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Tue Sep 16 13:18:14 BST 2008

Dear Pret,

I understand your premises. I am certain that there is a job waiting for Ken
Mattox in Geneva with the International Federation of Red Cross Red Crescent
Societies whose main purpose is to co-ordinate relief efforts around the
world for natural catastrophes. There is also one in the International
Committee of the Red Cross if his interest is more in line with armed
conflict. Must make a choice; it's the way of the world.

Small problem, however, that I also have had to face. If you are a
"hands-on" surgeon, co-ordination (planning, assessment, programme
elaboration, monitoring, evaluation) does not leave you much time for using
your hands, and the frustration builds inexorably.

Some of us choose to stay "hands-on", but then have to put up with less than
adequate co-ordination. Or we move into co-ordination, and we stop
operating. Finding the balance between the two is not easy; some would say
impossible.

That is the real challenge from an individual's point of view. From the
institutional point of view, I repeat (this is the co-ordinator speaking,
not the surgeon): if you make a comparative analysis of different responses
to various natural catastrophes, the most important factor in determining
the efficacity and efficiency of the response is political will. And that is
beyond the individual surgical co-ordinator.

best
christos giannou

>
> From: "Bjorn, Pret" <pbjorn at emh.org>
> To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
> Date: Mon, 15 Sep 2008 10:15:02 -0400
> Subject: RE: MEDICAL RESPONSE TO DISASTERS, incl DMAT, NDMS, etc
> Okay, ouch.
>
> Very well stated -- a sober and articulate reminder of our undeniable
> ethnocentrism.  America's well-earned reputation for humanitarian engagement
> has increasingly been eclipsed by less charitable acts and attitudes, to our
> certain shame and regret.
>
> Still, I reject that the List is somehow complicit or sympathetic.  Indeed,
> I recall long List-mediated discussions in the aftermath of the Bam quake
> and the Indonesia tsunami and other (natural and man-made) disasters.  What
> you're seeing with Ike is simply a function of Ken Mattox (an expert in
> trauma and disaster response, and notably the most globally-oriented voice
> of the List) being in the wrong place at the right time.  Again.
>
> Indeed, the world might be a better place if Dr. Mattox could -- safely --
> observe and chronicle ALL such large-scale tragedies firsthand.  He brings
> unmatched energy and insight to the danger zone, for which I think we should
> be grateful.
>
> Absent that, I offer my deep empathy to victims and providers all along
> Ike's path, and encourage subscribers to actively become the voice of those
> otherwise forgotten.  Surely there must someone in the Caribbean who can
> help us all understand the culture, the politics, the infrastructure, and
> the impact of these storms, that we might all suggest and discuss systematic
> responses.
>
> Pret Bjorn, RN
> Bangor, ME USA
>
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org] On Behalf Of Christos Giannou
> Sent: Monday, September 15, 2008 7:41 AM
> To: trauma-list at trauma.org
> Subject: Re: MEDICAL RESPONSE TO DISASTERS, incl DMAT, NDMS, etc
>
>
> Dear colleagues,
>
> We have been reading about the American alphabet soup (DMAT, NDMS, FEMA
> etc)
> of disaster response the last several days. The same hurricane that struck
> Texas first killed hundreds and TOTALLY destroyed the city of Gonaïves in
> Haïti. (To rebuild the city, they will probably have to reconstruct
> somewhere else.) Strangely, there have been no messages on the list
> concerning this phase of the hurricane.
>
> Just a short reminder that natural catastrophes strike everywhere. In 2004,
> a devastating earthquake in Bam, Iran. The Iranian Red Crescent Society
> triaged 15,000 wounded in three days. Military and civilian airplanes then
> distributed the wounded to all the major hospitals throughout the country.
> By then, international help arrived (including an American military field
> hospital), largely for political purposes, to deal with the public health
> problems.
>
> Take a close look at Bam 2004, the tsunami 2005, or Kashmir earthquake
> 2006,
> earthquake in China just before the Olympics and Haïti, and Katrina, and
> then compare. First step for a rapid and effective response: political
> will.
> Everything else is secondary and follows afterwards.
>
> This is for natural catastrophes; armed conflict is another matter, but the
> response also depends upon political will, as a first step.
>
> Before getting caught up in an entirely US of A-centered affair, it might
> be
> worthwhile having a look at what happens elsewhere in the world.
> Re-inventing wheels is such a waste of time.
>
> --
> christos giannou
> Monemvasia Lakonia
> 23070 Greece
> tel & fax: (++30) 27320-61772
> mob: (++30) 69 74 83 28 18
> --
>
>

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