The province of Navosa in Fiji is less developed with water, sanitation, and hygiene (WASH) standards below other provinces in Fiji. In February, 2022 Navosa suffered an outbreak of Leptospirosis cases leading to severe disease, hospitalization, and death. The Fiji Emergency Medical Assistance Team (FEMAT) was activated to respond.

To describe FEMAT response to the Leptospirosis outbreak in a rural island setting.

FEMAT joined the local public health team based out at the Keyasi Hospital with early contact tracing occurred for 26 villagers and 37 of 63 settlements were surveyed for early case detection. It provided additional support to the local clinical team with case management. Health inspectors supported community awareness sessions, and distribution of purification tablets and WASH Kits.

The team was able to treat 12 cases in the community with an additional of 20 acute febrile illnesses in the contact tracing. 87 cases of leptospirosis were treated at the hospital. Therefore, the team treated 99 cases of leptospirosis directly preventing more severe presentation to health facilities. Our health inspectors distributed 200 WASH kits in five communities.

The FEMAT response assisted in the containment and control of the leptospirosis outbreak in the Navosa province while at the same time provided community outreach, preventative care, and surgical management in a rural island community.

EMT2-ITA Regione Piemonte (EMT2-ITA) was classified by WHO as Emergency Medical Team type 2 in 2018. The WHO EMT type 2 standards do not include Intensive Care Unit (ICU) for this type of field hospitals.

On February 2023, after the 7.8 earthquake struck Türkiye and Syria, the EMT2-ITA deployed its field hospital in Antakya (capital of the Hatay province, 1,686,043 inhabitants)

The objective of this study is to report ICU activity of EMT2-ITA in Türkiye, raising interesting points of discussion regarding the essential role of this capacity in a EMT type 2 field hospital.

Starting from the paper patient records and the anesthesiologist logbook, a chart review was conducted: the anonymous data of the patient records were manually entered into an electronic data collection form by healthcare staff (nurses supervised by doctors). Descriptive statistics were used to analyze the database.

A total of 11 patients were admitted in the ICU during the 29 days of field hospital activity with a mean of 1.5 occupied beds per day (with peaks of all the 4 ICU beds occupied for 2 days): almost all the admissions (9; 82%) were patients needing sub-intensive care; 2 patients were critical (treated with intubation and ventilation) and were referred to other facilities after stabilization in the ICU.

The data collected show that an EMT type 2 would benefit from at least 2 ICU beds plus a sub-intensive capacity to treat patients needing higher standards of care than inpatient ward.

The Specialized Care Teams (SCTs) provide additional specialized care supporting an existing local facility or a type 2 or 3 EMTs. The “rescEU EMT” project, funded by European Union, currently under development, aims to become the largest field hospital globally, made of 21 capacities, including EMTs and SCTs. The EMT2-ITA Regione Piemonte is in charge to develop the ICU Truck-based (together with Germany), Portable CT Scan, Dialysis and Oxygen Supply (together with Portugal and Türkiye) SCTs. Even though the WHO is working to publish technical notes for SCTs, at the moment, very few documentation is available.

To describe the process of designing SCTs in a multi-national project.

The working group was composed by medical doctors, nurses, engineers, technicians coming from the partner countries of the project. This multidisciplinary and multinational team carried out a 3-phase process: (1) a literature review searching for publications, international and national guidelines, legislations relevant for the SCTs under development; (2) the definition of standards of care and deployment’s policies for each SCTs; (3) a market survey to reach a realistic budget estimation and to investigate technologies, materials, and products.

The main result is the definition of the technical specifications for each SCT to be used during the next procurement phase. The main challenges were the tight deadlines, the harmonization of different medical practices and the level of the care to provide.

This model can offer valuable guidance and can be applied by other teams involved in the development of SCTs.

Past studies have raised the need for improvements in the Korea Disaster Relief Team (KDRT)'s communication and information management systems.

This study aims to develop guidelines to enhance the technological interoperability of KDRT medical teams, focusing on communication and information management systems at international disaster sites.

A literature review and analysis of KDRT documentation and international research were conducted using PRISMA methodology. The study applied the Interoperability Continuum Framework’s five domains to assess and enhance KDRT’s technological capabilities. The PRISMA flow diagram was used to systematically identify, screen, and include relevant studies and documents.

From 17369 initial documents, 20 were included in the final qualitative synthesis. Key areas for improvement were identified:

1. 1. Governance: Establish a robust structure for clear decision-making and coordination. Create an inter-agency committee and regularly review policies.

2. 2. Standard Operating Procedures (SOPs): Develop and standardize SOPs aligned with WHO standards. Provide regular training for team members.

3. 3. Technology: Integrate advanced communication systems for real-time data sharing. Utilize digital platforms for resource management. Regularly evaluate and update tools.

4. 4. Training & Exercises: Implement comprehensive training programs, including joint exercises. Focus on real-life scenarios and new technologies. Conduct after-action reviews.

5. 5. Usage: Ensure team proficiency in using guidelines and tools. Monitor effectiveness during deployments. Analyze data to improve practices.

Implementing the proposed guidelines will enhance KDRT’s technological interoperability, streamline disaster response, and align with global standards. This will maximize life-saving interventions and improve crisis coordination, addressing current gaps and leveraging advanced technologies for efficient future disaster relief operations.

In May 2024, ICRC and 12 Red Cross-National Societies combined efforts to open a field hospital in Rafah, Gaza, to help address the overwhelming health needs emanating from the ongoing armed conflict. The hospital complements and supports the essential work performed by the Palestine Red Crescent Society (PRCS) in providing urgent care.

MHPSS is an essential part of emergency response, but it is still seen as an optional ‘nice to have’ intervention and therefore not always integrated within emergency health response in a timely manner. ICRC, in line with the International Red Cross and Red Crescent Movement MHPSS Policy and World Health Assembly MHPSS Resolution, decided early on to integrate MHPSS within the health services being provided by the field hospital.

Presentation and discussion on:

• How was MHPSS integrated within the hospital services, including mass casualty management and triage?

• What impact has early access to MHPSS had for patients and their families?

• What do EMTs need to know about MHPSS?

• What were the challenges and lessons learnt from this deployment?

• Sustainable approaches to ensuring MHPSS service provision within emergency health settings

ICRC and Danish Red Cross (DRC) highlighted the importance of early integration of MHPSS into emergency health services and share best practice examples and case stories from the field hospital in Gaza.

Early and appropriate access to MHPSS saves lives.