IN-FIELD TRAINING AND EDUCATION FOR PARAMEDICS IN HUMANITARIAN SITUATION (CASE of VELIKA KLADUŠA, B&H)

 

IN-FIELD TRAINING AND EDUCATION FOR PARAMEDICS
IN HUMANITARIAN SITUATION (CASE of VELIKA KLADUŠA, B&H)

Dimitar Anakiev dr. med

GP and Global Health spec.

Humanitarian situation has been present in B&H frontier from June 2018. Since November same year we started organizing In-Field Training and Education with Paramedics of S.O.S. Bosnian Frontier volunteers practicing in field and street medicine. Training and education topics are grouped in three section: base of medicine, humanitarian medicine principles and medical procedures.

1.BASE OF MEDICINE:

Medicine is by nature autonomous work regulated by own rules. That means in no case medicine work cannot by ruled by police. We discussed general medicine principles expressed by proverbs:
Primum non nocere (First, do not harm). That usually means that practitioner uses only procedures that he/she is trained.
Medicus curat, natura sanat (A doctor administers the cure; nature does the healing.) is also discussed.
We discussed also differences in approaches of „clinical medicine“ and „in-field medicine“. Clinical medicine means work in „controlled conditions“ while „in-field medicine“ means opposite: work in uncontrolled condition. That is why sometimes they use different measures. In clinical condition we usually do not put iodine on open wound while in-field we often do so in case of small wounds and skin ulcers. The similar case is use of antibiotic: in bad hygiene conditions prevention of secondary infections is more important than side effects of use of antibiotics etc.

2.HUMANITARIAN MEDICINE

Different from „social medicine“ (medical assistance to poor) which is regular part of the political system and mostly included in different institutions (like churches etc.) humanitarian medicine provides medical care out of the system (mostly „in-field“) and is politically independent – that means: not controlled by government. That is why governments usually hesitate in allowing humanitarian medical work. Four basic principles of humanitarian medicine are:

-Humanity (health & dignity)

-Impartiality

-Political independence

-Neutrality (avoiding risk of complicity)

3.MEDICAL PROCEDURES (CURETTAGE AND LOCATION OF PAIN)

Supervision of work of the team of paramedics of S.O.S. Bosnian Frontier showed that treatment of wounds is not always proper i.e. cleaning of wounds must be better. It is especially important in substandard hygiene condition. That is why I introduced the technique of curettage (Curettage is medical procedure meaning use of a curette /French, meaning scoop/ to remove tissue by scraping or scooping.) and improvisation of curette (A curette is a surgical instrument designed for scraping or debriding biological tissue or debris in a biopsy, excision, or cleaning procedure) by using gauze or bandage as the tool in combination with Povidone-iodine. This simple but efficient improvised medical procedure was very well accepted by our paramedics and soon they changed way of treatment of wounds with superb results.

Also we trained location of pain by palpitation of numerous contusions (result of EU police violence) judging degree of pain, outspread of pain and functionality of injured part of the body.

To be continued...