The way forward - Registration and coordination of Foreign Medical Teams responding to sudden onset disasters
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Download document I. Executive summary
Sudden onset disasters (SOD) are natural disasters that occur with little or no warning and can cause excessive injuries far surpassing the residual response capacity of the affected country. The demand for rapid trauma care is particularly critical in the aftermath of earthquakes. In recent disasters, a large number of Foreign Medical Teams (FMTs) arrived at the crisis location to provide emergency care to patients with trauma, injuries and other life-threatening conditions. In most cases, the deployment of these teams was not based on the needs of the situation and there was significant variation in capacities, competencies and professional ethics.
There are several factors at the root of this problem: the absence of agreed international standards and criteria for humanitarian surgical-trauma response; the lack of reliable information on existing bilateral or international response capabilities and their criteria for deployment; and a host country and Health Cluster not yet operational and/or unprepared to coordinate and ensure quality control of the external surgical-trauma response.
Against this background of concern is an even stronger desire to improve. Several initiatives have already prepared the ground for change;
Following the recommendations from a Technical Expert Group meeting in Cuba in December 2011, the Global Health Cluster (GHC) endorsed the need to address these issues and created a FMT Working Group (FMT-WG).
The work of the International Search and rescue Advisory group (INSARAG) has ensured that the concepts of registration, classification and training are already understood by the international community, and INSARAG is welcoming collaboration with WHO on FMTs, connecting these to the existing operational structures: the On-Site Operational Coordination Centres (OSOCC) and Reception and Departure Centres (RDC).
Operational aspects for managing the virtual OSOCC and deploying FMT experts to establish FMT Coordination Cells under the OSOCC/RDC will be integrated in the WHO surge mechanisms as per the Emergency Response Framework.
In 2012, the Pan American Health Organisation (PAHO) passed resolution CSP28.R19 that recommends “a flexible mechanism for registration and accreditation of rapid-response foreign medical teams with the goal of improving the quality of the medical response in coordination with WHO”.
The commitment to predictable service delivery and accountability is in line with WHO humanitarian reform and the Interagency Standing Committee (IASC) Transformative Agenda The FMT-WG has already developed a classification system for FMTs based on capabilities, and there is a first edition of professional standards. Furthermore, there is an outline for the process for on-site coordination and registration with national authorities, and mechanisms for authorising arriving teams. The way forward for this initiative will build on those foundations laid out by the FMT-WG. It will:
Promote wide ownership of and compliance with the classification system and standards for FMTs;
Develop and manage a global registry of potential providers of FMTs based on their capabilities and the agreed upon classification, including self-declared commitment to adhere to the standards;
Strengthen the capacity of potential host countries to request, register, and coordinate the FMTs in the aftermath of a Sudden Onset Disaster (SOD);
Enable WHO and international partners to provide technical and/or operational on-site support to coordinate and monitor the activities of FMTs in case of a SOD requiring significant external surgical-trauma assistance.