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.

Following the February 6th, 2023 Kahramanmaraş Earthquakes (Mw: 7.7 and 7.6), critical health services were needed in regions with limited access. TRC, coordinated by the Ministry of Health, deployed mobile health teams to address these needs, reaching those with restricted access due to the disaster

This study evaluates the effectiveness of mobile health services provided post-earthquake, examining service accessibility, diversity, and impact on affected populations to assess the strategic role of mobile health in disaster response.

Between February 18 and June 12, 2023, 11 mobile health teams were deployed across six affected provinces (Adıyaman, Gaziantep, Hatay, Kahramanmaraş, Malatya, Osmaniye). Each team, consisting of a doctor, nurse/paramedic, radiology technician, and psychologist, operated from mobile vehicles converted for health services. Primary care services, including medication supply, wound care, home health care, X-rays, and ECGs, were provided. A survey of 453 individuals from a population of 47,127 was conducted to assess satisfaction.

The teams reached 42 districts, examining 47,127 patients, distributing 75,156 boxes of medication, taking 997 X-rays, and performing 117 ECGs. Wound care and home health care were provided to 1,351 and 1,051 patients, respectively, with psychosocial support offered to 18,081 individuals. Satisfaction was high, with over 93% satisfied with services and 97% with team communication.

The mobile health services effectively met the health needs in disaster-affected regions, emphasizing the importance of strategic coordination and the potential for similar models in future emergencies.

Israel is prone to a major earthquake along the Jordan Valley which will have a devastating impact on Jordanians, Palestinians, and Israelis. Magen David Adom Israel partnered with other national societies and is working together with the Israeli authorities to prepare for such an eventuality.

To describe the processes of the preparation work done in Israel, identify the main results, and lessons learnt.

The activities followed this methodology:

• A mapping exercise of the main issues to be addressed across different sectors.

• Series of joint multi-sectoral workshops with the relevant stakeholders to discuss the issues identified.

• Formulating the respective SOPs of the different stakeholders.

• Series of joint multi-sectoral workshops with the relevant stakeholders to discuss the issues identified.

• Formulating the respective SOPs of the different stakeholders.

Main results:

• Dedicated immigration procedures

• Dedicated customs procedures, including import permits including customs clearance and transport to the operations site.

• Health EoC to be tasked with handling arriving EMT and monitoring their operation.

• EMT to be embedded into existing Israeli health care facilities.

• Overcoming gaps in pain medication (controlled substances) and new generation antibiotics.

• Working with hospitals expected to receive an EMT on a joint deployment SOP

While many issues identified in the processes were resolved with many positive outcomes, there is still a list of other issues still pending decisions, which are in the future work plan. In order to sustain the results, and ensure their validity over time, an ongoing cooperation, nationally and with the international partners, including simulations, is essential.

During disasters, support for victims is prioritized, with EMTs providing essential medical care. However, the health of EMT members and other supporters is often overlooked. To address this issue, Japan implemented the J-SPEED Health Checkup tool for the first time during the Noto Peninsula Earthquake in January 2024 to collect real-time health data on EMTs and supporters.

This study aims to examine the fatigue levels and influencing factors among EMT members and other supporters.

The J-SPEED Health Checkup tool collected data on fatigue levels and factors such as working environment, activity type, job type. Fatigue levels were measured on a scale from 0 to 10, with higher scores indicating greater fatigue. A multivariable regression analysis was conducted to determine the association between fatigue and these factors.

From January 1 to March 31, 2024, a total of 20,551 data were collected. Logisticians reported significantly higher fatigue scores than other job types, with an increase of 0.23 points. Those working in headquarters also had higher fatigue scores compared to other activity types, with an increase of 0.19 points. Responders who perceived worse “unclear tasks,” “unsafe working environment,” and “lack of meals and breaks” reported significantly higher fatigue levels.

The study highlights the significant impact of job type, activity type, and perceived working conditions on the fatigue levels of EMT members and other supporters during disaster response efforts. Addressing these factors is crucial to ensuring the well-being of responders, which in turn can enhance the overall efficiency and effectiveness of disaster response operations.

In January 2022, TC Cody, a category 1 cyclone, caused widespread damage across Fiji with significant rainfall leading to extensive flooding in the western and central mainland. Over 4,500 people were displaced.

Describe FEMAT’s response to TC Cody in the midst of COVID-19 Delta and Omicron outbreak.

FEMAT coordinated initial response through the sub-divisional mobile teams that were activated within 12 hours after impact and tasked with monitoring the evacuation centers and screening the affected communities for illness or injuries. Later post-disaster (72 hours) deployments included WASH, food, and vector control activities.

Health Inspectors provided technical expertise for FEMAT in WASH, vector control and food safety. During this deployment, they led the team with disinfection of 177 evacuation centers, provided surveillance for food safety at local food outlets, distributed 1,874 hygiene kits, 141 menstrual hygiene management kits, 1,097 WASH kits, 476 water containers and 179 hygiene promotion kits, assisted in emergency water distribution carting for 210 households and 1,667 water purification tablets to the beneficiary. This provided aid to 12,705 households. The team also implemented vector control activities with source reduction targeting hot spot and high-risk areas with the removal of mosquito breeding sites, anti-mosquito fogging and larvciding.

The FEMAT response assisted in minimizing of potential outbreaks in communities post-disaster during COVID-19 outbreaks.

In March 2023, Vanuatu faced severe impacts from twin tropical cyclones Judy and Kevin. This state of emergency necessitated the activation of the National Health Emergency Operations Centre (NHEOC) and the Emergency Medical Team Coordination Cell (EMTCC) to coordinate deployment of both national and international EMT responses.

The primary objectives were to provide life-saving services, ensure essential medical support, maintain minimum standards of healthcare, and improve coordination among the various health teams and sectors involved in the disaster response.

The EMTCC managed the deployment of over five National EMTs and four International EMTs. Reception and Departure Centers (RDCs) were set up at entry ports for team verification and briefing. Daily Minimum Data Set (MDS) reporting facilitated consistent monitoring and planning. The EMTCC coordinated logistics, transport, ration supplies, and implemented a medivac process for patient referrals.

Over five National EMTs, including medical officers, midwives, psychosocial support, logistics, and nurses, were deployed, serving at least 1,638 patients. RDCs efficiently processed international teams, and daily MDS reports supported informed decision-making. Collaboration with international partners was effective, and a medivac process ensured timely patient transfers. Despite logistical delays, financial constraints, and human resource shortages, the coordinated efforts led to significant positive outcomes.

The EMT deployment in Vanuatu highlighted the importance of well-coordinated emergency responses. Key lessons include the need for standardized tools and procedures, continuous training, improved financial processes, and stronger logistical arrangements. Future recommendations emphasize dedicated budgets, pre-positioned resources, clear SOPs, and enhanced coordination to improve EMT resilience and efficiency in disaster scenarios.

In the context of war in Ukraine, a simultaneous emergency struck following the breach of the Kakhovka dam on 6 June 2023 and acutely stressed the health system. Extensive flooding, water shortages, drought and widespread environmental damage in several regions occurred. Over 4,000 people were evacuated from their homes and several hospitals transferred patients elsewhere.

To explore if the HR health surge needs of the flood affected health facilities in Kherson, Mykolaiv and Zaporizhzhia were met over the 6-month period.

The Ukrainian Scientific and Practical Center for Emergency Medical Care and Disaster Medicine (CDMU) of the Ministry of Health (MoH) of Ukraine, centrally managed the recruitment, onboarding and deployment of all HR health staff and surge requests over the 6 months project implementation period. Several meetings were held with the MoH regarding national regulation and a mechanism to deploy healthcare workers was established.

A total of 340 healthcare staff (216 doctors and 124 nurses) were identified through the Regional Departments of Health (according to MoH Order. 1597) or through self-referrals. In order of demand, 165 requests (120 doctors, 45 nurses) were submitted by healthcare facilities from (1) Kherson, (2) Mykolaiv and (3) Zaporizhzhia. All requests were met, aside from certain specialisms (i.e. neurosurgeon). The length of time for surge ranged from 3 to 6 months.

Despite the lack of regulatory documents and mechanism for engaging and deploying healthcare workers, the surge needs were successfully met for the Kakhovka dam breach emergency, although future efforts are required to attract certain specialisms to deploy.

Tuvalu was one of the last countries in the world to experience widespread COVID-19 outbreaks. Community cases were recorded in November 2022; this impacted on the health system. The government requested for medical assistance from Fiji.

To describe the Fiji Emergency Medical Assistance Team’s (FEMAT) response in Tuvalu. To describe the Fiji Emergency Medical Assistance Team’s (FEMAT) response in Tuvalu.

The team consisted of clinicians, nurses, and a Health Inspector. FEMAT together with World Health Organization (WHO) staff provided guidance on various standard operating standards (SOP) and clinical pathways development and training. Clinicians supported case management and referral pathway. They were later deployed as part of a mobile team.

FEMAT provided support to the working group on data collection that aided the government’s decisions. Clinicians provided training on Infection Prevention Control (IPC) standards for medical staff. Hospital staff were trained on management of moderate to severe cases with advice on the setting up of the high dependency unit. The health inspector contributed to the development of a waste management SOP with its implementation around health facilities. The team with the local medical team and WHO representatives were deployed for a week-long mobile response to smaller islands. The FEMAT team provided medical equipment’s and medications to the hospital upon return.

FEMAT through trainings and implementations of SOPs assisted the health working group to consolidate the governments’ COVID-10 response.

In May 2021, Lautoka Hospital a tertiary referral hospital recorded the first Delta variant COVID infection within medical wards. This prompted the national Incident Management Team to close the hospital and convert the entire facility to a COVID 19 isolation hospital. The staff and patients were isolated for a period of 28 days. The Fiji Emergency Medical Assistance Team (FEMAT) was deployed to set up and manage a field hospital.

To describe the response of FEMAT to continuity of health service delivery in Lautoka.

FEMAT set up a 28-bed inpatient field hospital within 72 hours. The facility was furnished with water and electrical power supply systems from the existing FEMAT cache. The service provided included general outpatient (GOPD), special outpatient (SOPD), inpatient wards (men, women, maternity, and resuscitation), dental, pharmacy, radiology, and minor surgical services. This was managed at a 12-hour shift by a 48-member team of clinicians, administrators, and logisticians.

There were 78 admissions, 671 cases triaged, 414 GOPD, 61 SOPD, 16 pediatric, 161 dental, 16 antenatal clinic, 1 Home retrieval, 4 cases requiring medical evacuation, 165 COVID screenings, 11 transfer of cases, 35 surgical procedures, and 8 deliveries within the field hospital.

FEMAT response ensured continued provision of critical health services for the people of Lautoka during the main hospital lockdown.

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.

Understanding surge capacity needs and EMT response following disasters is pivotal to improve the capacities to provide appropriate healthcare to populations affected. Although some research has analyzed individual EMT deployments in response to disasters, a comprehensive review of deployments since the 2010 Haiti earthquake has not been undertaken yet.

This review aims to gather information on the deployment of EMTs used as surge capacity in the aftermath of various disasters since 2010, including information on the disasters that required mobilization of such capacities.

A scoping review methodology was followed. We conducted an electronic search during July until October 2023 to gather data on deployments from 2010-2023 using PubMed, Google Scholar, and other key websites.

We found around 80 disasters that triggered EMT response, involving more than 450 deployments. Epidemics were the most frequent disaster type triggering response and earthquakes were the disaster type causing the largest EMT mobilization to a single event. Meteorological disasters also triggered a significant number of deployments. Very few reports documented responses to conflicts. Most disasters triggering deployments were registered in the African and Western Pacific regions and few deployments were registered in the European region. The geographical distribution of EMT responses highlights imbalance between needs and capacities and underlines the need to invest in EMT development in certain regions.

Current available data on EMT deployments is insufficient and of low quality. Reporting and data sharing should be encouraged to enhance accountability and allow needs-based improvements within the EMT initiative.

Migration and forced displacement are remodeling cities and countries. The number of people being displaced due to war, persecution, serious human rights violations and disturbance in social and political order has increased exponentially. Colombia is a vivid example of a massive mixed migration crisis, receiving refugees from Venezuela, crossed by migrants of various origins and a protracted internal displacement affecting mostly its Pacific Region.

The purpose of this study is to showcase the field experience of the Colombian EMT Hospital Barco San Raffaele through its response to two forced displacement crises: (1) in Colombia’s Pacific Region, and (2) Venezuelan refugees, aiming at providing evidence for the improvement of EMTs Type1 Standards of care.

Mix method case study methodology is employed to describe a complex phenomenon of mixed-migration. Data is gathered from response reports, program activities, clinical presentations; data will be analyzed using triangulation method, allowing comparison between adaption of health services, configuration of teams, legal frameworks, using the surge capacity components (4S) and current standards of care for Type1 EMTs.

Preliminary analysis shows the need to adapt services and configure teams to respond to volatile contexts; collaboration, negotiation, coordination, interoperability with local institutions, organizations and community leaders prove to be key to ensure credibility, access, and quality of care.

Enabling factors such as legal frameworks have a major impact/influence in ensuring access to care to displaced populations, facilitating or preventing responses. EMTs Type 1 Standards of care must be adapted if teams are to respond to this worldwide phenomenon.

Planning for WYD2023 by INEM began in July 2022, leading to the formation of the WYD2023 Taskforce in September. Over 90 meetings established key collaborations with entities like the Local Organizing Committee, Ministry of Health, Security Forces, Municipality of Lisbon, and His Holiness’ Security Team.

Share knowledge and lessons learnt from planning WYD 2023 and the PT EMT’s role in this event.

Analysis and reflection on lessons learnt from PT EMT’s experience in Portugal’s WYD 2023.

The event’s comprehensive risk assessment anticipated 1.5 million pilgrims over 12 days, guiding strategic and operational response plans. Reinforcements to the Prehospital Medical Emergency Integrated System included ALS Emergency Vehicles and support for main events.

The plan addressed satellite events with varying populations. Health care responses were organized into three levels: aid stations and mobile teams from Pilgrim support and the Portuguese Red Cross; Advanced Medical Posts; and EMT Type 1. Rigorous record-keeping covered admissions, clinical records, vaccination forms, birth certificates, death verifications, informed consents, narcotics controls, and personal belongings.

The response mobilized 500 staff, 124 mobile teams, 94 first aid sites, 4 EMT Type 1, 17 Advanced Medical Posts, and 7 “Calm” tents. This effort assisted 4376 patients within WYD sites, 253 outside, and 153 were evacuated to hospitals.

Key lessons from WYD2023 include the importance of collaborative planning from local to national levels, meticulous record-keeping, diverse logistical and operations levels, and establishing a WHO-classified EMT-based response. Flexibility and dynamic planning were essential for adaptability, and psychological support was integrated across all areas.

The ability to predict a dynamic crowd response during Mass Gatherings may improve medical access and egress in a mass casualty incident. Validated models that accurately anticipate the chaos and crowd flow are not readily available. Recent advances in machine learning for crowd simulation offer an under-explored opportunity to improve emergency response strategies.

Train a crowd simulation model on video data and prove validity by comparing its predictions to an actual crowd-egress event.

A physics-based Social Force Model was used to simulate crowd movement. The model considers obstacles and other pedestrians in trajectory prediction, seeking best to estimate crowd density rather than individuals’ positions. Four parameters– maximum speed multiplier, motivation factor, social force factor, and obstacle repulsion factor –were found to be meaningful when comparing simulations to known pedestrian video. These parameters were optimized using an evolutionary algorithm to predict crowd response to an actual bomb scare in Times Square. A convolutional neural network model, CSRNet, was used to analyze crowd density frame by frame from an actual video for comparison.

Predicted density heat maps were compared to the video, demonstrating a realistic simulation of crowd egress. The pedestrians filter similarly in the prediction model and the ground-truth video. Divergence is mainly noted in the upper portion of the image, accounted for by the fact that the model currently does not adjust for additional population to enter the frame.

This study marks a significant stride in demonstrating the potential of machine learning in crowd-egress prediction using video data.

Since the first documented medical mission of Doctor Peter Parker in 1834 to China, the practice and study of medical missions have gained prominence. Despite the increasing prevalence of medical missions, significant ambiguity surrounds their definitions, benefits, and challenges.

This study investigates the effectiveness of regular Short-Term Humanitarian Missions (STMMs) focusing on the Mission of Hope (MoHope) III conducted in the Kyangwali refugee settlement in Uganda.

A qualitative case study approach was employed, utilizing semi-structured interviews and focus group discussions (FGDs) to gather insights from participants, including volunteers and beneficiaries. Data collection adhered to the Standards for Reporting Qualitative Research (SRQR), and thematic analysis was conducted using Clarke and Braun’s approach. Ethical considerations were strictly followed, ensuring participant confidentiality and informed consent.

Analysis of data from 16 participants revealed six emergent themes: barriers (financial constraints, health information flow, infrastructure, etc.) benefits (quality improvement, capacity building, etc.), doubts (sustainability, patient rights, etc.), requirements (decolonization, training, etc.), and new paradigm. Participants highlighted significant obstacles that hinder the effectiveness of STMMs, while also recognizing the added value these missions provide to local healthcare systems.

Regular STMMs, such as MoHope III, can enhance healthcare delivery in low-resource settings, but face numerous challenges that must be addressed for sustained impact. Recommendations include improving infrastructure, ensuring better financial support, and fostering local staff training. This study contributes valuable insights into the complexities of implementing effective STMMs in similar contexts, contributing to the broader discourse on the efficacy and sustainability of short-term medical missions.

Emergency deployment readiness relies on fit-for-purpose warehousing management, a capability that is often under-resourced. Since 2017, WHO has collaborated with 13 Pacific Island Countries (PICs) to establish national Emergency Medical Teams (EMTs). Warehousing EMT supplies can be a challenge due to inadequate storage facilities leading to storing EMT cache in multiple locations, suboptimal tracking, and maintenance.

To describe an agile EMT warehousing strategy in the Pacific for rapid mobilization for health emergency response.

WHO has worked with colleagues in PICs on national EMT cache storage, tracking, and maintenance. The warehousing system needed to match available storage solutions in hot, humid climates. An inventory management system was designed for ease of use for national EMT logisticians with small support staff.

WHO logisticians created a two-fold solution for national EMT warehousing: an EMT-focused stock report system and a semi-mobile storage solution. The system automates stock tracking with regular warehousing features while also offering deployment history tracking with a three-color tier coding system of stock readiness for deployment. Complementing the stock tracking is a shipping container, refitted into a modular storage room, which provides a secure, relocatable solution.

Effective EMT warehousing is central to rapid and quality deployments. Continued work is necessary to improve EMT warehousing in PICs and explore its applicability to other low—and middle-income country EMTs. Solutions must be tailored to local contexts, and resources allocated to ensure efficiency and sustainability. The experience in the Pacific with innovative warehousing solutions can be adapted by other national EMTs in low-resource settings.

This study explores the role of Information Management (IM) in disaster management, through the use of the Minimum Data Set (MDS). The International Search and Rescue Advisory Group (INSARAG) Asia-Pacific Regional Earthquake Response Exercise (ERE) and the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) have provided platforms for such exploration. As an exercise controller, my involvement has focused on supporting the EMTCC from the IM perspective.

The primary objective was to evaluate the effectiveness of IM, through MDS, in supporting EMTCC during disaster response exercises and actual disaster scenarios.

Participation in regional collaboration drills and real-world disaster scenarios provided insights into IM practices. Key activities included supporting EMTCC during exercises, assisting the Moldovan government and WHO regional office affected by the 2022 Russian invasion of Ukraine, and collaborating with WHO’s regional office (EMRO) for Palestinian support in 2023. IM support involved data collection, situation analysis, and the ongoing provision of off-site support for MDS implementation.

The exercises and real-world engagements demonstrated significant growth in national EMTs’ capabilities and highlighted the critical role of IM. The MDS-supported IM processes effectively facilitated data collection and analysis, enhancing coordination and decision-making.

Ongoing training and support for EMTCC through IM are vital for effective disaster response. The study underscores the importance of structured IM in improving disaster management and the operational readiness of EMTs. Future efforts should continue to focus on refining IM practices and enhancing data management capabilities to ensure robust responses to health emergencies.

The WHO EMTCC coordinated responses to Cyclone Idai in Mozambique (2019), the refugee crisis in Moldova (2022), the earthquake in Türkiye (2023), and the humanitarian crisis in Cairo (2024). Each event presented unique Information Management (IM) challenges.

Analyze and compare WHO EMTCC Information Management practices across these crises, identifying specific challenges and implemented solutions.

• Disaster: Cyclone Idai

• Impact: Infrastructure destruction, numerous casualties

• Information Management: Diverse data collection, weak real-time updates, lack of unified management, poor communication infrastructure

• Disaster: Refugee crisis from Ukraine invasion

• Impact: Overburdened medical system

• Information Management: Fragmented EMT management, information overlaps, language barriers, stable communication infrastructure

• Disaster: Major earthquake

• Impact: Building collapses, numerous injuries

• Information Management: Improved use of tools like MDS, rapid data collection, multi-national team coordination challenges, real-time sharing needs, lack of domestic EMT data

• Disaster: Palestine Humanitarian Crisis

• Impact: Numerous casualties, infrastructure damage

• Information Management: Secretive management, high-security needs, limited internal sharing, independent coordinator decisions

Mozambique highlighted the need for digitalization and unified data systems. Moldova emphasized unified platforms and pre-registration processes. Türkiye showed progress in data tools but needed better real-time systems and domestic coordination. Cairo underlined secure and efficient information sharing in high-security contexts.

WHO EMTCC’s IM practices varied across disasters. Common challenges included unified data management, real-time sharing, and multi-national team coordination. Future efforts should standardize protocols, improve communication infrastructure, and enhance WHO EMT Initiative training. The Japan Disaster Relief team’s contributions provided valuable insights for future improvements.

The National EMT, Disaster Medical Assistance Team (DMAT) in Japan is crucial for coordinating medical relief during disasters at the prefectural level. The prefectural Emergency Operation Center analyzes information and determines action plans to ensure efficient medical support. This involves strategic information collection, management, and decision-making to address the immediate and ongoing needs of affected populations. Understanding DMAT’s processes provides valuable insights into disaster management.

This study aims to:

1. 1. Identify DMAT’s information collection and management methods.

2. 2. Describe the strategic decision-making process for action plans.

3. 3. Evaluate the effectiveness of these processes in disaster scenarios.

DMAT systematically collects data from affected medical institutions. Key steps include:

• Data Gathering: Collecting data on damage assessments, facility status, patient numbers, and resource availability.

• Real-time Updates: Continuously updating information to reflect the changing situation.

• Data Integration: Consolidating data to create a comprehensive overview of the disaster’s impact.

The decision-making process includes:

• Needs Assessment: Evaluating medical needs based on collected data.

• Resource Allocation: Allocating medical teams and resources to high-need areas.

• Coordination: Establishing communication with local, and national agencies.

• Action Plan Formulation: Developing detailed response plans.

• Enhanced Coordination: Clear communication improves coordination among stakeholders.

• Effective Resource Utilization: Strategic allocation maximizes the impact of medical resources.

• Successful Case Studies: Effective responses to multiple disasters demonstrate DMAT’s approach.

DMAT’s framework for information management and action planning enhances disaster response. Continued refinement and integration of new technologies will further improve medical support, saving lives and reducing disaster impacts.

The Red Cross Red Crescent Health Information System (RCHIS) is an electronic medical record (EHR) and health information management system (HIS) which has been designed for international disaster responses with a cloud-based server and a local server to bridge temporary internet outages. This architecture allows for remote information management and operational support should data processing agreements allows it.

Describe adapting a cloud-based health information system to a fully offline setting and improve business continuity in case of a system failure.

An analysis of the existing architecture of RCHIS was conducted to identify components and procedures that only work on the cloud-based server with an existing internet connection. Offline alternatives were identified and developed to ensure full offline operational capacity and redundancy.

A mechanism to set up a second local server for redundancy improves business continuity planning, and having locally stored backup allows the recovery of data without an internet connection. Instead of creating new user accounts in the cloud and emailing a one-time password (OTP), a mechanism to create accounts on the local server and display the OTP was added. The offline generation of the WHO EMT MDS report was embedded.

Adding the capability to work fully offline to RCHIS meant significant software architecture changes. Despite losing some of the benefits, such as remote information management, RCHIS is now a robust offline tool for deployment in settings without any internet connectivity. Having a local server also means that we can comply with data sovereignty rules where they exist.