PARM CARES – TYPHOON HAIYAN TO PRESENT MODEL ISPRM NATIONAL SOCIETY DISASTER REHABILITATION PROGRAM Filipinas G. Ganchoon, MD Chair, Philippine Academy of Rehabilitation Medicine Disaster Rehabilitation Relief Committee (PARM CARES) International Society of Physical Rehabilitation Medicine 9th World Congress Maritim Hotel, Berlin, Germany June 21, 2015 - storm surge recorded in East Asia of 9.14m due to strong winds, resulting in the majority of deaths due to Highest drowning and catastrophic damage - intensity of a Category 5 tropical cyclone with sustained winds of 315 kph (above the 252 kph threshold for a Category 5 hurricane, the highest category on the Saffir-Simpson scale) - Reference: Meteomedia ANIBONG, TACLOBAN, LEYTE REUTERS/ROMEO RANOCO IMPACT Significant national impact: 6,268 confirmed deaths, 28,689 injured, and 1,061 missing, with 3.4 million families (over 16 million persons) affected in 44 provinces, 57 cities, and 591 municipalities . Reference: National Disaster Risk Reduction & Management Council (NDRRMC) PARM Philippine Academy of Rehabilitation Medicine Membership: 340 PMR Centers: 412 Chapters North Luzon (46) National Capital Region (178) Visayas (22) Mindanao (20) The Role of the Philippine Physiatrist in a Large-Scale Natural Disaster • Provide descriptive epidemiology of Typhoon Haiyan • Compare rehabilitation injury data from two affected populations • Summarize aid missions conducted by PARM members in the primarily-affected Visayas region • Describe the strategic development of PARM’s disaster rehabilitation program • Elaborate the potential role of a local physiatrist in a large-scale natural disaster using the example of the Philippine physiatrist in Typhoon Haiyan Medical Missions Conducted by PARM CARES (Nov 2013 – Feb 2015) NCR (Manila) Philippine Orthopedic Center Villamor Airbase Region VI Antique Capiz Iloilo Lakawon Island Northern Negros Occidental Region VII Northern Cebu Bantayan Island Region VIII Leyte Ormoc 31 MISSIONS 31,884 kits 8934 patients distributed served PM & R CONDITIONS EVALUATED IN PHILIPPINE ORTHOPEDIC CENTER (POC) (NOV 10, 2013 – DEC 18, 2014) TABLE 1: PM & R Conditions Evaluated at Philippine Orthopedic Center (POC) (November 10, 2013 - December 18, 2013) Diagnosis Number Total Percentage of 79 Persons Percentage of 125 Conditions MSK 73 92% 58% Fractures 68 86% 54.4% Upper Limbs 16 Ribs 8 Spine 18 Pelvis 4 Lower Limbs 22 Amputations (Traumatic) 2 2% 1.6% Other MSK Conditions 3 4% 2.4% Soft Tissue Injuries 19 24% 15.2% Wound/Skin Infections 15 19% 12% Neurological 18 23% 14.4% TBI 2 2.5% 1.6% SCI 15 19% 12% Ulnar Neuropathy 1 1.3% 0.8% Total 125 125 PARM CARES MEDICAL MISSION TO BURAUEN, LEYTE (FEB 18, 2014) Graph 1. Medical Conditions seen in Burauen, Leyte (100 Days Post-Haiyan) 143 62 40 7 4 22 17 15 6 6 4 18 Graph 2. Musculoskeletal Diagnoses 2% 5% UE DJD 3% 11% LE DJD 3% Neck OA 37% Lumbar OA Low Back Strain 34% Fibromyalgia Myofascial pain Fracture (Osteoporotic) 5% 31 RELIEF & MEDICAL MISSIONS OF PARM CARES (NOV 10, 2013 – FEB 1 , 2015) TABLE 2: PARM CARES Missions (Nov.10, 2013 – Feb. 1, 2015) Date Location Mission Team Relief Kits Patients Served November 10, 2013 Brgy Tapilon, Daan, PARM(V)/Cebu 500 300 Bantayan; Northern Cebu (40 MDs, AMRO) November 12, 2013 Brgy (4), Cadiz City; PARM(V)/Bacolod 3000 Brgy (4), Sagay City; (1MD, 30 Volunteers) Northern Negros November 15-17, 2013 Brgy Libertad, PARM(V)/Ormoc 3500 2000 Cagbuhangin,Mabato, (3 MDs, 5 nurses, 12 (Brgy Libertad) Linao, Valencia; Ormoc HWs, City; Leyte HELP for Ormoc) November 17-30, 2013 Villamor Air Base, Manila; PARM National 420 Luzon December 28-29, 2013 Brgy Marasbaras, RTR; PARM CARES (National) 2000 400 Tacloban, Leyte ISPRM (Brgy Marasbaras, RTR ) (12MDs, 30 HWs) 50 (children (ASP , Tacloban) February 17, 2014 Tent City, San Jose; PARM( CARES (National) 1300 1085 Tacloban, Leyte (6 MD, 40HW, (basic needs/medical Abuog General Hospital, ISPRM, PAPA) screening survey) Abuog; Franciscan Clinic, ISPRM, PFP, PSPO 16 (P&O evaluations) Baybay; Leyte February 18, 2014 Burauen, Leyte PARM CARES (National) 288 RTR, Tacloban, Leyte PAPA (basic needs/medical ISRPM, PFP, PSPO screening survey) 283 (344 diagnoses) 1 (P&O) June 27, 2014 RTR, Tacloban, Leyte PARM Cares/ PARM (V) 25 Lower Limb 24 PFP Prostheses (20 BK & 5AK) TABLE 2: PARM CARES Missions (Nov.10, 2013 – Feb. 1, 2015) Date Location Mission Team Relief Kits /Mobility Patients Served Aids June 28, 2014 Brgy Abukay Relocation Site, PARM Cares/ PARM (V) 250 Clothes and Sleeping 250 families Tacloban Mats Tacloban City Gym PARM Cares/ PARM (V) 25 Sleeping mats and 25 Families for Relief clothes, 28 Patients for Mobility Aids 8 wheelchairs, 10 crutches and 10 canes July 20, 2015 RTR, Tacloban, Leyte PARM Cares/PARM (V), PARM CARES Physiatrist in World Rehabilitation Fund Tacloban received the WRF donated Physical Rehabilitation Equipment and donated it to the 3 hospitals: Remedios Trinidad Romualdez Hospital, Divine Word Hospital and Eastern Visayas Regional Medical Center October 18, 2014 RTR, Tacloban, Philippines PARM Cares/ PARM (V) 47 Haiyan Amputee 50 Buddhist Tzu Chi Foundation, Survivors were casted for 50 PARM CARES Physical Lower Limb prostheses Therapy volunteers 20 PT Volunteeers were trained for casting of amputee stumps and gait training October 19, 2014 RTR, Tacloban, Philippines PARM Cares/ PARM (V),PFP, 25 Lower limb prostheses 25 PARM CARES Physical were fitted and distributed Therapist Volunteers (20) October 25, 2014 Estancia, Panay island, PARM Visayas Roxas/PARM 16 wheelchairs 16 Philippines CARES,Balay Mindanao and JDC American Jewish Joint Distribution Committee January 30, 2015 Divine Word Hospital PARM CARES / PARM (V) , 60 Mobility Aids (50 walkers 60 Tacloban, Philippines Loving Rose Mission. and 7 crutches and 3 canes) January 31, 2015 Remedios Trinidad PARM CARES / PARM (V) 50 47 Romualdez Hospital Buddhist Tzu Chi Foundation Tacloban, Philippines PARM CARES WRF REHAB CENTER PROJECT PARM CARES LEGS FOR LIFE PROGRAM: TABLE 3: PARM CARES Haiyan Disaster Response Outcome (Nov.10, 2013 – Feb. 1, 2015) Date Nov 2013-Feb 2014 Mar 2014-Feb2015 Outcome Missions 23 8 31 Relief Goods 31,609 275 31,884 Distributed No. of Mobility Aids 0 104 104 distributed (74 wc, 17 Cruthes, 13 Canes) No. of artificial legs 0 75 75 distrubuted Patients Served 7,035 1899 8934 179 (missions) 1720 ( 450 at RTR, 858 at DW, 431 at EVRMC) No. of Rehabilictation 0 3 Rehab Centers 3 Rehab centers Centers provided with repaired and given new equipments rehab equipments No of Volunteers 0 24 24 trained PARM CARES PROJECTS FOR 2015-2016 1. Establishment of a community based rehabilitation center and evacuation center for PWDs in Tacloban by December 2015 (Disaster Rehabilitation & Community Integration) 2. Establishment of Orthotics and Prosthetics shop at RTR Hospital by Feb 2016.( Disaster Rehabilitation & Community Integration) 3. Training of PMRs who are interested in Disaster Rehabilitation at AOSPRM in Cebu on Feb 2016. (Disaster Prevention & Preparedness) 4. Establishment of a Local disaster response coordination and training center by Feb 2016. (Disaster Prevention & Preparedness) Physiatrist Roles in Disaster Response Clinical Non-Clinical . First Responder . Rehabilitation Needs Assessor . Triage/ER . Medical Mission Volunteer: leader, coordinator, relief . Inpatient and Outpatient distributor Rehabilitation . Trainer . Medical Mission Volunteer Provider . Disaster Rehab Program Developer . Trainer . Researcher ACKNOWLEDGMENTS: Dr. James Earl Gosney Jr. Dr. Romil R. Martinez Dr. Renald T. Ramiro ISPRM & ISPRM CRDR PARM Executive Board and members PARM CARES Donors & Volunteers MARAMING SALAMAT (Thank You) MERON BA KAYONG TANONG? (Questions?) .