilitation area could be regarded as the much-needed steps in the right direction.  However, there are many challenges ahead. The DRC can play significant role in future disaster management processes, and its role should be recognised in future disasters to facilitate coordination among major rehabilitation providers worldwide, to minimize delay and duplication in deployment and deliver timely and effective rehabilitative care to victims.

There are almost 60 current members in the DRC at present. The committee welcomes more ISPRM members to join the DRC and support various activities.