IN-FIELD
TRAINING AND EDUCATION FOR PARAMEDICS
IN
HUMANITARIAN SITUATION (CASE of VELIKA KLADUŠA, B&H), Part Two
Dimitar Anakiev, dr. med
GP and Global Health spec.
1.BASE
OF MEDICINE:
-INFLAMMATION
OF DAMAGED TISSUE: Paramedics in the field very often meet
inflammation of damaged tissue (skin, for example). Orientation about
degree of inflammation is very important for both: triage and
treatment.
The
four cardinal signs of inflammation are:
redness
(Latin rubor),
heat
(calor),
swelling
(tumor),
and pain
(dolor).
-DEVELOPMENT
OF SITUATION: Another important issue to discuss is development of
medical situation. Following the development is important to learn
more about our treatment
(sufficient
or not) and about nature of the illness. That is why we order patient
to come again (in three days, for example).
2.HUMANITARIAN
MEDICINE:
International
humanitarian system, that is today broken, is formed in the end of
1960' during the Biafran secession war (1967-1970). Among many
international medical humanitarian organizations in the region of the
Balkans we mostly meet Médecins Sans Frontières (MSF) and Médecins
du Monde (MdM).Two sister organizations have a different ways
of working: while the MSF prefers isolated work of experts („jump
and go“ system), the MdM builds its work on the basis of connecting
to the society in the way primary health care is usually defined.
This
is a triad of medical humanitarian activities described by the
MdM:
1.Health
Care
2.Documentation
3.Advocacy
We
will see in continuation how important is documentation.
In humanitarian situation many participants simply forgot to document
own work. That is the most typical mistake especially among medical
crew coming from public sector. Documentation is a tool to control
chaos, it is the foundation of medical work and finally a base for
advocacy-an obligatory posture of humanitarian medical worker.
3.MEDICAL
PROCEDURES (CONTINUATION ON SKIN SITUATIONS):
More
than 70% percents of refugees and migrants in Velika Kladuša suffer
from different skin diseases (15% scabies). This the result of
substandard hygiene condition. Treatment of these diseases is part of
obvious front line duty of paramedics together with injuries (75% of
injuries are result of EU police violence). Let us take a look at
some of typical skin situations:
-MYSTERIOUS
PLANT: Following skin conditions are result of contact with
mysterious plant that lives in woods around Velika Kladuša.
Typical white foam that goes from the infected parts of the skin
speaks that probably plant contains
some toxic substance that irritates the skin. Often we also see
secondary infection (yellow brown scabs). Infected skin creates berry
likes papules that are commonly seen in viral skin infections. We
really do not know what is this plant and its toxin.
Suggested
treatment:
1.washing
with water (plus soap)
2.curettage
with gauze and iodine
3.covering
or not
4.control
of development
-BACTERIAL INFECTIONS
They
are very widespread with varying degrees of tissue inflammation
(redness, heat, swelling, pain!). Cleaning is very important,
especially in the case of abscess (purulent collection) - extruding
purulent content is necessary if possible.
case of abscess
inflamation (redness, swellin) worthy of Betadine net
Suggested terapy:
1.cleaning
2.curettage
with gauze and iodine
3.Betadine
cover.
-TREATMENT
OF WOUNDS
One of greetings of European democracy:
Clean,
not close! Only gentle protection of wound is suggested.
Photo documentation: Adis Imamović Pixi
To be continued
