Addressing the increasing burden of trauma in humanitarian settings in EMR

Addressing the increasing burden of trauma in humanitarian settings in EMR

1. Addressing the increasing burden of trauma in humanitarian settings in EMR Dr. Rick Brennan Regional Emergency Director, WHO EMRO October 2024

2. 9 Fragile and Conflict-Affected Situations 8 MS with >1,000 deaths in 2023 Gaza – 11 months of war Rising trauma burden - Conflicts in EMR 42,000+ Deaths 94,000+ Injuries ⁠~6% of the population ⁠72% women & children Sudan – 17 months of war 19,600+ Deaths 32,600+ Injuries Natural disaster-related deaths Libya, Storm Daniel, 2023 12,352 Syria, Earthquake, 2023 5,900 Morrocco, Earthquake, 2023 2,948 Afghanistan, Earthquake, 2023 2,445 Pakistan, Floods, 2022 1,739

3. Types of injuries Frequent mass casualty incidents Interventions need adaptation Specific types of equipment & supplies Few operational partners Why trauma care in humanitarian settings?

4. The impact of Trauma 5

5. Fatality rates in LICs triple those in HICs > 60% of trauma deaths occur before reaching hospital 25% deaths avoided with simple, immediate life-saving techniques Children <15 account for 40% of the trauma case load in FCS in EMR Some facts… 1. 2. 3. 4.

6. Some facts… Fatality rates in LICs triple those in HICs > 60% of trauma deaths occur before reaching hospital 25% deaths avoided with simple, immediate life-saving techniques 3. 1. 2. Children <15 account for 40% of the trauma case load in FCS in EMR 4. Alternative to page 6

7. 8 Challenges to delivering trauma care in humanitarian settings

8. Poor trauma care infrastructure, staffing, systems Damaged health facilities and disrupted HS Conflict 36% hospitals Gaza; 25% Khartoum 3,670 attacks on health care since 2018 N atural disasters Pakistan floods, Libya Operating environment Insecurity and access De facto authorities – 6 of 9 FCS Bureaucratic constraints * HeRAMS ; ** WHO SSA Systems & operational issues

9. An operational framework for addressing trauma care in humanitarian settings in EMR

10. Applying lessons & best practices – trauma systems, ECO & military medicine Community POI First aid EMS 1 st Hospital Ref hospital Rehab TSP EMT Type 1 EMT Type 2 EMT Type 3 Emergency, Critical & Operative Care

11. Mosul – Iraq 1500–1800 lives saved 2017 Gaza Strip 435–1227 lives saved 2018 Regional Trauma Initiative (RTI) founded 2020 200 mass casualty incidents supported across 5 FCS reaching 800 000 injured patients 2023 Support continues (Gaza, Sudan, Lebanon) Expanded to other regions Innovations – use of AI for trauma pathways 2024 Building on own experiences

12. Strengthen community response to trauma Build capacities at primary health care level Improve the timeliness & quality of care Strengthen ECO care Early integration of rehabilitation Develop protocols & systems for pain management & palliative care Develop and reinforce rapid response and surge capacity Strengthen information systems Strategic objectives

13. Technical and operational support across the trauma-care pathway​ Strengthen operational and academic partnerships , including EMTs​ Support MS to undertake descriptive, operational and interventional research ​ Use trauma care data to advocate for protection of civilians, health care and resources​ WHO support to Member States

14. A systems approach to trauma​ Community-based approaches and primary care capacities for initial management of trauma​ Trauma care integration into emergency, critical and operative care ​ Strengthen information management ​ Develop rapid response capacities, including Emergency Medical Teams ​ Resolution asks Member States to

15. The ultimate solution: peace…