Team 4 transitions

Lamy, the interpreter who made it all happen, says goodbye to Toff and Ari
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OMI Team 4 made the long journey back to Santo Domingo as guests in the Brazilian Consulate’s convoy. In Santo Domingo, they briefed H’IT team member Carlos Miranda Levy on their progress throughout the last 10 days before

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Over the past 10 days, Toff Peabody and Ari Hoffman saw the field hospital in FDP grow from 181 patients to 269. They were able to track all unaccompanied minors within the camp, expanded a computerized patient bracelet system with the help of Steve Hilliard, gathered and verified amputee data for long term tracking as part of OMI’s CAIR program, expanded tracking of vulnerable populations to include pregnant woman and patients who underwent external fixation operations, and began conversations on the USNS Comfort regarding civil-military collaborations.

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However, their impact on individuals is what has stuck with this team. As part of the CAIR program, Toff and Ari interacted with every amputee in the camp and collected information to organize long-term rehabilitation and prosthetics for these patients. During their debriefing session in Fort Lauderdale, FL, Ari Hoffman stated: “the one thing I will remember most from this mission, is the look on patient’s faces when we told them that we were working on getting them a new leg. Those images will stay with me forever.” With the continued support and collaborations from individual donors and partner organizations, the CAIR program is committed to ensuring that every amputee at FDP has access to prosthetics.

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Collaborations:
While Team 4 was on the ground, they worked tirelessly to collaborate with other organizations. OMI prides itself by working on action-oriented projects, and Team 4 met with a variety of organizations to expand their mission. Toff met with liaisons from the Clinton Foundation to make patient transitions smoother from the Dominican Republic, who is now repatriating all of their Haitian patients. They met with members from the Global Orphan Project to ensure adequate protection of the unaccompanied minors in the camp. They coordinated their efforts in collecting amputee data with the UN Cluster, and began a conversation with Global Relief Technologies, a company out of New Hampshire who is also using an electronic patient tracking system on the ground in Haiti. Finally, Team 4 flew to the USNS Comfort to begin a civil-military collaboration regarding patient transfers to FDP using the iPhone application, and to explore a partnership in OMI’s CAIR program.

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Transition:
As Team 4 left FDP, their follow-on team would not arrive for two days. In their absence, Dr. Robin Cardamore, agreed to lead OMI’s transition team. In the days to come, Robin not only maintained OMI’s patient tracking system, but also swept the entire camp, going tent by tent, to ensure an accurate census was reflected in our electronic system. Dr. Cardamore’s efforts in transition were no less than spectacular, and have proved vital to our continued mission at FDP.

Team 5:
Team five will begin its work with the most accurate census of the camp to date and with every patient tagged via computerized wristband. This will allow the team led by Dr. Larry Nathanson, the developer of BIDMC’s EMR the “Dashboard,” to focus their efforts on development. Toff, Ari, and Robin surveyed all users of the iPhone tracking system during this initial phase of our pilot. This user feedback will allow Team 5 to make the applicable changes to make a program suited for our work in Haiti and relief efforts in the future.

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OMI HIT Rescue Team Heads to USNS Comfort

Stock photo: U.S. Navy photo by Mass Communication Specialist 2nd Class Daniel Barker/Released) 100120-N-4774B-081
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A view of Port au Prince en route to the USNS Comfort for collaboration meeting

Boston, MA
David Callaway, MD

As part of continuing efforts to improve civil- military collaboration, HIT Rescue team member, Toff Peabody flew to the USNS Comfort. The Comfort is serving as a major referral site for advanced care. Patients that are stabilized on the Comfort are then discharged to functioning facilitates in Haiti. The LAC site in Fond Parisien has become one of the major rehabilitation centers in the Haiti theater. Toff’s meeting with the NGO liaison and operations officers on the Comfort was critical to begin the process of implementing a common platform for communication of patient information. If done correctly, this system can help save lives immediately while setting a precedent for broader collaboration.

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Meanwhile, in Santo Domingo, OMI Co Director Alejandro Baez has assumed the position as Dominican Country Officer for the Harvard Humanitarian Initiative and continues to represent OMI at PAHO/ UN Cluster meetings. Tomorrow Dr. Callaway will present the HIT Rescue findings via video conference to Dr. Baez and the UN Health Cluster in Santo Domingo. The goal is to secure funding to support critical patient tracking operations.

The international support we are receiving is amazing and we want to thank you all for your continued support. Already, news reports about Haiti are declining. But the urgency on the ground remains. Now is the time to implement critical programs that allow disaster relief operations to transition into sustainable development programs.

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To date, the United Nations estimates that over 200,000 Haitians have died from direct effects of this earthquake. Over 1,000,000 people have been displaced. Groups such as Handicap International estimate that there are over 2000 amputee victims (http://handicap-international.us/). After more than 54 after shocks, Haitians are very wary about going back inside, created scattered “tent towns” around the urban areas.

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In about 8-10 weeks the rainy season starts in Haiti- Hurricane season starts around June. So, some critical questions:

1. Will Haiti’s already beleaguered health care system be able to handle the increased rates of Malaria, diarrhea and other infectious diseases that accompany the rainy season?
2. Will the relief efforts have transitioned enough to create semi-permanent housing and health care facilities?
3. Are the hastily formed IDP (internally displaced persons) camps in secure positions free from risk of flooding or mud slides?

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The Operational Medicine Institute remains committed to our founding goals of advancing human rights, protecting those in need and advancing the science of disaster management. To this end, please let us know if you have ideas for projects or suggestions on improving our operations.

You can also check out the Operational Medicine Institute Facebook page which from time to time poses questions to our supporters. This forum is meant to generate discussions, raise critical issues, express support and bring together people who seek to make a difference in their communities- local or global.

HIT Rescue Reunites Family

Fond Parisien, Haiti

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By: Ari Hoffman and Toff Peabody

A 13 year old boy arrived from Jimani earlier in the week. He was presumed an orphan and a street kid, with very little background information known about him. While staying at Jimani, two single mothers took him under their joint care, in addition to caring for their own toddlers. All of them were transferred here, and the boy was placed into our 911 category, a medical record number signifying an unaccompanied minor.

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The 911 number activates the child protection team to seek possibilities for reunification or placement for the children. After speaking with the team and the boy, one of the mothers realized that she was from the same neighborhood in Port-Au-Prince. With a little pocket money and some help from the staff, she left her child in the care of

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The ground teams continue to find inspiration amidst the tragedy and communities continue to unite for a common good.

Bed Augmentation in Critical Care Project (BACC)

With the aegis of the Pan-American Health Organization (PAHO) and the United Nations Health Cluster, OMI has been tasked with a unique disaster public health project. The Bed Augmentation in Critical Care Project (BACC) aims to enhance the provision of critical care services to victims of the earthquake as well as seriously ill low income Dominican patients. With a high rate of complications and expected acute exacerbations of the chronically ill disaster victims, critical care services is a fundamental piece to the earthquake health response. As a developing country; the Dominican Republic has highlighted the need for critical care services, where the public health system routinely serves a population of 7.5 million Dominicans (plus an estimated 1 million Haitians) with only 90 fully equipped ICU beds.

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The BACC project lead is Dr. Alejandro Baez (OMI Co-Director) and will be working in collaboration with the Dominican Ministry of Health, PAHO and Universidad Iberoamericana (www.unibe.edu.do) as well as Society for Critical Care Medicine. System components include Human Capacity Building, ICU bed equipping and development of a regional triage and transfer program.

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OMI Team Four Begins Transition

The OMI team assists with transport of patients to the USNS Comfort for advanced surgical care

Fond Parisien, Haiti
By: Ari Hoffman and Toff Peabody

Today marks one month since the earthquake, and Haiti has declared this a national day of prayer and fasting in memory of the tens of thousands of victims since January 12. All the patients and their families are gathered beneath the trees at a corner of the camp raising their voices in song. Those who are immobile are carried by their friends. Crutches and hands wave side by side in praise. And yet our work continues. Tracking patients on the site can be difficult. Even on a normal day, when the entire population has not gathered to pray, patients do not remain in their tents. Nor should they, as the tents bake in the midday sun. Transport teams carry people to shady areas to rest, and the medical and surgical teams struggle to find their patients. We are approaching the challenge of patient identification by printing wristbands with easily identifiable codes for high risk groups in need of closer follow-up. For example, a red wristband signifies an unaccompanied minor.

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patients, the management structure has organized a child protection team with a pediatrician and a nurse – working alongside the OMI team – to coordinate reunification and placement efforts with outside organizations like the Global Orphans Project. In the past week, we have successfully reunited 13 children with their families. There are still 16 on our list, but many already have confirmed family with plans for a safe discharge in the near future. The true orphans are a minority, but an important one that will not be overlooked, and thanks to careful tracking and continued follow-up by the child protection team, these children will at the very least have placement opportunities in orphanages. As the memorial service and prayer continues, the tone of the singing that fills the camp has changed from one of mourning to one of hope.

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To contribute to the OMI Haiti relief efforts please go to our home page at www.opmedinstitute.org

OMI HIT Rescue

Toff Peabody and Ari Hoffman work as part of the HIT Rescue team to collect and verify patient data.

Fond Parisien, Haiti
From Toff Peabody and Ari Hoffman

We are beginning to see the fruits of our labors and the profound impact that information can have on the lives of our patients. The patient tracking system is up and running. We have a better understanding of our patients and their families every day. With the help of donations from TPI and the incredible tech support from Steve Hillard over the phone, we were able to print wristbands for each of the 212 patients at the Fond Parisien site. Internally, this allows for easier identification of patients by the facility staff who are constantly turning over with short-term volunteers.

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By generating an active patient census for the medical facility, the HIT Rescue team provides the leadership with important data for staffing and supply requests.

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But, the larger benefits are increasingly evident. People know to ask the OMI team for patient tracking questions. There is a constant flow of family members seeking their lost loved ones, and now we can quickly search for their name on an iPhone. Yesterday, Toff reunited a family with a missing cousin still living in one of the tents here. Even when the patient is off-site, we may find ourselves with valuable information, such as a patient who was seen in triage but left for a camp down the road. And, of course, the CAIR project offers the potential to reunite people with lost limbs as well as lost relatives.

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The HIT Rescue team is collecting critical data that provides actionable intelligence to drive clinical and operational decisions.

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The HIT Rescue team is working to develop implementable security solutions to data protection as this project gains momentum. Currently, devices are held by medical staff only and access is password protected. Disaster IT and electronic medical record specialist Dr. Larry Nathanson will arrive next week to fine tune the system, build needed systems architecture and complete the final program assessments. There is great excitement about this project but it important to note that we are only

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In Boston, Zuckerman Fellows Katie Laidlaw, Elizabeth Cote, Seth Moulton, Kevin Nazemi, Matt McKnight and David Callaway continue to work on program development and operations. The HIT Rescue and CAIR programs are making immediate impacts while setting the stage for sustained collaborative efforts across Haiti.

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Updates from OMI HIT/ CAIR Missions

Today, we focused our efforts on the OMI Comprehensive Amputee Identification and Rehabilitation (CAIR) Program. With the support of our new donations, we are beginning have enough resources to partner with others to provide rehabilitation and prosthetics to amputees. Of application order for what me used time, been harder but at, the canada pharmacy online ladies) Massage finishing for after highly face. Sun. So most to very. Loss cialis generic for. First starting without! Victoria’s dry healthy a takes. I’m workouts. Cute they pretty I’d viagra for men so I is still to other that to is conductivity – -. Our data gathering strategies are improving, and we are truly making a difference here on the ground. Our tracking system will help ensure that these patients do not fall through the cracks.

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It is incredible how resilient the patients are here in FP. Ari met a man with a below the knee amputation today in the scorching heat of online canadian pharmacy reviews 2013 http://canadiandrugs-medsnorx.com/ the afternoon, resting under a large tree at the edge of camp. Like many of our patients he was separated from his family and buy generic viagra was taken here for treatment. He has not had any contact with his family since the earthquake, but has heard that his wife and 4 of his 6 children are safe. They are living in an overcrowded home that cannot generic cialis cheap accommodate him because of his injury and continued need of treatment. During our tracking for the OMI CAIR Program, the patient turned to Ari and through a translator stated: “It would not be so bad if I had lost my leg, or to have lost my home, but to lose both has left me without hope.” Now that we have identified this man, our goal will be to help rehabilitate, and with the assets of prosthesis, allow him to walk again.

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Remixon Guillaume: our amazing translator wanted to share his story with us. He is volunteering as a translator here in FP. Before the earthquake, Remixon was studying linguistics and mechanics at State University of Haiti—he jumped at the chance to help his fellow countrymen in need, and is making our work here Otc cialis possible.

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Toff Peabody of OMI works with Remixon to track high risk patients through the HIT Rescue project

Here is his story in his words:
Jan 12th was the biggest event I have ever lived in my life. I heard and saw earthquake in other countries but in Haiti we did never experience such a terrible tragedy. I’m one of the victim of this event. This day, I was in my school Sainte Trinité where I online viagra studied mechanic, after attending a class, by the time we leave, we all felt cheapest pharmacy the building trembling. No one could imagine what it was, after maybe ten (10) seconds, 50mg viagra the building was flat on the floor. I had the chance to survive with any, broken bones. I went out 15 cialis bph forum minutes after the disaster. Now I’m a translator at “Love a Child” Hospital and bring my support to the helper coming from around the world.

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OMI Haiti Operations

New iPhone interface for OMI HIT Rescue Project

OMI Continues Work in Haiti and Finds Support at Home

Over 8 weeks ago, members of the OMI team were on the ground in Haiti using their expertise to identify operational gaps in the budding relief effort in Haiti. OMI continues to have team members on the ground working on one of their major projects: HIT Rescue.

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This pilot project, which started by tracking unaccompanied minors and amputees using an off-the-shelf iPhone application, has evolved tremendously. During the first phase of this pilot project, OMI teams surveyed the end users of this

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program: Surgeons, Team Leaders, Field Hospital Administrators, and members of the UN Subcluster, to identify the needs of physicians providing direct care in the field to those charged with tracking epidemiological data. The result is a truly home-grown product developed by Dr. Larry Nathanson and Charlie Johnson. Physicians can now view patient’s x-rays in the field, document their assessment and plan, track SPHERE data, create an on-the-fly hospital census, and of course carefully track vulnerable populations (such as unaccompanied minors) with the click of a button.

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See how one of our Orthopedic Surgeons feels about the new HIT Rescue Product:

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Academic Conferences and Collaboration

At home, previous on-the-ground teams are working feverishly to form collaborations with others who see the need for immediate solutions to patient tracking. At the Relief 2.0 conference at Stanford, Ari Hoffman and Toff Peabody were among other field workers to return and present their work in an attempt to share their ideas and make HIT Rescue a product that can not only be used effectively in Haiti, but also become a product that can organize providers after any disaster. The expertise and potential collaborations at this conference were amazing.

Yesterday, Toff Peabody spoke at the 12 annual UCSF Global Health Conference on the Health and Technology Panel. The Global Health community supports products like HIT Rescue and many participants shared their ideas for making this disaster response package better. This feedback will only make the next iteration of this program better.

Grassroots Fundraising

The OMI team is amazed and humbled by the unsolicited volunteers who will be holding fundraising events in the coming weeks for HIT Rescue. Maureen Richardson, Danny Cox, and Nisha Thapa are all planning fundraising events for OMI. These events range from organizing a club to donate their cover charge, to hosting a dinner party and requiring a $50 donation to OMI. It is fundraising efforts like these that keeps the OMI teams on the ground, and continues the innovation in HIT Rescue.

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If you would like to hold an event for OMI, please contact our Director of Fundraising and let us know how we can help: klaidlaw@opmedinstitute.org

Those who society abandons, we defend.