DOCSLIB.ORG

Medecins Sans Frontieres Australia 2017 Highlights

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Medecins Sans Frontieres Australia 2017 Highlights Médecins Sans Frontières Australia ANNUAL REPORT 2017 OUR CHARTER Médecins Sans Frontières is a private international association. The association is made up mainly of doctors and health sector workers and is also open to all other professions which might help in achieving its aims. All of its members agree to honour the following principals: Médecins Sans Frontières offers assistance to Médecins Sans Frontières volunteers undertake populations in distress, to victims of natural or to respect their professional code of ethics and to man-made disasters and to victims of armed maintain complete independence from all political, conflict, without discrimination and irrespective economic or religious powers. of race, religion, creed or political affiliation. As volunteers, members are aware of the risks and Médecins Sans Frontières observes neutrality and the dangers of the mission they undertake, and impartiality in the name of universal medical have no right to compensation for themselves or ethics and the right to humanitarian assistance their beneficiaries other than that which Médecins and demands full and unhindered freedom in the Sans Frontières is able to afford them. exercise of its functions. CONTENTS 3. Médecins Sans Frontières charter 4. Message from the President 6. 2017: Our Year in Review 8. Australian and New Zealand field staff 10. Message from the Medical Unit 12. Médecins Sans Frontières Australia 2017 highlights 14. Médecins Sans Frontières projects funded by Australian and New Zealand donors 56. Financial report Front cover: Australian doctor Roslyn Brooks assesses a young patient in Lankien, South Sudan, October 2017. © Kati Romics Left: Dr Andrew Dimitri (R) from Australia cares for a baby with pneumonia in Qayyarah hospital, Iraq. © Javier Rius Trigueros/MSF Médecins Sans Frontières Australia Annual Report 2017 – 3 MESSAGE FROM THE PRESIDENT In 2017, we witnessed continuing emergency team. We had received written authorisation from PNG authorities to destructive conflicts, major crises assess the medical conditions of refugees of displacement and unacceptable and asylum seekers inside the officially- attacks on healthcare facilities. closed regional processing centre on Manus. Despite this, we were not able to Globally, millions of people remain access the centre before the 328 remaining disproportionally affected by the impacts men were removed and sent to alternative of violence, disease and natural disasters. transit centres. We spoke out against Unfortunately, the critical situation and the denial of access, as an independent needs of these people, from refugees with humanitarian actor with the means to an uncertain future to civilians trapped provide much needed medical assistance in conflict zones, are often overlooked or to these people. Our team was eventually dismissed by the rest of the world. In this able to treat some men on the island, and context, independent humanitarian action we continue to monitor the situation. remains more essential than ever. All people should have equal access to medical Forgotten crisis in the Stewart Condon aid – regardless of their racial, religious, Central African Republic President political or economic status – and the right Médecins Sans Frontières Australia to be treated with dignity. While not a priority of the media in © Sarah Norton Australia, the conflict in the Central Revolutionising TB treatment African Republic (CAR) heightened in in Papua New Guinea 2017 and continues to take an extreme toll (see pages 22-23 for more details). Brutal In November, I travelled to one of our violence against civilians has led to mass projects in a nation close to home: displacement. Many people are extremely Papua New Guinea (PNG). There, in vulnerable and in desperate need of Gulf Province and the National Capital medical care. In 2017, Médecins Sans District, our teams are diagnosing and Frontières ran 17 projects in CAR, but treating the world’s deadliest infectious several attacks on our staff and hospitals disease, tuberculosis (TB), of which PNG forced us to cease work in some areas, a bears a heavy burden. I was struck by painful decision when this meant leaving the complexity of treating this disease patients without access to medical care in this setting, where geography makes that they clearly depend upon. accessibility extremely difficult. Devastating conflict in Yemen Moreover, the cultural barriers to treatment are high. In areas where Attacks on health facilities continued to education is limited, health literacy is low define another conflict in 2017, in Yemen. and patients often don’t understand how Dubbed “the forgotten war”, the conflict to limit the spread of TB. Many people in Yemen has claimed over 100,000 lives still believe TB is the result of sorcery. in three years. Providing emergency Médecins Sans Frontières runs mobile medical aid in this country continued to clinics and home visits to reach patients be a priority for Médecins Sans Frontières in remote areas and improve adherence Australia. In 2017 we directed the highest to treatment, together with counselling proportion of funding there with a and education programs. The use of a contribution of $4.1 million. Tragically, GeneXpert machine allows our teams to civilians, medical personnel and health quickly diagnose drug-resistant TB, and structures continued to be affected by individualise management. Medication fighting, and Médecins Sans Frontières for serious conditions like TB should be hospitals were hit by airstrikes and shelling available to all, and we have adapted our several times. These attacks leave both response in an effort to achieve this for the healthcare workers and people in need people of PNG. of medical treatment fearful to enter healthcare facilities. Civilians were further Immediately following this visit, I flew deprived of medical aid by the blockade on to another area of PNG, Manus Island, humanitarian assistance in 2017. as part of a Médecins Sans Frontières Dr Stewart Condon sits with a tuberculosis patient at her home on the outskirts of Port Moresby in Papua New Guinea. © Sophie McNamara/MSF An uncertain future for the Rohingya governed organisation, but I believe our board offers good and reasonable this to be the case. Our board of oversight of the organisation, while In late 2017 a wave of Rohingya refugees directors, almost entirely comprised of continuing to challenge ourselves in the from Rakhine state, Myanmar, fled over returned field workers or others who work that we do. the border into Bangladesh, seeking have experience working in Médecins safety from horrific systematic violence Sans Frontières offices, takes the task of The lifesaving medical care provided by targeting this ethnic group. These governance seriously. This year we have Médecins Sans Frontières would not be displaced Rohingya quickly formed the worked together with management on possible without the generosity of our largest refugee camp in the world. Even market entry into New Zealand, allowing field partners and donors. To you, our in Bangladesh, they remain extremely our Kiwi donors the opportunity to have supporters, I express my sincere gratitude vulnerable, at the mercy of disease tax deductible donations. for making our mission a reality. related to poor living conditions and overcrowding, the enduring physical Our board committees, particularly the Stewart Condon and mental effects of violence, and the Governance and Association Committee President upcoming rainy season. Médecins Sans and the Finance, Audit and Risk Médecins Sans Frontières Australia Frontières has been treating conditions Committee have reviewed multiple issues including respiratory tract infections and over the year, and assisted the board in diphtheria as well as providing mental guiding our strategy. In 2017 we were healthcare and water and sanitation able to remit more funds to the field as support. The situation remains critical for well as maintain the ratios which guide the Rohingya, who continue to face an our work, so that we continue to spend uncertain future. reasonable amounts on administration. Our patients remain our focus, while we Governance in 2017 continue to prioritise our duty of care to our field staff – whether they responding It would be clichéd to say that Médecins to conflict in Yemen or an epidemic Sans Frontières Australia is a well- outbreak. Most importantly, I believe, Médecins Sans Frontières Australia Annual Report 2017 – 5 2017: OUR YEAR IN REVIEW In 2017, Médecins Sans Frontières the Philippines, Pakistan, Nigeria, South scaled up its response in emergency Sudan, Haiti, Liberia and Lebanon. contexts around the world, Raising the voice of our patients delivering medical aid to those who Throughout 2017, we participated in need it most with the support of our 70 speaking engagements, produced Australian executive team. approximately 100 pieces of original content, facilitated 149 external media With millions of people displaced globally interviews and had more than 763,000 after being forced to flee conflict or visits to our website. With 65.6 million persecution, continued violence against people forcibly displaced from their homes civilians and outbreaks of infectious around the world, we highlighted their disease, Médecins Sans Frontières perilous journeys and precarious living increased its capacity to deliver quality conditions with a communications project medical assistance. In the Message from during Refugee Week. Across the year the President (page 4), Dr Stewart
Load more

Recommended publications
  • National Fire Protection Association Technical Committee On
    National Fire Protection Association Technical Committee on Emergency Medical Services National Stakeholders Meeting on Mobile Integrated Healthcare and Community Paramedicine Report National Fire Protection Association 1 Batterymarch Park, Quincy, Massachusetts 02169-9101 Telephone (617) 770-3000 ∙ Fax (617) 770-0700 ∙ www.nfpa.org Report on the NFPA Technical Committee on Emergency Medical Services National Stakeholder Meeting on Mobile Integrated Healthcare and Community Paramedicine April 2 & 3, 2014 MGM Grand Hotel Las Vegas, NV Background The NFPA Technical Committee on Emergency Medical Services (EMS-AAA) convened a national emergency medical services (EMS) stakeholders meeting to discuss the subject of Mobile Integrated Healthcare/Community Paramedicine (MIH/CP). Previously, the EMS Technical Committee had reviewed a new project request for a MIH/CP document, though that request was later administratively withdrawn. The entire EMS Technical Committee worked to develop that new project request which was submitted individually by Dr. David Tan, representing the National Association of EMS Physicians (NAEMSP) in late 2011. Since submittal of the proposal by Dr. Tan there 1 have been many changes to the delivery of healthcare, including the delivery of EMS. These reforms compelled the EMS Technical Committee to organize a meeting for stakeholders to garner input from a broad group of healthcare professionals and to discuss the possibility for a new request on MIH/CP. The meeting afforded the opportunity to not only learn the opinions of prominent national EMS and healthcare professionals, but also to discuss how the NFPA could assist the community of actors involved in MIH/CP. History The concept of MIH/CP has existed for quite some time, but more prevalent in other countries around the world than in the U.S.
    [Show full text]
  • Ambulance Service 2020
    Ambulance Service 2030: The Future of Paramedics Andy Newton Submitted to the University of Hertfordshire in partial fulfilment of the requirements of the degree of PhD November 2013 ________________________________________ Abstract ________________________________________ Some innovations are termed ‘disruptive’, a designation that is normally applied to technology; examples include computers, digital cameras, and mobile phones. The term can also be applied to groups of workers, particularly if they are able to offer specific technical capabilities within a market at lower cost, but broadly equal and effective to that offered by traditional products or services. Paramedics could be described in this way and are a newly professionalised group, with distinctive capabilities in terms of responding to the needs of not just the acutely ill and injured, but increasingly those patients with undifferentiated non-life- threatening conditions, which increasingly make up the bulk of 999 call demand. The key to their transition from an artisan, skilled worker to professional status is the acquisition of certain ‘hallmarks’. Perhaps the most important of these is the completion of more prolonged education that affords the opportunity to graduate with enhanced decision-making and other clinical skills in order to meet the needs of the full spectrum of patients in the pre-hospital setting. Paramedics were surveyed to determine how they rated their ‘traditional’ preparation and to establish what their attitudes were to a more educationally based approach. Paramedics themselves proved to be realistic regarding shortcomings in established training and education systems, while also being strongly motivated to learn more i within a higher education setting, particularly if this additional effort would result in being able to offer a wider range of care to their patients.
    [Show full text]
  • 1 ORIGINAL RESEARCH the Exploration of Physical Fatigue
    Journal of Emergency Primary Health Care (JEPHC), Vol. 9, Issue 1, 2011 - Article 990435 ISSN 1447-4999 ORIGINAL RESEARCH The exploration of physical fatigue, sleep and depression in paramedics: a pilot study Sarah Sofianopoulos* Brett Williams* Professor Frank Archer* A/Professor Bruce Thompson** *Department of Community Emergency Health and Paramedic Practice Faculty of Medicine, Nursing and Health Sciences Monash University, Melbourne, Australia **Department of Allergy, Immunology and Respiratory Medicine The Alfred Hospital, Melbourne, Australia Abstract Ambulance paramedics are members of a discipline that forms a unique part of the emergency services. As pre-hospital providers they are constantly and increasing faced with heavy workloads that are physically, mentally and emotionally tiring. Fatigue and sleep disturbance are factors which can compromise the effectiveness of these workers, and as a result not only hamper patient safety but can have detrimental consequences on the paramedics‟ health and overall well-being. The objective of this study was to investigate the impact shift work on physical fatigue, sleep and psychological factors among paramedics in Australia. Methods A convenience sample of paramedics was asked to complete a number of self-reporting standardised questionnaires: The Epworth Sleepiness Scale (ESS) (8-items), Berlin Questionnaire (BQ) (10-items), Pittsburgh Sleep Quality Index (PSQI) (19-items) and the Beck Depression Inventory (BDI) (21-items). Ethics approval was granted. Results The study recruited 60 participants, the majority of which were male 77% (n=46), > 45 years of age 31% (n=19), and having worked shift work between 5-10 years 35% (n=21). Nine out of ten (92%, n=55) of paramedics reported having experienced fatigue in the last 6 months, with 88% (n=53) believing it had affected their performance at work.
    [Show full text]
  • Predictors and Impacts on Paramedic Clinical Decision Making, Attitudes and Behaviours
    Predictors and impacts on paramedic clinical decision making, attitudes and behaviours Alexander Cardenas A thesis in fulfilment of the requirements for the degree of Doctor of Philosophy School of Public Health and Community Medicine Faculty of Medicine March 2017 THE UNIVERSITY OF NEW SOUTH WALES Thesis/Dissertation Sheet Surname or Family name: Cardenas First name: Alexander Other name/s: Daniel Abbreviation for degree as given in the University calendar: PhD School: School of Public Health and Faculty: Medicine Community Medicine Title: Predictors and impacts on paramedic clinical decision making, attitudes and behaviours. Abstract Paramedicine has transitioned rapidly from a trade to a modern, autonomous largely unsupervised health profession. The speed and extent of this development has resulted in its clinical governance, procedures and accreditation being largely untested, leading to a situation with immediate potential implications for patient care. This mixed methods study began with an examination of the evolution of paramedicine within the context of current best practice training and management of sudden cardiac arrest (SCA). It then utilised the findings to inform the design and testing of two new online platforms to assess and improve paramedic decision making in SCA. The first platform developed was the Online Cardiac Arrest Simulator (OCAS), which included both instructional videos and a simulated SCA. The second platform, the Online Clinical Decision Platform (OCDP), was then designed based on the results and recommendations of OCAS. All educational materials and platforms were designed by the PhD candidate and included point of view filming, realistic location shoots, high- fidelity simulation and clinically accurate scenarios; and were accessible by multiple media devices.
    [Show full text]
  • Understanding the Role of the Paramedic in Primary Care: a Realist
    Eaton et al. BMC Medicine (2021) 19:145 https://doi.org/10.1186/s12916-021-02019-z RESEARCH ARTICLE Open Access Understanding the role of the paramedic in primary care: a realist review Georgette Eaton1* , Geoff Wong1, Stephanie Tierney1, Nia Roberts2, Veronika Williams3 and Kamal R. Mahtani1 Abstract Background: Since 2002, paramedics have been working in primary care within the United Kingdom (UK), a transition also mirrored within Australia, Canada and the USA. Recent recommendations to improve UK NHS workforce capacities have led to a major push to increase the numbers of paramedics recruited into primary care. However, gaps exist in the evidence base regarding how and why these changes would work, for whom, in what context and to what extent. To understand the ways in which paramedics impact (or not) the primary care workforce, we conducted a realist review. Methods: A realist approach aims to provide causal explanations through the generation and articulation of contexts, mechanisms and outcomes. Our search of electronic databases was supplemented with Google and citation checking to locate grey literature including news items and workforce reports. Included documents were from the UK, Australia, Canada and the Americas—countries within which the paramedic role within primary care is well established. Results: Our searches resulted in 205 included documents, from which data were extracted to produce context- mechanism-outcome configurations (CMOCs) within a final programme theory. Our results outline that paramedics are more likely to be effective in contributing to primary care workforces when they are supported to expand their existing role through formal education and clinical supervision.
    [Show full text]
  • Community Paramedicine
    The National EMS Advisory Council Final Advisory on Community Paramedicine Adopted on December 4, 2014 Adopted on December 4, 2014 1 The National EMS Advisory Council Table of Contents Background ...............................................................................................................................................................................4 The Patient Protection and Affordable Care Act ..................................................................................................... 4 Intended and Direct Consequences ......................................................................................................................... 4 Unintended and Indirect Consequences .............................................................................................................. 5 Unknown Consequences ............................................................................................................................................. 8 Problem Statement ...............................................................................................................................................................9 Resources and References ............................................................................................................................................ 10 Crosswalk with Other Standards Documents or Recommendations ..................................................... 11 Analysis ...................................................................................................................................................................................
    [Show full text]
  • Fluency and Confidence Predict Paramedic Diagnostic Intuition: an Experimental Study of Applied Dual-Process Theory
    Fluency and confidence predict paramedic diagnostic intuition: An experimental study of applied dual-process theory Toby Keene https://orcid.org/0000-0002-6030-5151 The Australian National University Kristen Pammer https://orcid.org/0000-0002-3183-5268 University of Newcastle Bill Lord https://orcid.org/0000-0001-8821-5353 Monash University Carol Shipp https://orcid.org/0000-0002-7586-3762 Australian Capital Territory Ambulance Service Author Note This research is supported by an Australian Government Research Training Program Scholarship. Correspondence concerning this article should be addressed to Toby Keene, Research School of Psychology, The Australian National University, Acton, ACT, Australia, 2600. Contact: [email protected] 1 Fluency and confidence predict paramedic diagnostic intuition: An experimental study of applied dual-process theory Abstract Introduction. Paramedics care for the sick and injured in a variety of settings and have been observed to form an impression of their patient prior to meeting them based on limited information. We report an experiment using Australian paramedics (n=64) and Australian paramedicine undergraduates (n=44), which considered the processes underlying the formation of an intuitive diagnostic impression. Previous research has signalled roles for objective likelihood of the disease, subjective typicality of the disease, and the ease with which the impression comes to mind (answer fluency) as important in impression formation. Method. Participants completed four brief written clinical vignettes under time pressure and with a concurrent navigation task to simulate conditions faced by paramedics prior to meeting a patient. The vignettes varied the objective likelihood of a diagnosis of Acute Coronary Syndrome (ACS), a condition often encountered by paramedics characterised by ambiguity and a need for accuracy.
    [Show full text]
  • Professionalism and Professionalisation in the Discipline of Paramedicine
    University of Wollongong Research Online Faculty of Science, Medicine and Health - Papers: Part B Faculty of Science, Medicine and Health 2019 Professionalism and professionalisation in the discipline of paramedicine Buck Reed University of Wollongong Leanne S. Cowin Universty of Western Sydney Peter O'Meara Monash University Ian G. Wilson University of Wollongong, [email protected] Follow this and additional works at: https://ro.uow.edu.au/smhpapers1 Publication Details Citation Reed, B., Cowin, L. S., O'Meara, P., & Wilson, I. G. (2019). Professionalism and professionalisation in the discipline of paramedicine. Faculty of Science, Medicine and Health - Papers: Part B. Retrieved from https://ro.uow.edu.au/smhpapers1/1067 Research Online is the open access institutional repository for the University of Wollongong. For further information contact the UOW Library: [email protected] Professionalism and professionalisation in the discipline of paramedicine Abstract Background Professionalisation was cited as one of the key drivers for the recent addition of paramedics to the National Registration and Accreditation Scheme (NRAS) making paramedics the fifteenth health profession in the NRAS. Self-regulation inherently shifts the basis of establishing professional identity and the formal authority for determining professional standards. This has increased discussion of professionalism in paramedicine, however, professionalisation and professionalism are often poorly defined concepts wita myriad of interpretations. Method A scoping review was conducted to determine the available literature about professionalism and professionalisation in paramedicine. The review utilised 10 academic databases augmented with Google and Google Scholar to capture grey literature; 2740 results were refined ot 53 sources for review. Results Several works on paramedic professionalisation explore elements such as autonomy and occupational characteristics.
    [Show full text]
  • Pre- and Post-Home Visit Behaviors Using an After- Hours House Call (AHHC) Medical Services: a Questionnaire-Based Survey in Tokyo, Japan
    Pre- and Post-home Visit Behaviors using an after- hours House Call (AHHC) Medical Services: A Questionnaire-based Survey in Tokyo, Japan Ryota INOKUCHI ( [email protected] ) University of Tsukuba Kojiro MORITA University of Tsukuba Xueying JIN University of Tsukuba Masatoshi ISHIKAWA University of Tsukuba Nanako TAMIYA University of Tsukuba Research Article Keywords: After-hours primary care, Quality, Triage, Severity, AHHC, out-of-hour service, out-of-hours services, OOH, emergency department, ED Posted Date: March 1st, 2021 DOI: https://doi.org/10.21203/rs.3.rs-253637/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/12 Abstract Background: To reduce the burden caused by emergency department (ED) visits and ambulance use, after-hours house call (AHHC) medical services have been implemented. Examining the pre-and post-home visit behaviors of those who use AHHC medical services, stratied by age and illness severity, may help determine the populations these services should target effectively to reduce ED visits and ambulance use. Methods: This questionnaire-based study used data from anonymized medical records and internet-based questionnaires completed by patients who used AHHC medical services in Tokyo, Japan, between January 1 and December 31, 2019. The questionnaire consisted of two questions: what action would the patient have taken in the absence of AHHC services, and what action was taken within three days following the use of the AHHC services. Results: Of the 15,787 patients who used AHHC medical services during the study period, 2,128 completed the questionnaire (13.5% response rate).
    [Show full text]
  • The Establishment of a National Registration System for Australian
    The Senate Legal and Constitutional Affairs References Committee Establishment of a national registration system for Australian paramedics to improve and ensure patient and community safety May 2016 Commonwealth of Australia 2016 ISBN 978-1-76010-422-1 This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Australia License. The details of this licence are available on the Creative Commons website: http://creativecommons.org/licenses/by-nc-nd/3.0/au/. This document was produced by the Senate Legal and Constitutional Affairs Committee secretariat and printed by the Senate Printing Unit, Department of the Senate, Parliament House, Canberra. ii Members of the committee Members Senator Glenn Lazarus (GLT, QLD) (Chair) Senator the Hon Ian Macdonald (LP, QLD) (Deputy Chair) Senator Catryna Bilyk (ALP, TAS) Senator Jacinta Collins (ALP, VIC) Senator the Hon Joe Ludwig (ALP, QLD) Senator Linda Reynolds (LP, WA) until 12.10.2015 Senator Dean Smith (LP, WA) from 12.10.2015 Substitute Member Senator Nova Peris (ALP, NT) substitute for Senator the Hon Joe Ludwig (ALP, QLD) on 20.04.2016 Participating Member Senator Sam Dastyari (ALP, NSW) Secretariat Ms Sophie Dunstone, Committee Secretary Dr Marcus Smith, Principal Research Officer Ms Jo-Anne Holmes, Administrative Officer Suite S1.61 Telephone: (02) 6277 3560 Parliament House Fax: (02) 6277 5794 CANBERRA ACT 2600 Email: [email protected] iii iv Table of contents Members of the committee ..............................................................................
    [Show full text]
  • The Role of Law in the Professionalisation of Paramedicine
    The Role of Law in the Professionalisation of Paramedicine in Australia Ruth Townsend LLB LLM A thesis submitted for the degree of Doctor of Philosophy of The Australian National University © Copyright by Ruth Townsend December 2017 All Rights Reserved ii Statement of Originality I certify that the thesis entitled, ‘The Role of the Law in the Professionalisation of Paramedicine in Australia,’ submitted for the degree of Doctor of Philosophy at the Australian National University is my own original work. Where reference is made to the work of others, due acknowledgement is given. I also certify that the material in this thesis has not previously been submitted for a degree or diploma at any university. Name: Ruth Townsend Signature: Date: December 2017 iii Acknowledgements I would not have been able to even think about undertaking this project if it wasn’t for the encouragement and support of some very special people. Thank you to my mum for giving me the gift of reading that has led to a lifelong love of learning, fostered my creativity and imagination, and allowed me to feel a sense of success and self-confidence in my abilities. Thanks dad for instilling in my a sense of social justice that has sparked a passion to try and make the world a better place even if it is in just a very small way. Thank you to my supervisors, Professor Tom Faunce, Associate Professor Michael Eburn, with whom I have worked closely on paramedic law matters for many years, and panel member Dr Dominique Dalla Pozza who have all offered me enormous support and shared their very limited and precious time, and great wisdom and intelligence with me so generously.
    [Show full text]
  • Mental Health and Paramedics
    mental health and paramedics Submission For Senate Inquiry into the high rates of mental health conditions experienced by first responders, emergency service workers and volunteers June 2018 "At the root of this dilemma is the way we view mental health in this country. When it comes to mental health conditions, we often treat them differently from other diseases like cancer, diabetes or asthma. And that makes no sense. Whether an illness affects your heart, your leg or your brain, it’s still an illness, and there should be no distinction." Michelle Obama Former First Lady of the USA ‘Change Direction’ Mental Health Summit, Newseum, Washington, 4 March 2015 1 1 Office of the First Lady, The White House, Remarks by The First lady at "Change Direction" Mental Health Event, Washington D.C., 4 March 2015 https://bit.ly/2pJBdTg accessed 01/06/2018 Senate Inquiry into Mental Health June 2018 - Bange Page 2 of 50 Table of Contents Page EXECUTIVE SUMMARY ..................................................................................................... 4 BACKGROUND ................................................................................................................. 5 THE WORK OF PARAMEDICS ............................................................................................ 6 THE EXTENT AND PROBABLE CAUSES OF PARAMEDIC DISTRESS ...................................... 8 THE CENTRAL IMPORTANCE OF ORGANISATIONAL CULTURE ........................................ 12 PROVIDER OVERSIGHT AND ACCREDITATION ...............................................................
    [Show full text]