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Medical Support Manual for United Nations Peacekeeping Operations

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Medical Support Manual for United Nations Peacekeeping Operations UNITED NATIONS NATIONS UNIES MEDICAL SUPPORT MANUAL FOR UNITED NATIONS PEACEKEEPING OPERATIONS UNITED NATIONS DEPARTMENT OF PEACEKEEPING OPERATIONS MEDICAL SUPPORT MANUAL FOR UNITED NATIONS PEACEKEEPING OPERATIONS 2nd Edition Medical Support Manual for United Nations Peacekeeping Operations (2nd Edition) The manual is distributed by the Department of Peace-keeping Operations/ Office of Planning & Support/ Medical Support Unit, New York, 1999. The first edition was issued in 1995 and has since been revised. Copyright © United Nations 1999 This document enjoys copyright under Protocol 2 of the Universal Copyright Convention. Member States’ governmental authorities may, however, photocopy this document for exclusive use within their training institutes. The number of this copy, which is shown at the end of this page, should be noted for future distribution of updates and amendments. No portion of this document may be reproduced for resale or mass publication without the expressed written consent of the Medical Support Unit. No part of the document may be stored in a retrieval system without the prior authorization of the Medical Support Unit. Any communications with regards to the above are to be directed to: DPKO/ OPS/ MSU Secretariat Building, Room 2200-E 1 United Nations Plaza New York, NY 10017, USA Phone: (212) 963-4147 Fax: (212) 963-2614 PREFACE General There has always been a requirement for a standard reference document on the medical support aspects of United Nations peacekeeping operations. To meet this requirement, the Medical Support Manual for United Nations Field Operations was published and distributed in 1995. This aimed to outline operational and procedural guidelines for medical support in the field. With new developments and changes, as well as input from Field Missions and other agencies, this manual has been updated and incorporates lessons learnt from recent peacekeeping operations. Structure of the manual This manual comprises a set of chapters, annexes and appendices, with a table of contents and an index providing references to relevant sections of the text. It serves as a comprehensive reference text for the medical officer in the field, as well as a guide for medical planners in the United Nations Headquarters, Field Missions or national militaries from troop-contributing countries. It is also a useful reference source for the training of United Nations peacekeepers and medical personnel. Relationship to other official documents The contents of this manual are compatible with the financial rules and regulations of the United Nations, administrative issuance, official UN guidelines and other documents relevant to the administration of United Nations field operations. Distribution and up-keep The Chief, Medical Support Unit, Department of Peacekeeping Operations (MSU/ DPKO), controls the distribution of this Manual. In consultation with the Medical Services Division (MSD), he is responsible for the regular review of its contents and for revision of its text where required. The manual will be updated and distributed every 3 years. Any comments by its users is appreciated. Acknowledgements The authors would like to thank the Medical Services Division, UN HQ, for its assistance in reviewing the manual, to Field Missions and national agencies for their invaluable input, and to the Training Unit, DPKO, for its assistance in publication matters. Medical Support Manual for United Nations Peacekeeping Operations iii This manual is dedicated to the gratis military medical officers who have formed the backbone of the Medical Support Unit since its inception and without whom its publication would not have been possible. TABLE OF CONTENTS Page Chapter 1 Introduction 1 Chapter 2 The UN Headquarters Medical Organization 5 Introduction ...........................................7 The Medical Support Unit ................................7 The Medical Services Division.............................8 Chapter 3 Structure of Medical Support in Peacekeeping Operations 11 Structure and Organization ..............................13 Terms of Reference of Key Medical Personnel ...............14 UN Levels of Medical Support - Basic Level .................19 - Level One..............................20 - Level Two..............................22 - Level Three ............................25 - Level Four .............................28 - Forward Medical Team....................29 Chapter 4 Medical Support Planning 31 Principles of Medical Support ............................33 Planning Considerations ................................33 The Medical Support Plan ...............................35 Annex 4-1. Medical Survey and Reconnaissance Checklist .....39 Medical Support Manual for United Nations Peacekeeping Operations vii TABLE OF CONTENTS Chapter 5 Health Care Policies and Procedures 43 Medical Examination and Clearance .......................45 UN Medical Standards and Policies .......................46 Entitlement to and Provision of Medical Services.............48 Compensation for Injury, Illness or Death Attributable to Service . 50 Medical Confidentiality .................................52 Annex 5-1. Entry Medical Examination (MS-2) ...............53 Chapter 6 Preventive Medicine 59 Introduction ..........................................61 Immunization Policy....................................61 Malaria Prophylaxis and Vector Control .....................62 HIV / AIDS and Sexually Transmitted Diseases ...............64 Hygiene and Sanitation .................................65 Road Traffic Accidents .................................66 Managing Stress ......................................67 Chapter 7 Casualty Treatment and Evacuation 71 Triage ...............................................73 Treatment and Holding Policy ............................74 Medical Evacuation and Repatriation.......................75 Arrangements Concerning the Deceased ...................79 Notification of Casualties................................80 Mass Casualty and Disaster Management ..................81 Annex 7-1. Approval Form for Medevac / Repatriation .........83 Annex 7-2. Format of NOTICAS ..........................85 Annex 7-3. Medical Statement by Staff Member’s Physician....86 Annex 7-4. Medical Director’s Report of Accident or Illness.....87 viii Medical Support Manual for United Nations Peacekeeping Operations TABLE OF CONTENTS Chapter 8 Medical Logistics 89 Introduction ..........................................91 Categories of Medical Support ...........................91 Medical Standards and Quality Control ....................92 Responsibility for Logistics Management ...................93 Reimbursement of Troop Contributing Countries .............94 Contribution Agreement based on Standard Reimbursement Rates ...............................................95 Letter of Assist Arrangement ............................97 Other Arrangements ...................................98 Raising a Requisition ...................................98 Receiving and Inspection Reports........................100 Disposal of Medical Waste .............................100 Blood and Blood Products ..............................101 Annex 8-1. UN Medical Procurement Process ..............103 Annex 8-2. Requisition Form for Medical Supplies and Equipment ..........................................104 Chapter 9 Medical Records and Reports 105 Medical Records and Documentation .....................107 Medical Reports .....................................108 Annex 9-1. MSA-1A: Casualty Incident Report ..............113 Annex 9-2. MSA-1B: Casualty Individual Report .............114 Annex 9-3. MSA 2: UN Medical Facility Report..............116 Annex 9-4. MSA-3A: Medical Treatment Report - Per Capita ...118 Annex 9-5, MSA 3B: Medical Treatment Report – By Diagnosis. 119 Chapter 10 Medical Standard Operating Procedures 121 Development of Medical SOP ...........................123 Format of Medical SOP ................................123 Medical Support Manual for United Nations Peacekeeping Operations ix TABLE OF CONTENTS Chapter 11 Medical Training 129 Background .........................................131 Types of Medical Training ..............................131 Annex 11-1. Objectives of Pre-Deployment Training .........134 Annex 11-2. Components of First Aid Training ..............136 Appendix Medical Support Manual 137 Contents ...........................................137 Appendix 1: Glossary of Commonly Used Abbreviations ......139 Appendix 2: Levels of Medical Support – Equipping Requirements - Basic Level............................145 - Level One.............................147 - Level Two.............................151 - Level Three ...........................157 - Forward Medical Team...................163 Appendix 3: UN Standards for Provision of Medical Supplies for Peacekeeping Operations - UN Requirements for Provision of Medical Supplies Used in Peacekeeping Operations . 165 - Quality Assurance and Quality Control ......169 x Medical Support Manual for United Nations Peacekeeping Operations Chapter 1 INTRODUCTION Medical Support Manual for United Nations Peacekeeping Operations 1 Chapter 1 INTRODUCTION 1.01 United Nations Medical Support Mission for Peacekeeping Operations The mission statement reads: “The United Nations’ medical support mission is to secure the health and well-being of members of United Nations peacekeeping operations through planning, co-ordination, execution, monitoring and professional supervision of excellent medical
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